Women who wouldn’t consider smoking while pregnant might not think twice about putting flea collars on their pets or spraying to control cockroaches. Thankfully, somebody did. While revelers were celebrating at midnight on New Year’s Eve 2000, a new federal regulation quietly went into effect banning an insecticide, chlorpyrifos, at least from products that say on the label that they may be used indoors.

Investigators have compared matched children with acute, red hot ear infections who were treated initially with observation (including earache relief) and those who were treated initially with antibiotics. How did the two groups fare? I.d rather be treated with observation! The two groups felt the same as each other after 24 hours, and again after 2-3 days, and 4-7 days. The same percentage in both groups were over their ear infections after 7-14 days.

Ask your doctor if the observation option is appropriate for your child. It.s the best option for many children, even many of those with red hot ear infections. In the absence of antibiotics, the child receives treatment tailored to her symptoms . especially toward relieving her pain. Pain relief is part of the observation option, especially for the first 24 hours. In addition, a responsible, available adult is needed to be able to take action if the child is getting worse or has not improved within 48 to 72 hours.

The consensus, evidence-based 2004 guidelines recommend that children under 6 months of age with red hot ear infections should be treated with antibiotics for 10 days and pain relief for at least the first 24 hours, whether or not the diagnosis is certain. Remember, antibiotics do not help pain during the most painful first 24 hours, and help pain only minimally after that. Kids 6 months to 2 years should receive 10 days of antibiotics and at least 24 hours of pain relief for a red hot ear if the diagnosis of an acute ear infection is certain (it must be an abrupt onset, with physical certainty of fluid in the ears, and clear evidence of an inflamed eardrum . all 3).

With garden-variety ear infections (what doctors call otitis media with effusion, or OME), germ-filled fluid is present in the middle ear. Most ear infections in children are OME. We.ve known for about a decade that antibiotics are not necessary for these vanilla ear infections (as I like to call them). In fact, it is perhaps even more important for these children to avoid antibiotics than it is for their peers, to avoid selectively breeding their most virulent bacteria. An acute ear infection (what doctors call acute otitis media, or AOM) can hurt like hell!

Fluid must be present in the ear, behind the eardrum, for there to be an ear infection (what doctors call otitis media). The tiny eardrum is a sensitive structure, and can hurt for many reasons: including stretching, trauma, irritants, changes in pressure, changes in temperature, viruses, allergies, and ear infections. Many supposed-ear-infections aren.t ear infections at all, just earaches. Far too often people get antibiotics for earaches, when these are the last thing they need.

If your little girl has a stuffy nose, a slight fever, and wakes up crying, tugging on her ear, and saying, .My ear hurts!. . then she may have an acute ear infection. But it is almost as likely that she has a cold virus, with ear pain from pressure in the ear, and no acute bacterial infection at all. She may need earache relief, not ear infection treatment. Ear infections cannot be accurately diagnosed just based on the story, either by good doctors or by good parents.

Most parents are taught to think that if an antibiotic is given to their child for an ear infection, the medicine will help the child to recover. Not necessarily! Of the 10 million annual antibiotic prescriptions for ear infections, somewhere between 8.5 million and 9.5 million prescriptions didn.t actually help the children, according to the best medical research (and according to the American Academy of Pediatrics). Put another way, we have to treat between 7 and 20 children with antibiotics for ear infections before one child benefits from the medicine.

I.ve long said that doctors should be giving more pain medicines than antibiotics to children with ear infections . because every child with an ear that is inflamed enough to need antibiotics clearly deserves pain relief. In addition, many children who don.t need antibiotics also deserve relief for their sore ears.

Contrary to common practice, most children with ear infections should not be treated with antibiotics, according to powerful, evidence-based guidelines released in March 2004 by the American Academy of Pediatrics and the American Academy of Family Physicians. While some of us have been following this approach for years, currently in the United States there are more than 10 million antibiotic prescriptions for the 5 million ear infections diagnosed in children each year . about half of all the antibiotic prescriptions in young children are for ear infections.

Asthma is becoming more and more common at all ages, now affecting more than 20 million Americans (including more than 5 million children). What do we know about managing asthma in pregnancy? Inhaled steroids are one of the standard treatments for moderate asthma in adults and children, even though we know that they can slow growth slightly in children.

It’s not unusual for women to become depressed at some point during the first year after having a baby. Often this depression sets in sometime after the routine 4- to 6-week visit with the obstetrician. The pediatrician may be the only doctor a woman sees while she is depressed, even though the new mother is not the pediatrician’s patient. Because depressed women often do not recognize their symptoms of depression, some experts are now recommending that pediatricians give women a simple questionnaire at well-baby visits to help identify depression, and get families the help they need.

A controversial 1998 study published in The Lancet implied that the MMR vaccine might be a cause of autism. This sparked deep suspicion of the vaccine and prompted a great deal of new research involving hundreds of thousands of children (that has been unable to find any such connection). The original study included only a dozen children, and was based partly on parents’ reports. In 2004, serious allegations were raised against this original paper, asserting that the dozen children selected in the study were not randomly chosen as described in the paper, but included children involved in a legal action claiming vaccine injury. Perhaps the parents’ reports were biased - but either way, the possible conflict of interest was not disclosed.