Love, marriage, and kids, Getting children to eat right, Preventing HIV infection, Resources for pediatricians. Eye on Washington



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Love, marriage, and kids

According to a new report from the National Marriage Project at Rutgers University, marriage is as out of fashion as the horse and carriage that the old song compared it to. The State of Our Unions indicates that men and women in their 20s are less likely to be seeking a marriage partner than young people were in the past and are more willing to cohabit in informal and often uncommitted relationships. Focus groups from five major metropolitan areas show that while young adults without a college education still have romantic dreams about the lifelong marriages they will make someday, few are currently headed toward such relationships. Young women, in particular, are pessimistic about the likelihood of forming a long-term, happy marriage.

This contemporary acceptance of cohabitation, according to project directors David Popenoe and Barbara Dafoe Whitehead, magnifies the effect of our high divorce rates and results in large numbers of children born outside of marriage and growing up in what they call "fragile families." Children in such families have "negative life outcomes at two to three times the rate of children in married, two-parent families."

The finding that births to couples who live together account for a large portion of current high levels of nonmarital childbearing is reiterated in a new research brief from Child Trends, a research organization dedicated to studying children, youth, and families. Child Trends is less alarmed by the data, however, pointing out that—contrary to popular perceptions—most unmarried mothers have a relationship with their child's father and two thirds are women 20 years of age and older. Child Trends, like The Marriage Project, acknowledges that children's life chances are diminished by out-of-wedlock birth. "Statistics show that children born to unmarried mothers are more likely to be poor, experience more changes in living situations, and have academic and behavior problems."

For more information about The State of Our Unions, go to the Web site of the National Marriage Project at http://marriage.rutgers.edu . To download the Child Trends study, Births Outside of Marriage: Perceptions vs. Reality, go to www.childtrends.org .

Getting children to eat right

Parents and health-care providers would like children to eat a healthy, nutritious diet, but it's an uphill fight. The enemies of good nutrition are everywhere.

  • Children who watch TV are subjected to a steady stream of commercials touting a variety of sugary treats. Researchers asked a group of 46 toddlers to watch a videotape with and without food commercials and then choose the products they preferred from pairs of similar foods. The children who saw the ads were significantly more likely to choose the advertised brands (J Am Diet Assn 2000;101:42).

  • Carbonated, flavored milk will soon be available in supermarkets in the Northeast. Called E-Moo, this new beverage is made with skim milk and will be available in three flavors: Orange Creamsicle, Bubble Gum, and Chocolate Raspberry. E-Moo's promoters claim the new product will turn soda-swilling youngsters into milk drinkers. The drink is sweetened with fructose.

  • Coca-Cola has announced that it is "scaling back" its admittedly aggressive strategy of marketing its product in schools. Coke machines have become ubiquitous in public schools, although with this announcement Coke is abandoning exclusivity policies that have kept competing soft drink brands out of schools that sign up with Coke. Coke has also promised that in the future its vending machines will dispense juice, milk, and water, along with—of course—Coke.

Preventing HIV infection

According to the Institute of Medicine (IOM), when it comes to preventing infection with the human immunodeficiency virus (HIV) that causes AIDS, there is No Time to Lose. That's the title of a new report from an IOM committee convened to review research on effective HIV prevention measures. Key components of the report's recommendations include:

  • Centers for Disease Control and Prevention surveillance of the incidence of infection, in addition to the incidence of AIDS, focused on high-risk groups such as enrollees in drug treatment programs and patients at clinics for sexually transmitted disease.

  • Integration of HIV prevention activities in all clinic settings.

  • High priority for microbicide and vaccine research at the National Institutes of Health.

  • Faster Food and Drug Administration approval of products that show promise in clinical trials or are used effectively in other countries.

  • Last but certainly not least, national leadership to overcome barriers that impede prevention, such as prohibitions against comprehensive sex education in schools and condom availability programs.

The report can be ordered from the National Academy Press Web site, http://books.nap.edu/catalog/ 9964.html .

Resources for pediatricians

Keeping up with the ever-changing field of pediatrics isn't easy. Here is a listing of new resources that can help you grow professionally and meet the needs of families that rely on your expertise:

PDR for Nutritional Supplements, a 700+ page reference for physicians and consumers from the publishers of the Physicians' Desk Reference. Written by Sheldon S. Hendler, PhD, MD, this new reference work summarizes existing clinical research and provides data on indications, dosage, and interactions with drugs, alcohol, and herbs. This new PDR, which is published by Medical Economics Company, retails for $59.95 and is available in bookstores and by calling 800-678-5689.

A new edition of the HVO Guide to Volunteering Overseas, with background information on international health issues and contacts for overseas placements. To order, go to the HVO (Health Volunteers Overseas) Web site, www.hvousa.org .

Child Development and Medicaid: Attitudes of Mothers with Young Children Enrolled in Medicaid, a report of the Commonwealth Fund based on focus groups of Medicaid mothers in North Carolina, Utah, Vermont, and Washington. To obtain a copy, call the fund at 888-777-2744 or go to the fund Web site, www.cmwf.org .

www.chop.edu , an expanded interactive Web site recently launched by Children's Hospital of Philadelphia, offering families parenting and safety advice as well as a comprehensive library of information on pediatric illnesses and conditions.

Eye On Washington

By April's close, the cherry blossoms had floated down from the trees, the president's budget at long last found its way to Capitol Hill, and Congress was home for the Easter/Passover recess. Working on the Alice in Wonderland principle of tax cuts first, spending details afterwards, the Administration proclaimed a triumph for its notions of what the federal government should do and who should pay the lion's share of the bill. Some members of the Senate are not so ready to recognize an administration victory, however; before the budget arrived, senators had succeeded in cutting back the proposed tax cut and increasing funding for some programs the administration wants to cut.

In terms of children's health and welfare, the crucial issues in President Bush's program included a tendency to relax environmental regulations (about how much arsenic is not too much, for example); a disinclination to spend more money on training pediatricians, providing child-care grants to the states, and preventing child abuse; and a sizable increase in funding for education, tied to Bushian concepts of standardized testing and accountability but—for now, at least—not including vouchers.

As always, federal actions that affect children are not confined to the White House and Capitol Hill. For example:

The Surgeon General's Report on Smoking has come out, this year concentrating on women—who have come such a long way, baby, that they die of lung cancer and heart disease at much the same rates as men do. Teenage girls, after some years of smoking less, are hooked again; current smoking among high school senior girls was the same in 2000 as it had been in 1988.

The Consumer Product Safety Commission forced Cosco to pay a $1.75 million penalty for failing to notify the agency that safety problems resulting in two deaths had been found in some of their baby products—cribs, high chairs, and car seats.

The Department of Agriculture flirted with the idea of eliminating testing for Salmonella in ground beef used in the school lunch program, going so far as to publish a new regulation to that effect. When she found out, Agriculture Secretary Ann Veneman disavowed the proposal, saying she hadn't been consulted. The upshot: New tests, begun last year in the Clinton Administration, will continue.

The Substance Abuse and Mental Health Services Administration's household survey revealed that inhalants were the most popular drug among 12-year-olds, beating out marijuana, psychotherapeutic drugs, and hallucinogens. More than 2 million teens use inhalants, according to the survey; 56,000 teens reported they were dependent on inhalants in the 2000 survey, and more than 2 million said they had engaged in huffing everything from glue to nail polish, gasoline, and nitrous oxide.

The Supreme Court overturned a lower court ruling and held that hospital workers cannot test maternity patients for illegal drug use without their consent if the purpose is to alert police to a crime. The suit was brought by maternity patients in Charleston, S.C., who were arrested under a cooperative program between a public hospital and the local police department, after their urine tested positive for cocaine.


June 12, National Community Access to Child Health (CATCH) Meeting, New York City. For more information, go to the American Academy of Pediatrics (AAP) Web site, www.aap.org/profed/cmecourses.htm .

July 29-31, Promoting Student Success: Clinical Assessment and Management of Differences in Learning, Chapel Hill, N.C. Co-sponsored by the School of Medicine of the University of North Carolina-Chapel Hill and the All Kinds of Minds Institute. For more information, call the Continuing Education Registrar at 919-962-2118.

October 4-6, Practical Pediatrics Continuing Medical Education, Vancouver, British Columbia For information, go to the AAP Web site, www.aap.org/profed/cmecourses.htm .

October 20-24, American Academy of Pediatrics National Conference and Exhibition (formerly AAP Annual Meeting), San Francisco. For registration information, go to the AAP Web site at www.aap.org/profed/2001pros.htm .

Judith Asch-Goodkin
Contributing Editor


Updates. Contemporary Pediatrics 2001;5:13.

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