Mum Star

Some timely advice has been given by the Medicines and Healthcare Regulatory Authority (MHRA) as to how much paracetamol it is really safe to give to your children. It’s around this time of year, when coughs, colds and fevers abound, and a bottle of liquid paracetamol like Calpol is always close at hand.

The labels on these bottles are quite clear about how many teaspoons should be given (based on age) over what period of time. But MHRA is warning parents to reduce the amount they are giving their children because many children are being given more than is necessary.

The dosage on the labels is based on previous advice from the MHRA that babies aged three months and one year could be given half a teaspoon (2.5ml) up to four times per day, and that children aged one year to six years can have up to two teaspoons (10ml) up to four times a day. But MHRA now says that those age ranges are too broad, and that a one-year-old should not be given the same as a six-year-old.

Hospitals and GPs who prescribe paracetamol will give dosages that are based on the child’s weight, rather than age, whilst bottles bought over the counter or in supermarkets have dosages based purely on weight.

The new guidelines, which will be filtered through to labels on bottles, will be as follows:

Babies aged between six months and two years to have up to one teaspoon (5ml), no more than four times a day.

Babies age 3 months – 6 months to be given half a teaspoon (2.5ml) up to four times a day (same as previously)

Children age 2 years – 4 years to have up to one and a half teaspoons (7.5ml) no more than four times a day.

Children age 4 years – 6 years to have up to two teaspoonfuls (10ml) up to four times a day.

A spokeswoman for MHRA, Dr June Raine, sought to reassure parents about the changes by saying, “The change is to ensure children get the optimal dose for their age. The change is not because of safety concerns, and parents should not be worried that they have done anything wrong.”

About three years ago the paracetamol-based sedative Medised was made unavailable over the counter for children under two because parents were routinely using it whether or not their baby was poorly in order to make their child sleep through the night. Not only did it not improve sleep (since the baby got used to the sedative), obviously it meant that babies were being sedated when it wasn’t medically necessary to do so.

This week there was some lovely news stemming from a very unhappy story. A pregnant woman called Sarah Best from Leamington Spa discovered early in the pregnancy (at 16 weeks gestation) that she had oral cancer.

Many women in these circumstances are advised that undergoing treatment – chemotherapy – can harm the baby and cause miscarriage. Many women consider abortions in order to have the treatment, and others refuse treatment and hope that they will survive the pregnancy and be able to have the treatment after the birth.

Sarah Best decided to go ahead with the chemotherapy whilst pregnant and amazingly she gave birth to a healthy baby boy. This makes her one of a very few women in the world to have had successful treatment for cancer whilst pregnant and to go on to have a healthy child – baby Jake is the only baby known to have been born in the UK in these circumstances and is only one of about eight in the world.

Her baby was born on the last day of her treatment, which had switched to radiotherapy after initial doses of chemotherapy and surgery to remove the cancer.

Sarah Best said, “It was devastating really. Because I thought pregnancy was supposed to the happiest time… you’re supposed to feel wonderful. And it didn’t really… I had other things I had to cope with because of this cancer. The hospital [staff] worked so well for me. They were like my best buddies.”

Baby Jake was only 4lbs 10oz at birth, which is perhaps a good job since Sarah’s treatment meant she couldn’t have gas and air or other anaesthesia.

The reason Jake was protected from the effects of the treatment was that a 1.5 tonne shield had been designed to protect mum and baby during radiotherapy. It was the thought of this protective lead shield that prompted Sarah to undergo the treatment, believing that it would protect her baby.

Lydia Fresco, who worked on the design of the baby-shield, said, “Sarah’s case was extremely rare. As far as published cases go she was the only woman with mouth cancer in the world to have this combination of chemotherapy and radiotherapy while pregnant. The combination is very aggressive and is never usually considered for pregnant women because of the risks to the unborn baby. Because Sarah was young and very fit and the cancer was in her head and neck it was decided that this combination of treatments would be safe to use. I have never heard of any other examples of pregnant woman having cancer and being treated with chemotherapy and radiotherapy in the UK.”

Sarah’s been given the all-clear so far but will need regular checks to make sure it doesn’t return. Meanwhile, despite being born five weeks prematurely, mum and baby Jake are doing well.

Big babies and children may well not just have ‘puppy fat’ – they may well be already on the road to obesity. Parents are advised not to ignore the issue believing that the child will grow out of it – chances are, they won’t.
Research looked at the weight and length of over 40,000 babies and children every six months between the ages of one month and two years. Those babies whose weight went up by more than two weight categories (or ‘percentiles’) early on were more likely to be obese by the ages of five years and ten years.
Babies who start off in ‘higher weight categories’ (i.e. higher percentiles) are also more likely to be obese later on. That is, babies with high weight-to-length percentile are more likely to be obese at the ages of five or ten years.
So excess weight increases in babyhood and early childhood is associated with later childhood obesity.
The study was limited, though, by the lack of adjustment for other factors that can influence weight – socio-economic factors are known to influence weight. Although this study shows a correlation between the early weight/weight change and later obesity, it doesn’t tell us why. But obesity is known to be caused by a combination of diet, exercise and genes.
The study does mean, though, that those children and babies on the higher percentiles and those who cross two percentile points in infancy could be monitored as it identifies them as being at risk of continued weight problems. It can also mean that those parents can be given appropriate advice to follow to improve the lifestyle and diet of their child before it becomes a problem.

The normal method of inducing labour is an injection (or application of a gel) of a hormone called oxytonin. Its effect is to immediately bring on contractions and if anaesthesia isn’t already in place or on hand it can be pretty eye-watering to say the least.
New research has found that actually an older method of induction, used in and around the 1930s works just as well but with fewer side effects.
That method is by means of something called a Foley catheter. The researchers studied over 800 women and found that the Foley catheter and hormone gel/injection both led to similar numbers of labours being successfully induced, with similar numbers of women going on to deliver naturally, with ventouse/forceps, and by caesarean section.
Using the Foley in the first twenty-four hours led to longer labours, but overall the side-effects were far fewer. The research might mean that the guidelines from the National Institute of Clinical Excellence (NICE) that currently say that induction should be by hormone gel may be revised.
A Foley catheter works by mechanically opening the cervix by filling a balloon with fluid whilst it is placed in the cervix, stretching it until it is big enough to allow the baby to pass through. The hormone gel (prostaglandin) mimics the woman’s natural hormones that would normally start labour.
The researchers say that using the Foley catheter means that contractions don’t have to be monitored as closely as in other types of labour. Foley catheters are also cheap and easy to store.

This may sound like something you get from cows but in fact it is a very common, very mild illness amongst children. It’s caused by some things called enteroviruses or coxsackie viruses. It is called ‘hand foot and mouth disease’ because of the rash that appears on the palms and soles and inside the mouth – the rash doesn’t itch but the little blisters are sore and the disease can cause a general feeling of unwellness. It may cause a loss of appetite because it is uncomfortable to eat with the blisters in the mouth.
It’s very contagious and because children spend large amounts of their time together in close proximity it is most common amongst children age 10 and under, though older children and young people, and adults, can also develop the illness. Many adults may have already been exposed to one or two of the viruses that cause it and so are immune, and anyway if affects adults with less severity than children. Because three viruses are known to cause the disease, it is possible to contract the disease more than once, though not usually twice in the same outbreak.
Normally it’s a case of sitting it out and waiting for the illness to pass, since there is no treatment (as it is a virus, not bacteria that causes the disease so antibiotics are useless). Symptoms normally disappear after a week or two at most.
As it’s so contagious it is best to keep your child at home if they are suffering, so as to minimise the risk of infection to other children. However, your child could have it for a few days before displaying symptoms so it’s not always easy to prevent. It is airborne, so can be caught if you get sneezed or coughed on, and it’s also liquid-borne, so can be caught by coming into contact with saliva, fluid/pus from the sores, or with unwashed hands that have poo on them. Encouraging your child to wash their hands often, and obviously keeping your baby’s hands clean, can reduce the risk of infection.
If your child develops the disease you could see your GP just for reassurance that it is definitely hand, foot and mouth disease, but if it is then there’s nothing he’ll be able to do to help the disease to go away any quicker than it would naturally. You should see your GP if your child develops a high temperature or doesn’t start to feel better after a couple of days, particularly if they’re not eating or drinking well. If your child is not drinking, then try persuading them to suck ice lollies as this will keep them hydrated and might soothe the pain. Paracetamol can help with the pain and will usually lower a high temperature but check the label for age guidelines. Teething gel can also help with the pain in the mouth (not adult ulcer treatments though).
There is a small risk of miscarriage associated with hand, foot and mouth disease so avoid exposing pregnant women to it.

Pregnant women who worry more and who are suffering from long-term stress tend to give birth to more boys than girls. This strange finding suggests that something happens at the point of conception in stressed mums-to-be that makes it more likely for them to go on to have girls than boys. The same study that made these conclusions also found that women with acute anxiety (as opposed to chronic, long-term stress) were slower to conceive. Ironically, of course, if you’re trying to get pregnant and aren’t doing so, then that acute anxiety only gets worse and may well be reducing the chances of conception.
As we learn more about pre-natal care and the effects of the environment in the womb on babies’ future development, it is perhaps not too surprising that a mother’s mental state during pregnancy will have some sort of affect – after all, what a pregnant woman eats, drinks and smokes all affect the baby, so why not how she feels?
So these findings make it clear that as well as following a healthy diet and lifestyle physically, women who wish to conceive should keep their stress-levels low to maximise their chances of conceiving.
One of the experts, Dr Cecilia Pyper of Oxford University’s Department of Public Health said, “This research addressed healthy women in UK trying for a baby; this area is important to research because we need to identify ways of making pregnancies and babies as healthy as possible. We want to understand what factors influence the chances of a pregnancy being normal; many couples are very keen to know what they should do to improve their chances of conceiving and having a healthy baby, and this research will help us provide the best advice.
“This research study is investigating stress in women trying to conceive; research has already identified that anxiety and stress in pregnant women may cause problems during the pregnancy and with the development of the baby.
“Women who are trying to conceive are already told how important it is for their future baby to take folic acid tablets, to stop smoking and to check they are immune to rubella; if the findings of this study are confirmed by larger studies women may also be advised about reducing stress. But it is important to put this new information into context by recognising it is a very small study and although it is the first time that research suggests that preconception stress may cause a difference in foetal sex, this hypothesis needs to be tested in other larger studies to confirm or refute this observation.”
Of the women found to be stressed in the study, 58 went on to have boys, and 72 went on to have girls, contrary to the normal pattern in which 105 boys are born to every 100 girls (this excess in boys is widely believed to account for the higher death rate amongst males caused by fighting wars).
Explaining the results, though, Dr Allan Pacey, fertility expert at the University of Sheffield, commented: “The results do not necessarily mean that stress is the cause. Perhaps the stress measured here is a marker for another aspect of these women’s lives, such as their occupation, their nutrition or factors do to with their relationship, all of which have been shown to correlate with sex ratio.
“I think it is important to caution couples that there is no surefire way to influence the sex of their baby and nature has a wonderful way of balancing everything out. So although we often see observations like this, on the whole there is generally the same number of boys born as there are girls. For an individual to change aspects of their lifestyle to try and stack the odds one way of the other is no guarantee of success and may in itself lead to disappointment. In my view, couples should just be happy with the sex of baby they get.”

Night terrors are not nightmares. If you have ever borne witness to someone having a night terror (whether that person was a child or an adult), you could never confuse it with a nightmare. Night terrors are terrifying for the person having them, and for anyone who witnesses them!
They’re not as common as ‘normal’ nightmares – only about three per cent of the population has them – but they are most common amongst young children and more so in boys than girls. If there’s a family history of night terrors then there’s a good chance that a child will also have them.
They’re best described as a sudden awakening in the middle of the night, whereby the child suffering them is really, really scared, crying and screaming. Sometimes, though, the child can be in a state of abject, silent terror as they are convinced that there is something scary in the room or on their ceiling (like a giant snake, spider, or scary person).
They usually happen a few minutes (or up to an hour or so) after falling asleep (nightmares usually happen in the early morning, and are normally remembered, often in vivid detail). The child will be very hard to wake, and when they do awake (whether immediately after the terror or in the morning) they will usually have little or no recollection of anything having happened.
Perhaps the most alarming feature of a night terror (to those who are witnessing one and trying to help) is that the child having the terror will usually have their eyes open and may well seem to be awake. But closer inspection will reveal that they’re not looking at you, they’re looking through you and are not even really aware that you are there. They are still in a deep sleep.
They often occur in clusters – your child may have them for several nights in a row, or on several nights over the period of a week or two, then not have a single episode for weeks or months. The cause isn’t known and there is usually no obvious trigger (though many people report that stress is often a sure trigger) but it’s believed that night terrors are caused by increased brain activity, perhaps caused by some rogue chemical in the brain making it go a bit haywire. Roughly half of children who have night terrors will have grown out of them by the time they’re eight years old.
Your child is more likely to have night terrors if there is a family history of night terrors or nightmares, sleep-walking and sleep-talking and even of bed-wetting.
Usually the person has no recall of any bad dreams or nightmares, but may have a vague sense of frightening images. Many people see spiders, snakes, tigers or even people in the room. They are unable to be fully awakened and are difficult to comfort, with no memory of the event on awakening the next day.
Night terrors are not harmful unless they cause the child to act in a way that could cause harm (e.g. running away from the source of fear, and possibly falling downstairs). However, many people and children who suffer from them report massive fatigue the following day.
Contrary to popular belief, it is perfectly safe to wake a child who is having a night terror (or who is sleep walking). Doing so can be hard, though! Try turning on a light, removing a blanket – a dramatic, sudden change to the surroundings can snap them out of the state and they will immediately return to sleep. You may need a glass of warm milk to calm yourself before you can go back to sleep though! If your child regularly has night terrors, try gently waking them up soon after they have fallen asleep at night, which might break the pattern. Or if you know what time they will normally have a night terror, you could rouse them shortly before that time. Speak to your doctor if you are really concerned.

Congratulations! You’re expecting a baby! Now, stop smoking and drinking, make sure you eat your five-a-day, take folic acid supplements, take plenty of exercise, don’t dye your hair, don’t eat raw eggs or shellfish… the list of advice on how to have a healthy pregnancy is never-ending. You will be given advice from every man and his dog, not to mention every article you read on pregnancy. You may think ‘enough!’.
The thing is, though, the more we learn about life in the womb, the more apparent it becomes that everything you do, eat, drink, inhale, is also done, eaten, drunk and inhaled by your baby. There is also plenty of evidence to say that experiences in the womb have extremely long-lasting effects, to the extent that babies in the womb can go on to be more likely to suffer diabetes, or have behavioural difficulties, or have mental health disorders, if conditions in the womb aren’t optimal.
That’s a lot of pressure for mums-to-be. But that’s motherhood for you. A never-ending round of guilt and worry.
So, just to add another thing to worry about to your list, researchers have found that mums who eat lots of sweet food and drink lots of sugary drinks during their early pregnancy (first trimester) are more likely to go on to have obese babies.
Researcher Suzanne Phelan of the California Polytechnic State University says, “There is something about the exposure to sweets in utero that may lead to heavier babies. The risk factor is independent of the mother’s weight gain during pregnancy or starting weight.”
The study looked at food-intake of 285 pregnant women throughout the pregnancies, and also noted the resultant babies’ weights at birth and again at six months of age.
They found that women who were of normal weight but who drank sugary drinks in the first trimester were at higher risk of having obese babies compared to women who didn’t drink many sugary drinks.
Women who were obese or overweight and who got more than 20% of their daily calories from sweet foods/drinks, were twice as much at risk of having an obese baby than were obese/overweight women who ate less sugary food/drink.
Women who put on more weight then they should (there are guidelines widely available as to how much weight is normal to put on during pregnancy) are more likely to have big babies who go on to be obese or overweight themselves.
As always, the key is moderation. Don’t deprive yourself, but if you’re feeling sapped of energy and tired and want a pick-me-up, turn to the fruit bowl instead of the naughty cupboard.

Having been told that we must be careful with our diets during pregnancy, not only to ensure that we ingest sufficient vitamins and minerals to keep our growing child healthy and to avoid excess weight-gain that can impact on our health and that of our baby, many women have found that eating low-fat yoghurts has helped them to do just that.
However, it has now been discovered that the lack of fatty acids in these low-fat yoghurts are actually putting foetuses at risk of going on to suffer asthma and hay fever. Women who ate one low-fat yoghurt each day were 1.6% more likely to give birth to children who went on to suffer from asthma. However, there was no such link with the consumption of milk, which remains a good way of consuming calcium whilst pregnant and in fact actually reduces the risk of asthma in children if their mothers consume it during pregnancy.
Lead researcher Ekaterina Maslova, of Harvard School of Public Health said, “It is a puzzling finding. The absence of fatty acids in low-fat yoghurt may be key to the results. The results suggest that fatty acids play an important role or it could be that people who ate this kind of yoghurt had similar lifestyle and dietary patterns, but we cannot make any conclusions at this stage. We need to replicate these results in other studies first.”
Asthma UK recommends that pregnant women follow a balanced diet and acknowledges that pre-natal diet can impact on child development, but adds that, “pregnant women [should] discuss any drastic changes to their diet with their GP first.”
There are a few foods that pregnant women really must avoid. These are:
raw and undercooked meat and seafood (including sushi) (risk of salmonella and listeria)
raw eggs (check sauce ingredients, especially at restaurants which may use raw egg for certain sauces including mayonnaise – shop-bought bottled mayonnaise is fine) risk salmonella)
Some fish – sword fish, shark, prawns (possibly high in mercury)
Soft or blue cheese (e.g. feta, brie, Camembert) – ok if pasteurized, and soft cheese like philadelphia is fine.
Unpasteurized milk and juices;
alcohol (some research says that alcohol is fine in small amounts – the consequences though can be devastating and giving up alcohol for a short period is not so onerous when one considers what can be caused – see ‘Foetal Alcohol Syndrome’).
Enjoy your pregnancy!

Fast-paced cartoons like Spongebob Squarepants might have a negative affect on children’s memory and attention spans, according to recent research.
The researchers found that children who viewed fast-paced cartoons performed less well in memory and attention tasks given to them after doing so.
The researchers say that it is the nature of the ‘rapid presentation’ cartoons that cause this effect: the cartoons are stimulating the bit of the brain that deals with the senses (mainly vision and hearing) rather than the bits of the brain that deal with memory, inhibition controls and problem-solving. So those bits of the brain don’t get much of a work-out whilst the cartoons are on: ”they become neurologically exhausted and it inhibits the ability to concentrate.”
Spongebob Squarepants is popular with many children from about four years and up, but is aimed mainly at children aged 6 to 11 years.
A representative from the show’s network (Nickelodeon) Mr Bittler says that the study is flawed because the test subjects were younger than the target audience, and were also from predominantly white, middle-class families so doesn’t give a broad spectrum analysis. He said, “Having 60 non-diverse kids, who are not part of the show’s target demographic, watch 9 minutes of programming is questionable methodology. It could not possibly provide the basis for any valid findings that parents could trust.”
An independent researcher reviewed the findings. Rahil Briggs, PsyD, who is based at the Montefiore Medical Center. She commented that actually such cartoons can prepare children for multitasking in later life by helping them to grasp foreign or strange concepts (like the fact that there’s a talking sponge who is friends with a starfish and works in a burger bar at the bottom of the sea). However, she says, “I’m not sure we’ve agreed multitasking is the optimal state for us. I don’t think constant multitasking is a goal.”
It is common knowledge amongst parents that TV should be limited and guidelines are widely available as to how much is too much dependent on the child’s age. However, it would seem from the findings of this research that if your children are going to watch TV then fast-paced programmes ought to be avoided, especially before bed. “The bottom line is to realize that these sorts of [fast-paced] shows are taking your kids’ brains into another place for awhile,” says Briggs.