Some very young infants (less than 6 months) or those who were premature can become tired because of the extra work of breathing and can have episodes of “apnea,” or briefly stopping breathing. Other babies may have a slight bluish color change around the lips or face, indicating a need for extra oxygen. Babies with pre-existing lung or heart problems often become very ill with RSV infections.

The pediatrician should be called for advice if an infant (less than 1 year of age) develops a very frequent cough with signs of nasal congestion and fever. It is important for the baby to be seen by the doctor, especially if the baby is wheezing or the baby’s chest or tummy seems to be heaving with each breath. If the doctor suspects RSV, an RSV test may be done, in which a bit of nasal or throat mucus is obtained with a soft plastic tube and then sent to the lab for identification of the RSV or other virus. The pediatrician may arrange for a chest X-ray to be done to be sure there is no pneumonia, and the nurse may also measure the oxygen level of the blood (using a simple and painless “oximeter” on the finger or toe) in the office or emergency room.

Occasionally asthma medications (such as albuterol) are tried to see whether they relieve the wheezing. The pediatrician may suggest that the baby receive more liquids, including more frequent breast-feedings, or more water or watered-down formula, and medications (usually acetaminophen) to reduce the fever. It may also be helpful for the baby to sleep in the car seat or other half-upright position.

RSV infections tend to last about a week, although the cough may last for several weeks after the illness begins. The first RSV infection tends to be the worst.

There is good evidence that breast milk contains maternal antibody against RSV, which can protect breast-fed infants — one of many reasons why pediatricians so strongly recommend breast-feeding! Infants who are exposed to tobacco smoke or other environmental pollutants like woodstove smoke will also have more difficulty handling RSV infections.

Because infants who were born two or more months prematurely are at very high risk during RSV illnesses. Special prevention measures, using an RSV antibody, are available from pediatricians and neonatologists at medical centers for premature infants during their first winter. The good news, too, is that a RSV vaccine is on the horizon!

Cough is so common to children that I will explore more of the many reasons for cough, especially the special coughs that should prompt a call or visit to the pediatrician, in the weeks to come.

Let’s begin with one of the most common causes of winter cough in infants in the first year or two of life: respiratory infection caused by RSV, the respiratory syncytial virus.

Respiratory Syncytial Virus
RSV has been recognized as a very important cause of respiratory illness in infants and children since the 1950s. But it has only been in recent years that we have actually been able to do lab tests to demonstrate the presence of this virus. And so parents these days may hear the doctor or a friend mention “RSV.” Like the common cold, children (and adults) can get RSV infections again and again.

RSV is the most common cause of “bronchiolitis,” an infection involving the smallest airways, or bronchioles, of the lungs of young children, especially in the first year of life.

Other respiratory viruses, like parainfluenza, influenza, adenovirus, and others, can also cause bronchiolitis. Bronchiolitis is a distinctly infantile illness and is often associated with mild fever, coughing, wheezing, rapid breathing, and often decreased interest in eating and drinking.

Two studies from China found that drinking green tea was associated with reduced risk for cancer of the rectum, pancreas, and stomach. (Interestingly, they found no decrease in colon cancer.) The more green tea a person drank, the greater the reduction in stomach cancer risk.

At Texas Medical Center, cancer researchers are looking for more definitive information about the effects of green tea. “The epidemiological studies are interesting,” says Waun Ki Hong, M.D. of the University of Texas, M.D. Anderson Cancer Center in Houston. “In Japan, people who drink green tea have a delayed occurrence of cancer compared to those who don’t drink it.” Researchers plan to start by examining tea’s safety among people who actually have cancer.

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Both black and green tea are made from the same plant, Camellia sinensis, which has been cultivated in China for centuries. The key difference is in their preparation. Black tea, traditionally ingested in Europe, India, and America, is made by drying and fermenting the leaves. Green tea is not fermented and is made by steaming or pan-frying tea leaves before drying them. More of the original substances endure in the less-processed green form, which is traditionally consumed in Asia.

Based on the widely publicized results of some observational studies, green tea has become popular as a daily drink for cancer prevention. Yet these studies—which look at cancer rates among groups of people who drink varying amounts of tea—have shown varied results, which makes interpretation challenging.

One study followed more than 8,500 Japanese adults for nine years. Women who drank more than 10 cups a day had a delay in onset of cancer and also a 43% lower cancer incidence. Male tea-drinkers also had a lower cancer incidence, but researchers said it was too small to be significant.

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There are three components of the triple screen:

alpha feto protein or AFP
human chorionic gonadotropin or HCG
unconjugated estriol
The triple screen is not a perfect test, nor does it diagnose all problems in the fetus. It is valuable as a screening tool to determine whether your baby has an increased risk of certain abnormalities. It is completely non-invasive and offers women the chance to learn more about the health of their babies, particularly the majority of pregnant women who are too young to be offered chromosomal tests like amniocentesis.
In the AFP test, a high level means that there is an increased risk of spina bifida in the baby. An ultrasound is usually recommended to view the spine and brain if a high level of AFP is found. AFP can also be elevated if you are carrying twins. Since the level rises during the second trimester normally, it is important to know your correct gestational age (the number of weeks pregnant you are).

A high level of AFP also indicates an increased risk of you having high blood pressure later in the pregnancy or of having a baby that grows slowly in utero.

If there is a low level of AFP, there is a greater risk of the baby having Down syndrome or another chromosome abnormality.

HCG is a hormone produced by the placenta, and levels tend to be higher in women whose fetuses have Down syndrome.

Estriol is a hormone produced by the fetus. Its levels tend to be lower in cases of Down syndrome.

Inhibin is an additional marker that is used in some labs.

The ratios of each of these substances are compared to what is considered normal for that time in gestation. The AFP is usually done at around 16 weeks into the pregnancy, counted from the last menstrual period.

While some practitioners only tell patients the test was normal or abnormal, I don’t find that helpful. You can ask for the risk number instead. For example, a woman in her mid-30s might have a risk of Down syndrome of 1 in 200 based on her age. If the triple screen result is a risk of 1 in 750, it’s very reassuring, but if it’s 1 in 50, she might want an amniocentesis.

If the triple screen shows a high risk of problems, your doctor or midwife may schedule an ultrasound to look for signs of Down syndrome. It is important that an ultrasound like this be performed by a facility with lots of experience at finding fetal abnormalities. Based on the triple screen alone or combined with the ultrasound you may want to think about an amniocentesis to rule out Down syndrome.

This test is very helpful for women who aren’t sure whether they want an amniocentesis because it gives more precise risk assessment than age alone. In the past, using age alone we identified only about 1 in 5 Down syndrome fetuses before birth. With triple screening we can raise that to about two-thirds. Since Down syndrome fetuses have a high risk of problems like heart and intestinal abnormalities, correct prenatal identification can help with neonatal care, so triple screening can be helpful even for couples who would never consider abortion.

Most women get reassuring results from the triple screen. About 1 in 20 younger women are told they need further testing by ultrasound and sometimes amniocentesis.

Up to 1 in 4 older women are referred for ultrasounds and possibly an amniocentesis, but considering that there is a small risk of miscarriage with amniocentesis, that is better than our past practice of routinely doing amniocentesis on all women over 35.

In a future column I’ll talk about some exciting new developments for first trimester screening.

Aspirin also reduces inflammation, but only at maximum daily doses.

Cautions

Aspirin reduces the clotting capacity of blood, thereby prolonging bleeding, more than acetaminophen and ibuprofen do.

Aspirin can cause stomach ulcers or make them worse. People with ulcers or other bleeding problems should not take aspirin. Aspirin can trigger asthma attacks in 5 percent to 10 percent of people with asthma.

Aspirin can cause stomach upset or heartburn.
Never give aspirin to a child under 12 who has chickenpox, the flu or any other illness you suspect of being caused by a virus.

The material in this book shows us in a careful analysis of minutely recorded dream sequences how one might attempt to derive valuable insights into the nature of the remedy from them. Reading this book, I became painfully aware, how inadequately and simplistically we often deal with this matter. The most complicated organ of the human body produces the most complex kind of symptoms.

The authors write about provings of remedies, which have been known to us for a long time. They are typical examples of faceless remedies, which exist thanks only to a hodge-podge of physical symptoms with little or no individual character traits. The remedies are Berberis, Rhododendron and Convallaria.

In the first 32 pages of the 200 page paperback, the authors describe their method and motivation. Following this is a very readable account of each proving with dreams juxtaposed with their psychological interpretation. Not only informative but also a great learning tool for the adept student. Concluding this is a list of suggested repertory additions for each remedy. These are not only mind symptoms but include the many physical symptoms which came up as well. Several instructive cases with long follow up periods are also included.

Uta Santos-Konig, MD, is a clinical psychiatrist and Jungian analyst, who practices homeopathy. Peter Konig, MD, practices homeopathy and has many teaching and lecturing obligations in Austria and abroad. Both authors have conducted several high-quality provings in the past, which, unfortunately, have not found their way into the English speaking part of our homeopathic community. Among the remedies proved are: Ginkgo biloba, Abrotanum, Magnesium fluoratum, Succinum acidum, Adeps boae constricorae, Cerastes, Banisteriopsis caapi, and several others.

The only problem with the book is that it is, at the time of this writing, only available in German. An English publication is being pursued, the manuscript has already been translated, but publisher has yet to come forth and express interest.

I enjoyed reading this book immensely. It not only introduced three hitherto rather bland and one-dimensional remedies to me, it also taught me respect of the language of dreams and offered a glimpse on the synthesis between psychology and homeopathy.

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“To my knowledge, this work is the first of its kind attempting to link the methodology of homeopathic drug provings with modern psychodynamic insights into dream assessments. …
…
At the times of Hahnemann and Kent there still prevailed the idea that the so-called ‘healthy’ prover constitutes a ‘tabula rasa’, a clean slate, on which the remedy being proved leaves its pathologic symptomatology. Dreams were considered irrational activities, malfunctions of the ganglia, therefore potential pathology. Because of this, it made sense to include dreams of, e.g., dogs, robbers, cars, snakes, death, etc., which were remembered during the proving, as symptoms in our materia medica and repertory.

Today we know that both assumptions are incorrect.

First, the prover is not a clean slate, which is being passively written on, but he reacts selectively to the remedy, according to his own individuality. Just as the two authors of this book describe, it is never clear in advance, which ‘proving’ symptoms are to be ascribed to the prover and which to the remedy. The same, of course, holds true for the physical symptoms, but it is of particular importance for the assessment of dreams.

Second, dreams are not a pathological malfunction of the brain cells, but a normal, even essential, activity of the unconscious psyche, which assists our conscious functions and, if necessary, compensates it. …
…
While the mere surfacing of words or images in dreams has no symptomatological value and permits no conclusion as to any kind of pathology, it is the patterns of combinations, the way in which the dreamer deals with them, that is important. …

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Since then, the frequency with which provings have been conducted has gone down. But not only the frequency, their quality has become chancy and less reliable as well. Kent already complained that since Hahnemann’s time there had been less than 25 well done provings.

Luckily, this trend seems to reverse now. With the growth of the homeopathic community and the increasing globalization, we have seen a significant increase in published provings. As the number increases, we must ensure that our quality standards do not deteriorate. It becomes even more important to separate the good from the bad and the ugly.

The temptation to “produce” symptoms and turn out new remedies quickly is large. We all know of dream provings, which are done within a night or two by placing the remedy under the pillow and sleeping on it. Whatever wells up to the conscious part of our minds in the morning is cherished as the remedy speaking directly to us. This, in my opinion, is going out too far on thin ice.

Yes, dreams are a valuable source of information otherwise inaccessible to us. And, yes, neglecting this information blurs the image of the remedy we are trying to understand. But it takes knowledge, skill, and much experience to find the nugget of gold encapsulated in the colorful and sometimes intentionally misleading language of our unconscious.

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Passive smoke, now called environmental tobacco smoke (ETS), is a health risk that affects about 150,000 to 300,000 children and kills 53,000 nonsmokers each year. It even affects your pets’ health.

In fact, ETS is the only environmental pollutant conclusively proven to be hazardous to the health of children and adults. It is classified as a Group A carcinogen. Other Group A carcinogens include asbestos, radon and benzene.

The consistency of results seen in numerous American and international research studies of ETS lead to a certainty of more than 99.9 percent that second-hand smoke increases the risk of lung cancers in nonsmokers.

ETS is a real health risk, but it is one that is preventable. There are two types of second-hand smoke: The first type is the “mainstream” smoke exhaled by smokers, and the second type is the “sidestream” smoke emitted from the burning end of a cigarette into the environment. Both types of second-hand smoke are chemically similar and both contain carcinogenic compounds.

About five dozen substances have been found in ETS that are known to initiate and/or promote cancer, including nicotine, formaldehyde, cyanide, arsenic, carbon monoxide, methane and benzene. Research has shown conclusively that increased exposure to second-hand smoke increases health risks.

Although definitive evidence has linked ETS with cancer, the risk of developing lung cancer is relatively small compared to other health risks related to its exposure. ETS contains strong irritants and sensitizers, and many adults and children suffer respiratory and ear problems such as decreased lung performance, chronic coughing and wheezing, bronchitis, pneumonia, fluid in the middle ear, allergies and asthma.

Children with asthma have more frequent and more severe asthma attacks because of exposure to second-hand smoke. There also is an increased risk for the onset of asthma in exposed children. Mounting evidence suggests that ETS can affect the cardiovascular system and increase the risk of sudden infant death syndrome (SIDS). In addition, nicotine is found in a mother’s breast milk up to five hours after smoking.

Protecting children from exposure to ETS should be a priority for all American citizens. Children from birth to age 2 are especially vulnerable to ETS because their lungs are not fully developed. In 1994, Congress passed, and President Clinton has signed into law, legislation that restricts smoking in nearly all public places where federal assistance is provided for services to children.

Pending legislation (H.R. 3434, S.1680, S. 262) would protect nonsmokers, including children, from second-hand smoke in most public places.

These bills would not make the sale of tobacco illegal, bring government regulations into the home nor take away a smoker’s right to choose to smoke. They would help improve the quality of our environment and the health of our children and loved-ones.

If you are a smoker, or live and/or work with a smoker, you can reduce the ETS health risks in your home and workplace by following these guidelines:

Limit indoor areas where smoking is permitted.
Prohibit smoking indoors, and permit smoking outdoors only.
Open windows and/or doors while you smoke.
Keep indoor areas well ventilated.
Do not smoke if you are pregnant.
Do not smoke around children or where they eat, play or sleep.
Prohibit childcare workers and babysitters from smoking around your children.
Learn how to motivate smokers to reduce or quit their use of tobacco.