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Myth Busting | Can Vicks VapoRub on the Feet Shorten A Baby’s Cold?

By January 5, 2017 1 Comment
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My nine-month-old has her first cold and I can’t stand to see her like this! I asked my mom for advice and she told me to cover [my daughter’s] feet in Vicks VapoRub at night and then put socks on her. She said she used to do this with me and my cold would be gone in the morning. For the record I don’t remember her doing this to me EVER, and I feel like this is something I would remember. I know that I’m not supposed to give [my daughter] cough syrup, but is this the same thing? I don’t even know how this is supposed to work.
– Ashley, via Facebook

This is something I’d never heard of before I became a parent, however, once my son had his first cold I heard from many, many mothers that I should put Vicks VapoRub on his feet at night to shorten his cold. I never tried this with my kids (or on myself) for a few reasons, but to be honest, I’ve never actually investigated whether or not this trick could work or is safe.

Before we get into whether or not putting Vicks on your baby’s feet could vanquish their cold, we need to get some safety issues out of the way first.

Vicks VapoRub is manufactured by Procter and Gamble, so I spoke first with spokesperson Velvet Gogol Bennett about the safety of using Vicks VapoRub on an infant’s feet, which isn’t recommended on the product’s label. “We recommend Vicks VapoRub be used according to package instructions, which is to rub a thick layer on the throat and chest for cough suppression in adults and children 2 years and over. [Vicks VapoRub] should not be used in children under 2 years of age.”

While there is a version of Vicks marketed for use on children over three months of age, both the U.S. Food and Drug Administration (FDA) and the American Academy of Pediatrics (AAP) strongly advise against the use of any cough or cold medication for children under the age of six. While Vicks VapoRub isn’t ingested, there is some evidence that in it’s traditional form it can increase mucous production in the throat of infants as well as cause skin irritation. Before you use any OTC medication on your child it’s always a good idea to call your child’s doctor and double check with them first.

Now that we know that using traditional Vicks VapoRub on a nine-month-old’s feet isn’t recommended by Procter and Gamble, the FDA or the AAP, let’s talk about older kids and if using Vicks on can actually shorten the duration of a cold.

“Using Vicks VapoRub on the feet may distract a child from their symptoms, but there’s no way for it to be more effective if applied there,” says pediatrician Dr. Clay Jones.  He says that the symptom relief benefits of Vicks comes from breathing in the vapors, and the feet are, obviously, further away from the nose than the chest and neck, where Vicks is supposed to be applied.

So what’s up with putting it on the feet?

“If you think about it, it feels good to have a foot massage, it’s relaxing, which may be where the perceived benefit is coming from, but it’s not from the product itself [Vicks VapoRub] or using it on the feet instead of on the chest as directed. You’d probably get the same effect if you used petroleum jelly or hand lotion to give your sick child a foot massage.”

While Dr. Jones says he advises parents of children in his practice against using any cough and cold medications, he says that cold symptoms can improve and worsen again on their own. “Cold symptoms are subjective, from one day to the next parents can’t (and shouldn’t try to) measure how much mucous their child’s runny nose produces, or where their child’s sore throat is on the Wong-Barker scale.  Sometimes a child’s symptoms actually improve as a part of the course of the virus and if we’ve tried a new treatment we can inaccurately attribute that improvement to the treatment.  And sometimes we think their symptoms are improving because we expect to see an improvement because of something we’ve done, when they’re actually the same as they were before.”

He notes that camphor, one of the ingredients in Vicks VapoRub can be toxic if ingested so it’s important to keep the product out of reach of children and that includes socks slathered in Vicks VapoRub soaked socks, if your child is prone to putting things in their mouth.

“No matter where Vicks VapoRub is applied, there’s no way for it to shorten the duration of a cold,” says Pediatric Allergist and Immunologist Dr. David Stukus. He says that despite many attempts, there’s still no cure for the common cold. “Over the counter cough and cold medications do not shorten the duration of an illness, they only provide temporary symptom relief. Colds are caused by viruses and all of the symptoms we experience as the result of a cold (coughing, stuffy nose, sore throat) are all caused by our immune system’s response to that virus. Cold medications can make us feel better by relieving those symptoms, but they don’t do anything to shorten the duration of the illness.”

According to the experts it you can save your money on additional tubs of Vicks VapoRub this cold and flu season. A safer way to get the same result as the Vicks on the feet myth would be to give your baby a gentle foot massage before bed and then slip some comfy socks on her.  And who doesn’t love a good foot rub?

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Categories: Infectious Disease + Vaccines, Newborns + Infants, Science 101 + Mythbusting, Toddlers + Preschoolers

Shorties: Is Merck Testing the HPV Vaccine on Babies?

By December 5, 2016 1 Comment
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qA store that I follow [on Facebook] just shared this article. [The article states that Merck — the company that manufactures Gardasil — will soon “push” all infants in the US to receive the HPV vaccine and is currently testing the vaccine on infants.] It seems highly unlikely to me that this is true, but all my quick Google search turns up are from similar sites whose information is just as suspect. I was wondering if you could shed some light on this.
– Bonney, via Facebook

I was skeptical of this claim as well, however, after a little digging it turns out there is a kernel of truth at the center of this claim, but it has been grossly misrepresented in the article you read.

There is a clinical trial out of the National Institute of Child Health in Budapest, Hungary that is investigating the efficacy of using the 4-valent HPV vaccine to treat children between the ages of one and 17 with juvenile-onset recurrent respiratory papillomatosis (JoRRP). If you haven’t heard of JoRRP before that’s because it’s not all that common in North America, however, it is rather severe for those children who do have it. Children with JoRRP develop warts in their airway. These warts restrict or block their ability to breathe, and the nature of the warts makes it difficult to reopen their airways.

The warts that cause JoRRP are caused by the same strains of HPV that also cause cervical cancer. Children with JoRRP likely acquire the virus from their mother during the labor and delivery process. Children born to younger mothers with lower levels of education and income are disproportionately more likely to develop JoRRP than the general population. Hungary has one of the highest rates of teen motherhood in the European Union, which is likely why the study is being carried out there.

To be included in the Hungary study a child must meet certain parameters. The study is specifically closed to children that are otherwise healthy. To be included in the study, an ear nose and throat (ENT) doctor must confirm a child’s JORRP diagnosis. The child must also have experienced at least three episodes wherein the warts inhibited their ability to breathe, and have blood work that falls within the parameters set out by the researchers.

Unfortunately it looks like the author of the article you sent misread or misunderstood the age range parameters in the clinical trial. Newborns and infants are specifically excluded from the Hungary trial, however the study is open to toddlers. The misunderstanding seems to come from this paragraph:

“After an initial immunological and ear-nose-throat (ENT) assessment, children with at least 3 relapses in their patient history will be vaccinated with the 4-valent HPV vaccine according to the following schedule: 0., 2., 6. months. It will be followed by an immunological and 3 ENT examinations to assess response to vaccination … 3. Follow-up: 1 month after 3rd vaccine dose – immunological assessment (same tests as in the enrollment phase) 6, 12 and 18 months after the 3rd vaccine dose – ENT + oesophagoscopy”.

What this means is that children will receive the 4-valent vaccine upon being screened into the study (this is zero months), they will receive their second dose two months after their first dose and the final dose will be received six months after their first dose. Once the children have received their last dose of the vaccine the researchers will follow up with them after one month, six months, 12 months and 18 months.

So if this is all happening in Hungary where rates of JoRRP are higher, why is this clinical trial listed on the NIH’s website?  It likely has to do with Merck’s involvement.  Merck is listed as a collaborator on the trial, and the arm of Merck that’s involved is headquartered in New Jersey.  This is likely what required them to get approval through NIH for the trial, even though the primary investigator, recruitment and subjects are all based in Hungary.  It’s also a little misleading for the article to claim that Merck is conducting the trial, when the primary investigator is listed Dr. Zsofia Meszner of the National Institute for Child Health in Hungary.  Merck’s role in the study isn’t clear yet, however, it may be as simple as providing the investigators with the vaccines needed for the study.

Merck’s role in the study will become clearer when the results are published.  The primary data collection phase is set to end in January 2017, so it may be a little while before we see the publication of the results.

As we say frequently on this site, a single study does not science make.  To say that this single study in a highly specific population in Hungary means that Merck will soon “push” the HPV series on all infants in the US is a huge leap in logic and there’s no evidence to back it up.

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Categories: Infectious Disease + Vaccines, Science 101 + Mythbusting

The FDA Answers Your Questions About Hyland’s Teething Tablet Advisory

By November 8, 2016 No Comments
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A little over a month ago the United States Food and Drug Administration (FDA) issued an advisory to parents to stop using and immediately dispose of any homeopathic teething aides or gels they may have in their homes or may be using.  The most popular of the brands that falls under this umbrella are Hylands Teething Tablets.

We received a number of questions from readers about the recall, and while we were able to independently find several references in the medical literature of seizures and death resulting from belladonna poisoning as a result of using the tablets as directed, the FDA’s advisory left many parents with questions.  We’ve covered the issues with products marketed as homeopathic remedies previously, but like others we needed more information about what specifically prompted the FDA’s advisory about Hyland’s Teething Tablets.  For that we reached out to the FDA directly.  We spoke with Lyndsay Meyer who works in communications at the FDA and also happens to be the mother of a four-year-old boy.

Due to the nature of the FDA’s investigation, which is ongoing, Lyndsay was limited in what information she could provide.

Can you provide a little more information about what prompted the September 30 advisory?
On Sept. 9, the FDA received a comprehensive report of a recent adverse event of a child having a seizure associated with use of a homeopathic teething product, which triggered an agency investigation.

At this time, the FDA is still conducting our investigation, and we have not yet completed the analyses of products to determine if there is an association between the adverse events and the homeopathic teething products.

It is important to note that while adverse event reports give us some information about a product and serious injuries or deaths related to use of a particular product, they often indicate situations that require additional analysis and do not constitute conclusive evidence of a problem with the product. Sometimes after further analysis, the adverse events may inform agency decisions to take regulatory action. Other times, further analysis shows that the adverse events were not attributable to a problem with the product but to other factors, such as a patient’s underlying health conditions. It also is important to note that the number of adverse events identified may fluctuate with our growing understanding of an issue, as well as through identification and elimination of duplicate reports.

The FDA’s September 30 advisory didn’t offer much information about the nature, frequency and severity of the adverse events associated with the use of the teething tablets, what symptoms should parents be aware of?
The FDA issued the warning following this report and because further examination showed more than 400 reports of adverse events associated with homeopathic teething products in the last six years. These adverse events included  seizure, death, fever, shortness of breath, lethargy, constipation, vomiting, sleepiness, tremor, agitation, and irritability.

We are also aware of reports of 10 deaths during [the time period reviewed in the report] that reference homeopathic teething products, though the relationship of these deaths to the homeopathic teething products has not yet been determined and is currently under review.

The FDA previously recalled the tablets in 2010, is the 2016 advisory related to the issues reported in 2010 or are these new issues?
Our preliminary review shows that these adverse events are similar to those observed in 2010 when the FDA warned of belladonna toxicity associated with Hyland’s Teething Tablets, when we also issued a warning to protect the public health.

What, if any products, can parents use to help manage teething discomfort?
There are more theories about teething and “treating” a baby’s sore gums than there are teeth in a child’s mouth. One thing doctors and other health care professionals agree on is that teething is a normal part of childhood that can be treated without prescription or over-the-counter (OTC) medications.

If your child’s gums are swollen and tender,

  • gently rub or massage the gums with your finger, and
  • give your child a cool teething ring or a clean, wet, cool washcloth to chew on.

Chill the teething ring or washcloth in the refrigerator for a short time, making sure it’s cool—not cold like an ice cube. If the object is too cold, it can hurt the gums and your child. The coolness soothes the gums by dulling the nerves, which transmit pain.

Parents should supervise their children so they don’t accidentally choke on the teething ring or wash cloth.

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Categories: Accidents, Injuries, + Abuse, Newborns + Infants, Toddlers + Preschoolers

Shorties: Children and Secondary THC Exposure

By November 2, 2016 No Comments
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qWe live in a state where the production and sale of marijuana products is legal.  My husband works for a legal grower and trims the plants and doesn’t wear gloves.  Whenever he comes home his clothes smell awful and his hands are super sticky from the oil.  He washes his hands but they’re still really smelly and sticky.  Am I crazy for wanting him to shower, change his clothes and thoroughly wash his hands before he holds our seven-week-old baby? I can’t find anything about this issue online and I’m afraid to ask our doctor.  Please help! I need science and reason!
– Anonymous, via Facebook

Tetrahydrocannabinol (THC) is the primary psychoactive component of marijuana and you’re not alone in a fruitless search for information on this subject.  After an exhaustive search of the medical literature, I’ve been able to turn up very little on this type of THC exposure and children.  Coming up empty on a review of the literature I reached out to several subject matter experts to see if they could shed some light on this issue.

The first person I contacted was Dr. Kevin P. Hill, Assistant Professor of Psychiatry at Harvard Medical School whose clinical research has focused on addiction and bridging the gap between public perceptions of cannabinoids and what science can actually tell us.  Dr. Hill says that while handling dry cannabis plant material will not lead to THC absorption through the skin, that’s not the case with the oils. “Handling oils or hash may result in absorption,” which means that if your husband comes home from work with the oil on his hands or clothes and then holds the baby, there could be some transfer.

Whether or not there is enough THC in the oil to cause intoxication in your infant is difficult to know.  The THC level in the oil varies depending on the breed of plant he’s working with, how much and how long your baby is exposed to the oil and the type of exposure (absorbed through the skin, or orally).  It wasn’t a question that any of our experts felt qualified to answer without having more information.

Dr. Clay Jones, a pediatrician who writes at Science Based Medicine, advises that other factors outside of direct contact with the oil on your husband’s skin could pose a risk to your child.  Depending on how much oil your husband has on his hands when he comes home, if your husband handles objects that your son puts in his mouth like a pacifier, feeding supplies or pacifier it could pose a greater risk in an infant. “When cannabis is ingested, younger children are at higher risk for major complications such as breathing difficulty and death.”

According to Dr. Jones, symptoms of cannabis intoxication in infants and young children vary depending on their age and the degree of exposure, “A mild intoxication may consist of just sleepiness,” he says. “They may be irritable or oddly giddy. They may have elevations in their blood pressure and heart rate reflecting either an excited state or they may be generally physiologically depressed. Nausea and vomiting, slurred speech, and repetitive involuntary eye movements may be seen.”

I called the Infant Risk Center at the Texas Tech University Health Sciences Center to get their perspective and they advise that there is no known “safe” level of THC exposure in infants or children.  They also advise women who are pregnant or nursing to avoid both primary and secondary THC exposure.  When asked what they would recommend in a situation like yours, they said they would advise your husband to shower thoroughly using an oil dissolving soap before coming into the house or handling the baby.  They would also advise that his clothes be laundered separately from the rest of the family’s.

Infant Risk also advised that while the production and use of marijuana products is legal (or decriminalized) for adults, if a mandatory reporter such as a doctor, nurse or child care provider suspects that a child has been exposed to THC they are required to inform Child Protective Services.

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Categories: Accidents, Injuries, + Abuse

Shorties: Room Sharing for Safe Sleep

By November 2, 2016 1 Comment
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qCan you provide more feedback on the 6-12 month change for room sharing with the child [as advised in the 2016 update to the AAP’s Safe Sleep Policy]? That seems like an incredible step higher than what was previously advised (though not official recommended). Keeping your child in the room with you for an entire year is a seriously drastic life-change.
– Daniel, via Facebook

The interesting part of this is that the recommendation it isn’t new, however, because the recommendation was highlighted using bold font in the updated policy, many in the media have interpreted it as a new portion of the policy.  The 2011 Safe Sleep Policy also recommended room sharing for 6-12 months to reduce the risk of SIDS.

This recommendation is based on 3 case-control studies from the 1990s and early 2000s, the citations for these studies are below my response, which shows that room sharing for at least six months, but ideally longer, can reduce the risk of of SIDS by as much as 50%, although most studies put the risk reduction in the range of 24-36%. Room sharing is most effective at reducing the risk of SIDS from birth to six months.  There is some, but not ample, evidence that sharing a room beyond six months continues to reduce the risk of SIDS. Given the evidence at hand, the committee stuck with that recommendation and I can see why.

My personal opinion is that the sleep environment (the infant sleeps alone, on it’s back, in a crib or bassinet, without bedding) far outweighs the location of the child.  As with most recommendations, parents need to do what works best for their sanity. If parents feel more comfortable with the infant in their room, beyond six months, do it. If the baby is able to roll over and is keeping you up all night then, move her to her own room.

Resources:

Carpenter RG, Irgens LM, Blair PS, et al. Sudden unexplained infant death in 20 regions in Europe: case control study. Lancet. 2004;363(9404):185191pmid:14738790

Blair PS, Fleming PJ, Smith IJ, et al; CESDI SUDI Research Group. Babies sleeping with parents: case-control study of factors influencing the risk of the sudden infant death syndrome. BMJ. 1999;319(7223):14571461pmid:10582925

Mitchell EA, Thompson JMD. Co-sleeping increases the risk of SIDS, but sleeping in the parents’ bedroom lowers it. In: Rognum TO, ed. Sudden Infant Death Syndrome: New Trends in the Nineties. Oslo, Norway: Scandinavian University Press; 1995:266269

Tappin D, Ecob R, Brooke H. Bedsharing, roomsharing, and sudden infant death syndrome in Scotland: a case-control study. J Pediatr. 2005;147(1):3237pmid:16027691

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Categories: Accidents, Injuries, + Abuse, Newborns + Infants, Policy, Politics, + Pop Health