Coronavirus Update #54 – This audiocast is a deeper dive into policy and opinion based on the same for Omicron.
Cold and cough medications (CCMs) have been linked to a high number of emergency department visits and rare cases of deaths in infants and children. It is for this reason that manufacturers and government agencies stopped recommending these medications be used for children less than four years of age. In 2007, manufacturers voluntarily withdrew infant cough and cold medications sold over the counter from the US market. In 2008, the US government acted to revise labels of over the counter CCMs to warn against use by children < 4 years. These new recommendations and labeling revisions have been followed by efforts to educate parents about the dangers of giving over the counter CCMs to infants.
If you are one of the 37 million Americans who suffer from migraines, you know the symptoms all too well: pounding pain in a specific area in your head, nausea, and sensitivity to light and sound. You continually reach for the Advil to relieve your pain, but it doesn’t always work, or sometimes even causes additional discomfort from side effects. Some other prescription anti-migraine drugs have side effects that numerous patients can’t handle. For example, pregnant women, women who certainly require relief from migraines, often cannot take some of these drugs because some cause birth defects and other potential side effects of the medicines. Shouldn’t there be a more effective, less risky solution? Now there is for adult migraine sufferers and hopefully children as well soon.
Ask any mother or grandmother who was alive 1900, and they would tell you about a disorder that is rarely seen today, that of Vitamin K Deficiency Bleeding (VKDB) in a newborn baby. A simple single dose of vitamin K, given to almost all babies born in the U.S., made this disease just a bad memory… until recently. Parents today just don’t worry about this disease anymore but imagine you were a mother who had a perfectly normal pregnancy and delivery, had a healthy infant who was thriving at home, and suddenly at about 2 months of age, they had a devastating bleeding event in their brain with seizure and other devastating effects or began bleeding to death from a gastrointestinal hemorrhage. Unfortunately, in today’s hyper informed world, many parents have become more worried about theoretical risks of harm to their newborn from a simple dose of vitamin K that is recommended for newborns at birth, than the known risk of hemorrhagic disease in a newborn who don’t receive this therapy.
Aside from the common cold and stomach bug, parents should add the term urinary tract infections (UTIs) to their shortlist of worrisome common illness, especially if they have daughters. To effectively treat urinary tract infections, pediatricians need accurate diagnosis and tailored therapy. Unfortunately, this information is often lacking. A recent survey of how healthcare providers diagnose and treat urinary infections in children, published in the journal Pediatrics, found that pediatricians, family doctors, and nurse practitioners treating children frequently do not order the necessary tests needed for accurate diagnosis and treatment. Experts recommend a course of antibiotics to treat a UTI, only after the child’s urine has been analysed and cultured. As it turns out, appropriate laboratory confirmation is only being done in about 50% of the time when various outpatient settings were analyzed. Antibiotics were being prescribed without knowing for sure that a child had a urinary tract infection. Amazing.