Rickets, Not Enough Vitamin D for Baby

Vitamin D is powerful. It helps a lot of things like diabetes, artery disease, cancer and good old fashioned death-risk. And now, Roni Caryn Rabin of The New York Times explores how lack-of-it impacts babies and rickets. Here’s a bit:

Once Aleanie started putting weight on her feet, her mother noticed that her legs were curving in a bow shape below the knees. Doctors diagnosed vitamin D-deficiency rickets, a softening of the bones that develops when children do not get enough vitamin D — a crucial ingredient for absorbing calcium and building bone, and the one critical hormone that breast milk often cannot provide enough of.

“I thought I was doing the best thing for her,” said Stephanie Remy-Marquez, of Hyde Park, Mass., after blood tests showed her daughter had no detectable vitamin D. X-ray images of the baby’s wrists and knees showed the edges of the bones and growth plates as blurry and fraying instead of crisp and sharp.

“Breast milk is supposed to be an entire meal, dessert and drinks included,” Ms. Remy-Marquez said. “I thought it was the ultimate cocktail.”

Aleanie’s case was unusual enough to be written up in the journal Clinical Pediatrics in May, but several similar reports have been published in recent years. Some experts fear that vitamin D deficiency, which can be asymptomatic, may be more common than pediatricians realize and that rickets — perceived to be a 19th-century scourge that was wiped out with the fortification of milk — may be going undetected.

Physicians have known for more than a century that exclusive breast-feeding may be associated with vitamin D deficiency and rickets, and that the condition is easily prevented and treated with inexpensive vitamin drops or cod liver oil. But doctors are reluctant to say anything that might discourage breast-feeding.

Now some researchers are also linking vitamin D deficiency with other chronic diseases like diabetes, autoimmune disorders and even cancer, and there have been calls to include blood tests of vitamin D levels in routine checkups.

“I completely support breast-feeding, and I think breast milk is the perfect food, and the healthiest way to nourish an infant,” said Dr. Catherine M. Gordon, director of the bone health program at Children’s Hospital Boston and an author of several studies on vitamin D deficiency, including Aleanie’s case.

Excluding societal hangups, it’s hard to make a case against breastfeeding. Dr. Fuhrman is all about breastfeeding. Take kid’s allergies, breastfeeding helps! Not to mention breastfeeding also helps prevent ear infections and breast milk provides brain-building DHA.

Health Points: Monday 8.24.08

In a population-based, case-control study, the researchers matched 1,001 men with prostate cancer diagnosed between 2002 and 2005 with 942 age-matched cancer-free controls from King County, Washington.

No overall association was observed between the risk of prostate cancer and the current or past use of statin treatment. Duration of statin use was also not associated with prostate cancer risk.

"We also found no evidence that use of a statin was associated with risk of developing more aggressive subtypes of prostate caner," Stanford said in an interview with Reuters Health. "Overall we found no support for the current hypothesis that statin use may reduce risk of prostate cancer."

However, the results do suggest a significant increase in the risk of developing prostate cancer associated with current statin use and with longer durations of use among obese men (defined as a body mass index of 30 greater).

A team led by Linda Bartoshuk at the University of Florida in Gainesville surveyed 1300 people, 245 of whom had a history of ear infections, and found that among the over-30s, those who had suffered from ear infections were twice as likely to be obese as those with no such history. A subsequent analysis of four US medical databases confirmed the link. Those who had suffered from ear infections also rated fattier foods as 18 per cent more pleasurable than the others.

Infections may damage the chorda tympani taste nerve, which is stimulated at the front of the tongue and passes through the middle ear to the brain, says Bartoshuk. She says that the nerve normally inhibits some of the creamy sensations of fatty foods, as part of a response that inhibits tactile sensations that would otherwise make us gag. But nerve damage would lower this inhibiting effect, making foods seem creamier and so more pleasurable.

The postures, breathing and meditation included in the yoga intervention were "aimed at one common effect, i.e. 'to develop mastery over modifications of the mind' ... through 'slowing down the rate of flow of thoughts in the mind,'" the researchers explain.

Women in the yoga group also listened to lectures on using yoga to manage stress and other yoga-related topics, while those in the control group heard lectures on diet, exercise, the physiology of menopause, and stress.

After eight weeks, women in the yoga group showed a significant reduction in hot flashes, night sweats, and sleep disturbances, while the women in the control group did not, Dr. R. Chattha, of the Swami Vivekananda Yoga Anusandhana Samsthana in Bangalore, India, and colleagues found.

The state has given its 37,527 employees a year to start getting fit -- or they'll pay $25 a month for insurance that otherwise is free.

Alabama will be the first state to charge overweight state workers who don't work on slimming down, while a handful of other states reward employees who adopt healthy behaviors.

Alabama already charges workers who smoke -- and has seen some success in getting them to quit -- but now has turned its attention to a problem that plagues many in the Deep South: obesity.

The State Employees' Insurance Board this week approved a plan to charge state workers starting in January 2010 if they don't have free health screenings.

The American Academy of Pediatrics recommends that children devote no more than two hours per day to watching TV and playing video games.

Experts also encourage children to exercise regularly; some groups, including the AAP, recommend that boys move enough to take 13,000 steps each day, while girls should strive for 11,000. Another common recommendation is for children and teenagers to get at least one hour of moderate exercise on most, if not all, days of the week.

For the new study, researchers at Iowa State University in Ames looked at whether there were weight differences between children who met or did not meet recommendations for "screen time" and exercise.

They found that among 709 7- to 12-year-olds, those who did not meet either recommendation were three to four times more likely to be overweight than their peers who met both guidelines.

Both vaccines target the human papillomavirus, a common sexually transmitted virus that usually causes no symptoms and is cleared by the immune system, but which can in very rare cases become chronic and cause cervical cancer.

The two vaccines, Gardasil by Merck Sharp & Dohme and Cervarix by GlaxoSmithKline, target two strains of the virus that together cause an estimated 70 percent of cervical cancers. Gardasil also prevents infection with two other strains that cause some proportion of genital warts. Both vaccines have become quick best sellers since they were licensed two years ago in the United States and Europe, given to tens of millions of girls and women.

“Despite great expectations and promising results of clinical trials, we still lack sufficient evidence of an effective vaccine against cervical cancer,” Dr. Charlotte J. Haug, editor of The Journal of the Norwegian Medical Association, wrote in an editorial in Thursday’s issue of The New England Journal. “With so many essential questions still unanswered, there is good reason to be cautious.

According to the data, women's life expectancy saw a significant decline in 180 counties between 1983 and 1999. The cause for this precipitous drop? The folks at Women's Health attribute it to chronic diseases associated with obesity, smoking, and high blood pressure.

Here is a quick look at the U.S. counties that have experienced the greatest drop (numbers measured in years of average decline in female life expectancy):

Pulaski County, VA - 5.8
Radford, VA - 5.8
Dolores County, CO - 3.3
Montezuma County, CO - 3.3
San Juan County, CO - 3.3.
East Feliciana Parish, LA - 3.2
St. Helena Parish, LA - 3.2
West Feliciana Parish, LA - 3.2
Callaway County, MO - 3.0
Danville, VA - 3.0

Ted Nugent has never been one to beat around the bush so why should he stop now. Honestly I respect the man for the way he is willing and quick to speak his mind, but sometimes he’s a bit too blunt about things. Old Uncle Ted was on Anthony Bourdain’s No Reservations show on The Travel Channel where he was exploring the elements of Southwestern cuisine and stopped by Ted Nugents ranch in Texas. Anthony and Ted were speaking on many things to include Obesity. The Nuge’ said “Obesity is a manifestation of a cultural depravation in its most vulgar and displeasing-to-look-at form. And it’s suicide as a lifestyle.” Nugent also added “It all comes back to the horror, the soullessness of a trend in America that is the abandonment of parenting. Somebody’s got to go, ‘You can’t eat that. You’re way too fat.‘”

While I can understand what Ted is saying, Obesity is more than just an image issue. The last part of his statement is true that it may lead to certain and early death, but I think someone needs to give this guy a lesson in tact.

Inner Ear Infections, Antibiotics No Help

Last Friday we learned that ear infections are over-treated. In case you missed it. Here’s a quote from Dr. Fuhrman that helps explain why:
Studies show that the majority of ear infections are of viral etiology. For example, 75 percent of pediatric ear infections were caused by common respiratory viruses in a microbiological survey.1 Generally speaking, the use of antibiotics should be reserved for serious or life-threatening infections, not conditions that the body is well-equipped to resolve on its own.
Now, here’s more reason to hold the antibiotics. New research has determined that antibiotics do little for inner eat infections. Steven Reinberg of HealthDay News reports:
Dutch researchers did a meta-analysis of several previously published studies and found the results don't support the use of antibiotics for the fluid buildup that can accompany inner ear infections.
"Due to the marginal effect and the known negative effects of prescribing antibiotics, such as the development of antibiotic resistance and side effects, we do not recommend prescribing antibiotics to prevent middle ear effusion," said lead researcher Maroeska M. Rovers, from the Julius Center for Health Sciences and Primary Care at the University Medical Center Utrecht in The Netherlands.

Ear infections are very common among infants and children. They can lead to fluid buildup in the ear, which is known as otitis media with effusion. This buildup can result in hearing loss, which can affect language development, cognitive development, behavior and quality of life, according to the researchers.
Hey parents, do me a favor. In the comments tell me what you do when your young children get ear infections—I imagine its tough to resist just taking them to the doctor.
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Ear Infections, Over-Treated?

“Whether bacterial or not, our children get a routine prescription for an antibiotic at every minor illness,” explains Dr. Fuhrman. And when it comes to ear infections kids are REALLY getting hit with the antibiotic stick. More from Dr. Fuhrman:
In some European countries, antibiotics are used for ear infections only when there is a persistent drainage or persistent pain because these infections resolve on their own more than 85 percent of the time without treatment.1 Studies show that the majority of ear infections are of viral etiology. For example, 75 percent of pediatric ear infections were caused by common respiratory viruses in a microbiological survey.2 Generally speaking, the use of antibiotics should be reserved for serious or life-threatening infections, not conditions that the body is well-equipped to resolve on its own.
Adding fuel to the fire, Laurie Tarkan of The New York Times wants to know, are ear infections too often misdiagnosed and then over-treated? Let’s find out:
One reason why ear infections are so often overdiagnosed is that they can be hard to identify in young children, especially ones in screaming pain. “You’re dealing with a tiny subject, the baby or toddler, where the ear canal is narrow and tends to be occluded with wax, which you must remove to see the eardrum, and doing that can be a harrowing experience,” said Dr. Jack Paradise, professor emeritus of pediatrics at the University of Pittsburgh School of Medicine. Doctors then have to interpret what can be subtle differences between an ear inflamed by crying or fever and a true ear infection. “Many if not most practitioners have difficulty in this area,” Dr. Paradise said…

…In 80 to 90 percent of ear infections, the bacterial infection will clear up on its own. Though these bacteria are not typically harmful in and of themselves, clearing up the infection sooner with antibiotics can hasten pain relief. A trade-off is drug side effects like nausea, upset stomach, diarrhea and even rare, life-threatening allergic reactions. “For every case of ear infection that goes away faster, we may cause between three and seven cases of diarrhea,” Dr. Powers said. “We’ve moved the problem from up North to down South.” The use of antibiotics can also increase a child’s susceptibility to new ear infections.
This easy way out of ear infections does carry serious risks. Dr. Fuhrman talks about how antibiotics can actually lead to more—not fewer—ear infections. Have a look:
The vicious cycle of poor nutrition and the overuse of antibiotics works to place a tremendous disease burden on the future health of our children. We bring our young (improperly fed) children to physicians with their first ear infection. At this point the majority of these infections are viral, not bacterial. Nevertheless whether it's viral, bacterial, fungal, or some mixture, a healthy child has no problem recovering from an ear infection without antibiotics. In the United States almost all these children are routinely given antibiotics. Taking the antibiotic kills off the beneficial bacteria and promotes the colonization of more disease-causing strains, and now the next ear infection has a greater chance of being bacterial, not viral. Viral, bacterial, or a mixed infection, it matters not, because at the next visit your kid gets another antibiotic anyway, starting the cycle of infection after infection, antibiotic dependency, and impaired immune function.
I guess the lesson to be learned here is, don’t mortgage the future for the present—quick-fixes are not without their price tag.
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"Superbug" Woes

It seems that a certain strain of ear infection has become quite the advisory. Serena Gordon of HealthDay News explains:
An emerging "superbug" that causes ear infections in children and is resistant to multiple antibiotics can only be treated with an adult medication, researchers report.

Two Rochester, N.Y., pediatricians report finding a multiple antibiotic-resistant strain of Streptococcus pneumoniae that caused ear infections in nine children in their practice over three years. The only antibiotic that was effective in treating these infections was levofloxacin, which isn't approved by the U.S. Food and Drug Administration for use in children.

"We found a superbug causing ear infections in Rochester -- the Legacy strain -- that's resistant to all antibiotics approved by the FDA for use in children," said the study's lead author, Dr. Michael Pichichero, a professor of microbiology, immunology and pediatrics at the University of Rochester Medical Center, and a private practice pediatrician with the Legacy Pediatric Group.

The resistant infections accounted for only 1.5 percent of the ear infections in their practice, Pichichero noted.
Could the problem be the overuse of antibiotics? More from Dr. Fuhrman:
Most doctors want to please their patients and they want to do it quickly and move to the next patient as soon as they can. Patients often expect them for common respiratory illnesses and many doctors comply with their wishes. Antibiotics as a solution work great; they enable the doctor to maintain their important role in the eyes of the patients, reinforce the value of doctor visits, and allow the patient to think their care was indispensable. The only problem is that most prescriptions are either not needed, or not in the best long-term interest of the patients.

Ear Infections: Maybe it's Fat Ears

Why do kids get ear infections? Well, I’m no doctor. So I can’t say for sure, but, according to Dr. Fuhrman improper nutrition is a major contributing factor. A reason that most likely goes overlooked, because after all, it’s easier just to write a prescription for antibiotics.

In a previous post Dr. Fuhrman shares the story of one little girl who kicked her persistent ear infections not with antibiotics, but with nutritional excellence. Take a look:
When Stephanie Rogers, a typical seven-year-old girl, became my patient, her parents handed me a printout from the local pharmacy documenting the filling of 67 rounds of antibiotics at the cost of $1,643.80 by the ripe age of seven. Once the pediatric group started prescribing the antibiotics for minor complaints of fever and cough, it escalated to ear infections, sinus infections, and finally visits to the ear specialist by the age of four. She received 15 separate prescriptions of antibiotics when she was five years old. The first year she was my patient, the entire family changed its diet style. Stephanie went along for the ride and did fine. I did use an antibiotic once for her that next winter, when she had a persistent high fever and a red painful eardrum; however, that was the last time an antibiotic prescription was necessary. Luckily, Stephanie has been free of antibiotics ever since.
And here’s a little more proof that nutrition has something to do with ear infections. New research claims there is a link between body fat and a certain type of ear infections, meaning overweight children might be at a heightened risk of ear infections. Randy Dotinga of HealthDay News is on it:
Scientists in South Korea have uncovered a possible connection between body fat in children and a certain kind of ear infection, but several specialists in the United States are expressing doubts about the research.

If the link does exist, however, it could provide doctors with yet another indication of how extra fat is bad for kids just as it is for adults. "We have to pay close attention to decrease childhood obesity," said study co-author Dr. Seung Geun Yeo, a researcher at Kyung Hee University in Seoul.

Ear infections in children remain very common, affecting as many as eight or nine of every 10 kids. Doctors blame the middle ear, which often cannot fully drain fluid as it is developing.
It sure seems like so many things come back to nutrition. And yet, we don’t pay it enough attention. It’s a shame that we evolved these big brains, because so many of us don’t use them. Here are a few more posts about ear infections:

Report: Ear Tubes Hit or Miss

Now I had ear tubes, I don’t really know why? I was little at the time and don’t remember much about it. According to my mother I used to get a lot of ear infections and my doctor at the time thought it was the best course of action. And back then it didn’t seem that usual because almost all my classmates were getting them. It was kind of like a first grade rite of passage.

Of course I’m older now and regularly exposed to alternative points of view; most notably Dr. Fuhrman’s. So to say the least, I wish my parents hadn’t fed me milk—especially since I later found out that I’m very lactose intolerant. Maybe if they skipped the milk I might have avoided some of those ear infections that led to my tubing. Disease-Proof Your Child has more on this:
Ear infection, or otitis media is the most common medical problem for children in the United States, and it is the most common reason for prescribing antibiotics for infants and children. Not only do nine out of ten children develop at least one ear infection each year, but almost one-third of these children develop chronic congestion with fluid in the middle ear that can lead to hearing loss and make the child a candidate for myringotomy, or tube placement by a specialist.

Babies who drink from a bottle while lying on their backs may get milk and juice into their eustachian tubes, which increases the occurrence of ear infections. Children who are breast-fed for at least a year have been shown to have much fewer infections than those weaned earlier.1
So as you can imagine, this next report compelled me. According to Reuters a new study found that children who didn’t receive tubes suffered no additional developmental difficulties than children who underwent the tubing procedure. Gene Emery reports:
But a new long-term study challenges that practice, saying it does nothing to help most youngsters with fluid-filled ears develop normally.

In a study to be published in the New England Journal of Medicine on Thursday, researchers from several institutions studied hundreds of otherwise-healthy children up to 11 years old in the Pittsburgh area. They tested the benefits of a procedure that once was the second-most common surgery in the United States and found none.

Even when it doesn't cause pain, an ear infection can cause fluid to build in the middle ear, muffling hearing. Because hearing is essential to speech development, doctors and parents worried that persistent middle ear infections could cause developmental problems.
Now, since I’ve grown up to become the kind of person who doesn’t like going to the doctor, popping pills, or undergoing medical procedures, news reports like this make me curious. Was there a better way? Did I really need tubes? Maybe if my parents paid better attention to my nutrition I could have avoided the whole thing. Just makes me wonder, you know what I mean?

For more on tubing and ear infections, check out these previous posts:
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Inappropriate Use of Antibiotics

A recurring topic here on Followhealthlife is the misuse and overuse of antibiotics. According to Dr. Fuhrman antibiotics are too often prescribed for conditions that when treated with proper nutrition will resolve naturally, without medication—ear infections are a big one. More from a previous post entitled Childhood Ear Infections: A Multibillion-Dollar Industry:
Studies also point to the fact that most ear infections early in life are viral, not bacterial.1 The vast majority of ear infections resolve nicely on their own, whether bacterial or viral, without an antibiotic. It is a common practice in this country to treat all ear infections with an antibiotic. Whether bacterial or not, our children get a routine prescription for an antibiotic at every minor illness. This cycle often is repeated many times, which may beget other medical problems in adulthood…

…Another international study following over 3,000 children treated by general practitioners in nine countries showed that antibiotics did not improve the rate of recovery from ear infections. Nearly 98 percent of U.S. physicians in the survey prescribed antimicrobials routinely, the highest percentage of all countries surveyed.2 The variable showing the strongest relationship with protection from ear infections was breast-feeding.3
So after considering all this, I wasn’t exactly surprised by the contents of this report from the American Academy of Family Physicians (AAFP). Apparently a lot of patients associate antibiotics with pain-management, which doesn’t appear to be a good thing. Read on:
"Our study suggests that the patient's desire for an antibiotic may be based on the mistaken view that this treatment is best for pain relief," say Mieke van Driel, M.D., M.Sc., of the department of general practice and primary health care at Ghent University, Belgium, and the other authors. They call for a clinical trial "to find out whether exploring patients' expectations about treatment for pain and offering adequate analgesic treatment can assist physicians in the management of sore throats more often without prescribing antibiotics."
Now, I’m sure most people can relate to this. When you’re hurting, priority one is stopping the pain, and in a distant second is determining the source or cause of your discomfort. So with this being said, I decided to get a professional opinion on the AAFP’s report. And here’s what Dr. Fuhrman had to say:
Everyone knows antibiotics are overused by physicians and that they are dangerous drugs. So called “Lyme Disease” specialists and some of the labs that support them are some of the worst offenders, repeatedly falsely diagnosing patients with chronic Lyme, and giving antibiotics because they can relieve pain and make patients feel better from a host of potential causes. All physicians should work aggressively to curtail unnecessary antibiotic use.

Most doctors want to please their patients and they want to do it quickly and move to the next patient as soon as they can. Patients often expect them for common respiratory illnesses and many doctors comply with their wishes. Antibiotics as a solution work great; they enable the doctor to maintain their important role in the eyes of the patients, reinforce the value of doctor visits, and allow the patient to think their care was indispensable. The only problem is that most prescriptions are either not needed, or not in the best long-term interest of the patients.

Nutritional excellence practically negates the need for most prescriptions such as those prescribed for headaches, cholesterol lowering, high blood pressure and diabetes. Antibiotics are more dangerous, than most physicians and their patients consider. I believe much more care should be taken to restrict antibiotic use to only the most severe infections and documented bacterial conditions.
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Health Points: Thursday

Doctors can't help patients recover more quickly by prescribing antibiotics, said Richard P. Wenzel, chairman of the Department of Internal Medicine at Virginia Commonwealth University. “There is probably some sense of a placebo effect, but that's short-lived,” he said.
Given the intensity and high-voltage anxiety of serious illness, public crying in hospitals — by patients or family or staff — is less common than one might expect. Sure, it goes on more frequently than, say, at a department store or a restaurant. But more often, people remain buttoned up, dry-eyed, determined to maintain composure.
Africa, a continent usually synonymous with hunger, is falling prey to obesity. It's a trend driven by new lifestyles and old beliefs that big is beautiful. Ask Nodo Njobo, a plump hairdressing assistant. She is coy about her weight, but like many African women, proud of her "big bum." She says she'd like to be slimmer, but worries how her friends would react.
Staying slim and fit is especially important for cancer survivors, because obesity raises the risk of cancer coming back, the American Cancer Society said in new guidelines issued on Wednesday.
Children whose mothers smoked during pregnancy were nearly three times more likely to start smoking regularly at, or before, age 14 and about twice as like to start smoking after age 14 compared to children born to nonsmoking mothers.
  • Okay, how many of you belong to a gym? I do. Have you ever really looked at some of the trainers? A lot of them could use a personal trainer themselves—they’re pumped up, but a little doughy. So this begs the question, how qualified are they? Rick Callahan of the Associated Press investigates:
Virtually anyone can become a certified trainer because there are no national educational standards for the field. Numerous Web sites offer personal trainer certification after just a few hours of online training -- and a few hundred dollars.
And at this time of year, bitter greens are calling from nearly every other stall or stand at the farmers market or the grocery store; they're a boon of winter. Until fairly recently, bitter greens have been popular in this country only in the South, but more of them have become more widely available, though their names still can be confusing. Greens in the chicory and endive family include Belgian endive (also called French endive and witloof), curly endive (sometimes called chicory or frisée), escarole and several varieties of radicchio. Then there are dandelion greens, mustard greens and turnip greens (yes, keep the tops of your turnips).
The study by World Health Organization researchers projects global figures for mortality and the burden of 10 major disease groups in both 2015 and 2030.

"According to our baseline projection, smoking will kill 50 percent more people in 2015 than HIV/AIDS and will be responsible for 10 percent of all deaths globally," said their study in the Public Library of Science Medicine.

Ear Infections and Antibiotics

In Disease-Proof Your Child Dr. Fuhrman’s position on treating childhood ear infections certainly deviates from common medical practice. How so? I’ll let him explain:
Studies also point to the fact that most ear infections early in life are viral, not bacterial.1 The vast majority of ear infections resolve nicely on their own, whether bacterial or viral, without an antibiotic. It is a common practice in this country to treat all ear infections with an antibiotic. Whether bacterial or not, our children get a routine prescription for an antibiotic at every minor illness. This cycle often is repeated many times, which may beget other medical problems in adulthood.
What, no antibiotics? For some this is hard to believe. Hey, it shocked me too. As a kid I got tons of ear infections, and each time my doctor prescribed antibiotics. Now, Dr. Fuhrman believes antibiotics should only be administered if the condition lingers or worsens. Not a bad idea considering all the news about the emergence of antibiotic-resistant bacteria and viruses.

Julie’s Health Club shares this concern. Today she’s taking a look at a recent study published in Journal of the American Medical Association advocating a wait-and-see approach for treating ear infections. Here’s a quote from the study that sounds awfully familiar:
"In this country, 96 to 98 percent of physicians treat ear infections immediately with antibiotics, even though most cases will resolve on their own without treatment," lead researcher David Spiro told Web MD, an on-line source of health information.
Julie points out that approximately 15 million prescriptions for antibiotics to treat childhood ear infections are written each year.

For more on ear infections and antibiotics, check out this previous post: Childhood Ear Infections: A Multibillion-Dollar Industry
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