PEDIATRIC NEWS UPDATES Updates from April 2005

April 22 - New warning for Phenergan
The FDA recently issued an updated warning for a widely used antiemetic medication called Phenergan. Usually given as a suppository, Phenergan very commonly used to stop children from vomiting during the “stomach flu”. A common side effect is drowsiness, which is not a big deal for a child. Respiratory depression is a less common side effect, and there have also been reports of deaths in children under age 2 years who have taken Phenergan. This recently lead the FDA is issue a statement that states that the use of Phenergan is contraindicated in children under age 2 years – this means it should NOT be used under age two. They also reported that caution should be used when giving Phenergan to older children and reminded doctors that antiemetics are not recommended for the treatment of children with uncomplicated vomiting.

April 29 - Is wild salmon really wild?
I get a lot of questions about the safety of fish these days. There are legitimate concerns about levels of mercury, PCBs and other toxins in the fish we eat. Most questions are about two popular fish, tuna and salmon. Should it be farmed or wild? Is canned tuna okay?

To add to the confusion was a recent article in the New York Times revealing some fraudulent practices by some fish stores. Wild, uncontaminated salmon has become hard to find, driving the price up, which in turn, has tempted some stores to label farmed salmon as “wild” to boost profits. Shame on them!

So, here are a few tidbits to help clear up the confusion:

First, uncontaminated fish is very healthy and we should eat it at least twice a week. Cold-water fish is generally the best. This is why northern pacific salmon is one of the best. I have come across various lists of healthy fish in recent health magazines and websites showing which fish are safer than others. These lists are overwhelmingly complex and difficult to remember. For example: mackerel from the Atlantic is fine twice a week, but Spanish mackerel from the Gulf of Mexico is only good once a week. Oh, wait a minute, Mackerel chub is also fine twice a week… ooh, but King mackerel from the Atlantic and Gulf of Mexico should be avoided altogether!? I’m getting a brain cramp!

Forget the lists!

There are really only a couple of fish that I like anyway, so I looked into these in detail: Salmon, and Tuna. The lists usually divide fish in the following categories: safest – enjoy up to twice a week; less safe – one serving per week, or once/twice a month; and then not safe – avoid altogether. Here are my thoughts: I’m only having fish once or twice a week anyway, so I want to have the safest fish possible, so I only choose from the “safest” list:

Enjoy twice a week:

• Wild, pacific salmon
• Canned chunk light tuna

Notes: canned albacore is on the “less safe” list; tuna steaks are on the “not safe” list. Yes, there are other fish on the safe list, but this is a quick and simple way to remember what to eat.

Where to get wild salmon?

You can find “wild salmon” in many markets such as Trader Joes. How do you know it’s really wild? That’s a tough one. Dr Bill has found a very reliable source of wild salmon through a company called Vital Choice. Their salmon is carefully tested for mercury, PCBs and other contaminants. At this time it is the only salmon that Dr. Bill trusts. He has been enjoying this salmon more than twice a week without worrying about pollutants. I recently tried some of this and I thought it was the best salmon I have ever tasted! Sure it costs a little more, but I think it is well worth it. Click here to read more about Vital Choice.