Baby 411 Blog

Infant cough and cold med recall

The major manufacturers of infant cough and cold preparations have voluntarily recalled 14 products from the market today, saying that there is too much risk of misuse or overdose of these products. They should be applauded for being proactive on this one.

This comes shortly before the Food and Drug Administration is scheduled to release a report next week about their investigation on these over the counter preparations.

The FDA was alerted to potential for overdose by the City of Baltimore Health Commissioner, who identified four children under three years of age whose cause of death was accidental overdose of cough and cold products.

As we all know, these products say "consult a physician" instead of offering a dosing guideline. Parents may then try to guess-timate what is the correct dose. To add to the confusion, some products are used to treat multiple symptoms and thus, contain two or even three different medications. If a parent then gives another medication, like a decongestant, the child may be accidentally be getting double doses of one product.

I, like most of my pediatrician colleagues, have never recommended these cough and cold remedies anyway. They have marginal benefit in relieving symptoms of the common cold or flu and don't make the disease go away any faster. And, clearly the risk outweighs the benefit.

I still recommend using saline nose drops (you can';t overdose on those!), a humidifier, and lots of TLC from Mom and Dad.

Toy Recalls: Get the lead out!

Yes, first it was a toxic Thomas and dangerous Dora, now its bad Batman.

As you may have heard, there was another major toy recall for toys manufactured in China. Today’s alert instructs families to throw away some 9 million Mattel toys due to loose magnets and lead paint:

http://www.cpsc.gov/ (click on Recent Recalls)

Given recent events, we thought we’d get you up to speed on lead and our suggestions for how keep your kids safe.

Q. What is the problem with lead anyway?

A. Lead is a metallic element which is a known neurologic toxin. When it became apparent that lead could cause significant harmful effects in humans, even at low levels of exposure, it was removed from gasoline and paints in the 1970’s.

Blood levels of 10 micrograms/dl or more are considered toxic and may have adverse health effects. Kids under six years of age are most sensitive because the lead can impact the developing brain.

Most children do not have any symptoms when they are diagnosed with mildly elevated blood lead levels. However, potential effects include developmental delays, loss of developmental milestones (especially in language skills), and learning difficulties. More serious health consequences are also possible, especially with higher toxicity levels and chronic exposure.

Q. How can my child be exposed to lead in the environment?

A. The most significant exposure risk is in children who live in homes built before 1978. Lead paint dust can be ingested by young children, especially when they spend time crawling on the floor and putting their hands in their mouths. Lead water pipes can also be a source of exposure.

Lead continues to be used in products (paint, pottery glaze, cooking products, pigment in cosmetics, crayons, paints, medications) throughout the world, particularly in developing countries. And, when these products are imported into the U.S, we may be exposed to them.

Q. What should I do if my child has toys that are recalled?

A. Odds are, your child has not had a significant lead exposure even if you have more than one of the toys lying around your playroom. It’s a little more concerning if your child was using one of these toys as a teething toy or really enjoys exploring toys with his mouth.

It’s probably wise to bring up your concerns with your child’s doctor, and get a blood lead level drawn depending on your child’s possible risk of exposure. If your child’s blood lead level is less than 10 micrograms/dL, toss out the recalled toys and call it a day.

Plastic Baby Bottles: Are they safe?

Breaking news: Experts cite “concern” over polycarbonate baby bottles

Are certain plastic baby bottles dangerous? Readers of our new 3rd edition (out in stores now) may remember our discussion of the safety of polycarbonate baby bottles—and how a federal panel studying the issue was about to weigh in on the issue.

Well, the results are in. Here’s the scoop:

An independent review panel assigned by the National Institute of Environmental Health Sciences and the National Toxicology Program weighed in on the toxic plastics debate last week. Their conclusion: they have “some concerns” about chemical used to make polycarbonate bottles, Bisphenol A (BPA), potentially causing neurologic and behavioral problems in fetuses, infants, and children.

What does that mean for your baby and those baby bottles and sippy cups sitting in your kitchen? Here are the most common questions parents are asking, and our answers based on what we know.


Q. What the heck is BPA? Why is it dangerous?

Clear plastic baby bottles (as well as some food containers and water bottles) are made of polycarbonate, which contains a chemical called Bisphenol A (BPA). It is the BPA that makes the hard, clear plastic bottles . . . well, hard and clear.

Here’s the rub: BPA’s chemical bond with polycarbonate breaks down over time—especially with repeated washings or heating of the bottle. As a result, BPA may leach out of the plastic bottle or sippy cup . . . and into the liquid (that is, breast milk or formula). BPA has been used since the 1950’s in a variety of products and we know that humans ingest (and eliminate) small amounts of this substance on a daily basis considering 95% of humans studied have it in their urine.

While most data BPA comes from animal research, studies show even low-level BPA MAY be linked to everything from early puberty to breast cancer, to attention and developmental problems. It’s hard to say that humans will have the same health consequences, but there is certainly enough concern that it deserves investigating the effects on humans.

The Environmental Protection Agency has set an “acceptable” or “safe” level of daily BPA exposure to be 50 micrograms per body kilogram per day. However, some scientists worry that humans may be exposed to up to ten times that daily dose.

We wrote a detailed article on BPA and plastic baby bottles in our newly revised 3rd edition of Baby 411. It is available online at our website:

http://www.windsorpeak.com/baby411/bpa.html

Q. Do we really know that these bottles are dangerous to humans?

No, we don’t. There have been no human studies on BPA—so far, researchers have only found problems in animal research.

There is a split opinion here among scientists. The same federal panel that said it had “some concern” about behavioral and developmental problems in babies also stated that links to other ailments like birth defects and adult ailments were “negligible.”

That contrasts to the group of 38 scientists who last week called the threat from BPA as “significant.”

But the fact the federal panel said there were some concerns for the health of babies tipped the balance for us.

As a parent, we realize it can be hard to decide what to do when the debate is so heated. As always, our mantra is “show us the science.” We believe enough science is now in to recommend a change in course.

Q. Isn’t it a bit alarmist to say stop using these bottles?

The truth is we won’t know for YEARS if there is a human health problem. And, it could be YEARS more before the government decides to take some regulatory action.

Our opinion: if concerns exist today (and that is backed up by reputable scientific research), then why not try to limit your baby’s exposure to this chemical?

We suggest stop using polycarbonate baby bottles and sippy cups now. Since there are quite a few BPA-free bottles on the market (see below), we believe this is an easy call for parents.

Q. The Juvenile Products Manufacturer’s Association said plastic baby bottles are safe.

In a recent statement, the JPMA said the federal panels report on BPA “reaffirms the safety of plastic baby bottles.”

With all due respect to the fine folks at the JPMA, we’re not sure they were reading the same report we did. If they did, they would note this sentence: “The Expert Panel expressed some concern that Exposure to BPA causes neural and behavioral effects.”

Click here to read it:

http://cerhr.niehs.nih.gov/chemicals/bisphenol/draftBPA_MtgSumm080807.pdf

We realize you can argue that the panel didn’t call for the ban of products with BPA. But, that’s NOT what the panel was asked to do. It will now take years of debate among scientists, researchers and politicians as to the best course to take with BPA.

For the record, Avent told us they believe their bottles are safe and pose no health threat to babies.

Q. Which bottles should we NOT use? Which ones are BPA-free?

Polycarbonate baby bottles make up about 90% of the bottle market. The most common polycarbonate bottle is Avent’s Natural Feeding Bottle and Dr. Brown’s Natural flow. But other major baby product companies like Playtex and Gerber also make polycarbonate bottles.

See our website at baby411.com for pictures of bottles containing BPA:

http://www.windsorpeak.com/babybargains/BPAbottles.html

Here are the alternatives that are BPA-free:

• Use glass bottles. Obviously, there is a risk of injury to baby or mom if the bottle is dropped, so glass isn’t a perfect alternative.

• Use bottles made of opaque plastic. These bottles (made of polyethylene or polypropylene) do not contain BPA.

• Consider a BPA-free plastic bottle. Born Free makes a BPA-free clear plastic bottle (Newbornfree.com) sold at Whole Foods. But these cost about $10 each, twice the price of Avent bottles.

• Use a drop-in system. For example the Playtex Drop-in System is BPA free (that is, the bottle liners do not contain BPA). Avent’s Tempo liners are another example.

Pictures of BPA-free bottles are here:

http://www.windsorpeak.com/babybargains/BPAFREEbottles.html


Q. Is there a way to tell if a bottle has BPA?

A. Unfortunately, it isn’t easy. Here’s a general guide:

BAD:
• Bottles that have a #7 on their recycling label most likely are made of polycarbonate (and contain BPA).

GOOD:
• Bottles that have a #2, #4 , #5 are made of polyethylene or polypropylene—these do NOT have BPA.

We call on the government to require disclosure of which bottles have BPA, so consumers can make an informed choice.

Q. What about sippy cups?

A. Basically, the same advice applies: avoid those made of polycarbonate. Sippy cups made of opaque plastic are fine.

Q. What about breast-pump collection bottles?

A. Again, avoid polycarbonate bottles (Avent Isis is an example) and choose BPA-free options. For example, all of Medela’s bottles are made from BPA-free plastics.

Q. I just bought $50 worth of Avent bottles. Are you saying I should throw them out?

A. Yes. We realize this in an inconvenience—but if you think about it, buying replacement bottles would run only $50 to $100. When it comes to safety, we think this is a worthwhile investment.

What if you don’t want to give up your polycarbonate bottles? While we don’t recommend that option, to lower the amount of BPA that may leach out, avoid heating the bottles in a dishwasher, microwave, or sterilizer. And, toss out any baby bottles that are cracked. Again, we believe the safest course is to replace the bottles with BPA-free alternatives.

Cough and cold meds: BEWARE

The Centers for Disease Control is investigating the deaths of three babies under six months of age who died after taking cough and cold medication.

According to the CDC, “because of the risks for toxicity, absence of dosing recommendations, and limited published evidence of effectiveness of these medications in children aged <2 years, parents and other caregivers should not administer cough and cold medications to children in this age group with-out first consulting health-care provider and should follow the provider’s instructions precisely.”

Bottom line: Cough and cold remedies don’t work that well and in some cases, may be dangerous to young children. Don't guess-timate the right dose of a cough and cold product made for kids over six years of age. And, multi-symptom products or using a combo of over-the-counter and prescription products may inadvertently cause an overdose. For a majority of viral respiratory illnesses, the best remedy is time.