Perhaps someone -- one brave soul committed to the cause -- just needs to take a stand. Doctors? Public health officials? Pfft. What kind of credibility do they have? They're not the ones doling out the snacks. A mom is what's called for here.

And parent Jennifer Steinhauer writes in today's New York Times:

"When it comes to American boys and girls, snacks seem both mandatory and constant. Apparently, we have collectively decided as a culture that it is impossible for children to take part in any activity without simultaneously shoving something into their pie holes." Read the full story.

Columnist Sarah Smiley wrote in a similar vein on Military.com last summer:

"After-game snacks are no longer about hydration; they were about one-upping the sorry mother who brought the kids raisins the week before." Read more.

Then she got warmed up. There's this from her follow-up column:

"Conflict ensues when on the baseball field being a 'good parent' is paradoxically defined as making sure that no one feels discomfort, whether it be hunger pain, the 'pain' of sitting on the bench and waiting your turn, or not being picked to play first base. The children naturally want to feel good and have a reward. We as parents have unfortunately catered to them." Read more. 

Perhaps this is how attitudes change. A mom here, a mom there. ... (Sorry, dads, I realize that you too bring snacks and that you too could draw a line in the snacking sand, but the other moms are not going to follow your example in this matter. They'll just figure you didn't know better.)

In the matter of full disclosure, let it be known that I'm not completely without bias in this matter. Having once carried approximately 20 bananas to a girl's softball game for the post-play, coach-talk, snack-fest -- and having returned home with approximately 20 bananas -- I'm looking for any moral support I can get.

And quite obviously, I'm not the one to lead the revolution. I now take cookies, pleaded-for by the kid whose mom once took bananas. (Sure, the cookies make the kids happy -- and, as a bonus, tweak the other moms -- but the guilt ...)
 
If you can stand to look at any more stats on kids and obesity, here they are.

-- Tami Dennis

Photo: Maybe some kids used up this many calories -- and then some -- and need to have their blood sugar spiked just to have the energy to make it home for dinner. But I doubt it. ... I watched the game. ... Credit: Daniel Acker / Bloomberg

 

The next time your little one dumps a cup of coffee into your laptop keyboard, keep this in mind: A new study finds that having children may be linked to having lower blood pressure.

Researchers from Brigham Young University, the University of Utah and Cal State Long Beach took ambulatory blood pressure readings of 198 married men and women, aged 20 to 68, over one 24-hour period. About 70% of the couples had children of various ages.

The subjects wore blood pressure monitors that took readings at random intervals during the day, including while they were sleeping, giving researchers a good idea of daily blood pressure highs and lows.

Overall, parents scored 4.5 points lower than those without kids in systolic blood pressure (the top number that measures when the heart is contracting), and 3 points lower in diastolic blood pressure (the bottom number that measures the heart at rest, in between heartbeats). Among women, the spread was even greater: Women with children showed a 12-point difference in systolic pressure and a 7-point difference in diastolic pressure compared with their counterparts without children.

The researchers arrived at these numbers after accounting for such variables as age, body mass, exercise, being employed, and smoking. They note that although the study took blood pressure readings only once, other studies have shown the benefits of parenthood, including a higher sense of self-esteem from giving to others. On the flip side, studies have also shown that being a caregiver is associated with high levels of stress and an increased risk of cardiovascular disease.

"While caring for children may include daily hassles, deriving a sense of meaning and purpose from life's stress has been shown to be associated with better health outcomes," said lead researcher Julianne Holt-Lunstad, via a news release. Holt-Lunstad is in the department of psychology at BYU.

The study appeared recently in the Annals of Behavioral Medicine.

-Jeannine Stein

Photo credit: Maria J. Avila / Associated Press

It’s hard to imagine a bigger strain on a marriage than the loss of a child to cancer. Conventional wisdom holds that such tragedies increase the risk of divorce, but a new study says that isn’t so.

Researchers from the Division of Clinical Cancer Epidemiology at Karolinska University Hospital in Stockholm tracked down 442 Swedish parents who had lost a son or daughter to cancer before the age of 25. Four to nine years after the loss, 74% of the parents were still married to or living with the child’s other parent.

To serve as controls, the researchers also found 452 parents with living children of the same age, sex and region of residence as the ones who died of cancer. Among those parents, 68% of their relationships were still intact.

Statistical analysis revealed that the bereaved mothers and fathers were 10% more likely to remain with their co-parents compared with the controls. The difference was statistically significant. The results were published today in the Archives of Pediatric and Adolescent Medicine.

There’s little doubt that caring for a terminally ill child causes great psychological distress and marital strain. But previous studies that examined how families cope with the loss of a child have had mixed findings when it comes to divorce. Based on these Swedish results, the researchers conclude that, at the very least, “parents who have lost a child to cancer are not more likely to separate than others.”

-- Karen Kaplan

Photo: Contrary to popular belief, marriages can survive the loss of a child to cancer. Credit: Robert K. Yosay / The (Youngstown, Ohio) Vindicator

Parents eyeballing public playground hazards may first look to the infamous monkey bars, perilously high above the earth.

They have reason to fear. “You see monkey bar injuries and monkey bar injuries and monkey bar injuries,” pediatric orthopedic surgeon Andrew W. Howard said of his line of work.

What they may not look at is the ground itself. In a study published today in PLoS Medicine, Howard and his fellow researchers documented the playground injuries at 37 elementary schools in Toronto. They found that children who fell from a height onto a wood chip surface were nearly five times more likely to sustain an arm fracture than children who fell onto granite sand.

Both surfaces meet school safety standards, Howard said, but what gives granite sand the edge is each surface’s sliding friction. When a person falls, the surgeon pointed out, the hand usually hits the ground before the body does, which could force the arm to bend beyond the load it can carry. But granite sand allows the hand to slide a little bit, saving the arm from a nasty break.

The study took advantage of a playground safety overhaul that the Toronto School District Board was going through at the time – so no other surfaces, such as those made from recycled rubber, were examined.

But of the 5,900 fracture-related hospitalizations that happen as a result of a playground fall in the United States, the study observes, 3,900 to 4,700 could be prevented if they had occurred on granite sand surfaces.

Time to level all the playgrounds in America?

“I don’t think we need to call the gravel trucks tomorrow,” Howard said in an interview. “But in a gradual enlightened way we should be using sand under playground whenever possible as the falling surface.”

If you feel like seeing if your child’s playground is up to standard, here’s a safety checklist courtesy of the Consumer Product Safety Commission.

-- Amina Khan

It goes by many names: "black out," "space monkey," "fainting game." Participants – teenagers, mostly, it seems – play it by cutting off oxygen to the brain. They use belts, neckties, other types of binding – or a friend's helping hands – to induce a "natural high." 

Yet, say authors of a paper published in the January issue of Pediatrics, of the 163 Ohio physicians who responded to a survey, only 111 (68.1%) said they had heard of the game – mostly through popular media sources. Of those who knew about it, only 7.6% reported having a patient who they suspected was
 playing the choking game.

That’s a seriously low level of awareness, says Nancy E. Bass, one of the authors of the paper. "The choking game may not be as prevalent as other [risky behaviors] like drugs, but the issue is it can result in death," Bass said, adding, "It’s becoming more prevalent ... if you have an asphyxia related death, it's difficult to know whether it's unintentional."

The Centers for Disease Control and Prevention surveyed media reports and counted 82 deaths between 1995 and 2007 that were likely the result of the choking game. It's an indication that physicians simply may not be trained to recognize the warning signs, from strange bruises to bloodshot eyes.

Bass said she hopes the paper will encourage physicians – particularly those in pediatric practice and emergency room training – to include the choking game in their general-advice discussions with teenagers, which includes such topics as smoking, balanced diets, school performance and alcohol use.

For a personal account, here's Sandy Banks' 2005 story of a family dealing with the aftermath of a likely choking game-related death. Here's a CDC fact sheet on the choking game and its warning signs.

-- Amina Khan

If you’re thinking about talking to your child about sex, you could be too late. Kids appear to be engaging in sexual activity much earlier than they have in the past – but today’s parent hasn’t gotten with the program.

In a new study published online Monday in the journal Pediatrics, more than 40% of teens surveyed said they had had intercourse before discussing key issues with their parents. Such issues included sexually transmitted diseases, how to use a condom, and what to do if your partner refuses to use a condom. Boys had the talk even later than girls. Parental talks for both genders were still behind the times, though – which is troubling, given that medical professionals are recommending early and frequent STD screening for young women within a year of having sex for the first time.

For the reluctant parent, a handy primer from Planned Parenthood on discussing birds and bees with your child. 

-- Amina Khan

In recent years, some private adoption agencies have promoted "embryo adoption" services in which people can take possession of donated embryos and use them in concert with fertility treatments to become pregnant. But a major medical group today blasted the term "embryo adoption," calling it inaccurate and misleading.

The position paper from the ethics committee of the American Society for Reproductive Medicine says that the traditional model of adoption involves a legal process to establish parentage of infants or older children and should not be confused with the transactions involving donated embryos. The group said the preferred term is "embryo donation," because it is a medical intervention that only become possible through medical technology.

Some adoption agencies that deal with embryos require prospective parents to divulge information on their religious beliefs or sexual orientation. Use of the adoption model places an "inappropriate burden" on patients seeking an embryo donation, the statement said.

"Embryo donation is an important therapeutic option for infertile patients," said Dr. Robert Brzyski, chairman of the ASRM Ethics Committee. "Home visits, judicial review and other adoption procedures are not necessary and not appropriate for a patient whose case entails what is most accurately characterized medically as a tissue donation."

Embryo donation, however, is regulated similarly to any medical procedure that uses donated tissues or organs.

The statement is published in the December issue of the journal Fertility & Sterility.

-- Shari Roan

Photo: A petri dish containing embryos suspended in a growth media. Credit: Mark Boster / Los Angeles Times

In the long-running nature-nurture debate over what makes us who we are, chalk up a new victory for nature.

A study published Monday in the Proceedings of the National Academy of Sciences has found a single coding variation in the human genome that appears responsible, at least in part, for individual variations in such personality and behavior traits as empathy and response to stress. 

The gene they looked at -- the OXTR gene -- carries the design and production blueprint for cells scattered throughout the heart, uterus, spinal cord and brain that serve as docking stations for a chemical called oxytocin.

Scientists have long known oxytocin as the chemical of bonding and nurture. Produced in the hypothalamus and pumped into both the brain and the bloodstream, oxytocin responds to warm human interaction and drives us to seek it out when our stores are low. It is thought to cause the letdown of milk in breastfeeding mothers, and to soar for many after lovemaking. At the same time, oxytocin appears to have a pronounced calming effect: people and mice alike seem to chill out when the chemical is puffed up their noses or pumped into their bloodstreams, even under conditions of stress.

These two qualities prompted research psychologists from Oregon State University and University of California Berkeley to ask themselves: If some people's genetic endowment made them richer in oxytocin receptors, might they not, by nature, be more attuned to others and more unflappable when under stress?

In the massively complex human genome, it's a daunting challenge to find a single site where a tiny variation in the code of inheritance might produce observable differences in behavior. Fortunately, the authors of the PNAS study had a few clues to guide them: Researchers had earlier found a site on the OXTR gene where certain variations brought with them a higher incidence of autism -- a disorder marked by impairments in social interaction and communication. Variations in this site also had been shown to predict how sensitively mothers responded to their offspring. Perhaps, they asked, coding variations at this same site would yield more subtle differences in a person's sociability and ability to withstand stress?

To make a long story short, they did. The researchers put 192 college students at UC Berkeley through a pair of experimental tests -- one that measured their ability to infer the emotional state of others from looking at their facial expressions and another that measured their jumpiness when warned that a loud blast of noise was imminent. The students also were asked to rate their own levels of empathy and ability to handle stressful situations.

The one in four subjects who inherited a variation in this allele called G/G were significantly better at accurately reading the emotions of others by observing their faces than were the remaining three-quarters of subjects, who had inherited either a pair of A's or an A and a G from their parents at this site. Compared to the three-fourths with A/A or A/G variations, the G/G individuals were also less likely to startle when blasted by a loud noise, or to become stressed at the prospect of such a noise. And by their own reports, the G/G subjects were mellower and more attuned to other people than were the A/As or A/Gs.

The group's findings would appear to strike a decisive blow for nature over nurture in shaping who we are and how we behave. In fact, subjects were asked to rate how nurturing their own parents were, and researchers found that a subject's genetic inheritance seemed a better predictor of his empathic disposition than did his mother and father's parenting styles.

But UC graduate student Laura R. Saslow, a co-author of the paper, cautioned that genetic inheritance -- nature -- is never the sole determinant of our personalities. While researchers will get closer to filling in the inborn components of our personalities, the environments in which we've been raised will always interact with our genetic inheritance and shape how it expresses itself, Saslow says.

"Really, both matter," says Saslow.

-- Melissa Healy

  

Being spanked as a child is linked to having a lower IQ, according to a study presented today at the International Conference on Violence, Abuse and Trauma in San Diego.

The relationship between spanking and intelligence is found in children around the world, said the lead author of the study, University of New Hampshire professor Murray Straus. Children in the United States who were spanked had lower IQs -- by 2.8 to 5 points -- than those who were not spanked, Straus found.

Straus studied 806 children ages 2 to 4 and 704 ages 5 to 9. Both groups were retested four years later. How often parents spanked influenced IQ score. "The more spanking, the slower the development of the child's mental ability," Straus said in a news release. "But even small amounts of spanking made a difference."

Straus and his colleagues looked at corporal punishment practices in 32 countries by surveying 17,404 university students. The analysis found a lower average IQ in nations in which spanking was more prevalent. The strongest link between corporal punishment and IQ was for those whose parents continued to use corporal punishment even when they were teenagers.

"It is ... time for the United States to begin making the advantages of not spanking a public health and child welfare focus, and eventually enact federal no-spanking legislation," he said.

How would spanking impact intelligence? Straus suggests that the chronic stress created by regular spanking creates post-traumatic stress symptoms in children. PTSD is linked to lower IQ. Economic status also underlies both spanking practices and IQ, Straus said, a leading researcher on corporal punishment. His studies were funded, in part, by the National Institute of Mental Health.
 
Another study, reported earlier this month in Booster Shots, found that many poor children are spanked at ages as young as 1 and that the practice is tied to more aggressive behavior by age 2 and delayed social-emotional development by age 3.

-- Shari Roan

Photos: The top chart shows the correlation between parents who use corporal punishment with teenagers and the nation's average IQ. The bottom chart shows the more spanking, the greater the likelihood of post-traumatic stress symptoms. Credit: Murray Straus, University of New Hampshire.

Germ-spreading school children are expected to be the focus of a massive U.S. vaccination campaign against the novel H1N1 flu. But if their parents are hearing the sounding of the tocsin at all, they're not buying it, says a new national survey.

A poll conducted by the University of Michigan's C.S. Mott Children's Hospital found that only 4 in 10 parents said they would get their children immunized against the H1N1 virus--even as 54% indicated they will get their kids vaccinated against regular seasonal flu. Among those that said they do not intend to have their kids vaccinated against H1N1, almost half--46% indicated they're not worried about their child becoming ill with the pandemic virus. One in five told surveyers they do not believe the H1N1 flu is serious.

Skepticism about the new vaccine among parents has drawn on many old, and a few new fears, according to a recent look at the subject in The Times.

There were differences along racial and ethnic groups in parents' responses. More than half of Latino parents said they will bring their kids to get vaccinated against H1N1. Among white parents, 38% said they would do so. African American parents were least inclined to vaccinate: 30% said they planned to do so.

About half of the parents who planned to take a pass on the H1N1 flu shot for their kids expressed concern about possible side effects of the vaccine.

The chatter about seasonal flu and novel H1N1 flu and their relative virulence has certainly confused parents, the survey suggests. Half of respondents said they believe that, for children, seasonal and H1N1 flu pose roughly equivalent risks.

"That perception may not match the actual risks," says Dr. Matthew Davis, a University of Michigan professor of pediatrics and internal medicine and director of the poll. The Centers for Disease Control and Prevention has said that while serious complications of seasonal flu appear to spare most kids and strike the elderly and very young most heavily, the novel H1N1 flu appears to hit children and young adults hardest.

Parents who believe that H1N1 flu will be worse for children were most likely to say they will have their own children vaccinated. In a news release accompanying the poll results, Davis said that public health officials wishing to maximize vaccination rates among school children need to communicate clearly to their parents that kids are at relatively greater risk of becoming seriously ill with the novel flu strain if they get it.

-- Melissa Healy