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	news bulletins july 2006

• Dream a Little Dream
• Formula Bag Ban Goes National
• Safety for Cyclists in a Four-Wheeled World
• Secondhand Smoke: Worse than Previously Thought
• A Shot in the Dark

Dream a Little Dream
by Marin Sardy

While most children begin to stay dry through the night around the age of three, over six million kids in the U.S.—nearly 15 percent—wet their beds beyond the age of five. A new study, published this month in Pediatrics, may offer an easy way to reduce those numbers. Led by Dr. Joseph Barone of Rutgers University School of Medicine, the study indicates that bedwetters are far less likely to have been breastfed than children with proper nighttime bladder function. When Barone and his colleagues examined the early feeding habits of children aged five to 13, they found that more than eight in ten of the latter group had breastfed for at least three months during infancy, compared to less than half of bedwetters.

Despite its history as a problem enmeshed in shame and misunderstanding, bedwetting is now known to be neither an intentional act nor a disease, but rather a delay in the normal development of the central nervous system. This means conditions that aid cognitive development should reduce the likelihood of the problem's occurrence, and that's why Barone has suggested that breastfeeding may soon prove to be "the first true preventative approach towards bedwetting."

Further research is necessary to determine whether this relationship is causal, or if other factors are responsible for the correlation. But Barone pointed to a component of breastmilk as one possible factor: n-3 and n-6 long chain fatty acids, which are essential to brain development. Formula-fed babies may not get enough of these nutrients.

Infant formula fortified with these fatty acids has recently become available (too recently for the participants in this study to have used), but previous research in related fields suggests that it is still unlikely to have the same effect as breastfeeding. Lots of direct interpersonal contact, such as that involved in the act of breastfeeding, has also been shown to be integral in promoting nervous system development—and that simply can't be bottled and sold.

Formula Bag Ban Goes National
The Massachusetts Breastfeeding Coalition has announced a new national campaign to limit formula company marketing by hospitals. "Ban the Bags" will help hospitals to stop distributing formula company discharge bags to new mothers on maternity units. The organization and its website, www.BantheBags.org were founded in the wake of Massachusetts recent struggle to enact a regulation banning the bags from all hospitals in the state. While the regulation was initially approved, Gov. Mitt Romney intervened to kill it, going so far as replacing one third of the Public Health Council just before its May decision. Just two weeks later, the Massachusetts government announced a state-sponsored deal with Bristol-Myers Squibb, makers of Enfamil infant formula, to build a $660 million pharmaceutical plant in Massachusetts, in a move widely expected to bolster Romney's possible presidential bid.

Health care professionals have long opposed the practice of in-hospital formula giveaways. "This tactic is the crown jewel in the companies' marketing strategy, because parents see the hospital as endorsing baby formula, especially the expensive brands" says Marsha Walker, RN, IBCLC, a Board member of MBC and a national authority on formula marketing. The practice is common, in part because formula companies cultivate relationships with hospital staff and offer lucrative incentives to get hospitals to market their product.

Infant formula is an $8 billion a year global industry, with almost half of all sales coming from the US. The promotional bags advertise only the most expensive brands of formula. Because research shows that most parents who use formula use the brand advertised in the hospital, this results in these families paying 66% more than store brands, or more than $700 a year.

Research also shows that when breastfeeding mothers take home one of these commercial brands, they are more likely to start using formula. "The advertising effect is so dramatic that it occurs even if the bags do not contain any formula samples," says Merewood, Director of the Breastfeeding Center at Boston Medical Center, and with Walker, a founder and co-chair of Ban the Bags.

Hospital distribution of commercial bags is opposed by many health professional organizations. Not breastfeeding, or early weaning is linked with an increased risk in many acute and chronic diseases in children, as well as breast cancer, ovarian cancer, and type 2 diabetes in mothers.

Ban the Bags operates under the auspices of the Massachusetts Breastfeeding Coalition (MBC), but is run by a committee of experts from around the country, as well as by board members of MBC, a non-profit organization comprised largely of health care professionals involved in maternal and child health. Urge lactivists in your state to join this national campaign.

Contacts:
Anne Merewood, MPH, IBCLC
Anne.merewood@bmc.org
617 414 7902
Marsha Walker, RN, IBCLC
marshalt@aol.com
781 893 3553

Safety for Cyclists in a Four-Wheeled World
By Marin Sardy

In spite of the increasing popularity of Critical Mass bicycle rallies, which promote ditching the car in favor of pedal power, America's mean streets continue to get meaner for users of two-wheeled conveyances. More traffic, bigger roads, and a conspicuous absence of bike lanes in most cities are all making it harder for people to ride safely in their own neighborhoods. But for parents to limit or avoid bike riding not only prevents kids and teens from enjoying their own mobility, it also takes away a valuable means of instilling in them some healthy, earth-friendly habits.

Don't let the cars win: instead of giving up on biking as a family pastime, teach your kids proper bicycle safety—and not just the basics. While always wearing a helmet is imperative, bike safety is about more than simply having the right gear. It's also about knowing how to share the road with cars: how to stay visible, how to communicate, and how to watch out for common pitfalls. Consider making cycling a family activity, in which you can supervise any challenging circumstances. Exposing kids to the kinds of choices cyclists must make will help them develop good judgment about safety issues.

Also, don't forget to support the construction of bike lanes and community bike trails—especially paths within the city, which can become important transportation routes as well as recreational areas.

Here some important tips for urban and suburban cycling:

• Always ride with—not against—the flow of traffic.
• Use hand signals religiously.
• Stop at all stop signs and red lights.
• Don't stay too far to the right. This may render you invisible to motorists, and could also cause you to get hit by the opening door of a parked car.
• Look, look, look. Before turning, stopping, or riding through an intersection, always glance back and to the sides to make sure the coast is clear.

Secondhand Smoke: Worse than Previously Thought

US Surgeon General Richard H. Carmona recently issued a comprehensive scientific report which concludes that there is no risk-free level of exposure to secondhand smoke. Nonsmokers exposed to secondhand smoke at home or work increase their risk of developing heart disease by 25 to 30 percent and lung cancer by 20 to 30 percent. The finding is of major public health concern due to the fact that nearly half of all nonsmoking Americans are still regularly exposed to secondhand smoke.

The report, The Health Consequences of Involuntary Exposure to Tobacco Smoke, finds that even brief secondhand smoke exposure can cause immediate harm. The report says the only way to protect nonsmokers from the dangerous chemicals in secondhand smoke is to eliminate smoking indoors. Secondhand smoke exposure can cause heart disease and lung cancer in nonsmoking adults and is a known cause of sudden infant death syndrome (SIDS), respiratory problems, ear infections, and asthma attacks in infants and children, the report finds.

"The health effects of secondhand smoke exposure are more pervasive than we previously thought,"said Surgeon General Carmona, vice admiral of the U.S. Public Health Service. "The scientific evidence is now indisputable: secondhand smoke is not a mere annoyance. It is a serious health hazard that can lead to disease and premature death in children and nonsmoking adults." Secondhand smoke contains more than 50 cancer-causing chemicals, and is itself a known human carcinogen. Nonsmokers who are exposed to secondhand smoke inhale many of the same toxins as smokers. Even brief exposure to secondhand smoke has immediate adverse effects on the cardiovascular system and increases risk for heart disease and lung cancer, the report says. In addition, the report notes that because the bodies of infants and children are still developing, they are especially vulnerable to the poisons in secondhand smoke.

"The good news is that, unlike some public health hazards, secondhand smoke exposure is easily prevented,"Surgeon General Carmona said. "Smoke-free indoor environments are proven, simple approaches that prevent exposure and harm."The report finds that even the most sophisticated ventilation systems cannot completely eliminate secondhand smoke exposure and that only smoke-free environments afford full protection. Sustained efforts are required to protect the more than 126 million Americans who continue to be regularly exposed to secondhand smoke in the home, at work, and in enclosed public spaces.

To help communicate the report findings as widely as possible, the Surgeon General offers practical information on the dangers of secondhand smoke and steps people can take to protect themselves.

Source:
http://www.surgeongeneral.gov/

A Shot in the Dark

Sick of the aggressive, targeted marketing onslaught of often inappropriate goods and services aimed at pre-teens? One of the latest “products” directed at young girls might make them sick too—literally. Merck’s new vaccine Gardasil, which the CDC has just recommended for all 11 and 12 year old girls, has not been adequately or appropriately assessed for risks, according to vaccine safety advocates.

The National Vaccine Information Center (NVIC) maintains that Merck's clinical trials did not prove that the human papillomavirus (HPV) vaccine, touted as preventing cervical cancer and genital warts, is safe to give to pre-adolescents. “There is too little long term safety and efficacy data, especially in young girls, and too little labeling information on contraindications,” said NVIC president Barbara Loe Fisher.

According to NVIC’s June 27 press release, in Gardasil’s clinical trials, the FDA allowed Merck to use a potentially reactive aluminum containing placebo as a control for most participants, rather than a non-reactive saline solution placebo.¹ A reactive placebo can artificially increase the appearance of safety of an experimental drug or vaccine in a clinical trial. Gardasil contains 225 mcg of aluminum and, although aluminum adjuvants have been used in vaccines for decades, they were never tested for safety in clinical trials. Merck and the FDA did not disclose how much aluminum was in the placebo. ²

Animal and human studies have shown that aluminum can cause nerve cell death ³ and that vaccine aluminum adjuvants can allow aluminum to enter the brain,^{4 5}as well as cause inflammation at the injection site leading to chronic joint and muscle pain and fatigue.^{6 7} Nearly 90 percent of Gardasil recipients and 85 percent of aluminum placebo recipients followed-up for safety reported one or more adverse events within 15 days of vaccination, particularly at the injection site.⁸ Pain and swelling at injection site occurred in approximately 83 percent of Gardasil and 73 percent of aluminum placebo recipients. About 60 percent of those who got Gardasil or the aluminum placebo had systemic adverse events including headache, fever, nausea, dizziness, vomiting, diarrhea, and myalgia.^{9 10} Gardasil recipients had more serious adverse events such as headache, gastroenteritis, appendicitis, pelvic inflammatory disease, asthma, bronchospasm and arthritis.

Gardasil is the first childhood vaccine to exclusively target girls. The HPV vaccine is also the first to be credited with preventing cancer, a claim hyped in Merck’s multi-channel marketing campaign “Tell Someone.” In fact, even the types of HPV billed “high risk” rarely actually result in cancer; the immune system generally removes the virus before it causes problems. Also, in the rare instances where it does occur, cervical cancer usually takes five to ten years to develop. Prior to cancer, HPV causes the growth of tell-tale abnormal cells, which can be detected by a Pap smear. Upon detection, the disease can be easily cured by minor surgery to remove the abnormal cells. Therefore, a woman who gets regular Pap smears every one to three years is almost 100% protected from cervical cancer—with no need for an expensive, potentially problematic, under tested vaccine. Cervical cancer accounts for only about one percent of all cancer deaths in US women.

Health and Human Services is expected to approve the CDC recommendation—meaning Gardasil will be routinely administered to all 11 and 12 year old girls. The vaccine has also received CDC approval for sale and marketing to girls and women ages nine to 26. At $120 a pop, the three required doses of Gardasil will earn Merck $360 per consumer. With over 35 million US girls and women between the ages of 9 and 26, recommended administration of Gardasil could mean over 12 billion dollars for the drug company. Merck is currently fighting more than 11,500 lawsuits related to another of their drugs, Vioxx, which is also plagued by controversy surrounding false data on its safety.

Sources:

http://www.gardasil.com/

http://www.merck.com/

http://www.metrokc.gov/health/apu/std/hpv.htm#whatis

http://www.909shot.com/PressReleases/pr62706gardasil.htm