Area Experts Address Chemicals, Allergies, Autism, Diet and Vaccines
By Michelle Cox

Being a parent means having questions – lots of questions. Here are a five medical-related inquiries that many of us have floating around in our heads, with answers from some of the area’s most knowledgeable experts.

Q: Recently, the Food and Drug Administration expressed concern about the potential effects of bisphenol-A, a widely used component of plastic bottles and food packaging, on fetuses, infants and children. What do parents need to know about chemical exposures in light of recent BPA news?

A: Andrew J. White, Pediatric Program director at Washington University/St. Louis Children’s Hospital, said that the FDA has issued a precaution, meaning they are investigating whether BPA is safe or not. “They do not believe it is harmful for adults or older children but are concerned about the possible effects on developing brains, especially in newborns and in fetuses. So, don’t panic and eliminate all plastics from your home, but try to minimize use of older, scratched, worn-out plastics, and don’t use these for newborns or if you are pregnant.”
What you should know: Take common-sense steps to minimize the use of plastics with young children.

Q: Why is St. Louis such a hotbed of allergies and asthma in children, and what can parents do about it?
A: No one knows for sure why our fine city is plagued with so many respiratory challenges, White said, but it is partly due to our location on the eastern edge of the Great Plains, where pollen blooms come “sweeping ‘cross the plains,” and partly from higher mold content in the air from floods. He added, “There also is the hygiene hypothesis, which essentially says that Western society is so much more clean than underdeveloped countries − and more clean than we used to be − so the part of our immune system that usually fights off parasites is bored or confused, and this part of the immune system is actually involved in allergies and asthma.
“Thankfully, symptoms of asthma are treatable – remove the offending allergic trigger, [which could be] cigarette smoke, dust mites, cats and dogs,” White said. And follow a doctor’s advice. “The children who tend to do poorly with their asthma tend not to manage it well.”
What you should know: If your child has asthma, see a physician who can teach you and your child how to manage it.

Q: What is the status of autism research?
A: Dr. John Constantino, professor of psychiatry and pediatrics at Washington University and chief of psychiatry at St. Louis Children’s Hospital, said that autism research is advancing across four major frontiers: genetics, brain imaging, early development of autism syndrome and treatment. “There have been distinct advances made in these areas recently and this is likely where the discoveries are going to come from.

“Autism is an enormous problem,” Constantino said. “It is prevalent and it is mysterious and our treatments are only beginning to show the ability to have a sustained impact on outcome. The genetic research indicates that there are many genetic pathways to autism and we are just beginning to get a handle on some of those pathways. Brain imaging offers the most exciting advances, as it may lead to a much better understanding of how social development goes awry.”
Constantino said that researchers recently completed one of the most rigorous analyses of the feasibility of early intervention and it showed significant gains. In addition, work in early development is providing clues as to how the condition arises. “Most exciting is the fact that on three of these research frontiers in the United States, there are strong multi-site collaborative networks that are pooling resources and data,” he said.
What you should know: Research is moving quickly. For more information on all of these advances, parents can turn to the St. Louis-based nonprofit Autism Speaks at www.autismspeaks.com.

Q: How can I get my kids to eat healthier?
A: Connie Diekman, director of University Nutrition at Washington University, said that one of the best ways to get kids to eat healthy is to let them help. “Involve your kids in meal planning, shopping and preparation. Getting them involved boosts interest. Offer two or three options to your kids so they get to choose but you control the choices. Consider topping vegetables with cheese, and offer new foods at the start of a meal when kids are hungrier. Encourage tasting of unfamiliar foods but don’t push them.”

Diekman said it’s important for parents to remember that eating behaviors are learned from observation and maintained over a lifetime. “Take time to eat with your kids and model enjoyable, healthful eating. You can offer foods in fun shapes or smaller pieces so it’s less overwhelming, and listen to their appetite cues. If they say they are full, let them stop. If they didn’t eat enough, a small snack two hours later is OK, but don’t offer a new meal.”  
What you should know: Teaching kids to make the right choices arms them with behaviors that they can maintain.

Q: What is the value of vaccination against routine childhood illnesses such as the flu?
A: “Routine childhood illnesses such as the flu can be deadly,” said White. “Last year, 36,000 people in the United States died of the flu – about the same number as died in automobile accidents. It’s a no-brainer to wear a seatbelt, right? So, it should be a no-brainer to get the vaccine, especially since the side effects of the vaccine are less common than the side effects of the actual flu. Plus, parents should ask themselves if they are willing to risk spreading the flu to others such as infants, the elderly or other children with whom their children play. The side effects are minimal – a sore arm and, rarely, muscle aches and a low-grade fever, and the vaccine cannot give a child influenza.”
What you should know: The benefits of routine vaccinations against the flu, rotavirus, chicken pox and pneumococcal infection (which can lead to pneumonia or meningitis) outweigh the potential side effects.

This story appears in the Spring issue of St. Louis Kids Magazine