Caesarean Births - Risk of Obesity!

Babies born by Caesarean are at higher risk of becoming obese, especially compared with siblings born by vaginal delivery, a large study suggests.

Writing in JAMA Pediatrics, the researchers said this might be because babies born vaginally are exposed to healthy gut bacteria that play an important role in regulating diet.
The study followed more than 22,000 babies into adulthood.
But experts said there were likely to be many different factors at work.
These include the diet of the mother, whether she had diabetes during pregnancy and whether the baby was breastfed. Babies born via Caesarean are less likely to be breastfed, and this has been shown to lead to an increased risk of obesity. Children's diets also have an effect on their future weight.



Steady rise
In the UK, about 26% of babies are delivered by Caesarean section - an operation where a cut is made in the tummy and womb to get the baby out. Rates have been rising steadily over the past few years, according to the Royal College of Midwives.
In this study, American researchers from Harvard Medical School and other institutions found that babies delivered by Caesarean were 15% more likely to grow up to be obese after adjusting for a number of factors, including the mother's weight and age.
In families where children were born by different methods, those born by Caesarean were 64% more likely to be obese than their siblings born by vaginal delivery.
But the researchers could not say Caesareans were the cause of obesity or explain the mechanisms behind the link.
Their best guess was that differences in gastrointestinal microbiota, or healthy gut bacteria, between babies born by different methods could have an effect.

'Medical necessity'

Microbiota is the term used to describe the microbes that colonise our bodies and which vary from one person to another. They are linked to some diseases but can also be used to treat disease and promote health.

A technique called "vaginal seeding" can be used to transfer maternal vaginal fluid - which contains the healthy bacteria - to a baby born by Caesarean but doctors say there could be risks with infection.
Dr Simon Cork, research associate in the department of investigative medicine at Imperial College London, said there were many factors to consider in children's risk of obesity - not just their mode of delivery at birth.
"Overall, the literature surrounding this area suggests that there may be a link between Caesarean section and obesity. However, this link is neither fully proven nor understood.
"Most often Caesarean births are as a result of medical necessity, rather than elective, and as such this risk would outweigh any concerns mothers should have regarding the possibility of future weight issues."

Informed choice

Prof Neena Modi, President of the Royal College of Paediatrics and Child Health said more research was needed to find out whether birth by Caesarean was a cause of obesity.

"Caesarean section can be life saving for women and their babies. However many women are now considering Caesarean section where there is no medical indication.
"It is important that they are told about the possibility of increased risk of obesity in their children, to help them make an informed birth choice.
She added: "It is also important for parents to focus on factors that they can influence which definitely impact on their infant's health. This includes maintaining a healthy weight at the time of conception, and throughout pregnancy. "

Schools study shows fitness level stalls in teenage girls

The fitness level of Irish girls stalls in their early teenage years, with the average 16-year-old performing no better in tests than a 12-year-old, the results of a countrywide schools-based challenge show.

Boys’ fitness improves over the same age period, with 16-year-olds on average 33 per cent fitter than 12-year-olds, according to the challenge taken by 148 schools.

“The fact that girls are not showing the same improvement in cardiovascular fitness as boys is clearly a cause for concern,” said Prof Niall Moyna of DCU’s school of health and human performance, who set up the challenge four years ago.

Related research into children with low levels of fitness has found evidence of heart disease in the arteries of 15-year-olds, he said. The same children were also found to have high cholesterol, blood pressure and fat levels.

Both boys and girls improved their performance after undertaking a six-week fitness programme that forms part of the challenge, which was taken by more than 10,000 children this year.

The average improvement for boys was 12 per cent while for girls, coming from a lower base, it was 19 per cent.

Prof Moyna says a variety of social and cultural reasons may explain young girls’ poor fitness levels.

“There are issues around the continuing participation of girls in sport as they grow older. They may become unused to pushing themselves, to being out of breath, even to the fact their make-up could run.”

However, he is optimistic about the future because of a “paradigm shift” in recent years which has made it more acceptable for girls to continue in sport, as well as an increase in team sport options.

While Irish boys and girls are well above the European average for fitness for their age group, this is not regarded as an accurate guide to the minimum fitness level required for optimal health, according to Prof Moyna.

The European figures are a “race to the bottom” in terms of performance and Ireland should develop its own national norms, he maintains.

“Lifestyle behaviours tend to track from childhood to adulthood. Children who are unfit and overweight in their teenage years will likely be unfit and overweight as adults.”

Taoiseach Enda Kenny will today present prizes to the most improved schools in the challenge, which is sponsored by Aviva Health.  : The Schools' Fitness Challenge

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Concern over mental health services for children

An Oireachtas committee was told the waiting list for Child and Adolescent Mental Health services is too high

An Oireachtas committee has heard that a third of children and adolescents in need of mental health services up to June this year, were admitted to adult wards.

The Director of Mental Health Reform told the Oireachtas Health Committee this morning that despite the Mental Health Code of Practice stating no child should be admitted into an adult ward outside exceptional circumstances, of 158 admissions, 53 were to adult units.

Dr Shari McDaid said this was "too many". She also told the committee that the waiting list for Child and Adolescent Mental Health services is too long. By July this year, 2,757 children were waiting to be seen by CAMS. Dr McDaid said that while that represented a 2% decrease on the previous year, "there are a large number of children waiting to be seen".

She also criticised the Health Service Executive, saying it had been very slow in deciding where to spend the money allocated to Mental Health Services, noting that it decided where to spend the 2014 allocation in September of this year.

Dr McDaid said it is the third year the decision on spending has been delayed, and said she hoped the HSE would be quicker with that decision in 2015.

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Depression top cause of illness in world's teens: WHO

Some studies show that half of all people who develop mental disorders have their first symptoms by the age of 14

Depression is the top global cause of illness and disability for adolescents, with suicide the third-biggest cause of death, the World Health Organization has said.

The finding is in a new report by the UN agency.

It has pulled together a wealth of published evidence with direct consultations with 10 to 19-year-olds around the world to assess the health issues that affect them.

Some studies show that half of all people who develop mental disorders have their first symptoms by the age of 14, said the report.

The study looked at a broad range of issues, including tobacco, alcohol and drug use, HIV, injuries, mental health, nutrition, sexual and reproductive health, and violence.

Traffic injuries were the number two cause of illness and disability, behind depression, with boys three times more likely to die than girls.

WHO said it was crucial for countries to reduce the risk by increasing access to reliable and safe public transport, improve road safety regulations such as alcohol and speed limits, establish safe pedestrian areas around schools and graduated licensing schemes where drivers' privileges are phased in over time.

Worldwide, an estimated 1.3 million adolescents died in 2012, it said.

View WHO/adolescent health here

'The Mental Health of Young People in Ireland' report launched

On 10th October 2013 the PERL (Psychiatry Epidemiology across the Liefspan) Group launched its first research report on The Mental Health of Young People in Ireland. This report summarises findings on the rates of mental ill-health among Irish youth from their Adolescent Brain Development Study and their Challenging Times Two Study.

Click here to view Report
Click here to view PERL homepage