Asthma risk for babies

  • Health
  • Sunday, 19 Jan 2003

New research shows that children who go to bed with a bottle have a greater risk of wheezing episodes, which may contribute to asthma.  

PUTTING a baby to bed with a bottle increases the risk of wheezing, which may persist throughout early childhood and contribute to asthma, new research shows. Infants with a family history of allergies appear to be especially vulnerable.  

Nearly 500 children whose parents had asthma or allergies were followed for five years as part of an ongoing study on home allergens and asthma led by Dr Diane Gold of Brigham and Women’s Hospital in Boston. During the first two years, parents reported every two months how often their babies were bottle-fed in bed before sleep. The parents also kept track of episodes of wheezing and asthma during that time and for the next three years.  

Children who went to bed with a bottle more than three times in their first year had 50% greater risk of wheezing episodes from ages one to five than children who went to sleep without one.  

The wheezing may be triggered by irritation in the airways, because formula or milk can flow into them when the infant is lying flat. Tiny amounts of liquid also can be inhaled and cause spasms in the airways.  

Lead author Dr Juan C. Celedon, a researcher at Brigham and Women’s Hospital, said children should not be bottle-fed large amounts of liquid just before bedtime, and should not be put to bed on their backs immediately after feeding.  

The study was published in the December issue of the Journal of the American Academy of Pediatrics.  


Older devices more accurate  

IT’S not unusual for blood pressure to soar at the doctor’s office, but so-called “white coat hypertension” is not necessarily a sign of nervousness. The reason for an unusually high – or low – blood pressure reading may be as simple as a damaged blood pressure device.  

Frequently used dial-recording and digital units are not as reliable as the old-fashioned, mercury-gauged cuffs and are easily damaged, some experts say. The non-mercury devices can be as much as 50 (diastolic or systolic) points off, says Daniel W. Jones, co-chairman of a recent meeting on blood pressure measurement at the US National Institutes of Health.  

He and other experts are concerned that dial and digital cuffs are not being regularly checked against mercury-gauged ones. Mercury-gauged blood pressure devices are less commonly used because of concerns about proper mercury disposal should the glass that contains the toxic substance break. But Jones says every doctor’s office and hospital should have at least one on hand to use as a check for the dial and digital devices.  

The panel of 23 experts recommended, among other things, that research be done to determine if a system for using mercury devices for calibration purposes could be implemented.  


Mountain trekking  

may trigger asthma  

ASTHMA and adventure travel may not be a good mix, according to Israeli and U.S. researchers.  

The team evaluated 203 patients with asthma before and after adventure trips, including 147 who went on a high-altitude trek. Eighty-eight of the travelers reported asthma attacks; more than three-quarters of those who had attacks were high-altitude trekkers. About half the travelers who suffered an attack said their asthma worsened during the trip, and 32 said they had the worst attack of their life on the trip. Eleven classified the attack as life-threatening.  

Those who trekked and exerted themselves intensely were more likely to have had an attack. Those who used their inhalers three times a week or more before the trip were also more likely to have had attacks during travel.  

A frequent need to use the bronchodilator shows that the asthma is not well controlled, says Yoav Golan, an assistant professor of infectious diseases at Tufts University School of Medicine in Boston and one of the authors of the study, published Nov. 25 in the Archives of Internal Medicine.  

Those travelers who used the bronchodilators frequently and exerted themselves while trekking were even more likely to have had an asthma attack.  

“People with asthma should make sure their asthma is optimally controlled, especially if they are going to trek,” Golan says. “Many who trek don’t exercise regularly at home.” High altitude can complicate the situation. If necessary, treatment should be intensified before a trip. Trekking should be discouraged until the asthma is under control. – LAT-WP 

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