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Your Teen

What Is the Most Common and Deadly Cancer Found in Teens?

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Do you know the most common and deadly cancer found in teens and young adults? You may be as surprised as I was when I read that a new study shows it is brain cancer.  It’s also not a particular type of brain cancer, but can vary widely as people age.

"For these individuals -- who are finishing school, pursuing their careers and starting and raising young families -- a brain tumor diagnosis is especially cruel and disruptive," said Elizabeth Wilson, president and CEO of the American Brain Tumor Association (ABTA).

"This report enables us for the first time to zero in on the types of tumors occurring at key [age] intervals over a 25-year time span, to help guide critical research investments and strategies for living with a brain tumor that reflect the patient's unique needs," Wilson said in an association news release.

Researchers look at data from 51 separate cancer registries, representing 99.9 percent of the U.S. population in the 15 to 39 year-old-age group.

While 2 types of tumors were the most frequently found in this age group, brain and central nervous system tumors, the report also noted that other types of cancer became more prevalent as people got older.

"What's interesting is the wide variability in the types of brain tumors diagnosed within this age group, which paints a much different picture than what we see in [older] adults or in pediatric patients," said report senior author Jill Barnholtz-Sloan, an associate professor at Case Western's Comprehensive Cancer Center in Cleveland.

"For example, the most common tumor types observed in adults are meningiomas and glioblastomas, but there is much more diversity in the common tumor types observed in the adolescent and young adult population," Barnholtz-Sloan said in the news release.

"You also clearly see a transition from predominantly nonmalignant and low-grade tumors to predominantly high-grade tumors with increasing age," she added.

Nearly 700,000 people in the United States have brain and central nervous system tumors. And more than 10,600 such tumors are diagnosed in teens and young adults each year, with 434 dying of their disease annually, according to the ABTA.

The most common treatment for brain cancer continues to be surgery, radiation and chemotherapy. However, new research is looking into the development of tailored therapeutics involving a combination of targeted agents that use different molecules to reduce gene activity and suppress uncontrolled growth by killing or reducing the production of tumor cells based on their genetic character. Experimental treatment options may include new drugs, gene-therapy and biologic modulators that enhance the body’s overall immune system to recognize and fight cancer cells.

"There are clearly unique characteristics of the 15-39 age group that we need to more comprehensively understand, and the information in the ABTA report starts that important dialogue," Barnholtz-Sloan said.

The ABTA-funded report was recently published in journal Neuro-Oncology.

Story source: Robert Preidt, http://consumer.healthday.com/cancer-information-5/brain-cancer-news-93/brain-cancers-both-common-and-deadly-among-young-adults-report-shows-708339.html

http://www.ninds.nih.gov/disorders/brainandspinaltumors/brainandspinaltumors.htm

Your Child

Antibiotics Often Prescribed When Not Needed

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By now, most parents understand that antibiotics are not effective for viral infections, only for illnesses caused by bacteria.

However, that hasn’t deterred many physicians from over-prescribing antibiotics for children with ear and throat infections.

More than 11 million antibiotic prescriptions written each year for children and teens may be unnecessary, according to researchers from University of Washington and Seattle Children's Hospital. This excess antibiotic use not only fails to eradicate children's viral illnesses, researchers said, but also supports the dangerous evolution of bacteria toward antibiotic resistance.

"I think it's well-known that we prescribers overprescribe antibiotics, and our intent was to put a number on how often we're doing that," said study author Dr. Matthew Kronman, an assistant professor of infectious diseases at Seattle Children's Hospital.

"But as we found out, there's really been no change in this [situation] over the last decade," added Kronman. "And we don't have easily available tools in the real-world setting to discriminate between infections caused by bacteria or viruses."

 Doctors have limited resources when it comes to differentiating between bacterial or viral infections. Physicians can use the rapid step test to determine if the streptococcus bacteria is the cause of a child’s sore throat, but that is about it for immediate diagnostic tools.

Most colds are virus related and one of the first symptoms will be a sore or scratchy throat. It will typically go away after the first day or so and other cold symptoms will continue. Strep throat is often more severe and persistent.

A virus often causes ear infection as well. Many doctors treat ear infections as though they are bacterial to be on the safe side and avoid serious middle ear infections.

To determine antibiotic prescribing rates, Kronman and his colleagues analyzed a group of English-language studies published between 2000 and 2011 and data on children 18 and younger who were examined in outpatient clinics.

Based on the prevalence of bacteria in ear and throat infections and the introduction of a pneumococcal vaccine that prevents many bacterial infections, the researchers estimated that about 27 percent of U.S. children with infections of the ear, sinus area, throat or upper respiratory tract had illnesses caused by bacteria.

But antibiotics were prescribed for nearly 57 percent of doctors' visits for these infections, the study found.

Kronan hopes that the study’s results will encourage the development of more diagnostic tools and will spur doctors to think more critically about prescribing antibiotics unless clearly needed.

Previous research has shown that parents often pressure their doctor to prescribe an antibiotic to treat their child’s ear or sore throat symptoms. However, when parents are given other suggestions on how to alleviate the symptoms they have been much more receptive than when their doctor just flat out says he won’t prescribe antibiotics.

Many physicians and researchers are concerned that the amount of antibiotics being prescribed these days is setting us all up for future problems when dealing with bacterial infections. Bacteria are adaptable and mutate over time becoming less responsive to antibiotics. When possible, it’s much healthier in the long run to treat your child’s symptoms with simpler therapies. Ask your physican ways you can make your little one more comfortable until the symptoms pass. 

The study was published online in the journal Pediatrics.

Source: Maureen Salamon, http://consumer.healthday.com/infectious-disease-information-21/antibiotics-news-30/antibiotics-prescribed-twice-as-often-as-needed-in-children-study-says-691686.html

Your Teen

Knee Surgeries Increasing for Female Teen Athletes

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In 1972, Title IX of the Education Amendments Act was passed. The law requires educational institutions to maintain policies, practices and programs that do not discriminate against anyone on the basis of gender. 

Young women and girls were given the opportunity to equally participate in school sports programs and receive athletic scholarship money proportional to their participation.

It was a monumental advancement for young girls and women, but along with opportunity came injuries.

A growing number of teenage girls are joining their male counterparts on the operating table to repair torn knee ligaments, according to a new study.

Researchers focused on surgery for a common knee injury known as an anterior cruciate ligament (ACL) tear, which has long been linked to intense participation in sports like basketball and soccer which require constant pivoting as well as contact sports like football.

The study of private insurance data for 148 million U.S. residents found that overall, the average annual ACL surgery rate climbed 22 percent from 2002 to 2014, when it reached 75 procedures for every 100,000 people.

For teen girls, however, the average annual knee surgery rate rose by 59 percent during the study period to 269 procedures for every 100,000 people. 

“Although there are proven ACL injury prevention programs available, they are not being widely adopted, particularly among young women,” said lead study author Mackenzie Herzog of the University of North Carolina at Chapel Hill.

The study didn’t focus on why the injuries are happening, but Herzog noted a few reasons why he thinks the increase in injuries might be happening in youth sports.

“Two particular trends that concern us are increased trends toward year-round sports participation at a young age and the tendency to specialize in one sport early,” Herzog said.

For teen boys, the average annual knee surgery rate climbed 44 percent during the study period to end at 212 procedures for every 100,000 people, researchers report in JAMA Pediatrics. 

Surgery rates also rose faster for women than for men, although adult male athletes still had more procedures. By the end of the study, 87 men and 61 women out of every 100,000 people had ACL surgery each year.

In an email to Reuters, Dr. Devin Peterson, a researcher at McMaster University in Hamilton, Ontario, who wasn’t involved in the study, said cross-training programs that include exercises to improve strength, balance, coordination and muscle control could help prevent ACL tears.

Pediatric sports medicine expert R. Jay Lee, offers these tips and more from the Johns Hopkins Medicine website:

Get a preseason physical. A preseason or back-to-school physical is a great way to determine if your young athlete is fit to play. “Sports physicals help assess any areas of concern for athletes before they start an activity, and in turn keeps them from further injuring themselves during play if a condition is present and needs to be treated,” says Dr. Lee.

Encourage cross training and a variety of sports. “I see kids today who play on two baseball or lacrosse teams on the same day or throughout the week and year. But it’s important for athletes to change the sports or activities they are doing so they are not continuously putting stress on the same muscles and joints,” warns Dr. Lee. Parents should consider limiting the number of teams their athlete is on at any given time and changing up the routine regularly so that the same muscles are not continuously overused.

Warm up before the sports activity. Stretching is an important prevention technique that should become habit for all athletes before starting an activity or sport. Dr. Lee suggests a mix of both static and dynamic stretching during warmups to help loosen the muscles and prepare them for play. Toe touches and stretches, where you hold the position for a certain amount of time, are considered static, while jumping jacks and stretches, where the body continues to move during stretching, are considered dynamic.

Make sure the proper equipment is used. Protective equipment, like helmets, pads and shoes, are very important for injury prevention. Parents should talk with coaches before the season starts so that they have adequate time to properly outfit their child before practices begin.

Recognize injury and get help quickly.  “I’ve seen a number of young athletes who have serious injuries and didn’t do anything about them, and now the damage has progressed,” Dr. Lee warns. “We need to get these kids in to see a doctor earlier to keep this from happening.”

If parents notice that there is a change in their athlete’s technique, such as a limp when running, throwing differently or rubbing a leg during activity, they should pull the athlete out of play. If the problem persists, parents should seek an assessment for their child prior to returning to the activity.

Dr. Lee warns: “Athletes will alter the way they do things because of pain, but then they can end up with a more serious injury because of it.”

Story sources:  Lisa Rapaport, http://www.reuters.com/article/us-health-acl-surgeries-girls-idUSKBN1952SE

http://www.hopkinsmedicine.org/health/articles-and-answers/prevention/10-tips-for-preventing-sports-injuries-in-kids-and-teens

 

Your Child

Melatonin May Help Kids with Eczema Sleep Better

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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

 

Your Teen

FDA to Regulate E-cigarettes, Raise Age for Purchasing

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Cigarette smoking among teens and young adults has been on a slight decline in the past few years, but e-cigarette use has been rapidly increasing.

Because there are no regulations and scant information on the products used to fuel e-cigarettes, many leading health organizations, including the American Academy of Pediatrics have been urging the Federal Drug Administration (FDA) to bring e-cigarettes and liquid nicotine under its authority.

The U.S. government has responded and taken action. The FDA issued a tough set of rules for the e-cigarette industry that included banning sales to anyone under 18, requiring package warning labels, and making all products—even those currently on the market—subject to government approval.

For many teen and health organizations, the ruling has been long overdue.

Though the product-approval process will be phased in during three years, that will be little solace to the fledgling but fast-growing $3.5 billion industry that has, until Aug. 8 when the rules take effect, largely been unregulated and dominated by small manufacturers and vape shops.

Many of the vape shops, device manufacturers and liquid nicotine producers are not happy with the change.

“This is going to be a grim day in the history of tobacco-harm reduction,” said Greg Conley, president of the American Vaping Association, an industry-funded advocacy group. “It will be a day where thousands of small businesses will be contemplating whether they will continue to stay in business and employ people.”

In June, the FDA proposed requiring warning labels and childproof packaging because of an increase in nicotine exposure and poisoning incidents. The agency could move to regulate advertising or flavors such as cotton candy and watermelon that also might appeal to youth.

“We’re looking at the flavor issue with e-cigarettes,” said FDA Tobacco Center Director Mitch Zeller during a news conference. Later, he said, that while the agency was aware of “anecdotal reports” that e-cigarettes have helped smokers kick their habit; those benefits were outweighed by concerns about youth using the devices.

E-cigarettes are not the only tobacco related products that will come under the control of the FDA. Unregulated tobacco items, including pipe tobacco and water-pipe tobacco, will also fall under the supervision of the FDA.

The FDA has been regulating cigarettes since Congress granted it oversight of traditional smokes with the 2009 Family Smoking Prevention and Tobacco Control Act.

“Today’s announcement is an important step in the fight for a tobacco-free generation—it will help us catch up with changes in the marketplace, put into place rules that protect our kids and give adults information they need to make informed decisions,” Department of Health and Human Services Secretary Sylvia Mathews Burwell said in a statement.

Most researchers agree e-cigarettes are less harmful than cigarettes because, unlike cigarettes, they don’t combust. Studies have shown that when traditional cigarettes combust they release more than 60 carcinogens. But the long-term effects of using the electronic devices remain largely unknown, and many anti-tobacco groups and public health officials are concerned they could become a gateway to traditional smoking.

Anti-tobacco groups have been frustrated with FDA, saying the agency has taken far too long to finalize its rules.

Concerns escalated when a study published in August by the Journal of the American Medical Association found ninth-graders who used e-cigarettes were 2½ times as likely as peers to have smoked traditional cigarettes a year later.

The Centers for Disease Control and Prevention reported in April that e-cigarette use tripled among U.S. teenagers in 2014.

The AAP issued its recommendations on tobacco and e-cigarettes in late 2015.

In a press release, the organization said it strongly recommends the minimum age to purchase tobacco products, including e-cigarettes, should be increased to age 21 nationwide.

"Tobacco use continues to be a major health threat to children, adolescents and adults," said Karen M. Wilson, MD, MPH, FAAP, chair of the AAP Section on Tobacco Control and section head of Pediatric Hospital Medicine at Children's Hospital Colorado. "The developing brains of children and teens are particularly vulnerable to nicotine, which is why the growing popularity of e-cigarettes among adolescents is so alarming and dangerous to their long-term health."

Under the new rules, e-cigarette manufacturers would have up to two years to continue to sell their products while they submit an application to the FDA.

Story sources: Tripp Mickle, Tom Burton, http://www.wsj.com/articles/fda-to-regulate-e-cigarettes-ban-sales-to-minors-1462455060

https://www.aap.org

 

Your Child

The Most Common Childhood Injuries

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Like many folks, most of my injuries happened when I was a child. Kids - with their excess energy - like to run, climb, jump, hide, swim, dive, bike, rollerblade, skateboard, and fall from heights – to name just a few activities!

Hands, elbows, and knees are the places most likely to get hurt. You can treat minor bumps and bruises at home.

For cuts and scrapes, rinse the area under running water until it’s clean. You can use mild soap. Apply some antibiotic ointment and cover it with a bandage. Call the doctor if the cut is large, deep, or if the area becomes red and swollen, or you see pus -- these are signs of infection. 

For bruises, soothe the swelling with an ice pack wrapped in a wet cloth. If your kid has trouble walking or moving, or the swelling doesn’t go down, call the doctor.

A relatively new phenomenon in kids’ injuries is back and shoulder problems from carrying backpacks. If your child lugs around a backpack that’s too heavy or carries it on one shoulder, he or she can develop back, neck, and shoulder pain, along with posture problems. The American Academy of Pediatrics (AAP) recommends that kids always use two shoulder straps, and backpacks shouldn’t weigh more than 10% to 20% of the child’s body weight. (You can use the bathroom scale: If your child weighs 80 pounds, the backpack should weigh between 8 and 16 pounds.)

What child doesn’t eventually pick up a splinter in the hand? It’s relatively easy fix if you can keep your child’s hand steady. Use a needle sterilized with rubbing alcohol to gently prick the skin over it, then pull it out with clean tweezers. If that doesn’t work, try touching the area with tape to see if that helps get it out. Once the splinter is removed, use an antibiotic ointment to help keep it from getting infected.

Various sports can cause strains and sprains in young athletes.  Baseball, soccer, gymnastics, football, tennis, even golf can lead to torn muscles, ligaments and tendons.

If it happens to your kid, they’ll need to rest the injured location.. Apply ice, wrap it snugly, and keep it raised. Over-the-counter pain medication like acetaminophen or ibuprofen can help. Call the doctor if he or she can’t walk or move the injured area. It could be broken, and may need to be X-rayed.

Fractures are more serious. They can happen in a variety of ways. Skateboard, monkey bar and bicycle falls as well as many contacts sports can lead to broken bones. Breaks are most common in arms because it’s natural to throw your hands out to try to break a fall. The area will swell and be painful to press on or move. Call 911 if you can see the bone through the skin. If you suspect your child has broken a bone, take him or her to an ER.

Concussions are a hot topic and unfortunately, a fairly common injury. Kids in the U.S. have 1 million to 2 million sports and recreation-related head injuries each year. For children under 14, the top causes are cycling, football, baseball, basketball, and skateboards or scooters. If your child has taken a hit to the head, keep an eye on him. Symptoms of concussion usually show up right away, but not always. 

Call the doctor immediately if your child loses consciousness, appears dazed, or complains of blurry vision or a headache that won’t go away.

A busted mouth and broken teeth are painful, but not unique as a childhood injury. It’s probably a good thing we get two sets of teeth. Another common childhood injury is broken, chipped, and knocked-out teeth. Nearly 50% of kids will have some type of tooth accident during childhood. The reasons: trips, falls, sports, and, yes, fights. The front teeth take the brunt of it. 

Call the dentist if a tooth is broken, loose, or sensitive. If a baby tooth is completely knocked out, don’t try to place it back in the gums. But if it’s a permanent tooth, rinse it with clean water, put it back in the socket as fast as possible, and head to the dentist. It may save the tooth.

There are other injuries that childhood enthusiasm can produce, but these are some of the most common. Fortunately, most of us survive this chaotic time with bumps, bruises and maybe a few stiches. Anytime you’re uncertain about how severe your child’s injury may be; it’s best to have him or her checked out by a doctor.

Story source: http://www.webmd.com/children/ss/slideshow-kids-injuries

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Daily Dose

Milk vs. Non Cow's Milk

1:00 to read

Once your child turns one, the AAP recommends that they transition from formula to milk…cow’s milk that is. But, more and more of my patients state that they prefer to drink almond milk, soy milk, rice milk, coconut milk, hemp milk and even goat’s milk. I am constantly having to look up the calcium, protein or fat content of all of these “cow’s milk alternatives”.  In the majority of the cases there is not a medical issue driving the choice of milk, but rather parental preference for non dairy, lactose free etc. etc.  

 

Interestingly, I just read an article from the American Journal of Clinical Nutrition that found that children that drink non-cow’s milk may be “slightly shorter” than those children of the same age who drink cow’s milk. There is an ongoing research project which studied about 5,000 children between the ages of 2 and 6, and looked for height differences between those children “who consumed about 8 ounces of non-cow’s milk per day compared to those who drank the same amount of cow’s milk”. 

 

The children who drank non-cow’s milk were about 0.15 inches shorter than average for their age. Although this is just one study,  it will be important to continue to evaluate this data to see if the height differences continue into adolescence. This is a good study to keep following.

 

While I am always concerned about the calcium intake in children and their long term bone health, here is yet another concern.

 

It may be time to re-think your family’s milk choice and unless there is a medical reason to avoid dairy…..try good old cow’s milk…it may actually make you a bit taller?  

Your Baby

“Furry Pets” May Help Kids Avoid Some Allergies

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You might think that having pets would be a nightmare if you have small children with a family history of allergies. A new study says that furry pets may actually help protect children against some allergies.

The infants’ mothers had a history of allergy, so the babies were at increased risk too, and it was once thought that pets might be a trigger for allergies in such children, the authors point out in the Journal of Allergy and Clinical Immunology.

“Earlier it was thought that exposure to pets early in childhood was a risk factor for developing allergic disease,” said Dr. Merja Nermes of the University of Turku in Finland, who coauthored the research letter. “Later epidemiologic studies have given contradictory results and even suggested that early exposure to pets may be protective against allergies, though the mechanisms of this protective effect have remained elusive.”

Adding pet microbes to the infant intestinal biome may strengthen the immune system, she told Reuters Health by email.

The study team collected fecal samples from diapers when the babies were one month of age and these were tested for the DNA of two types of Bifidobacteria that are found specifically in animal guts: B. thermophilum and B. pseudolongum.

One third of infants from the pet-exposed group had animal-specific bifidobacteria in their fecal samples, compared to 14 percent of the comparison group. It’s not clear where the infants without furry pets at home acquired their gut bacteria, the authors write.

When the babies were six months old they had skin prick tests to assess allergies to cow’s milk, egg white, flours, cod, soybeans, birch, grasses, cat, dog, potato, banana and other allergens.

At six months of age, 19 infants had reactions to at least one of the allergens tested. None of these infants had B. thermophilum bacteria in their fecal samples.

Other studies have pointed out the connection between kids exposed to farm animals and household pets and building a better immune system.

“When infants and furry pets live in a close contact in the same household, transfer of microbiota between pets and infants occurs,” Nermes said. “For example, when a dog licks the infant´s face or hand, the pet-derived microbiota can end up via the mouth into the infant´s intestine.”

Human-specific Bifidobacteria have beneficial health effects, and animal-specific strains may also be beneficial, she said. It is still unclear, however, if exposure to these bacteria protects against allergies later in life, she said.

“Future research is needed to assess if these infants develop less atopic dermatitis, asthma or allergic rhinitis later,” she said.

Nermes also noted that she believes pediatricians should not discourage pregnant women or parents of infants from having pets in order to prevent allergies.

“If a family with a pregnant mother or an infant wants to have a pet, the family can be encouraged to have one, because the development of allergic disease cannot be prevented by avoiding pets,” she said.

Source: Kathryn Doyle, http://www.reuters.com/article/2015/09/10/us-health-allergy-pet-microbes-idUSKCN0RA2CK20150910

 

 

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DR SUE'S DAILY DOSE

New report says not enough babies are getting much needed tummy time!

DR SUE'S DAILY DOSE

New report says not enough babies are getting much needed tummy time!

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