Friday, February 12, 2010
A new understanding of SIDS

By Dr. Anthony Policastro

Some things about being a pediatrician are harder than others. One of those is giving parents bad news about their child. That is especially true when the news is about a child who up to that point has been healthy. Sudden Infant Death Syndrome (SIDS) or crib death is one of those times. A recent study has suggested that SIDS might be due to a deficit of a chemical called serotonin in the brain. Serotonin belongs to a group of chemicals called neurotransmitters. These are the chemicals that allow our brain cells to work properly. For example, ADHD is caused by deficits of two neurotransmitters. One of them is called dopamine. The other is called norepinephrine. The drugs that we use to treat ADHD are stimulants. They stimulate the body to produce more dopamine and norepinephrine. This results in better attention being paid. That is why stimulants "slow down" hyperactivity. It now appears that SIDS is another disorder related to a deficit of a neurotransmitter. Serotonin is one of the things that is used in the breathing center of the brain. If the levels are low, the area might not stimulate the breathing the way it should. The result will be that the infant who is supposed to breathe more does not. We know that other things affect neurotransmitters. For example carbon dioxide can affect serotonin. There is speculation that perhaps children who lie on their abdomen breathe back in a lot of the carbon dioxide that they inhale. This could interfere with serotonin stimulation of breathing. The result would be that the infant stops breathing. Thus if we lie an infant on his/her back, it allows them to breathe more oxygenated air. The result is that they do not have interference with their serotonin levels. They are less likely to have a crib death. The campaign to let infants sleep on their back has helped lower the rate of SIDS. Unfortunately, there are still some children who have SIDS even with the proper sleeping position. It would appear that it might be related to them having low serotonin levels in the first place. They do not need carbon dioxide levels to lower their serotonin level. Thus even if they sleep on their back, they might have issues with breathing. The studies looked at the brains of infants who died of SIDS. They compared them to infants who died of other things. The children with SIDS had lower serotonin levels. Of course that may help explain what is happening. The next question is what to do about it. How could you identify someone with low brain serotonin levels? If you find it, how do you treat it? Hopefully over the next few years we can get answers to questions like that. I have been called to the ER many times to try to resuscitate an infant who has died of SIDS. It usually means that I then have to tell parents that their apparently healthy infant is now dead and we do not know the reason why. It would certainly be nice to avoid those conversations in the future.

Make 5-2-1-Almost None a part of your daily routine

By Mary Trotter, MS, RD Not only have we begun a new year, but it's also a new decade. Milestones make us reflect and think ahead. As you make your New Year's resolutions, try to be gentle with yourself. Instead of setting specific weight loss goals or making hard and fast rules about exercising, resolve to improve your health by making simple lifestyle changes to your diet and activity level. Nemours Health and Prevention Services has a "prescription" for a healthy lifestyle: 5-2-1-Almost None. Key ingredients to maintaining optimal weight and health include: eating at least five servings of fruits and vegetables daily, watching no more than two hours of television daily, getting at least one hour of physical activity daily and drinking almost no sugary beverages. It's easy to make 5-2-1-Almost None part of your achievable goals for 2010. 1. Resolve to eat five or more servings of a variety of fruits and vegetables everyday. Look for ways to work fruits and vegetables into every meal - whether you are cooking in or eating out. At breakfast, add fruit to cold cereal or oatmeal. For lunch add a side salad to that sandwich instead of fries. Include fruit as your mid-day snack. And at dinner fill half your plate with fruits and vegetables. Make the most of mealtimes and plan to have the family eat together as often as possible. Provide an assortment of foods and encourage children to sample everything. Engage children in conversation during meals. It not only helps to slow the pace of eating, but also to build family communication. 2. Resolve to limit screen time to no more than two hours a day for everyone in your family. Give kids a TV allowance and help them choose shows they really want to watch. Turn the TV on for pre-selected shows and turn it off afterwards. Keep the TV in a central location and out of kids' bedrooms. This also goes for sedentary video games and computer use that is not school-related. 3. Make a commitment to be more active. Activity is the antidote to aging and sets young people on the path to lifelong good habits. Exercise strengthens the cardiovascular and musculoskeletal systems, promotes balance, coordination and physical endurance, all while energizing the body and the mind. The less time you and your children spend in front of a screen, the more opportunity you will have to use your body in active ways. The recommended hour a day of physical activity doesn't have to happen all at once or be a formal exercise session at a gym with special equipment. Walking the dog, parking your car further away from your office building or the mall entrance, taking the stairs, riding your bike - it all adds up throughout the course of a day. 4. Save the sugary drinks for those "once-in-awhile" special occasions. They provide extra calories with little or no nutritional value. Over time, they may contribute to tooth decay and weight gain. Water is the best choice for quenching thirst and calcium-rich, low-fat or fat-free milk helps build strong bodies. Be a role model - let kids see you drinking water and milk too. One hundred percent fruit juice is okay, but it should be limited to one serving a day; that is, four ounces for younger children and eight ounces for adolescents. 5. As you reflect on ways to improve your life and the lives of those you care about in this new decade, resolve to make 2010 the first of many years practicing 5-2-1-Almost None and reaping the rewards of good health. About the author Mary Trotter is a program and policy analyst for Nemours Health & Prevention Services.

'Books are Fun' Book Fair Shop for that bookworm in your life, or get a little something to read for yourself in the lobby at Nanticoke Memorial Hospital from 7 a.m. to 4 p.m. on Thursday, Feb. 18 and from 7 a.m. to 3 p.m. on Friday, Feb. 19. The Look-In Glass Shoppe at Nanticoke Memorial Hospital is hosting a "Books Are Fun" fair featuring quality books and unique gifts at great savings. Join us for huge savings. Payroll deductions for purchases are available for eligible Nanticoke Health Services employees. All proceeds from The Look-In Glass Shoppe benefit Nanticoke Health Services.

Cardiac Professionals Week Bayhealth Medical Center will sponsor Cardiac Professionals Week, Feb. 14-20. All week, cardiac professionals will offer educational displays between 11 a.m. and 1:30 p.m. outside the cafeterias of Milford Memorial Hospital and Kent General Hospital. On Monday, Feb. 15, the Milford and Kent cafeterias will feature a heart healthy food exhibit to help encourage heart healthy food choices. There will be other special activities and daily prize drawings for Cardiac team members throughout Cardiac Professionals Week.

Prescription drug discount program Goodwill of Delaware and Delaware County has partnered with FreeForAll Incorporated to offer a discount prescription medication program to Goodwill customers, team members and their families. Anyone with or without prescription drug insurance coverage can obtain a discount card that will enable the participant to receive a discount on their medication ranging from 15 to 75 percent, depending upon the medication and the pharmacy. In addition, as part of the partnership arrangement, FreeForAll will provide a per transaction fee toward an educational endowment fund being created by Goodwill. Program information in English and Spanish and discount cards for the RxCut Prescription Savings Program can be found at all of Goodwill's 15 retail stores and at The Goodwill Center in Wilmington. Information can also be found on Goodwill's website, The discount card is free, never expires and is accepted at more than 54,000 participating chain and independent pharmacies, including Rite Aid, Walgreens, Walmart, Kmart and Target. It can be used for all FDA approved prescription medications, and also offers a discount for lab and imaging services. No sensitive personal information is collected when the card is used, making the program completely anonymous.

Support group for parents Those who have experienced the loss of a child will find help at Delaware Hospice's Family Support Center's "Parent Educational Support Group," beginning Tuesday, Feb. 23 until Tuesday, March 30, from 6-7:30 p.m., at the Delaware Hospice Center, 100 Patriots Way, Milford. A Sibling Group will be offered simultaneously during the first, third and final sessions. Mickie Chapman, Licensed Mental Health Counselor (LPMHC), a Bereaved Parent & Private Practice therapist at Continuing Bonds, will facilitate the parent sessions. Topics covered will include: "My Grief Counts," "William Worden's Tasks of Grief," "Handling Anger/Guilt," "Traumatic GriefNo Time to say Goodbye," "Being Bereaved ParentsComfort within Devastation," and "Honoring the Memory of your Child." Lezley Sexton, Licensed Mental Health Counselor (LPMHC), New Hope coordinator for Delaware Hospice, will lead the Sibling Groups. There is no fee, however, registration is required. To register or learn more, contact Vicki Costa, associate director of the Family Support Center, 856-7717, x1129, or, by Friday, Feb. 19. Early registration is recommended as space is limited.

Drs. Franks and Greco join NHS Nanticoke Memorial Hospital welcomes Eric Franks, MD and John D. Greco, MD to its active medical staff at Peninsula Orthopaedic Associates' Seaford office. Dr. Franks specializes in arthroscopic surgery of the shoulder and knee, primarily on an outpatient basis. He is a graduate of George Washington University School of Medicine and completed his residency at Johns Hopkins Hospital, his internship at Walter Reed Army Medical Center and a fellowship at Hughston Sports Medicine Foundation in Georgia. Dr. Franks is Board Certified in Orthopaedic Surgery, and was recently appointed master instructor for the Arthroscopic Association of North America where he teaches other surgeons advanced arthroscopic techniques. Dr. Greco specializes in spine surgery and total hip and knee replacement surgery. He is a graduate of Temple University and completed his residency at Boston University Medical Center, his internship at Presbyterian-University of Pennsylvania and a fellowship at New England Baptist Hospital.Dr. Greco is Board Certified in Orthopaedic Surgery. For more information and to schedule appointments, call 629-4787.

NMH holds cholesterol screenings Nanticoke Memorial Hospital will offer cholesterol screenings on Feb. 19 & 20 from 7 to 10 a.m. at the Powerhouse Plaza, 628 W. Stein Hwy., Seaford.The Lipid Profile test requires a 12-hour fasting and reads the HDL, LDL and triglyceride blood levels. Cost for the Lipid Profile is $15. There is no need to pre-register. Results will be mailed within three weeks along with information to evaluate the results and follow-up if needed. In addition to cholesterol screenings, free blood pressure checks and free glucose screenings will be offered. There will also be health information and interactive displays. For more information, call 629-6611, ext. 4536.

Annual women's conference The fifth annual "Women Supporting Women Through Opportunity Conference" will begin Friday, March 26, and last through Sunday, March 28, with an array of activities including eight workshops, door prizes, food, fellowship and lots of fun and learning opportunities. The conference is open to 55 women, ages 18-80 and beyond and workshop assignments are made based on registration dates. For more information, or if you or someone you know is interested in becoming a sponsor of the Conference or the "GeeYou Will Project," call Rosemary Joseph-Kappel at 302-242-0032 or e-mail