New Sleep Times, Plastic Bronchitis, Exercise and Bone Strength, Military Families' Healthcare Needs

Pediatric research at The Children’s Hospital of Philadelphia has the power to solve problems for children and families. Our news highlights this week show just a few such examples, including new evidence-based sleep recommendations that will help parents figure out bedtimes; a new champion for helping military families navigate children’s healthcare issues; a lifesaving solution to a mysterious surgical side effect; and an encouraging finding to help children predisposed to fragile bones grow up stronger. Read on to see how our scientists are delivering solutions.

New Sleep Guidelines: How Much Rest Does Your Child Need?

Ensuring that children get enough sleep every night isn’t always easy for parents to accomplish, but new pediatric sleep guidelines issued by the American Academy of Sleep Medicine (AASM) and backed by the American Academy of Pediatrics give them fortification when it comes time for “lights out.”

The recommendations follow a 10-month project conducted by a Pediatric Consensus Panel of 13 of the nation’s foremost sleep experts, including Lee Brooks, MD, an attending pulmonologist and member of the Sleep Center at The Children's Hospital of Philadelphia. The expert panel reviewed 864 published scientific articles addressing the relationship between sleep duration and health in children, evaluated the evidence using a formal grading system, and arrived at the final recommendations after multiple rounds of voting, according to an AASM press release.

“This will give parents and physicians some guidance on how much sleep a child of whatever age needs in order to promote optimal health and learning,” said Dr. Brooks, who also is president of the New Jersey Sleep Society.

Sleeping the number of recommended hours on a regular basis promotes an overall healthy lifestyle for children, the panelists found, and is associated with improved attention, behavior, learning, memory, emotional regulation, quality of life, and mental and physical health. Not getting enough sleep is associated with an increased risk of accidents, injuries, hypertension, obesity, diabetes, and depression.

“There was an upper range as well,” Dr. Brooks pointed out. “Everybody knows that insufficient sleep is bad, but there is some data that shows too much sleep can be a problem as well.”

Regularly sleeping more than the recommended hours may be associated with adverse health outcomes, such as hypertension, diabetes, obesity, and mental health outcomes, the recommendations state.

Find the recommendations published in the Journal of Clinical Sleep Medicine here. And see a CBS News article featuring an interview with Dr. Brooks, with tips on how to help children and kids get more shut-eye.

Philadelphia Inquirer Features Innovative Treatment for Plastic Bronchitis

Jameson Finley was born with a severely underdeveloped heart and underwent a series of surgeries to repair it. But a year after his final surgery, called the Fontan procedure, he began to cough up mysterious branch-like rubbery casts.

"It feels like a strong, cooked spaghetti," his father, Todd Finley, told The Philadelphia Inquirer. "They look like a white tree branch without leaves."

Jameson’s parents searched for help for their son’s condition, known as plastic bronchitis, and discovered the work of Maxim Itkin, MD, an interventional radiologist and director of the Center for Lymphatics Imaging and Interventions, a joint program at CHOP and the Hospital of the University of Pennsylvania. The Philadelphia Inquirer recently featured the pioneering and lifesaving work of Dr. Itkin and Yoav Dori, MD, PhD, pediatric cardiologist and the director of Pediatric Lymphatic Imaging and Interventions and Lymphatic Research at CHOP.

The CHOP team has devised an innovative and minimally invasive procedure that helps relieve these rare but potentially life-threatening airway blockages that occur in children who had surgery for congenital heart defects. They also discovered the primary cause of this complication: It is a lymphatic flow disorder, occurring due to abnormal lymphatic flow into lung tissue. Drs. Itkin and Dori, along with colleagues from the divisions of Cardiology, Pulmonary Medicine, and department of Radiology at CHOP, recently reported on outcomes for 18 children treated at CHOP in the journal Circulation.

Read the Philadelphia Inquirer article and learn more about plastic bronchitis in this Cornerstone post.

Study Gives Another Good Reason to Get Kids Off the Couch

New research shows that high-impact activity can benefit children and adolescents genetically predisposed to bone fragility. The scientists say their findings underscore that genetics does not necessarily equate to destiny, and reinforce the importance of physical activity as a key factor to improve the bone health of children in the present and into later life.

“This study was the first to show that physical activity can counteract the negative effects of genetic variants that associate with bone fragility in childhood,” said first author Jonathan A. Mitchell, PhD, a pediatric researcher and instructor of Pediatrics at CHOP.

The study team, co-led by senior authors Babette S. Zemel, PhD, and Struan F.A. Grant, PhD, both from CHOP, analyzed a cohort of 918 children and adolescents, from 5 to 19 years old, all of European ancestry, who were part of a larger study group, the Bone Mineral Density in Childhood Study. The results showed that children had higher bone density scores if they had higher levels of high-impact, weight-bearing activity, such as gymnastics and soccer, which involved sprinting, turning, or jumping actions. This even applied to those with a higher genetic risk for bone fragility.

Based on their current results, the researchers advise that pediatricians, schools, and child activity programs should encourage high-impact physical activity for children who are generally healthy.

Read the study appearing online in the Journal of Bone and Mineral Research and get more details in a CHOP press release.

Physician-researcher Named to Council Supporting Military Families

Congratulations to David Rubin, MD, director of PolicyLab, a research center at CHOP, who was appointed to the United States Department of Defense (DoD) Military Family Readiness Council (MFRC). The MFRC reached out to the Children’s Hospital Association (CHA) to provide perspective from the pediatric healthcare arena and to nominate a representative to serve on the Council.

Military family readiness is the concept that military families must be well-supported so that the servicemen and servicewomen can focus on their mission. While all children have unique healthcare needs as compared to adults, children of military families face special circumstances as a result of their parents' service.

“The known effects of deployments and frequent relocations on children must be taken into consideration when developing the medical and social support systems necessary to serve these families in a timely and efficient manner,” Dr. Rubin said.

Dr. Rubin’s team at PolicyLab has been conducting research for the DoD’s Defense Health Program (DHP) since 2011. Their work specifically examines the stress families experience when soldiers return home from deployment. The team’s recent findings in the American Journal of Public Health illustrate the need to support families throughout the deployment cycle, especially during high-risk time periods such as the six months following deployment.

“With his demonstrated commitment to the comprehensive needs of children from military families, and with CHOP being one of the largest providers of care and treatment to military children from all around the globe, Dr. Rubin’s appointment to the Council was fitting,” said CHA Vice President of Public Policy Jim Kaufman, PhD.

Read the CHOP press release for more information.

ICYMI

In case you missed it, earlier this week on Cornerstone we brought you Chief Scientific Officer Bryan A. Wolf’s perspective on the value of diversity in pediatric research.

Last week’s In the News post gave highlights from the American Society of Clinical Oncology Annual Meeting, reported study findings that showed early anesthesia in healthy children has no cognitive impact, and shared new perspectives in a Research in Action blog about the “golden age” of clinical trial recruitment.

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