Breast Cancer linked to Timing of Pregnancy

Reuters is reporting waiting longer to have your first child may be linked to a higher rate of breast cancer. That's a scary thought. Here's the article:

A longer interval between the age a woman first begins to menstruate and her age when she first gives birth is associated with an increased risk of breast cancer, the results of a study published in the American Journal of Epidemiology suggests.

Age at menstruation and first birth are "established risk factors for breast cancer," Dr. Christopher I. Li, of the Fred Hutchinson Cancer Research Center, Seattle, and colleagues write. The interval between these ages may also influence breast cancer risk because the breast becomes more susceptible to carcinogenic exposure during this period , they note. "However, few investigators have studied this relation."

To investigate further, Li's group used data from the Women's Contraceptive and Reproductive Experiences Study (1994 to 1998), including 4,013 women with breast cancer and 4,069 women without breast cancer (the controls).

Among the white women, those who were premenopausal, had given birth and who also had an interval of at least 16 years from when they began to menstruate and their first birth had a 1.5-fold increased risk of breast cancer compared to those who had fewer than 5 years between these ages. This association was not observed among premenopausal African-American women.

The increased risks were mainly confined to women with hormone-receptor-positive tumors and tumors located in the breast lobules. The results associating age at first full-term birth and breast cancer risk are generally consistent with previous results, but the findings regarding age at first menstruation are not, Li's team adds.

"Epidemiologic studies of both premenopausal and postmenopausal women have consistently found that breast cancer risk is reduced 5 to 20 percent for each year (menstruation) is delayed," they explain. However, in this study an older age at first (menstruation) was not associated with a reduced risk of breast cancer."

SOURCE: American Journal of Epidemiology, January 2008.

According to the Centers for Disease Control and Prevention:

Breast cancer is the most common form of cancer in women.

In 2004 (the most recent year numbers are available):

• 186,772 women and 1,815 men were diagnosed with breast cancer
• 40,954 women and 362 men died from breast cancer

-NewsAnchorMom Jen

Valentine's Day Family Traditions

I heard a lot of people this week say they aren't celebrating Valentine's Day because it's a "Hallmark" holiday, meaning retailers created the holiday to make money. While that has some truth to it, I wanted to know what kind of an impact that negative attitude has on kids.

I know my four-year-old really looks forward to every holiday. I don't remember a lot of family traditions growing up, by my husband has a great memory and knows every detail of his traditions. I am so glad because my son really loves traditions. He woke up this morning and told me Happy Valentine's Day! He was so beyond excited for his Valentine's Day party at school. He showed me every card he got. He jumped up and down when my husband and I gave him some Car's pajamas and Sponge Bob shaped candy.

Clinical Psychologist Dr. John Day said,"Any type of holiday traditions, like birthdays does impact children. I think all of us remember back to our own childhoods, certain traditions Christmas Eve and Easter. I think Valentines' Day is the same thing. I think there's a sense of family identity that goes along with that. I think it's very important to have those traditions, to build them in the more the better."

Dr. Day said kids like having something to look forward to. He said they like traditions because it makes the family unit that much stronger. He said it's critically important in terms of family life and family development to build traditions and carry them on to the next generation. He said, "It really is kind of an identifier for families, a sense of belonging, reassurance that everything's okay. It's Valentine's Day and we're going to have a box of chocolates or we're gonna have roses on the table or whatever. It's more than just blood relationships of kids to parents. I think that traditions are the part of the behavior that cement that and allow the family to identify itself as "the Smith family.""

I used to roll my eyes at family traditions, but now that I have kids, things have changed. How do you feel about family traditions?

-NewsAnchorMom Jen

Doctor Responds to Botox Fears

Are any of you moms considering botox or know someone who is? Do you know anyone who has a child with cerebral palsy that is looking into alternative treatments like botox? You might want to read this CNN story about botulism.

At the end of the article, hear what the owner of Soderstrom Dermatology Center in Peoria, Il has to say about the federal warning.

The popular anti-wrinkle drug Botox and a competitor have been linked to dangerous botulism symptoms in some users, cases so bad that a few children given the drugs for muscle spasms have died, the government warns.

Botox contains botulinum toxin, which blocks nerve impulses to muscles, causing them to relax. The Food and Drug Administration's warning includes both Botox, a wrinkle-specific version called Botox Cosmetic, and its competitor, Myobloc, drugs that all use botulinum toxin to block nerve impulses, causing them to relax.

In rare cases, the toxin can spread beyond the injection site to other parts of the body, paralyzing or weakening the muscles used for breathing and swallowing, a potentially fatal side effect, the FDA said.

Botox is best known for minimizing wrinkles by paralyzing facial muscles -- but botulinum toxin also is widely used for a variety of muscle-spasm conditions, such as cervical dystonia or severe neck spasms.

The FDA said the deaths it is investigating so far all involve children, mostly cerebral palsy patients being treated for spasticity in their legs. The FDA has never formally approved that use for the drugs, but some other countries have.

However, the FDA warned that it also is probing reports of illnesses in people of all ages who used the drugs for a variety of conditions, including at least one hospitalization of a woman given Botox for forehead wrinkles.

The FDA wouldn't say exactly how many reports it is probing.

"We're not talking hundreds. It's a relative handful," said Dr. Russell Katz, FDA's neurology chief.

But the agency warned that patients receiving a botulinum toxin injection for any reason -- cosmetic or medical -- should be told to seek immediate care if they suffer symptoms of botulism, including:

• difficulty swallowing or breathing


• slurred speech, muscle weakness,


• difficulty holding up their head.
  

"I think people should be aware there's a potential for this to happen," Katz said. "People should be on the lookout for it."

The warning came two weeks after the consumer advocacy group Public Citizen petitioned the FDA to strengthen warnings to users of Botox and Myobloc -- citing 180 reports of U.S. patients suffering fluid in the lungs, difficulty swallowing or pneumonia, including 16 deaths.

In a statement, Solstice said it supports FDA's inquiry but stressed that the agency hasn't concluded the drug poses any new risk.
While the FDA said the problems may be related to overdoses, it also has reports of side effects with a variety of doses.

Public Citizen's Dr. Sidney Wolfe criticized FDA's warning as falling short. He asked that the agency order a black-box warning, the FDA's strongest type, be put on the drugs' labels and require that every patient receive a pamphlet outlining the risk before each injection.

"Every doctor needs to notified about this, every patient needs to be notified," Wolfe said. "Children are showing the way, unfortunately some dead children."

He said drug regulators in Britain and Germany last year required that sterner warnings be sent to every doctor in those countries.

Dr. Carl Soderstrom at Soderstrom Dermotology Center in Peoria, Illinois said the current warning for botox for cosmetic use are sufficient, but “in the judgement of the FDA further labeling for Botox use in children with spastic diseases is warranted, it should be done. For cosmetic use I believe the warnings are more than adequate and the current warnings have served us and our patients well. “ He said the treatment of Botox for children with spastic diseases uses much higher doses than those used for cosmetic treatments.

Dr. Soderstrom said he isn't aware of any patients having a negative result from cosemtic botox procedures at his office and he has been offering the wrinkle reducing procedure since it was first available several years ago.

Soderstrom Dermatology Center uses botox for one other reason besides wrinkles: post herpetic pain in some hyperhidrosis patients, or people who has excessive sweating. He said those patients say it's very helpful.

Dr. Soderstrom said both the American Society of Dermatological Surgeons and the American Society of Plastic Surgeons support the current labeling of all Botox® products, and believe that the current data supports the continued safe use of this product with no change in labeling necessary.

Here is a list of the possible side effects of Botox when used for cosmetic reasons:

• A rare syndrome of migraine headaches
• Malaise
• Weight loss and disability, that is unproven, but may be related in unusual circumstances to Botox®;
• Temporary paralysis of other nearby muscles resulting in temporary loss of function (eg drooping eyelid, difficulty closing the eye);
• Headache, local numbness, rash and bruising.

-NewsAnchorMom Jen

Which Thermometer is Best?

CNN ran a story on thermometers this week and I was concerned the reporter didn't answer the question we as parents want to know. The reporter didn't ask about the new over-the-counter head thermometers that are supposed to be more accurate than ever before. I think they're so much easier to use, but if they are completely inaccurate, I need to throw it away.

Here's the CNN story:

During cold and flu season, taking a child's temperature can be a real challenge for some parents, but experts say it doesn't have to be. They say to get an accurate reading, you need to use the type of thermometer most appropriate for your child's age.

• Rectal Thermometer:best for infants under three months
• Underarm or rectal thermometer: best for children between three months and three- years-old
• Thermometer under the tongue: older than three-years-old

A normal temperature is around 98-point-6 degrees. Experts say any temperature over 100 is reason to see a doctor.

So, here's are the responses from Dr. Elizabeth Kramer, the Pediatric Residency Program Director and Clinical Assistant Professor for the Department of Pediatrics at the University of Illinois College of Medicine at Peoria.

Jen: Do you agree with the recommendations?

Dr. Kramer:"I agree with all of the recommendations except seeing a Dr. if thetemperature is over 100. The number is not as important as the child's level of activity. If the child is listless, lethargic, inconsolable, not drinking or urinating they need to be seen immediately regardless ofthe temperature. The exception to this recommendation is if a child under 2months of age has a temperature over 100.4 rectally they need tobe seen immediately (do not give medicines to reduce fevers) regardlessof the child's appearance."

Jen: What thermometers do local pediatricians recommend using?

Dr. Kramer: "Pediatricians recommend the use of digital thermometers either orally or rectally. These are the most accurate on the market.

Jen: How accurate are the over the counter head thermometers that are on the market now? They package says they are much more accurate than older versions.

Dr. Kramer:"I am unaware of studies with regards to the accuracyof the forehead thermometers."

Jen: What about the ear thermometers you can buy over the counter? How accurate are they?

Dr. Kramer:"If an ear thermometer is used correctly it can be as accurate as a digital thermometer unless the child is under 3 years of age. Bottom line: Use a Digital thermometer."

-NewsAnchorMom Jen

Pregnancy Weight

Are we gaining too much weight when we get pregnant? I know I felt like I did the second time around, but my doctor said I was doing fine. Comparing the pictures from my first pregnancy to my second, WOW! I gained a lot more the second time!

Here's a baby calculator so you can see how much weight you are supposed to gain based on your height and weight before pregnancy.

Here's a story we ran on WHOI that sparked my interest in this topic:

Government research reveals pregnant women are packing on more pounds these days - added weight that increases their health risks. Doctors generally recommended that women gain between 25 and 35 pounds during pregnancy when they're expecting a single baby. Too little weight gain can put the baby at risk for malnutrition and small size, while too much weight increases health problems for the mother.

But new government research finds American women are increasingly gaining more than 40 pounds - something that doctors rarely advise. That's because women who gain such excess weight are at greater risk for pregnancy-related diabetes and high blood pressure. They also are more likely to suffer complications during birth. The new statistics show in 2005, 20 per cent of women gained more than 40 pounds during pregnancy, compared to 15 per cent of pregnant women in 1990.

White women were more likely to gain excess weight than black or hispanic women. Doctors advise pregnant women to eat a healthy diet without too much saturated fat, soda, or desserts. But they also say women should not diet during pregnancy because consuming too few calories can harm the baby's development.

Experts say the average pregnant woman carrying one child should eat about 24-hundred calories per day. And some good foods to eat during pregnancy include foods high in folic acid like peas, asparagus, papayas, and strawberries. Experts also recommend pregnant women to take a prenatal vitamin with folic acid to prevent certain types of birth defects.
So how much weight did you gain? Do you think it was too much?

-NewsAnchorMom Jen

Childhood Obesity

Reuters is reporting the way you raise your kids may not have as much to do with childhood obesity than once thought.

Diet and lifestyle play a far smaller role than genetic factors in determining whether a child becomes overweight, according to a recent British study of twins.

Researchers looking at more than 5,000 pairs of twins wrote in the American Journal of Clinical Nutrition that genes account for about three-quarters of the differences in a child's waistline and weight.

"Contrary to the widespread assumption that family environment is the key factor in determining weight gain, we found this was not the case," said Jane Wardle, director of Cancer Research UK's Health Behavior Centre, who led the study.

Previous studies have pointed to environmental factors as the main cause of obesity, a major problem worldwide that increases the risk later in life of type-2 diabetes, cancer and heart problems.

The World Health Organization classifies around 400 million people worldwide as obese, including 200 million children under the age of five.

The British team looked at pairs of identical twins who share all their genes and compared their measurements with those of non-identical twins who share only half their genes.

A statistical analysis found that the differences in the children's body mass index and waist circumference were 77 percent attributable to genes and 23 percent due to the environment in which the children were growing up.

BMI is calculated by dividing weight by the square of height.

"These results do not mean that a child with a high complement of 'susceptibility genes' will inevitably become overweight, but that their genetic endowment gives them a stronger predisposition," the researchers said.

The results suggest that parents whose children are at the greatest genetic risk may need support to make sure they provide a healthy environment, the researchers said.

"This study shows that it is wrong to place all the blame for a child's excessive weight gain on the parents," the researchers said.

-NewsAnchorMom Jen

Valentine's Day Fears

I heard on "The View" this morning that getting Valentines in grade school is a big deal. The hosts were talking about how the "cool" girls will get a bag full and other girls won't get any. That is a horrible thought.

My son is only 4-years-old, so the teachers make sure everyone in the class gets a Valentine. Should teachers continue to regulate this activity as kids get older? Can they regulate it? I would think at some point kids would just start giving their Valentines to anyone they want, no matter what the teacher said.

What are your thoughts on Valentine's Day fears for kids? Does this happen at your child's school?

-NewsAnchorMom Jen

Ineffective Flu Shot?

Did you give your kids the flu shot? It may have been all for nothing. I often wonder if the strain of flu in the shot is the right one. There are a lot of strains. Several doctors I have interviewed have said when referring to immunization shots you have to look at the risks versus the benefits. Most doctors believe the risks outweigh the benefits when it comes to childhood immunization shots, but some of them are not as adament about the flu shot. I found the following article on MSNBC saying this year the flu shot may not be as effective as you think.

The influenza vaccine given to Americans may not protect as well as expected, U.S. health officials said as the number of flu cases increase nationwide.

The U.S. Centers for Disease Control and Prevention said slightly more than half of the influenza virus strains reported to its surveillance system are not good matches against the strains included in this flu season’s vaccine.

The number of states reporting widespread flu activity jumped to 31 last week compared with 11 the week before, the CDC said. But Dr. Joe Bresee of the CDC’s influenza division said there are no indications this flu season is worse than usual.

“Seasonal flu activity was slow to start this year but has increased sharply in recent weeks,” Bresee told reporters.

One measure officials use to gauge the severity of the season is the number of flu-related child deaths. Bresee said the CDC has heard of six U.S. children who have died from the flu, a relatively low number compared with recent years.

Flu viruses mutate and change all the time, so every year a different vaccine is created as officials predict which particular strains will circulate.

The vaccine is designed to protect against three influenza strains — two from Type A, an H1N1 and an H3N2 version, and one for Type B.

Bresee said about 30 percent of the overall strains of influenza in the United States may be a Type A strain that emerged in Australia called H3N2 A/Brisbane. It emerged too late to be included in the flu vaccine offered in the United States beginning in September and October.

The Type B strain chosen for this year’s vaccine also was not a good match for most of the B virus strains seen in the United States this flu season, Bresee said.

“While a less-than-ideal virus match between the viruses in the vaccine and those circulating viruses can reduce vaccine effectiveness, we know from past influenza studies that the vaccine can still protect enough to make illness milder or prevent flu-related complications,” Bresee said.

Bresee noted that decisions on the composition of the annual vaccine are made about nine months before it is made available to the public in the fall, and it is sometimes hard to know that far in advance which strains will circulate.

Flu vaccines take months to make.Bresee also said some resistance is being reported to the antiviral drug Tamiflu, made by Switzerland’s Roche Holding AG and Gilead Sciences Inc of the United States. Of the viruses tested in CDC flu labs, 4.5 percent are resistant to the drug, Bresee said.

Influenza kills an estimated 36,000 Americans in an average year, and puts 200,000 into the hospital, the CDC said.

-

NewsAnchorMom Jen

Fish and Pregnancy

I was completely torn on whether or not to eat fish during my last pregnancy. I had a pretty good idea which ones contained a lot of mercury, but I just figured it was easier to avoid all of it. I did, however, eat tuna(non albacore) and salmon.

The Federal Drug Administration and its European equivalent have very different advice on the subject.

Dr. Michael Leondardi from Maternal Fetal in Peoria, IL said, "The issue is that omega 3 fatty acids in cold water fish are good for developing eyesight, brain development, etc. In fact, some prenatal vitamins now come with an additional capsule of omega 3 fatty acids. Unfortunately, some large cold water fish are more likely to concentrate mercury which is not a good thing for pregnant women and small children."

There is a great series of articles in the Chicago Tribune. The paper did a three part investigative report on the mercury levels in fish and its health effects. If you haven't heard about this study, you will be alarmed when you read it. There is basically very little testing done to see how much mercury is in the fish we eat. Even the health food stores say they get their fish from the same distributors as everyone else, so their mercury levels aren't any safer.

"Supermarkets throughout the Chicago area are routinely selling seafood highly contaminated with mercury, a toxic metal that can cause learning disabilities in children and neurological problems in adults, a Tribune investigation has found.

For high-risk groups--young children, pregnant women, nursing mothers and women who could get pregnant--some fish might do more harm than good. Mercury can damage the central nervous system of children, causing subtle delays in walking and talking as well as decreased attention span and memory.

In one of the nation's most comprehensive studies of mercury in commercial fish, testing by the newspaper showed that a variety of popular seafood was so tainted that federal regulators could confiscate the fish for violating food safety rules.

The testing also showed that mercury is more pervasive in fish than what the government has told the public, making it difficult for consumers to avoid the problem, no matter where they shop."

And what about the canned tuna I ate during pregnancy that was not albacore? Well, I thought it was safe, but according to the Chicago Tribune investigation, "The fishing industry also has failed consumers. The newspaper's investigation found that U.S. tuna companies often package and sell a high-mercury tuna species as canned light tuna--a product the government specifically recommends as a low-mercury choice."

What fish are the safest?

Small or short-lived species, such as sardines, shrimp, crab and tilapia, generally have low amounts of mercury. Wild salmon, which eat plankton and small fish, are low in mercury, as are farm-raised salmon, which are fed fish meal containing little mercury. Regulators report that fish sticks and fast-food fish sandwiches, which typically are made with pollock, are low in mercury. But scientists say more tests are needed to confirm that.

What fish have the most mercury?

Large predator fish, such as swordfish and shark, generally have the most mercury.

There is a section on the Tribune's website where you can actually type in your weight and the computer will tell you how many ounces of certain kinds of fish you can have each week. The information is based on a Chicago Tribune study. After doing the calculations, I don't think I ever eat enough seafood to go over the recommended allowance. I would have to eat more than two cans of tuna each week.

Dr. Michael Leonardi points out, "Depending on one's dietary choices, it could be a major issue for pregnant women and young children. I advise my patients to read it and use their own best judgement."

Here's what you need to know about mercury and fish from the U.S. Department of Health and Human Services.

Here's an editorial from Dr. Charles Lockwood on modern medicine.com. You do have to register for the site, which I don't like doing, but this is good information.

-NewsAnchorMom Jen