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Parenting

HPV Vaccine: Fewer Doses Recommended for Preteens

1:30

Based on recent studies, the Centers for Disease Control and Prevention (CDC), is recommending that children 11 to 14 years old receive only two doses of the HPV vaccine instead of three.

The vaccine protects against cervical and other cancers caused by the human papillomavirus (HPV).

However, the CDC says that teenagers and young adults who start the vaccinations later, between at ages 15 to 26, should continue with the three doses.

The new advice is based on a review of studies showing that two doses in the younger group “produced an immune response similar or higher than the response in young adults (aged 16 to 26 years) who received three doses,” the C.D.C. said in a statement. The two doses should be given at least six months apart, the agency said.

The government agency noted that the two-dose schedule should make the process easier for families and hopefully will increase the number of preteens getting the vaccine.  So far, despite the vaccine’s proven effectiveness, immunization rates have remained low.

HPV is a group of more than 150 related viruses, according to the disease centers. They are spread by intimate, skin-to-skin contact, and by vaginal, oral and anal intercourse. HPV is so common that nearly all sexually active people become infected at some point. In most people, the immune system destroys the virus. But in some, the infection lingers. Some viral strains cause genital warts, and others can cause cancers of the cervix, vagina, vulva, penis and back of the throat.

The vaccine is recommended for preteens and young teenagers, ideally before they become sexually active, because it works best if given before a person is exposed to HPV.

The CDC still recommends vaccination for young people who have already had sex, saying that it should provide “at least some protection.”

HPV vaccination rates are slowly rising for boys and girls as parents begin to understand the health benefits for their children. Many pediatricians are now recommending the vaccine as a regular part of a child’s inoculation routine.

Story source: Denise Grady, http://www.nytimes.com/2016/10/20/health/children-14-or-under-need-fewer-hpv-vaccine-doses.html

Your Child

Are Hand Sanitizers Are Making Kids Sick?

2:00

Hand sanitizer is available just about everywhere you go, especially during the flu and cold season.  I’ve used it myself to wipe down grocery cart handles and while visiting friends and family members in the hospital. Schools have also become very conscientious about spreading germs and many have sanitizer dispensers in classrooms and halls. Lots of families make sure that sanitizers are available in the home to help keep bacteria and viruses at bay.

While gel hand sanitizers are convenient, they are also contributing to a rise in kids getting sick after ingesting the products, according to a new government report.

The U.S. Centers for Disease Control and Prevention (CDC) researchers tracked illnesses from 2011 to 2014 for children aged 12 and under. The investigators believe some kids in the higher age range may be drinking sanitizers because of the products' high alcohol content.

"Older children [aged 6-12 years] were more likely to report intentional ingestion and to have adverse health effects and worse outcomes than were younger children, suggesting that older children might be deliberately misusing or abusing alcohol hand sanitizers," wrote the team led by Dr. Cynthia Santos, of the CDC's National Center for Environmental Health.

Typical hand sanitizers contain 60 to 90 percent ethanol or isopropyl alcohol, as well as scents that children might find appealing.

"Recent reports have identified serious consequences" with ingesting hand sanitizers, the CDC team said. These include breathing difficulties, excessive acid buildup in tissues, and even coma.

So, what’s going on with kids and hand sanitizers? The researchers said that answer might depend on the age of the child. Most of these exposures may have been accidental, with 91 percent occurring in kids, aged 5 and under. But about 6,200 incidents affected kids aged 6 to 12, and these have a much higher odds of being intentional ingestions, the research showed.

Santos noted that ingestion of alcohol sanitizers was also associated with worse symptoms in kids.

While vomiting and eye irritation were the most common symptoms, much more serious events were also recorded, including five cases of coma and three cases involving seizures, Santos' group said.

What’s influencing this change? According to the CDC team, in recent years many schools have installed gel hand sanitizer dispensers, or requested that children bring their own hand sanitizer gels to school.

Santos' group pointed to "a study examining Texas poison center data from 2000 to 2011 [that] found that, among 385 adolescents who ingested hand sanitizer, 35 percent of ingestions occurred at school.

The CDC team noted that "hand washing with soap and water is the recommended method of hand hygiene in non-health care settings" such as the home and school. Hand washing is a safe, effective germ-killer, they said, without the risks to children that can come with hand sanitizers.

If hand sanitizers must be used, the researchers said adult supervision and proper storage -- away from children's reach when not in use -- could help lower poisoning risks.

Hand sanitizers play a role in making sure that germs aren’t spread or for a quick cleanup when water and soap aren’t available, but as with most chemicals, they need to be kept out of the mouths of young children. Older kids may not understand the dangers of ingesting products with alcohol listed as an ingredient. What may seem like a lark could put them in a coma. A discussion about drinking alcohol and the facts about the different types of alcohol – such as ethanol or isopropyl alcohol – may save them from a trip to the ER.

The report was published in the CDC journal Morbidity and Mortality.

Story source: E.J. Mundell, https://consumer.healthday.com/public-health-information-30/poisons-health-news-537/rising-number-of-kids-ill-from-drinking-hand-sanitizers-cdc-720300.html

 

 

Your Child

Sweet Potatoes May Help Prevent Diarrhea in Children

1:45

Orange sweet potatoes get high approval ratings from many pediatricians and family doctors because they offer a lot of health benefits and they taste good, so kids are more likely to eat them.

Recent research suggests they may also be helpful in reducing the cases of diarrhea in some young children by more than 50 percent.

Erick Boy, head of nutrition at HarvestPlus, said that the body converts the beta-carotene in the sweet potatoes to vitamin A the same day the food is eaten. That vitamin A is then used in the outer lining of the human gut, forming a barrier against different types of bacteria. Boy further explained that the gut uses surplus vitamin A from time to time to replace worn-out cells with healthy ones.

The researchers claimed that if a child below age 5 has consumed orange sweet potatoes in the past week, then the chances were 42 percent less that child would suffer from diarrhea. In children below age 3, the likelihood of developing the condition reduced by 52 percent.

Regular consumption of orange sweet potatoes also helps decrease the duration of diarrhea, the researchers claimed. The team observed that the duration was reduced by 10 percent among 5-year-olds and 25 percent in 3-year-olds.

This could be extremely helpful in countries like Africa, where 40 percent of the children are vitamin A deficient. This increases their risk of diseases such as diarrhea, which is one of the leading causes of mortality in children, taking more than 350,000 lives of children under five in Africa every year.

Vitamin A deficiency is rare n America, however, diarrhea in U.S. children is fairly common; typically related to viral infections or tainted food sources.

Sweet potatoes are easy to prepare and can be baked as fries or tater-tots, veggie muffins, made into soup, and mashed like regular potatoes. Many kids like their orange color and sweet taste. Besides being high in vitamin A, they contain vitamin B5, B6, thiamin, niacin, and riboflavin and are high in carotenoids. They are lower in calories than white potatoes – but a little higher in sugar.

For as sweet as they are, sweet potatoes have a low glycemic index (which means they release sugar slowly into the bloodstream).

The study was published in the journal World Development.

Sources: Guneet Bhatia,  http://www.universityherald.com/articles/20051/20150615/sweet-potatoes-may-reduce-diarrhea-in-children.htm#ixzz3djHgM93e

 

 

 

Your Teen

FDA Proposes Ban on Tanning Beds for Minors

1:30

When warm summer days give way to cold gray skies, tanning beds can become the go-to alternative for a continuous tan. A 2014 study found that 59% of college students and 17% of teens use indoor tanning beds and a 2011 study reported that 32% of 12th graders had used a tanning bed.

Researchers have also found that people who use tanning devices before age 20 were twice as likely to develop a form of skin cancer called basal cell carcinoma by age 50, than those who had never used a tanning bed. Tanning beds are known to contribute to other skin cancers as well, including melanoma, the deadliest form of the disease.

Several studies from Europe have suggested that the radiation from a tanning bed can be up to 15 times more intense than the radiation from the midday sun.

After years of studies, the U.S. Food And Drug Administration (FDA) is proposing a ban on tanning beds for people under the age of 18, along with new preventive measures that reduce the risks from tanning to adults.

Using tanning beds at a young age can be particularly harmful, according to a statement from the FDA. The effects of UV radiation exposure add up over a lifetime, so exposure in children and teenagers puts them at greater risk for skin and eye damage later in life, according to the statement.

How many minors are using tanning beds? According to a 2013 National Youth Risk Behavior Study, about 1.6 million adolescents.

The "action is intended to help protect young people from a known and preventable cause of skin cancer and other harms," Dr. Stephen Ostroff, the acting FDA commissioner, said in the statement.

The American Academy of Pediatrics responded to the FDA's proposal with a statement of support.

"The FDA's action today is part of ensuring a safe environment for every child and adolescent, and sends a loud and clear message: Tanning beds are dangerous and should not be used by anyone under age 18," said the academy. "Pediatricians welcome FDA's action and will continue to urge parents and our young patients to protect their skin from ultraviolet radiation and to avoid tanning beds altogether."

In addition to restricting minors, the FDA is proposing that before a person's first tanning bed session and every six months thereafter, they sign a "risk acknowledge certification" that states they have been informed of the health risks that may result from indoor tanning. The hope is that people will think twice about using a tanning bed of they are reminded and have to sign off on the health dangers.

The FDA is also proposing a second rule that would require sunlamp manufacturers and tanning facilities take extra steps to improve the overall safety of the devices. Some of the proposed measures would include making warnings more prominent on the devices, requiring an emergency off switch or "panic button" and improving eye safety equipment, according to the statement.

"The FDA understands that some adults may continue to use [tanning beds]," Ostroff said in the statement. "These proposed rules are meant to help adults make their decisions based on truthful information," he said.

The new proposed rules are available for public comment for 90 days. The rules were recommended on December 21, 2015.  To comment you can log onto http://www.fda.gov/forconsumers/consumerupdates/ucm350790.htm#Proposed

Source: Sara G. Miller, http://www.livescience.com/53159-fda-proposes-tanning-bed-restrictions.html

 

 

 

 

Your Child

Why the HPV Vaccine is Important for Girls and Boys

1:45

The human papillomavirus (HPV) vaccine has been embroiled in controversy almost from the day it was announced.  Many parents found the idea of giving their young daughter or son a vaccine to prevent a sexually transmitted disease (STD) repugnant. When some states included the vaccine as a requirement for school entry, the cry of government overreach rang out loud and clear.

However, as more information about the benefits of the vaccine becomes known, vaccinations have slowly been climbing.  Health officials say that compliance is nowhere near what it should be and that the opportunity to reduce 6 cancers is being lost.

Cancers linked to the sexually transmitted HPV keep rising in the United States, even though most cases are preventable, health officials said in a recent report.

Cancer experts say the public perception of the vaccine needs to change.

"In order to increase HPV vaccination rates, we must change the perception of the HPV vaccine from something that prevents a sexually transmitted disease to a vaccine that prevents cancer," said Electra Paskett. She is co-director of the Cancer Control Research Program at the Ohio State University Comprehensive Cancer in Columbus.

"Every parent should ask the question: If there was a vaccine I could give my child that would prevent them from developing six different cancers, would I give it to them? The answer would be a resounding yes -- and we would have a dramatic decrease in HPV-related cancers across the globe," Paskett added.

At current rates, these sexually linked cancers are developing in almost 12 of every 100,000 persons, the CDC said. In the previous five-year period, fewer than 33,500 of these HPV-linked cancers were diagnosed annually.

Using data from national cancer registries, CDC analysts looked for certain cancer types -- cervical, head and neck, and anal, among them -- that have links to HPV.

When looked at closely, researchers confirmed the HPV connection in 79 percent of cases.

The agency estimates that as many as 28,500 of these were preventable with recommended HPV vaccination.

The American Academy of Pediatrics recommends routine HPV vaccination of males and females at 11-12 years of age. The vaccine is most effective if administered before the onset of sexual activity, and antibody responses to the vaccine are highest at ages 9 through 15 years. Immunization of children against HPV infection will help prevent cancers and genital warts caused by HPV.

Even though no parent likes to think about their child growing up and being sexually active- most children will become young adults and eventually have families of their own. This vaccine protects against HPV, a disease that is strongly linked to 6 deadly cancers. It is most effective when administered to children between the ages of 9 and 15. That is why it is important for young boy and girls – as simple as that.

Story sources: Margaret Farley Steele, http://www.webmd.com/cancer/news/20160707/hpv-linked-cancers-still-climbing-in-us

https://www.aap.org/

Your Baby

AAP: No Fruit Juice for Children Under 1 Years-Old

1:45

Kids under the age of 1 should avoid fruit juice, older kids should drink it only sparingly and all children should focus, instead, on eating whole fruit, according to the American Academy of Pediatrics.

A 2006 AAP policy recommended no juice for children younger than 6 months of age, 4-6 ounces daily for children ages 1-6 years and 8-12 ounces for children 7 and older. Since then, however, considerable concern has been expressed about increasing obesity rates and risks for dental decay.

The new policy advices against giving children under the age of 1 any fruit juice at all unless there is a strong clinical basis for it in the management of constipation. For older children, maximum daily intakes of 100% juice products should be 4 ounces for children ages 1-3 years, 4-6 ounces for children ages 4-6 years and 8 ounces for those 7 and older.

When juice is served to older toddlers, it is important that it not be sipped throughout the day or used to calm an upset child. 

Instead of juices, the AAP recommends fresh fruit in children’s diets. Fruit generally contains additional fiber compared to juices. Consistent with recent AAP recommendations, water and cow’s milk are preferred as primary fluid sources after breastfeeding or formula ceases.

The policy clarifies that there is no reason to give juice during the first year of life and that expensive juice products marketed specifically for infants have no value.

The guidelines also strongly discourage unpasteurized juice products, which can carry pathogens such as E. coli.

As far as which juice is better for kids, the AAP does not favor one juice over the other, but does recommend 100 % fruit juice and not fruit drinks – which contain less than 100 % juice and have added sweeteners.

"Some juices naturally have certain vitamins or minerals in them," Abrams said, noting that orange juice has lots of vitamin C. "But that doesn't mean that apple juice doesn't provide vitamin C, because it's usually fortified."

Story sources: Steven A. Abrams, M.D., FAAP, http://www.aappublications.org/news/2017/05/22/FruitJuice052217

Katherine Hobson, http://www.npr.org/sections/health-shots/2017/05/22/528970924/pediatricians-advise-no-fruit-juice-until-kids-are-1

Parenting

Flour with Added Folic Acid Is Reducing Birth Defects

2:00

Folic acid is a B vitamin that is known to help prevent certain types of birth defects in newborns. In January 1998, the FDA added a requirement that folic acid be added to breads, cereals, and other products that use enriched flour. These fortified foods include most enriched breads, flours, corn meals, rice, noodles, macaroni, and other grain products.

Since then, a new report shows that serious birth defects have fallen 35 percent. While that is certainly wonderful news, a 2014 study found that as many as 25 percent of American women are still not receiving even the minimum amount of recommended folic acid from either their diet or through supplements.

Women who don't get enough folic acid have an elevated risk of giving birth to a child with conditions called neural tube defects, the best known of which is spina bifida, which often causes paralysis.

Health experts began recommending that women of childbearing age take folic acid in 1992 because studies showed that taking 400 micrograms a day could reduce spina bifida and related birth defects by up to 70%.

Doctors now recommend that women who are considering having children start taking folic acid before trying to get pregnant. Since some pregnancies are not necessarily planned, many doctors recommend that women of childbearing age take a daily multivitamin that contains folic acid.

The benefits of folic acid have been researched for quite some time and since food producers began adding folic acid to grains, that simple step has prevented more than 1,300 babies a year from being born with spina bifida or related conditions, according to a report from the Centers for Disease Control and Prevention.

Authors of the new study found that Hispanic women are more likely to have a baby with spina bifida or a similar birth defect.

That's partly because the "masa harina" corn flour used in tortillas and other Hispanic foods isn't fortified with folic acid, the study says. The March of Dimes has petitioned the FDA to require that folic acid be added to corn flour. Adding folic acid to corn flour would prevent another 40 cases of spina bifida or related conditions each year, the report says.

"Even with fortification, there will be some women that do not get the recommended amount of folic acid every day," says Candice Burns Hoffmann, of the CDC's National Centers for Birth Defects and Developmental Disabilities. "We still have more work to do."

If you’re considering having a baby, talk to your doctor before becoming pregnant about the benefits of folic acid and how much you may need.

Sources: Liz Szabo, http://www.usatoday.com/story/news/nation/2015/01/15/folic-acid-birth-defects/21784019/

http://www.spinabifidaassociation.org

Your Toddler

Proof That Reading to Your Child is Good for Them

1:45

Not only do small children love being read to but a new study confirms that it is actually good for them.

Brain scans taken of 19 preschoolers whose parents regularly read to them showed heightened activity in important areas of the brain. Experts have long theorized that reading to young children on a consistent basis has a positive impact on their brain development; researchers say this study provides hard evidence that it does.

 The study’s leader Dr. John Hutton, of Cincinnati Children's Hospital Medical Center,

 and his team used functional MRI scans to measure real-time brain activity in 19 children, aged 3 to 5 years, as they listened to stories and to sounds other than speech.

Parents were interviewed about "cognitive stimulation" at home, including how often they read to their children. Based on their responses, the number ranged from two nights a week to every night.

Overall, Hutton's team found, the more often children had story time at home, the more brain activity they showed while listening to stories in the research lab.

The impact was largely seen in the area of the brain that is used to obtain meaning from words. There was "particularly robust" activity, the researchers said, in areas where mental images are formed from what is heard.

"When children listen to stories, they have to put it all together in their mind's eye," Hutton explained.

Even though children's books have pictures, he added, that's different from watching all the action play out on a TV or computer screen.

When a child is listening to a story being read to them, they are engaging a different part of the brain than when they are passively sitting in front of a screen with images.

The American Academy of Pediatrics (AAP) advises parents to read to their children every day, starting at birth. That pre-kindergarten time is a critical time for brain development, Hutton said. Other research has found that children with poor reading skills in first grade usually do not "catch up" with their peers.

Hutton believes that a traditional story time provides a critical "back-and-forth" between parents and children.

"It's not just a nice thing to do with your child," he said. "It's important to their cognitive, social and emotional development."

Reading to your child can help him or her build a lifelong relationship with the written word. That skill will help them be able to navigate more easily in school, later on in business and can bring hours of personal pleasure through the stories of gifted writers.

Source: Amy Norton, http://consumer.healthday.com/cognitive-health-information-26/brain-health-news-80/brain-scans-show-why-reading-to-kids-is-good-for-them-701897.html

 

 

Daily Dose

Staying Heart Healthy

1:30 to read

With it being heart month it seems like an appropriate time to discuss sudden cardiac death (SCD) in children. Thankfully, sudden cardiac death is rare in children with estimates somewhere between 0.6-6.2 deaths /100,000 in children in the U.S.  

SCD is defined as “a death that is abrupt, unexpected, and due to a cardiovascular cause”. It is also defined as a death that occurs within 1 hour from the onset of cardiovascular symptoms, and in the pediatric population death typically occurs within a few minutes of symptoms.  The majority of these tragic sudden deaths occur during sports (20-25%), and in many cases there have been no previous warning signs.

While congenital heart disease is the most common cause of SCD, there continues to be a great deal of research into this subject.  It is now known that there are genetic risk factors involved for many of the disorders that lead to heart disease, arrhythmias and SCD.  Hypertrophic cardiomyopathy ( enlargement of the heart) is the most common cause of SCD in children and adolescents and is due to a genetic abnormality as is prolonged QT syndrome.

Since sport participation has been associated with an increased risk of SCD in children, it is now recommended that athletes are pre-screened for risk factors associated with SCD. A good history is always important, with questions directed towards the heart - including chest pain with exertion, recurrent syncope (fainting) or syncope with exertion.  While many children may not be symptomatic a detailed family history of sudden early unexplained death may be a clue to provoke a further work . The physical exam is equally important including blood pressure readings with the patient both supine, sitting and standing. A good cardiac exam is necessary to listen for murmurs as well as any physical findings suggestive of Marfan’s syndrome. 

Routine ECG (electrocardiogram) screening for all athletes is currently not recommended, although this is the recommendation in several other countries ( Italy has a lot of data on this topic). Unfortunately, an ECG alone does not diagnose all abnormalities and there are frequent false positive results as well, which may lead to unnecessary testing.  An echocardiogram is also necessary to diagnose some abnormalities, and again is not routinely recommended and requires a pediatric cardiologist to read it. 

The most important treatment for SCD is early cardiopulmonary resuscitation (CPR) and to have an AED (automatic external defibrillator) available.  It is estimated that early CPR/AED use could prevent about 25% of pediatric sudden deaths.  If we increase the number of people ( including older children)  who have been instructed in CPR and feel comfortable knowing the correct way to use an AED the statistics for survival may even become more favorable.  There have been anecdotal reports of children performing CPR successfully simply due to the fact that they had seen CPR performed on TV shows or the internet.  Taking CPR/AED training into middle and high schools may be one way to insure this. For children that have been found to have a genetic abnormality which puts them at risk for SCD, or for those who have survived a sudden cardiac event, there are treatments available including medications and in some cases implantation of an internal cardioverter and defibrillator ( almost like your own AED).  Evaluation and treatment by a pediatric cardiologist with expertise in this area is preferred.  

So…with it being heart month a good family activity might be CPR training…who knows when you just might save a life!

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