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Your Baby

Preparing for Twins or Triplets

1:45

The number of U.S. parents expecting twins and triplets has reached an all-time high according to the National Center for Health Statistics. Multiple births make up a small portion of births in general, but since 1980, multiples numbers have been on the rise.

The number of twins born in the U.S. has increased the most. Along with twice the cuteness comes twice the workload. The American Academy of Pediatrics (AAP) offers parents of multiples some handy preparation tips:

Keep in mind that "multiples" are often born early and tend to be smaller than the average newborn. The AAP says parents may need to visit with their pediatrician more often than usual and reach out for help with feeding concerns or strategies.

And then there are the diapers- lots and lots of diapers! Go ahead and start purchasing your diapers ahead of time. The more you have stocked away before your little ones are born, the less worries you’ll have about running out when you need them most. Also, you’ll be able to gage about how many you’ll need when you start shopping again.

Having multiples also means fitting more safety seats into the car, more clothing, more food and possibly even a larger home! Check out how well your home is going to work for a larger family and plan accordingly.

One of the most important things for parents to consider is making sure that each child has their own identity. Multiples may share everything, but they are individuals and should be raised as such, the AAP advises. Identical twins, in particular, may seem like a duo, and parents might be tempted to give them the same things and the same amount of attention. But even genetically identical children have different personalities, thoughts and emotions. The AAP urges parents to acknowledge and support their differences to help them become happy and secure individuals.

If you have other children, remember they need special attention too. It’s easy to overlook the older kids when the new kids on the block are demanding so much attention.

As multiples grow, they may form exclusive bonds and may even communicate in a way only they can understand. Sometimes, they become unwilling to seek out other friendships. Giving multiples some time apart can help them develop friendships and ensure that other siblings aren't left out, the academy says.

And efforts to encourage multiples to spend time apart should start early to head off resistance. Most elementary schools place multiples in separate classes, the news release noted. Parents who are concerned about preventing separation anxiety can turn to their pediatrician for advice.

Don’t be afraid to ask for help! Multiples demand a lot of attention. If your budget allows, hire someone to clean the house a few days a week. Grandparents, uncles and aunts, brothers and sisters may be willing to pitch in and give you some much needed down time or date time.  Don’t forget about your friends – while you may think it’s too much of an imposition, they may love being able to spend some quality time with your children – then turn them back over to you!

Take turns getting up at night for feedings and changings. Giving your spouse a few hours of uninterrupted sleep will do wonders for your relationship.

There’s a lot to prepare for when multiples are involved but the rewards are great. It may feel a little overwhelming at first, but eventually you will figure out a routine that works for everyone.

Story source: Mary Elizabeth Dallas, https://consumer.healthday.com/women-s-health-information-34/birth-health-news-61/having-twins-or-triplets-what-you-need-to-know-before-they-arrive-715653.html

http://www.pewresearch.org/fact-tank/2015/12/11/twins-triplets-and-more-more-u-s-births-are-multiples-than-ever-before/

Your Baby

Breastfeeding May Improve Infant’s Dental Development.

2:00

Infants that breastfeed exclusively or predominately for their first three to six months of life are less likely to develop any kind of dental misalignment later on according to a new study.

The researchers, led by Karen Peres at the University of Adelaide in Australia, tracked just over 1,300 children for five years, including how much they breast-fed at 3 months, 1 year and 2 years old.

The children were also monitored for pacifier use.  About forty percent used a pacifier daily for four years.

When the children were 5, the researchers determined which of them had various types of misaligned teeth or jaw conditions, including open bite, cross bite, overbite or a moderate to severe misalignment.

The risk of overbite was one-third lower for those who exclusively breast-fed for three to six months compared to those who didn't, the findings showed. If they breast-fed at least six months or more, the risk of overbite dropped by 44 percent.

Similarly, children who exclusively breast-fed for three months to six months were 41 percent less likely to have moderate to severe misalignment of the teeth. Breast-feeding six months or longer reduced their risk by 72 percent.

The reason breastfeeding might offer protection from dental misalignments is the way it works an infant’s jaws. Breastfeeding involves coordinated tongue and jaw movements that support the normal development of teeth and facial muscles.

Dr. Danelle Fisher, vice chair of pediatrics at Providence Saint John's Health Center in Santa Monica, California, agrees that it’s the jaw movement.

"Breast-feeding requires the use of jaw muscles more so than bottle-feeding, so the mechanics of breast-feeding stimulate muscle tone in the jaw," Fisher said.

Open bite, overbite and moderate to severe misalignment were generally less common overall among the children who mostly or exclusively breast-fed. Children who mostly breast-fed but also used pacifiers, however, were slightly more likely to have one of these misalignment issues, the study found.

"Pacifiers are used for non-nutritive sucking but when overused, they can put pressure on the developing jaw and lead to more problems in older children with malocclusion [teeth/jaw misalignment]," Fisher said.

Parents oftentimes depend on the pacifier to help babies relax and self-soothe. The key is moderation of use.

The American Academy of Pediatrics recommends parents consider using a pacifier for an infant's first six months because pacifiers are associated with a reduced risk of sudden infant death syndrome (SIDS).

"Most infants need to suck for comfort or non-nutritive sucking," Fisher said. "Pacifiers can be helpful in the newborn period and even help reduce incidents of SIDS in infants who sleep with them."

Instead, parents should simply limit pacifier use, she said. In addition, pacifiers are not needed past the first six to 12 months, Fisher said, so parents can begin weaning after that time.

Like most studies, the results did not prove cause and effect, but an association.

The findings were published online in the journal Pediatrics.

Source: Tara Haelle, http://www.webmd.com/parenting/baby/news/20150615/breast-feeding-may-have-dental-benefits-study-suggests

Your Child

2 Doses of Chickenpox Vaccine Almost 100 Percent Effective

2:00

Chickenpox is one of the most common childhood illnesses. It is a viral infection caused by the Varicella zoster virus and produces a painful, itchy rash with small, fluid-filled blisters.

It occurs most often in early spring and late winter and is highly contagious. Typically, chickenpox occurs in kids between 6 and 10 years of age.

A new study shows that among schoolchildren, two doses of the chickenpox vaccine is more effective than one.

Giving the first dose at age 1 and the second dose at ages 4 to 6 is nearly 100 percent effective in preventing the once common childhood disease, researchers have found.

"A second dose of varicella [chickenpox] vaccine provides school-aged children with better protection against the chickenpox virus, compared to one dose alone or no vaccination," said lead researcher Dana Perella, of the Philadelphia Department of Public Health.

Two doses of the vaccine protected against the moderate to severe chickenpox infections that can lead to complications and hospitalizations, she said.

Before routine chickenpox vaccination began in 1995, virtually all children were infected at some point, sometimes with serious complications. About 11,000 children were hospitalized each year for chickenpox, and 100 died annually from the disease, according to the CDC.

One-dose vaccination greatly reduced incidence of chickenpox, but outbreaks continued to be reported in schools where many kids had been vaccinated. That led the CDC in 2006 to recommend a second vaccine dose.

To evaluate effectiveness of the double- dose regimen, Perella and colleagues collected data on 125 children with chickenpox in Philadelphia and northern Los Angeles and compared them with 408 kids who had not had the disease.

They found that two doses of the vaccine was slightly more than 97 percent effective in protecting kids from chickenpox.

"With improved protection provided by two-dose varicella vaccination compared with one-dose only, continued decreases in the occurrence of chickenpox, including more severe infections and hospitalizations, are expected as more children routinely receive dose two between the ages of 4 and 6 years," Perella said.

For children with weakened immune systems that cannot take the vaccine, having their classmates and playmates protected by the vaccine helps protect them against the viral infection.

School vaccine requirements should include two-dose varicella vaccination, Perella said.

"In addition, 'catch-up' varicella vaccination is also important," she said. This applies to anyone over 6 who haven’t had a second vaccine dose, especially if they could be exposed to chickenpox or shingles - a painful condition in older people caused by reactivation of the chickenpox virus, she said.

Most healthy children who get chickenpox do not have serious complications from the illness. But there are cases when chickenpox has caused hospitalization, serious complications and even death.

A child may be at greater risk for complications if he or she:

·      Has a weakened immune system

·      Is under 1 year of age

·      Suffers from eczema

·      Takes a medication called salicylate

·      Was born prematurely

The report was published online March 14 and will appear in the April print issue of the journal Pediatrics.

Story sources: Steven Reinberg, http://www.webmd.com/children/news/20160314/two-dose-chickenpox-shot-gets-the-job-done-study-shows

http://www.parents.com/health/vaccines/chicken-pox/chickenpox-facts/

Your Child

Kids: Mouthguards For All Contact Sports

1:45

Youth sports participation has grown steadily over the years and so have injuries. The National Youth Sports Foundation for Safety reports dental injuries as the most common type of face and mouth injury kids experience in sports related accidents.

A new report issued by dental experts at the University of Alabama at Birmingham, says that mouthguards should be included in safety gear for all contact sports.  

Sports-related dental injuries send more than 600,000 people to the emergency room every year, the U.S. Centers for Disease Control and Prevention reports.

Most of these injuries involve the front teeth, but the tongue and cheeks can also be hurt while playing sports, the UAB team said.

The best way to protect the mouth and teeth during sports is to wear a mouthguard, says Dr. Ken Tilashalski, associate dean for academic affairs at the UAB School of Dentistry. Mouthguards have been shown to reduce the risk of sports-related dental injury by 60 times, he said.

"Wearing a mouthguard reduces the chances of tooth fractures, tooth dislocations and soft tissue cuts," Tilashalski said in a university news release. "The guards also protect against jaw fractures and concussions by absorbing the energy of a traumatic blow to the chin."

The American Dental Association (ADA) recommends wearing custom mouthguards for the following sports: acrobats, basketball, boxing, field hockey, football, gymnastics, handball, ice hockey, lacrosse, martial arts, racquetball, roller hockey, rugby, shot putting, skateboarding, skiing, skydiving, soccer, squash, surfing, volleyball, water polo, weightlifting, and wrestling. Other experts include baseball and softball infielders on that list. They further recommend the mouthguard to be worn during all practices and competition.

There are basically three types of mouthguards to choose from:

·      Stock: These are preformed and ready to wear, but they may not fit well inside the mouth.

·      Boil and bite: These may be customized and molded to the mouth by softening in boiling water before biting down.

·      Custom-made: A dentist tailor-makes these mouthguards to fit an individual's mouth. These mouthguards provide the best fit and the highest level of protection.

"For my kids, I have chosen to use custom mouthguards as they fit and feel better, do not interfere with speech, and are essentially invisible," Tilashalski said. "Mouthguards need to be replaced as they wear down, and athletes in the tooth-forming years will have to have these replaced more often as the mouth grows and the teeth change."

These mouthguards vary in price and comfort, yet all provide some protection. According to the ADA, the most effective mouthguard should be comfortable, resistant to tearing, and resilient. A mouthguard should fit properly, be durable, easily cleaned, and not restrict speech or breathing.

After each use, rinse your mouthguard and store it in a hard container to prevent the buildup of germs, Tilashalski said. Players should also avoid chewing on their mouthguard to extend its life.

It is important to remember damaged teeth do not grow back. Protect your child’s teeth by making sure he or she wears a mouthguard during practice, competition or just out having fun in a sport where falls are common such as biking, skating and skateboarding.

Story sources: Mary Elizabeth Dallas, https://consumer.healthday.com/dental-and-oral-information-9/misc-dental-problem-news-174/mouthguards-key-defense-against-sports-related-injuries-716284.html

http://www.nationwidechildrens.org

Your Child

Changes May Expand Kids Diagnosed With High Blood Pressure

2:00

An estimated 3.5 percent of children and teens in the U.S. have already been diagnosed with hypertension (high blood pressure,) but that number will likely increase because of new guidelines from the American Academy of Pediatricians (AAP).

"If there is diagnosis of hypertension, there are many ways we can treat it," Dr. David Kaelber, co-chair of the AAP Subcommittee on Screening and Management of High Blood Pressure in Children, which developed the report, said in a statement. "But because the symptoms are silent, the condition is often overlooked."

The new recommendations are an update to the guidelines released in 2004 by the National Heart, Lung, and Blood Institute. The previous guidelines were based on blood pressure values for overweight or obese children, who are at a higher risk for hypertension, only. The new blood pressure tables are based on normal-weight children. Because of that change, the new blood pressure values are lower than they were before and allow for a more exact classification of blood pressure according to the patient's weight.

"Prevention and early detection are key," said Dr. Joseph Flynn, who co-chaired the subcommittee. "High blood pressure levels tend to carry into adulthood, raising the risks for cardiovascular disease and other problems. By catching the condition early, we are able to work with the family to manage it, whether that's through lifestyle changes, medication, or a combination of treatments.”

When high blood pressure is left untreated, it can have devastating effects on the body, including damage to the heart, kidneys, brain and eyes.

Because high blood pressure doesn’t present any symptoms, having your child’s blood pressure checked is the only way to know if it is higher than it should be.

Most physicians prefer not to start children on blood pressure lowering medications and will begin treatment by recommending life style changes. However, if those changes do not work or the child has diabetes, kidney disease or a family history of high blood pressure, medications may be started immediately.

Lifestyle changes, including improved diet and increased physical activity, should still be the first line of defense against obesity and high blood pressure, the guidelines recommend.

"These guidelines offer a renewed opportunity for pediatricians to identify and address this important – and often unrecognized – chronic disease in our patients," Kaelber said. "The easy part was developing the new guidelines. Now we begin the harder work of implementing them to help children and adolescents."

The report from the AAP calls on pediatricians to perform routine blood pressure checks at all annual visits. 

Story source: Ashley Welch, https://www.cbsnews.com/news/more-children-to-be-diagnosed-with-high-blood-pressure-under-new-guidelines/

Your Baby

FDA Recommends Limits on Arsenic in Rice Baby Food

1:45

The Food and Drug Administration (FDA) on Friday proposed new limits for inorganic arsenic in infant rice cereal, an effort to reduce the leading source of arsenic exposure for babies.

The draft guidance to industry would cap the inorganic arsenic at 100 parts per billion, a level that most infant rice cereals already meet, or are close to meeting, the agency said.

Arsenic is naturally present in water, air, food and soil in two forms: organic and inorganic. Organic arsenic passes through the body quickly and is less toxic. But inorganic arsenic may pose a cancer risk if consumed at high levels or over a long period of time. Rice is thought to have arsenic in higher levels than most other foods because it is grown in water on the ground, optimal conditions for the contaminant to be absorbed.

Babies' consumption of rice, which is primarily through rice cereal, is about three times greater than that of adults, according to the FDA. Most people consume the highest amount of rice, relative to their weights, at about 8 months of age.

The proposed limit is based on testing of rice and non-rice products, as well as a 2016 FDA risk assessment on the association between exposure to inorganic arsenic and adverse pregnancy outcomes and neurological effects in early life.

The agency said that inorganic arsenic exposure can result in a child's decreased performance on certain developmental tests.

The agency tested 76 samples of infant rice cereal from retail stores and found that nearly half met the agency's proposed limit of 100 parts per billion of inorganic arsenic. More than three-quarters of the samples had levels at or below 110 parts per billion.

The agency advised parents to feed their babies iron-fortified cereals; they can include oat, barley and other grains. It also urged pregnant women to consume a variety of foods, including grains, such as wheat, oats and barley. The FDA also noted that cooking rice in excess water - six to 10 parts water to one part rice - can reduce a significant part of the inorganic arsenic.

Urvashi Rangan, executive director of the Consumer Reports Food Safety & Sustainability Center, said that Consumer Reports was pleased by the FDA's proposal, which he said was close to the level proposed by the group three years ago. But he said the organization remains concerned that other rice-based products consumed by children and adults don't have any such standards. "This is particularly true of children's ready-to-eat cereals," he said, urging the FDA to set levels for these other products.

The agency will accept public comments on the proposed limits for 90 days.

Story source: Laurie McGinley, http://www.chicagotribune.com/lifestyles/health/ct-infant-rice-cereal-inorganic-arsenic-20160402-story.html

 

Your Toddler

AAP: Winter Car Seat Safety

2:00

So far in Texas, this year’s El Nino weather pattern has made for a pretty mild winter compared to previous years. But, other areas around the country are being hit hard with a wintery punch and it’s only a matter of time till temperatures drop and snow and ice find their way to the Lone Star State.

Winter can be a bit tricky for child car seat use. While it sounds like the opposite might be true, bulky clothing such as coats and snowsuits should not be worn under the car seat harness.

More padding - more cushion right? That seems logical until you know what happens when a car crashes. In a wreck, fluffy padding immediately flattens out from the force, leaving extra space under the harness. A child can then slip through the straps and be thrown from the seat.

So how can you keep your little one warm and protected while buckled up? The American Academy of Pediatrics (AAP) has these tips to help strike a comfortable and safer balance.

·      Use a coat or blanket over the straps. You can add a blanket over the top of the harness straps or put your child's winter coat on backwards (over the buckled harness straps) after he or she is buckled up. Some parents prefer products such as poncho-style coats or jackets that zip down the sides so the back can flip forward over the harness. Keep in mind that the top layer should be removable so your baby doesn't get too hot after the car warms up.

·      Use a car seat cover ONLY if it does not have a layer under the baby. Nothing should ever go underneath your child's body or between her body and the harness straps. Be sure to leave baby's face uncovered to avoid trapped air and re-breathing. Many retailers carry car seat bundling products that are not safe to use in a car seat. Just because it's on the shelf at the store does not mean it is safe!

·      Dress your child in thin layers. Start with close-fitting layers on the bottom, like tights, leggings, and long-sleeved bodysuits. Then add pants and a warmer top, like a sweater or thermal-knit shirt. Your child can wear a thin fleece jacket over the top. In very cold weather, long underwear is also a warm and safe layering option. As a general rule of thumb, infants should wear one more layer than adults. If you have a hat and a coat on, your infant will probably need a hat, coat, and blanket.

·      Don't forget hats, mittens, and socks or booties. These help keep kids warm without interfering with car seat straps. If your child is a thumb sucker, consider half-gloves with open fingers or keep an extra pair or two of mittens handy — once they get wet they'll make your child colder rather than warmer.

·      Get an early start. If you're planning to head out the door with your baby in tow on winter mornings, you need an early start. You have a lot to assemble, and your baby may not be the most cooperative. Plus, driving in wintry conditions will require you to slow down and be extra cautious.

·      Tighten the straps of the car seat harness. Even if your child looks snuggly bundled up in the car seat, multiple layers may make it difficult to tighten the harness enough. If you can pinch the straps of the car seat harness, then it needs to be tightened to fit snugly against your child's chest.

·      Remember, if the item did not come with the car seat, it has not been crash tested and may interfere with the protection provided in a crash. Never use sleeping bag inserts or other stroller accessories in the car seat.

·      Store the carrier portion of infant seats inside the house when not in use. Keeping the seat at room temperature will reduce the loss of the child's body heat in the car.

·      Pack an emergency bag for your car. Keep extra blankets, dry clothing, hats and gloves, and non-perishable snacks in your car in case of an on-road emergency or your child gets wet on a winter outing.

·      Make sure your cell phone is charged. If there is an emergency, you want to be able to reach 911 or call for assistance in case of a flat tire or engine trouble.

This is a time when there is a lot of holiday travel from state to state or just down the road to grandma’s house.

Remember, it’s not just children in car seats whose coats shouldn’t be tucked under the harness, adults and older children should make sure their coats are on the outside of the seat-belt.

Little steps can make a big difference in everyone’s safety.

Source: https://healthychildren.org/English/safety-prevention/on-the-go/Pages/Winter-Car-Seat-Safety-Tips.aspx

Your Teen

Teen’s E-cigarette Use Linked to Family and Friends

2:00

For many teens, e-cigarettes have taken the place of the traditional combustible cigarette. A new study suggests that teenagers are more likely to use electronic cigarettes if their friends or a family member uses them.

It’s a pretty safe bet that no teen ever started smoking traditional cigarettes because they tasted good. More than likely it was because someone thought it was cool, felt like walking on the edge of rebellion, watched family members light up on a daily basis or a friend pressured them to give it a try.

These days, the reasons teens smoke e-cigarettes are pretty much the same as they are for regular cigarettes. However, these new nicotine packed products have a number of appealing differences for those just starting out. They don’t smell bad or leave a lingering aroma, they taste a little like candy, and no one is quite sure whether they are producing unhealthy side effects that will come back to haunt you later in life.

“There is a lot of concern by the public health community that e-cigarettes may be recruiting a whole new group of people who never smoked cigarettes," said lead author Jessica Barrington-Trimis of the University of Southern California in Los Angeles.

Other studies have linked e-cigarette and traditional cigarette use, but this new study suggests that teens who begin smoking with e-cigarettes may belong to their own unique group.  

Researchers found that many of the teens in the study that said they'd recently used e-cigarettes, had never smoked traditional cigarettes. This was their first venture into smoking.

"If you think of e-cigarette and cigarette use as two circles, the overlap isn’t as big as expected," Barrington-Trimis said.

Using data collected in 2014 from 2,084 Southern California teens, the authors found that about 25 percent reported ever using e-cigarettes and about 20 percent reported ever using traditional cigarettes.

This finding is a cause for concern because e-cigarettes were the dominant tobacco product used, and a substantial proportion of e-cigarette users had no history of cigarette use, the authors noted in their report.

Fourteen percent of teens thought e-cigarettes are not harmful, compared to about 1 percent who thought cigarettes are not harmful. The teens also felt their peers were more likely to accept their e-cigarette use than traditional cigarette use.

Like many other studies on the use of e-cigarettes, this one can’t say with absolute certainty that smoking e-cigarettes leads to smoking traditional cigarettes. However, the researchers suggest that the more accepted these products become by teenagers, the more they contribute to the “re-normalization” of tobacco products.

"Our findings really suggest there’s a lot of kids who are using these e-cigarettes," Barrington-Trimis said.

The lack of research makes it difficult to know what to tell people about e-cigarettes, she added.

She said parents should tell their children that while research into the health effects of e-cigarettes is still in its infancy, nicotine is known to impact youngsters' developing brains.

Nicotine is also highly addictive and one of the most difficult drugs to break free from.  The longer you smoke – whether it’s e-cigarettes or combustible cigarettes – the harder it is to quit. Plus, little is known about the chemicals used to create the sweet tasting flavors of e-cigarettes.

Parents should make sure they know if their child or their child’s friends are using e-cigarettes. Unfortunately in this day and age, discussions about smoking and drug use have to begin early in a child’s life. Waiting till your child is a pre-teen or teenager to talk about e-cigarettes may be too little too late.  

Source: Andrew M. Seaman, http://www.reuters.com/article/2015/07/27/us-health-teens-smoking-ecigarettes-idUSKCN0Q11YC20150727

http://pediatrics.aappublications.org/content/early/2015/07/21/peds.2015-0639.full.pdf+html

Your Teen

Experts Recommend Screening All Teens for Major Depression

1:30

Studies indicate that one-in-five U.S. children have some for of mental, behavioral or emotional problems.  Among teens, one –in- eight may suffer from depression with only about 30 percent receiving any treatment.  Those are troubling statistics for parents, caregivers and health professionals.

The U.S. Preventive Services Task Force (USPSTF), believes more needs to be done to help these children and has recommended that primary care physicians screen all patients between the ages of 12 and 18 for major depression.

Screening tools are available to help primary care doctors accurately identify major depression in adolescent patients, and there are effective treatments for this age group, the task force said.

"Primary care clinicians can play an important role in helping to identify adolescents with major depressive disorder and getting them the care they need. Accordingly, the task force recommends that primary care clinicians screen all adolescents between 12 and 18 years old for this condition," task force member Dr. Alex Krist said in a USPSTF news release.

Currently, there isn’t enough evidence to know whether screening children 11 and younger would be beneficial. The task force noted that more research on depression screening and treatment in this age group is needed.

The consequences of undiagnosed and treated major depression in teens can have serious consequences such as involvement in the criminal justice system, drug or alcohol abuse and in some cases, suicide.

"It is important to take any concern about depression seriously, regardless of age, and any parent who has a concern about their child's mood or behavior should talk with their child's primary care clinician," he said in the news release. Kemper is a professor of pediatrics at Duke University School of Medicine, in Durham, N.C.

The recommendation was published online Feb. 9 in the Annals of Internal Medicine and Pediatrics.

For more information about child and teen depression, one resource is The American Academy of Child and Adolescent Psychiatry at http://www.aacap.org.

You can also talk with your family doctor or pediatrician if you feel your child is suffering from depression. They should have resources for you as well.

Source: Robert Preidt, http://www.webmd.com/children/news/20160208/doctors-should-screen-teens-for-major-depression-us-task-force-says

 

 

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