Thursday, June 19, 2014

Exclusive breast feeding and food allergies in babies

There is a well-supported notion that exclusive breastfeeding prevents the development of food allergies in infants. 

However, this rule, just like any other has exceptions. Even exclusively breastfed infants can develop food allergies. The most common culprits are peanuts and cow's milk protein. Egg and wheat proteins can also cause a problem.  This happens when nursing mothers use products containing milk, peanuts, egg, and wheat in their diet when large particles of allergy-causing proteins find their way to breast milk. Just like with any food allergy, the most common manifestation is atopic dermatitis. Some infants may develop chronic diarrhea and colic-like abdominal pain. More severe manifestations, including life-threatening, are rare. The issue of indirect infant's exposure to a variety of food allergens via breast milk is quite complex. 

There is evidence, that maternal consumption of peanuts during breastfeeding may actually prevent the sensitization of children to peanuts. Why in some mothers peanut consumption can cause allergies in babies while preventing the same in others? There is no good answer. 

Obviously, something is missing in our knowledge about food allergen transmission and sensitization at a very early age.

Sergei Shushunov, MD

Tuesday, April 22, 2014

Swaddling danger

What can make us feel more comfortable than hugging and snuggling? We all need this simple expression of love and affection. It calms us down. It makes us feel worry-free. All mammals hug and snuggle. Even snakes and birds snuggle. The reason behind it is the way the mammals, birds, and snakes develop after conception – in a confined, space of a uterus or an eggshell. We carry this need through our lives, but it is the strongest in early infancy. I doubt that a crying baby can become “spoiled” by being picked up and held tightly every time. The problem is that we can’t do it every time a baby cries. We decided to cheat on nature and invented swaddling. Swaddling is hugging and snuggling surrogate. It is known forever to work wonders for upset babies. Swaddling a baby is not hard, but it has a few tricks. In older times swaddling was a skill passed down from generation to generation. Now young parents don’t have anyone around to learn it from. The gap was filled by a multitude of companies offering swaddling garments, which require less effort and fewer skills than a blanked.

There is a small but significant difference between a baby blanket used for swaddling and swaddling garments: the fasteners. All baby garments designed to make swaddling easy use some form of fasteners, such as snaps or velcro. This could make them more dangerous with improper use. An article published by the Journal of Pediatrics in January 2014 described 36 serious incidents, including deaths, reported to the Consumer Product Safety Commission, which was attributed to improper swaddling. In two-thirds of incidents a swaddling garment was used. The number of unreported incidents is probably many times higher.

Swaddling is good if done right – parents need to be educated on how to do it. There are risks regardless of what is used, higher with a garment and lower with a blanket. Informed and educated decision on what to use and how to use seems to be the key to safely and happily sleeping babies and parents as well.

Wednesday, April 16, 2014

Genetically modified food. Is it really that bad?

Almost all living creatures we use for our own benefits have been genetically modified. Think of 500 breeds of dogs, some ugly as hell, 7000 varieties of apples, many of which are inedible and 80,000 of corn. It took 10,000 years, or putting it in perspective 400 generations of humans to produce this incredible number of genetically butchered plant and animal species until someone only recently realized it did not have to be that way.

Genetic engineering is a form of breeding. Clean, thoughtful and precise – just like robotic surgery. Genetically modified organisms have their genes replaced forcefully rather than by a chance, without waiting for one generation after another, with full knowledge of what genes must be changed to give us the result we want. Genetic engineering relies on taking a desirable gene from another animal or plant and placing it exactly in the right part of the chromosome. No waiting for several generations to see the results, no unpredictable characteristics in the offsprings.

Here is the best thing: DNA or the set of genes that define certain species or breeds is totally digestible. This means that once genetically modified food passes our stomachs it's DNA turns into the same mixture of amino acids and carbs that is produced from any other food source.

Sergei Shushunov, MD

Friday, February 14, 2014

Plagiocephaly: everything new is well forgotten old.

There was a time when absolutely all babies used to sleep on their backs. The practice of placing babies on their backs started most likely at the time when people did not know how to write. It was a tradition. Why do traditions exist? Apparently only for one reason: to change them. Placing babies to sleep on the back did not escape the challenge of time and several decades ago someone decided that the best position for babies to sleep was on their bellies. That was a change, revolutionary in its courage and boldness, not as revolutionary as the polio vaccine, but still, it was something.

It turned out that our grandparents, and great grandparents, and before them Moses, and before him, Sarah and Abraham were correct placing their babies on the backs. Maybe they have known something we discovered not so long ago - that belly sleeping was often responsible for sudden infant death. Following this re-discovery “back to sleep” campaign was started and in a mere decade, it almost succeeded. Nowadays most nurses and doctors do their best trying to change the bad habits of their patient’s parents. Not all nurses and doctors succumbed to changing their views because bad habits tend to be very resilient. This resistance to change is reinforced by the discovery of a “new” disease called “plagiocephaly”.

Plagiocephaly is the molding of the baby’s naturally soft skull caused by the pressure of sleeping in one position. Since the “back to sleep” campaign required placing babies on their backs, many babies developed flattened backs of their heads. This new disease epidemic caused enormous alarm among pediatricians. A new industry sprang up to deal with it and a score of companies began manufacturing helmets to treat plagiocephaly.

If the same pediatricians asked their grandmothers, or opened old, really old, text book written while then their grandparents were young they could have made an astonishing discovery that plagiocephaly is as old as the world, that head deformities go away once babies begin to roll and to sit and that using helmets is a waste of money and it works as well as time itself.

Sergei Shushunov, MD