Allergy, Depression and Tricyclic Antidepressants

Psychiatrists have been very reluctant to accept the idea that depressions, which they know so well, may be caused by allergies to common environmental molecules such as foods, airborne particles, and chemicals in water. When patients were depressed and anxious, and at the same time suffered from diseases accepted as allergic, psychosomatic explanations were used. This usually meant that a psychological explanation for the presence of the allergic reactions was invoked. The mood disorder was looked upon as a natural reaction to the discomfort of the allergic reaction. Read more...

Ayurtox for Body Detoxification

The Food Allergy Pantry Purge

By Sean Kelley

A few days after my son, Graeme’s, food allergies (to peanuts, corn, soy, wheat, egg whites, and chicken) were confirmed, my wife mentioned his problems to a surgery colleague at the hospital where she is a nurse. “We harvested the organs of a 2-year-old this week. She got into the pantry when no one was looking,” he told her. “Peanut butter.”

I’ve learned from my wife that people in the medical profession don’t often sugarcoat things and the sheer terror we felt hearing that story sent us straight to the pantry for an all out purge. Though it would have been easier to seal it off with bricks than to only remove the items that offend Graeme’s sensitive body, we opted for a surgical strike. Read More

Allergies Can Dig Into Gardening's Fun

(HealthDay News) -- For gardeners with allergies, it can be difficult to enjoy their passion for plants when they have to cope with the misery of sneezing, itchy eyes, congestion and, in some cases, an asthma attack.

"Gardening outside during times of high pollen counts puts patients at risk for severe allergic symptoms," Dr. Warren Filley, an allergist/immunologist in Oklahoma City, said in a prepared statement.

"Avoidance measures, as well as the use of medications and allergy immunotherapy, can make the difference between having fun in the garden and being miserable," said Filley, a long-time gardener who suffers from allergies.

An allergist/immunologist can help determine which plant species are causing allergies and offer advice on the best time of day or season to work in the garden, according to the American Academy of Allergy, Asthma & Immunology (AAAAI). For example, pollen levels are typically lower on rainy, cloudy and windless days.

Gardeners can also control their allergies by careful selection of plants. Certain flowers, trees and grasses are less likely to produce pollen. These include: cacti, cherry, dahlia, daisy, geranium, iris, magnolia, rose, snapdragon and tulip.

Plants that are highly allergenic include: ash, cedar, cottonwood, oak, maple, pine, saltgrass and timothy.

Skin testing is the best way to determine which plants will trigger allergic reactions in individuals, said the AAAAI, which offered some additional allergy prevention tips for gardeners:

• Whenever working around plants likely to cause an allergic reaction, avoid touching your eyes or face.


• Consider wearing a mask to reduce the amount of pollen spores that you inhale.


• Wear gloves, long-sleeved shirts and long pants to minimize skin contact with allergens.


• Leave gardening tools and clothing, such as gloves and shoes, outside to avoid bringing allergens indoors.


• Shower immediately after gardening or doing other yard work.

More information

The American Academy of Family Physicians has more about allergies.

Doctor-Patient Bond Frays After Medical Mistake

(HealthDay News) -- Serious medical errors don't just affect the health of the patient, they can quickly destroy the patient's relationship with his or her doctor, too, experts say.

Too often, a health care mistake causes shame and fear in the physician responsible, leading to stilted, unsatisfying conversations with -- or avoidance of -- the affected patient, say the authors of an article in the Oct. 25 New England Journal of Medicine.

All of this can quickly move patient and doctor into an adversarial or litigious position.

But that's not always necessary, said one of the article's co-authors.

"Trust is an enormously important part of medicine -- if people aren't straight with you, you do not trust them," said Dr. Tom DelBanco, a professor of general medicine and primary care at Harvard Medical School.

"So, being upfront and honest, indicating that you want to do something about what happened, makes all the difference in the world," said Delbanco, who co-wrote the article with Harvard colleague Dr. Sigall Bell.

In many cases, doctors who frankly admitted their mistake and told patients how they would safeguard against future errors avoided litigation by doing so, Delbanco said. Those doctors also maintained strong, long-lasting bonds with the patient and the patient's family.

According to Delbanco, several patients interviewed for the article (and a related film) said that, " 'We don't expect you to be perfect, everybody makes mistakes. We just want you to be honest when it happens. We can deal with that.' "

In fact, "There are now some malpractice [insurance] companies that teach doctors to be honest and open," Delbanco noted. "There is slowly growing evidence that it may actually prevent lawsuits."

Medical errors have gotten a lot more attention recently, ever since the U.S. Institute of Medicine issued its 1999 report, To Err is Human. That report estimated that the deaths of more than 100,000 Americans each year are tied to some form of medical mistake.

In the wake of such errors, doctors often feel shame and guilt, as well as fear linked to the looming threat of lawsuits. For legal reasons, "I think that doctors are very confused about what they can and cannot say" to patients after an error comes to light, Delbanco said. That includes the use of simple words such as "mistake," "error," or even "I'm sorry."

"It depends on their institutions' views, it depends on the lawyers that they may or may not talk to," Delbanco said. "Very often, they are not only confused, but depressed, because they feel like they cannot say what they really feel like saying."

People who care deeply for a patient affected by a medical mistake often shoulder their own level of guilt after the incident. "Family members, in particular, can feel extraordinary guilt," Delbanco said, and often berate themselves, thinking, " 'If I had done this, this wouldn't have happened,' 'If I had been there, I would have prevented it,' 'If only I had been more forceful, the doctor wouldn't have done this.' "

Such was the case for those close to a young man with sickle cell anemia, mentioned in the NEJM article. The unnamed patient received morphine while in the hospital -- despite a well-documented allergy to the painkiller. He slipped into kidney failure and coma soon after, and his sister said she felt as if she "failed her family in terms of 'I should have been there.' That's a guilt that everyone shares."

Doctors who acknowledge that a mistake has happened, and outline steps to prevent such mistakes going forward, can ease a lot of distress for themselves and the patient, experts say.

But, in many cases, physicians have "a lack of confidence in their communication skills -- they just aren't sure how to have these conversations," said Dr. Thomas Gallagher, associate professor of medicine at the University of Washington School of Medicine, in Seattle.

Gallagher said Delbanco's and Bell's article echoes the findings of studies he has led, which revealed profound differences in the ways doctors and patients communicated after a serious medical error.

But he also believes the landscape around medical errors is changing. Already, about 30 states have enacted so-called "I'm sorry" laws, which, to a certain degree, make a doctor's apology for an error inadmissible in a court of law.

That should help ease patient-doctor conversations. But Gallagher said many of these laws still "provide very little protection for clinicians. They allow you to say 'I'm sorry,' but they don't allow you to make any expression that a mistake happened or to admit liability."

And, he said, it's not entirely clear that admitting to mistakes always wards off a lawsuit. "It's not a magic bullet," Gallagher said. "There will clearly be some cases where disclosure is what precipitates a lawsuit."

So, work remains to be done in finding strategies that allow patients and doctors to remain close even after a mistake occurs.

For his part, Delbanco said he is currently screening his film for third-year students at Harvard Medical School -- at the request of the school's dean -- to help them become better physicians. "Traditionally, there's been little coaching in this area," he said. "That's changing."

His advice to patients: If a serious medical error occurs, "be very aggressive in asking for communication. Patients should not be afraid of opening their mouths." And if that communication is not forthcoming, "Ask why and with whom can they speak?" he said.

And a hasty "I'm sorry" from a physician may not always be adequate, Delbanco added.

"Apology only means something when you show what you are going to do for that person -- and for the next person," he said. "Otherwise, they are just words."

More information
There's more on preventing medical errors at the U.S. Agency for Healthcare Research and Quality.

Farms Shield Kids From Bowel Disease

(HealthDay News) -- Children regularly exposed to farm life as babies are about half as likely as other kids to develop Inflammatory bowel disease such as ulcerative colitis or Crohn disease, German researchers report.

The findings, published in the August issue of Pediatrics, fall into line with what experts in inflammatory bowel diseases (IBDs), allergy and asthma call the "hygiene hypothesis."

That theory "refers to the observation that children living in environments with lower levels of microbial exposure seem to be at higher risk for the development of allergies," explained the study's lead researcher, Katja Radon, of Ludwig-Maximilians-University in Munich.

Crohn's and ulcerative colitis are autoimmune illnesses, where the body's immune system mistakenly attacks its own tissues. It is possible that this dysfunction may originate, at least in part, in how immune responses develop very early in life, said Dr. Joel Rosh, director of pediatric gastroenterology at Goryeb Children's Hospital, part of the Atlantic Health System in Morristown, N.J.

He pointed out that while rates of IBDs are holding steady in the developing world, they are rising sharply in more affluent nations.

"It's something that we are doing to ourselves," Rosh said.

"The thinking is that if your immune system isn't appropriately challenged at the appropriate time in life, then it might do some wacky things," Rosh added. In other words, a too-clean environment -- while healthy in some ways -- might be less than ideal when it comes to immune-linked illness, experts say.

The German study is one of the first to compare inflammatory bowel disease rates against infant exposures to farm animals and farm life. The German team questioned the parents of more than 2,200 6- to-18-year-old children. More than 300 of the children had ulcerative colitis, another 444 had Crohn's, and almost 1,500 were free of either illness.

Kids with either Crohn's or ulcerative colitis "were less likely to have lived in rural environments and were less likely to have farm contact in the first year of life, before the disease had developed," Radon noted.

In contrast, children who had spent regular amounts of time visiting or living on farms during their first year of life were 50 percent less likely to develop Crohn's as they got older and 60 percent less prone to ulcerative colitis, compared to youngsters who had not had that experience.

Early exposure to cattle, especially, appeared to help keep the diseases at bay, cutting the odds of Crohn's by 60 percent and colitis by 70 percent, the study authors said.

Cattle appeared to have a more potent effect on IBD risk than exposure to household pets, the study found. Household cat and dog exposure has been the focus of much study and debate among allergists and immunologists.

In this study, regular exposure in infancy to cats reduced Crohn's risk by just 20 percent, a statistic the researchers described as only of "borderline significance." Cat exposure was somewhat more useful against colitis, with rates dropping by 50 percent compared to unexposed children.

The cat-cattle discrepancy didn't come as a big surprise to Rosh.

"It seems that it's not so much animals, per se, as it is which animals," he said. "So, the domesticated cat that stays in the corner cleaning himself all day may not be 'dirty enough' to save you."

Radon agreed. "It has also been shown for allergies that farm animal contact is more efficient [in reducing risk] than pet contact. Therefore, it is not surprising that we see the same for inflammatory bowel disease," she said. "The reason might be that the level of exposure to bacteria and fungi in the farm environment is much higher than if you have a cat or dog at home."

Rosh has his own theories as to where the protective element might lie. "They sanitize it in the article, but they do say it can't be a clean animal -- it's got to be livestock. It's got to be something in that environment, and I would say, it's not in the air so much, as in the poop," he said.

So, does all this mean that modern-day babies need to get "back to the land"?

Perhaps not, according to the experts.

"You can't make the leap to say that to protect our children against autoimmune disease, we need to take them to farms, because we don't know yet what the [protective] exposure is," said Dr. Peter Mannon, head of the Clinical Inflammatory Bowel Diseases Research Unit at the U.S. National Institute of Allergy and Infectious Diseases.

"Are you supposed to be exposed to hay? To a particular type of vermin? The rats in barns? It's very hard to know," he said. While there's no reason not to bring infants to more pastoral settings, "I would not guarantee that it is going to add any protection," Mannon said.

Radon agreed that "at the moment, we cannot give direct advice to parents" since the study showed no cause-and-effect relationship, only an association.

And she pointed out that society's obsession with cleanliness does have its rewards. "We should not forget that an improved level of hygiene has relevantly contributed to today's health in industrialized countries," she said.

For his part, Rosh said there might be some virtue in letting kids get a little dirty -- a prescription most youngsters should have no problem with.

"I don't mean that we all have to eat dirt, but if we could isolate what is in it that is good, maybe we'd have a good [IBD] treatment," he said. "These various areas of research are going to unlock the secrets that we need to cure these diseases."

More information
There's more on the hygiene hypothesis at the American Academy of Allergy, Asthma & Immunology.

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Scientists Probe How HIV Infection Turns Into AIDS

(HealthDay News) -- The common scientific wisdom on how HIV infection proceeds to full-blown AIDS might be wrong, two U.S. researchers say.

They hope that their new insights, if proven, will lead to exciting new treatment targets down the line.

Working from a complex mathematical model of viral replication and immune cell death, the researchers now suspect that AIDS begins when one especially fast-killing strain of HIV gains the upper hand over a less-lethal, but more prolific, strain.

"This throws into question a lot of the notions that have been accepted about the evolution of the virus" within a typical infected human, explained study co-author Dominik Wodarz, associate professor of biology at the University of California, Irvine.

He and another researcher, David Levy, of New York University, published their findings in the July 31 issue of the Proceedings of the Royal Society B.

Since its first recorded appearance nearly three decades ago, HIV infection has followed the same deadly path: a short, weeks-long period of acute flu-like symptoms followed by years of asymptomatic dormancy, and then symptoms of immune system breakdown that herald the emergence of AIDS.

But what is it that tips asymptomatic, low-level infection into AIDS?

The common dogma among scientists has long been that various strains of HIV battle a silent war within the body over time until the fittest -- defined as the strain that reproduces itself the most -- wins. That strain then goes on to overwhelm the body's immune cells and destroy the host's defenses against disease.

To test that theory, Wodarz and Levy constructed a complex mathematical model that took into account two factors about HIV: how fast the various strains replicate and how fast they kill cells (not always the same thing, the researchers noted). They also factored in human immune system responses to HIV.

What the two scientists found surprised them. According to the new model, AIDS actually begins when a less fit variety of HIV wins the day. This strain kills immune system cells extremely widely and quickly, but, in doing so, also limits the number of copies of itself it can produce. "It basically kills its own habitat, its house," Wodarz explained.

However, because this form of HIV is very good at quickly killing large numbers of immune cells, "once these less-fit strains emerge, they can plunge the patient into AIDS," Wodarz said.

In many cases, two or more strains of the virus can co-infect the same immune system cell, he added. If a fast-killing variety is one of those strains, it kills the cell before slower -- but better-replicating -- versions can go to work making millions of new viral particles.

"But without this ganging up on the same cell, the killer virus [that leads to AIDS] would go extinct, because evolution would select against it -- because it is less fit and replicates less," Wodarz explained.

That means that -- according to the model -- one way of keeping AIDS at bay might be to make sure that only one type of HIV invades a cell at any given time.

Specific cellular mechanisms do allow a second or third viral particle to enter a cell, and a medicine that thwarted these "party crashers" might keep the deadliest form of HIV from ever emerging, Wodarz speculated.

He pointed to wild monkeys that are infected throughout their lives with HIV-like simian immunodeficiency virus (SIV) but never get sick.

"Some of them have a lot of the virus, and it evolves a lot, but it does not cause AIDS, ever," Wodarz said. He suspects the monkey's immune cells may have evolved to block secondary viral entry and thereby keep the most dangerous strain of SIV at bay.

Not everyone is convinced by the new model, however.

Dr. Benigno Rodriguez is assistant professor of medicine at Case Western Reserve University in Cleveland, and a specialist in the evolution of HIV disease. He called Wodarz and Levy's paper "an interesting concept," but said it contained a few significant flaws.

First of all, he said, most of the available data suggests that HIV does get better at forming copies of itself as AIDS progresses. And Rodriguez believes the two scientists have left another important factor out of their model -- the fact that most AIDS patients' immune cells are not killed off by the virus directly but are destroyed by so-called "bystander" mechanisms that accompany AIDS.

"In an individual with advanced disease, if you look at the number of cells that are actually infected [with HIV], we are talking less than 1 percent," he said. "But, in reality, that individual may have lost 20, 30, 50 percent of his immune cells."

Rodriguez also questioned the importance of multiple strains of HIV infecting the same immune cell. "The data that we already have in hand shows that multiple infection is relatively infrequent," he said.

The bottom line, according to the Cleveland expert: As with any mathematical model, this one needs to be tested out in the laboratory.

Wodarz agreed that experimental verification is necessary, but he said mathematical disease models more often than not prove to be right.

In fact, he said, it was just such a model that led scientists to discover that HIV never stops evolving in the body -- even during infection's years-long asymptomatic phase.

"In HIV, mathematical models have led to great progress before," Wodarz said.

More information
To find out more about HIV/AIDS, head to the U.S. National Institute of Allergy and Infectious Disease.

Health Tip: Causes of Fainting

(HealthDay News) -- Fainting occurs due to a sudden drop in blood flow to the brain, resulting in brief loss of consciousness. Fainting can be accompanied by dizziness or nausea.

Here are some common triggers, courtesy of the U.S. National Library of Medicine:

• Straining during urination or a bowel movement.
• Excessive coughing.
• Standing for too long in the same position, or quickly standing up from a lying position.
• Severe pain, stress, fear or emotional distress.
• Excessive bleeding or dehydration.
• Medications used to treat conditions like high blood pressure, anxiety, allergies and nasal congestion.
• Use of drugs or alcohol.
• Low blood sugar.

Added Pounds Mean Added Risk for Asthma

(HealthDay News) -- Overweight and obese individuals are 50 percent more likely to develop asthma than normal-weight men and women, new research suggests.

Public health efforts to control asthma should therefore emphasize the importance of healthy weight management, the researchers argue in the April issue of the American Journal of Respiratory and Critical Care Medicine.

"The bottom-line is that being overweight appears to significantly increase the risk of asthma," said study co-author Dr. E. Rand Sutherland, of the National Jewish Medical and Research Center (NJMRC) in Denver. "But the caveat is, that until further studies are done, it won't be clear exactly what type or severity of asthma is present in obese people."

According to the U.S. National Institutes of Health, asthma is an incurable but usually controllable chronic disease involving inflammation and narrowing of the airways that carry oxygen into and out of the lungs.

The disease typically provokes recurrent wheezing, coughing, and a hypersensitivity to allergies and affects approximately 20 million Americans, including 9 million children.

A recent national survey found that about 65 percent of Americans are either obese or overweight, and research has long suggested links between asthma and obesity.

In this study, Sutherland and NJMRC colleague Dr. David A. Beuther pored over prior data on the body mass indices -- measurements of body fat based on the height and weight -- of adult asthma patients.

They looked at data from seven prior studies conducted between 1966 and 2006 in the United States, Canada, and Europe. Together, these studies had looked BMI and asthma in more than 333,000 severely asthmatic patients.

During data review, Sutherland and Beuther adopted standard BMI yardsticks, which define "normal weight" as having a BMI of under 25, "overweight" as a BMI between 25 and 29, and "obese" as a BMI more than 30. For example, a person who is 5 feet 6 inches tall and weighs 145 pounds has a BMI of 22.

The odds of developing asthma grew by 50 percent among patients with a BMI of 25 and up, and the risk climbed as the pounds piled on, the study found.

Women and men appeared to be equally susceptible to the weight-asthma association, they added.

Based on the findings, the researchers believe asthma should be added to the long list of diseases -- including diabetes, sleep apnea, stroke, cardiovascular illness, and arthritis -- for which excess weight is a risk factor.

And because two-thirds of the U.S. adult population are now thought to be obese or overweight, that means millions more Americans may be at risk of developing asthma than was previously thought, they said.

On the up side, "significant weight loss" could potentially reduce asthma cases by as many as 250,000 each year, the researchers said.

Not every overweight person with respiratory symptoms necessarily has asthma, however. The experts noted that excess weight can cause lung volume reduction, chest wall restriction, and breathlessness unrelated to the disease.

"If you're overweight, and you have respiratory symptoms, you don't need to jump to the conclusion that you have asthma," said Sutherland. "But, of course, it would probably be appropriate to have those symptoms further evaluated."

Dr Norman H. Edelman is chief medical officer for the American Lung Association and professor of preventive medicine and medicine at Stony Brook University in Stony Brook, N.Y. He said the findings regarding gender were most interesting.

"There's a lot of work that suggested the [obesity] effect was there in women and not in men," he said. "Certainly, in terms of my own clinical practice, I see people -- men and women -- with asthma that's difficult to manage, and many of them are overweight. But for men, it's something that wasn't clear before, and that's why this analysis is valuable."

But he agreed that proving cause and effect is tricky.

"The problem with asthma is that, unlike many other diseases, it's not like flipping a switch. It's not that you have it or don't have it. There are a lot of people walking around with a little bit of asthma, and they don't even know it," Edelman said. "So, it's not clear if obesity is actually causing the disease or perhaps converting a pre-existing undiagnosed asthma into a severe asthma. So, I don't know if I would say that obesity causes asthma. But certainly, it's a risk factor for clinically significant asthma."

More information
For more on asthma, visit the U.S. National Institutes of Health.

Breast-Feeding Helps Shield Babies From HIV

(HealthDay News) -- By breast-feeding only, HIV-positive mothers reduce the risk of postnatal HIV infection in their babies, South African researchers report.

The study, published in the March 31 issue of The Lancet, also found that early introduction of animal milk and solid foods while breast-feeding increases the risk that infants will be infected with HIV, the virus that causes AIDS.

The findings suggest that current World Health Organization, UNICEF and UNAIDS infant-feeding guidelines need to be revised, said researchers from the University of KwaZulu-Natal.
They found that infants of HIV-positive mothers who received formula milk in addition to breast milk were nearly twice as likely to be infected by HIV as infants who received breast milk only. The addition of solid foods increased the risk of HIV infection in the infants 11-fold.
The death rate at three months for babies who were fed animal milk or solid foods was more than double that of babies who received breast milk only, the researchers found.

"The key finding of our study is the definite demonstration that early introduction of solid foods and animal milks increases HIV transmission risks compared with exclusive breast-feeding from birth. These data, together with evidence that exclusive breast-feeding can be supported in HIV-infected women (and uninfected women), warrant revision of the present UNICEF, WHO, and UNICEF infant feeding guidelines that were revised in 2000," the study authors wrote.

More information

The U.S. National Institute of Allergy and Infectious Diseases has more about HIV infection in infants and children.

Coming Clean on Personal Care Products

(HealthDay News) -- Is your deodorant boosting your breast cancer risk? And how much chemical preservative in hand and body lotions is too much?
News reports over the past few years have heightened consumer awareness of the myriad chemicals found in everyday beauty and hygiene products, but two expert dermatologists say it pays to investigate before tossing any product into the bathroom wastebasket.
The debate over deodorants and antiperspirants is one good example. Small studies have suggested that daily use of these products might raise a woman's risk for breast cancer over time, especially given the armpit's proximity to sensitive breast tissue.
But Dr. Lisa Donofrio, an assistant clinical professor of dermatology at Yale University School of Medicine, said that "there have also been a couple of studies that have been pretty good at showing that [these products] -- at least the aluminum in them -- are not really related to breast cancer." While future studies might turn up additional data, "this debate right now is probably closer to 'case closed,' " she said.
One issue that remains an ongoing source of concern for Donofrio is that of preservatives called "parabins" found in a wide range of beauty products meant to have a very long shelf life. One reason manufacturers tend to use parabins is that a small minority of consumers develop allergies to a competing class of preservatives, formaldehyde releasers.
"So, parabins are now found across the board in beauty items -- makeup, and most commonly in lotions," Donofrio said. But the problem with parabins is that they "are estrogenic, meaning they will bind to estrogen receptors [on cells], and in test tube studies, they actually stimulate breast cancer cells," she said. Higher levels of circulating estrogens has long been a prime risk factor for breast cancer.
Industry experts note that parabins are used in extremely small amounts in health and beauty products. "For that reason, they say they're just in too small amounts to cause any problems," Donofrio said. "But over a lifetime, with daily use of these creams, we don't actually know what the cumulative dose really is."
For that reason, Donofrio advises that anyone not allergic to formaldehyde releasers shy away from products containing parabins, which are usually noted on label ingredient lists as either methyl parabin or propyl parabin. For those people who are allergic to formaldehyde releasers, she suggests using products containing a third class of preservative, sodium benzoate. Compared to parabins, "it's the lesser of two evils," the Yale expert said.
Another long-debated issue -- the connection between hair dyes and certain malignancies -- may have already been solved by industry, said Dr. Steven Feldman, a professor of dermatology at Wake Forest University School of Medicine. "First of all, the link has been talked about, but the studies don't really support it," he said. In any case, he said, hair dyes used today no longer contain the suspected carcinogen that gave rise to these fears in the first place.
Of course, consumers can develop lesser ailments, such as rashes and other signs of allergy, from skin and hair products. While manufacturers can help minimize the risk, Feldman said there's not much they can do to ensure that no one ever develops a reaction to their product.
"A person can be allergic to practically anything," he said. "Fragrances, especially, are one of the more common allergens -- people can expose themselves to them even through their fabric softener in the laundry."
As with any allergy, individuals who notice a reaction should note what they were using at the time and consult their doctor, if necessary. Feldman did offer one piece of advice: "Stick to well-recognized brands," he said. "I know some people fear big business, but companies that have a lot at stake don't want to blow it, and with business, the more they have to lose, the safer I think the product will be."
On the other hand, he said, "if you go for some fly-by-night company that promises you some herbal remedy, then, if somebody sues them, they just close up shop." Buying from a nationally recognized brand may "give you some assurance about quality that you might not otherwise get," Feldman said.
Many consumers may not be aware that health and beauty products are not subject to the tough federal safety standards that guide drug development.
"Most of us expect that the products we find on store shelves have been tested for safety, but the [U.S.] government has no authority to require tests," Jane Houlihan, vice president for science at the Washington, D.C.-based nonprofit Environmental Working Group, said in a prepared statement. "An average adult is exposed to over 100 unique chemicals in personal care products every day -- these exposures add up."
Not everyone agrees that consumers need to worry about the products they apply to their bodies each day, however. In a prepared statement, scientists at the American Council on Science and Health -- which describes itself as a consumer-based advocacy group that receives some "no strings attached" funding from the cosmetics industry -- said organizations like the EWG "have invested a great deal of work in publicizing supposed health risks from myriad chemicals that have long been in everyday use with no evidence of harm to humans."
According to the New York City-based ACSH, much of the evidence for these "scares" relies on high-dose animal tests that "are not good predictors of human cancer risk."
Yale's Donofrio said that argument does have some merit. However, she said she's more concerned about the absorption of toxins through the skin and their slow build-up in the body over time.
"If you start thinking in terms of 'Well, this does this to cells in the test tube, and I'm using X amount of this over this amount of years,' then there's the potential that I could end up being those [affected] cells," she said.
More information
Find out more about the science of beauty products at the U.S. Food and Drug Administration.

Tiny Balloons Open Blocked Sinuses

(HealthDay News) -- A new procedure that uses tiny balloon catheters to prop open inflamed sinuses is easing the misery of chronic sinusitis sufferers.

A report on the procedure was to be presented at the American Academy of Otolaryngology Head and Neck Surgery Foundation annual meeting Sunday, in Toronto.

"This new technology presents what seems to be faster healing, less postoperative care, minimal pain and bleeding, and improved quality of life for many patients who suffer with chronic sinusitis," said study investigator Dr. Howard L. Levine, director of the Cleveland Nasal Sinus and Sleep Center.

Chronic sinusitis, which can be due to infection, inflammation or anatomical obstructions, affects some 37 million Americans. Many people with the disorder are helped with antibiotics, but more severe cases call for surgery. In conventional endoscopic sinusotomy, an otolaryngologist uses an endoscope to examine the sinuses, and inserts micro-shavers and delicate instruments to remove diseased bone and soft tissue.

"This enlarges the sinus and returns it to function," Levine explained.
From this concept, balloon catheterization was born. The investigators describe it as another technology that will augment the ability to preserve sinus function.

Dr. David Sherris, chairman of otolaryngology at the University at Buffalo in New York, agreed. "The study shows the balloon catheter is effective in opening some sinuses, and this may prove to be less invasive for certain aspects of sinus surgery," he explained.

Even though it is performed in the operating room under general anesthesia, the new procedure is shorter, with a quicker recovery, the researchers say. Using fluoroscopic imaging, a small flexible wire is guided into the sinus. Over this guide wire, a 3-millimeter, 5-millimeter or 7-millimeter balloon is passed into the sinus cavity. Once positioned, the balloon is dilated, the catheter is removed, and the dilated opening is inspected, Levine said.

The procedure takes from 30 minutes to two hours, depending on degree of pathology and the complexity of the patient's sinus anatomy. Depending on the disease, this procedure can be combined with traditional endoscopic sinus surgery.

The multi-center landmark study analyzed six-month data from 115 patients (41 male, 74 female). Mean patient age was 47.8 years, and ranged from 21 to 76 years. Twenty-one patients (18.3 percent) had previous endoscopic sinus surgery. At 24 weeks, endoscopies showed that 82.1 percent (252 of 307 sinuses) were open. Patients showed consistent symptomatic improvement over baseline, the researchers reported.

No serious adverse events occurred, and there were no complications. Narrowing of dilated openings occurred infrequently, and revision surgery was rarely necessary, the researchers reported.
"Realistically, we know sinusitis is caused by many things -- respiratory infections, allergies. And even with the best of surgical procedures, there are always ups and downs, with the possibility for recurrence," Levine said. "The hope is that (balloon sinusotomy) will lessen disease severity and frequency and, hopefully, cure it."

Patients who are not candidates are those with nasal polyps, previous sinus surgery with severe scarring, or those with previous surgery who have new abnormal bone growth, said Levine.
In the end, people who live with the misery of chronic sinusitis now have a minimally invasive option that can preserve structure and function and allow return to normal activity faster, Levine said. He also speculated that the procedure could lower health-care costs because patients would be back to work and school sooner. "It could reduce costs in the long run, with less postoperative care compared to conventional sinusotomy," he said.

Although he is not currently trained in the procedure, Sherris said he "would be interested in trying it in minor revision sinus surgery and some sinus surgery in children."
"Longer term studies and head-to-head comparisons with standard endoscopic sinus surgery techniques will be necessary to establish the place of balloon sinuplasty in the toolbox of endoscopic sinus surgeons," Sherris said.

Because it is minimally invasive, the procedure could be "ideal for children," Levine said, noting a prospective study is under way to evaluate its feasibility in pediatric cases. The U.S. Food and Drug Administration approved the procedure for adults last year, he noted.

More information
The National Institute of Allergy and Infectious Diseases has more on sinusitis.

Children's Health

Children's Health
In this section many common questions related to children’s health are explored.

Contrary to popular belief, children are not "little adults," and the approaches to their health conditions are often markedly different than those used for grown-ups.

The rapid changes that occur during growth and development require special consideration in choosing both treatments and medications.

In some cases, specific treatments have not been well studied in children, but the majority of childhood health concerns are those that parents have been asking about for many generations, and the solutions are tried and true. Information on other childhood conditions can be found in the QA archives.

• Acupuncture
• Attention Deficit Disorder
• Asthma from Exercise
• Bedwetting
• Broken Bones
• Carsickness
• Colicky Babies
• Constipation
• Ear Infections
• Early Puberty
• Fluoride
• Food Coloring
• Head Lice
• Overweight Kids
• Sore Throat
• Teething
• Toy Safety
• Vitamins

Acupuncture
In the United States, acupuncture hasn’t often been used to treat children, mainly because youngsters tend to be afraid of needles.

But several recent studies have suggested that this fear can be overcome and that children can benefit from acupuncture treatment for certain conditions.

The latest study on this subject was conducted at the Harvard-affiliated Children’s Hospital in Boston by Yuan-Chi Lin, MD, an anesthesiologist who specializes in pain management in children. Dr. Lin’s study included 243 youngsters ranging in age from six months to 18 years who were being treated for headaches, stomachaches, back pain and other chronic complaints that often caused them to miss school.

When the study began, the young patients rated their pain as an "8" on a scale of 1 to 10. (One of Dr. Lin’s methods of demonstrating to the kids that the needles won’t hurt is by inserting them first in the children’s parents.)

When the year-long study was over, the average pain rating among the youngsters was a "3." The kids also reported missing less school, sleeping better, and being more able to participate in extracurricular activities as a result of treatment.

In an earlier study at the same hospital, 70 percent of the 47 youngsters participating reported that acupuncture helped relieve their pain and 59 percent of their parents agreed.

The conditions for which these patients were treated included migraines, endometriosis in teenage girls, and reflex sympathetic dystrophy (a syndrome in which pain becomes chronic after an injury).

In this study, 15 children were age 12 or under while 32 were between 13 and 20 years old. Other studies have looked at acupuncture as a treatment for attention deficit hyperactivity disorder and cerebral palsy in children.

While not many acupuncturists specialize in treating children, Dr. Lin estimates that about a third of pediatric pain centers nationwide now offer acupuncture to their young patients.

Acupuncture is best used for pain reduction as part of comprehensive treatment that includes relaxation techniques, clinical hypnosis and various forms of bodywork.

Attention Deficit Disorder
Ritalin, a stimulant, remains the most common treatment for Attention Deficit Disorder (ADD), also called Attention Deficit Hyperactivity Disorder (ADHD). Paradoxically, with ADHD the drug has a calming effect, apparently because it stimulates parts of the brain that regulate activity and attention.

While it can have excellent results in some cases, it is greatly over-prescribed.
There currently is no herbal treatment for ADHD, except possibly coffee, which may work like Ritalin for some patients.

Pediatrician Sandy Newmark, M.D., of Tucson, Ariz., confirms that no herbs have been found effective for treating the main or "core" symptoms of ADHD — that is, lack of focused attention that often leads to poor school performance. And he doesn’t think coffee is a good long-term solution. However, Dr. Newmark notes that herbs can help with some of the associated symptoms. For example, valerian tea can help youngsters with sleeping problems and St. John's wort can help relieve depression. For children under 12, use half the adult dosage.

Dr. Newmark does recommend a dietary supplement, omega-3 fatty acids, for all children with ADHD because levels of omega-3s in the plasma and red blood cells of children with ADHD are lower than in normal children. He also recommends that youngsters with ADHD take a quality multivitamin as well as a good probiotic, a product that contains "friendly" bacteria that can stabilize the digestive tract. You can find milk-free brands in health-food stores.

Make certain that the underlying cause of your child’s disruptive behavior really is ADHD, and that he or she isn’t acting out difficulties at home or expressing frustration with a learning disability. Be sure to rule out hearing or vision problems, allergies, depression or even boredom in a gifted child.

As far as foods are concerned, while there’s no evidence that a dietary approach helps in all cases, a 1993 Cornell University study found that eliminating dairy products, wheat, corn, yeast, soy, citrus, eggs, chocolate, peanuts, artificial colors and preservatives seemed to decrease ADHD symptoms. An even earlier study showed that a low-allergen diet supplemented with calcium, magnesium, zinc and vitamins produced favorable results.

Asthma from Exercise
Exercise can trigger asthma symptoms in children and adults – even those who don't otherwise suffer from the condition - and can aggravate the problem in up to 80 percent of those who do have asthma.

The symptoms – coughing, wheezing, shortness of breath or tightness in the chest – usually come on after exercise, although they can occur soon after exercise has begun. It can be treated with medication and by taking precautions to prevent or minimize symptoms. Here’s a rundown of medication options, provided by pediatrician John Mark, MD, an assistant professor of pediatrics at the University of Arizona who treats asthma in both adults and children.

Albuterol – A short-acting bronchodilator that’s inhaled 15 to 20 minutes prior to exercise and that protects against symptoms for about four to six hours.

Salmeterol – A long-acting bronchodilator that’s inhaled twice a day which offers protection for up to 12 hours. You can also use salmeterol as a preventive before you work out.

Montelukast (Singulair) – A drug that blocks the action of leukotrienes in the lungs, resulting in less constriction of bronchial tissue and less inflammation. Leukotrienes are one of several classes of chemical messengers produced in the body that can trigger bronchial constriction and inflammation. Montelukast is available in pill form and is taken the night before you exercise.

Cromolyn (Intal) – An anti-inflammatory drug inhaled 15 to 20 minutes before exercising that prevents the release of histamines and leukotrienes. It’s most useful in asthma when an allergic component is present.

In addition to medication, the following approaches can help prevent or minimize symptoms:
A very slow warmup. Even to the point that your child reports the beginning feelings of the "tightness" associated with exercise-induced asthma.

Then your child should stop and stretch, or slow down if exercising vigorously. By taking this break, the development of asthmatic symptoms can often be blocked and a normal pace can be resumed. This may take some getting used to, but can sometimes eliminate the need for medication.

Try breath work. The most effective approaches are pranayama techniques – breath control exercises taught in some yoga classes for adults. You can have your child do these after the initial warm-up, again, when the symptoms are almost felt. For most children, you can start with Dr. Weil’s technique for "The Relaxing Breath."

Find a form of physical activity that minimizes exercise-induced symptoms. Sports or activities that have intermittent rest periods (such as tennis, softball and golf) can allow your child to regain control of his or her breathing. Swimming may be better than running outdoors in cold weather, but no type of exercise is off-limits with proper treatment. In fact, some of the world’s top athletes have exercise-induced asthma, and they’re still able to compete successfully in Olympic-level events.

Bedwetting
Although by age 8 most youngsters have outgrown bedwetting, a sizeable minority still haven’t. As a matter of fact, 5 to 10 percent of boys still have enuresis (the medical term for bedwetting) by age 10. Enuresis tends to run in families and, when this is the case, children usually outgrow it at the same age as the parent, sibling or other relative who had the problem did.

No one knows what causes bedwetting, although it is sometimes associated with constipation. If so, simple dietary changes such as eating more fruits and vegetables and drinking more water early in the day can help resolve matters. Pediatrician Sandy Newmark, MD, of Tucson, Ariz., suggests making sure that children aren’t drinking any beverages that contain caffeine (such as some sodas) and trying to limit (within reason) the amount of fluids they drink in the evening.

Dr. Newmark explains that an "enuresis alarm" is the most simple and effective intervention for youngsters. This device is a wristwatch with a sensor that is attached to pajamas so that the alarm sounds at the first sign of wetness.

This system eventually conditions a child to wake when the bladder is full. Dr. Newmark says that the alarms work in about 70 to 80 percent of children. They are available at most drugstores and cost about $50. Be patient with this system since it can take weeks, and sometimes months, to see results.

If the alarm doesn’t help, Dr. Newmark suggests trying hypnosis as a safe and effective treatment. While some pediatricians prescribe drugs for children who wet the bed, using medication is controversial and should be viewed as a last resort. Homeopathic remedies also may be effective; consult a homeopathic practitioner if you want to try this approach.

Broken Bones
Results of a recent study at the Mayo Clinic in Rochester, Minn., suggest that the rate of wrist and forearm fractures among young girls has increased dramatically in the last 30 years. The study results, published in the Sept. 17, 2003, issue of the Journal of the American Medical Association showed that the fracture rate for young girls increased 56 percent from 1969-1971 and 1999-2001.

Boys still suffer more fractures, but the rate of increase among young boys was only 32 percent. Overall, the Mayo Clinic researchers found that the fracture rate among young people had increased 42 percent over three decades.

The researchers had no answers for why this is happening. It is unlikely that youngsters are breaking more bones because they’ve become more physically active. One possibility is that kids may not be getting enough calcium during a period when their bones are growing rapidly.

If so, their bones may never become as dense as they should, which raises the possibility that affected youngsters may be more vulnerable later in life to osteoporosis and hip and vertebral fractures.

The researchers noted that government surveys have shown a decrease in milk consumption among older girls and an increase in consumption of carbonated drinks. The phosphates in carbonated beverages interfere with calcium absorption.

The RDA for calcium is 1,300 mg for young people age 9 to 18. This translates to 4-5 servings of dairy per day, but kids don’t have to drink milk to get their calcium. Other good sources include yogurt, cheese, sea vegetables, collard and mustard greens, kale, bok choy, broccoli, canned salmon and sardines, tofu that has been coagulated with a calcium compound, calcium-fortified soy milk, fruit juice and blackstrap molasses.

Other experts have noted instances of vitamin D deficiency that could contribute to weakened bones. Our bodies make vitamin D with exposure to sunlight, and youngsters who spend too much time indoors may not produce optimal amounts of vitamin D. Spending 10 minutes in the sun without sunscreen a few days each week will do the trick, but it is not a bad idea for kids 12 and older to take a multivitamin supplement that includes 400 IU of vitamin D.

Carsickness
Carsickness, like all types of motion sickness, occurs when the brain receives conflicting signals from the inner ears, eyes, and other parts of the body that sense motion. A child sitting in the back seat of a car may sense movement – her inner ear perceives the motion – but she may not be able to see out the window to see that she is moving. At the same time, her perception is that her body isn’t moving at all. In some children, these conflicting messages can result in very distressing nausea.

One effective remedy for motion sickness comes from an old Chinese fisherman’s remedy of stimulating the acupressure points that control nausea. The updated version of this treatment is done with wristbands equipped with a plastic peg that presses on acupressure points on the inner surfaces of the wrists. The wristbands are available at most drug and health-food stores. Follow package directions carefully – proper placement of the wristbands is critical.

Motion sickness can also be prevented (and treated) with ginger. Mix a half teaspoon of ginger powder in a glass of water and give it to your child 20 minutes before you get in the car. Or give your child two capsules of powdered ginger.

This remedy has proved more effective than Dramamine – with none of the drowsiness that can occur as a side effect of the drug. Ginger snaps, ginger ale and candied ginger can all help with mild nausea, so keep some in the car should someone develop symptoms during the trip. You also could explore homeopathic remedies – and possibly hypnosis – as a long-term solution.

The American Academy of Pediatrics suggests trying to deal with carsickness in children by focusing youngsters’ attention away from their queasiness. Listen to the radio or tapes, sing or talk. Also, direct their attention at things outside the car, not at books or games. Make sure that they look out the front windows, where apparent motion of objects is less.

Colicky Babies
First, exclude other reasons for the baby’s crying. Make sure the infant isn’t running a fever, isn’t lethargic, is eating normally and isn’t having any trouble breathing. Your pediatrician will also want to exclude GERD (gastroesophageal reflux disease), which can occur among babies (although it is much more common among adults).

The good news about colic is that what you see is what you get – a fussy, crying but otherwise perfectly healthy baby. Some doctors think that this irritating phase may be part of normal development. Between 5 and 28 percent of infants develop colic between when they are two to six weeks old, and usually outgrow it by the time they’re three to four months old.

Here are Dr. Russell Greenfield’s suggestions for dealing with colic – and with the frustration it can breed among parents:

• Try massage therapy, a great way to enhance bonding between parent and child at a time when colic may be interfering with the bonding process.
• Rock your baby rhythmically.
• Turn on music or try the clothes dryer or vacuum cleaner. Sometimes the white noise they produce helps.
• Try cranial osteopathy or homeopathy; both may help and are safe forms of treatment.
• Try herbal remedies such as cooled chamomile or fennel tea. You can get tea bags at the health food store and give the baby one to two ounces at a time, no more than three to four ounces per day.
• Switch to a cow’s milk-free formula, or, if breast feeding, change the mother’s diet to affect what is entering her breast milk (in some cases, a food sensitivity may play a role).
  Swaddle your baby – it provides a nice snug feeling.
• Chill – find a way to relax; try breathing exercises or other relaxation techniques to lower your frustration level.

By the way, the latest international report on colic comes from a Canadian study that found that mothers don’t appear to sustain any lasting psychological effects as a result of dealing with a colicky infant.

Constipation
Constipation is a common problem for children and usually is temporary. Strictly speaking, a child is constipated if he or she has fewer than three bowel movements per week or if the stools are hard, dry, and unusually large or difficult to pass. Because constipation can make bowel movements painful, youngsters may try to avoid having them. (In addition, about 60 percent of constipated children experience recurrent abdominal pain, a common stress-related condition in youngsters.)

The causes of constipation in kids usually are simple and relatively easy to correct: not enough fiber in their diets, not drinking enough liquids or not getting enough exercise. Then, too, constipation can occur when youngsters ignore the urge to have a bowel movement, which they can do for reasons ranging from not wanting to take a break from playing to embarrassment at using a public bathroom or because a parent isn’t around to help when the urge occurs.

Medication can also be a factor. Those that can cause constipation include aspirin and codeine, vitamins with high doses of iron, the bismuth in Pepto-Bismol, as well as some chemotherapy agents (vincristine) and some psychiatric drugs (imipramine).

Sandy Newmark, MD, a pediatrician at the University of Arizona Program in Integrative Medicine, recommends the best ways to deal with constipation in young children, listed here:
Decrease dairy products: They can be constipating. Provide your child with an alternative source of calcium such as soy milk fortified with calcium or a calcium-fortified breakfast cereal.
Increase fluids: Encourage your child to drink lots of water.

Increase fiber: Give your child lots of high-fiber fruits and vegetables as well as high-fiber cereals, whole-grain breads and beans.

Although these measures probably will do the trick, if a child’s episodes of constipation last longer than three weeks and prevent him or her from participating in normal activities, you might want to consult a pediatrician. Don’t be tempted to administer the over-the-counter laxatives designed for children. They can be dangerous to youngsters and should be given only under the direction of a pediatrician.

Ear Infections
Recurrent ear infections can be troublesome during early childhood. Here are two strategies:
Eliminate milk and milk products from your child’s diet for at least two months. This means avoiding all dairy products as well as other foods containing milk in any form. Soy, rice, and nut milks such as almond milk are all right. The protein in milk, casein, is often associated with recurrent ear infections in early life as well as with sinus conditions, eczema, chronic bronchitis, and asthma.

Try cranial osteopathy. It is another good treatment for recurrent ear infections. When performed by a skilled practitioner, this technique can often end cycles of ear infections, sometimes with a single treatment.

The late Bob Fulford, D.O., a leading practitioner of cranial osteopathy, had great success curing recurring infections in young children. He believed that fluid stagnation in the middle ear – caused by restricted breathing – was at the root of the trouble.

Gentle manual manipulation (and sometimes application of a vibrating instrument known as a percussion hammer) opens up breathing, which in turn helps fluid drain from the middle ear. To find a practitioner of cranial osteopathy, send a self-addressed stamped envelope to the Cranial Academy, 8202 Clearvista Parkway, #9D, Indianapolis IN 46256. At the University of Arizona, researchers are now concluding a study funded by the National Institutes of Health's National Center for Complementary and Alternative Medicine on the use of both cranial therapy and Echinacea to break cycles of recurrent childhood ear infections.

Early Puberty
In the United States, there's a virtual epidemic of precocious puberty these days – the onset of puberty at very young ages in both boys and girls. Among Caucasian girls today, 1 in 7 starts to develop breasts or pubic hair before she is 8 years old. Among African-American girls, the number is 1 out of 2! Unfortunately, no one knows why this is happening, although there's plenty of speculation. Precocious puberty can be triggered by tumors in the pituitary gland, hypothalamus, ovaries, or testicles, but these cases are rare. Environmental factors are more likely to blame for the upsurge in cases today. The theory with the most scientific support is that obesity is responsible. I think this may be true, since we've long known that overweight girls mature physically earlier than thin ones.

Research also has suggested that environmental pollution may play a small role. In the spring of 2000, results of a study reported in the Journal of Pediatrics showed that boys exposed to DDE (a breakdown product of DDT) were heavier than their peers, while girls exposed to PCBs were heavier than their peers and tended to reach puberty a bit sooner, even though the actual numbers involved in the study were not deemed statistically significant. (Both DDT and PCBs are chemicals that appear to interfere with the body's own hormones.) Researchers are also looking at other environmental chemicals – among them Bisphenol A (BPA), used in manufacturing plastic – but so far haven't found a definitive link.

Unfortunately, there's not a lot to offer in terms of treatment and no natural remedy that I can suggest. Since it's occurring so often these days, some physicians believe that precocious puberty in girls between the ages of 6 and 8 should be seen as normal and not treated at all. (We do know that the risk of breast cancer later in life increases with an earlier onset of puberty.) The only approved allopathic treatments are two drugs: Gonadotropin-Releasing Hormone, GnRH, and Luteinizing Hormone-Releasing Hormone, LHRH, both given by daily injections or at intervals of every three to four weeks. These drugs interfere with the hormonal changes responsible for precocious puberty, in effect putting them on "hold" until the child reaches a more appropriate age (typically between the ages of 11 and 13 in girls). The drugs may also reverse the changes that already have taken place.

The physical changes are only one aspect of what girls must contend with as a result of precocious puberty. Because they look like young women, they're often treated as if they were much older than they are by boys (or men who should know better) and may also be teased by friends and at school. If you are a parent with a child in the midst of precocious puberty, you must keep the parent-child lines of communication open. Make sure that your child understands that despite the change in her appearance, he or she is still a child.

Fluoride
The only children who need fluoride supplements of any type are those who live in communities without fluoridated water supplies or in homes with water purifiers that remove minerals. The easiest, most efficient and most cost-effective means of making sure that children have adequate fluoride to protect against tooth decay is to support fluoridation of your area's water supply.

If your community's water is not fluoridated, your child will need dietary fluoride supplements which are available only by prescription from your dentist or physician. To protect against tooth decay, children need fluoride on a daily basis from the age of 6 months to 16 years. (Pregnant women take fluoride supplements beginning in the sixth month of gestation to ensure strong tooth development in the fetus – check with your obstetrician about this.) The correct dosage for your child must be calculated on the basis of the natural fluoride concentration of your local drinking water as well as your child's age, and the extent of his or her exposure (if any) to other sources of fluoride, such as toothpaste or commercial products.

Some fluoride is present in all water sources, but according to the American Dental Association, most bottled waters don't contain enough to prevent tooth decay. Fluoridation of community water supplies involves adjusting the fluoride content to the optimal level for dental health, 0.7 to 1.2 parts fluoride per million parts water. Too much fluoride can be bad for children's teeth, just as too little is bad. An excess of fluoride can lead to mottled, chalky, white spots on the teeth. Other health risks include weight loss, brittle bones, anemia and weakness. Be aware that there are conflicting reports that continue to fuel the controversy over fluoridation. Yet at proper levels, fluoride is of immeasurable benefit to the teeth – during childhood and throughout life.

Food Coloring
We are seeing more and more strangely colored foods and snacks, but as a precaution, keep children – and adults – away from foods with artificial colorings. The danger is that the chemicals used to create color are energetic molecules, many of which are capable of interacting with and damaging DNA. Anything that damages DNA can injure the immune system, accelerate aging, and increase the risk of cancer. Indeed, many synthetic food dyes once considered safe have turned out to be carcinogenic. Some approved for use in Europe are considered unsafe in the United States, and vice versa.

Dyes are added to foods for the convenience of the manufacturer, not for the health of the consumer. Luckily, these are among the easiest types of food additives to avoid. Try to convey to your children that garishly colored snack foods are weird and unhealthy – rather than attractive – and make it a rule not to buy them. Watch out for labels that list any of the following terms: "color added," "artificial color added," "U.S.-certified color added," or "FD&C red No. 3" (or green or blue or yellow followed by any number; these are FDA-approved food drug and cosmetic dyes).

There is nothing wrong with foods dyed with natural colors obtained from plants. The most common, annatto, is from the reddish seed of a tropical tree. It is widely used in Latin American cooking to make yellow rice and breads, and is also commonly added to butter and cheese to make them yellow or orange. Other safe food colorings are a red pigment obtained from beets, a green one from chlorella (freshwater algae), caramel, and carotene from carrots.
Definitely keep your kids away from bright green ketchup, a product designed specifically to appeal to youngsters.

Head Lice
Head lice are a common nuisance of childhood. Kids pick them up from someone who already has them by wearing each other’s hats, scarves, hair ribbons and other clothes; sharing combs, brushes or towels; or lying on a bed, couch, pillow or even cuddling a stuffed animal that belongs to a child who has lice. Try to discourage this kind of sharing, particularly if you hear that there’s an infestation at school, at a day care center, or wherever your children spend time.

The conventional treatment is one-percent lindane, sold as Kwell lotion. Yet lindane is a cousin of DDT and can harm the nervous system. Natural and safer alternatives include one-percent permethrin cream rinse, sold as Nix and Neem, which is derived from a tree in India. Lice can develop resistance to permethrin products, and they can aggravate asthma in some children, but both are relatively nontoxic. (Neem is sold in garden shops.)

Some California school systems are using a new product called Lice B Gone, a non-toxic, multi-enzyme shampoo made from plant sources that seems to get rid of lice in a single application. It works by softening the glue that holds the nits (lice eggs) to the hair shaft and also dissolves the exoskeletons of adult lice. Since it contains no pesticides, Lice B Gone is considered safe for pregnant women, nursing mothers, young children and people with asthma.

Overweight Kids
You'll probably be happy to hear that not all children who are heavy grow up to be overweight adults. However, we do have an epidemic of childhood obesity in the U.S., and all parents should be aware that for every year that a child remains overweight, his or her chances of growing into an overweight adult increase.

Aside from eliminating sodas or junk food at home, look to physical activity as a way to help your child lose weight. Try for at least half an hour of physical activity each day. Unfortunately, only 25 percent of school-aged children now take physical education classes. If your child doesn't get any exercise at school, it's up to you to make sure he or she does some type of physical activity at home.

Here are some approaches to add exercise to your child's life as well as foods that will help control his or her weight:
Curb screen time. Limit the time your child spends watching television, sitting at the computer or playing video games.
Set a good example. Studies have found that children are more likely to be physically active if their parents and siblings are active, and if they're encouraged to take part in physical activities. Take family walks, hikes or bike rides on a daily basis, if possible.
Emphasize nutritious foods. Don't limit the amount your child eats, but make sure the foods he does eat are low in fat and high in fiber. When making these changes, say that you're doing it for the entire family to avoid drawing attention to your child's need to lose weight.
Eat meals together. Family breakfasts and dinners give you more control over what your child eats and allow you to make sure that everyone gets at least two nutritious meals per day.
Think about drinks. Cut back on fruit juices, sodas and whole milk. Drinks can provide a surprisingly large number of calories per day.
Teach a relaxation technique. If your child eats in response to stress, you might show him how a relaxation technique such as deep breathing can help to calm him.

Sore Throat
The most important thing parents can do when children develop sore throats is to make sure that the problem isn’t strep, a bacterial infection that requires antibiotic treatment. Strep is diagnosed via a throat culture. (Or a rapid strep test, which takes only 10 minutes but is not as accurate.) While the results may not be available for a few days, a doctor often can tell on the basis of observation whether strep is the likely problem and begin immediate treatment with penicillin. The sore throat usually eases in 24 to 48 hours.
Besides a very sore throat, symptoms of strep often include fever, swollen and tender lymph glands under the jaw, and a swollen and marked redness at the back of the throat that may have white dots. Those symptoms don’t always mean strep, but they often do. (Another clue: suspect strep when there are none of the typical symptoms of a viral infection such as a cough, runny nose, hoarseness and eye irritation.)
It is very important to treat strep throat with antibiotics as soon as possible, because in rare cases it can lead to an autoimmune reaction – rheumatic fever – that can affect the joints, heart and kidneys.
To reduce your child’s susceptibility to sore throat, try to build up his or her immune system by administering a course of the Chinese herb astragalus (Astragalus membranaceous) during cold and flu season. You can get astragalus in tincture form or in capsules at the health-food store. Administer one half the adult dose. This herb is safe for regular use.
If your child can gargle, give her a mixture of half hot water and half hydrogen peroxide to use several times a day. Gargling with warm salt water (one-quarter teaspoon salt to one cup of warm water) is also soothing.

Teething
In many infants, the process of teething is painless, causing only some increased drooling and a desire to chew. However, some infants develop tender, swollen gums, may not sleep or eat well, and may run a low fever (under 100 degrees). A fever above 100 degrees or diarrhea suggests problems unrelated to teething.
Here are some recommendations to keep a teething baby comfortable:
Wipe the drool off your baby’s face with a soft cloth (to prevent rashes).
Rub the baby’s gums with a clean finger.
Let your baby chew on a wet washcloth that has been placed in the freezer for 30 minutes (wash it after each use). Alternatively, use a cool spoon or rubber teething ring (take it out of the freezer before it gets so hard that it bruises the tender gums).
Never tie a teething ring around a baby’s neck – it could get caught on something and strangle the child.
Homeopathic teething tablets are a good option. Many parents tell me they have used them successfully to relieve the minor discomforts of teething in their babies.

Toy Safety
Look over the toys you have at home to see if they are age-appropriate for your children. In general, this means making sure they aren't too advanced for the youngest child, but sufficiently sophisticated for the older ones. Homes with infants or toddlers should make sure all toys (and their removable parts) are large enough so they can't be put into a child's mouth and become a choking hazard. (An easy test: A child can choke on any object that fits inside the tube from a roll of toilet paper.)
Parents or grandparents should also be aware that over the last two years toy manufacturers have recalled teethers, rattles, and other products that contain a cancer-causing chemical called diisononyl phthalate (DINP) from the market. Phthalates are used to soften plastics, but high doses have been linked to cancer in mice and rats. The U.S. Consumer Product Safety Commission has said the amounts that might have been ingested by small children are not high enough to pose a risk, but it does make sense to toss any soft plastic rattles and teethers that you’ve had more than a year – that's when most toy manufacturers agreed to phase out use of the additive.
The following guidelines for toy safety are from the American Academy of Pediatrics and the Consumer Products Safety Commission:
Check the surface and edges of wooden toys. Sandpaper sharp corners and splinters.
Don't give hobby kits, such as chemistry sets, to children younger than 12.
Don't permit children to play with adult darts or other hobby or sporting equipment that have sharp points.
Examine all outdoor toys regularly for rust or weak parts that could become hazardous.
Discard all plastic wrappings on toys before they become deadly playthings.
New toys intended for children under age 8 should be free of glass and metal edges.
Toys with long strings or cords may be dangerous around infants and very young children. Never hang toys with long strings, cords, loops, or ribbons in cribs or playpens where children can become entangled.
Keep toys designed for older children out of the hands of little ones.

Vitamins
Yes, children should take vitamins, mostly because so many kids don’t eat enough fruits and vegetables, and because their diets are often full of processed and refined foods. However, vitamin supplements shouldn’t be substitutes for whole foods, especially fruits and vegetables.
Teach children of any age to enjoy healthy food by involving them in its preparation, even if they’re only in the kitchen to observe. In "The Healthy Kitchen," Rosie Daley and I give a number of ideas for recipes and snacks that kids will like. Also, try to discourage your children from eating too much fast food, processed food, sugar and caffeine (in cola and other soft drinks). There’s no harm in the occasional ice cream, pizza or candy bar in the context of a well-balanced diet, but try to encourage snacking on healthier foods – fresh or dried fruit; a small handful of raw, unsalted nuts such as cashews and walnuts; a piece of flavorful, natural cheese; or a piece of dark chocolate.
As far as supplements are concerned, give children a complete antioxidant formula as well as multiminerals. Be sure to keep the vitamins out of the reach of young children – some supplements for kids taste and look like candy and there is a danger of overdosing, especially when supplements contain iron.

Andrew Weil, M.D.–Author of:
Eight Weeks to Optimum Health
Spontaneous Healing
The Natural Mind
The Marriage of the Sun and Moon
Health and Healing
Natural Health, Natural Medicine
From Chocolate to Morphine (with Winifred Rosen)