Volume 14
A Survey of Current Developments Affecting Child Health Care December 1996
Is Apple Juice Safe For Children?
In recent weeks, news reports
have described two epidemics
involving contamination of different
apple drinks by bacteria called E. coli
0157:H7. One of these involved a
small numBer of cases blamed on
apple cider produced in Connecticut;
the other involved the popular brand
of Odwalla "natural" juices sold in
the West and Southwest, affecting at
least 49 people (mostly children) and
causing the death of one 15-month
old child in Denver. Besides its
apple juice, Odwalla makes 13 types
of drinks that contain some apple
juice, and most don't have the word
11apple" in the name.
As a result of these episodes, the
company has removed all of its
drinks that contain apple juice from
store shelves. Government investigators have now confirmed that the
E. coli that caused the illness is the
same bacteria that were found in the
drinks containing apple juice.
Associated PresslNew York Times,
November 1, 1996; ReuterslBoston
Globe, November 3, 1996; Morbidity
and Mortality Weekly Report, p. 975,
November 8 ' 1996; Associated
PresslBoston Globe, November 12,
1996)
COMMENT: What's new--and
disturbing--about the Odwalla problem is that the E. coli bacteria were
found in apple juice, not in apple
cider. In recent years, we've become
aware that raw apple cider can be contaminated with E. coli. Even though it had been thought that these
bacteria couldn't survive in apple
juice, this epidemic clearly shows
that they can. As a result, the U.S.
Food and Drug Administration is
considering a requirement that apple
juices be pasteurized, but even if this
were to be implemented it won't hap
pen in the very near future.
So the question many parents and
child care providers may be asking is
whether they should stop giving their
children apple juice (and other fruit
juices that contain apple juice). That
wouldn't seem necessary. Ironically,
as we pointed out in just the last
issue of CHILD HEALTH ALERT,
there are ways to reduce the risk of
E. coli contamination. For cider,
brushing and washing the apples
thoroughly before pressing them may
help, but the best way way to make
sure that apple drinks--whether cider or juice--are safe is to make sure they have been pasteurized, because pasteurization kills E. coli. Remember
that the apple products in the recent
epidemics were all unpasteurized.
Though some think unpasteurized
apple juice tastes better, it is safer to
avoid it, particularly for children-, if
the label says "natural", most likely
it's unpasteurized.
Unfortunately, even though commercial apple juice products may be
pasteurized, their labels haven't necessarily said so. We suspect that
apple juice labels will change very
quickly, and we'd also be surprised if
supermarkets aren't already putting
up signs to indicate that certain
brands of apple juice are pasteurized.
So as long as parents and child care
providers avoid apple drinks that are
not pasteurized, they shouldn't worry
about giving commercially-prepared
apple juices to children.
DIET& NUTRITION
A New Scare About Aspartame (NutraSweet
& Equal)
A recent study reported that brain
tumors have increased by about 10%
in the mid 1980s, shortly after
NutraSweet hit the market
(NutraSweet and Equal are brand
names of aspartame, an artificial
sweetener). The study does not prove
that aspartame is the culprit, and figures show that the increase in brain
tumors leveled off beginning in 1985,
four years after NutraSweet began
selling. (Associated PresslBoston
Globe, November 19,1996)
COMMENT: This is not the first
time we've read about the health hazards of aspartame, and it's probably
not the last. However, like so many
reports before it, this one appears not
to be based on good science. As the
Commissioner of the U.S. Food and
Drug Administration stated, the link
between aspartame and cancer "just
doesn't hold up", and his view was
repeated by other scientists who have
focused a lot of research attention on
this issue.
While we agree that the evidence
doesn't indicate that aspartame is harmful, we do wonder whether children need to consume as much of it
as many do. In adults, there are some
real benefits to aspartame. since it is
helpful in reducing calories and controlling diabetes, however, these
problems are not concerns for most
children. We suspect that children
consume aspartame partly because it , s
in so many foods and drinks in their
homes and partly because many
adults think sugar is harmful for children. What is harmful, we believe, is
our society's exaggerated concern
with being thin--something that is
increasingly becoming a focus of
younger and younger children. By
encouraging children to prefer eating
"diet" products containing aspartame,
are we doing them more harm than
good?
ENVIRONMENT
Good News On Health Effects Of Electric
Power Lines
After reviewing more than 500
studies conducted over the past 17 years, a panel convened by the National Research Council has
concluded that there is no convincing
evidence that exposure to electric
and magnetic fields from power lines
and appliances in the home presents
a health hazard. After the three-year
analysis, the committee stated that
"specifically, no conclusive and consistent evidence shows that exposures to residential electric and magnetic fields produce cancer, adverse
neurobehavioral effects or reproductive and developmental effects."
(Leary WE: New York Times,
November 1, 1996)
COMMENT: We've been following this issue for ears. since early reports linked high voltage
lines to childhood leukemia (CHILD
HEALTH ALERT, August 1987), and
this expert report seems to reflect the
evidence that has been accumulating
since that time. While some will
argue that it's impossible to prove
that power lines have absolutely no
effect, the large amount of information that is currently available suggests that if electric or magnetic
fields have any harmful effects, they
are likely to be so small as to be
unmeasurable.
Kids Need Fiber,
Too
It's clear that American adults
consume too much fat, but there's
debate over how much fat is appropriate for infants and very young
children. There seems to be little
debate, however, that both adults and
children should include more fiber in
their daily diets. To promote healthful nutrition for children, the American Academy of Pediatrics and the
Food Marketing Institute have developed a nutrition newsletter called
"Healthy Start: Food To Grow On".
The winter issue, for example, discusses why fiber matters for kids,
some fiber foods to try, and even
includes a recipe for "spaghetti with
a twist" or "wormy spaghetti". As
reflected by this recipe title, the
newsletter tries to encourage healthy diets by making food (and food
preparation) fun.
The newsletter may be reproduced for distribution, and is available at no cost. Readers interested in
obtaining the winter issue should
send a stamped, self-addressed business size envelope to American
Academy of Pediatrics, Department
C-HS Winter, P.O. Box 927, Elk
Grove Village. IL 6009-0927.
CHILD CARE ISSUES
Mary Ucci:
Coping With The Holidays
December is a month filled with
holidays- -including Christmas,
Chanukah, and Kwanza. These holidays have in common a sense of joy
and excitement. and as adults we
want to share these feelings with our
children. In our enthusiasm, however, we have to be careful to recognize
that children view the holidays differently from adults. First. the activities surrounding the holidays can
simply overwhelm a child. Their
meal schedule is different, the foods
they eat are different, there are many
visits from family and friends, parties
to attend, and in general the pace is much faster than any other time of
the year. Second, since adults are
caught up in these activities, they
may not focus their usual levels of
attention on their children's emotional needs.
With this in mind, we should consider thoughtful and sensitive ways
to bring the spirit and excitement of
the holidays into the classroom or child care setting. Whether the children are cared for in a nondenominational or religious environment, it's
important to consider that very young
children (ages 3 to 5) aren't terribly
capable of anticipating the holidays;
for them, the holidays mean something when they happen. Further, it
takes several years for them to develop the sense of tradition that we as
adults take for granted.
So what can be done in the classroom that will provide a sense of
JOY
without being overwhelming? First,
it's useful to find out what holidays
are represented by children of different religions in the classroom, and to
learn what's going on in their homes
in relation to the holidays. The challenge is to discover what's really
meaningful to the children in our care,
as this information will guide what we
do for a given group of children.
With all the excitement going on, I like to make the classroom a place where the holidays are acknowledged, but children can still find the comfort and security of their usual routines and surroundings. For this reason, I try to include symbols of the various holidays without having decorations that take over the classroom. In addition to the symbols, children do well relating to scenes of people gathering for the holidays; these scenes can add to the decorations and at the same time can be used to discuss what holidays mean to children. Projects can follow the same theme of recognizing the holidays without being overwhelming-for example, children can make and decorate cookies. read stories, and have art activities that reflect the joy of the holidays.
The bottom line is for us to recognize that holidays can be a time of great stress for children. as they can be for adults, and it's important to keep classroom (and home) routines stable and predictable. By being mindful of young children's perspectives, we can share the joy of the season in a way that is appropriate to their developmental level.
Mary, Ucci, who is Educational
Director of the Child Study Center of Wellesley College, writes this periodic
column on early childhood development; she welcomes questions from readers, which she will
answer
as space permits. Questions should
be sent to her c/o CHILD HEALTH
ALERT, P.O. Box 610228, Newton
Highlands, MA 02461.
Child Health
ALERT
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