It’s a natural instinct, and it works: Cuddling infants will help sooth them when they’re getting needles, a new study has found.

A team of researchers from Toronto’s York Univeristy looked at the results of 70 research studies to look at how babies managed pain during routine procedures.

“Holding your baby against your chest, giving the baby something to suck, and rocking are effective ways to help babies with the pain they feel from heel pricks and immunizations,” professor Rebecca Pillai Riddell said in a release about the study, which was published Wednesday in the Cochrane Review.

“This can happen naturally, like when a mother breastfeeds during an immunization procedure. Unfortunately some physicians – for younger infants in particular – give immunizations with the infant lying on a table.”

Researcher Pillai Riddell said “kangaroo care” works best for premature babies, along with a soother and swaddling.

Full-term newborns also respond to being swaddled tight, rocking/close holding and sucking a pacifier before and after the injection, Riddell said.

Babies and toddlers who undergo multiple surgeries and receive general anesthesia before they turn two are at an increased risk of developing a learning disability, a new study has found.

Researhers at the Mayo Clinic in Rochester, Minn., looked at existing data on 5,357 children born between 1976 and 1982.

Of that group, 350 children underwent surgeries with general anesthesia before their second birthday. Of those exposed to anesthesia, 286 experienced only one surgery and 64 had more than one.

Of those children who had multiple surgeries before age two, 36.6% developed a learning disability later in life. Of the children who had just one surgery, 23.6% developed a learning disability, while 21.2% developed learning disabilities but never had surgery or anesthesia.

“After removing factors related to existing health issues, we found that children exposed more than once to anesthesia and surgery prior to age two were approximately three times as likely to develop problems related to speech and language when compared to children who never underwent surgeries at that young age,” study co-author Dr. David Warner said in a release about the study, which was published online Monday and will appear in the November issue of the journal Pediatrics.

The researchers noted, though, that there was no increase in behaviour disorders among children with multiple surgeries.

A reader asks, “Is it necessary to get a hernia repaired quickly?”

The time-honoured tradition has always been to fix it. But is this approach always the right one? Or is “tincture of time”, namely watchful waiting, the best way to treat this common condition?

A hernia is a protrusion of bowel through a weak spot in the abdominal wall near the groin. But there is no sexual fairness in this condition. As one of my surgical professors used to say, “Sometimes you get the big brown egg.” In this case, the egg goes to men, as 90% of hernias occur in males.

In the past, surgeons believed that failing to return the bowel to its natural location inside the abdomen was fraught with danger. They worried that the bowel would become trapped in the hernia, causing intestinal obstruction, a serious complication. If this happens, the bowel may lose its supply of oxygenated blood, resulting in gangrene and death if an emergency operation is not done. There was also the concern that small hernias could become larger, making surgical repair more difficult.

Several years ago, a study involving five U.S. medical centres found that these surgical worries rarely occur. To prove this point, doctors followed 700 men with hernias that were causing minimal or no discomfort.

Half of the men were randomly selected to have the hernia repaired. The other 50% were told to monitor their symptoms and to report back for regular medical checkups.

To their surprise, surgeons discovered that the most feared complication, intestinal obstruction, occurred in less than one percent of patients per year. This is much better than the odds in Las Vegas. Moreover, any discomfort that was initially present did not increase over a two-year period in the majority of cases.

Twenty-five percent of the watchful waiting group did eventually ask for surgery due to an increase in pain. But this delay in surgery had no effect on the complication rate, such as infection, length of operation or the recurrence of hernia.

But what about the other half who initially were chosen to have the hernia repaired? About 20% developed complications after the surgery such as infection and difficulty passing urine, and three had life-threatening problems. Other studies show that, even after a successful hernia repair, about five percent of patients continue to have pain. No surgical procedure offers a “free lunch.”

Since this study involved only men, it’s not known whether women or children who also develop hernias would have the same result. But one would suspect little or no difference.

Dr. Michael Alexander is an expert on hernia surgery at the Shouldice Hospital in Toronto. This facility specializes in hernia repair and is a world authority on this operation.

Dr. Alexander believes that surgeons must get rid of the idea that all hernias must be repaired. This applies particularly to the elderly if they are without discomfort. But age is not a factor as long as the patient is free of cardiovascular and other problems that increase the risk. He says his oldest patient was 99 years of age!

We’ve all heard the phrase, “If it’s not broken, don’t fix it.” Now we can add another equally sound surgical dictum, “If it’s only partially broken, there may be no need to fix it.”

In the past, the usual medical practice was to tell patients that gallstones had to be removed. It’s still true if there are repeated attacks of gallstone colic or if gallstones are small and are blocking the common bile duct that drains bile into the intestines. But today, X-rays, CT scans and MRIs often detect gallstones, even though these procedures are done for other conditions. In these instances, if the gallstones are not causing any problems, they are normally left for the crematorium.

So if a hernia is present, just remember that porcupines make love very, very cautiously. Be just as cautious about hernia surgery. Always ask yourself, “How much trouble is the hernia causing me?” Your doctor should then make the final decision.

Visit www.docgiff.com for more columns, and for comments, e-mail info@docgiff.com.

The life expectancy of Canadians has risen to 80.9 years, new statistics show.

Statistics Canada says between 2006 and 2008, average life expectancy went up 0.2 years compared to 2005-2007.

Residents of British Columbia (81.4 years), Ontario (81.3 years) and Quebec (81 years) have life expectancies at birth above the national average.

The lowest life expectancies are in the three territories, at 75.2 years.

Life expectancy among seniors at the age of 65 has also been on an upward trend for several years. Life expectancy at age 65 reached 20.0 years in 2006-2008, up 0.2 years from 2005-2007.

In 2008, 238,617 people died in Canada, up 1.4% from 2007.

As well in 2008, the infant mortality rate remained stable at 5.1 infant deaths per 1,000 live births.

It’s already the end of September and we’re all back in our post-summer routines. There are lots of beginnings in September and going back to school and school lunches is at the top of many parents mind. Its an important meal because it fuels your kids and keeps their energy up. Here are some tips to help:

Make it a family affair. Get the kids involved. Ask them what they want for lunch and then have them help with preparation. Sit down with them and make a list. You can do it week by week, because things change. When you can, take them shopping and let them pick out some foods they want.

Don’t worry if they want the same thing everyday. As long as it’s nutritious and filling, it’s OK. But from time to time, ask them if they’d like to make a change.

Make lunch the night before to avoid the rush of the morning.

There are lots of ready-made “quick and easy” lunch products on the grocery shelves but when it comes to nutrition, you’re better off making your own. Instead of the high sodium lunchables or other meal kits that contain processed meats, cheese, refined crackers and sometimes candy, you can easily make your own with a reusable bento box, cubes of cheese, leftover cooked chicken or meat, hard boiled eggs and whole wheat crackers or mini pitas and some fruit.

Make healthy treats like oatmeal cookies, whole wheat muffins or squares, or banana bread to include in their lunch. Get your kids to help bake them and they’ll be more likely to eat them.

Sandwiches are always popular because they are portable and easy to eat. Be sure to avoid “mushy” fillings that don’t hold up well in lunch boxes or backpacks. Use whole wheat breads, rolls, English muffins, mini pitas. If they don’t like sandwiches, try wraps, made with whole wheat flour tortillas, crackers with cheese or hummus, or bread free sandwiches like a piece of cold meat wrapped around a cheeses stick.

Make their drinks healthy. Skip the pop, fruit drinks or energy drinks and include water, milk, soy beverage or 100% vegetable juice.

Leftovers are great but discuss them with your child before you send them. They may love them at home but not want to take them to school. Left over pizza is often popular or lasagna, macaroni and cheese, chili or stews.

Let your child pick the fruits and veggies they like. Send easy to eat, easy to carry fruit like apples, pears, grapes. Pack a small container of blueberries or strawberries or send sealed containers of unsweetened canned fruits. For smaller kids, cut up the fruits so they are easier to eat. Some popular vegetables are baby carrots (include a small container of dip), pepper slices, celery hearts, cherry tomatoes with sugar snap peas.

For younger kids, be creative with shapes and sizes. Use a cookie cutter for their sandwiches, make mini muffins or cookies.

Women whose first pregnancy ended in infant death are significantly more likely to have a subsequent stillbirth, according to a new study.

Researchers from the University of South Florida and the University of Rochester looked at 320,350 women who had two pregnancies between 1989 and 2005. Of those, 1,347 had stillbirths in the second pregnancy.

Mothers who’d lost their first child within the first year of its life were found to be three times more likely to experience a stillbirth in their subsequent pregnancy. They also had complications during the pregnancy nearly twice as often.

When women who’d had an infant death did deliver their second baby, the birth weights of the infants were, on average, 293 grams lighter.

The researchers also found that black women had higher rates of stillbirth in the subsequent pregnancy than white women.

“It is important that clinicians note the potential risk for subsequent stillbirth following infant mortality when they speak with patients in the period preceding their next pregnancy,” said the study’s lead investigator, Dr Hamisu Salihu of USF.

The study is published Wednesday in BJOG: An International Journal of Obstetrics and Gynaecology.

Flu vaccines are being shipped and should be in your doctor’s office by now. We received ours in August and have already started vaccinating patients. As in previous years, everyone age 6 months and older needs to be vaccinated.

This year’s vaccine contains three strains of influenza virus that are identical to last year’s chosen strains. Even though the vaccines are identical, that doesn’t mean you can skip your flu shot this year. Because protection from the flu wanes over the year, it’s important to get re-vaccinated annually. You just don’t know how much antibody you have left!

For children six months old to age 8, and who’ve never been vaccinated, the recommendation continues to be that they should receive two doses of vaccine, given at least four weeks apart.

If your child received at least one dose of flu vaccine in 2010-2011, he/she will only need one dose of the 2011-2012 vaccine.

The recommendation for pregnant women to be vaccinated also continues. There has been some good recent data that babies born to mothers who had received flu vaccine had a 45-48% less chance of being hospitalized with the flu than babies born to unvaccinated mothers. So, the take home message is that your baby, even in utero, is getting antibody protection from the mother. We’ve known this about other diseases and now there’s evidence of influenza protection, too.

As we move into fall, flu viruses are also back from “vacation,” so get your vaccination now.

Dr. Sue Hubbard is a pediatrician and co-host of “The Kid’s Doctor” radio show. Submit questions at www.kidsdr.com.

(c) 2011, KIDSDR.COM DISTRIBUTED BY TRIBUNE MEDIA SERVICES, INC.

CHICAGO – Fatherhood lowers testosterone levels, U.S. researchers said they have confirmed, making it easier for men to be involved in raising children.

High levels of the hormone can rev up a man’s sex drive, increase risk-taking behaviours and raise the need for social dominance. Those factors can help win a mate but are poor traits when it comes to raising a baby, which requires cooperation from both parents.

“Our study shows that human fathers are biologically wired to help with the job,” said Christopher Kuzawa of Northwestern University, who worked on the study published in the Proceedings of the National Academy of Sciences.

Prior studies have shown fathers tend to have lower testosterone than men who have no children but it was not clear whether fatherhood was the cause or that men with lower testosterone were more likely to become fathers.

The Northwestern study tried to answer that question by following a group of more than 600 men from the Philippines over five years. The men were not fathers at the start of the study.

The team saw clearly that right after the men became fathers, their testosterone levels dropped, at least for a short time.

“It’s not the case that men with lower testosterone are simply more likely to become fathers,” Lee Gettler of Northwestern University, who worked on the study, said in a statement.

“On the contrary, the men who started with high testosterone were more likely to become fathers, but once they did, their testosterone went down substantially.”

Gettler said the findings suggest fathers may experience an especially large but temporary drop in testosterone when they first bring home a newborn baby.

“Fatherhood and the demands of having a newborn baby require many emotional, psychological and physical adjustments,” Gettler said. “Our study indicates that a man’s biology can change substantially to help meet those demands.”

Dr. Allan Pacey of the University of Sheffield said testosterone levels in men generally do not change much.

“They can slowly decline as men get older and change in response to some medical conditions and treatment. But to see dramatic changes in response to family life is intriguing.” he said in a statement.

Professor Ashley Grossman, a professor of endocrinology at the University of Oxford, said endocrinologists tend not to pay much attention to men’s testosterone levels, as long as they are in the normal range.

“Life and biology may be much more subtle and adaptable than we had previously thought,” he said.

Scared of needles? Don’t worry, biomedical engineer Aaron Wheeler’s got your back.

The University of Toronto professor has developed a new method of blood sampling that scraps the fist-making, elastic-band squeezing, vein-tapping, deep-piercing, blood-draining, have-a-cookie-afterwards needle and replaces it with a quick pinprick.

The usual way blood is collected involves drawing a couple of millimetres, separating the serum, freezing it for transport or storage and then thawing it out for analysis.

An alternative that’s been gaining in popularity involves taking just a couple microlitres of blood and storing it as a dried blood spot on filter paper, where it remains stable.

While this process has been around for a while, it’s never become the standard because the actual analysis is a long and complicated process.

For example, Newborn Screening Ontario (NSO) in Ottawa collects dried blood spot samples from some 140,000 newborns each year to screen for a variety of diseases. Technicians must prepare each sample for testing by putting them into a centrifugal tube, using a chemical dropper to add solvent, extracting the necessary material from the tube and then conducting chemical analysis using robotics.

Wheeler worked with NSO researchers to automate this system, manipulating the samples and extracting the necessary materials using electrical signals in a process dubbed “lab on a chip.”

“The applications for this process go far beyond newborn screening,” Wheeler said in a U of T press release. “Pharmaceutical companies are moving towards dried blood spot analysis, but they’re still lacking the tools to make widespread use feasible. We’ve demonstrated that digital microfluidics could be that tool. Our system is fast, robust, precise, and compatible with automation.”

Pranesh Chakraborty, director of NSO, said this is a major step in moving away from traditional blood sampling, but added it will take a long time.

“This approach could save considerable costs as a result of the lower volumes of reagent required,” he said. “An automated system based on this approach would also process samples faster, with higher accuracy, less risk of errors, all while freeing up time for technologists to perform other work.”

Wheeler used his technique to screen for phenylketonuria, homocystinuria, and tyrosinemi in infants. His next step is to test the other 28 diseases on the NSO’s list.

He’s also filed a patent for the process and is looking into commercializing it.

NEW YORK – The heavier a woman is, the more trouble she may have getting pregnant and having a baby through in vitro fertilization, or IVF — and may lose the baby more often, according to a U.S. study.

Researchers led by Barbara Luke of Michigan State University found that women who were overweight or obese were less likely to become pregnant using fertility treatments than normal-weight women.

Past studies have also hinted at worse IVF outcomes in heavier women, although they don’t prove that the extra weight is directly responsible for the reproductive troubles those women experience.

“Treatment and pregnancy failures with increasing obesity significantly increased starting with overweight women,” Luke and her colleagues wrote in Fertility and Sterility.

They drew data from a reporting system that includes more than 90% of IVF treatments done in the United States — information on 150,000 fertility treatment cycles done in 2007 and 2008 at 361 different clinics.

For each cycle, the reporting system included whether the cycle was cancelled, if it led to a pregnancy, and whether that pregnancy ended early in a miscarriage or stillbirth, or if the woman gave birth to a live baby. For most cycles, it also had data on women’s height and weight before starting treatment.

From the beginning through the end of fertility treatment, heavy women saw poorer results.

“We know that being overweight and obese is not good (for IVF), it’s just how bad is it and where are the bad effects?” said Brian Cooper of Mid-Iowa Fertility in Clive, who wasn’t involved in the study.

About 9% of cycles in normal-weight women were stopped early, compared to 16% of cycles in the heaviest women — those with a body mass index over 50, which is equivalent to a 1.6-metre (5-foot-5-inch) woman who weighs over 136 kg (300 pounds).

Normal weight women had a 43% chance of getting pregnant during each cycle using their own, fresh eggs for IVF, compared to 36% for very heavy women. Rates for overweight and less obese women fell in between.

For women who did get pregnant, the trend continued, with the heaviest about twice as likely as normal-weight women to lose the baby in many cases.

For overweight and obese women trying to get pregnant, even a little bit of weight loss helps, said Howard McClamrock, an infertility specialist at the University of Maryland Medical Center in Baltimore.

“This is what we’re constantly faced with: ideally she might like to lose weight, but she might not have that much time,” added McClamrock, who was not involved in the study.

Though he noted that research has been pointing more and more towards a connection between extra weight and worse IVF outcomes, the reason is unclear.

One explanation is that extra fat tissue releases estrogen, which fools the brain into thinking the ovaries are working when they really aren’t, so it doesn’t do its part to kick the ovaries into gear, Cooper said.

Luke and her colleagues said that thin and heavy women may have different causes of infertility, though they added that they did not have data on lifestyle factors that may affect IVF success, or any data on the male partners.

Thin and normal-weight women generally had higher rates of endometriosis, in which cells from the lining of the womb grow on other organs. Polycystic ovary syndrome, where the ovaries become enlarged and contain several small cysts, were more common in very heavy women.

Cooper said that weight still isn’t as big an issue for fertility as age, or whether a woman smokes.

“Weight isn’t everything, but it’s an important factor that we have control over. Fix it now, because even a little bit (of weight loss) can make a big difference,” he added.

(Reporting by Genevra Pittman at Reuters Health; editing by Elaine Lies)