Pediatric Grand Rounds

The first 2007 Pediatric Grand Rounds are up at Parenting Solved. Host Dr. Bryan Vartabedian, a pediatric gastroenterologist and nutritionist at Texas Children’s Hospital in Houston, the country’s largest children’s hospital, has compiled a terrific collection of articles from doctors, nurses and parents standing up against popular ideas that could hurt kids.

The articles address such hard-hitting issues as eugenics in unborn babies; use of fringe alternatives in pediatrics; the ethical dilemmas of worldwide healthcare resources (saving one premie or saving an entire community from malaria); the personal story of parents awaiting a kidney transplant for their child; a pediatrician’s exposure of the consequences of antibiotic abuse and over prescribing; immunization pseudoscience; and weird skin things growing in, out of and on newborn babies. Dr. Vartabedian kindly mentions two Junkfood Science articles, giving his thumbs up on the hype over fat children and “the lunacy of cholesterol screening in healthy kids” and the public health hysteria surrounding mercury in thermometers.

But a post that I found fascinating was Dr. Vartabedian’s looking at the oldest myth that has circulated in neonatalogy and pediatrics for eons. I’ll confess that in my early days in neonatal ICU, it was one we all fell for: iron in formula makes babies constipated and colicy. He praises Mead Johnson for its recent decision to discontinue low-iron formulas, showing that the low-iron formula supplies only about 10% of the iron a typical 3-month old baby needs. Despite what many may believe, regular formula doesn’t have extra iron, he writes, it contains the appropriate levels of iron. He refers to an earlier post where he looked at the clinical evidence:

So what’s the big deal? Iron happens to be very important for brain development. Studies have documented the long-lasting developmental effects of iron deficiency early in life. And what about the association between iron in formula and constipation? There isn’t one. This association was disproved in clinical studies some years back....But so long as misconceptions about formula and constipation exist, there will be demand. And where there’s demand there’s a market.

Yet another example of marketing and beliefs not following the clinical evidence.