MOTHERS OF KIDS WITH AUTISM TOOK LESS IRON

Mothers of children with autism are significantly less likely to report taking iron supplements before and during their pregnancies than the mothers of children who are developing normally, a study by researchers with the UC Davis MIND Institute has found

Low iron intake was associated with a five-fold greater risk of autism in the child if the mother was 35 or older at the time of the child's birth or if she suffered from metabolic conditions such as obesity hypertension or diabetes.

The research is the first to examine the relationship between maternal iron intake and having a child with autism spectrum disorder, the authors said. The study, "Maternal intake of supplemental iron and risk for autism spectrum disorders," is published online in the American Journal of Epidemiology.

"The association between lower maternal iron intake and increased ASD risk was strongest during breastfeeding, after adjustment for folic acid intake," said Rebecca J. Schmidt, assistant professor in the Department of Public Health Sciences and a researcher affiliated with the MIND Institute.

The authors of the current study in 2011 were the first to report associations between supplemental folic acid and reduced risk for autism spectrum disorder, a finding later replicated in larger scale investigations.

"Further, the risk associated with low maternal iron intake was much greater when the mother was also older and had metabolic conditions during her pregnancy."

The study was conducted in mother-child pairs enrolled in the Northern California-based Childhood Autism Risks from Genetics and the Environment (CHARGE) Study between 2002 and 2009. The participants included mothers of children with autism and 346 mothers of children with typical development.

The researchers examined maternal iron intake among the study's participants, including vitamins, other nutritional supplements, and breakfast cereals during the three months prior to through the end of the women's pregnancies and breastfeeding. The mothers' daily iron intake was examined, including the frequency, dosages and the brands of supplements that they consumed.

"Iron deficiency, and its resultant anemia, is the most common nutrient deficiency, especially during pregnancy, affecting 40 to 50 percent of women and their infants," Schmidt said. "Iron is crucial to early brain development, contributing to neurotransmitter production, myelination and immune function. All three of these pathways have been associated with autism."

"Iron deficiency is pretty common, and even more common among women with metabolic conditions," Schmidt said. "However we want to be cautious and wait until this study has been replicated.

"In the meantime the takeaway message for women is do what your doctor recommends. Take vitamins throughout pregnancy, and take the recommended daily dosage. If there are side effects, talk to your doctor about how to address them."

PARENTAL SMOKING PUSHES KIDS INTO POVERTY

Smoking is not only bad for your health; it also puts 400,000 children in poverty. Smoking places a financial burden on low income families, suggesting that parents are likely to forgo basic household and food necessities in order to fund their addiction, according to UK research published in the open access journal BMC Public Health.

This is the first UK study to highlight the extent to which smoking exacerbates child poverty. The findings are based on national surveys which estimate the number of children living in poverty by household structure. In 1999, the UK government announced a target to abolish child poverty by 2020, though this target is unlikely to be met. It is therefore crucial to identify avoidable factors that contribute to and worsen child poverty.

"Smoking reduces the income available for families to feed, clothe and otherwise care for their children living in low-income households. This study demonstrates that if our government, and our health services, prioritized treating smoking dependence, it could have a major effect on child poverty as well as health," says lead author, Dr Tessa Langley from the UK Centre for Tobacco and Alcohol Studies at the University of Nottingham.

Smoking is an expensive habit and one that impoverishes millions of people around the world. In the US, smokers spend less on housing than non-smokers and recent research in India showed that smoking cuts spending on food, education, and entertainment.

This new study estimates that 1.1 million children in the UK, almost half of all children in poverty, were living with at least one parent who smokes. A further 400,000 would be classed as being in poverty if parental tobacco expenditure were subtracted from household income.

In July 2014, the weighted average price of 20 cigarettes in the UK was £7 (GB). Although many smokers save money by opting for budget brands or switching to hand rolling tobacco, the cost of their smoking is still a substantial drain on the budgets of families living on low incomes. "The poverty threshold income level for a two parent household with two children is £392. If both parents are smokers, these households will be spending an average of £50 on tobacco per week, which is a big drain on an already tight budget," says Tessa Langley.

This is a key opportunity for the UK Government to take action to improve the lives of millions of children. "Tobacco control interventions to encourage low income smokers to quit, would not only improve health but also alleviate poverty," says Tessa Langley. Future studies are needed to determine what families sacrifice to sustain their habit, whether they do without fresh fruit or food in general; heating bills or clothing. This would provide a better picture on the burden of smoking in poor households.

Substitutes For Lidocaine Patches For Kids With Neuropathy

Today's post from ask.metafilter.com (see link below) is taken from a forum discussion on finding an alternative for lidocaine patches to use with children living with neuropathy. Here the aim is to find cheaper options but lidocaine patches can also be too strong for smaller children. The responses to the original question are shown below. We often forget that children can also suffer from neuropathy and although it is less frequent, the pain and sicomfort can be every bit as difficult to deal with. Children aren't as able to rationalise their pain as adults are, so treating them 'kindly' with our medications is very important.

Lidocaine patch substitute for child's neuropathy.
September 25, 2014 
 
Looking for a cool (as in chilly), inexpensive, gel-like patch to replace Lidocaine patches for a child with nerve pain.

Little Orsonet, who is 7, has small nerve fiber neuropathy which manifests as a burning sensation in her feet. The pain varies in intensity and is not present all the time. Her neurologist just prescribed Lidocaine patches, which we tried today and she loves them.

Yeah! However, they are $8 a patch ($240 for a month's supply of the generic) and Medicaid doesn't pay for them. She's on Medicaid because she was adopted through foster care. I have a hunch that what she likes about them is the cool gooeyness (sp?) rather than the actual lidocaine and I'd like to test that hypothesis by finding a patch that I can buy over-the-counter for, hopefully, a lot less money.

I found this on Amazon, but it's basically the same price. I've looked at pain patches, but some of them contain aspirin (a no-no) and most of them appear to lack the cooling gel goodness. Anyone have any suggestions? A worried mom appreciates any input.

If it's relevant, she takes 5 ML of Gabapentin twice a day and Tramadol as needed. posted by orsonet to Health; Fitness (11 answers total) 3 users marked this as a favorite

They aren't super cheap, but they are cheaper than that and can be reused: lansinoh soothing gel breast pads intended for nursing mothers.
posted by bq at 5:48 PM on September 25 [1 favorite]

Will she be walking on them (or at least walking on them a lot), or is it something she does with her feet up?
posted by Lyn Never at 5:56 PM on September 25

What about Biofreeze? Its not a patch, but I would use those exact adjectives (cool and gooey) to describe the sensation.
posted by Nickel Pickle at 5:57 PM on September 25 [1 favorite]

She doesn't need to be able to walk on them.
posted by orsonet at 6:00 PM on September 25

there are menthol gel patches you can buy in the drugstore, and they are indeed cool and gooey.
posted by The Elusive Architeuthis at 6:03 PM on September 25 [1 favorite]

I immediately thought of BioFreeze too. I have chronic wrist pain and use it frequently and it sounds like what you describe.
posted by kbanas at 6:09 PM on September 25 [1 favorite]

FWIW the ones you linked to are $6.99 for a four-pack, not per patch.
posted by celtalitha at 8:05 PM on September 25 [1 favorite]

The methanol gel patches that I like are Salon Pas. They are pretty cheap, and they give a cool feeling.
posted by heathrowga at 8:08 PM on September 25 [1 favorite]

Thanks everyone!
posted by orsonet at 3:53 AM on September 26 

http://ask.metafilter.com/269052/Lidocaine-patch-substitute-for-childs-neuropathy

African Kids And HIV Related Neuropathy

 Today's post from i-base.info (see link below) is a subject that won't go away until the drug companies stop supplying older and more toxic HIV drugs to third world countries. They do this for two reasons: they're under political pressure to reduce costs for poorer communities and they want to get rid of their supplies of older drugs. D4T, for example is notorious for causing neuropathy as a side effect and it is happening to HIV children more frequently than ever. If you are a neuropathy sufferer, you wouldn't wish it on your worst enemy but to think that young children will be suffering for years on end before a 'cure' or effective treatment arrives, is just tragic. It's a moral question and it's about time governments and pharmaceutical companies got their priorities in order.
 

High prevalence of peripheral neuropathy in children taking d4T in rural South Africa
1 August 2012. Polly Clayden, HIV i-Base

Peripheral neuropathy is a well-known side effect of older nucleosides, particularly d4T, which is still used widely in poor settings.

Although it clearly occurs, this phenomenon is less well characterised in children and it is difficult to assess, particularly with limited resources.

In an oral presentation at IAC 2012, Remco Peters from the Anova Health Institute, Khutso Kurhula Project, Tzaneen, South Africa, showed findings from an evaluation of neuropathy in children in the rural Mopani district. This district is a health priority area in South Africa and the institute runs a nurse managed ART programme in 100 public health care facilities with the support of PEPFAR.

The group used two clinical tools to screen for neuropathy – the neuropathy symptom score (NSS) and neuropathy disability screen (NDS). These tools are feasible for resource limited settings and the NDS only uses a reflex hammer, cotton buds, tooth pick and cold water (to access ankle reflex and perception of vibration, pin-prick and temperature).

It was a cross sectional study of 182 children of median age of 9 years (range 5-15 years) and receiving ART for a median of 2 years (range 2 months to 6.4 years). The majority (86%) received d4T-containing regimens.

Forty-nine (27%) children reported neuropathy symptoms and NDS was positive for 25 children (14%); 43 (25%) children fulfilled the study criteria for peripheral neuropathy.

Co-trimoxazole use was negatively associated with neuropathy OR 0.42, (95% CI 0.20 – 0.88, p=0.019) and there were trends for peripheral neuropathy to be associated with older age and longer time on ART but this analysis is still onging.

Dr Peters included quotes from the children: “My feet are burning, I must take off my shoes in class otherwise I can’t concentrate” from one and, “I can’t sleep at night because of the tingling of my feet; I’m tired during the day” from another.

He concluded that neuropathy is common and frequently undiagnosed in this region and that NSS and NDS are useful diagnostic tools in such settings. Most importantly he added: “Talk to the child!”
comment

d4T associated toxicities have been well documented and screening tools that can be used where resources are limited are welcome.

That children’s experience of adverse events reliant on patient reporting often seems to increase as they get older (and gain a vocabulary) is worth noting.

Co-trimoxazole use appears to be a proxy marker in this study for time on ART/exposure to d4T: children taking co-trimoxazole are much shorter on ART (p = less than0.001). There is not likely to be a specific or direct effect of co-trimoxazole use, but the investigators need to finalise the analysis to be sure about this (Remco Peters, personal communication).

Reference:Peters RPH et al. Clinical screening shows high prevalence of peripheral neuropathy in children taking antiretroviral therapy in rural South Africa. 19th International AIDS Conference. 22-27 July 2012, Washington. Oral abstract MOAB0205.

http://i-base.info/htb/19847