Monday, November 29, 2010

More children have eating disorders than ever before, or, should we say more cases are being diagnosed and treated?

Happy Thanksgiving everyone! After all that food and fun, Healthday and are back to remind us that when it comes to our children, now, more than ever there are more reasons to be terrified all day, everyday. Hyper-vigilance seems like the only answer. ENOUGH IS ENOUGH. This post will illustrate the difference in literal meaning of rate of incidence vs. rate of observation/diagnosis  (and it's a BIG one) and examine what I call the REALLY small denominator problem.

"Rate of eating disorders in kids keeps rising 

Eating disorders have risen steadily in children and teens over the last few decades, with some of the sharpest increases occurring in boys and minority youths, according to a new report."

My friends at Babycenter are back with a doosey. Eating disorders are among the most serious of mental illnesses and not to be trifled with. If you or a loved one are exhibiting any of the signs of an eating disorder as described here , seek help immediately. Go directly to a qualified professional; Do not pass go; Do not collect $200. 
Now that that's out of the way, back to the skewering.
According to this headline, more and more children have eating disorders every time we turn around. The evidence cited is a recent study that shows that , "hospitalizations for eating disorders jumped by 119 percent between 1999 and 2006 for kids younger than 12."

So the correct headline is "Frequency of hospitalizations for eating disorders in kids increased." Definitionally, more children may have eating disorders, but that's not what we see here. The other thing is that we don't really know if the rate of INCIDENCE of eating disorders is on the rise. All we DO know is that more cases are being diagnosed, documented and treated. It could even be that eating disorders are less prevalent than before, but because of better reporting and diagnostic tools, the rate of OBSERVATION is increasing. The rate of incidence implies that the absolute rate of eating disorders in the entire population is X. The rate of OBSERVATION refers the number that were counted and classified as an INCIDENCE of an eating disorders in the entire population. So if Susie had anorexia nervosa in 1998, but was untreated and undiagnosed, she still HAD anorexia nervosa. The INCIDENCE of anorexia nervosa was one. However, the number of observations for Susie would be zero. 

What we see here is that more children are being hospitalized for eating disorders. This may not even be a bad thing. What if, in the past, children with eating disorders were not hospitalized and instead were under-treated? Couldn't that mean that children were dying, carrying their disease longer into adolescence and adulthood, remaining in a sub-clinical state of misery for untold periods of time? Now that's awful. While hospitalizing anyone for anything is serious, not treating an illness that should be treated by hospitalization shows much more serious systemic problems (ignorance and neglect on the part of adults, mostly).  

On the other hand, maybe it's even worse. What if, in the past children were treated by mental health professionals and their pediatricians at an early phase and because of increasingly stringent and bizarre rules pertaining to health insurance plans limiting mental health benefits, children are having to reach death's door (literally) before they receive the treatment that they need? That's a different awful problem.

On the third hand (foot, I guess), what if these children were being hospitalized with a different primary diagnosis? Perhaps they have other illnesses such as depression, severe abdominal distress, or anything else for that matter and the eating disorder was not considered the primary cause of the hospitalization? 

And yet another foot, what if eating disorders weren't listed as the diagnosis code because some doctors knew that insurance would be more difficult to deal with?  According to someone I know, in the 1950's many doctors admitted Mrs. Smith with acute appendicitis and performed an appendectomy at the same time as an abortion. 

The truth is that we don't know if more children have eating disorders than in the past. We do know that more are being hospitalized at a young age with the primary reason for hospitalization being cited as an eating disorder.


The other disturbing part of this article is the idea that more and more boys and minorities are really seeing more eating disorders. Here we go again. Is it that these kids didn't have eating disorders, or that they went untreated and unreported? My guess is the latter, but I can only speculate because there is no base control to work form. But here's the more important lesson. the rate of anything occurring is a probability. That is a fraction reduced to 1 in X. A three fold increase sounds REALLY big but what if that is the increase from 1 in 1 Billion to 3 in 1 Billion? In the grand scheme of things, it's not a very significant change. It certainly wouldn't warrant a change in policy for the group that is 4x the population of the United States. (That's not to say those 3 cases aren't important, you aren't likely to come across the on or the three in your everyday life). 

In this article we hear that the sharpest increase is for boys and minorities. Let's do the math.

"...experts estimate that between 0.8 to 14 percent of Americans generally have at least some of the physical and psychological symptoms of an eating disorder, according to the report.
Boys now represent about 5 to 10 percent of those with eating disorders, although some research suggests that number may be even higher, said Lisa Lilenfeld, incoming president of the Eating Disorders Coalition for Research, Policy and Action in Washington, D.C."  
Ooh - catch that the first paragraph and the second are using 2 different data sets. Yikes (that's a problem for another post).
If math makes your eyes glaze over skip to the BIG bold part for a summary...
US population clock : 
For simplicity let's split the difference between 0.8 and 14 and say 7%...
310,814,706 * 7% = 21,757,029
21,757,029 * 10% (high-end estimate for boys) = 2,175,703
Let's just say that in the next year we saw 2,300,000 and the population stayed flat. the percentage increase would be (2,300,000-2,175,703)/2,175,703 = 5.7% increase.
Since non boys represent the rest of the eating disorders population is 21,757,029 * 90% = 19,581,326
If the same increase in CASES was seen there (about 124,297 CASES), we would see that there was an increase of (124,297/19,581,326) = 0.63%. 
5.7% vs. 0.63% HUGE difference but the same number of cases. So when you hear that the increase is sharper for boys this makes sense, they are starting off a much smaller base. 
If you sold one car today and two cars tomorrow, you had a 100% increase in the number of cars sold. The next day you sold three cars but you only have an increase of 50%, and so on... As the denominator increases the % change will continue to decrease.

Sunday, November 14, 2010

And we're back...Healthday tells us that social class affects your ability to get well if you have depression...

Please, someone hand me a frying pan to smack myself with. Maybe then I could lose enough brain cells to fail to notice the logic errors this wire service forces down our throats each day.

Here's the headline, 

Social Class May Affect Outcome of Depression Treatment

Really? How did Healthday get that from, 
Researchers reviewed the cases of 239 patients with major depression who took part in the U.S. National Institute of Mental Health Treatment of Depression Collaborative Research Program from 1982 to 1986.
The patients took antidepressants or received one of two different kinds of psychotherapy: interpersonal psychotherapy or cognitive-behavioral therapy. After treatment with drugs or psychotherapy, working-class and poor patients showed less improvement in their ability to function at work than did middle-class patients who had the same treatments, the University of Illinois researchers found.
1982-1986? Seriously. A meta analysis from OVER 20 years ago!!!  There were 3 groups. One group had antidepressants, one group had individual psychotherapy and 1 group had cbt.  Reminds me of "this little piggy, went to market...this little piggy stayed home."  Then, they tried to make conclusions about the efficacy based on the fact that "poor or working class" people having a different experience. Let's begin...
Sample size. How many of the patients were classified as "poor/working class" vs. "middle class"? Were they EQUALLY distributed in the three groups? What was the result for the "no treatment" control group ($20 says there wasn't one)? Each time you make the group smaller, it becomes harder to detect differences. Perhaps these things were addressed, Healthday doesn't tell us this, because Heathday seems not to respect our collective intelligence enough to do so.
Age of data.  Just so we're clear, antidepressant drugs have changed. Prozac and SSRIs came to market (there are those little piggies again) in 1987. Got that? A year AFTER the data were closed. The data may be irrelevant. Perhaps prozac would have worked wonders for both groups. Since those are the most prescribed class of antidepressants these days, it seems really silly to not have data about how patients do with that therapy. The title of the article would lead you to believe that drugs are less likely to help you when you're poor and depressed. Well, until someone adds the drugs we have today into the investigation, it's explanatory value remains limited at best.
Methods of treatment. No group had BOTH the drug and the psychotherapy. It is a well researched theory (NOTE I don't say FACT here because nothing in science can be "proven", even evolution remains a theory) that the most successful outcomes for depression patients come from a COMBINATION of psychotherapy and antidepressants.
Measurement of outcome. Success was considered "ability to function at work." Interesting. How the heck did they measure that? Supervisor interviews? Bonus payments? Performance appraisals? Attendance? Give me a break.
Oh and putting "may" in the title is a pathetic answer, so Healthday should give up the ghost and admit to writing for click through rates.
Please tell me what you think. Do you have a set of statistics driven journalism needing skewering? Let me know.

Saturday, November 13, 2010

Henry Blodgett Tells The Truth about the October employment numbers, or "This one goes to eleven..."

Today I must depart from my recent rants about medical journalism to give a shout out to Henry Blodgett and John Maudlin.  Maudlin writes a weekly investor email that parses economic data, reinterprets it, and offers far better analysis than most business journalists can muster in their entire career. Henry, well, he wrote about it and gave us a GREAT headline...

"Wow -- Check Out How Blatantly Our Government Misled Us With The October Jobs Numbers!"

Read more:

I encourage you all to read at least the Blodgett post, if not his source.

Basically, the government came out and said that we added 100,000 jobs in October. That's a nice story. The economy is on the mend, the bluebird of happiness is chirping away, babies are cooing and... wait, is that my BS alarm going off? Darn, I hate it when that happens.

Turns out, employment numbers are a result of a survey (mmmm sampling error smells good... but I won't even go there). After the survey folks at the BLS (and they ARE actually REALLY smart folks) apply a factor to the number to adjust for "seasonality".  What they are trying to accomplish is taking out the "noise" in the employment numbers. A perfect example is in June when all those young whipper-snappers graduate and can't find jobs and move home to mommy and daddy's basement.  No one wants to say, oh we now have 300K extra people without jobs (when actually, when you think about we totally do)... SO instead they "adjust out of that by multiplying the results by a factor of <insert result of scary looking algorithm designed to make your average mathphobe break into a cold sweat at the sight of it here>.

Well, they really did it this time.  They changed the factor. The following is a GROSS oversimplification for illustrative purposes. So 1,000,000 X .6 = 600,000. 600,000 employed people in September.  Now, the folks at the BLS thought this month seems different. All that Halloween candy made them giddy so they decided to change the factor to .7. In October, they say, 1,000,000 X .7 = 700,000. OK, but did we get 100K new jobs of course, not.

Here's the deal, anyone in government wanting to make a name for themselves would love to say 700,000-600,000 = 100,000 new jobs. IT'S A HALLOWEEN MIRACLE!

The reason this is so exciting is that a journalist has finally reported not on the number as released but on the manipulation of the data and how taking the number at face value is an insufficient form of inquiry.  

The other reason this is so funny is that the BLS basically just changed the scale of the ruler they use measure to measure employment. This one goes to 11... (If you don't recognize the reference, please add This Is Spinal Tap to your Netflix queue.).

Have a wonderful weekend. It's beautiful here in SF and I'm off to enjoy it with my husband and baby girl.


Friday, November 12, 2010

Don't blame accutane, the data sure as heck don't...

Before you make fun of me, "don't" in the title of this post is correct as the word "data" is the plural of "datum". Don't get me started on trying to figure out what, if anything, people mean when they use the phrase "data point". 

As hopefully now I have established, the purpose of this blog is to examine critically the ways in which statistics in the media are reported inaccurately (deliberately or out of ignorance) to the detriment of all of us. In today's Huffington Post, (I can feel a collective eye roll coming), via the Associated Press, we have a doozy of a headline.

"Acne Problems, Drug Treatments May Raise Suicide Risk

MARIA CHENG | 11/12/10 11:56 AM | AP"

A new study by Swedish researchers examined acne sufferers who took accutane (isotretinoin) to see if they had an increased incidence of suicide vs. the general population (remember increased incidence is NOT sufficient to imply causality).  They speculate (but DO NOT conclude) that it is not the drug, but rather the depression created form a painful and highly visible condition. The reason that they are required to speculate is that they could NOT reject the null hypothesis that there is "no relationship between suicide attempts and accutane." Rather than continuing to make a feeble conclusion that the data weren't (insert lame excuse here), they dealt honestly with the reality that until new evidence comes along, they cannot rely on the explanation that accutane wasn't more likely the CAUSE of any difference in the rate of suicide attempts between two populations than random chance.  The reason they couldn't was,
"Experts found the number of suicide attempts increased between about one and three years before the start of the treatment, though that increase was not statistically significant. The highest risk compared with the general population appeared to be within six months of the start of treatment. "

Since the headline is partially "Drug Treatments May Raise Suicide Risk", I have to wonder what gives? 
The author obtained a quote form another "expert." This doctor claims that all patients undergoing accutane therapy should be monitored for signs of depression. What we have here is one of the signs of propaganda I mentioned in an earlier post, "2.Is the writer supporting the claim with anecdotal quotes from someone unrelated to the research? This is key because the author needs someone else to say what the ethical and scientific method trained researcher won't because it's dishonest."

Really, what we see is a statistically insignificant difference wherein, 1 more person in 2,300 (2 people in 2,300 - which is the difference of 0.04% and 0.09%) may attempt suicide. Naturally this is something that one may take into consideration when deciding if drug therapy for acne is right for them. Perhaps, candidates for treatment may need to be screened for depression prior to and during treatment. But to assume that an otherwise happy, well-adjusted person with acne will double their risk of attempting suicide because they took an acne drug would be illogical and irrational.

One thing that I liked about the researchers was that rather than trying to defend the idea that the drugs WERE somehow linked to suicidal behavior, even though the data said otherwise, was that they actually considered other reasons why this sample may have had even a slightly higher incidence of depression. Turns out, having a painful and visible illness might be enough after all, without blaming "big pharma."

Who knows? The point is the headline is MISLEADING and in order to get to the headline, the writer needed another doctor to cough up a quote.  Watch for my next post about necessary and sufficient conditions and why we need both together in order to draw rational conclusions.

Thursday, November 11, 2010

So now babies born via C Section are less aggressive? How to spot a theory looking for a study.

Here we go again. C-section. Does she? Doesn't she? It's dangerous. It's necessary. A c section is surgery and has risks associated with it.  But here's a new study that's noteworthy because it "suggests" that children born by c section are less aggressive. 
Without further ado, here is the headline,

"Childhood aggression linked to stressful birth

Wed, Nov 3, 2010 (Reuters) — Babies who undergo a difficult birth and are delivered using forceps are more likely to develop problems such as aggression during childhood compared with those born by Caesarean section, according to a study in China."

Later in the article Reuters tells us that researchers believe that elevated levels of cortisol are somehow related to aggression in children. To be clear, we are hearing a lot about cortisol these days, it's being blamed for people's inability to lose weight, inflammatory disorders and strange hives.  The basic understanding is that cortisol is a hormone released by stress.  

So in this article, the idea is that "cortisol, a hormone the body produces during a stressful and difficult birth." So, by "stressing the baby with forceps or vacuum extraction, you're dooming your child to aggression and "psychopathology".  


Cortisol comes from stress. Excessive stress, elevates cortisol levels. Kids who have social problems between 4 and 6 have elevated levels of cortisol.  More of these kids were delivered with interventions; ergo interventions at delivery cause social problems by elevating cortisol SOOO MUCH that 4 years later, the kids can't recover.  Feels like a stretch. No chance these kids have other sources of stress? Did anyone check for other things that they might have in common? IS it possible that they already have social problems and that is driving stress and heightened levels of cortisol? (the tail wagging the dog, so to speak). Of course it is. BUT THAT DOESN"T SELL ADVERTISING!

So kids who have high cortisol levels are more likely to be antisocial between 4 and 6. 

Well, maybe, but then again, maybe not.

According to, the Mayo Clinic staff,
"When you encounter perceived threats — a large dog barks at you during your morning walk, for instance — your hypothalamus, a tiny region at the base of your brain, sets off an alarm system in your body. Through a combination of nerve and hormonal signals, this system prompts your adrenal glands, located atop your kidneys, to release a surge of hormones, including adrenaline and cortisol."

Could these children live in noisier households? Could these children have stressful home or school situations? Do we really want mothers to believe that if their baby is delivered via forceps or vacuum extraction, she will cause mental problems later in life? As if she doesn't have enough to worry about getting ready to give birth.
Interventions at birth happen because of emergencies; not because they are planned. So here goes Reuters trying to scare the heck out of mothers-to-be and is ALL OVER IT! 

Tuesday, November 9, 2010

And on to the breastfeeding propaganda machine - How to spot propaganda by asking 3 questions

"Breastfeeding won't rob mom of sleep, study shows 
Mon, Nov 8, 2010 (HealthDay News) — It's commonly believed that one of the sacrifices new moms must make in order to breastfeed is their sleep. But new research suggests that's just not the case."

The study had 80 women in it - TOTAL! The purpose of the study was to squelch the idea that women use lack of sleep to justify formula feeding. Since formula feeding is tantamount to poisoning your child in today's La Leche League AAP run world of child-rearing, lots of research that supports the claim that breastfeeding is a) easy and b) desirable gets funding. What gets funded gets researched. The study showed that in a population of 80 women, the ones who breastfed got the same amount of sleep as the formula feeding mothers (in the first 12 weeks). It doesn't speak to the quality of the sleep, the help that women are or are not getting from relatives/husbands, etc. It does not address whether or not the mothers had reported sleep issues in the past. In short, there were not nearly enough controls to make any claim here. The null hypothesis that there was no difference in the sleep of the two groups (and there was a mixed group to screw things up further) was not able to be rejected. THIS PROVES NOTHING. It also doesn't "prove" that the women were getting the same amount of sleep, it was just saying that based on the variables measured and the size of the population (note n=80!!!) no difference could be detected that couldn't be explained by randomness. So there you have it ladies, even though the baby will probably sleep longer if formula fed, you may have less anxiety because when breastfeeding doesn't come easy for you, you stress out and feel like a depressed failure, you can't say that it was making you more tired. WHO ARE THESE PEOPLE? 

This, ladies, is mind control and propaganda pure and simple. Before you claim that I am anti-breastfeeding, I'm not. I did it. It was hard, painful and exhausting. I didn't feel like my life was made better by the experience, rather I felt trapped and scared. I continued for the good of my child. The day I stopped feeding my daughter "nature's perfect food" was when the pediatrician told me to go out and buy baby vitamins because breast milk didn't have enough iron (or DHA or whatever).  All that and still I had to buy manufactured nutrients for her. This went straight into my "You've got to be F'in kidding me" file.
At least the researcher stated that lack of rest was a factor in PPD. Did anyone check to see how many feedings the women were doing? If they were doing 90% of the feedings, guess what? It's because they're not getting any help which is not a factor that can be addressed by the decision to breastfeed or not. And that my dears is why you haven't had more than two consecutive hours of sleep in four weeks.
"Shelby Harris is director of the behavioral sleep medicine program at the Sleep-Wake Disorders Center at Montefiore Medical Center in New York City. She said: "Breastfed babies do wake up a little bit faster because they metabolize the milk faster, and it's always been assumed that moms wake up more, too. And, a lot of women give up on breastfeeding because they think formula will help them sleep more."
To be clear, Shelby Harris WAS NOT one of the researchers. What is "a lot" anyway? Let's start with the fact that she works in a sleep disorder center. Her frame of reference are women who are seeking the help of professionals for their sleep troubles. Perhaps they decide against breastfeeding at a higher rate than the general population. The fact is that the quote is unrelated, anecdotal evidence that doesn't belong in the article in the first place (paid by the word, weren't we?).


1. Is the issue "fraught with controversy" and/or supported by special interest groups on either side pouring money into the research?

2. Is the writer supporting the claim with anecdotal quotes from someone unrelated to the research? This is key because the author needs someone else to say what the ethical and scientific method trained researcher won't because it's dishonest.

3. Does it have a prescriptive quality? Ladies, we ALL already "know" that breastfeeding is best, so now let's fund research to take away your reasons for not wanting to rather than funding research to get you some darn help already...

Friday, November 5, 2010

Vaccine Rate Falls Among the Educated - Irrational! Otherwise Smart People Listen to Jenny McCarthy?

"Kids' vaccination rate dropping among higher-income families

Wed, Nov 3, 2010 (HealthDay News) — Vaccination rates for children insured by commercial plans dropped almost four percentage points between 2008 and 2009, even though the rate of children on Medicaid getting vaccinated is rising."
I can't take this anymore. I recently spoke with a friend who has more than one Master's degree. She told me that the decision to vaccinate was "so hard on all of us new moms."
Not able to restrain my Spock-like rational brain, I replied, "No, it isn't."
The study that linked Autism and bowel problems associated with MMR had 12, count 'em 12 children in it. The children were chosen because they were suing the vaccine maker. 
So this year, my home state, California, has had more cases of Measles than it's had in the past decade by June. 
That's unacceptable. People are behaving irrationally DESPITE being educated about statistics and logic. I recently survived a "flame war" with a well meaning moron on's community who called me a "pharma troll" for stating that vaccines don't CAUSE Autism.  She said that I was being disrespectful of other people's beliefs and opinions. Well, that's just the thing, this isn't a matter of opinion or belief - it's factual information. Babycenter describes the "vaccine controversy" What controversy? Vaccines are a great success for public health.  Even that statistic abusing Dr. Sears (who is largely to blame for half of this insanity) says things like the side effects of the MMR vaccine are akin to having the diseases. WHAT? PEOPLE die from measles. They don't get measles from the shot nor does a cranky baby for one or two days resemble anything like a full blown case of measles. Enough is enough. 

12 kids does not a sample make. 12 kids that were in a lawsuit even worse. Jenny McCarthy still famous, time to start testing people for common sense...

Wednesday, November 3, 2010

Risk of bowel disease tied to antibiotics in infancy - (well no, not really)

This is the first post skewering the reporting of health-related news. is my favorite because they not only rely on poorly edited and written content from birth Reuters and HealthDay, they usually write an even more misleading headline to encourage parents to click from their "helpful" weekly emails that would scare the heck out of any loving parent. This reporting is a SHAM, a mockery and an insult to our collective intelligence.

Reuters Health has a great title here. "Risk of bowel disease tied to antibiotics in infancy". Except that the study that they're reporting on says nothing of the sort.

They story leads with, 
"Babies treated with antibiotics for middle-ear and other infections may have increased odds of developing inflammatory bowel disease later in childhood, a small study suggests."
So here's the concern, the headline and the article would lead the unsuspecting reader to question whether or not to put themselves and their infants out of their misery by treating a middle ear infection, lest the child develop inflammatory bowel disease, Chron's or Colitis. 

The study results and methodology as reported later in the article show nothing that would lead anyone with a background in the scientific method to believe any of this, but people become irrational where their children are concerned. (Case-in-point, I know that it is safer for my daughter and husband to fly home from Maui on an airplane than to drive to a shopping mall, yet I experience the emotion of fear more intensely when they are on an airplane. Luckily, I took statistics in high school, college and bschool and can calm myself (sort of) with the knowledge that they are actually safer than they would be on the 101 Freeway).
Even the researcher told the news outlet, 
"The design of the study does not, however, allow any conclusions about cause-and-effect, senior researcher Dr. Charles N. Bernstein, of the University of Manitoba in Winnipeg, told Reuters Health in an e-mail." 
I assume this email was after he heard that Reuters was about to link him with recommending letting a nine-month-old suffer needlessly from a  painful infection (and risk meningitis and hearing loss in EXTREME cases).
Reuters tells us this in PARAGRAPH 7. As if anyone reads that far down. It's "below the fold" on my computer monitor as well.  

Now, let's look at the study and what the study DID show 

A group of children with IBD, 36 children to be precise, who were an average age of 8 (between 1996 and 2008) had their medical records as infants examined to see if there were any things that they group had in common as infants. One common factor was that 58% of them had been treated by antibiotics at least once in the first year of life. The article does not report if they had anything else in common, (gender, family origin, diet, where they lived, what type of water they may or may not have ingested, relatives who also have IBD). it's likely that they had lots of things in common. Any one of these things may have occurred at rates higher than 58%.

Another group, children without IBD, 360 to be precise (10X the sample), 39% were treated with antibiotics.


Well, the difference between 58% and 39% was probably big enough to allow the team to continue investigating the rejection of the null hypothesis.
"Null hypothesis, what's that you say?" 

I'm so glad that you asked.  Since NOTHING can be proven in science, only disproved, we start with a statement that we wish to test. We can reject the statement if we can DISPROVE or REJECT it base on empirical evidence. According to the scientific method and logic, only in the realm of mathematics and logic can things be proven (think 1=1). Remember that when someone says, "It's a proven fact..." In your head, your BS alarm should immediately start ringing. 

An inquiry must begin by assuming that there is no relationship between two things that can't be explained by random chance. So, using whatever generally accepted test the researcher used, they are able to say that this difference in the rate of treatment may not be random and warrants further research (i.e. MONEY to pay for a bigger study).


Well, nothing really. So some already very sick children were treated with antibiotics as infants at a greater rate than an otherwise healthy group of kids. This should come as no surprise.  Many factors could explain this difference, perhaps these children were more prone to infections, perhaps they all lived in the same house, exposed to some crazy bacteria. Who knows? Reuters sure as heck doesn't (and if they do, they didn't show us that).  

But Reuters sold this content to who got me to click on it and can now sell advertising to make money because I looked at the BS article in the first place.


There isn't one. At least, there isn't a link that can explain how increased antibiotic use has ANYTHING WHATSOEVER TO DO WITH A CHILD DEVELOPING IBD. So young, nervous parents, please continue to save your child from the pain and risks associated with the actual ear infection.  Please note, that I am not suggesting the willy-nilly prescribing of antibiotics. However, if you want to not treat with antibiotics, this can't rationally be your reason.