Baked custard was my childhood get-well dish. My mother made it for me when I was ill. As a disciple of the nutritional guru of the day, Adelle Davis, Mom put bigtime value on dishes that were rich in protein. She liked the primary ingredients, milk and eggs. She closed her eyes to sugar, an ingredient she usually eschewed, probably because she thought a treat might be the cure.

I love custard to this day. I like to top the chilled treat with fresh strawberries, although later in the summer I might substitute small wedges of stone fruit, such as apricots or plums.

Baked Custard with Strawberries

Yield: 6 servings

INGREDIENTS

2 1/2 cups milk

3 large eggs

1/2 cup granulated sugar

1/4 teaspoon salt

1 1/2 teaspoons vanilla extract

1 3/4 cups fresh strawberries, trimmed and cut into halves if small or quarters if large

1 to 2 tablespoons granulated sugar, depending on sweetness of berries

Optional garnish: Sprigs of fresh mint or peppermint

DIRECTIONS

1. Adjust oven rack to middle position. Preheat to 350 degrees.

2. Place milk in large, heavy-bottomed saucepan. Scald milk on medium-high heat. To scald means to heat below the boiling point. Remove from heat.

3. In large bowl, whisk milk, eggs, sugar, salt, and vanilla to combine. Whisking constantly, add hot milk little by little to egg mixture. If you add the hot milk too quickly, it might curdle THE eggs.

4.. Ladle mixture into 6 (1-cup) custard cups. Place cups in a 9-by-13-inch baking pan. Add enough hot water to the pan to come 1 inch up the sides of the cups. Place in oven and bake 40 minutes or until set; when pressed with a finger it should feel bouncy. Remove cups from water. Cool for 1 hour and refrigerate.

5. Meanwhile, place the strawberries in a bowl and sprinkle with sugar; gently toss and leave at room temperature for 20 to 30 minutes. Toss again; cover and refrigerate.

6. Serve chilled custard topped with strawberries, and if desired, sprigs of fresh mint.

Source: Adapted from “Melissa’s Everyday Cooking with Organic Produce” by Cathy Thomas (Wiley, $29.95)

Award-winning food writer Cathy Thomas has written three cookbooks, including “50 Best Plants on the Planet.” Follow her at @CathyThomas Cooks.com.

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Measles is on the rise in the United States. In the first quarter of this year, the number of cases was about 17 times what it was, on average, during the same period in each of the four years before, according to the Centers for Disease Control and Prevention. Half of the people infected— mainly children — have been hospitalized.

It’s going to get worse, largely because a growing number of parents are deciding not to get their children vaccinated against measles as well as diseases like polio and pertussis. Unvaccinated people, or those whose immunization status is unknown, account for 80% of the measles cases this year. Many parents have been influenced by a flood of misinformation spouted by politicians, podcast hosts, and influential figures on television and social media. These personalities repeat decades-old notions that erode confidence in the established science backing routine childhood vaccines. KFF Health News examined the rhetoric and explains why it’s misguided:

The No-Big-Deal Trope

A common distortion is that vaccines aren’t necessary because the diseases they prevent are not very dangerous, or too rare to be of concern. Cynics accuse public health officials and the media of fear-mongering about measles even as 19 states report cases.

For example, an article posted on the website of the National Vaccine Information Center — a regular source of vaccine misinformation — argued that a resurgence in concern about the disease “is ‘sky is falling’ hype.” It went on to call measles, mumps, chicken pox, and influenza “politically incorrect to get.”

Measles kills roughly 2 of every 1,000 children infected, according to the CDC. If that seems like a bearable risk, it’s worth pointing out that a far larger portion of children with measles will require hospitalization for pneumonia and other serious complications. For every 10 measles cases, one child with the disease develops an ear infection that can lead to permanent hearing loss. Another strange effect is that the measles virus can destroy a person’s existing immunity, meaning they’ll have a harder time recovering from influenza and other common ailments.

Measles vaccines have averted the deaths of about 94 million people, mainly children, over the past 50 years, according to an April analysis led by the World Health Organization. Together with immunizations against polio and other diseases, vaccines have saved an estimated 154 million lives globally.

Some skeptics argue that vaccine-preventable diseases are no longer a threat because they’ve become relatively rare in the U.S. (True — due to vaccination.) This reasoning led Florida’s surgeon general, Joseph Ladapo, to tell parents that they could send their unvaccinated children to school amid a measles outbreak in February. “You look at the headlines and you’d think the sky was falling,” Ladapo said on a News Nation newscast. “There’s a lot of immunity.”

As this lax attitude persuades parents to decline vaccination, the protective group immunity will drop, and outbreaks will grow larger and faster. A rapid measles outbreak hit an undervaccinated population in Samoa in 2019, killing 83 people within four months. A chronic lack of measles vaccination in the Democratic Republic of the Congo led to more than 5,600 people dying from the disease in massive outbreaks last year.

The ‘You Never Know’ Trope

Since the earliest days of vaccines, a contingent of the public has considered them bad because they’re unnatural, as compared with nature’s bounty of infections and plagues. “Bad” has been redefined over the decades. In the 1800s, vaccine skeptics claimed that smallpox vaccines caused people to sprout horns and behave like beasts. More recently, they blame vaccines for ailments ranging from attention-deficit/hyperactivity disorder to autism to immune system disruption. Studies don’t back the assertions. However, skeptics argue that their claims remain valid because vaccines haven’t been adequately tested.

In fact, vaccines are among the most studied medical interventions. Over the past century, massive studies and clinical trials have tested vaccines during their development and after their widespread use. More than 12,000 people took part in clinical trials of the most recent vaccine approved to prevent measles, mumps, and rubella. Such large numbers allow researchers to detect rare risks, which are a major concern because vaccines are given to millions of healthy people.

To assess long-term risks, researchers sift through reams of data for signals of harm. For example, a Danish group analyzed a database of more than 657,000 children and found that those who had been vaccinated against measles as babies were no more likely to later be diagnosed with autism than those who were not vaccinated. In another study, researchers analyzed records from 805,000 children born from 1990 through 2001 and found no evidence to back a concern that multiple vaccinations might impair children’s immune systems.

Nonetheless, people who push vaccine misinformation, like candidate Robert F. Kennedy Jr., dismiss massive, scientifically vetted studies. For example, Kennedy argues that clinical trials of new vaccines are unreliable because vaccinated kids aren’t compared with a placebo group that gets saline solution or another substance with no effect. Instead, many modern trials compare updated vaccines with older ones. That’s because it’s unethical to endanger children by giving them a sham vaccine when the protective effect of immunization is known. In a 1950s clinical trial of polio vaccines, 16 children in the placebo group died of polio and 34 were paralyzed, said Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia and author of a book on the first polio vaccine.

The Too-Much-Too-Soon Trope

Several bestselling vaccine books on Amazon promote the risky idea that parents should skip or delay their children’s vaccines. “All vaccines on the CDC’s schedule may not be right for all children at all times,” writes Paul Thomas in his bestselling book “The Vaccine-Friendly Plan.” He backs up this conviction by saying that children who have followed “my protocol are among the healthiest in the world.”

Since the book was published, Thomas’ medical license was temporarily suspended in Oregon and Washington. The Oregon Medical Board documented how Thomas persuaded parents to skip vaccines recommended by the CDC, and reported that he “reduced to tears” a mother who disagreed. Several children in his care came down with pertussis and rotavirus, diseases easily prevented by vaccines, wrote the board. Thomas recommended fish oil supplements and homeopathy to an unvaccinated child with a deep scalp laceration, rather than an emergency tetanus vaccine. The boy developed severe tetanus, landing in the hospital for nearly two months, where he required intubation, a tracheotomy, and a feeding tube to survive.

The vaccination schedule recommended by the CDC has been tailored to protect children at their most vulnerable points in life and minimize side effects. The combination measles, mumps, and rubella vaccine isn’t given for the first year of a baby’s life because antibodies temporarily passed on from their mother can interfere with the immune response. And because some babies don’t generate a strong response to that first dose, the CDC recommends a second one around the time a child enters kindergarten because measles and other viruses spread rapidly in group settings.

Delaying MMR doses much longer may be unwise because data suggests that children vaccinated at 10 or older have a higher chance of adverse reactions, such as a seizure or fatigue.

Around a dozen other vaccines have discrete timelines, with overlapping windows for the best response. Studies have shown that MMR vaccines may be given safely and effectively in combination with other vaccines.

’They Don’t Want You to Know’ Trope

Kennedy compares the Florida surgeon general to Galileo in the introduction to Ladapo’s new book on transcending fear in public health. Just as the Roman Catholic inquisition punished the renowned astronomer for promoting theories about the universe, Kennedy suggests that scientific institutions oppress dissenting voices on vaccines for nefarious reasons.

“The persecution of scientists and doctors who dare to challenge contemporary orthodoxies is not a new phenomenon,” Kennedy writes. His running mate, lawyer Nicole Shanahan, has campaigned on the idea that conversations about vaccine harms are censored and the CDC and other federal agencies hide data due to corporate influence.

Claims like “they don’t want you to know” aren’t new among the anti-vaccine set, even though the movement has long had an outsize voice. The most listened-to podcast in the U.S., “The Joe Rogan Experience,” regularly features guests who cast doubt on scientific consensus. Last year on the show, Kennedy repeated the debunked claim that vaccines cause autism.

Far from ignoring that concern, epidemiologists have taken it seriously. They have conducted more than a dozen studies searching for a link between vaccines and autism, and repeatedly found none. “We have conclusively disproven the theory that vaccines are connected to autism,” said Gideon Meyerowitz-Katz, an epidemiologist at the University of Wollongong in Australia. “So, the public health establishment tends to shut those conversations down quickly.”

Federal agencies are transparent about seizures, arm pain, and other reactions that vaccines can cause. And the government has a program to compensate individuals whose injuries are scientifically determined to result from them. Around 1 to 3.5 out of every million doses of the measles, mumps, and rubella vaccine can cause a life-threatening allergic reaction; a person’s lifetime risk of death by lightning is estimated to be as much as four times as high.

“The most convincing thing I can say is that my daughter has all her vaccines and that every pediatrician and public health person I know has vaccinated their kids,” Meyerowitz-Katz said. “No one would do that if they thought there were serious risks.”

_____

(KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs of KFF — the independent source for health policy research, polling and journalism.)

©2024 KFF Health News. Distributed by Tribune Content Agency, LLC.

Did you know babies can get depressed?

Andria Goss, associate vice president of clinical and community services at the Erikson Institute, a graduate school for social work, early childhood education and child development programs, said people are astonished when they learn and appreciate that fact.

“Babies experience everything as a bodily feeling: If a parent is stressed, depressed and/or anxious, the baby is picking up on that,” she said. “Imagine a mom who has her own stresses and sometimes she’s able to focus on her baby and other times there’s an interaction, she’s angry, or not attuned to the baby, not doing the stuff that engages the baby. They have this on-off, on-off repeatedly. The baby doesn’t know what to do with that because the baby is working hard to get smiles, elicit cooing and it’s not happening. At a certain point, with all those failed attempts, the baby stops trying … and withdraws.”

Goss said that although that’s an extreme example, it illustrates how babies pick up stressors from their environment and don’t know what to do with them. When such interactions become chronic, that can create challenges in the parent-child relationship.

The Erikson Institute’s Center for Children and Families offers in-person and online mental health services to children as young as newborns and their families in and around Chicago from its River North and Little Village locations, and has been doing so for decades.

The Erikson Institute lobby welcomes clients at the organization’s North LaSalle Street offices in Chicago, seen May 13, 2024. (Antonio Perez/Chicago Tribune)

According to the Centers for Disease Control and Prevention, 1 in 6 U.S. children ages 2 to 8 years has a diagnosed mental, behavioral or developmental disorder and among that group, boys are more likely than girls to have such a disorder.

“What we do at the Center for Children and Families is more a preventive measure,” Goss said. “The expectation is that babies are going to assimilate into my life. But that’s not their job. That’s our job (as adults and parents).”

When families and schools identify that something may not be working for a child, they get in touch with CCF, whose focus is relationship-based therapy. The center tries to connect the dots when there is a disconnect and a child is unable to regulate emotions and less able to explore and learn.

“When we’re looking at mental health and psychiatric difficulties, it’s a nature-nurture situation — we call it a vulnerability stress model,” said Sally Weinstein, licensed clinical psychologist and associate director at the University of Illinois Center on Depression and Resilience. “We all are born into this world with some biological vulnerabilities that we inherit. And these may interact with our environment in ways that are either protective for our development, or may be harmful for our development. It is that combination that affects development, even of young kids.”

The goal of therapy is to strengthen attunement — a person’s ability to be aware of and respond to a child’s needs — to strengthen the child’s and caregiver’s capacities, their relationship and how a caregiver is able to experience and parent the child.

“What you want for your baby, being attuned to where your baby is and what he/she needs? We’re unpacking those types of things,” Goss said.

CCF gets to the heart of that through play. Licensed clinical social worker and CCF Director Sara Phou said the bulk of the families they serve have children age 3 to 6 who get 18 months of therapy. The center connects caregivers with therapists to glean the challenges in the caregiver-child relationship prior to the child being brought in. When the child comes to a CCF location, therapists observe the child playing with their caregiver as a clinician takes note of how play is unfolding, the themes, the feelings involved.

Center for Children and Families Director Sara Phou, seen in a therapy room at the Erikson Institute in Chicago on May 13, 2024, said the bulk of the families they serve have children aged 3 to 6. (Antonio Perez/Chicago Tribune)

“(Children) use play to develop, to understand the world, but also as a way to help share how they’re thinking and feeling,” Phou said.

If, for instance, a child plays with cars and races through a city knocking down blocks featuring a good guy and a bad guy, the child may be trying to make sense of good and bad in the world. “We can join them in their play, and help the car be regulated,” Phou said. “Using play as an extension of themselves and working through it there might provide a port of entry, a way for them to internalize it.”

Every behavior is a communication, Goss said. “We try to pull insight into what the kid is struggling with,” she said. “We want to evaluate cognitive skills, motor skills, social and emotional skills … it’s not a one size fits all.”

Goss said the center meets families where they are and works with them from perspectives that consider race, culture and their environment. By following their child’s lead and putting in the work in therapy, caregivers enable change in their child’s life.

Engaging in therapy aids caregivers in regulating themselves so they can help regulate their child. And caregivers and parents feel more confident in understanding what’s happening with their child. Once family units feel empowered, parents can feel a sense of efficacy, and feel like whatever happens, they can deal with it.

“Play is so important for development. … It’s that power of connection for the little one around who they are, you want to connect with them around something that is of value to them,” Phou said. “There’s research around 10 minutes a day: If you follow your child’s lead and play with them for 10 minutes a day, that is all they need to build that connection. … That is going to be a huge protective factor for their mental health.”

Weinstein agrees that the short amount of time can help children build trust with parents and help parents build confidence and competence. Phou said 10 minutes of daily play can be more beneficial than hours of planned family time every couple of months.

“Finding moments where there’s joy and delight, in who they are, and it feels good for both of you, is going to help the relationship and help that connection,” Phou said.

But how does a parent know when an issue escalates to something that needs intervention, especially when there’s such a broad range in how kids develop and so many symptoms of mental health difficulties that resemble what normal childhood looks like: mood variability, big emotions, irritability, all which can be part of a child’s experience?

Weinstein said parents should be looking for any sort of disruption or deviation from typical milestones, like toilet training, talking and walking, and keep in mind feedback from those around your child such as preschool teachers or day care staffers who may notice if your child is struggling.

“While kids brains are changing so much and that’s why they are having these big emotions and having a hard time regulating emotions, the great news is that the brain is still developing and very malleable,” Weinstein said. “So the more intervention, love and support, the more we can modify some of the difficulties.”

Early in the pandemic, Weinstein and Goss both noticed an uptick in referrals for mental health help and youths reaching out to access support themselves without their parents’ urging. The shift shows a growing acceptance of therapy, they said.

“When there’s a challenge around mental health for a young child, the treatment isn’t just for the child,” Phou said. “We’re working with both the caregiver and the child together and supporting that caregiver to help them think about what they might be bringing to the equation and how they can support their child and what their child is bringing to the equation.”

Goss added that can be challenging because caregivers have to look at themselves in relation to their child and how they are engaging and connecting in order to effect change.

For first-time parents, who may face sleep deprivation, burnout or a lack of feeling effective, Weinstein said their mental health is key. She suggests parents consider getting support by talking with other new parents or with their pediatrician. Since parents are the experts on their children, they are also the first line of defense when it comes to intervention.

“There are no hard and fast rules, even if a teacher says I see your child is struggling, that is not a reason to panic, but always a reason to seek out and gain support and more understanding about ways you could help your child,” Weinstein said.