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Your Toddler

Is Your Child a Biter?

2.00 to read

At some time or another your sweet child is going to bite or wallop someone, most likely another kid. And yes, it's embarrassing to have to pull your child off another or to apologize to grandma because her grandchild just took a chunk out of her arm. 

Know that you’re not alone - all kids bite and /or hit. The key to stopping aggression in children is teaching them that there are alternative ways to handle frustration and biting is not acceptable behavior.

Not all biting stems from anger. The younger the child, the less chance that biting is an aggressive behavior. It can also be a simple case of exploration. Young children bite for many reasons, from painful gums because they are teething to seeing what kind of reaction they get. Children between the ages of one and three typically go through a biting phase they eventually outgrow.

While biting may be a normal phase kids go through, it’s something you want to discourage.

Let’s look at some of the reasons kids bite.

  • They're in pain. When babies bite, typically it's because they're teething. They're just doing it to relieve the pain of their swollen, tender gums.
  • They're exploring their world. Very young children use their mouths to explore, just as they use their hands. Just about everything infants or toddlers pick up eventually winds up in their mouths. Kids this age aren't yet able to prevent themselves from biting the object of their interest.
  • They're looking for a reaction. Part of exploration is curiosity. Toddlers experiment to see what kind of reaction their actions will provoke. They'll bite down on a friend or sibling to hear the surprised exclamation, not realizing how painful the experience is for that person.
  • They're craving attention. In older kids, biting is just one of several bad behaviors used to get attention. When a child feels ignored, discipline is at least one way of getting noticed -- even if the attention is negative rather than positive.
  • They're frustrated. Biting, like hitting, is a way for some children to assert themselves when they're still too young to express feelings effectively through words. To your child, biting is a way to get back a favorite toy, tell you that he or she is unhappy, or let another child know that he or she wants to be left alone.

So, how do you prevent or teach your child that they can’t go through life biting others?

You start with consistent prevention and move on to discipline if they are older.

  • If your baby is teething, make sure to always have a cool teething ring or washcloth on hand so he or she will be less likely to sink teeth into someone's arm.
  • Avoid situations in which your child can get irritable enough to bite. Make sure that all of your child's needs -- including eating and naptime -- are taken care of before you go out to play. Bring along a snack to soothe your child if he or she gets cranky from being hungry.
  • As soon as your child is old enough, encourage your child to use words such as “I'm angry with you" or "That's my toy" instead of biting. Other ways to express frustration or anger include hugging (not hitting) a stuffed animal or punching a pillow. Sometimes redirection is helpful; shortening activities or giving your child a break can help prevent the rising frustration that can lead to biting and other bad behaviors.
  • Give your child enough of your time throughout the day (for example, by reading or playing together), so he or she doesn't bite just to get attention. Extra attention is especially important when your child is going through a major life change, such as a move or welcoming a baby sibling. If your child is prone to biting, keep an eye on any playmates and step in when an altercation appears to be brewing.

You’ve done all that is possible to prevent another biting situation, and low and behold your child is biting another. What do you do then?

When your child bites, firmly let your child know that this behavior is not acceptable by saying, "No. We don't bite!" Explain that biting hurts the other person. Then remove your child from the situation and give the child time to calm down. It’s important that you remain calm.

Seeing your child bite another is naturally going to create an unpleasant reaction in you. As soon as you witness a biting episode, your body tenses, your heart races, and even if you don't actually scream, you really want to. The angrier you are, the tenser the situation becomes. You are much more likely to strike your child when you let your anger get the best of you. Take a deep breath, assess the situation and intervene calmly. Remove your child, let him or her calm down and explain (yes, once again) that biting is not going to be tolerated. If your child is old enough to understand time-out, this is a good time to use it. If not, remove the child from the temptation. Playtime is over.

One way some parents handle biting is to bite their own child to show them how painful it can be. Doing what you are telling your child not to do sends a mixed message. It’s similar to hitting your child and then saying “don’t hit others.” Most likely your child will experience how painful it is because another child will bite them someday.

The point is not so much that biting is painful, the action itself is unkind, unproductive and wrong.

When biting becomes a habit or continues past the age 4 or 5, it may stem from a more serious emotional problem. This is the time to ask for help from your pediatrician, family doctor or a child psychologist.

If your child is bitten, wash the area with soap and water. If the bite is bleeding and the wound appears to be deep, call your child’s doctor. The bite may need medical treatment, which could include antibiotics or a tetanus shot or both.

Biting is a horrible habit to get into and a difficult one to stop. Start teaching your child early that momma and daddy are not putting up with it and that there are better ways to explore the world and handle frustration.

Source: http://www.webmd.com/parenting/guide/stop-children-from-biting

Your Child

Melatonin May Help Kids with Eczema Sleep Better

2:00

Eczema is a common skin disease that affects as many as 30 percent of all kids.  It’s an itchy red rash that often causes continuous scratching. Numerous children with eczema have trouble sleeping through the night. A new study suggests that over-the-counter melatonin may help them sleep longer and better.

These sleep problems can be difficult to treat in these children, said Dr. Yung-Sen Chang, an attending physician in pediatrics at Taipei City Hospital Renai Branch in Taiwan. Antihistamines can stop working after a few days, and tranquilizers have potentially serious side effects, Chang said.

But giving children melatonin, his study found, "is safe and effective for helping children with atopic dermatitis fall asleep faster."

The link between the skin condition and insufficient sleep "has an impact on people with eczema at all ages," said Dr. Lawrence Eichenfield, chief of pediatric and adolescent dermatology at the University of California, San Diego and Rady Children's Hospital.

According to Eichenfield, it's generally established that it’s the itching that keeps people with eczema from getting enough sleep. However, Chang said that may not be the case.

Chang and colleagues discovered that patients with eczema, that had difficulty sleeping, had low levels of nocturnal melatonin. That intrigued Chang and inspired the new study.

"Melatonin is a natural human hormone with minimal adverse effects," Chang said, "so it seemed like a good choice for children."

The study was small and involved 48 children, about 22 months to 18 years old, who had eczema. The children received treatment with either an inactive placebo or a 3-milligram daily dose of melatonin at bedtime for four weeks. Thirty-eight participants then took the alternate treatment (melatonin or placebo) for another four weeks.

When the children took melatonin, the severity of eczema dipped slightly, possibly because melatonin's anti-inflammatory effect improved the skin condition, Chang said.

Also, kids taking melatonin fell asleep about 21 minutes sooner than kids taking the placebo, the findings showed.

Total nightly sleep rose by 10 minutes on average (from 380 to 390 minutes, or 6.5 hours total) in the melatonin group, while it fell by 20 minutes among those who took a placebo, according to the report.

The participants did not report any side effects. Melatonin supplements are inexpensive in the U.S.- typically under 9 cents a pill from one major supplier.

Eichenfield, who wasn't involved in the research, said the study appears to be well-designed. Melatonin hasn't been studied much as a sleep treatment for kids, he cautioned.

While Eichenfield said melatonin may turn out to be helpful, he said there are a broad set of other tools available to treat eczema and minimize its effect on children. He suggested tackling the skin condition first to try to mitigate the sleep issues.

Chang recommended that parents talk to their child's doctor before starting melatonin. As for adults, melatonin may help them, too. But more studies are needed, Chang said.

The study was published in a November online edition of the journal JAMA Pediatrics.

Source: Randy Dotinga, http://www.webmd.com/children/news/20151124/melatonin-might-help-sleepless-kids-with-eczema-study-finds

 

Parenting

Recent Hurricane Disasters May Have Lasting Impact on Kids

2:15

Children may experience long lasting trauma from either living through or even viewing images of natural disasters such as hurricanes, Harvey and Irma, experts say.

"Compared to adults, children suffer more from exposure to disasters, including psychological, behavioral and physical problems, as well as difficulties learning in school," Jessica Dym Bartlett, a senior research scientist at Child Trends, said in that organization's news release.

It’s reasonable to think that children who have actually had to live through the devastation of being in a hurricane could be traumatized and suffer post-traumatic stress syndrome, (PTSD.) But child mental health experts say that even kids who have seen pictures of the damage and watched news reports can also be traumatized and may develop similar symptoms of PTSD such as depression and anxiety.

"Understand that trauma reactions vary widely. Children may regress, demand extra attention and think about their own needs before those of others -- natural responses that should not be met with anger or punishment," Dym Bartlett said.

To help children through this difficult time, parents should create a comforting and safe environment where their child’s basic needs are met. Keep to regular schedules and other routines that provide children with a sense of safety and predictability.

Children that stay busy are also less likely to have continuing negative thoughts; boredom can worsen adverse thoughts and behaviors. Youngsters are less likely to feel distress if they play and interact with others, Dym Bartlett noted.

Limiting your child’s exposure to the continuous images and descriptions of disasters coming from news reports is also helpful, but it’s not necessary to try and eliminate everything pertaining to catastrophes. It’s better to help children understand what has happened in age-appropriate language and to empathize hope and positivity. Reassurance that you are there for them and will do all that is humanly possible to protect them can ease some of the fear associated with disasters.

"Find age-appropriate ways for children to help. Even very young children benefit from being able to make a positive difference in others' lives while learning important lessons about empathy, compassion and gratitude," Dym Bartlett said.

If a child continues to have difficulties coping for longer than six weeks after an event, like the hurricanes, the National Child Traumatic Stress Network recommends seeking professional help.

Parents and caregivers should also make sure that they take care of their own emotional health during these trying and sad times.

Story source: Health Day News, https://www.upi.com/Health_News/2017/09/12/Hurricanes-may-take-lasting-emotional-toll-on-kids/4141505232381/?utm_source=sec&utm_campaign=sl&utm_medium=14

Your Baby

Teething May Make Your Baby Fussy, But Not Sick

2:00

Parents sometimes have trouble distinguishing between whether their cranky baby is actually ill or is just getting his or her first teeth. Because a baby’s gums may be tender and swollen as their teeth come in, a slight rise in temperature can occur.  Other changes may happen as well such as fussiness and increased drooling. All- in –all, babies can be pretty miserable till those first teeth break through.

That said, teething does not cause a full-fledged fever above 100.4 degrees Fahrenheit or any other signs of illness according to a new review led by Dr. Michele Bolan, of the Federal University of Santa Catarina, Brazil.

Certain symptoms can be confusing for parents says Dr. Minu George, interim chief of general pediatrics at Cohen Children's Medical Center, in New Hyde Park, N.Y.

"I get questions about this on a daily basis," said George, who was not involved in the study.

When a baby’s temperature reaches 100.4 degrees F or higher, it becomes an actual fever, not just a slight increase in temperature.

"Fevers are not a bad thing," she pointed out. "They're part of the body's response to infection." But, George added, parents should be aware that a fever is likely related to an illness.

Of course, new parents are going to be somewhat edgy when it comes to caring for their infant. It’s a new world of responsibility that can seem overwhelming at times. 

Pediatricians and family doctors regularly answer questions about this topic with an explanation of how a typical teething experience presents.

Over the ages, other symptoms have been linked to teething that should never apply. They include sores or blisters around the mouth, appetite loss and diarrhea that does not go away quickly. Any of these symptoms warrant a call to your pediatrician.

Babies differ in age as to when their teeth begin to come in.  Typically, the fist tooth begins to erupt around 6 months of age. It can also be as early as 3 months and as late as 1 year of age. There really isn’t a set age for teething to begin, just an average.

Baby’s teeth usually erupt through the gums in a certain order:

·      The two bottom front teeth (central incisors)

·      The four upper front teeth (central and lateral incisors)

·      The two lower lateral incisors

·      The first molars

·      The four canines (located on either side next to the upper and lower lateral incisors)

·      The remaining molars on either side of the existing line of teeth

By age 3, most children have all 20 of their primary teeth.

As for helping babies get through the misery of teething, George advised against medication, including topical gels and products that are labeled "natural" or "homeopathic."

Instead, she said, babies can find relief by chewing on a cooled teething ring or wet washcloth, or eating cool foods.

The analysis was published in the February online edition of the journal Pediatrics.

Sources: Amy Norton, http://www.webmd.com/parenting/baby/news/20160218/teething-makes-babies-cranky-but-not-sick-review

http://www.webmd.com/parenting/baby/tc/teething-topic-overview

Your Teen

More Teens Getting Tattoos and Piercings

2:00

To many a parent’s chagrin, tattoos and piercings have skyrocketed in popularity among teenagers. While mom and dad may not want to have a serious discussion about the pros and cons of getting a tattoo or body part pierced with their adolescent, the American Academy of Pediatrics (AAP) says pediatricians should be taking to their patients about the health risks and providing safety guidelines.

The AAP released its first report this week regarding tattooing and piercing for adolescents and young adults. The report discusses health risk issues from tattoos and piercings as well providing guidelines to talk to about important safety measures.

"Let's face it, kids are getting tattoos or piercings now," said Dr. Jay Greenspan, chairman of pediatrics at Nemours/A.I. Dupont Hospital for Children. "We know it's mainstream and we want the medical community to be a part of it."

It's unclear how many American teenagers have tattoos and piercings. The report cited a Pew Research Center study that said about 38 percent of young people ages 18 to 29 have at least one tattoo.

In some states, it’s illegal for someone to tattoo or body pierce a minor without the parent’s written consent. But we’re talking about teens here, and where there is a will; there is often a way found around any constraints.  That’s why Greenspan believes that an honest discussion is necessary.

Ten years ago, there was an association between tattoos and alcohol, drug use, violence, sexual activity, eating disorders and even suicide. But that's not the case anymore, the report said.

Today’s teens are more likely to associate tattoos and body piercings with celebrities and sports figures than with the seedier side of life.

Seventy-two percent of teens that have tattoos have them in places that can be covered, the report said. High-ear cartilage is one of the most common visible piercings, followed by navel, tongue and nipple and genital. 

While the rate of tattoo complications is unclear, the AAP believes it's likely low. Common tattoo complications can be inflammation, infections and neoplasms. Preexisting conditions like psoriasis, systemic lupus and sarcoidosis can lead to reactions.

Data on body piercing complications is also minimal. What is known is that teenagers who have a higher risk of infection, particularly those who are diabetic or taking blood thinning medication, may have a greater risk of complications when getting a piercing. 

For piercings, stainless steel posts and studs are recommended to avoid skin reactions. Cheaper products typically have lower quality materials that can lead to a reaction.

So, what do you do if your teen wants a tattoo on their arm or stud placed in their eyebrow? Once you’ve talked it through and if you decide that you’re ok with it, make sure to find a reputable parlor (there are many) and consult with your doctor beforehand to learn how to care for and what to expect during the healing process. Tattoos and body piercings may have become a trend that won’t go away, but they still involve needles and require that certain precautions be taken.

Story source: Meredith Newman, https://www.usatoday.com/story/news/nation-now/2017/09/20/young-people-tattoos-and-piercings-report/686360001/

 

Your Baby

Eating During Labor May Speed Up Delivery

1:45

In many hospitals, when a woman is in labor, all she is allowed to eat are a few ice chips. That rule may need updating, according to a new study that finds women who were allowed to eat before delivery had a slightly shorter labor than those who were restricted to ice chips or sips of water - although the study can't prove that eating caused deliveries to happen sooner.

The practice of limiting food during labor goes back a study in the 1940s in which women who delivered under general anesthesia were at risk of inhaling their stomach contents and choking in it, writes senior author, Dr. Vincenzo Berghella, of Thomas Jefferson University in Philadelphia, and his colleagues in Obstetrics and Gynecology.

“We really don’t know how much if anything people can eat or drink in labor," said Berghella,.

Whether women can have more than water or ice chips as they labor to give birth is a common discussion among healthcare providers, he told Reuters Health.

General anesthesia is not commonly used during delivery these days, but the old guidelines are still in use.

For the new study, the researchers compiled data from randomized controlled trials that compared the labor outcomes of women who were allowed to eat only ice chips or water and those who were allowed to eat or drink a bit more.

For example, one study allowed women to drink a mixture of honey and date syrup. Another study allowed all types of food and drinks. A few others allowed women to drink liquids with carbohydrates.

Overall, the researchers analyzed 10 trials that included 3,982 women in labor. All were only delivering one child - not twins or triplets - and were not at risk for cesarean delivery.

The women with the less restrictive diets were not at increased risk for other complications, including vomiting or choking, during the use of general anesthesia.

And women who were allowed to eat and drink more than the traditional ice chips and water had labors that were shorter, by an average of 16 minutes, compared to women with the more restrictive diets.

Speaking from experience, 16 minutes less of labor pains is a real bonus. How does adding more liquid or food during delivery help reduce the time before delivery? The researchers presented some ideas.

"If we’re well hydrated and have adequate carbohydrate in our body, our muscles work better," said Berghella. A woman's uterus is largely made of muscle.

Another of his studies, which found women who received more fluid than normal delivered faster than other women, reinforces the finding.

Berghella said it's still common practice for women with uncomplicated births to be restricted to water or ice chips during labor.

"The evidence from well-done studies is they can have more than that," he said.

Do women really want to eat much during labor? Probably not, there’s a lot going on in the body as labor progresses.  But more liquids and some light carbohydrates during the early part of labor may be welcomed – especially if they shorten the time between labor and when baby enters the world.

Story source: Andrew M. Seaman, http://www.reuters.com/article/us-health-pregnancy-labor-food-idUSKBN15O2ZR

 

Your Baby

Whooping Cough Shot During Pregnancy Protects Newborns

2:00

Whooping cough, also known as pertussis, typically affects babies younger than 6 months who haven’t received or aren’t old enough to receive the vaccine. It can cause such uncontrollable fits of coughing that it can be deadly for babies, who may stop breathing, have seizures, develop pneumonia, or suffer brain damage.

Since 2012, the U.S. Centers for Disease Control and Prevention (CDC) has recommended that pregnant women receive a vaccine called Tdap (tetanus, diphtheria, and pertussis), to prevent their newborn from getting the bacterial infection.

While the preventative measure is working to lower the numbers of infant whooping cough cases, only about half of mothers-to-be are opting to receive the vaccine, according to a new study.

Researchers from the CDC analyzed data from 2011 to 2014, from six states, on babies younger than 2 months. The investigators found that Tdap vaccination in the third trimester of pregnancy prevented 78 percent of whooping cough cases.

Among babies who developed whooping cough despite their mothers’ vaccination, 90 percent had mild cases and did not require hospitalization.

"Women have such a great opportunity to help protect their babies before they enter the world by getting the Tdap vaccine while pregnant," said Dr. Nancy Messonnier, director of CDC's National Center for Immunization and Respiratory Diseases. 

Babies cannot receive the vaccination before 2 months of age and infants younger than 1 year are at the highest risk for severe complications or death from whooping cough. Each year, five to 15 babies die from whooping cough in the United States. In most cases, these infants were too young to get their own shot, the CDC researchers said. So far this year, more than 11,000 cases have been reported.

Pertussis is highly contagious. The bacterium spreads from person to person through tiny drops of fluid from an infected person's nose or mouth. These may become airborne when the person sneezes, coughs, or laughs. Inhaling the drops or getting the drops on their hands and then touching their mouths or noses can then infect others.

"This study highlights how babies can benefit when their mothers get the vaccine, and reinforces CDC's recommendation for women to get Tdap vaccine in the third trimester of each pregnancy," Messonnier added in an agency news release.

Story sources: Marie McCullough, http://www.philly.com/philly/health/kids-families/study-whooping-cough-vaccination-during-pregnancy-protects-newborns-20170928.html

Robert Preidt, https://consumer.healthday.com/public-health-information-30/centers-for-disease-control-news-120/whooping-cough-shot-works-but-many-moms-to-be-skip-it-cdc-726985.html

Daily Dose

Homeopathic Medicine

1:30 to read

I am sitting here writing this while “sucking” on a honey-lemon throat lozenge and drinking hot tea…as it is certainly cough and cold season and unfortunately I woke up with a scratchy throat. I am trying to “pray” it away and drink enough tea to drown it out. While I am not sure it will work, drinking hot tea all day will not hurt you!

 

At the same time (multi-tasking) I am also reading an email from a mother with a 4 month old baby, and they are out of town. Her baby now has a fever and runny nose and she sent me a picture of a homeopathic product for “mucus and cold relief” and wonders if it is safe to give to her infant.  The short answer is NO…even though the product says BABY on the label and has a picture of an infant.

 

Although homeopathic medicines were first used in the 18th century and are “probably safe” it is still unclear if they really work. Unfortunately,  there have been adverse events and deaths associated with some products ( see articles on teething tablets). The principle of homeopathy is that “ailments can be cured by taking small amounts of products that, in large amounts, would cause the very symptom you are treating. In other words, “like cures like” as these products contain “natural ingredients” that cause the symptoms that you are trying to treat, but that have been so diluted as to hopefully stimulate your body’s immune system to fight that very symptom. In this case, congestion and runny nose due to a cold.

 

So…I looked at all of the ingredients which included Byronia, Euphrasia, Hepar and Natrum…to name a few. Byronia is used as a laxative for constipation, Euphrasia is supposed to help with inflammation, Hepar is for people who tend to get “cold and therefore cranky and irritable” and Natrum is used for inflammation due to “too much lactic acid”.  This is the short version. The bottle also says contains less than 0.1% alcohol, but it has alcohol! 

 

While the FDA does monitor how homeopathic medications are made, they do not require these companies to show proof that these medications do what they say they do, as they are “natural”.   With that being said, natural does not always mean effective or safe.  Just as over the counter cold and cough medications are not recommended for children under the age of 2, I too would not recommend homeopathic products be given to an infant.

 

Best treatment for a cold and cough in young children?  Use a saline nasal spray followed by nasal suctioning to relieve the nasal congestion and mucus. I would also use a cool mist humidifier in the baby’s room to keep moisture in the air and help thin the mucus ( especially once the heat is on in the house). Make sure the baby is still taking fluids (breast or bottle) but you may also add some electrolyte solution to give your baby extra fluids if you feel as if they are not eating as well.  Lastly, always watch for any respiratory distress or prolonged fever and check in with your pediatrician!

Your Child

Young Kids Still Being Injured or Killed in ATVs Accidents

2:30

Despite safety warnings from pediatricians and child health experts, children under 16 are still driving or riding as passengers on all-terrain vehicles.  The number of young kids being injured or killed in ATV accidents has not changed much in recent years, according to a new study.

Since 2000, the American Academy of Pediatrics (AAP) has recommended that ATV use be restricted to youth aged 16 years and older who wear helmets, don’t take passengers and steer clear of roads.

“Too many young children are driving these machines - equivalent to a motorcycle in many ways,” said senior study author Dr. William Hennrikus, medical director of the Pediatric Bone and Joint Clinic at Penn State College of Medicine in Hershey, Pennsylvania. 

“Children should not drive an ATV until they’re over 16, just like driving a motorcycle,” Hennrikus said by email to Reuters. “Helmets should always be worn, just like a motorcycle.”

For the study, researchers examined data on 1,912 patients under age 18 who were injured while using an ATV and treated at trauma centers in Pennsylvania from 2004 to 2014. 

During this period, 28 children died in ATV crashes, a mortality rate of roughly one per every 100,000 kids in the population, researchers calculated.

Fewer than half of the children were wearing helmets and a street or roadway was were 15% of the crashes happened. Rural areas tend to have more ATV crashes.

Being a passenger or being pulled by the ATV was a factor in almost one in four injuries, the study also found. 

Half of the kids involved in ATV crashes were 14 or younger, and about 6 percent were no more than 5 years old. 

Boys accounted for three in every four patients.

Limitations of the study include the possibility that researchers underestimated injuries and deaths because they only looked at trauma center patients, not children who were treated elsewhere or died before they ever reached a trauma center.

Experts agree that age isn’t the only factor parents should consider when letting their child drive an ATV.

“Parents need to think not just about their child’s size, but also their ability to think, to react to emergency situations and to maintain safe, cautious control of a very powerful vehicle,” said David Schwebel, a sports injury researcher at the University of Alabama at Birmingham who wasn’t involved in the study.

All across the country children are riding on or driving ATVs with sometimes-serious consequences. Just in the past few months a 12-year old boy from New York died from injuries in an ATV crash. A 15-year old boy in Illinois was killed and his passenger, his 12-year old sister, was seriously injured when he lost control of the ATV. A 14-year old boy was killed in New Jersey after losing control and crashing his ATV into another 14-year olds ATV; 2 other children were seriously injured from that crash. None of the children were wearing helmets or seatbelts. 

“Helmets absolutely have to be used for any ride, even short, apparently safe ones,” Schwebel said by email. “Passengers should never ride on ATVs unless the ATV is designed for more than one person.”

While ATVs can be dangerous for adults, they pose a much higher risk for children.

“Children are not developmentally capable of operating these heavy, complex machines,” Sandra Hassink, president of the AAP, said. “The American Academy of Pediatrics warns all parents that no child under the age of 16 should drive or ride an ATV.”

Story source: Lisa Rapaport, http://www.reuters.com/article/us-health-children-atv-injuries-idUSKBN1A422F

https://www.aap.org/en-us/about-the-aap/aap-press-room/pages/AAPCFAATVs.aspx

 

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