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Policy & Practice


 

AAP Policy on Pertussis

A new policy statement from the American Academy of Pediatrics (AAP) recommends universal immunization with the tetanus toxoid, reduced diphtheria toxoid and acellular pertussis (Tdap) vaccine at the 11–12 year-age visit, as well as catch-up immunization of older adolescents, to boost individual and herd protection against pertussis. Tdap has replaced the Td (tetanus and reduced diphtheria toxoids) vaccine for adolescents in the childhood immunization schedule. In 2004, more than 25,000 cases of pertussis were reported in the United States—with more than a third occurring in adolescents—up from a low of 1,060 cases in 1976. Additionally, reported pertussis-related deaths among infants increased from about 10 per year in the 1990s to about 20 per year in this decade. “In infants, pertussis can be dangerous, and very severe. Parents need to know how important it is to vaccinate their children on time to prevent a serious and potentially life-threatening disease,” AAP President Dr. Eileen Ouellette said in a statement.

Food Allergen Labeling

All food labels now must clearly state if a product contains any ingredients with protein derived from the eight major allergenic foods. Under the Food Allergen Labeling and Consumer Protection Act of 2004 (FALCPA), manufacturers are required to identify in plain English the presence of ingredients that contain protein derived from milk, eggs, fish, crustacean shellfish, tree nuts, peanuts, wheat, or soybeans in the list of ingredients or to say “contains” followed by the name of the source of the food allergen after or adjacent to the list of ingredients. It is estimated that 2% of adults and about 5% of infants and young children in the United States suffer from food allergies. Approximately 30,000 consumers require emergency department treatment and 150 Americans die each year because of allergic reactions to food. “The eight major food allergens account for 90% of all documented food allergic reactions, and some reactions may be severe or life threatening,” said Robert E. Brackett, Ph.D., director of the Food and Drug Administration's Center for Food Safety and Applied Nutrition. “Consumers will benefit from improved food labels for products that contain food allergens.” The statute, however, does not require manufacturers or retailers to relabel or remove products that don't have the labeling, because they were labeled before the effective date. For that reason, there will be a period of time where consumers will see packaged food on store shelves and in their homes without the revised allergen labeling, the FDA cautioned.

Improving Food Marketing

Food and beverage marketing targeted to children aged 12 years and under encourages them to consume high-calorie, non-nutritious products, according to a report from the Institute of Medicine. Although some companies and restaurants have begun to develop and promote healthier choices, overall, food industries spend most of their resources on products with high amounts of added sugar, fat, and salt, and a lack of essential nutrients, the report said. The IOM recommended that these industries shift their resources to developing a wider array of products that are “nutritious, appealing, and affordable.” Lawmakers should look at the IOM report as a road map to help improve children's diets and address childhood obesity, said Center for Science in the Public Interest Nutrition Policy Director Margo G. Wootan, D.Sc. “Getting junk food out of schools, promoting fruits and vegetables, putting nutrition information on chain restaurant menus, and scrutinizing food ads on children's television programming are four things Congress could consider right now to advance the IOM's recommendations,” she said.

Mental Health Screening Snapshot

More than half the states provide education or information to primary care providers to help them focus on young children's mental health development, according to a survey from the National Academy for State Health Policy (NASHP). As part of the Assuring Better Child Health and Development (ABCD II) program, NASHP surveyed Medicaid, maternal and child health, and children's mental health agencies in all 50 states and the District of Columbia to gather information on how states were addressing the healthy mental development of children aged birth to 3 years. Mental health consultation was mentioned most frequently (48%), followed by state-funded care coordinators (33%), public health nursing consultation (30%), and lists of organizations for physician referrals (27%). However, “these low percentages suggest that none of these resources are readily available,” the survey indicated. States reported that providers raised a number of concerns regarding screening for social emotional development, such as a lack of referral resources, insufficient payment, and a lack of expertise.

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