You can read about the study, by researchers from the Harvard School of Public Health (HSPH), the Food and Drug Administration (FDA), the Northern Ohio Poison Control Center and the Centers for Disease Control and Prevention (CDC), online in the 19 April ahead of print issue of Pediatrics.

Last year, RJ Reynolds, one the biggest tobacco companies in the US, started market testing a new pelleted product made with finely ground tobacco flavoured with mint or cinnamon that dissolves in the mouth like breath mints.
The product, called Camel Orbs, contains 1 mg of nicotine per pellet, which is about the same as that contained in the average nicotine lozenge marketed to people trying to quit smoking.

However, according to a CNN news report, Orbs, and other products in the range, Camel Strips (0.6 mg nicotine per strip) and Sticks (3.1 mg nicotine per strip) appear to be a new trend in the tobacco industry to create smokeless nicotine products that people can use in places where it is no longer legal to smoke, like bars and restaurants.

1 mg of nicotine is enough to make a small child feel nausea and vomit, said the researchers, who in their background information stressed that one of the biggest causes of poisoning that leads to calls to poison control centers throughout the US is babies and children swallowing tobacco products. The figures for 2007 show over 6,700 reported cases of tobacco-related poisoning among children aged 5 and under.

A poison control center in Portland, Oregon has already reported a case where a three-year old ingested an Orbs pellet. The center is in a region where the tobacco product is being test marketed.

Lead author and director of the Tobacco Control Research Program at HSPH, Professor Gregory Connolly, told the media that the introduction of these new products could be disastrous for public health, particularly for infants and adolescents.

Connolly said that while the product might be described as a “tobacco” product, to a four-year old child it looks like candy.

“Nicotine is a highly addictive drug and to make it look like a piece of candy is recklessly playing with the health of children,” said Connolly.

The researchers also noted that intentional use of smokeless tobacco products among adolescents went up 6 per cent per year from 2002 to 2006.

For the study the researchers worked out how much nicotine, based on median body weight, children would have to ingest to experience symptoms of poisoning:

• A one-year old child could get mild to moderate symptoms of poisoning from 8 to 14 Orbs, 14 Strips or 3 Sticks, while ingesting 10 to 17 Orbs, 17 Strips or 3 to 4 Sticks, could cause severe poisoning and death.
• A four-year old child could get mild to moderate symptoms of poisoning from 13 to 21 Orbs, 14 Strips or 4 Sticks, while ingesting 16 to 27 Orbs, 27 Strips or 5 Sticks, could cause severe poisoning and death.

The manufacturer argues that the packaging is child resistant, but the researchers said that adults could leave them lying around opened, and that this together, with their appealing candy-like appearance and flavoring, increases the chances that children will ingest them.

In an interview reported by CNN, Reynolds spokesman David Howard, said he didn’t think Camel Orbs looked “at all” like Tic Tac mints.

Howard stressed that the product was marketed to adults and came in child-resistant containers, and said it was unfair to criticize a product because of its flavoring, and pointed to smoking cessation aids like Nicogum. Besides, nearly every household has products that can poison children, such as cleaning products, medicines, health and beauty products, he said.

But that is not the point, commented one expert, who said children will be influenced by the behavior of the adults they observe.

Dr Jonathan P Winickoff, a Harvard medical professor and chairman of the American Academy of Pediatrics Tobacco Consortium, told CNN that, the last time he checked, he didn’t see adults going around “drinking toilet bowl cleanser in front of their kids”.

Winickoff also commented that accidental poisoning of young children was no the only cause for concern, intentional use by kids and teenagers was likely to be another public health problem from introduction of dissolvable nicotine products.

He said teenagers will look at the products and think they are harmless, and not realize they are exposing their brains to nicotine and priming themselves to become nicotine addicts.

“If teens ended up using smokeless product because they are attracted to candy flavors and they end up getting addicted to nicotine, the public health benefit of smokeless tobacco is neutralized,” said Winickoff, who was not involved in the study.

source: www.medicalnewstoday.com

A urine test that can differentiate between dangerous and safe snoring is possible, say researchers at the University of Chicago.

They looked at 90 children referred to a clinic to be evaluated for breathing problems in sleep, and 30 controls.

A number of proteins were increased in the urine of the children diagnosed with dangerous snoring.

The research is published in the American Journal of Respiratory and Critical Care Medicine.

The team say their findings need to be repeated but may lead to a simple test.

Sleep tests

The children all had standard overnight tests and some were classified as having obstructive sleep apnoea (OSA).

OSA can lead to mental, behavioural, cardiovascular and metabolic problems in children. It is estimated that up to 3% of all children up to the age of nine may suffer from it.

The researchers collected the children’s first sample of urine on the morning after the sleep study.

They used a process with fluorescent dyes to separate and characterise the proteins in the urine and found three proteins at higher concentrations in the urine of children with OSA: urocortin 3, orosomucoid and uromodulin.

Another protein, kallikrein 1, was at lower levels in the urine.

The scientists say further research is needed to work out which proteins work best for a test and the right time to get the urine sample.

They think that it may be possible to develop a simple colour-based test like a pregnancy kit that can be done by doctors or parents.

Diagnostic screening

“It was rather unexpected that the urine would provide us with the ability to identify OSA” said Dr David Gozal, who led the research.

“If we can develop this further we might be able to screen children for OSA for a fraction of the cost of keeping them in a sleep clinic overnight, and it would overcome the huge waiting lists for such screening.”

Ian Balfour, a respiratory consultant at the Royal Brompton Hospital, which carries out many sleep studies on children, said: “OSA is a big problem in children with large tonsils or who are obese.

“Some overweight children with this problem have to use ventilators to sleep at night.

“This is an interesting finding – the implication is that the children’s renal and kidney function is being affected by their OSA.

“But the research is too far from being something practical doctors and patients would be able to use.”

Dr Paul Gringras, consultant in Paediatric Neurodisability and Sleep Medicine at the Evelina Children’s Hospital, agreed that OSA was an important condition because of its harmful impact on physical health as well as learning and behaviour.

“The specialist centres that can accurately identify true cases are few, and at full capacity” he said.

“It is appealing to look at certain proteins from a single urine sample that could make the diagnosis.

“This study is the first step towards this possibility, but more work is needed to check the test is reliable, when the best time of day is to perform the test, and, finally, to simplify the biochemical tests so that they are easier to carry out.”

Teenagers when

Of 15,500 12 to 18-year-olds studied, those who went to bed after midnight were 24% more likely to have depression than those who went before 2200.

And those who slept fewer than five hours a night had a 71% higher risk of depression than those who slept eight hours, the journal Sleep reports.

It is estimated 80,000 UK children and young people have depression.

The researchers from Columbia University Medical Center in New York looked at data from 15,500 teenagers collected in the 1990s.

One in 15 of those studied were found to have depression.

As well as the higher risk of depression, those who were set a bedtime by their parents of after midnight were 20% more likely to think about suicide than those whose bedtime was 2200 or earlier.

Those who had less than five hours sleep a night were thought to have a 48% higher risk of suicidal thoughts compared with those who had eight hours of sleep.

Teenagers who reported they “usually get enough sleep” were 65% less likely to be depressed.

Depression and suicidal thoughts were also more likely in girls, older teenagers and in those who had a lower self-perception of how much parents care about them.

Most of the parents of the adolescents in the study set a bedtime of 2200 or earlier.

A quarter set a bedtime of 2400 or later.

On average the teenagers were having seven hours and 53 minutes sleep a night – less than the nine hours recommended at that age.

Study leader Dr James Gangwisch said although it it was possible that youngsters with depression struggle to sleep, the fact that parental set bedtimes were linked with depression suggests that a lack of sleep is somehow underpinning the development of the condition.

He said a lack of sleep could affect emotional brain responses and lead to moodiness that hindered the ability to cope with daily stresses.

This moodiness could affect judgment, concentration and impulse control.

Regular exercise

“Adequate quality sleep could therefore be a preventative measure against depression and a treatment for depression,” he added.

Sarah Brennan, chief executive at the mental health charity YoungMinds, said: “Enough sleep, good food and regular exercise are all essential to stay emotionally healthy.

“Nearly 80,000 children and young people suffer with depression, yet we are still failing to provide our young people with the help and support to cope with it and prevent it.

“Providing parents with information about how to look after your body, for example by getting enough sleep, and how to get help if they are worried about their teenager, will ensure problems are tackled early and prevent serious mental health conditions such as depression.”

Scientists have discovered what they believe is a genetic cause of severe obesity in children.

The team concluded that the loss of a key segment of DNA can be to blame.

It said the findings might improve diagnosis of severe obesity – which on occasion has been wrongly attributed to abusive overfeeding.

The study, of 300 children with severe obesity by the University of Cambridge and the Wellcome Trust Sanger Institute, appears in Nature.

Some of the children in the study had been formally placed on the social services ‘at risk’ register on the assumption that their parents were deliberately overfeeding them. They have now been removed from the register.

Obesity is increasing throughout the world and is recognised as a major global public health concern.

Although much of the problem is due to lifestyle factors such as an unhealthy diet, and lack of exercise, some cases are thought to be down to genetics.

The latest study examined each child’s entire genome, looking for deletions or duplications of DNA, known as copy number variants (CNVs).

Experts increasingly believe these CNVs play an important role in genetic disease.

Genome scan

By comparing the DNA profile of obese children with others of a normal weight they found certain parts of the genome were missing in the obese group.

In particular they zeroed in on a missing part of chromosome 16 which seemed to have a strong link to severe obesity.

Researcher Dr Sadaf Farooqi said: “Our results suggest that one particular gene on chromosome 16 called SH2B1 plays a key role in regulating weight and also in handling blood sugar levels.

“People with deletions involving this gene had a strong drive to eat and gained weight very easily.

“It adds to the growing weight of evidence that a wide range of genetic variants can produce a strong drive to eat.

“We hope that this will alter attitudes and practices amongst those with professional responsibility for the health and well-being of children.”

Dr Matt Hurles, who also worked on the study, said: “This is the first evidence that copy number variants have been linked to a metabolic condition such as obesity.

“They are already known to cause other disorders such as autism and learning difficulties.”

Dr Ian Campbell, medical director of the charity Weight Concern, stressed most children did not have significant genetic factors that predisposed them to obesity, and that lifestyle, diet and exercise remained important.

But he added that the causes of obesity – and the potential solutions – were complex.

He said: “The fact that several of the study children have been taken out of social care and returned to their parents as a result is disturbing in itself and must surely put an end to the claims by some that childhood obesity is a simple case of parental abuse.

“It clearly isn’t. These families need our support.”

Australian researchers have identified a link between allergic asthma in 3 to 5 year-old children and exposure to folic acid that their birth mothers took as supplements during late pregnancy. They said the timing of when folic acid is taken in pregnancy might be important.

The study was the work of Dr Michael Davies, associate professor with the Research Centre for the Early Origins of Health and Disease at the Robinson Institute in the University of Adelaide, and colleagues, and is published online in the 15 November issue of American Journal of Epidemiology.
The researchers said the study may have revealed why childhood asthma has been on the rise in Australia and other developed countries over recent decades.

Davies told the press that mothers are advised to take folic acid supplements during pregnancy to prevent birth defects, but research in mice and infants suggests this may also lead to “additional and unexpected” consequences.

“In our study, supplemental folic acid in late pregnancy was associated with an increased risk of asthma in children, but there was no evidence to suggest any adverse effects if supplements were taken in early pregnancy,” he added.

For the study, Davies and colleagues set out to investigate the effect of timing, dose and source of folate during pregnancy on childhood asthma.

They used data from an Australian prospective birth cohort study covering 1998 to 2005 that involved more than 500 women whose diet and supplements were assessed by food frequency questionnaire in early ( before 16 weeks) and late (between 30 to 34 weeks) pregnancy, and whose children’s asthma status was followed up at 3.5 and 5.5 years.

The results showed that:

• Asthma was reported in 11.6 per cent of children at 3.5 years and 11.8 per cent of children at 5.5 years.
• Nearly a third of these children reported persistent asthma.
• Folic acid taken in supplement form in late pregnancy showed a statistically significant association with an increased risk of childhood asthma at 3.5 years.
• There was a similarly statistically significant link to an increased risk of persistent asthma at 3.5 years.
• The links were just as strong when the researchers accounted for potential confounders.
• There was a similar but not statistically significant link at 5.5 years.
• Nearly half of all mothers in the study took a folic acid supplement pre-pregnancy and 56 per cent met the required daily public health recommended dosage of 400 micrograms in early pregnancy.

The authors concluded that:

“These findings on childhood asthma support previous observations that supplementation with folate in pregnancy leads to an allergic asthma phenotype in mice via epigenetic mechanisms and is associated with poorer respiratory outcomes in young children.”

Public health guidelines currently recommend that women supplement their diet with 400 micrograms of folic acid per day in the month leading up to and during the first trimester of pregnancy to reduce the risk of neural tube defects in children.

Davies said this study supports this guideline, because they found no increased risk of asthma when the folic acid supplements were taken before or early in pregnancy.

“These findings show there is a potentially important critical period during which folic acid supplement dosages may be manipulated to optimise their neuro-protective effects while not increasing the risk of asthma,” he said.

“However, these guidelines may need to be expanded to include recommendations about avoiding use of high dose supplemental folic acid in late pregnancy,” added Davies.

He also emphasized that they found no evidence that asthma was linked to folate found naturally in foods like green leafy vegetables, some fruits and nuts.

She went on to have two daughters, and she may have boosted their chances of avoiding becoming obese, like her two older children are.

That’s the implication of research suggesting that something in an obese woman‘s womb can program her fetus toward becoming a fat child and adult. It’s not about simply passing along genes that promote obesity; it’s some sort of still-mysterious signal.

The idea has only recently entered conversations between doctors and female patients, and scientists are scrambling to track down a biological explanation. That knowledge, in turn, may provide new ways to block obesity from crossing generations.

While there’s some disagreement on how important the womb signal is, “the evidence is building and building that it is a substantial issue,” said Dr. Matthew Gillman of Harvard Medical School, who studies prevention of obesity.

Others agree. “I think it could be a hugely significant factor,” said Robert Waterland of the Baylor College of Medicine in Houston, who studies the effect in mice.

Dr. Rudy Leibel, an obesity expert at Columbia University, says he doubts it plays a huge role, but still believes it’s worth studying. If scientists can uncover its biological underpinnings, he said, they may be able to use that knowledge to prevent or treat obesity from other causes.

Perusse, 39, of Three Rivers, Quebec, knows the effects of being very fat. Before her weight-loss surgery in 1995, she packed 284 pounds on her 5-foot-2 frame. She could not ride a bike or climb stairs to her second-floor home without stopping to rest.

Now, although she’s still overweight, those limitations are history, she said through an interpreter.

But her older children struggle with their weight. At 5-foot-3 and 300 pounds, her 22-year-old daughter can’t bathe her own two children, Perusse said. Her 16-year-old son weighs 230 pounds and stands 5-foot-6.

They were born before she had the weight-loss surgery. Her two younger daughters, ages 4 and 7, came along afterward. Their weights are normal so far, though Perusse said her older children weren’t overweight at those ages either.

So she’s using diet and exercise to try to protect them against what she called rotten genes, including those from their 400-pound father. She said she isn’t optimistic.

But Dr. John Kral of the SUNY Downstate Medical Center in New York says his research suggests that obese women who lose weight before pregnancy may be helping the next generation keep off excess pounds — even if fat-promoting genes run in the family.

With researchers at Laval Hospital in Quebec, Kral has studied children of severely obese women who were born before or after their mother’s weight-loss surgery. They found that, in comparison to children born before surgery, those born afterward were far less likely to be severely obese.

In addition, those born afterward showed lower levels of blood fats and indicators of future diabetes.

Kral says families typically don’t change lifestyle or diet after surgery, so that doesn’t explain the outcome.

Instead, he says, the surgical bypass operation made the women’s bodies less efficient at digesting and absorbing food, and lowered levels of sugar and fat in the blood. That, in turn, would reduce the number of calories delivered to the fetus to levels like those provided by a normal-weight mother, he said.

And the women’s shedding of pounds before the pregnancy would also help, he said.

While scientists are still trying to explain just how obesity could be transmitted from the womb, it makes sense that a mother’s obesity could affect her children’s long-term weight, Waterland said. Cues in early life, including some in the womb, guide the development of a person’s brain circuitry for controlling the balance between calories consumed and those burned away, he said. So a signal there could have a long-lasting impact.

Or, maybe such a signal predisposes the child to make more fat-storing cells, others said.

It’s still not clear just what in the womb could create such effects — high levels of blood sugar and certain fatty acids are some leading candidates.

Waterland has found evidence it may have to do with how critical genes are regulated. Chemical tags attach to the chromosomes and act like dimmer switches to modulate how hard certain genes work.

Waterland studied mice genetically prone to porkiness and found the fatter the mom, the heavier her offspring tended to be. But that effect was blocked when researchers fed pregnant mice a cocktail of substances that encourage the chemical tags to attach to the chromosomes.

What does that suggest? Maybe a mom’s obesity somehow interferes with the regulation of certain genes, and the chemical cocktail overcame that, Waterland says.

Those genes might affect the offspring’s long-term weight if they’re involved in the brain’s regulation of appetite and activity levels, Waterland proposes. He also says it’s too soon to tell whether an obesity-blocking supplement could work in women as well as in the mice.

Once scientists identify the obesity signal, they may be able to recommend ways to suppress it, perhaps through diet or behavioral strategies.

In the meantime, experts say, obese women can take their own steps.

• Avoid pregnancy until you’ve lost weight. That’s wise anyway, since obesity in pregnancy raises the risk of complications like diabetes, cesarean deliveries and stillbirth.

• If pregnant, hold down the weight gain during pregnancy. The Institute of Medicine recently recommended that an obese woman gain 11 to 20 pounds, rather than the 25 to 35 pounds allowed for healthy women of normal weight.

• After giving birth, get down to a healthy body weight to prepare for the next pregnancy.

Dr. Laura Riley of Massachusetts General Hospital in Boston said she gets her patients’ attention when she tells them their obesity could promote the same problem in their children.

“I’m a mother,” Riley added. “Believe me, it caught my eye.”

For instance, diphtheria used to be one of the most dreaded of childhood diseases, killing more than 10,000 Americans each year, but today’s doctors are likely to never see a single case. And smallpox, which was one of the most devastating diseases the world has ever known, has been eradicated from the Earth thanks to vaccination.

Most children do not have adverse reactions to vaccines, and for those who do, they are usually mild, like soreness or swelling at the injection site or a low-grade fever. Many parents try to spare their children, especially babies, from the discomfort by giving them acetaminophen right before or after the vaccination, a practice recommended by some doctors. But Czech scientists say that while acetaminophen does prevent post-vaccination fever, it may also reduce the effect of the vaccine.

To determine the effect of acetaminophen on fever and on the immunogenicity of vaccines, Roman Prymula, of the Czech University of Defence in Hradec Kralove, and colleagues conducted two randomized controlled trials; one for the initial vaccine and one for the booster shot. The trials involved 459 healthy babies, 9 to 16 weeks old, who were getting routine vaccines against pneumococcal disease, Haemophilus influenzae type b (Hib), diphtheria, tetanus, whooping cough, hepatitis B, polio and rotavirus. Half were also given acetaminophen every six to eight hours for 24 hours after vaccination, while the others received only the vaccines.

The team found that babies given acetaminophen had a significantly lower rate of fever after both the initial vaccine (42 percent vs. 66 percent) and the booster shot (36 percent vs. 58 percent). And, according to the concentration of antibodies in their blood, the acetaminophen group also had a “significantly lower” immune response. However, when the researchers analyzed other vaccine studies, they found that the effect of acetaminophen on antibody levels was much smaller when given after the vaccination when a fever had already developed.

Vaccines are made from the same germs that cause disease, but in a killed or weakened form, that prod the immune system to make antibodies. After destroying the vaccine germs, the antibodies stay in your body and provide protection against the real disease—immunity. Fever after a vaccine is a natural part of the body’s immune response. The researchers say that because acetaminophen reduces the fever, and thus the interactions between immune cells, the body makes fewer antibodies, which would explain the reduced effectiveness of the vaccines. “The interference of paracetamol (acetaminophen) on antibody responses could result from the prevention of inflammation,” the study authors wrote.

In an editorial accompanying the study, Dr. Robert T. Chen of the CDC and colleagues proposed another explanation. “Despite being an inhibitor of cyclo-oxygenase 2 (COX-2), (acetaminophen’s) anti-inflammatory activity is contested, perhaps related to inhibition of activity in high-peroxide environments that are common at sites of inflammation,” they wrote, adding that regardless of the mechanism, the findings “present a compelling case” against the routine use of acetaminophen during childhood immunizations. “This point has implications, especially for Haemophilus influenzae and pneumococcus, for which higher and sustained antibody concentrations are needed to interrupt the carrier state and reduce transmission within the population, and for pertussis, the bacterial vaccine-preventable disease that is the least well controlled.”

That brings up a very important question: What about the H1N1 flu vaccine? Dr. Marc Siegel, an infectious disease expert and associate professor of medicine at New York University School of Medicine in New York City, says that because the immune response from the H1N1 vaccine has been so robust, giving an infant acetaminophen before the shot “may not be a problem.”

Children can be taught to use their imagination to tackle frequent bouts of stomach pain, research shows.

A relaxation-type CD, asking children to imagine themselves in scenarios like floating on a cloud led to dramatic improvements in abdominal pain.

The US researchers said the technique worked particularly well in children as they have such fertile imaginations.

It has been estimated that frequent stomach pain with no identifiable cause affects up to one in five children.

The research, published in the journal Pediatrics, follows on from studies showing hypnosis is an effective treatment for a range of conditions known as functional abdominal pain, which includes things like irritable bowel syndrome.

In this study, the children had 20 minute sessions of “guided imagery” – a technique which prompts the subject to imagine things which will reduce their discomfort.

One example is letting a special shiny object melt into their hand and then placing their hand on their belly, spreading warmth and light from the hand inside the tummy to make a protective barrier inside that prevents anything from irritating the belly

The researchers, from the University of North Carolina and Duke University Medical Center, said a lack of therapists led them to the idea of using a CD to deliver the sessions.

In all 30 children aged between six and 15 years took part in the study – half of whom used the CDs daily for eight weeks and the rest of whom got normal treatment.

Among those who had used the CDs, 73.3% reported that their abdominal pain was reduced by half or more by the end of the treatment course compared with 26.7% in the standard care group.

In two-thirds of children the improvements were still apparent six months later.

Anxiety

It is not clear exactly how the technique works but studies have shown it is partly about reducing anxiety but there is also a direct effect on the pain response.

Some researchers think hypnosis-like techniques reduce “hypersensitivity” in conditions such as irritable bowel syndrome.

Study leader Dr Miranda van Tilburg said it was especially exciting that the children were able to use the technique on their own.

“Such self-administered treatment is, of course, very inexpensive and can be used in addition to other treatments, which potentially opens the door for easily enhancing treatment outcomes for a lot of children suffering from frequent stomach aches.

“Children are very good at using their imagination – when you use this in adults you have to overcome a barrier first.”

Professor David Candy, a consultant paediatric gastroenterologist at Western Sussex Hospitals, said his team had tried hypnosis in a small group of children with severe abdominal pain problems and had 100% success rate.

He added they are now keen to try the guided imagery technique to see if they can replicate the US findings.

“There is really a dearth of information on how to manage children with abdominal pain and it’s a very common problem which keeps children out of school.”

More than one million children in Britain currently suffer from asthma and an estimated up to 130,000 are believed to carry a double copy of a gene variant, which researchers said could significantly inhibit the effects of the drug.
Researchers found that children with the gene variant and who also had to use the drug daily were significantly more likely to suffer an attack than those without the variant.

Children with a single copy of the gene, estimated to number between 300,000 and 400,000 in Britain, were 30 per cent more likely to have an asthma attack than other sufferers also taking the medication daily, according to researchers from the University of Dundee and the Brighton and Sussex Medical School.

Youngsters who had a double copy and were daily users were twice as likely not to respond to the drug as those without the variant.

However, the team behind the study, which looked at 1,182 children and young adults in Scotland, warned that sufferers should not switch medications until more research was carried out.

Prof Somnath Mukhopadhyay, from the Brighton and Sussex Medical School, said: “We need to find out if alternative reliever medication will provide better asthma control in these children.

“Our work does not alter current consensus guidelines for the treatment of asthma. It points towards the need for further research in this area.”

However, the researchers suggested that in future children could be screened using a saliva test for the variant and offered an alternative treatment, if it can be proven to be effective in their case.

The study, published in the Journal of Allergy and Clinical Immunology, also suggests that patients with the genetic defect, called the Arg16 variant, became less sensitive to the drug, and more prone to attacks, the more frequently it was used.

Previous studies on how the gene variant affects adults taking Ventolin have proved conflicting.

Prof Neil Barnes, from the British Lung Foundation, said that the study was “potentially significant”.

However, he added that the research “requires considerable further investigation as recent large studies have shown no relationship between an individual’s genetic make-up and the effectiveness of this treatment.”

He added that deaths and admissions to hospital from asthma have fallen in Britain as the use of this treatment has increased, which, he said, would “strongly suggest” that the drugs were safe and effective.

Dr Elaine Vickers, research relations manager at Asthma UK, said: “The research did not look at whether a different sort of reliever asthma treatment would be more appropriate for this group of children however, so we don’t yet know whether they should be given a different treatment.”

Children who are smacked are more aggressive and have poorer mental development than those who are verbally castigated, studies have found.

Research on toddlers and other studies following children into adolescence found physical punishment was bad for children and made them more likely to show anti-social behaviour.

The children who were smacked at age one were more aggressive and had not developed cognitive skills as well as those punished verbally.

In a separate study children aged between five and 16 found that children who were spanked often were two to three times more likely to show anti-social behaviour than those not punished physically.

The findings are likely to reignite the debate on whether it is right for parents to smack their children.

in Britain mild smacking is allowed under a “reasonable chastisement” defence against common assault.

But any punishment which causes visible bruising, grazes, scratches, minor swellings or cuts can result in a prosecution for assault occasioning actual bodily harm, or more serious charges.

Last year a cross-party group of MPs failed to force through a ban in England and Wales on smacking children after there was just four hours to debate legislation in the Commons.

The latest research conducted in America has found that smacking young children affected their behaviour and their mental development.

In one study 2,500 families with children aged one, two and three recorded how often they were smacked and used recognised systems to measure their behaviour and mental skills.

Around one third of one-year-old children were spanked and received on average more than two spankings a week – defined as hitting with an open hand on the buttocks or other extremity.

Half of two-year-old were punished physically, receiving almost three spankings a week on average. The rate was similar for three-year-olds.

The findings show children who were spanked more often at age one behaved more aggressively when they were two and had lower scores on tests measuring thinking skills when they were three.

Dr Lisa Berlin, research scientist at the Centre for Child and Family Policy at Duke University in North Carolina, said: “Our findings clearly indicate that spanking affects children’s development.”

The study was conducted by researchers at Duke University, the University of Missouri-Columbia, the University of South Carolina, Columbia University, Harvard University, and the University of North Carolina at Chapel Hill and was published in journal Child Development.

The findings remained significant after factors such as race, ethnicity, age, education, income and the child’s gender, were taken into account.

Verbal punishment alone did not affect either children’s aggression or their cognitive development, Dr Berlin said.

Dr Berlin said the study examined if children who were more aggressive elicited more spanking and they did not. She said this meant that ‘although children’s characteristics always play a role, our findings emphasise the influence of parenting on child behavior and development’.

Another study in the same journal looked at the long-term effect of physical punishment on children as they grew up into teenagers.

A total of 750 children aged between five and 16 were studied and it was found that parents generally reduce physical punishment as the child gets older.

But in families where the physical punishment continued the children were more likely to have behaviour problems than those who never spanked them or who stopped spanking them when they were still young.

Dr Jennifer Lansford, associate research professor with the Social Science Research Institute and Center for Child and Family Policy at Duke University, who led the study, said children who were exposed to physical discipline most frequently were two to three times more likely to show anti-social behaviour as an adolescent, including things like getting into fights, being disobedient at home or at school, general delinquency and being in trouble with teachers.

High levels of physical punishment was defined in the study as spanking once a month, she said.

It was found that if spanking stopped by age nine the child was no more likely to show anti-social behaviour as an adolescent than if they had never been spanked.

Dr Lansford said: “Given these findings, mental health specialists and others who work with families should encourage parents to refrain from using physical discipline.

“They should also help parents come up with alternate strategies for disciplining their children.

“Parents are also more likely to continue using physical discipline with children who behave aggressively.”

John Dunford, general secretary of the Association of School and College Leaders, said corporal punishment in schools never worked because the same names would appear time and again in the punishment book.

He said: “It seems highly likely that children exposed to violence would themselves use violence in reaction to situations. Violence begets violence is a lesson from history not just child psychology.”

Sources: telegraph.co.uk/health