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How to talk to your teenaged patient about pregnancy and contraception – Contemporary Pediatrics
How to talk to your teenaged patient about pregnancy and contraception | Image Credit: JPC-PROD - JPC-PROD - stock.adobe.com.
Here is some sobering news: Teenaged mothers are twice as likely to experience postpartum depression (PPD) as adults.1 For this population who are still maturing on a cognitive level and have not yet fully developed their basic coping skills, the impact of PPD can be crippling. Additionally, the stress that a pregnancy adds to this population group can lead to other increased mental health concerns, including severe depression and anxiety.2 Furthermore, parenthood is the leading reason why teenaged girls drop out of school, with more than half of teenaged mothers never graduating from high school.3
Although the national teen pregnancy rates for girls aged 15 to 17 years and 18 to 19 years (the number of pregnancies per 1000 females in the specified age group) have declined almost continuously for the past 30 years,4 the teen birth rate in the United States is still higher than in many developed countries, including Canada and the United Kingdom.5 At the same time, sexual intercourse among adolescents has become the norm: by age 19, approximately 70% of teenagers have had sexual intercourse at least once.6
For these and other reasons surrounding sexual health, initiating discussion of sexual activity, pregnancy, and contraception is a necessity for health care providers. According to the American Academy of Pediatrics (AAP), Pediatricians [should] spend one-on-one time with adolescents starting at the 11- to 13-year-old checkups. The pediatrician will ask about sexual behaviorsand, if indicated, talk with the young person about birth control and ways to prevent sexually transmitted infections [STIs].7 The question is how to broach issues of pregnancy and contraception with this patient population to produce optimal outcomes.
Initiating the discussion As the Nike ad says, just do it. Jessica Peck, DNP, APRN, CPNP-PC, CNE, CNL, FAANP, FAAN, clinical professor of nursing at Baylor University Louise Herrington School of Nursing in Dallas, Texas, says to simply start a discussion, honestly and plainly. Having an established relationship with a primary care provider makes it easier to initiate conversation on both sides. As girls progress into the teen years, its important to give anticipatory guidance before any risk-taking behaviors occur.
Additionally, with the current laws on abortion having changed dramatically, Peck notes, It is critical to know your state laws and your scope of practice according to your education, training, licensure, and certification, and providers should adhere to those boundaries, referring when necessary. She adds, Its important to emphasize regular well childcare, where questions about reproductive health are easier to ask in the context of health promotion.
A recent paper published in Frontiers in Pediatrics8 discusses the actions that health care providers can take in the prevention of unplanned pregnancy. Study authors note it is crucial to be empowering young adolescents to become more aware and capable of making informed decisions about their sexual life, health, and future.8
The paper cites several factors contributing to adolescent pregnancy, including personal vulnerability, family context, lack of information, poor access to contraception, and religious and cultural background. Adolescents, especially under the age of 16 or 17 years, lack a long-term vision of the consequences of their behavior and are driven by experimentation and emotions. Therefore, although they cognitively know about contraception and the risk of pregnancy, they may choose to ignore these aspects of their behavior as a kind of denial (it cannot happen to me). This explains why, even in high-income countries with a good coverage of health care needs, some adolescents find themselves pregnant, the authors state.8
What the discussion should include The authors developed several recommendations for health care providers in terms of discussing pregnancy and contraception with their teenaged patients and educating them about it (Table). Key elements that impact on the quality and effectiveness of service provisions are, among others, easy access to health services, including sexual and reproductive health (SRH); confidential, respectful empathetic care; communication and counseling skills; [and] easy link with specialized colleagues and the community, the investigators note.8
Birth control recommendations When it comes to counseling teenagers on methods of birth control, the AAP continues to recommend long-acting reversible contraceptives (LARCs), which include contraceptive implants and intrauterine devices, as the most effective contraceptives to prevent pregnancy. They also recommend that teenagers who use LARCs should also use a condom or other type of barrier protection during sexual activity to prevent sexually transmitted infections (STIs).
Additionally, the AAP notes that hormonal contraceptivescombined oral contraception pills, progestin-only contraception pills, patches, injections, and vaginal ringsare more than 90% effective in preventing infection. They recommend use of a condom here as well to prevent STIs.
The progestin-only pill containing norgestrel (Opill) is the first nonprescription birth control approved by the FDA and is now being sold over the counter (OTC).
Finally, should a teenager decide they want to see their pregnancy through and become a parent, the AAP affirms that all pregnant adolescents should be counseled in a nonjudgmental, developmentally appropriate manner about their full range of pregnancy options.9
Click here for more from the May issue of Contemporary Pediatrics.
References:
1. Ladores S, Corcoran J. Investigating postpartum depression in the adolescent mother using 3 potential qualitative approaches. Clin Med Insights Pediatr. 2019;13:1179556519884042. doi:10.1177/1179556519884042
2. Hodgkinson S, Beers L, Southammakosane C, Lewin A. Addressing the mental health needs of pregnant and parenting adolescents. Pediatrics. 2014;133(1):114-122. doi:10.1542/peds.2013-0927
3. Teen moms. American Society for the Positive Care of Children. 2024. Accessed March 26, 2024. https://americanspcc.org/teen-moms/
4. About teen pregnancy. CDC. November 15, 2021. Accessed March 26, 2024. https://www.cdc.gov/teenpregnancy/about/index.htm
5. About teen pregnancy and childbearing. US Department of Health and Human Services. Accessed March 27, 2024. https://opa.hhs.gov/adolescent-health/reproductive-health-and-teen-pregnancy/about-teen-pregnancy-and-childbearing
6. Lindner J. Sexually Active Teen Statistics: Market Report & Data. Gitnux. Updated December 20, 2023. Accessed March 27, 2024. https://gitnux.org/sexually-active-teen-statistics/
7. Ott MA, Alderman EM. Contraception explained: birth control options for teens & adolescents. HealthyChildren.org. Updated March 8, 2024. Accessed March 26, 2024. https://www.healthychildren.org/English/ages-stages/teen/dating-sex/Pages/Birth-Control-for-Sexually-Active-Teens.aspx
8. Martins MV, Karara N, Dembiski L, et al. Adolescent pregnancy: an important issue for paediatricians and primary care providers-a position paper from the European Academy of Paediatrics. Front Pediatr. 2023;11:1119500. doi:10.3389/fped.2023.1119500
9. American Academy of Pediatrics; Committee on Adolescence. Options counseling for the pregnant adolescent patient. Pediatrics. 2022;150(3):e2022058781. doi:10.1542/peds.2022-058781
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How to talk to your teenaged patient about pregnancy and contraception - Contemporary Pediatrics
Adult RSV Shots Given to More Than 30 Babies by Mistake – Medpage Today
Nearly three dozen babies and young children have received respiratory syncytial virus (RSV) vaccines, which are only approved for adults, according to a brief CDC report.
Data from the Vaccine Adverse Event Reporting System (VAERS) revealed 27 reports of the Pfizer RSV vaccine (Abrysvo) and seven reports of the GSK RSV vaccine (Arexvy) being mistakenly administered to children under the age of 2 between Aug. 21, 2023 and March 18, 2024, Pedro Moro, MD, MPH, of the CDC in Atlanta, and colleagues detailed in Pediatrics.
"While rare, vaccine administration errors are known to occur and may increase after a new vaccine or product is introduced," Moro told MedPage Today in an email.
Thirty-one of the children who received the vaccines were infants under 8 months of age. In 21 of the cases, the vaccines were given in family medicine practices.
"Healthcare facilities that provide preventive care for children and adults might store and administer Pfizer and GSK RSV vaccines, other routine vaccines, and nirsevimab [Beyfortus]," Moro and colleagues wrote in the report. "Thus, the potential exists for Pfizer or GSK RSV vaccines to be administered in error to infants and young children."
Eric Simes, MD, a pediatric infectious diseases expert at Children's Hospital Colorado in Aurora, told MedPage Today that he was "not surprised" by the vaccine errors. "Mistakes will happen, especially with COVID vaccines being given to [both] adults and children, with pneumococcal vaccines being first given to children and now to adults, etc."
Simes said that he did not personally know of any cases where the RSV vaccines had been administered to children, but emphasized that "adult RSV vaccines should absolutely not be given to children."
The Pfizer vaccine is approved for use in pregnant individuals at 32 through 36 weeks gestational age, to prevent serious RSV cases in infants, and both the Pfizer vaccine and GSK vaccine are approved and recommended for adults 60 years of age and older.
Twenty-seven of the reports noted no adverse health events associated with the erroneous vaccines, but the remaining seven described at least one adverse event. One of those events occurred in an infant with a history of congenital heart disease who received the GSK RSV vaccine in combination with routine childhood vaccinations. That child required hospitalization for cardiorespiratory arrest within 24 hours after vaccine receipt. The remaining six reports described injection site reactions or systemic reactions, such as irritability, after receiving the RSV vaccines.
"Administration errors are preventable with proper education and training," the authors of the report emphasized. They suggested several strategies to prevent vaccine administration errors, including only ordering products that are approved for the patient population a facility serves, electronic health record alerts or warnings, close attention to labeling, and best practices for vaccine storage.
"To prevent mix-ups, CDC reached out to clinicians to educate them about the proper administration of the RSV vaccines," Moro said. "Education and additional vigilance will reduce the likelihood of errors."
The CDC and FDA will continue to monitor VAERS for vaccine administration errors, and clinicians are encouraged to report errors to VAERS.
The report was published several months after a notice was sent to healthcare providers that the CDC and FDA had received reports of 25 cases of the RSV vaccines being administered in error to young children in outpatient settings. At that time, there were also 128 reports of the GSK RSV vaccine being administered in error to pregnant people in outpatient settings and pharmacies. However, the CDC noted that, overall, these were a small number of cases relative to an estimated 1 million infants protected from RSV either through vaccination of pregnant individuals or infant receipt of nirsevimab -- a monoclonal antibody recommended for all infants under 8 months of age entering their first RSV season or born during it.
In instances when an RSV vaccine is given in error to children, no special monitoring is needed, according to the CDC. However, because the efficacy of the adult RSV vaccines in infants and young children has not been evaluated, children who receive an RSV vaccine in error should receive nirsevimab to prevent severe RSV disease, if otherwise eligible.
Katherine Kahn is a staff writer at MedPage Today, covering the infectious diseases beat. She has been a medical writer for over 15 years.
Disclosures
Moro and other study co-authors reported no potential conflicts of interest.
Simes reported consulting for GSK and has received grants for research and consulting from Pfizer.
Primary Source
Pediatrics
Source Reference: Moro PL, et al "Incorrect administration of adult RSV vaccines to young children" Pediatrics 2024: DOI: 0.1542/peds.2024-066174.
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Adult RSV Shots Given to More Than 30 Babies by Mistake - Medpage Today
Pediatric Health Care Teams Can Help Prevent Youth Suicide – The Pew Charitable Trusts
After losing a young patient to suicide in early 2023, Dr. Edward Salzberg, a pediatrician at Roswell Pediatrics Center in Georgia, found himself looking for solutions.
I had a teenager who died by suicide within 30 minutes of leaving their wellness visit, Salzberg recalled. After that, I thought to myself, How can we do better? Until it happens to you, until you have a really close encounter, you may not know what to do.
Suicide is the second-leading cause of death for young people ages 10 to 24. In 2021, the suicide rate for ages 20 to 24 was 19.4 deaths per 100,000, and the rate for 10- to 14-year-olds was 2.9 deaths per 100,000. In 2021, more than 7,000 young people died by suicide, accounting for 15% of all suicides in the United States that year. Between 2000 and 2021, suicide rates for this entire age group increased 52%, with 9% of high school students in 2021 reporting that they had attempted suicide in the past 12 months.
As the rate of youth experiencing suicide risk continues to increase, evidence-based strategies can help support pediatricians in identifying, assessing, and connecting at-risk young people to appropriate suicide care. In response to these trends, the American Foundation for Suicide Prevention (AFSP) and the American Academy of Pediatrics (AAP) began a partnership in 2021 to support pediatric providers in advancing equitable youth suicide prevention in all settings where those in this age group live, learn, work, and spend time.
AAP and AFSPs Suicide Prevention Project ECHO (Extension for Community Healthcare Outcomes) program engages pediatricians, other pediatric health providers, and community members to integrate recommendations from the partnerships Blueprint for Youth Suicide Prevention. That resource provides evidence-based strategies and tools to identify and support youth at risk for suicide in clinical and community settings.
Project ECHO uses a telementoring model that promotes knowledge-sharing and learning through virtual lectures, de-identified patient case studies, and real-time problem solving to teach providers to implement best practices for suicide prevention. A team of seven faculty members with expertise in pediatric suicide prevention, family medicine, public health research and practice, and effective clinical care pathways for suicide prevention facilitates the process. Participants then work with faculty and each other to measure clinical outcomes to help foster change.
Early last year, Salzberg participated in the first cohort for this program as a provider. [The program] was enlightening. I wasnt aware there were standard screenings that could be used, he said. I didnt realize there we so many resources available.
This cohort launched in January 2023 with support from AFSP, The Pew Charitable Trusts, and CVS Aetna. By December, more than 40 pediatric providers from urban, suburban, and rural communities across 17 primary care practices in 11 states had adopted universal suicide screening for all patients, regardless of the reason for their visit. Since then, this program has continued to engage and educate hundreds of providers and community members across more than 40 states.
There was definitely a sense of communityan instant connection with people, Salzberg said. They asked, How are you doing?, and I honestly hadnt even thought about ithow I was doing after losing a patient. The resources for providers who lose a patient were also so helpful.
Other participants shared Salzbergs sentiments in post-program surveys, highlighting the relevance and applicability of the content to what they are experiencing in their practices. Another provider remarked on the impact and benefits of the actual concrete suggestions as to how to implement suicide prevention in primary care, such as how to conduct a safety assessment and identify next steps for care for a patient who has screened positive for suicide risk.
AAP-AFSP surveys found that 85% of participants in the initial cohort reported afterward that they had increased their knowledge about suicide prevention (including risk factors and warning signs for suicide); 77% reported increased confidence in their ability to apply the information presented; and nearly all (93%) said they were committed to implementing the skills learned in practice.
In the months since, Salzberg has continued to apply those skills. He has worked to train staff on best practices in suicide prevention and treatment and provide suicide care resources to families.
Were at the beginning stages of implementing, and there are three projects: Were creating a list of reliable resources for patients and families, were training our staff on how to screen patients for suicide risk, and were looking into how we can incorporate these processes into our daily visits. We cant create a perfect system right away, but we can try, Salzberg said.
Models such as Project ECHO that bring partners together are key to implementing and scaling evidence-based mental health care. Just as health care providers are trained to respond to physical health problems, they have a key role to play in identifying and helping treat pediatric patients mental health needs.
Were always prepared for the asthma attack or seizure or a kid who isnt breathing, Salzberg said. Now we have a mechanism for assessing suicide risk and feel more confident managing these critical encounters.
Seven more Suicide Prevention Project ECHO cohorts are planned this year, including groups focused on school-based health centers and emergency departments, to ensure that more providers in these and other settings have the support they need to better address the growing risk of youth suicide.
Kristen Mizzi Angelone directs The Pew Charitable Trusts suicide risk reduction project, Corbin J. Standley is director of impact communication and continuous improvement at AFSP, and Jessica Leffelman is a program manager for Project ECHO suicide prevention initiatives at AAP.
To learn more about Project ECHO and upcoming opportunities to participate, contact [emailprotected].
Learn more about the Blueprint for Youth Suicide Prevention at aap.org/suicideprevention.
A version of this piece also was published on the American Foundation for Suicide Prevention website on April 22.
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Pediatric Health Care Teams Can Help Prevent Youth Suicide - The Pew Charitable Trusts
Small patients, big discoveries | Penn Today – Penn Today
Pediatrics is often thought of as cute people doing cute things for cute children, says Kerry Shields. Its so much more than that. Our work is highly complex. As a lecturer in the department of family and community health at Penns School of Nursing, Shields has a front row to the panoply of pediatrics innovations coming out of the school. She says, Childhood illness is often lifelong illness. Were not just treating whats in front of you, but changing the trajectory of someones entire life, as well as the lives of their siblings, parents, and community.
Penns faculty are leading the field of pediatric nursing science and research. Their work ranges from large-scale international studies to creating data models that are poised to advance the discipline and question accepted practices. Their queries are uniquely poised through the lens of nurses, meaning, with an eye toward empathy and equality. We partner with parents, we stand beside them at the bedside, we stay with patients around the clock and address their physical and emotional needs, says Martha A.Q. Curley,Ruth M. Colket Endowed Chair in Pediatric Nursing. Nursing is a discipline that requires its own science to support it. Her work also extends beyond the hospital doors. She recently finished enrollment on a cohort study looking at pediatric post-intensive care syndrome. Shes not just assuming that a patient is OK once they leave the ICU.
Advancements arent only coming from research. Faculty and nurse scientists are also thinking about how to better prepare students for clinical practice. Weve adjusted and structured the curriculum to focus on the lifespan of a patients health, says assistant professor Amanda Bettencourt. Its key to clear out a path where students see themselves as really making a difference in the lives of children and families. Bettencourt, a clinical nurse specialist, has a particular interest in implementation science. She figures out ways to help nurses adapt to necessary changes in the hospital, something that can be overwhelming to many. She does that by partnering with local pediatric clinicians for different research studies.
Faculty and nurse scientists are tackling such issues as burnout, nutrition in critically ill children, and shifting standard practices to improve outcomes. They also confront how data is collected and how it is used, and the changing cultural and political landscape in medical care. Nursing experts examine critical aspects of high-risk maternal-fetal care, and how the decisions and outcomes for this patient population are impacted by changing cultural beliefs and reproductive health laws, and partnering with community organizations to address the unique experiences and needs of individuals who have been largely missing from the evidence in high-risk maternal and fetal care.
This story is by Ashley Primis. Read more at Penn Nursing.
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HCPs can play an important role in addressing the US infant formula shortage – Contemporary Pediatrics
HCPs can play a role in addressing the US infant formula shortage | Image Credit: 279photo - 279photo - stock.adobe.com.
In results from a 2020 survey conducted by the CDC, 45.3% of infants in the United States were exclusively breastfed at the age of 3 months, with this percentage dropping to 25.4% by the age of 6 months.1 The World Health Organization and the US Dietary Guidelines for Americans recommend that all infants should exclusively receive breast milk until the age of at least 6 months.2,3 Caregivers can begin incorporating other solid and liquid foods at this 6-month mark; however, children should continue breastfeeding until the age of 2 years. The CDC reports that 20.8% of breastfed infants receive additional formula supplementation within the first 2 days of life, which can be attributed to a multitude of factors, including lactation issues, scheduling conflicts, and stigma.1 When breastfeeding is not an option, caregivers will turn to infant formulas to meet their childs nutritional needs.
Infant formulas contain important macronutrients such as carbohydrates and proteins, which are crucial to growth and development.4 In addition to the macronutrients, the infant formula contains micronutrients such as vitamin D, iron, and zinc. Vitamin D is a fat-soluble vitamin essential for the development of bones and the prevention of conditions such as rickets by regulating calcium and phosphorus levels in the body.4-6 Iron is required for hemoglobin production and tissue oxygenation, with low levels of iron causing anemia and failure to thrive.4,7 Zinc is a mineral that contributes to growth and immune function, with deficiencies leading to growth failure and skin rashes.4,6 Due to potential complications, it is important for all pediatric patients to meet their nutritional requirements. Unfortunately, when infant formula shortages occur, access is limited, leading to varying conservation efforts or work-arounds that put the infant at risk for the deficiencies and complications noted previously.
Infant formula shortages can be a direct result of supply chain issues, natural disasters, and/or recalls.8,9 One such example is the infant formula shortage in the United States in April 2022. Several brands of powdered infant formulas were found to be contaminated with Cronobacter sakazakii, prompting a nationwide recall due to the risk of sepsis and meningitis after ingestion.10 Another more recent example is the infant formula recall in the United States in December 2023, also due to Cronobacter sakazakii contamination.11 Health care providers (HCPs) play an important role in shortages, as they can provide education and resources to caregivers in need. The resources that HCPs can provide include but are not limited to comparative formulations, imports, proper feeding practices, and milk banks.
The North American Society of Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) has infant formula comparison guides that clinicians can use to make safe interchange recommendations.12,13 For example, NASPGHAN states that Similac Alimentum powder (Abbott) is interchangeable with Extensive HA (Gerber) for infants who require extensively hydrolyzed or hypoallergenic formula.13 HCPs can also recommend alternative formulations such as liquid concentrate or ready-to-feed formulations and provide appropriate mixing instructions, as this varies based on the product formulation.14 For example, powder and liquid concentrate formulations require mixing with water in varied ratios whereas ready-to-feed formulations require no mixing. HCPs should also counsel the family on a use-by date after mixing or opening the formulation, as these vary between the different formulations.15 However, it is imperative to note that cost fluctuates between the different formulations, and financial barriers should be considered.
Furthermore, families can seek imported formulas that are authorized by the FDA and available in US stores as an alternative.12 Initially, the FDA temporarily approved imported formulas that met the nutritional requirements but may not have met the labeling requirements of products in the United States.16 Manufacturers who received temporary approval during the initial shortage have since been provided guidance on labeling requirements in order to continue to market their product in the United States. Imported infant formulas are approved by the FDA with a close examination of the nutrients provided by the individual formula and compared with those required by US standards. Clinicians are encouraged to access the FDAs website, which provides recommendations for appropriate substitutions when switching to an imported infant formula.13,17 Third-party imported formula websites may sell products that are not FDA authorized and do not undergo the scrutiny necessary to mirror the nutritional values of US standards. Accessing and/or ordering from these websites should be avoided.4,18 The FDA provides advice to avoid counterfeit infant formulas by confirming the lot number and use-by dates on the package, checking for damage or label tampering, or calling the manufacturers toll-free line.19 If caregivers have used a specific product in the past, they should look out for discoloration and changes in smell or taste.
If an FDA-authorized imported infant formula is chosen, there are unique considerations. There may be unfamiliar language in the patient-facing directions, such as using the word teats for the nipple of the baby bottle.15 Additionally, the definition of a special infant formulation may vary based on the country of origin when compared with that of the United States. Furthermore, labeling may contain different languages that may not be readily translated. Imported products may use the metric system, requiring unit conversions and subsequent relay of this information to the caregiver. This is a key counseling point, as mixing the formula incorrectly may lead to electrolyte imbalance, seizures, and poor weight gain.15,16
Human milk banks are an option for caregivers if alternative formulas cannot be obtained. HCPs can provide caregivers a contact number for a local certified human breast milk donation center through the Human Milk Banking Association of North America.18 Human milk donors are thoroughly screened prior to donation.Purchasing human milk from the internet or social media sites should be avoided, as the milk is not adequately screened or regulated and could unintentionally expose the infant to infectious diseases, illicit drugs, and chemical contaminants.12
Cows milk is normally not recommended for children until they are 12 months or older due to nutritional differences, such as low levels of bioavailable iron and higher amounts of protein.20 If both human milk and infant formulas are unavailable, the American Academy of Pediatrics (AAP) recommends that infants older than 6 months consume cows milk for no more than 1 week.21 Iron supplementation can be given to infants under the supervision of a physician in the form of pediatric drops if they are younger than 6 months.8 Infants can be introduced to solid food at approximately 6 months of age, so it is important to introduce iron-rich foods or cereals to avoid iron deficiency.7,20 There are 2 sources of iron: heme and nonheme iron.7 Heme iron is available in red meat, seafood, and poultry. It is more easily absorbed by the body than nonheme iron. Nonheme iron is available in iron-fortified infant cereals, tofu, and beans. Moreover, goats milk is not approved for infants in the United States and plant-based milk is not recommended in children younger than 12 months.21 Soy milk, which is fortified with calcium and protein, may be used for less than 1 week if other avenues are exhausted. Lastly, toddler formula is not interchangeable with infant formula due to its differing nutritional value.3,6 Toddler formula is intended to be supplemented with an oral diet for toddlers. These formulas should only be used for children 12 months or older for a few days if there is no other choice.6,12,21
HCPs should be prepared to discourage conservation practices that could lead to unintentional infant harm. For example, in an effort to make infant formulas last longer, caregivers may dilute the product with more water. Infant formula should never be overdiluted, as it will offset the nutritional concentration and cause electrolyte disturbances.6,12,21 These complications can be fatal. In addition, homemade formulas should be discouraged, as they do not meet the nutritional or safety standards that commercial products have.21 Online recipes for homemade formulas may contain inadequate or excess amounts of vitamins and minerals and have been linked to severe, life-threatening complications.12 A case series published by the AAP described 2 patients who were fed with organic homemade infant formulas after transitioning from exclusive breastfeeding by the age of 1 month.22 The most notable laboratory abnormalities were related to inadequate vitamin D supplementation. Low levels of vitamin D resulted in inadequate calcium and phosphorus absorption and subsequent breakdown of bone. Further complications experienced by the patients included bone demineralization, cardiac arrest, hepatotoxicity, and ischemia of multiple organs. A summary of the dos and donts for HCP recommendations during an infant formula shortage can be found in the Table.4,9,12,16,17,21
Click table to enlarge.
Many homemade infant formula recipes can be found online and often contain ingredients that are harmful to infant growth and development. A 2020 study analyzed 149 homemade infant formula recipes distributed over 59 online blogs.23 A total of 24.3% of the recipes used whole unpasteurized cows milk, 23.6% used raw goats milk, and 14.5% used liver as the protein base for the homemade infant formula. Pasteurization is the process where raw milk is heated at a controlled temperature to reduce pathogens.24 Unpasteurized or raw milk is associated with outbreaks of foodborne illnesses such as Salmonella and Listeria infection. Liver contains high levels of vitamin A, which can lead to vomiting and bulging of the infants fontanelle.25 Additionally, only 84% of recipes included instructions for proper formula storage and 18.8% included shelf-life recommendations.23 Improper storage leads to an increased risk of bacteria proliferation and subsequent infection. Approximately 75% of the blogs did not encourage pediatrician consultations prior to the usage of a homemade formula.
Conclusion
HCPs are a vital source of information during the infant formula shortage and can provide reliable and safe resources to caregivers in need. It is imperative that HCPs discourage practices that can lead to unintentional infant harm. Education should be provided to all caregivers regarding proper feeding of infants and handling of infant formula.
Click here for more from the May issue of Contemporary Pediatrics.
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East Wenatchee Doctor Awarded For Boosting Child Vaccinations – KPQ
A Confluence Health East Wenatchee pediatrician is being credited with boosting the vaccination rate of children in the area.
Dr. Doug Eisert is being cited for improving the vaccination rates of children significantly at Confluence Health in Wenatchee and East Wenatchee.
According to the Washington Chapter of the American Academy of Pediatrics (WCAAP), Dr. Eisert has stood out for his leadership in raising vaccinations for children and adolescents by 24% at Confluence Health in Wenatchee and 15% at Confluence Health in East Wenatchee, impacting 6,215 patients.
The group says Dr. Eiserts leadership and work with teams at the two Wenatchee area clinics made a significant impact on the health of Hispanic children, improving their vaccination rates by 27.5%.
In his work on increasing HPV vaccination for 9 and 10 year olds, Dr. Eisert helped the clinics improve vaccination coverage by 31%, impacting 1,252 patients at both clinics. .
"Dr. Eisert is a true champion for Wenatchee Valley children and youth, improving public health and health for future generations, said Washington Chapter of the American Academy of Pediatrics executive director Sarah Rafton.
Dr. Eisert said his success is based on a group effort. We worked with several vaccine interest groups and tracked our successes and opportunities in making progress with increasing the vaccination rates of our patients," said Dr. Eisert.
The Leah Layne Memorial Health Leadership Award is named after the late Leah Layne, a long-time campaigner and activist for rural health.
Dr. Eisert stands out to me as exemplar of WCAAP and our members working every day to inspire and support his teammates in clinic to improve child and teen health, and public health, said Washington Chapter of the American Academy of Pediatrics executive director Sarah Rafton.
Gallery Credit: Parker Kane
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East Wenatchee Doctor Awarded For Boosting Child Vaccinations - KPQ
HPV vaccination coverage of US-children aged 9-17 years in 2022 – Contemporary Pediatrics
HPV vaccination coverage of US-children aged 9-17 years in 2022 | Image Credit: Tobias Arhelger- Tobias Arhelger - stock.adobe.com.
Vaccination prevents and controls Human papillomavirus (HPV), the most common sexually transmitted infection (STI) in men and women in the United States. According to data from a National Health Interview Survey and the Centers for Disease Control and Prevention (CDC), in 2022, 38.6% of children aged 9 to 17 years received 1 or more HPV vaccine doses.1
HPV vaccination has been recommended in the United States for girls since 2006 and for boys since 2011, with multiple doses required for boys. Vaccination can begin at age 9, and is targeted for children aged 11 to 12 years to prevent and control associated outcomes of HPV including: genital warts, precancerous lesions, and certain cancers, such as cervical, vaginal, vulvar, anal, penile, and oropharyngeal.1
Parent-reported data from the 2022 National Health Interview Survey is used in the CDC report to describe the percent change of children aged 9 to 17 years who received at least 1 dose of the HPV vaccine by "selected sociodemographic and health characteristics," the report stated.1
That National Health Interview Survey is a nationally representative household survey of the United States civilian noninstitutionalized population, and is conducted continuously throughout the year by the National Center for Health Statistics.1
Overall, for 2022, 38.6% of children received 1 or more HPV vaccine doses. That percentage increased with age, as 7.3% of children aged 9 to 10 years received 1 or more dose, 30.9% of children aged 11 to 12 years, 48.8% among children aged 13 to 14 years, and 56.9% among children aged 15 to 17 years.1
According to the report authors, girls were more likely to received 1 or more HPV vaccine doses compared to boys (42.9% vs 34.6%).1
The percentage of children who received 1 or more vaccine dose also varied by race and Hispanic origin, as Hispanic children were less likely to receive 1 or more doses compared to White non-Hispanic children (34.4% vs 39.9%). Observed differences between Asian non-Hispanic, Black non-Hispanic, White, and Hispanic children were not considered significant.1
Health insurance was also a factor in the percentage of children who received 1 or more vaccine doses, as was parental education and family income.1
Children with private health insurance (41.5%) were more likely to receive 1 or more HPV vaccinations compared to children with Medicaid (37%), other government sponsored coverages (30.2%), and those without insurance (20.7%). Children with Medicaid were more likely to receive vaccine doses compared to those without insurance.1
Increasing parental education was associated with higher vaccination percentages in children, as 31.1% of children who lived in households with parents whose highest education was high school or less. For those with parents who had an associate's degree or some college experience, 40.6% of children received 1 or more vaccine doses. For children with parents whose highest education was a bachelor's degree or higher, 42.1% received at least 1 HPV vaccine dose.1
For family income, 29.9% of children with a family income of less than 100% of the federal poverty level received 1 or more vaccine doses, compared to 45.7% among children with a family income of 400% or more of the federal poverty level.1
According to the US Department of Health and Human Services, $27,750 per year was the 100% federal poverty level in 2022 for a family or household size of 4 in the 48 contiguous states (not Alaska and Hawaii). The 400% poverty level for the same household was $111,000 per year.2
Additionally, children with disability were more likely to receive HPV vaccination compared to those without disability (44.1% vs 37.7%). The same was true for children living in "large metropolitan areas (39.4%), large fringe metropolitan areas (41.1%), and medium and small metropolitan areas (39.4%) compared with those living in nonmetropolitan areas (30.0%)," stated the authors.1
According to the report, the CDC recommends a 2-dose series with 2 doses given 6 to 12 months apart for children aged 11 to 12 years, though vaccination series can start when children are at age 9 years. For those with a weakened immune system and those starting at age 15 years or older, a 3-dose series is recommended.1
References:
1. Villarroel MA, Galinsky AM, Lu PJ, Pingail C. Human Papillomavirus vaccination coverage in children ages 9-17 years; United States, 2022. National Center for Health Statistics. February 2024. Accessed May 10, 2024. https://www.cdc.gov/nchs/products/databriefs/db495.htm#Data%20sources%20and%20methods
2. 2022 poverty guidelines: 48 contiguous states (all states except Alaska and Hawaii). US Department of Health and Human Services. PDF. Accessed May 10, 2024. https://aspe.hhs.gov/sites/default/files/documents/4b515876c4674466423975826ac57583/Guidelines-2022.pdf
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HPV vaccination coverage of US-children aged 9-17 years in 2022 - Contemporary Pediatrics
Weekly review: Profound genetic deafness gene therapy, measles increases, and more – Contemporary Pediatrics
Thank you for visiting the Contemporary Pediatrics website. Take a look at some of our top stories from last week (Monday, May 6, to Friday, May 10, 2024), and click on each link to read and watch anything you may have missed.
1.) DB-OTO improved hearing to normal in child with profound genetic deafness
Positive, phase 1/2 preliminary data for Regeneron Pharmaceuticals' DB-OTO, an investigational gene therapy for profound genetic deafness, was presented at the 2024 American Society of Gene and Cell Therapy (ASGCT) annual conference.
Click here for full commentary and data, in this discussion with Lawrence R. Lustig, MD, chair, Department of Otolaryngology-Head & Neck Surgery, Columbia University, and clinical trial investigator.
2.) Measles increase: Discussing vaccination with vaccine-hesitant parents
In a time when vaccine hesitancy is contributing to a rise in measles cases, an understanding of why parents are hesitant is key to help change their narrative.
Click here for the full article, part of the May issue of Contemporary Pediatrics.
3.) Child welfare: Now that we know better, lets do better
Improvement in access to mental health resources for children would decrease vicarious trauma of foster parents and social workers via improved living and working conditions.
Click here for the full article.
4.) Emergency department serves as equitable location for influenza vaccine delivery
Click here to watch the full interview with Courtney Nelson, MD, attending physician, director of Quality Division of Emergency Medicine, Nemours Children's Hospital Delaware; assistant professor of Pediatrics, Sidney Kimmel Medical College.
5.) The pediatrician's role in a multidisciplinary pediatric cardiology team
Carissa M. Baker-Smith, MD, MPH, explains how a multidisciplinary team works together to diagnose and treat hypertension, as well as obesity in children.
"We're not going to find the solutions to these problems by working in isolation within our respective fields or offices, we need to get out, include the patients, the community and the decision making, and very importantly, the general pediatricians."
Click here for the full interview.
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Pediatric Telehealth Platform Market is expected to Expand at a Massive CAGR of 26.6% through 2030 – openPR
Pediatric Telehealth Platform Market
The global Pediatric Telehealth Platform market research is predicted to record a Massive CAGR of +26.6 % during the review period 2024-2031.
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Market Overview: A Pediatric Telehealth Platform provides remote medical care for children, leveraging digital technologies. It offers real-time consultations with pediatricians through video calls or messaging. The platform facilitates timely diagnosis, treatment, and monitoring of various pediatric conditions. It enhances accessibility to healthcare, especially for families in remote or underserved areas. Additionally, it supports parental education and engagement in managing children's health. By promoting convenience and efficiency, it aims to improve pediatric healthcare outcomes while ensuring patient confidentiality and security.
Top Key Players in Global Pediatric Telehealth Platform Market, TytoCare, Alpha Medical, Blueberry Pediatrics, Anytime Pediatrics, NightLight Connect, Maven, Vsee, Anytime Telehealth, Amwell, Sesame, CallOnDoc, PM Pediatrics, Teladoc Health, K Health, Vivify Health, Southdale Pediatrics, KID-DOC Pediatrics, InSync Healthcare Solutions, CareXM,
The main goal for the dissemination of this information is to give a descriptive analysis of how the trends could potentially affect the upcoming future of Pediatric Telehealth Platform market during the forecast period. This markets competitive manufactures and the upcoming manufactures are studied with their detailed research. Revenue, production, price, market share of these players is mentioned with precise information.
In the geographic segmentation, the regions such as North America, Middle East & Africa, Asia Pacific, Europe and Latin America are given major importance. The top key driving forces of the Pediatric Telehealth Platform market in every particular market is mentioned with restraints and opportunities. The restraints are also given a counter act which prove to be an opportunity for this market during the forecast period of 2024 to 2030 respectively.
The Pediatric Telehealth Platform market is also explained to the clients as a holistic snapshot of a competitive landscape within the given competitive forecast period. A comparative analysis of regional players and segmentations, which helps readers get a better understanding of the areas and resources with better understanding.
Global Pediatric Telehealth Platform Market Segmentation:
Market Segmentation: By Type Cloud-based On-premises
Market Segmentation: By Application Respiratory Cold, Flu & Fever Gastroenterology Behavioural Health Dermatology Other
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An assessment of the market attractiveness with regard to the competition that new players and products are likely to present to older ones has been provided in the publication. The research report also mentions the innovations, new developments, marketing strategies, branding techniques, and products of the key participants present in the global Pediatric Telehealth Platform market. To present a clear vision of the market the competitive landscape has been thoroughly analysed utilizing the value chain analysis. The opportunities and threats present in the future for the key market players have also been emphasized in the publication.
Key questions answered in the report include: What are the main factors likely to encourage the growth of the global Pediatric Telehealth Platform Market? Which factors are expected to limit the development of the global Pediatric Telehealth Platform Market? Which application and product segments are anticipated to top in the forecast period? Which geographical segment is expected to lead and hold the main share of the global Pediatric Telehealth Platform Market in the next few years? What are the projected values and growth rate of the global Pediatric Telehealth Platform Market? Which are the key players operating in the global Pediatric Telehealth Platform Market?
Table of Contents Global Pediatric Telehealth Platform Market Research Report 2024 - 2030 Chapter 1 Pediatric Telehealth Platform Market Overview Chapter 2 Global Economic Impact on Industry Chapter 3 Global Market Competition by Manufacturers Chapter 4 Global Production, Revenue (Value) by Region Chapter 5 Global Supply (Production), Consumption, Export, Import by Regions Chapter 6 Global Production, Revenue (Value), Price Trend by Type Chapter 7 Global Market Analysis by Application Chapter 8 Manufacturing Cost Analysis Chapter 9 Industrial Chain, Sourcing Strategy and Downstream Buyers Chapter 10 Marketing Strategy Analysis, Distributors/Traders Chapter 11 Market Effect Factors Analysis Chapter 12 Global Pediatric Telehealth Platform Market Forecast
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