A note to my readers

I have written this page for one year and have received a lot of positive feedback. I give my sincere gratitude to all of you who have been reading it. I have published an index to make it easier to find articles you want to read. Each is listed with the month it was published. In my first year of doing the blog, I wrote at various intervals. To make it easier for my readers, I will start to publish an article every week on Friday. Thank you for you time and your support.  John O'Connell

Index of Titles/Subjects for 2012/2011

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Abdominal Pain

1     .     Constipation and tummy pain  Jan 2001

2     .     When to worry about abdominal pain  Sept 2012

3     .     Celiac disease  Nov 2012

Acetaminophen (Tylenol)  Feb 2012

ADHD

1     .     ADHD basics  April 2012

2     .     ADHD diagnosis  April 2012

3     .     Is it ADHD?  Nov 2012

4     .     ADHD Treatment  May 2012

Allergies and Asthma

1     .     Food allergies (1)  Jan 2012

2     .     Food allergies (2)  March 2012

3     .     Living on a farm to decrease asthma Nov 2012

4     .     Peanut allergy  Oct 2012

Antibiotics

1     .     Rash on antibiotics   June  2012

2     .     Using antibiotics sensibly  June 2012

Anxiety in children   Nov 2012

Arsenic in rice cereal   Sept 2012

Bedwetting  April 2012

Behavior

1     .     Behavior problems in toddlers  April 2012

2     .     Don’t teach, play  Dec 2012

3     .     Oppositional child  June 2012

4     .     Teaching behavior  Feb 2012

5     .     Temper tantrums  Feb 2012

6     .     Spanking  Aug 2012

Booster seats   Dec 2012

Circumcision  June 2012
Celiac disease  Nov 2012

Contraception in teenagers  Dec 2012

Chronic cough  March 2012

Chronic runny nose  March 2012

Croup  Feb 2012

Diet

1     .     Teaching healthy eating habits  Jan 2012

2     .     Starting on solids  Jan 2012

3     .     You can lower your child’ risk for heart disease  Aug 2012

Diet supplements and performance-enhancing drugs  June 2012

Discipline – Teaching discipline and behavior  June 2012

Earring alert  Oct 2012

Eczema  April 2012

Expectant mothers – What every expectant mother should know  Oct 2012

Feeding

1     .     Changing bad eating habits  Feb 2012

2     .     Feeding your newborn   Dec 2011

3     .     Feeding your 1 year-old (1)  Feb 2012

4     .     Feeding your 1 year-old (2)  March 2012

5     .     Starting on solids  Jan 2012

Formula  Dec 2011

Fever

1     .     Fever (1)  Jan 2012

2     .     Fever (2)  Jan 2012

3     .     Fever (3 ) Dec 2012

4     .     Fever longer than 3 days  Dec 2012

5     .     Fever seizures  Jan 2012

6     .     How to tell when a fever is dangerous  July 2012

7     .     The latest news on fever  Aug 2012

8     .     Taking your child’s temperature  July 2012

Fluoride   April 2012

Head Trauma

1     .     Bicycle helmets – pro and con  Aug 2012

2     .     Should a CT be done after head trauma?  Aug 2012

Head lice  March 2012

Holding kids back in school  July 2012

Infants  0 to 6 months

1     .     Diaper rash  March 2012

2     .     Fussy 1 month-old  Nov 2012

3     .     "The baby's crying"  Dec 20112

4     .     Gass and reflux  Jan 2012

5     .     Letting an infant cry  Sept 2012

6     .     Sleeping in infants  Jan 2012

7     .     Teaching good sleeping habits  March 2012

8     .     Starting solid foods   Jan 2012

9     .     Pacifiers   Jan 2012

1       .  Pooping problems  2012

Influenza 

1     .     Children at risk for death from influenza   Nov 2012

2     .     Influenza vaccine  Nov 2012

Intussuseption   Aug 2012

Jaundice in the newborn  June 2012

Masturbation looks like seizures in toddlers   May 2001

Meningitis  Oct 2012

Newborn

1     .     Circumcision  June 2012

2     .     Diaper rash  March 2012

3     .     Excessive tears  Jan 2012

4     .     Feeding your newborn  Dec 2011

5     .     Formula  Dec 2011

6     .     Jaundice in newborn  June 2012

7     .     Pacifiers   Jan 2012

8     .     Teaching good sleep habits  March 2012

9     .     Tongue-tie  March 2012

 One year-old

1     .     Don’t teach, play!   Dec 2012

2     .     Feeding one year-olds  Feb 2012

3     .     Feeding one year-olds  March 2012

4     .     Teaching behavior  Feb 2012

5     .     Temper tantrums  Feb 2012

6     .     Toddlers and bottles  March 2012

7     .     Spanking  Aug 2012

Pacifiers   Jan 2012

Potty training

1     .     Potty training  Jan 2012

2     .     More on potty training   Oct 2012

Rabies  Aug 2012

Sensory integration dysfunction   June 2012

Skin Problems

1     .     Skin problems in young athletes  Aug 2012

2     .     Diaper rash  March 2012

3     .     Eczema  April 2102

4     .     Moles  Jan2012

5     .     Rash on antibiotics  June 2012

6     .     Rash behind the ears  April 2012

Sleep

1     .     A cure for older child sleep problems  Sept 2012

2     .     Infant sleeping  Jan 2012

3     .     Letting your child cry  Sept 2012

4     .     Sleeping with mom and dad  Feb 2012

5     .     Teaching good sleep habits   March 2012

Sore throat   Oct 2012

Speech problems and stuttering  May 2012

Teenagers

1     .     K2, Spice and bath salts  Nov 2012

2     .     Diet supplements and performance enhancing drugs  June 2012

Teething  March 2012

Temper tantrums  Feb 2012

Ticks and tick –caused diseases  April 2012

Toddlers

1     .     Behavior  April 2012

2     .     Behavior Feb 2012

3     .     Bottles  March 2012

4     .     Sleep problems  Sept 2012

5     .     Spanking Aug 2012

6     .     Teach by playing  Dec 2012

7      .     Temper tantrums  Feb 2012

Tonsillectomy  Aug 2012

Tongue-tie   March 2012

Urine, bladder and Kidney infections  Feb 2012

Vaccines

1     .     Alternative vaccine schedules   Jan 2012

2     .     Influenza vaccine   Nov 2012

3     .     Thimerisol in vaccines  June 2012

4     .     Whooping cough vaccine  Aug 2012

Vitamin D  March 20112

Vomiting and Diarrhea   Feb 2012

X-rays: things to consider   July 2012

Emeregency Contraception For Teenagers

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     There are various forms of emergency contraception – medicines that will prevent pregnancy if taken within 120 hours after unprotected intercourse. It has been shown that if emergency contraception is available to teenagers the rate of teen pregnancy and, subsequently, the need for teen abortions is reduced. In most US states, teenagers older than 17 can get emergency contraception without a prescription but adolescents under 17 have to obtain a prescription. Both the American Academy of Pediatrics (AAP) and the American College of Obstetricians – Gynecologists (ACOG) have long supported making the emergency oral contraceptive called Plan B One–Step an over-the-counter medication available without prescription to any age group. The FDA agreed with this in 2011, but the agency was overruled by the Secretary of the US Department of Health and Human Services despite the fact that Plan B has been proven to be safe and effective in preventing pregnancies in 80% of cases of unprotected intercourse.

     The latest recommendation from the AAP encourages physicians to give girls under 17 a prescription for the “morning-after pill” before they need them. Some physicians and some parents hold ethical objections to teenage sex or sex outside of marriage. Others have moral objections to contraception in general. The AAP cautions physicians to “be aware of the ways in which the underlying beliefs they bring to clinical practice affect the care that they provide”. The Academy says that if pediatricians refuse to give emergency contraception treatment or information to teenagers on the basis of conscience, they are violating their duty to their adolescent and young adult patients and are morally obligated to refer the patient to a physician who will.

     13% of 15 year-olds, 43% of teens from 15 to 19 and 70% of 19 year-olds have sex, and the rate of teenage sexual assault is as high as 10%. Approximately 8 female adolescents out of 100 who have unprotected sex will get pregnant. If emergency contraception is used appropriately in those 100 cases, only 2 of those teens would get pregnant. Studies have repeatedly shown that availability to contraception and information about contraception does not increase sexual activity among teenagers. Physicians need to stop putting their own moral or political beliefs ahead of the welfare of their adolescent patients.

"The Baby's Crying!"

     In the first two months of life, babies cry. They cry a lot. This is difficult for many moms to deal with. After delivery, moms can find themselves exhausted, emotional and anxious - all of which makes it hard to live with a crying infant. Parents also get fooled by the first two weeks of the baby’s life when all the baby does is eat and sleep. After two weeks, when the serious fussiness starts, we are sure that we are doing something wrong, but babies naturally fuss and cry more and more up to about 2 months of age. This fussiness resolves by six months of age but by then you have already pulled most of your hair out. We also have our expectations about how babies should act and those can be wrong. Babies can sleep up to 18 hours a day, but some babies only do it in 2-hour intervals. Babies in those first fussy months can easily cry up to two hours a day.

     The first thing I do when the baby is crying is to change him. Sometimes, even if he is not wet, just readjusting the diaper or loosening the tabs can settle him down (You try stuffing a wad of material the size of your head into your underwear and see how comfortable it is!). The next thing is to try to feed him no matter when he last ate. If he doesn’t eat and keeps crying, it’s time for some quiet walking, rocking, reading and comforting. If he doesn’t settle down or if he starts to fall asleep, it’s time to go down into the crib. Even if he is asleep in your arms, he’ll wake up when you lay him down. Either way, it is OK to let him cry in his crib until he calms himself down and falls to sleep.

    During this difficult period, it is also important for parents to take care of themselves. Sleep as much as you can, recognize when you need a break and talk with people who are understanding without being judgmental. If your baby isn’t eating well, is acting unusually or if you are just worried, talk with you baby’s caregiver. We love to talk about babies and any time you are worried, we are worried.

Fever Longer than 3 Days

     In previous articles about fever I have stated that the usual course of fever is about three days of day and night fever followed by two to three nights of fever without daytime fever and then all fever resolves.

     If daytime fever lasts longer than three days, the child needs to be examined. The cause could be a more severe infection such as a urinary tract infection, but parents need to be aware of another possible cause: Kawasaki disease.

     Kawasaki disease is not an infection but is a generalized inflammation in the body. The first sign of it is daytime fever that lasts longer than three to four days. It can also cause red eyes without discharge, generalized rash, swelling in the fingers and toes and a peculiar red discoloration of the lips. The real reason parents need to know about this disease is that it can cause a weakening of the arteries in the heart and severe permanent heart damage. This serious complication can be prevented if the child is treated early enough. The problem for parents and physicians is that many of the more classic symptoms may not appear right away which makes diagnosis difficult. The longer treatment is delayed, the greater the risk of heart disease. A study done at Children’s Hospital Colorado showed that heart vessel damage occurred in 21% of the children who had been sick for 5 days, 60% of children who had been sick for 7 days and 80% of children sick for 10 days.

   The important message for parents is that daytime fever from routine viral infections does not last longer than three days. Kawasaki disease may only present with prolonged fever, especially in younger infants and any child with a prolonged fever needs to be closely evaluated. If there is any evidence of Kawasaki disease, the child needs to be hospitalized right away and treated to prevent heart damage.

Booster Seats In Older Children

     Car accidents are the third leading cause of death in children between 1 and 18 years of age. Most parents are careful to always use an appropriate car seat for infants and children less than 4 and all 50 states have enacted legislation requiring car seats for this age group. Statistics show a dramatic decrease in death and injury from motor vehicle accidents in infants to 4 year-olds. However, even though booster seats for children between ages 4 and 8 are highly effective in preventing injury and death in car accidents, parents are much less careful about using booster seats. These children are often simply buckled in with adult seat belts.  A study done in 2008 reported that less than half of children ages 4-5 and about a third of children ages 6-7 were placed in booster seats.

     A study published in the December 2012 issue of Pediatrics looked at the fatality rates of children between ages 4 and 7 in states that have laws requiring booster seats for older children versus states that do not. They found that states that had laws requiring booster seats for older children had lower car accident fatality rates in this age group and this was especially true in the older children.

   The message is clear to parents: when your child outgrows his car seat, you need to use a booster seat until he is up to a height of 4 feet 9 inches. Putting a smaller child in a regular seat with an adult seat belt is dangerous. Always use a booster seat for children ages 4 to 8 until they are tall enough to safely use the regular adult seatbelt alone. It would also be good for everyone concerned with children’s safety to advocate for state legislation requiring booster seats in older children.

    

Don't Teach, Play!

     Parents sometimes feel in competition with other parents. Parents inwardly compare whose child walked the earliest or whose child learned the alphabet soonest. We put the focus on teaching and we forget that toddlers learn best by playing. We also make the mistake of thinking about playing as only running and shouting. The most important way for a toddler to play is by exploring – wandering in a safe place, examining whatever takes his interest with a parent following behind talking to him and sharing his exploration with him.  Let the toddler determine the activity and allow his short attention span to move wherever and to whatever he finds. Forget about “games” and, especially, about “rules”.

     This important play activity needs an area with lots of things to touch, climb on, move, carry and stack. What is even more difficult for busy parents is that it demands time. Exploration cannot be directed and should never be hurried. The parent can offer a running monologue with the “learning” part tucked into it: “You have a blue shoe”; “There are two books on the table”. If the toddler finds something that is not to be played with, a firm “No” from the parent is a wonderful way of teaching discipline. If the child obeys and doesn’t touch the object, the parent should immediately praise him for “listening” and go right back to happy exploration. If a tear results, ride with it and the child will settle himself down and find something else to explore soon enough.  Exploration play serves as a way for the toddler to learn to deal with his own anger and frustration – he might struggle to climb up on something while the parent holds back, allowing him to struggle while giving reassurance: “You can do it”. It can also teach that when mom or dad says, “No”, he needs to listen to it.

     If the exploration starts to result in too many toddler tears, the child is probably tired and needs a break. If you find yourself getting frustrated or upset, it is time for you to take a break. Find someone to take over child-care for a while and spend a little time taking care of yourself.

Anxiety In Children

Anxiety disorders are the most common psychiatric problems of childhood. Parents should be aware of the different kinds of anxiety disorders and the ages at which they occur.

     Fear is a normal and protective reaction. Some forms of anxiety occur in specific age groups and represent normal development. Stranger and separation anxiety are common from 7 months of age to two years of age.  It is easy to see how toddler anxiety developed as an evolutionary advantage – toddlers have the mobility to move away from the protection of their mothers and yet have no awareness of danger, so toddlers who had no fear didn’t stay around for long.

     Preschoolers have “magical thinking”, so they can develop fears about monsters under the bed and bogymen in the closet. The original Grimm fairytales are full of fantastic (and frightening) creatures. Children of this age can also develop an obsession for order and want things done in exactly the “right way”. Parents should recognize that the fears are real, but reassure the child that things will be fine. Parents should not change routines or react as if they also hold the same fear: the night-monsters don’t result in the child sleeping with the parents; if the red socks are in the laundry, wear the blue and you can wear the red tomorrow. We teach our children that fears are normal for all of us but we are in control of how we react to those fears.

     School-aged children often have fears of physical injury to themselves or loved ones. Adolescents have anxiety about social acceptance and success.

     When anxiety impairs normal functioning, becomes obsessive or disrupts the family, it needs attention. Separation anxiety disorder can develop in children in elementary school. They worry about parents being harmed and can refuse to be separated – insisting on sleeping with the parents or refusing to go to school. These children can have significant disruption of their lives with full panic attacks if they are forced to separate from their parents. They can have absolute school refusal, selective mutism where they won’t speak outside the home and they can have physical complaints such as headaches or abdominal pains. A child with this level of impairment may need family counseling, individual therapy and/or medication.

     Adolescents can develop generalized anxiety disorder with continual worries about the future or about past actions. Another aspect of anxiety is obsessive-compulsive behavior where repetitive or ritualistic behavior can interrupt normal daily functioning.

     Any of the anxiety disorders can be related to depression.  A child who suddenly develops anxiety or depression needs to have their family and social situation examined closely for any new disruption. Anxiety and depression are so closely intertwined that the most successful medications used to treat anxiety are antidepressant medications called serotonin reuptake inhibitors or SSRIs.

     Finally, there is a belief among certain physicians that psychological problems, tics and compulsive behaviors that come on suddenly in children can be caused by an infection with streptococcus. In fighting the infection, the body makes antibodies that also attack the brain and nervous system. This diagnosis can be difficult to make and even more difficult to treat. Because some doctors don’t believe it exists, parents may find that their caregiver is reluctant to investigate this possibility.

A Fussy 1 Month-Old Grandson

     A recent 3-day visit from a 1 month-old grandson gave me a good reminder about reasons for infant fussiness.

     Infants in the first 2 months of life don’t need a reason to be fussy. Nothing feels normal for them. They hate it here and want to be put back into the uterus. They get hungry, tired and cold. Things are too loud and too bright. One other new thing they have to deal with is pooping. The sensation is new to them (infants don’t stool in the uterus). When an infant’s colon contracts to push the stool out, the infant can often tighten up and actually hold the stool in. The stool can get large and firm and cause even more discomfort the next time the colon contracts. That happens often because, every time we eat, our stomachs send a message to our colons to contract to make room for more food.

     In general, a fussy infant is either hungry, wet or tired.  Whether he “just ate” 15 minutes ago or “just woke up” or was “just changed”, always go through this list before doing anything else. If he has a clean diaper and he pushes out on the nipple and doesn’t latch on, then hold him for a bit and see if he starts to nod off. If so, he needs to sleep.

     My grandson was dropped off with the message that he had been “very fussy” lately. He had been given a new formula thinking he might be “sensitive” but it didn’t help. He would be falling asleep or happily awake and suddenly get red in the face, strain, pass gas and cry for less than a minute and then settle down again. He was otherwise eating and acting normally.  Through the 3 days he had only one large, very watery stool (common in constipation). After considering allergy, reflux and “gas” (although I’ve never known exactly what “gas” is), grandma and I decided that the problem was constipation. A half of a baby glycerin suppository produced a large, firm stool and a much happier grandson. He will stay on the suppositories about twice a week until he’s back to stooling normally.

"My Tummy Hurts" 2 - Celiac Disease

     The most common cause of recurrent abdominal pain in an otherwise healthy child is constipation. Children can poop everyday and can even have loose, explosive stools and still have constipation (see previous articles on constipation and tummy pain). Sometimes the only way to know is to put the child on a laxative (Miralax), until the child has daily, loose stools without pain or straining. But sometimes this doesn’t work and the child still has recurring abdominal discomfort. That is the time to consider celiac disease.

     Experts don’t consider celiac disease to be an allergy, but the best way for most people to think of it is as “kind-of-an-allergy”. The child’s intestinal wall lining has a reaction to contact with a certain protein and that reaction causes inflammation (like an allergic reaction). However, the child doesn’t develop hives, congestion or itching. There are microscopic finger-like projections on the lining of the gut called villi. These help you to digest your food. The inflammation from celiac disease damages these villi and impairs your gut function.

     The protein that causes the reaction is called gliadin. This is in grains such as wheat, barley and rye. These grains are called “gluten”, so celiac disease is called “gluten intolerance”. It is thought that celiac disease affects up to 1% of the population, which makes it a very common problem. It can start as early as 6 month of age when foods containing gluten are introduced into the diet but it often goes into adulthood without being diagnosed especially when there are only subtle symptoms such as anemia, infertility or slow growth. The intestinal symptoms of celiac disease are abdominal pain, diarrhea, bloating, gas, and vomiting. The child may loose his appetite, become fussy and have poor weight gain.

     There are several blood tests that can be done to make the diagnosis of celiac disease but parents have to be very certain what test was used because the tests have a wide variance of accuracy. It is even harder to get an accurate test in a child under 2 years of age.  A biopsy of the intestinal wall to see the damage to the villi is accurate, but is more difficult than just drawing blood.  

   The only treatment for celiac disease is to avoid glutens for life. This is very difficult, expensive and imposes a real burden on the whole family. It is important that a child (or adult) not be put on a gluten-free diet until after a firm diagnosis of celiac disease has been made because removing gluten from the diet can cause the diagnostic tests to be negative. There are many sources for information about gluten-free diets on-line and in local support groups. After being placed on a gluten-free diet, a child with celiac disease should be followed routinely be a health care professional who is comfortable dealing with the disease.

Living On The Farm Protects Against Asthma

     For decades, the rate of asthma and allergies in children has been increasing. One reason for this increase is the “antibacterial” mood of our society. Products from laundry soaps to hand cleaners are designed to kill bacteria and we strive to make our environment more “clean”. It has long been suspected that our “anti-germ” mentality has actually caused our children to have more allergies and asthma. When most of our population lived on farms, children were exposed to many forms of bacteria and fungus that today’s urban children don’t encounter. There have now been many studies, including a recent one in the New England Journal, that show that the exposure to these germs gives children who live on farms protection from developing allergy and asthma.

     This most recent study compared children in Germany who lived on farms to those who lived in cities. Dust from the children’s rooms and mattresses were examined for bacteria and fungus particles and it was clear that the farm children were exposed to more germs and also different types of germs. The farm children also had less allergy and asthma than the city children. In fact, the more they were exposed to different types of germs, the lower their risk for asthma!  

     This brings up interesting possibilities of how we might now try to expose modern city children to more germs. Once again, maybe Grandma was right when she said, “ You have to eat some dirt to be healthy.”

Is It ADHD?

     There are medical problems that can occur along with ADHD and there are medical conditions that can be mistaken for ADHD. When parents and physicians are evaluating whether a child or adolescent has ADHD, these other problems should be considered.

     Two important questions that are asked when making the diagnosis of ADHD are: “Were the symptoms present before 7 years of age?” and  “Have the symptoms been present for more than 6 months?” True ADHD symptoms develop early in life and are part of the child’s makeup. As the child gets older, the symptoms cause more and more difficulty for the child. If a child has been previously been doing well but then has a rapid decrease in grades or school performance, ADHD is not the cause. ADHD symptoms of inattention or hyperactivity can be caused by disease, seizures, drug use, depression, sleep disorders or family stresses such as divorce or sexual abuse. A careful investigation of the child’s physical health and social situation needs to be done when ADHD symptoms develop in a child who has not had them before.

     There are also problems that are commonly associated with ADHD. If not recognized, the treatment for the child’s ADHD can be less successful. The most common complications in children who have ADHD are conduct disorders and oppositional defiant disorder. These behavior disorders cause the child to have “repetitive behavior in which social norms and rules are violated” and “defiant, disobedient and hostile behavior”.   Almost 1/3 of children diagnosed as having ADHD have behavior problems. Another problem that limits a child’s response to ADHD therapy is learning disability. It is thought that up to 60% of children with ADHD also have a learning disability. It needs to be considered in any child who is being evaluated for ADHD. Finally, children with ADHD frequently have emotional problems – both anxiety and depression. In order for the ADHD therapy to be successful, these problems need to be treated, too.

K2, Spice and Bath Salts - New Recreational Drugs For Teens

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     Adolescents have begun using 2 different kinds of man-made drugs to get high. Both are legal, easily obtained in tobacco stores and gas stations and over the Internet, and both are dangerous.

     The first are synthetic forms of the active ingredient in marijuana – THC. THC is the compound that causes the high that marijuana gives and it is in a class of drugs called cannabinoids.. The synthetic forms of cannabinoids were developed for medical use and scientific research. They are stronger than the compounds found naturally in plants and animals. These drugs are marketed to adolescents as being a “safe” high and have over 100 names with the most common being “K2” and “Spice”.  They have the same “high” effects of marijuana including the less common effects of marijuana such as paranoia, sadness and sedation. Because they have a stronger effect on the nervous system, all of these effects can be magnified along with more serious panic attacks, headaches and hallucinations. These drugs are similar to THC but they are not THC, therefore they do not show up on a routine drug screen.

     The second group of drugs currently being abused by adolescents is called cathinones. These drugs are called “bath salts” but I don’t know why because they have nothing to do with the powders you add to your bath. The canthinones are stimulants – basically synthetic amphetamines. They have names like “Rave” and “Ecstasy”. Cathinones are more dangerous than the cannabinoids. They can have the same effects as “Meth” and cocaine – heart attacks, seizures strokes and death. They can cause the adolescent to harm himself or others and, like all amphetamines, they are addictive. They cannot be detected by routine drug testing.

     Parents need to be aware of the signs of adolescent drug use: sudden lack of interest in school, dropping grades, quitting previously enjoyed activities, acquiring a new group of friends who don’t seem to be interested in school or sports and dramatic changes in schedules or routines. If you think your adolescent is doing drugs, don’t let the teen’s excuses keep you from talking to the child’s caregiver. Because the drugs cannot be detected, the parent’s only recourse is straight talk.

    

Vaccines, Influenza and Autism

     In the wake of a new study about influenza and autism, I wanted to give a brief summary of what this new report may mean.

     In 1998 a small study by a British surgeon named Wakefield was published in the British Medical Journal Lancet. The study claimed that the MMR vaccine caused autism. This spread around the world like wildfire and the rate of MMR vaccination declined. After reviewing studies of hundreds of thousands of children, in 2010 the British General Medical Council found Wakefield guilty of 4 counts of dishonesty in his study and described his research as “irresponsible”. The next year the British Medical Journal labeled Wakefield’s study as an “elaborate fraud” and gave an apology for publishing it. Dr. Wakefield is currently barred from practicing medicine in the United Kingdom.

   But the damage was done and parents still express concerns about vaccines causing autism even though there has never been a scientific study that has even suggested a connection. Many viral illnesses, however, can infect the brain and cause a disease caused encephalitis. Encephalitis can lead to permanent brain damage, blindness, deafness and other neurologic problems. The damage done by these infections is not officially autism, but the symptoms can be confusing especially when a child gets infected early in life or in the uterus. Many vaccines protect children and adults against those kinds of viral illnesses.

     A recently released study suggests that if a mother gets influenza while she is pregnant, her child may have an increased risk of autism. We know for a fact that any viral infection in the mother’s bloodstream can be transmitted to a baby in the uterus, so, if the baby’s brain were to become infected, brain damage and autism could be a possible result. It was recommended that any woman of child-bearing years should get an influenza vaccine early in the flu season and see her doctor if she develops flu symptoms. Certainly, more investigation will be done on this subject.

     Most vaccines are “killed” vaccines. That means that the vaccine contains virus particles but no live virus. The vaccine cannot cause the infection. People commonly say “I got flu from the flu shot”, but it can’t happen from a killed vaccine. Another type of vaccine called a “live” vaccine has live virus particles in it and can give the patient a very mild infection, but a more serious infection can potentially occur. This is why it was easy for some physicians to believe Wakefield’s report of the measles vaccine (in MMR) causing autism because it is a “live” vaccine. Those doctors felt that a child could get encephalitis from the vaccine and that infection could cause autism. It was only after reviewing hundreds of studies from many sources involving thousands of children that the MMR connection to autism was proven to be completely false. 

     The nasal spray vaccine for influenza is also a live vaccine. Doctors already do not recommend the nasal flu vaccine for patients with asthma for fear that they could get the disease and, until we learn more about the possible connection between influenza and autism, it might be prudent for pregnant woman to get the killed influenza injection rather than the nasal spray. However, it is definitely recommended that all women of childbearing age get an influenza vaccine.