Children’s National Medical Center researchers Dr. Rachel Moon and Brandi Joyner looked at pictures of sleeping babies in 28 magazines popular with women of childbearing age and found that, of the 391 unique images analyzed (230 of which were in advertisements), 122 showed sleeping babies and 99 showed infant sleeping environments (but not the infants themselves).
More than a third of the sleeping babies were shown in improper sleeping positions (side and prone) that violate American Academy of Pediatrics’ recommendations and increase the risk of Sudden Infant Death Syndrome. Furthermore, two-thirds of the photographs portraying sleeping environments showed loose bedding and other objects and locations that violate the safety recommendations and, the report says, increase the risk of SIDS fivefold. In general, advertisements were more likely to include guideline-violating images than their editorial counterparts.
Maryn McKenna writes in Annals of Emergency Medicine that the impressive recent success of rotavirus and pneumococcus vaccines has caused emergency room doctors to ask “Where have the kids gone?”
The vaccines, Prevnar and Rotateq, were introduced earlier in the decade, and their effects are beginning to be felt across the country.
The benefits of such sharp changes in incidence include not only reduced burden of disease but reduced health care utilization and cost; one 2007 study found that, thanks to Prevnar, annual hospitalization and ambulatory expenditures for children younger than 2 years shrank 45% between 1999 and 2004, from $688.2 million to $376.7 million.3 There are more subtle effects as well, some as simple as reducing the stress on a child and his parents because less blood work means fewer needle sticks during an ED stay.
Interestingly, McKenna found physicians worrying that colleagues who entered the profession after these vaccines hit the market would be underexposed to cases of the now widely prevented diseases, and may thus find it difficult to recognize them if or when they do occur.
Physicians who have been in the specialty long enough to have experienced the introduction of Hib vaccine in the mid 1980s, with its extraordinary suppression of bacterial meningitis, and the subsequent introduction of Prevnar, caution that success brings its own risks as well. The lower the incidence of a disease, the less likely younger physicians are to experience it in their training — and thus the more careful medicine must be to make sure certain procedures are still taught.