I know schools are overburdened already, but I still think they need to add a class on all that stuff you’re just supposed to know. Where else should kids learn that the Nigerian finance minister will never randomly pick them as someone to be trusted with tens of millions of dollars hidden in a Swiss bank account? Where is it written that central air conditioners have filters and that if you don’t change them every few months your heat pump will explode in a giant ball of burning money?
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I am so disappointed that my parents did not buy me that $3,000 Aston Martin stroller.
And who tells you that neither kitchen grease nor wet wipes are to be flushed down the drain? Because wider knowledge of that last one would have saved Londoners 6 weeks of sewer work while technicians remove a 15-ton “fatberg” composed mainly of those two substances from under the city’s streets. I was just lucky to have a mother to show me how to pour food grease into an empty can for disposal in the garbage and a father to teach me that baby wipes are to be placed in the trash until the smell is so overwhelming that someone else empties it.
Drinking problem
I have a declaration of scientific principle that some may find controversial, but I don’t care: sugar-sweetened beverages (SSBs) are over. Done. Write them off, pour them down the drain, never speak of them again, and under no circumstances apply for a grant to study whether they contribute to obesity. They do, okay? Case closed. Let’s toast with our glasses of ice water and move on to the next pressing question: Why do artificially sweetened beverages also appear to contribute to obesity?
The final nail in the cask of sugar-sweetened beverages may well be a study in Pediatrics clearing up some ambiguity about the age at which SSB consumption causes obesity. Previously, the beverage industry had funded two studies demonstrating that SSBs did not contribute to obesity in children aged 2-5 years, although controversy remained as to why these children would be immune to the excess empty calories, with some researchers favoring unicorn magic while others suggested the intervention of elves.
The real problem may have been flawed study design, which these most recent authors overcame by assessing “SSB consumption and body mass index Z scores among 9,600 children followed in the Early Childhood Longitudinal Survey—Birth Cohort, using linear and logistic regression and adjusting for race/ethnicity, socioeconomic status, mother’s BMI, and television viewing.” Booyah! Their findings? SSBs contribute to obesity starting at about age 2 years. Now maybe we can finally dedicate some research dollars to figuring out whether vaccines cause autism.
Culture club
Don’t you love it when you don’t have to do something you thought you did, like take out the trash can full of diaper wipes? The story arc of pediatrics in our age seems to be the ever-forward march away from intervention and toward anticipatory guidance. When I was growing up, I had to give a urine and blood sample at every annual physical. In 10 more years, a wellness exam is going to consist of Skyping a parent and talking for 30 minutes about avoiding sugar-sweetened beverages.
The latest step away from intervention involves uncomplicated skin and soft tissue infections (SSTIs). Back in the old blood-and-urine days, admissions for these infections were rare and the organisms were interesting, so blood cultures were part of the routine work-up. Now, however, we’re in the future, and our children have been turned into replicant pod slaves by our methicillin-resistant Staphylococcus aureus (MRSA) overlords. A new publication confirms what you already suspected: We admit a child for an SSTI every other encounter, the blood cultures are always negative, and the wound cultures invariably grow some flavor of MRSA.
While these results may not apply to complicated SSTIs such as those from surgical or traumatic wound infection or infected ulcers or burns, the authors suggest sparing thousands of children unnecessary blood cultures that do nothing but prolong their hospitalizations by a day. With the money we save, we might even be able to buy up the nation’s supply of SSBs and pour them into the sewers to break up those baby-wipe fatbergs before they evolve into intelligent beings even more frightening than MRSA.
Soap what?
Have you heard of the meme “first-world problems?” Even my own kids realize that sometimes their complaints are, well, a little self-indulgent: “Dad, you bought the wrong kind of tofu-chicken nuggets...again!” But even this budding self-awareness occasionally needs a bump from actual reality. This week’s context comes from researchers at the London School of Hygiene and Tropical Medicine, who analyzed 14 studies of water, sanitation, and soap availability in low- and middle-income countries. Their findings? Having clean water and soap is enough to bump children’s height growth by 0.5 cm at age 5.