Ask The Labor Nurse: Why the latest study is not the final word | Fit Pregnancy

Studying The Study

08.24.12 Why the latest study is not the final word

A couple of headlines this week might be confusing for a few parents. Here’s one: “Giving antibiotics to babies could lead to obesity.”  Here’s the other: “Decrease in circumcisions could cost billions.”  Before we stop giving babies antibiotics and start giving them all circumcisions, let’s take a look at what these headline-making studies actually say.  Sometimes, studying "the study" is more important than the information the study reports. 

What is a study?  It’s the conclusion drawn from scientific experiments, research, data collection and opinion based on results from a clinical trial.  It is not necessarily the final word on whatever subject has been studied.  Studies are intended to provide new information, confirm old information or open the door to new ways of looking at a subject.  Too often, however, doctors, scientists, and patients alike think a particular study is the latest, greatest, absolute truth.  Not so fast.  Very often the final words on any given study are these:  More research is needed.  A better way to look at a study is as a piece to a puzzle, not as the whole darn picture. 

Now, back to those headlines:

According to a study published this week in the International Journal of Obesity, giving antibiotics to babies under six months of age could cause them to weigh more as children. Here’s what the study concludes:

Exposure to antibiotics during the first 6 months of life is associated with consistent increases in body mass from 10 to 38 months. Exposures later in infancy (6–14 months, 15–23 months) are not consistently associated with increased body mass. Although effects of early exposures are modest at the individual level, they could have substantial consequences for population health.

This study doesn’t guarantee you’ll have a heavy kid if he takes antibiotics.  It just says there’s 22 percent increased likelihood.  That means 78 percent aren’t at increased likelihood.  Even the kids in that 22 percent aren’t doomed to obesity. They just have increased odds. 

There’s a lot of focus these days on the negative impact overuse of antibiotics is making on our health. In addition to creating superbugs that are resistant to standard treatment, antibiotics are being linked to inflammatory bowel disease, asthma and other baffling autoimmune disorders. We’ve learned (through studies) that as antibiotics kill disease-causing bacteria they also kill healthy bacteria that keep our immune system functioning properly.

So, what should a parent do if his newborn gets ill and the pediatrician says, “antibiotics?”  Ask questions.

  1. Why does my baby need antibiotics?
  2. How else could we treat her illness?
  3. What’s your take on early exposure to antibiotics being linked to obesity and autoimmune disorders?
  4. Is it safe to see if my baby gets better on her own?

If your pediatrician says anything like, ”Are you nuts?  This baby is sick, sick, sick and the sooner we get antibiotics started the better chance we have of saving her,” well then, quit asking questions and get that prescription filled.  If, on the other hand, your doc says, “She might not need them, but, just in case, it couldn’t hurt,” then there’s time to consider other options. 

How about that other headline about circumcisions?  Currently, about 55 percent of American baby boys are circumcised and that number has been steadily declining in recent years. The American Academy of Pediatrics does not recommend routine newborn circumcision and in many states, insurance providers won’t even pay for the surgery because it’s widely considered an unnecessary cosmetic procedure. 

Update 08.28.12: The The American Academy of Pediatrics is reversing its long-held stance on circumcision and now says that the benefits of the practice outweigh the risks. Read more >>

This new study, conducted by an associate professor of pathology at Johns Hopkins University speculates if the percentage of boys who are circumcised drops to ten percent, (like it is in Europe); we’ll see an incredible increase in sexually transmitted diseases and skyrocketing medical expenses to treat them.  Let’s look at it another way:  IF only 10 percent of boys get circumcised, THEN we MIGHT see more STDS and it will POTENTIALLY cost billions to treat them. 

That’s a lot of speculation don’t you think?  And this study is really about the cost of treating disease, not so much about preventing disease itself.  America’s ridiculously high medical expenses might be better addressed by something other than adding more surgical procedures.

The studies connecting circumcision with STD reduction were primarily done in Africa where health, hygiene and medical care are a whole other ballgame.  We don’t actually know that circumcising more boys will lead to less infection.  We do know that teaching boys about good hygiene and safe sex is a good way to reduce STDs without surgery.

When you read headlines about medical studies that make exciting, frightening, confusing or provocative claims, remember they’re not the final word on anything. There have been plenty of studies that have turned the medical world upside down we later discovered were inaccurate; like studies that supported using antibiotics for everything was a good plan.  Instead of basing medical decisions on any one piece of information, get as much information as possible, weigh risks, benefits, options, and individual health factors and make a customized decision about what is or is not your best course of action.  

If your baby has a serious infection and needs antibiotics, don’t worry about the obesity it probably won’t cause that might or might not happen down the road. If you’re debating circumcision for you newborn, don’t worry about possible medical costs that might or might not happen decades from now. Take care of your baby now and let the future take care of itself. By the time that future comes around, there will have been thousands of other studies and some of them just might prove this week’s studies wrong. 

 

Jeanne Faulkner, R.N., lives in Portland, Ore., with her husband and five children. Got a question for Jeanne? Email it to labornurse@fitpregnancy.com and it may be answered in a future blog post. 

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This Fit Pregnancy blog is intended for educational purposes only. It is not intended to replace medical advice from your physician. Before initiating any exercise program, diet or treatment provided by Fit Pregnancy, you should seek medical advice from your primary caregiver.

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