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Spending more time in physical education classes helps students develop muscle strength and doesn’t increase their risk of broken bones, a new study finds.
The study included more than 900 girls and boys at a school in Sweden who had up to 200 minutes of physical education a week for two years. A control group of students continued with the standard amount of 60 minutes of physical education each week.
The children who had more physical education time developed greater muscle mass and strength than those in the control group, according to the study, published in the May issue of the journal Medicine & Science in Sports and Exercise.
The findings “could have important implications on public health guidelines and recommendations for school-based physical activity,” study author Dr. Bjarne Lofgren, of Lund University in Sweden, said in a journal news release.
“Regular weight-bearing exercise has been shown to consistently improve bone mass, structure and strength during childhood and adolescence,” Lofgren said. “It can also help reduce the risk of musculoskeletal diseases later on in adult years.”
Previous research has shown that students who get more exercise do better in the classroom.

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The finding is concerning as more and more parents ask about delaying or spacing out vaccines to avoid perceived harm from giving “too many [vaccines], too close together,” Dr. Simon J. Hambidge said at the annual meeting of the Pediatric Academic Societies.

The observed risk in febrile seizures with vaccine delays may be explained physiologically by the child’s increased ability to mount a vigorous immune response. When children mount a better immune response, they’re more likely to have a fever. Further, febrile seizures begin to rise in toddlers between the ages of 16 and 23 months.

“It’s a complicated relationship. … I think it’s clear that there is something going on at this time of life that’s increasing the risk of febrile seizures,” said Dr. Hambidge, professor of pediatrics at the Colorado School of Public Health, Denver.

Dr. Hambidge examined the rate of vaccine-related febrile seizures in a cohort of 324,000 children who were born from 2004-2008. The study population was derived from eight large health care sites, all of which participate in the Vaccine Safety DataLink program. All children were seen in an emergency department or hospital for a febrile seizure at 93-730 days of age.

A self-controlled case series analysis accounted for associations between time (pre- and post vaccination) and exposure (vaccinated or not during the exposure windows). Based on known risks for fever after vaccination, the exposure risk window was set at 0-2 days after vaccination for inactive vaccines; the exposure risk window was 7-10 days afterward for live vaccines. The final measure was an incidence rate ratio (IRR).

The first analysis examined febrile seizures in the group that had infant vaccines administered according to the usual schedule. These included the DTaP (diphtheria, tetanus, and pertussis), conjugated pneumococcal, polio, coronavirus, Haemophilus influenzae type b, and rotavirus vaccines.

“There were no statistically significant differences in the IRR after any of these vaccines, whether they were given on time or delayed,” Dr. Hambidge said. “I think this reflects the paucity of seizures generally seen during the first year of life.”

For vaccines given during the second year of life, the IRR was examined for measles, mumps, rubella (MMR) and for measles, mumps, rubella, and varicella (MMRV) given on the usual schedule (12-15 months) and on a delayed schedule (16-23 months).

For babies who got the MMR on schedule, the IRR was 2.5, “corresponding to an attributable risk of about 1 [febrile seizure] in 4,000 doses,” Dr. Hambidge said. When the MMR was delayed until the baby was 16-23 months old, the IRR significantly increased to 7.7 – an attributable risk of about 2 seizures per 4,000 doses.

A similar doubling of risk with the delayed schedule occurred with the MMRV vaccine, he said. Given at the normal schedule of 12-15 months, the IRR was 4.6, a risk of about one febrile seizure for every 2,000 vaccine doses. But when the MMRV was given at 16-23 months, the IRR rose to just above 15 – doubling the attributable risk to about 2 febrile seizures per 2,000 doses.

Parents should understand these risks but can be somewhat reassured that a febrile seizure isn’t generally a sign of something more sinister, Dr. Hambidge said in an interview.

“Kids with postvaccination febrile seizures have acute febrile seizures. None have gone on to develop epilepsy or have lasting problems. So the seizures are scary for parents, but typically result in a trip to the emergency department and then recovery. Still, it’s better to get the vaccines on time, rather than late, to minimize this risk,” he said.

This study was funded through a subcontract with America’s Health Insurance Plans from the Centers for Disease Control and Prevention. Dr. Hambidge had no financial disclosures.

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It is a particular problem in more affluent countries, with sleep experts linking it to the use of mobile phones and computers in bedrooms late at night.

Sleep deprivation is such a serious disruption that lessons have to be pitched at a lower level to accommodate sleep-starved learners, the study found.

The international comparison, carried out by Boston College, found the United States to have the highest number of sleep-deprived students, with 73% of 9 and 10-year-olds and 80% of 13 and 14-year-olds identified by their teachers as being adversely affected.

In literacy tests there were 76% of 9 and 10-year-olds lacking sleep.

This was much higher than the international average of 47% of primary pupils needing more sleep and 57% among the secondary age group.

Achievement gap
Other countries with the most sleep-deprived youngsters were New Zealand, Saudi Arabia, Australia, England, Ireland and France. High-performing Finland is also among the most lacking in sleep.
The BBC’s Jane O’Brien reports on how lack of sleep impairs learning
Countries with the best records for getting enough sleep include Azerbaijan, Kazakhstan, Portugal, the Czech Republic, Japan and Malta.

The analysis was part of the huge data-gathering process for global education rankings – the Trends in International Mathematics and Science Study (TIMSS) and Progress in International Reading Literacy Study (PIRLS).

These are among the biggest international benchmarks for education standards, based on tests taken by more than 900,000 pupils in primary and secondary schools in more than 50 countries and regional administrations.

The rankings of results for maths, science and reading were published at the end of last year, with Asian education systems dominating the top of the tables.

But the researchers also wanted to find out more about the influence of home life. There has been much analysis of the impact of family wealth and poverty, but the Boston College researchers also wanted to measure factors such as sleep and nutrition.

So the tests were accompanied by questionnaires for teachers, pupils and parents about sleep patterns. And this information was compared with pupils’ test results, so that the performance in maths, science and literacy could be compared with levels of sleep.

Brain food
“I think we underestimate the impact of sleep. Our data show that across countries internationally, on average, children who have more sleep achieve higher in maths, science and reading. That is exactly what our data show,” says Chad Minnich, of the TIMSS and PIRLS International Study Center.

“It’s the same link for children who are lacking basic nutrition,” says Mr Minnich, based at the Lynch School of Education, Boston College.
Mobile phones and computers in the bedroom are blamed for disrupting sleep
“If you are unable to concentrate, to attend mentally, you are unable to achieve at your optimal level, because your mind and body are in need of something more basic.

“Sleep is a fundamental need for all children. If teachers report such large proportions of children suffering from lack of sleep, it’s having a significant impact.

“But worse than that, teachers are having to modify their instruction based on those children who are suffering from a lack of sleep.

“The children who are suffering from a lack of sleep are driving down instruction.”

That means that even the children who are getting enough sleep are still suffering from this sleep-related dumbing-down.

Cramming school
The researchers uncovered regional trends that bucked expectations.

Asian countries are the highest-performing in maths tests – and Mr Minnich says this has often been associated with long hours and cramming in after-school classes.

“One would assume that they would be extremely tired,” he said. “And yet when we look at the sleep factor for them, they don’t necessarily seem to be suffering from as much sleep deprivation as the other countries.”

Getting a good night’s sleep isn’t going to transform an underperforming country into an education superpower. For instance, the least sleepy pupils seem to be in Azerbaijan, but they are still considerably behind the most sleep-deprived pupils in Finland.

But researchers say that it does show how differently individual pupils might be placed on the ability spectrum, with lack of sleep representing the difference between being high-performing and average.

There are also big changes as pupils get older. Younger pupils in South Korea have among the lowest levels of sleep deprivation in the world, but in secondary school they have some of the worst problems.

There are differences within countries too. At the level of US states, among secondary pupils Colorado has a much worse problem with lack of sleep than Massachusetts.

What the study does not show is why young people are missing out on sleep – or why more technologically advanced countries seem to have the biggest difficulties.

But sleep experts point to a particular problem due to technology in children’s bedroom – specifically the use of screens on smartphones or laptops late at night.

Serious barrier to learning
It isn’t only that young people are kept awake by messaging their friends or using the internet. The light from the screen, held close to the face, is physically disruptive to the natural onset of sleep.

“Having a computer screen that is eight inches away from your face is going to expose you to a lot more light than watching a television on the opposite side of the room,” says Karrie Fitzpatrick, sleep researcher at Northwestern University in Illinois.

“It’s going to tell your brain to stay awake,” says Dr Fitzpatrick.
Sleep exhaustion has become part of the 24-hour culture
“That light can reset the whole circadian rhythm system and say, ‘Wait a minute, it’s not time to go to bed’.”

Lack of sleep is also a serious physical barrier to learning.

“Sleepiness is a problem at all stages that are relevant to learning, memory and academic performance,” says Derk-Jan Dijk, director of the Sleep Research Centre at the University of Surrey.

Research into sleep disorders and brain function has shown the importance of sleep in memory and consolidating information.

Without sleep, the brain struggles to absorb and retain ideas.

“There is a growing interest in the associations between adequate sleep and academic performance,” says Prof Dijk.

‘Loss can be reversed’
Dr Fitzpatrick says lack of sleep is going to leave pupils more emotionally volatile, more potentially disruptive and physically struggling to learn.

And she says that the loss of sleep and short-term attempts to catch up can cause further and complex disruptions to the way the brain tries to store information.

But there is good news. If you start getting enough sleep on a regular basis, the loss to learning can be reversed.

“As long you haven’t gone into extreme sleep deprivation, if you go back to seven to nine hours per night, as long as there has been no permanent damage, you can probably restore the functionality of accumulating, processing and being able to recall memories,” says Dr Fitzpatrick.

“The basis of learning will likely be restored to normal levels.”

Otherwise trying to study without sleep is going to be tough. “Your brain is running on empty.”

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Infant reflux is common, occuring in more than 60%, a study shows
Lifestyle changes, such as feeding or position changes, may help reflux
Refusal to eat, poor weight gain or vomiting may be a more serious problem
Just because a baby regularly regurgitates after a meal isn’t necessarily a sign of acid reflux disease or the need for testing, medications, or surgical therapies, a new report advises.

Uncomplicated gastrointestinal reflux (GER), marked by the constant regurgitation or spitting up of stomach contents — and sometimes accompanied by other symptoms including coughing, hiccups, vomiting, and irritability — occurs in more than 60% of otherwise healthy infants and is the topic of discussion with pediatricians at 25% of all routine six-month doctor visits, says the report in the May issue of Pediatrics, published online today.

“Having an infant who regurgitates regularly, regardless of whether they might have some worrisome symptoms such as coughing, choking or irritability to go along with it, can pose concern and a lot of hurdles for families until the child grows out of the problem,” says pediatric gastroenterologist David Gremse, a professor at the University of South Alabama Medical School and co-author of the study.

But research shows that most infants outgrow symptoms by about 1 year, says Gremse.

According to one survey, the condition “tends to peak at 3 to 4 months of age and then starts to decline after that,” he says.

A more problematic condition, gastroesophageal reflux disease (GERD) affects a much smaller percentage of infants; symptoms include regurgitation, vomiting and irritability, but also refusal to eat, poor weight gain, indications of stomach ache and sleep disturbances.

“These children oftentimes do benefit from acid suppression medication to control symptoms and heal any acid damage to the esophagus that may be present,” says Gremse. He notes, however, that other conditions, such as colic and irritability from milk protein intolerance also can produce some of these symptoms.

There’s no indication that infant reflux is becoming more common, although for school-age children “obesity makes reflux a lot worse because it increases pressure on your belly,” says Carlo Di Lorenzo, a pediatric gastroenterologist at Nationwide Children’s Hospital in Columbus, Ohio. He was not involved in study.

Children born with birth defects affecting the esophagus are at a much higher risk of having GERD, as are children with some chronic respiratory conditions such as cystic fibrosis, and babies born with neurologic impairments, the report says.

It also addresses “some of the potential over-prescribing of the strongest acid blockers, such as protein pump inhibitors,” in the treatment of infants and young children,” says Gremse.

The report encourages pediatricians to follow guidelines developed by the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition when diagnosing and treating reflux conditions. It recommends lifestyle changes, which can include feeding and/or position changes as first-line therapy for both conditions, while medications are explicitly indicated only for patients diagnosed with GERD.

Giving infants smaller but more frequent feedings and making sure nursing mothers limit spicy and fatty foods and caffeine “can often make a big difference,” Gremse says.

“Even though a child may have problems from the reflux in infancy, the prognosis is good,” he adds. “Most will outgrow it and go on to lead healthy lives.”

Still, he says, “physicians and parents should be on the lookout to see if their child develops problems outside of the simple GER where their child might benefit from a medical evaluation and possible treatment.”

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A review of 70 studies looking at 200,000 children suggests parents who “buffer” children from negative experiences make them more vulnerable.

But children who have harsh or negative parents are most likely to be bullied, it finds.

Prof Dieter Wolke said everyone looked at schools, but his study says bullying really starts at home.

The University of Warwick-based psychology professor said he was expecting to find that children with the harshest parents were most likely to become prey to bullies.
But he said he was somewhat surprised to discover that children with overprotective parents were also at an increased risk of bullying.
‘Deal with conflict’
He said: “Although parental involvement, support and high supervision decrease the chances of children being involved in bullying, for victims – overprotection increased this risk.

“Children need support but some parents try to buffer their children from all negative experiences. In the process, they prevent their children from learning ways of dealing with bullies and make them more vulnerable.”

He added: “It is as if children need to have some distress so that they know how to deal with conflict. If the parents all the time do it for them then the children don’t have any coping strategies and are more likely targets.”

Bullying was defined as repeated instances over a six-month period, rather than just one-off conflicts in the playground.

He said the research suggested bullies find dominance by targeting the children they find to be the most vulnerable – picking again on the ones who cry or run away after an initial attack.

So the way a child reacts to an initial instance of bullying has repercussions for what the bullies do next. Once they have established who to target they increase their dominance by repeatedly victimising them.

‘Clear rules’
The research, which covered a number of European countries and the US, also found that children who were bullied by their siblings were more likely to be victims as well.

Prof Wolke said: “Parenting that includes clear rules about behaviour while being supportive and emotionally warm is most likely to prevent victimisation.

“These parents allow children to have some conflicts with peers to learn how to solve them rather than intervene at the smallest argument.”

Overall he found that 32% of children said they had been bullied over the previous six months. Some 10 to 14% went on to be chronic bullying victims.

The study was published in the journal of Child Abuse and Neglect.
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A recent study looked at whether reducing the juice allotments in a publicly funded program led low-income families to purchase less juice.

These researchers found that families did purchase less juice and did not appear to make up for the lost allotments through other drinks.

The program appeared to successfully reduce the amount of juice these families were drinking, thereby hopefully reducing their total daily calories.

“Drinking water is best.”
The study, led by Tatiana Andreyeva, PhD, of the Rudd Center for Food Policy and Obesity at Yale University, looked at the effects of reducing juice allowances in the WIC program.

WIC refers to the Special Supplemental Nutrition Program for Women, Infants and Children. It is a program for low-income mothers of young children that provides allotments of certain foods.

In 2009, the WIC program reduced the allowances for juice by half because children aged 2 to 5 were already drinking more juice than recommended by the US Department of Agriculture.

The researchers gathered data from supermarket scanners for 2,137 households using WIC over two years.

They compared the number of beverages bought before the juice allowance change (from January to September 2009) to the number bought after the change (January to September 2010).

The researchers found that two thirds of all juice purchased by the families before the change was bought with the WIC program.

After the juice allowance was reduced, the families purchased 43.5 percent less juice, almost the same amount of the reduction in allowances.

There was only a 13.6 percent increase in juices bought with personal funds or otherwise not through WIC funds. This increase was made up of 20.9 percent more fruit drinks, 21.3 percent more non-carbonated drinks and 12.1 percent less soft drinks.

Overall, the families bought 23.5 percent less juice. This reduction was equivalent to about 182 ounces of juice per month, down from 238 ounces of juice per month before the change.

The researchers concluded that this shift in the families’ purchases of juices could significantly reduce extra consumption of calories through juice.

The study was published April 29 in the journal Pediatrics. The research was funded by the Economic Research Services at the US Department of Agriculture. The authors declared no conflicts of interest.

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In a new poll, 44 percent of parents with children under age 4 said they had given their kids multi-symptom cough and cold medicine, 42 percent reported giving the children cough medicine, and 25 percent said they gave decongestants.

Doctors have known since at least the 1990s that cough and cold medicines are unlikely to help children, and since the mid-2000s, studies have shown that these medications could actually be harmful, said Dr. Matthew Davis, director of the C.S. Mott Children’s Hospital National Poll on Children’s Health, which reported the findings.

Kids can experience drowsiness, rapid heartbeat, breathing problems and seizures after taking these medicines, Davis said. While only a small number of children experience such side effects, the medicines aren’t effective in treating cold symptoms even for kids who don’t suffer such side effects, he said.

Its not exactly clear why the medicines don’t work for children, but it may be that kids’ narrower airways are more likely to retain blockages even after taking such medicines, he said.

“In my practice as a pediatrician, I do not recommend these medicines” for children, Davis said.

It can be a confusing situation for parents, because products labeled on the front of the box as “children’s” medications may say in small print on the back that they should not be used in kids under age 4.

In 2008, the Food and Drug Administration advised that these over-the-counter medicines not be used in infants or children under age 2. In response, the industry group the Consumer Healthcare Products Association, which includes manufacturers of over-the-counter cough and cold products, changed their labels to state that the medicines should not be used for children under 4.

“They wanted to be extra cautious,” and be more restrictive about what ages of children should use their products, Davis said.

Parents who are concerned about their children’s symptoms should call their doctors, Davis said. He also said that propping children up while they are sleeping, so that their head is higher than their hips, can help with drainage of congestion. Breathing in a warm mist can also help. “I tell parents to take their child into the bathroom, close the door, and turn on a warm shower and let the room fill,” he said

In 2008, the same poll showed that more than 60 percent of parents were giving these medicines to their children, Davis said. “So we are going in the right direction. But given that they aren’t helpful, we would like to see it be close to zero,” he said.

Pass it on: Cough and cold medicines may harm children under age 4.

Follow Karen Rowan @karenjrowan. Follow MyHealthNewsDaily @MyHealth_MHND, Facebook & Google+.

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