ROCHESTER, Minn. — In a retrospective case study, Mayo Clinic researchers have found that antibiotics administered to children younger than 2 are associated with several ongoing illnesses or conditions, ranging from allergies to obesity. The findings appear in Mayo Clinic Proceedings.

Using health record data from the Rochester Epidemiology Project, a population-based research collaboration in Minnesota and Wisconsin, researchers analyzed data from over 14,500 children. About 70% of the children had received at least one treatment with antibiotics for illness before age 2. Children receiving multiple antibiotic treatments were more likely to have multiple illnesses or conditions later in childhood.

Types and frequency of illness varied depending on age, type of medication, dose and number of doses. There also were some differences between boys and girls. Conditions associated with early use of antibiotics included asthma, allergic rhinitis, weight issues and obesity, food allergies, attention deficit hyperactivity disorder, celiac disease, and atopic dermatitis. The authors speculate that even though antibiotics may only transiently affect the microbiome, the collection of microbes in the body, this may have long-term health consequences.

"We want to emphasize that this study shows association ― not causation ― of these conditions," says Nathan LeBrasseur, Ph.D., a researcher at Mayo Clinic's Robert and Arlene Kogod Center on Aging and the study's senior author. "These findings offer the opportunity to target future research to determine more reliable and safer approaches to timing, dosing and types of antibiotics for children in this age group."

While recent data show an increase in some of the childhood conditions involved in the study, experts are not sure why. Other than the issue of multidrug resistance, antibiotics have been presumed safe by most pediatricians.

Researchers also say the ultimate goal is to provide practical guidelines for physicians on the safest way to use antibiotics early in life.

Other coauthors of the study are Zaira Aversa, M.D., Ph.D., first author; Elizabeth Atkinson; Marissa Schafer, Ph.D.; Regan Theiler, M.D., Ph.D.; and Walter Rocca, M.D. ― all of Mayo Clinic ― and Martin Blaser, M.D., of Rutgers University.

The study was supported by the Pritzker Foundation, Leonard and Mary Lou Hoeft Fund in Healthy Aging and Independent Living Research, Rochester Epidemiology Project, C&D Fund, and Transatlantic Networks of Excellence of the Leducq Foundation.

The Rochester Epidemiology Project has been supported by the National Institutes of Health since its inception more than 50 years ago.

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About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news and Mayo Clinic Facts for more information about Mayo.

About Mayo Clinic Proceedings
Mayo Clinic Proceedings is a monthly peer-reviewed medical journal that publishes original articles and reviews dealing with clinical and laboratory medicine, clinical research, basic science research, and clinical epidemiology. Mayo Clinic Proceedings is sponsored by the Mayo Foundation for Medical Education and Research as part of its commitment to physician education. The journal has been published for more than 90 years and has a circulation of 127,000. Visit the Mayo Clinic Proceedings website to view articles.

Media contact:

• Bob Nellis, Mayo Clinic Public Affairs, newsbureau@mayo.edu

The post Study finds antibiotics before age 2 associated with childhood health issues appeared first on Mayo Clinic News Network.

DEAR MAYO CLINIC: I am mom to two energetic boys, ages 5 and 8. A neighbor commented that my children must have ADHD. What is ADHD exactly and how do I tell the difference between a kid who just has a ton of energy and one who has a problem that needs to be addressed? Do I need an evaluation? Are there things that put a child at risk for ADHD?

ANSWER: Awareness of attention deficit hyperactivity disorder, or ADHD, has grown significantly over the past 20 years. The number of children diagnosed with ADHD has grown substantially, too. There isn’t one test that can diagnose ADHD definitively, but there are criteria that health care providers can use to identify this disorder.

Some people use the term ADHD casually for any child who can sustain high levels of activity for a long time or one who has trouble focusing on a task for long. But not all high-energy children have ADHD so it’s wise to be cautious about labeling children with excess enthusiasm and children who may have trouble focusing, as having ADHD.

ADHD is a chronic condition that involves problems with inattention or distraction, and/or hyperactivity and impulsive behavior. But it’s helpful to remember that most healthy people are occasionally inattentive, hyperactive or impulsive.

For example, it is normal for preschoolers to have short attention spans and be unable to stick with one activity. Even in older children and teens, attention spans can vary throughout the day. Young children also are naturally energetic. They often have plenty of energy left long after their parents are worn out. And some children simply enjoy a higher level of activity than others. Children should never be classified as having ADHD just because they are different from their friends or siblings.

A critical distinction between typical childhood behaviors and those of ADHD is that ADHD symptoms consistently and significantly disrupt daily life and relationships. Children with ADHD don’t have it only in one environment. If a child has significant problems at school but is fine at home — or the other way around — something other than ADHD is going on. Two other key characteristics of ADHD behaviors are that they begin when a child is young (before age 12), and they last more than six months.

Children who have a parent or sibling with ADHD tend to have a higher risk of developing the disorder than children who don’t have that family history. The same is true of children who experience a complex medical condition early in life. For example, children who were born prematurely tend to develop ADHD more often than other children.

Following are questions to ask when considering the possibility of ADHD. Is the child often easily distracted? Is he constantly on the move? Does he or she fail to think before acting, to the point that it raises safety concerns? And most crucial: Do issues with inattention, distractibility, impulsivity and hyperactivity significantly impair daily life?

If the answers to these questions are yes, then an evaluation with the child’s primary care provider is in order. Assessing a child for ADHD involves several steps. The first is a medical exam to rule out other possible concerns, such as hearing or vision problems, or learning, language or other developmental disorders.

The health care provider also will talk with the child and the parents about the child’s symptoms. Other family members, teachers, coaches or child care providers may be asked to fill out questionnaires about behaviors they regularly see in the child. This can give a more complete picture of the child’s condition overall. Based on the information gathered, ADHD is diagnosed using guidelines developed by the American Academy of Pediatrics and the American Psychiatric Association.

If you’re concerned a child’s behaviors could signal ADHD, make an appointment for an evaluation. If ADHD is diagnosed, treatment can help control symptoms, making it easier for a child to manage and enjoy daily life. —Dr. Michael Zaccariello, Psychology, Mayo Clinic, Rochester, Minnesota

The post Mayo Clinic Q and A: Diagnosing ADHD appeared first on Mayo Clinic News Network.

DEAR MAYO CLINIC: As the mom of an elementary schoolboy, I hear a lot of talk about ADHD. But what is it exactly? How do you tell the difference between a kid who just has a ton of energy and one who has a problem that needs to be addressed? Are there things that put a child at risk for ADHD?

ANSWER: Awareness of attention deficit/hyperactivity disorder, or ADHD, has grown significantly over the past 20 years. The number of children diagnosed with ADHD has grown substantially, too. But it’s wise to be cautious about labeling all high-energy children, or children who have some difficulty focusing, with ADHD. There isn’t one test that can diagnose ADHD definitively, but there are criteria that health care providers can use to identify this disorder.

ADHD is a chronic condition that involves problems with inattention or distraction, hyperactivity and impulsive behavior. Some people use the term ADHD casually for any child who has trouble focusing on a task for long or one who can sustain high levels of activity for a long time. But it’s helpful to recognize that most healthy people are occasionally inattentive, hyperactive or impulsive.

For example, it’s normal for preschoolers to have short attention spans and be unable to stick with one activity. Even in older children and teens, attention span can vary throughout the day. Young children also are naturally energetic. They often have plenty of energy left long after their parents are worn out. And some children simply enjoy a higher level of activity than others. Children should never be classified as having ADHD just because they’re different from their friends or siblings.

A critical distinction between typical childhood behaviors and those of ADHD is that ADHD symptoms consistently and significantly disrupt daily life and relationships. Children with ADHD don’t have it only in one environment. If a child has significant problems at school but is fine at home — or the other way around — something other than ADHD is going on. Two other key characteristics of ADHD behaviors are that they begin when a child is young (before age 12), and they last more than six months.

Children who have a parent or sibling with ADHD tend to have a higher risk of developing the disorder than children who don’t have that family history. The same is true of children who experience a complex medical condition early in life. For example, children who were born prematurely tend to develop ADHD more often than other children.

Following are questions to ask when considering the possibility of ADHD. Is the child often easily distracted? Is he constantly on the move? Does she fail to think before acting, to the point that it raises safety concerns? And most crucial: Do issues with inattention, distractibility, impulsivity and hyperactivity significantly impair daily life?

If the answers to these questions are yes, then an evaluation with the child’s primary care provider is in order. Assessing a child for ADHD involves several steps. The first is a medical exam to rule out other possible concerns, such as hearing or vision problems, or learning, language or other developmental disorders.

The health care provider also will talk with the child and the parents about the child’s symptoms. Other family members, teachers, coaches or child care providers may be asked to fill out questionnaires about behaviors they regularly see in the child. This can give a more complete picture of the child’s condition overall. Based on the information gathered, ADHD is diagnosed using guidelines developed by the American Academy of Pediatrics and the American Psychiatric Association.

If you’re concerned a child’s behaviors could signal ADHD, make an appointment for an evaluation. If ADHD is diagnosed, treatment can help control symptoms, making it easier for a child to manage and enjoy daily life. — Dr. Michael Zaccariello, Psychology, Mayo Clinic, Rochester, Minnesota

The post Mayo Clinic Q and A: High energy, lack of focus don’t necessarily mean your child has ADHD appeared first on Mayo Clinic News Network.

ANSWER: Awareness of attention deficit/hyperactivity disorder, or ADHD, has grown significantly over the past 20 years. The number of children diagnosed with ADHD has grown substantially, too. But it’s wise to be cautious about labeling all high-energy children, or children who have some difficulty focusing, with ADHD. There isn’t one test that can diagnose ADHD definitively, but there are criteria that health care providers can use to identify this disorder.

ADHD is a chronic condition that involves problems with inattention or distraction, hyperactivity and impulsive behavior. Some people use the term ADHD casually for any child who has trouble focusing on a task for long or one who can sustain high levels of activity for a long time. But it’s helpful to recognize that most healthy people are occasionally inattentive, hyperactive or impulsive.

For example, it’s normal for preschoolers to have short attention spans and be unable to stick with one activity. Even in older children and teens, attention span can vary throughout the day. Young children also are naturally energetic. They often have plenty of energy left long after their parents are worn out. And some children simply enjoy a higher level of activity than others. Children should never be classified as having ADHD just because they’re different from their friends or siblings.

A critical distinction between typical childhood behaviors and those of ADHD is that ADHD symptoms consistently and significantly disrupt daily life and relationships. Children with ADHD don’t have it only in one environment. If a child has significant problems at school but is fine at home — or the other way around — something other than ADHD is going on. Two other key characteristics of ADHD behaviors are that they begin when a child is young (before age 12), and they last more than six months.

Children who have a parent or sibling with ADHD tend to have a higher risk of developing the disorder than children who don’t have that family history. The same is true of children who experience a complex medical condition early in life. For example, children who were born prematurely tend to develop ADHD more often than other children.

Following are questions to ask when considering the possibility of ADHD. Is the child often easily distracted? Is he constantly on the move? Does she fail to think before acting, to the point that it raises safety concerns? And most crucial: Do issues with inattention, distractibility, impulsivity and hyperactivity significantly impair daily life?

If the answers to these questions are yes, then an evaluation with the child’s primary care provider is in order. Assessing a child for ADHD involves several steps. The first is a medical exam to rule out other possible concerns, such as hearing or vision problems, or learning, language or other developmental disorders.

The health care provider also will talk with the child and the parents about the child’s symptoms. Other family members, teachers, coaches or child care providers may be asked to fill out questionnaires about behaviors they regularly see in the child. This can give a more complete picture of the child’s condition overall. Based on the information gathered, ADHD is diagnosed using guidelines developed by the American Academy of Pediatrics and the American Psychiatric Association.

If you’re concerned a child’s behaviors could signal ADHD, make an appointment for an evaluation. If ADHD is diagnosed, treatment can help control symptoms, making it easier for a child to manage and enjoy daily life. — Dr. Michael Zaccariello, Psychology, Mayo Clinic, Rochester, Minnesota

The post Mayo Clinic Q and A: High energy, lack of focus don’t necessarily mean your child has ADHD appeared first on Mayo Clinic News Network.

On the next Mayo Clinic Radio program, Mollie Luhman, a living kidney donor, and Dr. Mark Stegall, a surgeon at Mayo Clinic who helped perform the transplant, will share their story. Also on the program, Dr. Michael Zaccariello, a psychologist at Mayo Clinic, will help explain why attention deficit hyperactivity disorder (ADHD) is on the rise. And Dr. Donald Hensrud, a preventive medicine specialist at Mayo Clinic, will discuss nutrition do’s and don’ts.

Here's your Mayo Clinic Radio podcast.

The post Organ donation story / ADHD on the rise / nutrition do’s and don’ts: Mayo Clinic Radio appeared first on Mayo Clinic News Network.

On the next Mayo Clinic Radio program, Mollie Luhman, a living kidney donor, and Dr. Mark Stegall, a surgeon at Mayo Clinic who helped perform the transplant, will share their story. Also on the program, Dr. Michael Zaccariello, a psychologist at Mayo Clinic, will help explain why attention deficit hyperactivity disorder (ADHD) is on the rise. And Dr. Donald Hensrud, a preventive medicine specialist at Mayo Clinic, will discuss nutrition do’s and don’ts.

To hear the program, find an affiliate in your area.

Use the hashtag #MayoClinicRadio, and tweet your questions.

Mayo Clinic Radio is on iHeartRadio.

Access archived shows or subscribe to the podcast.

The post Mayo Clinic Radio: Living donor kidney transplant appeared first on Mayo Clinic News Network.

Organ donation often is referred to as the gift of life. In the U.S., 100,000 people are waiting for an organ transplant, according to the United Network for Organ Sharing. Unfortunately, many may never get the call saying that a suitable donor organ has been found. It's estimated that every day in the U.S., 20 patients die because of the lack of donor organs. While organ donation is often thought of as something done after death, living donation is possible with some organs including kidney and liver.

On the next Mayo Clinic Radio program, Mollie Luhman, a living kidney donor, and Dr. Mark Stegall, a surgeon at Mayo Clinic who helped perform the transplant, will share their story. Also on the program, Dr. Michael Zaccariello, a psychologist at Mayo Clinic, will help explain why attention deficit hyperactivity disorder (ADHD) is on the rise. And Dr. Donald Hensrud, a preventive medicine specialist at Mayo Clinic, will discuss nutrition do’s and don’ts.

To hear the program, find an affiliate in your area.

Miss the show?  Here's your Mayo Clinic Radio podcast.

Use the hashtag #MayoClinicRadio, and tweet your questions.

Mayo Clinic Radio is on iHeartRadio.

Access archived shows or subscribe to the podcast.

Mayo Clinic Radio produces a weekly one-hour radio program highlighting health and medical information from Mayo Clinic.

The post Mayo Clinic Radio: Organ donation story / ADHD on the rise / nutrition do’s and don’ts appeared first on Mayo Clinic News Network.

ROCHESTER, Minn. – A Mayo Clinic study finds no evidence that children given anesthesia before their third birthdays have lower IQs than those who did not have it. A more complex picture emerges among people who had anesthesia several times as small children: Although their intelligence is comparable, they score modestly lower on tests measuring fine motor skills, and their parents are more likely to report behavioral and learning problems. The findings are published in Anesthesiology.

The U.S. Food and Drug Administration warned in 2016 that prolonged or repeated sedation before age 3 may affect brain development. The warning was based largely on data from animals, which may or may not apply to children.

Mayo researchers studied 997 people born from 1994 through 2007 in Olmsted County, Minnesota, the home of Mayo Clinic’s Rochester campus. They were grouped according to the anesthesia exposures they had before their third birthdays: 206 had two or more; 380 had one; and 411 had none. Ear, nose and throat procedures were the most common surgeries.

The researchers used the Rochester Epidemiology Project medical records database, brain function testing at ages 8-12 or 15-20, and parent reports to assess behavior and brain function. Beyond their anesthesia exposure, the three groups of patients were matched to be as similar as possible.

Intelligence, memory, and several other measures of brain function were similar among the groups.

However, those with multiple exposures to anesthesia had modest declines in fine motor skills, such as the ability to draw figures with a pencil, and how quickly they processed information when reading. Their parents reported more learning and behavioral problems, such as difficulty reading; behaviors consistent with attention deficit hyperactivity disorder; breaking rules; or displaying aggression, anxiety or social withdrawal.

Parents whose children had anesthesia once under age 3 reported more problems with mental skills known as executive functions – skills that help with memory, impulse control, planning and flexibility – but not with other behaviors.

“For the majority of kids undergoing surgery, the results overall are reassuring,” says lead author David Warner, M.D., a pediatric anesthesiologist at Mayo Clinic Children’s Center. “About 80 percent of kids who need surgery under age 3 only need one, and it’s relatively brief.”

Several other studies also show little evidence that a single anesthetic is associated with significant harm.

“Although we do have some concerns about the children who are receiving multiple anesthetics, it’s important to note that our results don’t allow us to conclude that anesthesia itself is causing problems,” Dr. Warner says, adding that other factors, such as the conditions that make surgery necessary, could contribute. “However, the fact that we found some problems in some of these children means that research in this area needs to continue, including further analysis of our data.”

In the meantime, in most cases the benefit of surgery outweighs any risk, Dr. Warner says.  However, the potential for problems may need to be part of the decision-making process when parents and surgeons discuss surgery, he adds.

The study was funded by grant R01 HD071907 from the National Institutes of Health’s Eunice Kennedy Shriver National Institute of Child Health and Human Development. The Rochester Epidemiology Project is supported by National Institute on Aging grant R01 AG034676.

The study’s senior author is Randall Flick, M.D., a pediatric anesthesiologist at Mayo Clinic Children’s Center.

Mayo Clinic’s research into the effects of anesthesia on children and other age groups is ongoing. The Mayo Clinic team next plans to image the brains of the children in this study to see whether there are structural and functional differences in those who had anesthesia as small children compared with those who did not.

###

About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to clinical practice, education and research, providing expert, comprehensive care to everyone who needs healing. Learn more about Mayo Clinic. Visit the Mayo Clinic News Network.

Media contact:

• Sharon Theimer, Mayo Clinic Public Affairs, 507-284-5005, newsbureau@mayo.edu

The post Mayo Clinic study finds no evidence that anesthesia in young children lowers intelligence appeared first on Mayo Clinic News Network.

On the next Mayo Clinic Radio program, Dr. Martha Hartz, the division chair of Pediatric Allergy and Immunology in the Mayo Clinic Children's Center, will discuss treatment of pediatric asthma and allergies. Also on the program, Dr. Rachel Lynch, a pediatrician at Mayo Clinic, will discuss attention deficit hyperactivity disorder (ADHD) in children. And Dr. Craig Sawchuk, a psychologist at Mayo Clinic, will explain why hoarding disorder is difficult to treat.

Here's your Mayo Clinic Radio podcast.

The post Pediatric asthma and allergies / ADHD / hoarding disorder: Mayo Clinic Radio appeared first on Mayo Clinic News Network.

Alzheimer's genes: Are you at risk?
Researchers have identified a number of genes associated with Alzheimer's disease. However, genetic risk factors are just one of the factors involved in getting Alzheimer's disease. Find out more about your risk and whether genetic testing might be right for you.

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Can you get genital herpes from a toilet seat?
Genital herpes is a sexually transmitted infection spread by skin-to-skin contact. It's nearly impossible to get the infection through contact with toilets, towels or other objects used by an infected person. Learn more from Dr. James Steckelberg, a Mayo Clinic infectious diseases expert.

Do food additives cause hyperactivity?
While there's no solid evidence that food additives, such as artificial colors, artificial sweeteners and preservatives, cause attention deficit hyperactivity disorder, the topic of their possible effects is controversial. Learn more from Dr. David Agerter, a Mayo Clinic family medicine specialist.

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