House CallFeb/Mar 2009 Issue

Medical News: Toddlers with Allergies, Tylenol, Asthma, And More!

Toddlers with Allergies

The Eyes Have It
The gaze of normally developing toddlers tends to be on the eyes of other people. But two year olds with autism focus more on the mouths, according to researchers at Yale University’s School of Medicine. Scientists there used novel eye-tracking technology to follow the visual fixations of toddlers. They monitored the toddlers’ eye movements as caregivers approached them and interacted by playing peek-a-boo, for example.

The research team found that the less the youngsters focused on the eyes, the higher their level of disability. Toddlers with autism focused on eyes less than 10 percent of the time and close to 60 percent of the time on the mouth. Typically developing toddlers spent more than 60 percent of the time focused on the eyes and only about 20 percent on the mouth.

Researchers hypothesize that children who fix more on mouths and lip movements may be seeing faces in terms of their physical attributes, rather than as partners in a social interaction. Looking into the eyes of others is important to social development—and social engagement throughout life, researchers say. The findings might lead to new ways to screen for and diagnose autism and to quantify its severity. The investigators are using the eye-tracking technology to do additional studies. In one study, they are working with infant siblings of kids with autism, who have increased risk of developing it.  

The work was published in the Archives of General Psychiatry.

Tylenol and Allergic Symptoms
Acetaminophen, the active ingredient in over-the-counter analgesic Tylenol, is linked to a higher risk of asthma, conjunctivitis and eczema in young children, according to research from the Medical Research Institute of New Zealand.

Giving infants acetaminophen (also called paracetamol) for fever during their first year of life was associated with a 46 percent increase in risk of developing asthma by ages 6 and 7. Current use was also associated with an increased asthma risk in children of the same age. First-year and current use of acetaminophen upped the risk of allergic conjunctivitis and eczema, too.

Researchers caution that the findings don’t prove a causative relationship, nor do they constitute a reason to stop using the drug in children.

“Paracetamol remains the preferred drug to relieve pain and fever in children,” says lead researcher and professor Richard Beasley. “However the findings do lend support to the current guidelines of the World Health Organization, which recommend that paracetamol should not be used routinely, but should be reserved for children with a high fever (101.3 degrees or above).”

Researchers also stress that acetaminophen is the preferred drug for pain relief or fever in children—and adults—with asthma, since aspirin and non-steroidal anti-inflammatories can trigger asthma attacks.   

The work, part of the International Study of Asthma and Allergies in Childhood, included data from more than 200,000 children in 31 countries. The research was published in The Lancet in a special issue on asthma.  


Gender Differences in Autism
A study of some 600 “high functioning” children with autism spectrum disorders found that girls with mild autism are less likely to be identified and diagnosed than boys. The children were seen at communications disorders and child psychiatry clinics in the United Kingdom and Finland. The findings were presented at a meeting of the Royal College of Psychiatrists’ Faculty of Child and Adolescent Psychiatry in Liverpool.

Investigators found that girls with ASD showed significantly fewer stereotypical and repetitive behaviors than boys. When the girls did evidence ASD-related behaviors, those behaviors were different from those of boys. Girls were more likely to have obsessive interests related to people and relationships, traits less likely to surface during standard ASD screening questionnaires. The study underscores the need for more research into gender differences in ASD.


Young Bones and the
Gluten-Free Diet

Untreated celiac disease in children can cause bone problems, including osteopenia, or the loss of bone density. Now researchers in Trieste, Italy, have found that problems with calcium metabolism and bone defects in children under 9 years old who have celiac disease resolve within six months of starting a gluten-free diet.

The findings suggest that, in children diagnosed with celiac before adolescence, studies of bone metabolism are unnecessary. The authors believe this can simplify management of patients with celiac for doctors, who could instead help motivate their patients to comply with a gluten-free diet.

Bone density may not be restored in newly diagnosed adults, however, because of their longer exposure to gluten. The research was published in the Journal of Pediatrics.  


Better Diet, Lower Asthma Risk?

Many studies have explored a link between diet and asthma but results have been inconclusive or shown links only with individual foods. Now researchers in Spain and Mexico have found that eating a Mediterranean diet seems to reduce kids’ risk of developing asthma and allergic rhinitis.

The Mediterranean diet is heavy in fruits, vegetables, whole grains, beans and nuts; it is light on high-fat dairy products, red meat, junk food and saturated fat. The research team collected information about the diets of almost 1,500 children in Mexico over the
previous 12 months, as well as data about mothers’ eating habits during pregnancy.
Results showed that a Mediterranean-style diet was linked to lower odds of having a history of asthma, wheezing, allergic rhinitis and sneezing. Children who ate more junk food and fat had a higher risk of asthma and allergy symptoms. The investigators found no relationship between the mother’s diet during pregnancy and asthma risk, however.

The results warrant further research, the authors say, but the study, published in Allergy, suggests another benefit to eating a healthy diet in childhood. LW

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