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Your Teen

AAP Supports Condoms for Teens

2.00 to read

While teens should be encouraged to abstain from sex, not all adolescents will follow that advise.  The American Academy of Pediatricians (AAP) would like to see free or low-cost condoms made available for teenagers, along with sex education programs, in schools.

Research has shown that easy accessibility to condoms and sex-ed classes does not increase sexual activity in teens, but there is still resistance by some to providing teens those options, said researchers. 

"I think one of the main issues is the idea that if you provide condoms and make them accessible, kids will be more likely to have sex. But really, that's not the case," Amy Bleakley said.

"Getting over the perception that giving condoms out will make kids have sex is a real barrier for parents and school administrators," she told Reuters Health.

Bleakley studies teen sexual behavior and reproductive health at the University of Pennsylvania in Philadelphia but wasn't part of the AAP committee.

Bleakley also noted that there are some studies that show that when teens have access to condoms and comprehensive sex education classes, those teens actually wait longer to start having sex than peers who don’t.

According to the Centers for Disease Control and Prevention (CDC), teen pregnancies are down in the U.S. In 2011, there were 31 births for every 1,000 U.S. women aged 15 to 19. In 2012, there were 29 births per 1,000 teens.

While the decrease in teens having babies is an improvement, that number is still higher than in other developed countries.

Rates of many sexually transmitted infections (STIs), including Chlamydia and gonorrhea, are highest among teenage and young adult women.

The new policy statement, an update to the AAP's 2001 statement on condom use by adolescents, was recently published in the journal Pediatrics.

"The biggest difference is that we have more evidence about how effective they are against sexually transmitted infections," Dr. Rebecca O'Brien, the policy statement's lead author, said.

That's especially true for viruses like herpes and HIV, she added.

Are condoms 100 percent effective in preventing pregnancy? No, the committee said. Even when used exactly as they are supposed to be, 2 percent of condoms will fail when used all the time-every time- over a year. In reality, the failure rate is about 18 percent during a year of typical use, the committee said.

Using condoms along with another birth control method, such as the Pill or an intrauterine device, may be the best way to prevent pregnancy and STIs.

In its recommendations, the committee said doctors should support consistent and correct use of condoms. They should also encourage parents to discuss condom use and prevention of STIs with their adolescent children.

Still, the committee said, abstinence should be encouraged as the best way to prevent STIs and unintended pregnancy.

Bleakley echoed the importance of communication between parents and teenagers.

"Parents really need to be proactive about communicating with their adolescents before their kids engage in sexual activity," she said.

"Really parents who talk to their kids about sexuality, about contraception, about condoms - their kids have much better outcomes," like fewer unintended pregnancies, Bleakley said.

If you’re not sure when to begin discussing sexuality with your child, talk to your pediatrician. It’s probably a lot earlier than you think.

Source: Genevra Pittman, http://www.reuters.com/article/2013/10/28/us-teens-condoms-idUSBRE99R03N20131028

 

Daily Dose

The Questions About Fever Continue

Back in the office and boy is it busy. It is going to be like this for a long time and frantic phone calls and office visits regarding fever continue.Back in the office today and boy is it busy. It seems like this has been going on a while with frantic phone calls and office visits. Many many of the questions are about fever.  You've heard me say before "fever is our friend".

I am a firm believer that the more information a parent has the easier it is to make good decisions about the care of their child. This is true for fever fears too. So, here is more information beginning with the fact that you do not have to take your child to the pediatrician or ER every time your child has a fever. Now, that is not to say that there are not times that you NEED to call the doctor’s office. But, fever in and of itself, in a child who is two years or older, who does not have an underlying chronic disease, and has classic symptoms of a “flu-like” illness, with headache, sore throat, cough and general “feels bad” does not require an immediate phone call to the doctor or an office visit. It does mean that you need to treat your child’s fever (NO ASPIRIN) to make them more comfortable, and make sure that they are hydrated and keep them home until they have been fever free for at least 24 hours. That also means no fever off of all medications like acetaminophen and ibuprofen. Masking a fever with medications does not count. Watching Elmo or Disney for a few days while recovering is never bad for anyone. This is the one time to let them be couch potatoes. Kids will always feel worse when their fever is higher, and better when it comes down with fever reducers. Being able to play with toys, play on the computer, Nintendo and Wii are all signs that your child is handling the virus and that they are not terribly sick. You should be watching for that, and be reassured, that is a good sign. Campbell’s chicken noodle soup should see record sales this fall and all of those other comfort foods like popsicles and smoothies sound good to those with a fever. Children usually do not want a full meal when they are feeling badly and neither will you if you are unlucky to also fall ill. Just push fluids and as your child feels better their appetite will return. What to watch for! #1: Any signs of breathing difficulty, or color change in your child, but remember too that your chest can feel tight with the flu, without having respiratory distress. Take off their t-shirt or pajama top and really look at their chest to see if you see any difficulty breathing. Turn the light on if you are worried and look at their coloring. Fever also makes you breathe faster, so treat their fever and watch their respiratory rate as the fever comes down. A child playing a video game is usually not in respiratory distress (note from office visit today), and will be better off at home on the couch than waiting in an office full of more sick people. #2: Any child who has a rebound fever is worrisome. That means they have the typical two to four days of fever, power through it and then several days later develop fever again. Those children should all be seen to rule out secondary infection. #3: Children with prolonged fever, who seem to be worsening rather than getting better. #4: Children with underlying chronic diseases need to be seen sooner rather than later (or at least warrant a phone call to discuss with their physician). These are some guidelines to help reassure you that you are doing all of the right things at home. You can expect your child to be out of daycare or school for three to five days, minimum, so stock up with movies and cards and pretend that you are “snowed in”. Luckily the children we have been seeing thus far have not been too ill. I work in a pediatric office with 12 doctors, in a very busy practice, and we have not had one child hospitalized or even come back because they were getting sicker. We can only hope that this will be the case for the rest of this year. Keep up the hand washing and go get those regular flu vaccines. That’s your daily dose, we’ll chat again tomorrow. Send your question to Dr. Sue!

Daily Dose

Waiting for the Doctor

1:30 to read

I just read a really good article from The Huffington Post that was written by a young woman from the UK.  She was discussing the issue of waiting for a doctor. She herself had been waiting for her doctor when she noticed another patient who was being very loud and quite verbal about waiting. He engaged her in conversation and said, “I bet that doctor is back there having a cup of tea”. He must have been stunned when she replied, “well, I certainly hope so”.  She knew that the doctors had recently seen her as an emergency when she began bleeding during her pregnancy. She knew that they had dropped everything to attend to her and her unborn baby and for that she was eternally grateful.  

I also “hate to wait” when I am seeing my own doctor, but I do know that he or she is not “back there eating bon-bons".  I also know that many patients have waited for me, sometimes for up to an hour.  I promise you that I know that I am running late and it makes me very anxious. But at the same time, I am doing the best that I can to treat each and every patient as if they were my own child or family member.  Sometimes a patient comes in with a more complicated or urgent problem and the time taken with that patient is much longer than was expected. Or, a child arrives wheezing and in respiratory distress without even having an appointment….they to will be “worked on” in front of everyone else…as they need a doctor immediately. 

The article continued to re-count how many times during her pregnancy that she had needed to be seen as she continued to have issues with bleeding, and each and every time, the doctors were there, no wait and no questions….they just did their job.

It is difficult to explain why doctors run late and I understand how patients are frustrated when they wait. But at the same time, how do you schedule the appropriate amount of time for a patient who calls for an appointment because their child is sick with a fever and a sore throat. But, while you are seeing their child they break down in your exam room and tell you that they have found out that their husband is “cheating on them” and that “he wants a divorce”.  As their pediatrician, do you tell them that you don’t “have the time” to listen to their problems. Do you just deal with their child’s sore throat and ignore the mother’s anguish. In my case, I choose to spend time with the mother, to empathize with her, and hope to help her.  I know that this reaction will make me late….but it is what I need and want to do for my patients and families.

Whenever I am talking to prospective patients I am perfectly honest when they ask me, “will I ever have to wait?”.  My response has changed over the years as I have come to realize that there will be times when they do wait….but it is not because I ever want to “run late” or make my patients wait. It is because, I have decided that my practice has just as many flaws as my parenting, not perfect. But similar to my children, at times one will need me more than another, and when they do I will spend more time with the one that needs me the most.  It may not seem “fair”, but how do you make it always be “fair”?  I hope that at the end of the 23-25 years I spend with these families they come to realize…it all evens out in the end…there are times that I spent too much time with them and then there are times that they waited.  But, just like parenting, you do the best that you can.  I will continue to practice that way as well. I promise, if you are waiting I am not having tea and bon-bons!!!   

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DR SUE'S DAILY DOSE

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