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Your Health transcript -- Edition 18

This is Your Health, offering tips and information to help you and your loved ones stay healthy.  In this edition of Your Health, we'll talk about plastic surgery and why you don't need to be a Hollywood starlet to seriously consider it.  We'll also explore whether firstborn children are smarter than their siblings, and we'll get gross for a while and talk about how to handle diarrhea in your children.

What do you think about when you hear the term “plastic surgery”? For many, they assume that's only for the vain.  But that's not the case, as Dr. Thad O'Neill, a plastic surgeon working in the Sheboygan and Fond du Lac areas, told me during a recent conversation.

<Interview transcript not available>

To learn more, go to www.Aurora.org/plastic.

As a first born, this edition's health myth is my favorite. Is it true that older children are more intelligent than their younger siblings?  Well, let's hope so. But let's find out for sure.

The implications of birth order are a popular topic of debate because birth order is a concrete, measurable, stable, and uncontrollable aspect of family life that can be used as an explanation for behavior and performance. For years, researchers claimed that older children were more intelligent than their younger siblings. Such conclusions were based mainly on cross-sectional data, which compared children from different families across a population.

More recent studies have examined children within the same families, and followed siblings over time. Using this more accurate method, researchers have found that birth order does not affect intelligence, and that differences in intelligence observed in previous trials are most likely due to external factors such as parents' intelligence or economic disadvantages more often faced by larger families.

The idea that birth order affects IQ and achievement was studied as early as 1874 by Francis Galton, an English anthropologist and, inconsequently, a half cousin of Charles Darwin. He proposed that firstborn children got more attention and resources from parents—especially those with limited finances, and that because of laws that stated the eldest child inherited the parents' entire estate, firstborn sons had greater opportunities to continue their education. Galton also believed that older siblings had a more open relationship with their parents, and were given more responsibilities than their younger siblings.

One interesting fact is that firstborn children, historically, have been over-represented among Nobel Prize winners and in academic fields such as classical music and psychology. Such trends, coupled with theories such as Galton's, have generated enormous interest in the topic of birth order and intelligence, and numerous studies have been conducted to verify or disprove a link between the two. Until the late 20th century, most researchers were limited to comparing children from different families, largely due to a lack of available data. The results of these comparisons found that intelligence drops with increasing birth order.

Various explanations have been proposed for the observed higher intelligence of firstborns, and their over-representation as college students and high achievers in scientific fields. Researcher Judith Blake proposed that parental resources are limited, and once they run out it may be difficult to produce more. Such resources include money, time, and cultural investments—all of which contribute greatly to children's cognitive development and opportunities for higher education. Also, firstborn children are automatically entitled to 100% of parental resources and attention at the start of their lives, while additional children must share the same amount of resources divided among an expanding number of siblings. This would also help explain why children in larger families have lower IQs.

Another researcher focused on the intellectual environment within a family. Besides the fact that only firstborn children get the undivided attention of their parents, he theorized that firstborn children are exposed to only adult language, whereas later-born children experience the less mature, childish speech of their older siblings. This aspect of the theory would help explain why firstborns tend to score higher on tests of verbal ability.

Finally, older siblings often answer the questions of younger siblings, and thus take on a teaching role. Some researchers believe that tutoring improves the intelligence of the teacher, which would help explain why 'only' children (who get undivided attention throughout childhood) do not test better than firstborn children.

In recent years, however, studies examining intelligence levels between children within the same family tend to produce different results than previous studies comparing children in different families. “Within-family” study designs are considered more reliable because variations in social class, number of siblings, economic status, and parental personality are controlled. These newer studies have shown relatively random patterns and little relation between intelligence and birth order.
Numerous studies have produced conflicting answers to the question of whether birth order affects IQ or not. The possibility that firstborn children are “more intelligent” than their younger siblings still exists, but recent evidence suggests otherwise. But if even the connection is valid, is this even the proper question to ask?

Studies have shown that IQ is only weakly related to achievement. According to a report, intelligence consists of the ability to effectively adjust to one's environment and to maximize success. The extent to which a person uses their intelligence is largely determined by their personality. And within-family tests of personality have found that firstborns are often higher achievers and more conscientious, while their younger siblings are often more rebellious, liberal, and creative. If this is true, IQ scores alone are a poor predictor of success in life.

For years, various studies reported that older children were naturally more intelligent than their younger siblings. Who knows how many stereotypes were created based on such findings? More recent research discredits the old claim, but so far no evidence is conclusive enough to draw a final conclusion. Let's just assume that all children have the potential to excel! Just don't tell my younger sisters.

If you have kids, they have had bouts of diarrhea. I know it isn't fun, and it may be even less fun to talk about, but let's be adults and take our medicine and learn what we need to know.  It's for the kids.

Diarrhea is the sudden increase in the frequency and looseness of BMs. Mild diarrhea is the passage of a few loose or mushy BMs. Severe diarrhea is the passage of many watery BMs.

It's usually caused by a virus or a bacteria. Call 911 Now if your child is not moving or is too weak to stand. Call Your Doctor Now (night or day) If:

• Your child looks or acts very sick.
• Signs of dehydration (e.g. no urine in over 8 hours, no tears with crying and very dry mouth).
• Blood in the stool.
• Fever above 105°F
• Age less than 12 weeks with fever above 100.4°F (38° C) rectally.
• Abdominal pain present more than 2 hours.
• Vomiting clear liquids 3 or more times.
• Age less than 1 month with 3 or more large diarrhea stools.
• Passed more than 8 diarrhea stools in the last 8 hours.
• Severe diarrhea while taking a medicine that could cause diarrhea (e.g., antibiotics).

Call Your Doctor Within 24 Hours during normal business hours if:

• Mucus or pus in the stool for more than 2 days.
• Loss of bowel control in a toilet trained child occurs 3 or more times.
• Your child has a fever longer than 3 days.
• If there was close contact with person and animal who has bacterial diarrhea.
• Contact with reptile (snake, lizard, turtle) in previous 14 days.

Otherwise, call your doctor if diarrhea persists more than 2 weeks or is a recurrent problem.

So what can you do to help?

1.   Mild Diarrhea:  Continue regular diet.  Eat more starchy foods.  Drink more fluids.  (Exception: avoid all fruit juices and soft drinks because they make diarrhea worse.)

2.   Formula-Fed Infants (less than 1 year old) WITH frequent, watery diarrhea:  Start Oral Rehydration Solutions (ORS).

• ORS (eg, Pedialyte or the store brand). It's a special electrolyte solution that can prevent dehydration. It's readily available in supermarkets and drug stores
• Start ORS (Infalyte, KaoLectrolyte or Pedialyte) for frequent, watery diarrhea (note: formula is fine for average diarrhea).
• Use ORS alone for 4 to 6 hours to prevent dehydration.  Offer unlimited amounts.
• If ORS not available, use full sterngth formula (unlimited amounts) until you can get some.  Avoid Jello water, sports drinks, or fruit juice.

Returning to Formula

• Get back to formula by 6 hours at the latest (reason: needs the calories).
• Use full-strength formula (reason: it contains adequate water).
• Offer the formula more frequently than you normally do.
• Lactose-free formulas (soy formula) are only needed for watery diarrhea persisting longer than 3 days
• Extra ORS: also give 2-4 oz. of ORS for every large watery stool.
• Solids: Infants older than 4 months old continue solid (e.g. rice cereal, strained bananas, mashed potatoes, etc).

3.   Breastfed Infants WITH frequent, watery diarrhea:

• Continue breastfeeding at more frequent intervals.  Continue solids as for formula-fed.
• Offer 2-4 oz. ORS between feedings for each large stool (especially if urine is dark)

4.   Older Children (over 1 year old) WITH frequent, watery diarrhea:

• Offer unlimited fluids. If taking solids, give water or 1/4 strength Kool-Aid or 1/2 strength Gatorade. If refuses solids, give milk or formula.
• Avoid all fruit juices and soft drinks (reason: make diarrhea worse).
• ORS is rarely needed, but for severe diarrhea, also give 4-8 oz. of ORS for every large watery stool.
• Solid starchy foods are absorbed best.  Give dried cereals, oatmeal, bread, crackers, noodles, mashed potatoes, rice, carrots, applesauce, strained bananas, yogurt, etc.  Pretzels or salty crackers can help meet sodium needs.
• If your child is more than 12 months old, give 2-6 oz. of active culture yogurt twice a day. (Reason: restores healthy bacteria to GI tract.)

5.   Wash buttocks after each stool to prevent a bad diaper rash. Consider applying a protective ointment (e.g. petroleum jelly) around the anus to protect the skin.

6.   Your child can return to day care or school after the stools are formed and the fever is gone.  The school-aged child can return if the diarrhea is mild and the child has good control over loose stools.

Viral diarrhea lasts 5-7 days.  And it's always worse on day 1 and 2. Call your doctor If:

• Signs of dehydration occur
• Diarrhea persists longer than 2 weeks

To learn more or to get help with other common illnesses and injuries, go to www.Aurora.org/HouseCalls.

That's it for this edition of Your Health.  I hope it was helpful. Please let us know if we can help you in any way by dropping us a line at internet@aurora.org.  I'm Neal Linkon, and thanks for listening.

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Your Health, Edition 18 (15:58)

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