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Thu Dec 9 03:57:02 EST 2010


Children
Together, Medicaid and the Children’s Health Insurance Program (CHIP)
provide health coverage to millions of low-income children in
communities across the country: Approximately 29 million children are
covered by Medicaid, and 7 million children are covered by CHIP.1 The
Patient Protection and Affordable Care Act (Affordable Care Act)
contains several provisions that bolster these programs, building on the
advances of the CHIP Reauthorization Act (CHIPRA) by strengthening
Medicaid and CHIP to provide better coverage for current enrollees, as
well as extending coverage to the estimated 7.3 million American
children who are still uninsured.2 
This fact sheet discusses provisions that are
designedhttp://www.familiesusa.org/assets/pdfs/health-reform/Low-Income-Children.pdfWIC
Controversy "[Today] a House committee will consider (
http://edlabor.house.gov/markups/2010/07/hr-5504-improving-nutrition-fo.shtml
)a bill to renew the WIC program, which provides carefully selected
foods and nutrition services to 9 million low-income pregnant and
postpartum women and young children.  As I explained in this paper (
http://www.cbpp.org/cms/index.cfm?fa=view&id=3201 )(and this blog post (
http://www.offthechartsblog.org/are-new-ingredients-adding-more-than-cost-to-wic-foods/
)and this podcast ( http://www.cbpp.org/cms/index.cfm?fa=view&id=3213
)), the program spends about $90 million extra each year on
higher-priced infant formula with ingredients that supposedly boost
children’s health and development — but it has no idea whether these
ingredients actually work.  Congress now has a chance to address the
issue." Read more on Off the Chartsblog (
http://www.offthechartsblog.org/fixing-wic%E2%80%99s-costly-blind-spot/
)http://www.offthechartsblog.org/fixing-wic%E2%80%99s-costly-blind-spot/
 
ARTICLES
 
 
Hager ER et al. Development and Validity of a 2-Item Screen to Identify
Families at Risk for Food InsecurityPEDIATRICS Vol. 126 No. 1 July 2010,
pp. e26-e32
The authors set out to develop a brief screen to identify families at
risk for foodinsecurity (FI) and to evaluate the sensitivity,
specificity,and convergent validity of the screen.
The 2-item FI screen included these questions (1) "Within the past 12
months we worriedwhether our food would run out before we got money to
buy more"and (2) "Within the past 12 months the food we bought just
didn'tlast and we didn't have money to get more."The sample included 30
098 families, 23% of which were foodinsecure. HFSS questions 1 and 2
were most frequently endorsedamong food-insecure families (92.5% and
81.9%, respectively).An affirmative response to either question 1 or 2
had a sensitivityof 97% and specificity of 83% and was associated with
increasedrisk of reported poor/fair child health (adjusted odds
ratio[aOR]: 1.56; P < .001), hospitalizations in their lifetime(aOR:
1.17; P < .001), and developmental risk (aOR: 1.60;P < .001).
The authors conclude that a  2-item FI screen was sensitive, specific,
and valid amonglow-income families with young children. The FI screen
rapidlyidentifies households at risk for FI, enabling providers totarget
services that ameliorate the health and developmentalconsequences
associated with FI.
Read the entire article free at
http://pediatrics.aappublications.org/cgi/content/full/126/1/e26

 
Leventhal JM et al. Fractures and Traumatic Brain Injuries: Abuse
Versus Accidents in a US Database of Hospitalized Children PEDIATRICS
Vol. 126 No. 1 July 2010, pp. e104-e115
The authors set out to use a national database to determine the
incidenceof abusive traumatic brain injuries (TBIs) and/or fracturesand
the frequency of abuse versus accidents among children <36months of
age.
They used the 2006 Kids' Inpatient Database and classified casesinto 3
types of injuries, that is, (1) TBI only, (2) TBI andfracture, or (3)
fracture only. Groups 2 and 3 were dividedinto 3 patterns, that is, (1)
skull fractures, (2) skull andnonskull fractures, or (3) nonskull
fractures. For each typeand pattern, they compared abuse, accidental
falls, other accidents,and motor vehicle accidents.
The authors found that the incidence of TBIs and/or fractures
attributable to abusewas 21.9 cases per 100 000 children <36 months of
age and50.0 cases per 100 000 children <12 months of age. In theabuse
group, 29.9% of children had TBIs only, 28.3% TBIs andfractures, and
41.8% fractures only. Abused children were youngerand were more likely
to be enrolled in Medicaid. For TBI only,falls were more common than
abuse in the first 2 months of lifebut abuse was more common from 2 to 7
months. For TBI and skullfracture, falls were more common during the
first year of life.For skull fracture only, almost all injuries were
attributableto falls.
The authors concluded that there wwas overlap in TBIs and fractures
attributable to abuse.Among <12-month-old children, TBIs and/or
fractures attributableto abuse occurred in 1 of 2000. Falls occurred
more commonlythan abuse, even among very young children.
Read this article free, go to
http://pediatrics.aappublications.org/cgi/content/full/126/1/e104 
Zhu P et al.Prenatal life events stress: implications for preterm birth
and infant birthweightAJOB Volume 203 (
http://www.ajog.org/issues?Vol=203 ), Issue 1 (
http://www.ajog.org/issues/contents?issue_key=S0002-9378(10)X0006-0 ),
Pages 1-34.
The objective of the study was to evaluate the effects of maternal
exposure to severe life events during different stage of gestation on
preterm birth and infant birthweight.
A sample of 1800 women who delivered after 32 weeks' gestation were
assessed with questionnaires that measured stressful life events during
different stages of pregnancy. Demographic characteristics and birth
outcomes were collected through the interviews and medical charts.
There was an increased risk of preterm birth among women with higher
levels of life events stress during the first trimester  and second
trimester. Each unit increase of perceived life events stress during
first trimester was associated with a 99.09 g decrease in infant
birthweight.
The auhtors conclude that prenatal severe life events, especially in
the first trimester, may play an important role in increasing the risk
of preterm birth and low birthweight.
Quote sent from our readers:
“Our lives begin to end the day we become silent about things that
matter.” Rev. Martin Luther King, Jr             
"For all those whose cares have been our concern, the work goes on, the
cause endures, the hope still lives and the dream shall never die."
Edward M. Kennedy
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The National Fetal and Infant Mortality Review Program is a partnership
between the American College of Obstetricians and Gynecologists and the
federal Maternal and Child Health Bureau.


 

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<P style=3D"LINE-HEIGHT: 115%"><SPAN style=3D"FONT-FAMILY: 'Arial','sans-se=
rif'"><FONT size=3D3>Reminder: World Breastfeeding Week (WBW) is August =
1st - 7<SUP>th</SUP>. <SPAN style=3D"FONT-SIZE: 11pt; LINE-HEIGHT: 115%; =
FONT-FAMILY: 'Arial','sans-serif'; mso-fareast-font-family: Calibri; =
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dingweek.org/">http://worldbreastfeedingweek.org/</A> </SPAN></FONT></SPAN>=
</P>
<P style=3D"LINE-HEIGHT: 115%"><SPAN style=3D"FONT-FAMILY: 'Arial','sans-se=
rif'"><FONT size=3D3>In support of WABA, LLL USA=E2=80=99s 2010 WBWC theme =
is </FONT></SPAN><SPAN style=3D"FONT-FAMILY: 'Arial','sans-serif'"><FONT =
size=3D3><STRONG><SPAN style=3D"FONT-FAMILY: 'Arial','sans-serif'">Breastfe=
eding =E2=80=93 The Baby Friendly Way</SPAN></STRONG>. This theme =
recognizes the importance of supporting mothers from the beginning of =
their breastfeeding experience so they can be successful in achieving =
their goal to breastfeed their babies. LLL USA=E2=80=99s World Breastfeedin=
g Week Celebration=E2=80=99s 2010 focus will be to: <o:p></o:p></FONT></SPA=
N></P>
<P class=3DMsoNormal style=3D"MARGIN: 0in 0in 10pt 81.55pt; TEXT-INDENT: =
-0.25in; mso-margin-top-alt: auto; mso-margin-bottom-alt: auto; mso-list: =
l1 level1 lfo1; tab-stops: list .5in"><SPAN style=3D"FONT-SIZE: 10pt; =
LINE-HEIGHT: 115%; FONT-FAMILY: Symbol; mso-fareast-font-family: Symbol; =
mso-bidi-font-family: Symbol; mso-bidi-font-size: 12.0pt"><SPAN style=3D"ms=
o-list: Ignore">=C2=B7<SPAN style=3D"FONT: 7pt 'Times New Roman'">&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </SPAN></SPAN></SPAN><SPAN =
style=3D"FONT-SIZE: 12pt; LINE-HEIGHT: 115%; FONT-FAMILY: 'Arial','sans-ser=
if'">Revitalize activities within health systems, and among healthcare =
providers and communities to support women to achieve their breastfeeding =
intentions. <o:p></o:p></SPAN></P>
<P class=3DMsoNormal style=3D"MARGIN: 0in 0in 10pt 81.55pt; TEXT-INDENT: =
-0.25in; mso-margin-top-alt: auto; mso-margin-bottom-alt: auto; mso-list: =
l1 level1 lfo1; tab-stops: list .5in"><SPAN style=3D"FONT-SIZE: 10pt; =
LINE-HEIGHT: 115%; FONT-FAMILY: Symbol; mso-fareast-font-family: Symbol; =
mso-bidi-font-family: Symbol; mso-bidi-font-size: 12.0pt"><SPAN style=3D"ms=
o-list: Ignore">=C2=B7<SPAN style=3D"FONT: 7pt 'Times New Roman'">&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </SPAN></SPAN></SPAN><SPAN =
style=3D"FONT-SIZE: 12pt; LINE-HEIGHT: 115%; FONT-FAMILY: 'Arial','sans-ser=
if'">Inform people everywhere that protection, promotion and support of =
breastfeeding is a mother=E2=80=99s right, a child=E2=80=99s right, and a =
human right. <o:p></o:p></SPAN></P>
<P class=3DMsoNormal style=3D"MARGIN: 0in 0in 10pt 81.55pt; TEXT-INDENT: =
-0.25in; mso-margin-top-alt: auto; mso-margin-bottom-alt: auto; mso-list: =
l1 level1 lfo1; tab-stops: list .5in"><SPAN style=3D"FONT-SIZE: 10pt; =
LINE-HEIGHT: 115%; FONT-FAMILY: Symbol; mso-fareast-font-family: Symbol; =
mso-bidi-font-family: Symbol; mso-bidi-font-size: 12.0pt"><SPAN style=3D"ms=
o-list: Ignore">=C2=B7<SPAN style=3D"FONT: 7pt 'Times New Roman'">&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </SPAN></SPAN></SPAN><SPAN =
style=3D"FONT-SIZE: 12pt; LINE-HEIGHT: 115%; FONT-FAMILY: 'Arial','sans-ser=
if'">Enable women and all who care about human rights to advocate for =
healthcare systems which support breastfeeding. <o:p></o:p></SPAN></P>
<P class=3DMsoNormal style=3D"MARGIN: 0in 0in 10pt 81.55pt; TEXT-INDENT: =
-0.25in; mso-margin-top-alt: auto; mso-margin-bottom-alt: auto; mso-list: =
l1 level1 lfo1; tab-stops: list .5in"><SPAN style=3D"FONT-SIZE: 10pt; =
LINE-HEIGHT: 115%; FONT-FAMILY: Symbol; mso-fareast-font-family: Symbol; =
mso-bidi-font-family: Symbol; mso-bidi-font-size: 12.0pt"><SPAN style=3D"ms=
o-list: Ignore">=C2=B7<SPAN style=3D"FONT: 7pt 'Times New Roman'">&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </SPAN></SPAN></SPAN><SPAN =
style=3D"FONT-SIZE: 12pt; LINE-HEIGHT: 115%; FONT-FAMILY: 'Arial','sans-ser=
if'">Ensure that health workers who care for mothers and babies are =
adequately trained to counsel and support them in optimal infant feeding. =
<o:p></o:p></SPAN></P>
<P class=3DMsoListParagraphCxSpFirst style=3D"MARGIN: 0in 0in 0pt 0.5in; =
mso-add-space: auto"><B><SPAN style=3D"FONT-SIZE: 12pt; COLOR: black; =
LINE-HEIGHT: 115%; FONT-FAMILY: 'Arial','sans-serif'; mso-fareast-font-fami=
ly: 'Times New Roman'">From ACOG Web Site: Ob-Gyns Issue Less Restrictive =
VBAC Guidelines </SPAN></B><SPAN style=3D"FONT-SIZE: 12pt; COLOR: black; =
LINE-HEIGHT: 115%; FONT-FAMILY: 'Arial','sans-serif'; mso-fareast-font-fami=
ly: 'Times New Roman'"><o:p></o:p></SPAN></P>
<P class=3DMsoListParagraphCxSpLast style=3D"MARGIN: 0in 0in 10pt 0.5in; =
mso-margin-top-alt: auto; mso-margin-bottom-alt: auto; mso-add-space: =
auto"><SPAN style=3D"FONT-SIZE: 12pt; COLOR: black; LINE-HEIGHT: 115%; =
FONT-FAMILY: 'Arial','sans-serif'; mso-fareast-font-family: 'Times New =
Roman'">Attempting a vaginal birth after cesarean (VBAC) is a safe and =
appropriate choice for most women who have had a prior cesarean delivery, =
including for some women who have had two previous cesareans, according to =
guidelines released today by The American College of Obstetricians and =
Gynecologists. The cesarean delivery rate in the US increased dramatically =
over the past four decades, from 5% in 1970 to over 31% in 2007. Before =
1970, the standard practice was to perform a repeat cesarean after a prior =
cesarean birth. During the 1970s, as women achieved successful VBACs, it =
became viewed as a reasonable option for some women. Over time, the VBAC =
rate increased from just over 5% in 1985 to 28% by 1996, but then began a =
steady decline. By 2006, the VBAC rate fell to 8.5%, a decrease that =
reflects the restrictions that some hospitals and insurers placed on trial =
of labor after cesarean (TOLAC) as well as decisions by patients when =
presented with the risks and benefits. In keeping with past recommendations=
, most women with one previous cesarean delivery with a low-transverse =
incision are candidates for and should be counseled about VBAC and offered =
a TOLAC. In addition, "The College guidelines now clearly say that women =
with two previous low-transverse cesarean incisions, women carrying twins, =
and women with an unknown type of uterine scar are considered appropriate =
candidates for a TOLAC," said Jeffrey L. Ecker, MD, from Massachusetts =
General Hospital in Boston. To learn more go to <A href=3D"http://www.acog.=
org/from_home/publications/press_releases/nr07-21-10-1.cfm"><FONT =
color=3D#800080>http://www.acog.org/from_home/publications/press_releases/n=
r07-21-10-1.cfm</FONT></A> <o:p></o:p></SPAN></P>
<P class=3DMsoNormal style=3D"MARGIN: 0in 0in 10pt; mso-margin-top-alt: =
auto; mso-margin-bottom-alt: auto"><SPAN style=3D"FONT-SIZE: 12pt; =
LINE-HEIGHT: 115%; FONT-FAMILY: 'Arial','sans-serif'"><o:p>&nbsp;</o:p></SP=
AN></P>
<P class=3DMsoNormal style=3D"MARGIN: 0in 0in 10pt"><SPAN style=3D"FONT-SIZ=
E: 12pt; LINE-HEIGHT: 115%; FONT-FAMILY: 'Arial','sans-serif'"><o:p>&nbsp;<=
/o:p></SPAN></P>
<H2 style=3D"MARGIN: 10pt 0in 0pt"><SPAN style=3D"FONT-SIZE: 12pt; COLOR: =
windowtext; LINE-HEIGHT: 115%; FONT-FAMILY: 'Arial','sans-serif'">CPSC =
Proposes New Rules for Full-Size and Non-Full-Size Cribs </SPAN><SPAN =
style=3D"FONT-WEIGHT: normal; FONT-SIZE: 12pt; COLOR: windowtext; =
LINE-HEIGHT: 115%; FONT-FAMILY: 'Arial','sans-serif'; mso-bidi-font-weight:=
 bold">The U.S. Consumer Product Safety Commission (CPSC) voted (5 to 0) =
today to approve proposed new mandatory standards to address the hazards =
posed by full-size and non-full-size cribs. Serious safety hazards with =
cribs have ranged from drop-side hardware or other drop-side entrapment =
issues to failures of the mattress support and detachment or breakage of =
the crib slats. All of these defects can create hazardous gaps allowing a =
baby to become entrapped and suffocate or fall out of the crib. The =
Consumer Product Safety Improvement Act of 2008 (CPSIA) directs CPSC to =
issue mandatory safety standards for durable infant or toddler products. =
CPSC=E2=80=99s notice of proposed rulemaking ("NPR") for cribs includes: =
</SPAN><SPAN style=3D"FONT-SIZE: 12pt; LINE-HEIGHT: 115%; FONT-FAMILY: =
'Arial','sans-serif'"><o:p></o:p></SPAN></H2>
<OL type=3D1>
<LI class=3DMsoNormal style=3D"MARGIN: 0in 0in 10pt; mso-margin-top-alt: =
auto; mso-margin-bottom-alt: auto; mso-list: l0 level1 lfo2; tab-stops: =
list .5in"><SPAN style=3D"FONT-SIZE: 12pt; LINE-HEIGHT: 115%; FONT-FAMILY: =
'Arial','sans-serif'">a standard for full-size cribs that is substantially =
the same as ASTM F 1169-10, <I>Standard Consumer Safety Specification for =
Full-Size Baby Cribs</I>, with one modification . The one modification =
that CPSC is proposing to the ASTM full-size crib standard would require =
cribs to be tested without the re-tightening of screws between tests in =
order to ensure that the tests reflect the lifetime use of the crib; and =
<o:p></o:p></SPAN></LI>
<LI class=3DMsoNormal style=3D"MARGIN: 0in 0in 10pt; mso-margin-top-alt: =
auto; mso-margin-bottom-alt: auto; mso-list: l0 level1 lfo2; tab-stops: =
list .5in"><SPAN style=3D"FONT-SIZE: 12pt; LINE-HEIGHT: 115%; FONT-FAMILY: =
'Arial','sans-serif'">a standard for non-full-size cribs that is substantia=
lly the same as ASTM F 406-10, <I>Standard Consumer Safety Specification =
for Non-Full-Size Baby Cribs/Play Yards</I>, with certain modifications. =
These modifications include adding certain requirements that apply to =
full-size cribs, such as the mattress support performance requirement, the =
side-impact test, and the order in which performance tests are to be done, =
applicable to non-full-size cribs so that the new standard for non-full-siz=
e cribs is more stringent. The proposal also would restore movable side =
latch tests to the non-full-size crib standard and would clarify that the =
proposal does not extend to play yards. To learn more go to </SPAN><A =
href=3D"http://www.cpsc.gov/cpscpub/prerel/prhtml10/10301.html"><SPAN =
style=3D"FONT-SIZE: 12pt; LINE-HEIGHT: 115%; FONT-FAMILY: 'Arial','sans-ser=
if'">http://www.cpsc.gov/cpscpub/prerel/prhtml10/10301.html</SPAN></A><SPAN=
 style=3D"FONT-SIZE: 12pt; LINE-HEIGHT: 115%; FONT-FAMILY: 'Arial','sans-se=
rif'"> <o:p></o:p></SPAN></LI></OL>
<P class=3DPa0 style=3D"MARGIN: 0in 0in 0pt; LINE-HEIGHT: 115%"><SPAN =
style=3D"COLOR: #005a9d; FONT-FAMILY: 'Arial','sans-serif'"><o:p><FONT =
size=3D3>&nbsp;</FONT></o:p></SPAN></P>
<P class=3DPa0 style=3D"MARGIN: 0in 0in 0pt; LINE-HEIGHT: 115%"><FONT =
size=3D3><SPAN style=3D"COLOR: #005a9d; FONT-FAMILY: 'Arial','sans-serif'">=


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