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Children's Health

Antibiotics

The excessive use of antibiotics still remains a huge problem. Doctors are not always to blame, as there is a huge expectancy amongst patients that if an infection is present, then rather give an antibiotic than not give one.

This is opposite to what most medical specialists are suggesting. Watchful waiting is suggested for example in acute Otitis Media. In a recent report from Ben-Gurion University in Israel, researchers pointed out again that most cases of middle ear infection will resolve without antibiotics, and antibiotics should be used only if clearly indicated because of severity of symptoms, or no improvement after a number of days. Short courses of antibiotics also fail to help in 21% of cases, and antibiotic use is responsible for the increasing incidence of resistance to antibiotics becoming a serious problem today.

So why has it been so difficult to change the culture of using antibiotics by both public and doctors? There are clearly many reasons but, as indicated above, expectation from parents (in the case of children) places enormous pressure on doctors. Giving antibiotics is "playing safe" from a medico-legal point of view. It’s also amazing how everyone relaxes when an antibiotic is given, as if somehow the best has been done for the child.

The truth is that giving antibiotics may be more dangerous to the child’s health than watchful waiting. Antibiotics are serious medicines. Children can develop allergies, diarrhoea, bowel problems, leaky gut and even, though rarely, may die following antibiotics. By changing the bowel flora, which may not recover immediately, the immune system is also affected.

Parents may be concerned about the eardrum bursting but this is the natural way pus is discharged from the middle ear, and healing of the drum occurs very easily and rapidly. My son who is now an adult had a burst ear drum on two occasions and both times the drum closed, leaving no signs of scarring.

So the rule is, when taking your child to the doctor with a middle ear infection, make it clear that you don’t expect an antibiotic and you are quite happy to practise watchful waiting. As a parent practising a more natural approach to healing, you can also go down to the local chemist or health shop and ask for homeopathic medicines for ear infection. That way you can t feel that you are doing something active and the drops do work.

Leibowitz E et al Current management of paediatric acute otitis media. Expert Rev infect Ther. 2010;8(2).

Twenty five years ago the dose of the antibiotic amoxicillin used to treat an ear infection was 20mg per kilogram of body weight per day. Today statistics show that people suffer from nearly four times as many ear infections, and that the average dose of amoxicillin required to eliminate a single infection is four times higher. Finding antibiotics that work is becoming more and more difficult, and the new ones are also more toxic to use. One of the strangest things is that natural substances which have antibiotic like properties, don’t seem to develop resistance and remain active despite being used for thousands of years. Essential oils like oregano still work amazingly well.

Melatonin and sleep

Melatonin use in children

I have for many years thought that the use of melatonin in children was not a good idea. I assumed that their pineal gland produced more than sufficient melatonin, but recently I have come across parents using melatonin because it is freely available in health shops and therefore assumed to be safe; secondly I have come across a number of articles on the subject. What follows is the information I have gathered so far on the use of melatonin in children.

Firstly, it is safe, and that is a good start.

Melatonin is a hormone involved in the regulation of the sleep-wake cycle. It is produced in the pineal gland through the conversion of tryptophan, to serotonin and then N-acetylseratonin, and finally melatonin. Levels begin to rise at nightfall and peak between 2am and 4 am in adults. The administration of melatonin does not appear to affect the endogenous production which is interesting, and suggests that there is no suppression of endogenous secretion by melatonin taken orally.

Melatonin can be used by children with sleep disorders. Studies have been done in children as young as six months given melatonin for sleep disorders who have failed to respond to traditional therapies. In one study nine of the patients had mental retardation and two had ADHD. The dose given was 2,5 to 5 mg or placebo at bedtime for a period of 7 to 10 days; this was then switched to an alternative arm after a four to five day wash out period. Children responding to the therapy remained on melatonin after completion of the study, and were followed at 3 and 6 months. Thirteen of the 15 children had a favourable response to melatonin, with improvement in sleep duration. Of special interest were not only the improvement in sleep but a better daytime mood and behaviour. Children with delayed sleep onset had the greatest improvement. No adverse effects were noted even in the children who continued taking the melatonin for up to a year.

Jan JE et al The treatment of sleep disorders with melatonin. Dev Med Child Neurol 1994;36:97-107

A further study by the same group showed similar results in patients ranging from three to 23 years of age and doses of melatonin between 0.5 to 4 mg. This group included 8 blind children and young adults. All patients showed some improvement and benefits were maintained up to six years in some patients. No adverse effects were noted.

Palm L et al Long-term melatonin treatment in blind children and young adults with circadian sleep-wake disturbances. Dev Med Child Neurol 1997;39:319-25

In another randomised, placebo-controlled study in 40 children (6 to 12 years of age) with chronic insomnia the children either received 5mg melatonin or placebo at 6pm over 4 weeks. Patients could continue therapy afterwards. Sleep onset and duration were significantly improved in the melatonin group, but showed no difference in the placebo group. After 18 months, 13 of 38 children evaluated had discontinued therapy without the return of the insomnia.

Smith MG et al Melatonin for chronic sleep onset insomnia in children: a randomized placebo-controlled trial. J Child Neurol 2001;16:86-92

Dodge NN et al Melatonin for treatment of sleep disorders in children with developmental disabilities. J child Neurol. 2001;16:581-4

Other studies support the benefits of melatonin in sleep disorders of children. Doses between 2,5 to 5 mg are generally used given 30 to 60 minutes before bed. Based on response, this dose can be increased after a few nights. Children with neurological injury may require higher doses. In children with night time wakening, a controlled release dosage form may be more effective.

Jan JE et al Clinical trials of controlled-release melatonin in children with sleep-wake cycle disorders. J Pineal Res 2000;29:34-9

Nutritional Supplements

NUTRITIONAL SUPPLEMENTS FOR CHILDREN.

Have a look at the following facts and decide if you still think that eating good quality food is enough to give your child optimum health. Keep in mind that we don’t live under normal conditions. The environment today is decidedly abnormal. I live in the country but the local farmers are spraying throughout the year and I can hear airplanes flying high overhead. I buy organic vegetables but worry about the plastic they are often packed in. Schooling today is also very stressful, and all this requires extra nutrition.

*In order to get the minimum requirement of vitamin C, you would have to eat five vine-ripened fruits and vegetables.

*The US organic association states that:

Children receive up to 35% of their entire lifetime dose of cancer-causing pesticides by the age of five. (This requires optimum nutrition to detoxify the system well)

Trace amounts of 17 pesticides were found in the top baby foods sold in the USA

80% of all cancers are caused by toxic agents in our environment.

*The National Institute of Health, Bethesda, Maryland, state that only 9% of Americans are in an optimal vitamin C state.

[Vanderhaeghe LR, Bouic PJD. The immune system cure. Pyramid Publishers.Hermanus.1999]

Lack of iron is one of the most common nutritional deficiencies in the world partly because of its poor bioavailability. Vitamin C increases the absorption of iron and certain food groups such as phosphates, tannates, phytates and certain fibres may inhibit nonhaeme iron absorption.