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Debate Club: ADHD – To Medicate or Caffeinate?


Prescribed ADHD Medications Help Children

by Cheryl Maguire

At first I was skeptical. Could prescribed medication really help children diagnosed with ADHD? I became convinced after several years of working as a counselor. I witnessed children dramatically improve their ability to function well both in school and social situations after taking medication.

The case of John* is an excellent illustrative example. He wanted to discontinue using Adderall at the start of 5th grade. He had been taking Adderall for three years and thought it was no longer necessary. Often when kids are doing well they think they don’t need medication anymore. In these instances, it can be helpful to take a medication holiday – stop the medication for an agreed upon time frame to see if it’s still necessary.

The first month without Adderall John thought he was doing fine, but his mid-term progress report said otherwise. He was earning a D in math and Cs in the other subjects. His parents wanted him to go back on the medication to see if there was an improvement.

After taking Adderall for a week, John’s mother checked in with his teachers who reported a dramatic improvement in both the quality of his schoolwork and his ability to focus/pay attention during class. They said he was a totally different kid. He stopped fidgeting and was able to focus for extended periods of time. And his responses to questions were thoughtful and correct.

John continued to take the medication for the reminder of the school year and received an A in math class. He got As and Bs in his other classes, which resulted in making the honor roll. He proudly displayed his certificate in his room.

I worked with many children who experienced similar positive effects from taking medication to help their ADHD.

Improved grades in school

Most schools require sitting still and paying attention for about six hours, which is particularly challenging for kids with ADHD. The National Resource Center on ADHD states that prescribed medication can help attention span, impulsivity, and focus, especially in structured environments. All of these improved behaviors can lead to better grades in school.

A study conducted at the National Institute of Mental Health found students who took medication for ADHD did better in math and reading compared to students with ADHD who did not take medication.

Improved social skills

Children with ADHD often have difficulty making friends because they may not pay attention to social cues. Their impulsive behaviors can also be annoying or hurtful to their peers. Sometimes their impulsivity can lead to aggression.

NIMH sponsored study – the Multimodal Treatment of ADHD (MTA) found children who took medication showed more improved social skills and peer relations than children in the in the non-medicated comparison group after 14 months.

Research studies have also examined how ADHD medication can be beneficial in sports settings. A study done at the University of Kentucky found children who took medication for ADHD performed better during baseball games.

One child I worked with thought other kids were making fun of him. When I investigated this situation I found the children actually wanted to be friends with him. He was misreading the other children’s social cues which caused him to feel both angry and left out. After helping this child develop social skills he was able to form friendships.

When children take medication it can help them to both focus on social cues and decrease the impulsivity which could result in better social interaction and an easier time developing friendships.

Improved self-esteem

Children with ADHD frequently have poor self-esteem due to the difficulties they experience in school and social situations. By taking medication a child can improve both their social skills and school performance, which could, in turn, improve their self-esteem. 

Medication isn’t magic

Medication isn’t a magic pill. I like the analogy that medication is similar to using a shovel. A person can dig a hole with their hands, but if they use a shovel it will be easier. The shovel is not going to magically dig the hole, the person still needs to physically use the shovel to dig it. Medication can be a tool that helps make it easier for children with ADHD to focus and be less impulsive, but the student still has to complete their schoolwork.

Medication can have side effects and is not helpful for everyone. There are other ways to treat ADHD such as counseling, behavioral management, and alternative treatments such as acupuncture. Often a combination of counseling and medication can be most effective. Ultimately the child and parents have to make an informed decision about which method will work best for them.

*name has been changed for privacy

Caffeinated Kids Have Reduced ADHD Symptoms With Fewer Toxic Side Effects

by Kristen Polito

It’s recently been reported that diet quality and mood are positively correlated. Moreover, one’s emotional compass, mental health, and cognition are actively conducted by what we choose to eat and drink.

Caffeine is one such consumable with a direct connection to the brain – specifically to mental clarity, alertness, and (usually) energy. Caffeine molecules bind to the adenosine receptors in brain cells and block adenosine from making us feel sleepy. Adrenaline is released instead, pumping us up. When this happens, the dopamine in our brain works more efficiently, helping us to feel good.    

According to a 2005 study of rats with hyperactivity, impulsivity, poor attention, and deficits in learning and memory, a significant improvement was reported in test results when caffeine was administered to the rats beforehand.

Accordingly, moderate caffeine intake (< six cups/day) has been associated with fewer depressive symptoms, fewer cognitive failures, and lower risk of suicide.

Benefits include increased alertness, attention, and cognitive function and elevated mood.

However, caffeine consumption is somewhat controversial because of the so-called increased risk of hypertension with regular consumption.

For many people, too much caffeine can have a negative emotional effect: it can contribute to feeling anxious, jittery or irritable. Depending of your caffeine threshold, it can even cause tremors, irritability, impulsivity, and insomnia.   

However, new research says a moderate amount of caffeine can do the opposite for those with attention deficit hyperactivity disorder (ADHD). Instead of making them more active and stimulated, it actually has a “calm-down” effect, and encourages sleep.

Some adults with ADHD have found that drinking coffee could help them feel more focused, calm, and stay on task. They are now using a cup of coffee as mild treatment for their negative symptoms  such as hyperactivity, restlessness, and flight of ideas. 

Because sensitivity to caffeine varies among people based on a number of things, dosing has to be adjusted on an as-needed basis. ADHD, like any other spectrum disorder, has varying degrees of intensity, so there is not “one size fits all” treatment plan for every patient. 

Interestingly, the body processes caffeine differently based on gender, and women naturally metabolize it more quickly. Because of this, males would require doses more frequently than females. Anecdotal evidence advocates for individuals who suffer from ADHD to take it upon themselves and self-medicate even their children. While it may seem controversial for mom to hand her seven-year-old an iced java, it’s not so far fetched. 

The effectiveness of coffee in calming ADHD children has become a popular discussion topic on various web sites and forums. Again, it’s a lot of anecdotal evidence, and less comprehensive medical research, but my opinion is that Big Pharma likes to keep it that way. 

My stance isn’t for leaving ADHD diagnoses unmedicated or untreated.  I am pro-treatment management and I support looking for alternative drugs such as medical marijuana and coffee.  

For parents who say they don’t want to administer drugs or chemicals to their child for their ADHD symptoms, a cup of coffee brewed from organically grown coffee beans might be the more attractive alternative. Here’s why:

Ubiquity

Caffeine has been the world’s “drug of choice” since the dawn of time. Chocolate, tea, coffee, Red Bull, soda, protein bars, fancy waters – caffeine is everywhere and in everything!

Affordability

Caffeine, in the form of homemade coffee, is (relatively) cheap!  I buy the bottom-shelf brand and the cost amounts to about 25 cents per cup, so 1/4 cup is a little over six cents, 30 days a month is less than $2. If the child needs it twice a day, then double the cost to $4. If the family has food stamps, coffee is covered by the food stamp card allowance.    

As far as insurance goes, that’s not really an option for everyone. I’m 100 percent uninsured.  Everything is out-of-pocket. Many families have fallen through the cracks in our healthcare system. With a cup of joe, there are no insurance claims forms to fill out, no drug-discount cards to search for at the bottom of your bag – just what fits into the family’s monthly grocery budget.  

Coffee is a mild alternative

ADHD medications are heavy stimulants, often with potential side effects such as reduced appetite, weight loss, and dependency. Caffeine is actually a milder alternative. Children with ADHD are usually given drugs like Ritalin and Strattera that increase dopamine levels in the body. Higher levels tend to calm and help overactive minds focus.

Coffee can also increase dopamine without the risks associated with prescriptions. The only side effect coffee has may be a headache from withdrawal. If you decide to go the coffee route, you should also avoid sweetening coffee with sugar because real sugar aggravates the symptoms of ADHD. A fantastic alternative is stevia as it is natural, yet not metabolized by the body, therefore it will not spike blood sugar levels.

Organic option

When considering our rising healthcare costs, its ubiquity, affordability, and ease of use are what make caffeine an intriguing option for an adult or child with ADHD. All of those factors make this consideration difficult to pass up.

Always exercise caution and learn as much as you can. This, while working concurrently with your healthcare provider, and gaining both insight and knowledge into your child’s ADHD, will serve your family well.

Please note that this post and the information herein is based on personal experience and anecdotal in nature. It is not intended to substitute for medical or mental health advice.

I am not a licensed therapist, psychologist, registered dietitian, nutritionist, or medical doctor. The views I express are mine alone, based on my own experiences, and should not be taken as medical or mental health advice. Please speak with a medical or mental health professional before making any changes to your diet, exercise, or daily routine.

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Going back to work after having a baby is hard. Regaining your footing in a world where working mothers are so often penalized is tough, and (just like most things during the postpartum period) it takes time.

The challenges we face as working women returning from a maternity leave can be so different from those we faced before, it can feel like we're starting over from scratch. But mothers will not be deterred, even if our return to the working world doesn't go exactly as planned.

We are resilient, as Serena Williams proved at Wimbledon this weekend.

She lost to Angelique Kerber in the final, just 10 months after welcoming daughter Alexis Olympia and recovering from a physically and emotionally traumatic birth experience.

Williams didn't get her eighth Wimbledon title this weekend, but when we consider all the challenges she (and all new moms) faced in resuming her career, her presence was still a huge achievement.

"It was such an amazing tournament for me, I was really happy to get this far!" Williams explained in an emotional post-match interview.

"For all the moms out there, I was playing for you today. And I tried. I look forward to continuing to be back out here and doing what I do best."

The loss at Wimbledon isn't what she wanted, of course, but Williams says it does not mean there won't be wins in her near future.

"These two weeks have showed me I can really compete and be a contender to win grand slams. This is literally just the beginning. I took a giant step at Wimbledon but my journey has just began."

When asked what she hopes other new moms take away from her journey, Williams noted her postpartum recovery was really difficult, and hopes that other moms who face challenges early in motherhood know that they don't have to give up on whatever dreams they have for themselves, whether it involves working or not.

"Honestly, I feel like if I can do it, they can do it. I'm just that person, that vessel that's saying, 'You can be whatever you want to be.' If you want to go back to workand to me, after becoming a mom, I feel like there's no pressure to do that because having a child is a completely full-time job," she said.

"But to those that do want to go back, you can do it, you can really do it."

Thank you, Serena. You may not have won, but this was still a victory.

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Since baby Crew became the newest member of Chip and Joanna Gaines' family three weeks ago, his proud parents have been keeping the world updated, sharing sweet snaps of their youngest and even giving us a glimpse into his nursery.

Now, Chip Gaines is showing off a pic that proves there is nothing cuter than a floppy, sleepy baby.

"My heart is full..." the proud father of five captioned the photo he posted on his Instagram and Twitter accounts.

Earlier this week Crew's mama shared how she gets him so sleepy in the first place, posting an Instagram Story showing how she walks around the family's gardens on their Waco, Texas farm to lull her newborn boy to sleep.



The couple are clearly enjoying every single moment of Crew's babyhood. As recently as 7 days ago Chip was still sporting his hospital bracelet. Joanna says with each child he's worn his maternity ward ID until it finally wears off. We can't blame Chip for wanting to make the newborn phase last as long as possible.

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It was a changing table must-have a generation ago, but these days, many parents are forgoing baby powder, and now, the leading manufacturer of the sweet smelling powder was dealt a big financial blow.

Johnson & Johnson was just ordered to pay almost $4.7 billion to 22 women who sued, alleging baby powder caused their ovarian cancer.

A St. Louis jury says the women are right, but what does The American Academy of Pediatrics say about baby powder?

It was classified "a hazard" before many of today's parents were even born

The organization has actually been recommending against baby powder for years, but not due to cancer risks, but inhalation risks.

Way back in 1981 the AAP declared baby powder "a hazard," issuing a report pointing out the frequency of babies aspirating the powder, which can be dangerous and even fatal in the most severe cases.

That warning didn't stop all parents from using the powder though, as its continued presence on store shelves to this day indicates.

In 1998 Dr. Hugh MacDonald, then the director of neonatology at Santa Monica Hospital and a member of the American Academy of Pediatrics Committee on Fetus and Newborn, told the Los Angeles Times "Most pediatricians recommend that it not be used," adding that the consensus at the time was that "anybody using talcum powder be aware that it could cause inhalation of the talc, resulting in a pneumonic reaction."

Recent updates

A 2015 update to the AAP's Healthy Children website suggests the organization was even very recently still more concerned about the risk of aspiration than cancer risks like those alleged in the lawsuit. It suggests that parents who choose to use baby powder "pour it out carefully and keep the powder away from baby's face [as] published reports indicate that talc or cornstarch in baby powder can injure a baby's lungs."

In a 2017 interview with USA Today, Dr. David Soma, a pediatrician with the Mayo Clinic Children's Hospital, explained that baby powder use had decreased a lot over the previous five to eight years, but he didn't believe it was going to disappear from baby shower gift baskets any time soon.

"There are a lot of things that are used out of a matter of tradition, or the fact it seems to work for specific children," he said. "I'm not sure if it will get phased out or not, until we know more about the details of other powders and creams and what works best for skin conditions—I think it will stick around for a while."

Talc-based baby powder is the kind alleged to have caused ovarian cancer in the lawsuit (which Johnson & Johnson plans to appeal), but corn starch varieties of baby powder are also available and not linked to increased cancer risks as alleged in the case.


Bottom line: If you are going to use baby powder on your baby's bottom, make sure they're not getting a cloud of baby powder in their face, and if you're concerned, talk to your health care provider about alternative methods and products to use on your baby's delicate skin.

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In the days since a The New York Times report revealed a resolution meant to encourage breastfeeding was blocked by U.S. delegates at the World Health Assembly, breastfeeding advocates, political pundits, parents, doctors—and just about everyone else—have been talking about breastfeeding, and whether or not America and other countries are doing enough to support it.

The presidents of the American Academy of Pediatrics and the American College of Obstetricians say the controversy at the World Health Assembly reveals that mothers need more support when it comes to breastfeeding, while others, including The Council on Foreign Relations, suggest the national conversation needs more nuance, and less focus on the "breast is best" rhetoric.

The one thing everyone agrees on is that parents need more support when it comes to infant feeding, and in that respect, the controversy over the World Health Assembly resolution may be a good thing.

In their joint letter to the editor published in the New York Times this week, the presidents of the American Academy of Pediatrics and the American College of Obstetricians, Dr. Colleen Kraft and Dr. Lisa Hollier urge "the United States and every country to protect, promote and support breast-feeding for the health of all women, children and families."

The doctors go on to describe how breastfeeding "provides protection against newborn, infant and child infections, allergies, asthma, inflammatory bowel disease and sudden infant death syndrome," and note the health benefits to mothers, including reduced risks for "breast cancer, ovarian cancer, diabetes, hypertension and heart disease.

"Helping mothers to breastfeed takes a multifaceted approach, including advancing public policies like paid family leave, access to quality child care, break time and a location other than a bathroom for expressing milk," say Kraft and Hollier.

Certainly such policies would support breastfeeding mothers (and all mothers) in America, but some critics say framing the discussion around domestic policy is a mistake, because the World Health Assembly resolution is a global matter and women and babies in other parts of the world face very different feeding challenges than we do here at home.

In an op-ed published by CNN, Gayle Tzemach Lemmon, an adjunct senior fellow at the Council on Foreign Relations suggests the laudable goal of breastfeeding promotion can backfire when mothers in conflict-riddled areas can't access formula due to well-meaning policy. Lemmon points to a 2017 statement by Doctors Without Borders calling for fewer barriers to formula distribution in war-torn areas.

"International organizations like UNICEF and the World Health Organization (WHO) promote breastfeeding ... and provide infant formula, but only by prescription. We believe that distributing infant formula in a conflict situation like Iraq is the only way to avoid children having to be hospitalized for malnutrition," Manuel Lannaud, the head of Doctors Without Borders Iraq mission wrote.

The various viewpoints presented this week prove that infant feeding is not a black and white issue, and policy debates should not be framed as formula versus breast milk—there is more nuance than that.

A recent study in the Journal of Pediatrics found opting to supplement with formula after first breastfeeding improves outcomes for infants and results in higher rates of breastfeeding afterward, and while the benefits of breastfeeding are numerous, they are sometimes overstated. Another recent study published in the journal PLOS Medicine found breastfeeding has no impact on a child's overall neurocognitive function by the time they are 16. Basically, parents should not be shamed for supplementing or choosing to use formula.

This, according to Department of Health and Human Services says national spokesperson Caitlin Oakley is why the HHS opposed the original draft of the breastfeeding resolution at the World Health Assembly (although critics and the initial NYT report suggest the United States delegation were acting in the interests of infant formula manufacturers).

"Many women are not able to breastfeed for a variety of reasons, these women should not be stigmatized; they should be equally supported with information and access to alternatives for the health of themselves and their babies," Oakley said in a statement.

That's true, but so is everything the presidents of the American Academy of Pediatrics and the American College of Obstetricians presented in their op-ed, and that's why the U.S. should support breastfeeding policy.

Here's another truth: This is an issue with many perspectives and many voices. And we need to hear them all, because all parents need support in feeding their babies, whether it's with a breast, a bottle or both—and we're not getting it yet.

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