For years, pregnant and nursing women have been warned to limit the amount of fish they eat, because many marine species may contain high levels of mercury, which endangers newborns and fetuses. Yesterday, however, a children’s health group challenged the conventional wisdom, advising pregnant women and nursing mothers to eat more fish so as to ensure optimal brain development in their babies.


Fearing mercury contamination, many pregnant women avoid seafood altogether. That may actually harm newborns, according to some scientists. (John McConnico for The New York Times)What’s going on here? Currently, the Food and Drug Administration advises pregnant women to limit their weekly seafood consumption to no more than 12 ounces, or about two servings, per week. The newest recommendation comes from the National Healthy Mothers, Healthy Babies Coalition, a nonprofit group that focuses on childhood health issues. That group’s scientific advisors say that pregnant women and nursing mothers should eat at least 12 ounces of fish per week.

Although both recommendations acknowledge that pregnant women can safely eat about two servings a week, fears of mercury contamination in seafood have prompted many pregnant women to forgo fish entirely. And here’s the conundrum: an increasing number of studies indicate that omega-3 fatty acids, found mostly in fish, are essential to brain development in fetuses and newborns.

Earlier this year, a report in The Lancet, a medical journal, concluded that women who had eaten more than 12 ounces of fish per week during pregnancy produced better developed, more intelligent children. “Advice that limits seafood consumption might reduce the intake of nutrients necessary for optimum neurological development,” wrote scientists from the National Institutes of Health and the University of Illinois at Chicago.

“The real problem here are the women who are just eliminating fish from their diet,” said Judy Meehan, executive director of the National Healthy Mothers, Healthy Babies Coalition. “Eating 12 ounces is a very safe, smart move, and nobody is disputing that.”

While none of the research cited yesterday in the coalition’s recommendations has been funded by the fish industry, the coalition is using a grant from the National Fisheries Institute, a seafood industry group, to fund its educational campaign, according to Ms. Meehan.

For women who want the health benefits but worry about mercury and other toxins, the wisest course is to choose fish with the lowest levels of mercury. A recent report in The Journal of the American Medical Association concluded that the health benefits are likely greatest from such oily fish as salmon, herring and sardines — which are all generally low in mercury anyway. Among the fish to avoid are shark, swordfish, king mackerel and tilefish, all of which may contain high levels of mercury.

Many people, including some doctors, think children don't develop peptic ulcers. Popular opinion used to be that peptic ulcers were caused by either living with intensive stress or frequently eating spicy foods.

Now, however, most experts agree the H. pylori bacteria is the primary cause of peptic ulcers in adults. When studies and experience concluded that children also can suffer from ulcers, it was found that, unlike ulcers occurring in adults, H. pylori wasn't seen as the culprit in most cases of childhood ulcers. Some doctors make the distinction between duodenal ulcers, which are commonly associated with H. pylori infection, and gastric ulcers, which may stem from other causes and appear to be the most common form of peptic ulcer to occur in children.

Certain medical conditions can contribute to the development of peptic ulcers in children. For example, children with severe burns may develop ulcers secondary to the stress of their injuries. The use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen and naproxen sodium, can make the stomach vulnerable to the harmful effects of acid and pepsin and may contribute to the development of ulcers.
Signs and Symptoms of Ulcers in Children
The following symptoms are also common with many other childhood illnesses, and not ulcers, but should be discussed with the child's doctor for a definite diagnosis.

Burning pain in the abdomen between the Bosom bone and the belly button
Nausea
Vomiting
Feeding difficulties
Loss of appetite
Weight loss
Blood in vomit or bowel movements

Diagnosing Ulcers in Children
The following tests are most commonly used to diagnose ulcers:

Upper endoscopy
Barium X-rays
If an ulcer is found, the doctor will then test for H. pylori. While H. pylori usually isn't the cause of ulcers in children, it needs to be ruled out as a cause since the treatment for an ulcer caused by H. pylori is different from the treatment for an ulcer caused by NSAIDs.


Treatment of Ulcers in Children
If the ulcer is H.pylori-related, the child's doctor will prescribe antibiotics. These antibiotics need to be taken as directed by the child's doctor, finishing the medication even if the symptoms disappear early.

If the ulcer is medication-related, the child's doctor will advise you to not give your child NSAIDs, such as ibuprofen or aspirin, or any medications containing ibuprofen or aspirin.

The child's doctor will most likely prescribe acid-reducing medications. These should be given as prescribed by the doctor.

Most doctors won't recommend big dietary restrictions unless certain foods cause problems for the child. There are some foods, though, that stimulate the production of acid in the stomach and can make an ulcer worse. These include any foods and beverages that contain caffeine, such as sodas and chocolate.

Emergency Situations
You should call your child's doctor immediately if your child has any of these symptoms:

Sudden and persistent pain in the belly
Blood in bowel movements (the bowel movement will appear black or tarry)
Blood in vomit
Vomit that looks like coffee grounds

These symptoms can indicate the following serious problems:
Perforation. This is when an ulcer becomes too deep and breaks through the stomach or duodenal wall.
Bleeding. This is when stomach acid or an ulcer breaks a blood vessel.
Obstruction. This is when an ulcer will block food and it can't pass through to the intestines.
Ulcers in children can be an upsetting experience for parents and child, but with timely and proper treatment, almost all ulcers can be cured.

Signs and Symptoms
Kids who have sickle cell anemia may feel pain in their chest, stomach, or bones when a blood vessel gets clogged with sickle cells. The pain can last a few minutes or several days, and it might hurt a lot or just a little. When this happens, it's called a sickle cell crisis (a crisis means a time of trouble). Nobody knows exactly when sickle cells might get stuck or which blood vessels might get clogged. Certain conditions, like if a person gets too cold or gets sick, can lead to a sickle cell crisis. Doctors and nurses can help by giving strong medicine to relieve the pain.
Because kids with sickle cell anemia don't have enough normal red blood cells, they get tired more easily. They also get infections more often than other kids do. They may not grow as fast or feel as hungry as their friends.
Sometimes the whites of their eyes have a yellowish color, known as jaundice (say: jon-dus), and they may have to go to the bathroom a lot. In little kids - usually those under age 2 - sickle cell anemia can cause their hands and feet to swell and hurt.
What Causes Sickle Cell Anemia?
Sickle cell anemia is an inherited (say: in-hair-uh-ted) disease. That means you can't catch sickle cell anemia like you can catch a cold or the flu. Kids are born with the disease when parents pass along the sickle cell anemia gene to their children.
More African Americans have sickle cell anemia than any other group of people. About one out of every 500 African Americans has the disease. But some people whose ancestors came from countries around the Mediterranean Sea - like Greece, Italy, and Saudi Arabia - have sickle cell genes, too.
Some scientists think sickle cell anemia may be connected to malaria (say: muh-lar-ee-uh), a serious and sometimes deadly disease that was very common in those countries. It is believed that people who carry the gene for sickle cell anemia are less likely to catch malaria. So more of these people survived and passed on the sickle cell gene to their children.
How Does a Doctor Know a Kid Has It?
Special blood tests can tell a doctor if a kid has sickle cell disease. The tests will show the doctor the type of hemoglobin (say: hee-muh-glow-bin) in the kid's red blood cells.
Hemoglobin is the part of the blood that carries oxygen to different parts of the body in the red blood cells. There are different types of hemoglobin, including hemoglobin A and hemoglobin S. Normal red blood cells contain hemoglobin A, but people with sickle cell disease have mostly hemoglobin S (the "S" stands for sickle) in their red blood cells.
How Is Sickle Cell Anemia Treated?
Most kids with sickle cell anemia take penicillin (say: peh-nuh-sih-lun), a drug that helps prevent infections. A doctor may also prescribe a vitamin supplement called folic acid. Folic acid helps the body make new red blood cells.
Taking penicillin or vitamins does not cure sickle cell anemia, but it can help keep a kid with sickle cell anemia from getting sick. Pain medicine also helps kids with this disease. A kid with sickle cell anemia may need to go to the hospital if he or she has a lot of pain or a serious infection. At the hospital, the kid can get IV fluids, antibiotics, or other medicine.
Sometimes kids with sickle cell anemia need blood transfusions (say: tranz-fyoo-shuns). That's a way to put healthy blood cells right into a kid's body. A blood transfusion raises the amount of normal hemoglobin in the blood. It also decreases the chances that blockage, or crisis, will happen.
Can Sickle Cell Anemia Be Cured?
In some cases, a bone marrow transplant can cure sickle cell anemia. Bone marrow transplants replace the sickle cells with healthy cells from a donor (say: doe-nur). A donor is a person who gives healthy bone marrow or other organs or body parts to someone else who needs it. Not just any bone marrow will do. For the transplant to work, the bone marrow must be a close match. Usually, the best donor is a brother or sister.
What Can a Kid Do to Stay Well?
Taking penicillin every day helps prevent infections in kids who have sickle cell anemia. It's important for kids with sickle cell anemia to stay as healthy as possible. That means eating healthy foods and drinks and getting plenty of sleep. Kids with the disease can play and exercise, but they should not get too hot, too cold, or too tired.
And if a kid with the disease gets a fever, pain, or any other problems, he or she needs to tell an adult right away. Fast treatment is very important, so the kid can get back to feeling good again soon.

    STORY HIGHLIGHTS
    New advice is replacing some old traditions in treating or preventing cold and flu
    Still cover your mouth when you sneeze, but instead of your hands, use an elbow
    OTC remedies are fine, just don't overdo it or expect miracle cures
    
Don't: Sneeze into your hands
Generations of parents and teachers have told children to cover their mouths and noses when they sneeze or cough. The rule still applies, but now kids are being taught to aim into their elbows or sleeves.
"With little kids especially, when they sneeze or cough into their hands, they don't always wash their hands, and then they use their hands to touch surfaces or other people," explains Dr. Priya Sampathkumar, an infectious disease specialist with the Mayo Clinic in Rochester, Minnesota.
It's hoped that sneezing into the elbow will prevent the further spread of germs, for young kids and adults alike.
Do: Keep your hands clean
Keeping your hands clean is crucial to avoid getting sick, according to the U.S. Centers for Disease Control and Prevention. However, colds and flu are viral, not bacterial, so antibacterial soap doesn't help fight the illnesses, says Sampathkumar. "In some ways, they can actually be harmful, because environmental bacteria could become resistant," she says.
Washing your hands successfully may take longer than you're used to; the CDC recommends rubbing your hands for 20 seconds -- about the length of time it takes to sing "Happy Birthday" twice.
Don't Miss
 
One recent study found, however, that American adults -- especially men -- don't wash their hands enough after using the bathroom. Researchers for the American Society for Microbiology found that one-third of men didn't bother to wash at all after using the bathroom, while 12 percent of women didn't.
No access to soap and water? Experts say hand sanitizers also help kill germs. And an added bonus: "During winter when you wash your hands frequently, the alcohol gels can be a lot gentler on your hands," Sampathkumar says.

Don't: Overload on vitamins once you're sick
Scientific research on the effectiveness of herbal remedies and vitamin supplements has drawn conflicting conclusions.
The therapeutic value of zinc lozenges has yet to be proved, but zinc nasal gel may have a positive effect, according to a comprehensive review of zinc studies by the Stanford University School of Medicine published in the journal Clinical Infectious Diseases in September 2007.
And, after previous studies had concluded that echinacea was an ineffective cold remedy, new research has come along to muddy the waters. A study from the University of Connecticut School of Pharmacy published in the journal Lancet Infectious Diseases in September 2007 found that the herb decreased the odds of developing a cold by 58 percent and reduced the duration by about a day and a half.
Nevertheless, once your nose is already stuffed, taking vitamin supplements is probably a waste of money, Sampathkumar says.
If you do want to take a supplement to fight colds and flu before they start, Sampathkumar warns not to overdo it: "If you wanted to take a supplement, at most you need one multivitamin a day." Mega-doses of vitamins really have not been shown to help, and they can be harmful, she says.
Do: Take it easy on the treadmill
Contrary to rumors, you cannot sweat out a cold, experts say.
In fact, too much sweating can dehydrate you at a time when you need extra fluids anyway, warns Dr. Richard Deichmann, an internist at the Ochsner Medical Center in New Orleans, Louisiana.
Still, you don't need to eliminate all physical activity. "Pay attention to what your body is telling you," Sampathkumar says. "You don't want to run the 10 miles you do every day if you're not feeling up to it, but you don't necessarily have to stay in bed if you feel up to taking a walk or doing some moderate exercise."
 
Don't: Overdo it with cold remedies
Phenylephrine is the ingredient in nasal decongestant, which some people take to clear up a stuffy nose. But the medication won't cut short your bout with a cold or the flu, Deichmann says. Taking it orally can cause jitteriness, rapid heartbeat or sleeplessness, he adds.
On the other hand, nasal sprays can also dry up a runny nose and will probably cause fewer side effects, but Deichmann doesn't recommend using them for more than three or four days. "You get a tolerance to it, such that if you don't keep using it, you get a whole lot of secretions," he says. "It's a big problem."
As for kids, a Food and Drug Administration panel recently recommended against giving children under age 6 over-the-counter cold medicines. FDA: We can't recommend cold meds for those under 6
Do: Eat what feels good, hot or cold
Foods' enticing smells make you want to eat them. So it's no wonder you might lose your appetite when you have a cold and your nose is stuffy.
Sampathkumar recommends the old standby -- hot soup -- to open up your nasal passages and therefore improve your appetite. But she says you don't have to stop at soup; eat other things that feel good, too.
"There's really nothing that says if you're cold you're going to get a cold. Colds are definitely caused by viruses." To that end, "if you have a child who has a cold and the only thing they feel up to eating is Popsicles ... that's perfectly fine," she says.
Don't: Smoke
Here's another reason to quit smoking: Research shows a higher incidence of flu cases in smokers compared with nonsmokers, and, worse, a higher mortality rate for smokers than nonsmokers from the flu, according to the CDC.
Smokers are predisposed to get more upper respiratory infections, Sampathkumar says. "Their nasal passages, their upper airways, are somewhat inflamed just from the smoke," she says, adding that smoking can delay healing once you're sick.

There are approximately 4000 chemicals in cigarette smoke, many of them toxic. The ingredients in cigarrate affect everything from the internal functioning of organs to the efficiency of the body's immune system. The effects of cigarette smoking are destructive and widespread.
•Toxic ingredients in cigarette smoke travel throughout the body, causing damage in several different ways.

•NICOTINE reaches the brain within 10 seconds after smoke is inhaled. It has been found in every part of the body and
in Bosom  milk.

•Carbon Monoxide binds to hemoglobin in red blood cells, preventing affected cells from carrying a full load of oxygen.

•Cancer-causing agents (carcinogens) in tobacco smoke damage important genes that control the growth of cells,
causing them to grow abnormally or to reproduce too rapidly.

•The carcinogen benzoic (a)pyrene binds to cells in the airways and major organs of smokers.

•Smoking affects the function of the immune system and may increase the risk for respiratory and other infections.

•There are several likely ways that cigarette smoke does its damage. One is oxidative stress that mutates DNA, promotes atherosclerosis, and leads to chronic lung injury. Oxidative stress is thought to be the general mechanism behind the aging process, contributing to the development of cancer, cardiovascular disease, and COPD.

•The body produces antioxidants to help repair damaged cells. Smokers have lower levels of antioxidants in their blood than do nonsmokers.

•Smoking is associated with higher levels of chronic inflammation, another damaging process that may result in oxidative stress.

Tips on How to Quit
     Below, some tips to help you quit smoking are listed. First and foremost, set a quit date and quit COMPLETELY on that day. To prepare for that day:
•Identify the times you are most likely to smoke. For example, do you tend to smoke when feeling stressed? When you are out at night with friends? While you are drinking coffee? When you are bored? While you are driving?
•   Keep a diary to help you determine such risky times. Record each time you have a cigarette, including time of day and what you are doing.

•Make a plan about what you will do instead of smoking at those times that you are most likely to smoke. For example, drink tea instead of coffee -- tea may not trigger the desire for a cigarette. Or, take a walk when feeling stressed. Remove ashtrays and cigarettes from the car. Place pretzels or hard candies there instead. Pretend-smoke with a straw.
 
•Let all of your friends, family, and co-workers know of your plan to stop smoking and your quit date. Just being aware that they know can be a helpful reminder and motivator.
 
•Prior to your quit date, start reducing your cigarette use, including decreasing the number and strength of the cigarettes. However, DON'T do this simply to make your diary "look good!" Get rid of all of your cigarettes just prior to the quit date and clean out anything that smells like smoke, such as clothes and furniture.
 
Other tips that can help you quit and stay quit include:
•Enroll in a smoking cessation program (hospitals, health departments, community centers, and work sites frequently offer programs).
 
•Ask your health care provider for advice, including whether prescription medications (such as bupropion -- Zyban or Wellbutrin) are safe and appropriate for you.

•Find out about nicotine patches, gum, and sprays.
•Try hypnosis -- it works for some people.
•Avoid smoke-filled settings and situations in which you are more likely to smoke.
•Exercise to relieve urges to smoke.