and a major cable news network. Their analysis of
(Barry CL and Busch SH: Pediatrics,
these stories showed that reporting quality was
mixed. While most stories correctly described risks
suicide itself, media reports varied in what part of
the issue they emphasized. Some were more likely
to include anecdotes of children harmed rather than
helped hy antidepressants (often these were TV
reports), whereas others included interviews with
experts who emphasized the benefits of the medica-
tions to children with depression. The authors
point out that patients often give anecdotal or
"personal" reports more credibility than "statistical"
evidence, and this may have led to a reduction in
use of antidepressants, which could lead to an
increase in suicides from untreaLed depression.
Further, media reports often left out important
parts of the FDA warnings, including the impor-
tance of monitoring treated children for signs of
suicidality, the need to slowly reduce doses if a
child's amide pressant were going to be stopped, and
the fact that FDA had approved only one of the
many antidepressants for treatment of depression in
CHILD DEVELOPMENT
Mozart Benefits Preterm Infants
About 15 years ago, researchers found that a
group of college students improved certain kinds of
intelligence after listening to 10 minutes of a Mozart
sonaLa. The findings came to be called "the Mozart
effect", and later studies showed that music could
reduce stress in preterm (premature) infants,
leading to improvement in their weight gain and
shortening the amount of time they stayed in the
hospital. While these results were encouraging, it is
unclear why music would have the effect it does.
Researchers in Israel wondered if the music
reduced the amount of energy an infant uses while
resting, and to examine their theory they conducted
an experiment in which they studied 20 healthy
preterm infants; for two days in a row, half were
assigned to be exposed to 30 minutes of Mozart
music each day or to no music.
Child Health
3 February 2010
children.
December 7, 2009 (online) DOI:10.1542/
peds.2009-0792)
COMMENT: This report is important, but
unfortunately doesn't give parents and others who
care for children much guidance on what sources
are most reliable. However, it is worth keeping in
mind that, except for some product recalls, it is rare
for FDA or other health agencies to issue such
urgent alerts that they require immediate action. So
it gives us time to learn more about a particular
report. While our health care providers often don't
have the background Information before the news
breaks in the papers, TV, or internet, parents and
others should consider going to the source of the
report—whether it's the FDA, CDC, Consumer
Product Safety Commission or other federal
agencies; the best way to learn what the alert is all
about is to go to their web sites, which will usually
have the complete press release readily availiable.
This is one sure way of being sure that the infor-
mation we first read or hear on media outlets is
complete and accurate. l""l
The authors found that after 10 minutes, the
babies who listened to Mozart for 30 minutes used
about 10-13% less energy at rest than the babies
who were not exposed to the music. The effect
lasted as long as the music was played, and didn't
seem to carry over to the next day. Further, the
researchers are careful not to overinterpret their
findings—for example, they note that they only
studied certain pieces by Mozart, so they can't
speculate whether music by other composers would
have the same effect (in fact, a study of adults with
seizures compared effects of music by a number of
classical composers, and found Mozart's music most
effective, perhaps because of the particular charac-
teristics of his music). (Lubetzhy R et al:
Pediatrics, December 7, 2009 (online) 125;e24-
e28, DOI: 10.1542/peds.2009-0990)
COMMENT: Many parents have heard about
"the Mozart effect", with some playing Mozart to the
fetus during pregnancy with the hope that it will
improve the baby's intelligence, music appreciation,
or a host of other things. The study above offers
some evidence that music by Mozart can indeed
have beneficial effects, but as the authors of this
study point out, the infants who benefited by
reducing the amount of energy they used at rest
only did so while the music was playing. On ihe
other hand, tliey afso point out that premature
babies are at risk for long-term disabilities, and
medical staff in neonatal intensive care units
(NlCUs) try to reduce things that might add stress
MEDICATION
Household Spoons Aren't The
Way To Measure Liquid Medicine
About two years ago, experts reported that some
children were getting overdoses of non-prescription
("over-the-counter", or "OTC") cough and cold
medicines, and in a small number of infants, these
overdoses proved fatal. One cause of overdoses of
liquid medications is that the recommended
amounts are given in teaspoons or portions of
teaspoons, but teaspoons are known to vary a great
deal in hovv' much they hold, so even though the
assumed dose of a teaspoon is 5cc, some can hold
less and a large number can hold a great deal more.
CMáHealth ALERT
EDITOR;
Allen A. Mitchell, M.D.
Professor of Pediatrics & Public Health,
Boston University Schools of Medicine &
Public Health; Lecturer on Pediatría, Harvard
Medical School, Boston, MA
EDITORUL ADVISORY BOARD:
Robert M. Filier, M.D.
pyofessor of Surgery &• Paediatrics, Emfriliis,
University of Toronto; Medical Director of
Tekheahh and External Medical Affairs,
Hospital (or Sick Children, Toronto, Ontatio
Frederick H. Lovejoy, Jr., M.D.
William Berenberg Professor of
Pediatrics. Han-ard Medical School;
Associate Physidan-in-Chief,
Cfîi/iîrcrrV Hospihii. Boston. KÍA
to the infants and perhaps in that way reduce the
risk for some later disabilities. They wonder if
music, whether by Mozart or. ot.hers, might be one
way to reduce the babies' stress, and they and other
researchers are conducting studies to see if that
might work. |nî*l
The problem can be different if a tablespoon is
used and the patient is tr)ang to estimate how much
of the tablespoon would hold a teaspoon's worth of
medicine. To examine this question, researchers
asked 195 university students to put a teaspoon's
worth of medicine into different spoons—one was a
teaspoon that indeed held 5cc, one was a table-
spoon that held 15 cc, and one was a larger spoon
that held 45 cc. The students first poured a cough-
cold medicine into the 5 cc teaspoon, and then
were told to pour the same amount into the other
two spoons. As it turned out, the students using
the medium size spoon poured 8% less medicine
than they should have, but when they used the
larger spoon, they poured 12% more.
The authors point out that while these differ-
ences might not seem very large, they occurred
among college students who had just seen how
Frederick Mandell, M.D. Mary Ucci, A.B., M.Ed, {lietvcd}
AssiKiatL' Cliniaii Professor of Educarional Director,
Pediatrics, Hazard Medical Schod: Child Study Center of Wellesley College,
Senior Associate in Medicine, WVlli'sltv. M.A i
Children's Hospital, Boston, híA
Karen Miller, B.S., R.N., S.N. SumnerJ. Yaffe,M.D.
School Nurse Consulimg Profesmr of Pediatrics,
Brookline, MA Stanford University School of Medicine,
Pdr "*•• ' A
John Modlin, M.D.
Professor of Pediatrics and Meécine
Dartmouth Medical School, Infectious Barry Zuckerman, M.D.
Disease Section, Dartmouth-Hitchcock Joel and Barbara Alpen Pmje^^'ior o¡ Pediamcs
Medical Center, Lebanon, NH and Chairman,
Dcfurtmcnl of Pediatrics,
Frank J. Twarog, M.D., Ph.D.
Boston Medical Center,
Clinical Professor of Pedialfwii, Boston University School of Medicine
Har\'ard Medical School;
Senior Associate in Medicine. PUBLISHER:
Children^ Homtal. Boston, MA Panla L. MitcheU, M.Ed.
Child Health yt/J^/îT
4 February 2010
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