Why does little Johnny not pay attention?  Unfortunately, there isn’t an easy answer.  Consider the following:  1)  Are you expecting too much of Johnny?  Know what is normal for age.  Attention span for children under 5 years is roughly 1 minute per year, but only if the child is interested in the activity.  2)  Is Johnny healthy, meaning that he is well rested, eats healthy foods, doesn’t have cavities, and can see and hear normally?  3)  Any accidents that could affect the brain, or exposure to chemicals, like mother drinking or taking drugs during the pregnancy?  One condition is Fetal Alcohol Syndrome, where the mother drinks alcohol during the pregnancy, causing many problems, especially mental retardation and lack of attention.  4)  Other behavior problems, like anger, anxiety or depression?  Well, after avoiding physical or lifestyle issues, we are left with focusing troubles, being caused by those brain chemical problems, caused by not enough, or too much of the neurotransmitters.  For example, a recent article in the journal Neuropsychiatric Disease and Treatment, tells of the differences in attention that are found in ADHD and in Fetal Alcohol Syndrome.  While both types of kids can’t focus, the kids with Fetal Alcohol Syndrome respond better to one type of medication, dexamphetamine, meaning that the alcohol must have affected one part of the brain a little differently.  Hopefully, with time, we will understand which parts of the brain are affected with different conditions.  But even if we figure it out, anyone who could possibly get pregnant, should not to drink or use drugs.  Teach your young teens that alcohol, the teen brain, and especially pregnancy, are a bad combination.  And if your child is having problems focusing, check the lifestyle issues, then call your doctor.  Give that kid a hug, I’m Dr. Greta McFarland.

Topic #2

Fetal Alcohol Syndrome (FAS) – here’s information from a lecture by Dr. Wesley Jones, clinical director of the Mental Health Center of East Central Kansas, in Emporia, KS.  Fetal Alcohol Syndrome is a series of effects on the unborn child when the mother drinks alcohol during the pregnancy.  Some of these were noticed as far back as Aristotle, when he stated that “Drunken women most often bring forth children like unto themselves, morose and languid”, and in the book of Judges 13:7, it admonishes against drinking wine or strong drink after conception.  The Fetal Alcohol syndrome brain doesn’t grow normally, so there are varying degrees of mental retardation, and focusing and attention problems.  In addition many children with FAS are very small, have small heads, and have specific changes in their facial appearance, like a thin upper lip, no vertical lines under the nose (this is called the philtrum), and a specific pattern to the eyelids.  There are 4 areas used to identify the affects of FAS.  These include; 1) the growth in height and weight, 2) the number of the facial characteristics, 3) brain involvement determined by IQ and/or small head size, and 4) maternal alcohol usage.  A rating scale using these has been developed by Astley and Clarren.  New research is looking into how to work with FAS children, as compared to others who may have mental retardation, or focusing problems.  Certain areas of the fetal brain seem to be especially hard hit with the alcohol, and thus, make the FAS child act or respond a little differently than other kids.  I sure hope we can optimize treatment and interaction.  But still the best thing is to avoid Fetal Alcohol Syndrome in the first place.  Anyone who could possibly get pregnant should not drink alcohol, and teens especially should not drink.  Give that kid a hug, I’m Dr. Greta McFarland. 

Topic #3

What difference does a week or two make?  Well, for the unborn baby, it can mean the difference in life and death.  Enter a new term, the ‘late preterm” infant.  A recent lecture by Dr. Sue Laudert, neonatologist at Wesley Hospital in Wichita, Ks, gave info on late preterm infants.  For convenience we often refer to a 9 month pregnancy as being normal.  This is about 40 weeks.  If a baby is born from 37 to 40 weeks, we say they are term, or on time.  Babies born closer to 40 weeks do better with bodily functions like breathing, feeding, and not getting too cold.  Babies born before 37 weeks are considered premature.  The phrase, late preterm, includes infants born from 34 weeks to 37 weeks after conception.  According to Dr. Laudert, the chance that babies born in this period will die, as compared to infants born after 37 weeks is up to 4 times higher.  They have about 6 times the chance of going to the neonatal unit for specialized care.  And of the babies who aren’t ill enough to go to the special center, a much higher percentage will need to stay in the hospital a few days longer, because they need to be watched for eating and weight gain, maintaining temperatures, and for a breathing problem called apnea, where they just quit breathing.  Late preterm infants are more likely to have yellow jaundice.  I bring this up, because Mommies get tired of being pregnant, and can really insist that their doctors start the birth process, called induction.  There are medical reasons to induce, but being tired of pregnancy isn’t one of them.  Also parents may think that a late preterm baby should be able to go home like a term baby, but it may be more dangerous, and so the baby should be watched a little more closely.  So more delivering doctors may refuse to induce early babies, for convenience.  Keep the bun in the oven until done, then give it a hug, I’m Dr. Greta Mcfarland.