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That picturesque wood-burning stove ranks alongside auto traffic as a risk factor for bronchiolitis, the respiratory condition that is the leading cause of hospitalization in the first year of life, a new study finds.

“Those infants who had more exposure to wood-burning appliances were more likely to show up in doctors’ offices or be hospitalized for bronchiolitis,” said Dr. Catherine Karr, an assistant professor of pediatrics at the University of Washington, and lead author of a report in the Nov. 15 issue of the American Journal of Respiratory and Critical Care Medicine.

There hasn’t been much research done on the effects of air pollution on very young children, Karr said. Such studies have typically focused on older children, in whom asthma is a more prevalent problem related to air pollution.

Karr and Canadian researchers analyzed nearly 12,000 cases of infant bronchiolitis between 1999 and 2002 in the province of British Columbia, checking on exposure to air pollutants such as nitric oxide, nitrogen dioxide, carbon monoxide and particulate matter. They also looked at the source of those pollutants.

Infants who lived within 50 meters — about 55 yards — of a highway had a 6 percent increased risk of bronchiolitis, while those with higher exposure to wood smoke had an 8 percent increased risk, compared to those with the lowest exposure.

“Bronchiolitis is the number one reason why a child ends up in a hospital in the first year of life,” Karr explained. “It is responsible for 13 percent of those hospitalizations.”

Bronchiolitis is a respiratory condition that starts out looking like a common cold but can become “quite severe,” she said. It can be caused by viruses, and is often the first infection a child experiences early in life.

The study “lets families know about concerns about infant exposure to traffic and wood-burning appliances,” Karr said. “If they can avoid those things, they should. If they do use wood-burning appliances, they should use safety practices, making sure the appliances are properly vented and burn efficiently.”

The study included such pollution because “here in the Pacific Northwest, we have more exposure to wood-burning stoves than in other places,” Karr said.

“This study extends some past findings that wood smoke can be very irritating to the respiratory system, and has been shown to have effects on the lungs of children,” said George Thurston, director of the Particulate Matter Health Effects Research Center in New York.

“Wood smoke seems to have the biggest effects on respiratory health, whereas fossil fuels seem to have the biggest effects on cardiac health, because they are more laden with metals,” Thurston said.

The Pacific Northwest is unusual because of a higher concentration of wood-burning appliances, he said. “In other areas, traffic may dominate more,” Thurston noted.

Exclusive breast feeding for up to 6 months, though beneficial for an infants’ immunity and mothers’ weight, may not alter children’s health risks over the long term, study findings hint.

Dr. Michael S. Kramer, at The Montreal Children’s Hospital in Quebec, Canada, and colleagues assessed children through age 6.5 years for a number of outcomes according to whether they were exclusively breast fed for 6 months, or for 3 months followed by 3 months of combined breast and formula feedings.

Their findings, in the American Journal of Clinical Nutrition, hint that long-term advantages for children exclusively breast fed for 6 instead of 3 months “do not include lower risks of obesity, asthma, allergy, or dental caries,” Kramer noted in an email to Reuters Health.

He and colleagues also observed no differences in intelligence, behavior, or blood pressure measures between the 524 children exclusively breast fed for 6 months and the 2,427 fed in this manner for the shorter period.

The healthy-borne children, about half male, and their mothers had been enrolled in a breast feeding intervention study, conducted in the Republic of Belarus, which tallied feeding data through the children’s first year.

In previous analysis of this group, Kramer’s team showed exclusive breast feeding for 6 months tied to significantly lower incidence of gastrointestinal infections from 3 to 6 month of age.

In the current study, which assessed the children’s outcomes through the age of 6.5 years as reported by their pediatricians, mothers, and teachers, the only observed between-group differences were slightly higher measures of body mass, hip circumference, and thickness of the skin at the upper arm - all indicators of greater overall body fat.

However, these associations “seem unlikely to represent” exclusive breast feeding for 6 months as a cause for increased body fat during childhood, the investigators note.

Rather, Kramer and his co-investigators suspect these indicators may be tied to a mother’s confidence “to continue breast feeding if her baby is gaining weight well,” he said.

Kramer’s team plans continued follow up of this group of children through the age of 11 to 12 years to investigate any ties between breast feeding and risk indicators for heart disease and type 2 diabetes.

New guidelines are needed to improve the diets of U.S. school children, finds a new government report that would set maximum calorie counts for school breakfasts and lunches.

School meals should have less salt; more vegetables, fruits and whole grains; skim and low-fat milk, and other dairy products, the report from the Institute of Medicine says. It called on the federally funded National School Lunch Program and the School Breakfast Program to update its current policies.

“The program was due for a revision,” said IOM committee chairwoman Dr. Virginia A. Stallings, a professor and director of the Nutrition Center at Children’s Hospital of Philadelphia.

The committee’s job was to make recommendations to the U.S. Department of Agriculture, which runs the school meal program, Stallings said. “We expect that they will take this information and revise the program,” she said.

“These recommendations will become regulations, and schools are required to follow them if they are going to get reimbursed for school meals,” she said.

The IOM recommendations would bring school meals in line with the latest dietary guidelines and reference intakes from the U.S. Department of Agriculture. The current standards for school meals are based on the 1995 dietary guidelines and the 1989 recommended dietary allowances.

Increased funding will be needed to implement the changes because of the higher cost of vegetables and whole-grain foods, the report noted. Also, greater federal meal reimbursement, capital investment and additional training of food service personnel will be required for the recommendations to succeed.

But these changes are needed to assure parents that schools are providing healthful, satisfying meals, Stallings said.

“The school meal programs were established when we were worried about children being hungry and undernourished,” she said. “Now we have to worry both about that safety net for children who may not have enough food, but also balance it with a food supply that will prevent the school meals from contributing to the obesity problem.”

In the past, there had only been a minimum calorie amount, Stallings said. “What the committee is now recommending is a minimum and a maximum,” she said.

The report on healthy school meals suggests lunches contain no more than 650 calories for students in grades kindergarten through five; 700 calories for children in grades six to eight, and 850 for those in grades nine to 12. Breakfast calories should not exceed 500, 550 and 600, respectively, for these grade groups.

To ease the adjustment to lower salt meals, the report calls for reducing sodium over the next decade from today’s average of 1,600 milligrams per lunch to 740 milligrams.

In addition, breakfasts should contain one cup of fruit, and lunches for grades nine to 12 should also contain one cup of fruit. No more than half of the fruit should come from juice, the report says.

Vegetable offerings should increase to three-quarters of a cup a day for grades kindergarten through eight, and one cup a day for grades nine to 12. Starchy vegetables, such as potatoes, should be served less often, and at least half a cup each of green leafy vegetables, orange vegetables and legumes should be provided each week, the report said.

For grains, half of the breads and pasta should be whole grain, Stallings said. Milk served with school meals should be skim or 1 percent fat, she added.

Meat with lunches should be kept to about two ounces for all grades, but can be higher for students in high school. For breakfast, meat should be kept to about one ounce a day for children in kindergarten through grade eight, and two ounces for high school students, the report noted.

The National School Lunch Program is available in 99 percent of U.S. public schools and in 83 percent of private and public schools combined. The School Breakfast Program is available in 85 percent of public schools.

About 30.6 million school children participated in the school lunch program in 2007, and 10.1 million children had school breakfasts. In 2007, schools in the program served about 5.1 billion lunches and 1.7 billion breakfasts, according to the report.

Stallings hopes the recommendations will filter down to the meals parents serve at home. “I do believe that parents will be able to use some of this to talk about the kinds of fruits and vegetables they should be serving at home and other recommendations that are easily implemented, like going to skim or low-fat milk and thinking about sodium both in cooking and table salt,” she said.

Dr. David L. Katz, director of the Prevention Research Center at Yale University School of Medicine, said “this update to school nutrition standards is timely, and most welcome.”

School nutrition standards were originally devised to protect children from malnutrition and want, Katz noted.

“But in an age of epidemic childhood obesity, when children are far more likely to get too many calories than too few, and when more and more succumb to what was called ‘adult onset’ diabetes just a generation ago, the time-honored school food standards are clearly obsolete,” he said.