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Your Child

Bullied Kids at Risk for Health problems as Adults

2:00

Being teased or humiliated by fellow classmates in school was once just a part of growing up for many kids. No one took it very seriously and children were basically told to either deal with it or physically fight back.

That began to change when bullying tactics changed from one-on-one painful snubs or pushing in the hallways to shaming and hateful social media taunts. All of a sudden everyone was in on the game and there was no where to hide or seek refuge from the never-ending onslaught of mean spirited and sometimes violent threats to a child’s very existence.

Bullying had reached a new stage of hurtfulness and too often the coping mechanism from children who were bullied was and still is suicide. Schools, parents and peers began to take notice and implement strategies to stop the bullying – at least in public environments.

Some of these strategies have been very effective and kids, as well as parents, are much more aware of the dangers that can come from bullying. However, there is always someone who thinks that they have a right to humiliate someone else. While it is more a reflection of the insecurity and abnormal personality of the person doing the bullying, the recipient still feels the pain and harbors the emotional damage to their self-value.

A new study looks at the possible future health hazards for children who have been bullied. Their findings reveal that adults who were bullied in childhood may be at an increased risk for obesity, heart disease and diabetes.

"Our research has already shown a link between childhood bullying and risk of mental health disorders in children, adolescents and adults, but this study is the first to widen the spectrum of adverse outcomes to include risks for cardiovascular disease at mid-life," said senior study author Louise Arseneault. She is a professor from the Institute of Psychiatry, Psychology and Neuroscience at King's College London.

"Evidently, being bullied in childhood does get under your skin," she said in a college news release.

The long-term study involved analyzed data from more than 7,100 people.  Participants in the study included all the children from England, Scotland and Wales that were born during one week in 1958. Their parents provided information on whether the participants were bullied at ages 7 and 11.

By age 45, more than one-quarter of women who were occasionally or frequently bullied during childhood were obese, compared to 19 percent of those who never experienced bullying, the study found. Both men and women who were bullied during childhood were more likely to be overweight.

Compared to those who weren't bullied, men and women who were bullied had higher levels of blood inflammation, putting them at increased risk for heart attack and age-related diseases such as type 2 diabetes, according to the researchers.

Like most studies, results didn’t show an actual cause and effect relationship, only an association or link between being bullied and future health risks.

"Bullying is a part of growing up for many children from all social groups," Arseneault said. "While many important school programs focus on preventing bullying behaviors, we tend to neglect the victims and their suffering. Our study implies that early interventions in support of the bullied children could not only limit psychological distress but also reduce physical health problems in adulthood."

Andrea Danese, a study co-author, pointed out that obesity and high blood inflammation can lead to potentially life-threatening conditions such as type 2 diabetes and cardiovascular disease. Taking steps to prevent these conditions is important, Danese said in the news release.

"The effects of being bullied in childhood on the risk for developing poor health later in life are relatively small compared to other factors," Danese added. "However, because obesity and bullying are quite common these days, tackling these effects may have a real impact."

Counseling coupled with family support for children who have been or are being bullied can offer tremendous value to helping a child disconnect with the hurtful words and actions of others. No one likes to be made fun of or taunted for some slight “imperfection”, but those kinds of things can linger in the mind and wear on one’s self-value. The sooner they are dealt with and put in their true perspective, the quicker one can let them go.

The study was published May 20 in the journal Psychological Medicine.

Source: Robert Preidt, http://consumer.healthday.com/kids-health-information-23/bullying-health-news-718/bullying-heart-disease-psych-med-kcl-release-batch-1756-699576.html

Your Teen

Lithium Safe for Children, Teens with Bipolar Disorder

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A new multicenter study says that lithium, a drug typically given only to adults, is safe and effective for children and adolescents who have bipolar disorder.

The study, led by a researcher at the Johns Hopkins Children's Center and published Oct. 12 in Pediatrics, affirms what clinicians who prescribe this drug have observed for years and suggests that doctors can now more confidently add lithium to the available treatments for this vulnerable population -- at least in the short term, the authors say.

Lithium is one of the oldest drugs for bipolar disorder, a chronic brain condition marked by spontaneous, seesawing bouts of abnormally high moods and depression. The drug's ability to stabilize mood extremes has been well established in adults.

The researchers point out that historically, children and women of childbearing age have generally been excluded from many clinical trials out of an abundance of caution. Some believe that while the intentions may have been good, being excluded in clinical studies may actually harm this population- leaving them without access to more effective treatments.

"Lithium is the grandfather of all treatments for bipolar disorder, but it has never been rigorously studied in children," says Robert Findling, M.D., M.B.A., a professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine and director of child and adolescent psychiatry at the Johns Hopkins Children's Center.

Findling initiated the work while director of child and adolescent psychiatry at Case Western Reserve University School of Medicine.

Though medications used to treat schizophrenia and other psychoses are prescribed to treat bipolar disorder in children, Findling says, those drugs have been linked to substantial weight gain, a considerable medical and social drawback for young people that causes many to stop taking them.

Results from the study showed that the patients on lithium experienced far more significant improvement in their symptoms over eight weeks compared with those on the placebo. Some 47 percent of those on lithium scored in the range of "very much improved" or "much improved" on the Clinical Global Impressions Scale, a rating system commonly used to assess the efficacy of treatments in patients with mental disorders, compared to 21 percent of those on the placebo.

Unlike antipsychotic agents, such as risperidone or olanzapine, lithium treatment was not associated with significant weight gain, and none of the patients experienced serious side effects due to the lithium treatment.

Findling says the findings provide a scientific and reliable confirmation of lithium's efficacy and safety for children in the short term, offering evidence that doctors can use when deciding what medication to prescribe their pediatric patients with bipolar disorder. Further analyses are currently in progress to examine the long-term implications of lithium use, he adds. Areas of particular focus include evaluation of any potential side effects, such as weight gain, reduced kidney function or diminished thyroid function -- all important considerations, as those with bipolar disorder may need a lifetime of medication and behavioral therapies.

Bipolar disorder affects approximately 1 percent of teens and is the leading cause of disability in adolescence.

Source: Adapted Media Release, http://www.medicalnewstoday.com/releases/300847.php

 

Daily Dose

MMR Vaccine Update

vaccine, virus, health, parenting

Although there is more and more data to confirm that childhood vaccines are safe, and DO NOT cause autism….there  continues to be some parental concern surrounding the timing of a child’s vaccines.  The majority (read as all of my patients) receive their vaccines according to the CDC guidelines…and for the most part my patients realize the importance of vaccines and how many lives have been saved as more vaccines are given to children today than 25 years ago.  

But, when it comes time for the MMR (measles, mumps, rubella) vaccine, there are still a few parents who express concerns and some who would “like” to defer the vaccine to a later date when their child is “older”….typically after their child reaches the age of 18-24 months. Concerns are not only about safety, but also about efficacy of the vaccine at a younger age.   There have been several recent studies that should help to allay fears and actually reassure parents that giving the vaccine at 12 months of age is preferable and may have even have fewer side effects, if any, than when given when the child is older.

A study from Finland (which uses the same MMR vaccine)  looked at whether the antibody response (protection) from the MMR vaccine was any different when given at 12 months vs 18 months of age.  This study showed that the antibody response and protection from the MMR vaccine was similar when given at 12 months vs 18 months. Good news for giving it younger and protecting the child earlier.

Another study looked at the risk of febrile seizures after the MMR vaccine. This study reported that the risk of a seizure was more than 6 times higher during the 7 - 10 day interval after the MMR vaccine among children who were 16-23 months, as compared to those who were 12 -15 months.  So..in fact, delaying the vaccine actually put a child at more risk for a seizure than if given earlier.

These studies point to the win-win in giving the MMR vaccine to children at their 1 year old well child visit.  Not only does it provide earlier protection against measles, mumps and rubella ( a new outbreak of measles in the Amish community in Ohio was just reported), the chance of your child having any adverse effects are actually even lower. 

But remember, while this study showed “twice the risk” for delaying the vaccine…it is still a VERY LOW number, out of 10,000 kids there may be 4 extra febrile seizures.  While that number may seem insignificant,  when your child is one of the 4 to have a seizure it is significant. This is coming from a mother whose child had a febrile seizure (unrelated to vaccines) and who is a pediatrician.  It was even frightening for me to watch my child have a febrile seizure and I knew what was happening. While most febrile seizures only last 1-2 minutes he of course decided to have a prolonged seizure, (always doctor's kids). I am happy to report that he is of course totally fine and never had another febrile seizure…as most children “outgrow” febrile seizures during the pre-school years. 

Bottom line,  with these studies in hand…you should feel reassured that immunizing at 12 months is  preferable, safe and prevents serious illnesses.  

Your Baby

Does Your Unborn Baby Hear You?

2.00 to read

More than twenty years ago I remember reading that fetuses can learn to recognize their mothers and father’s voices and then respond to those voices as newborns. I thought… well maybe… but it seemed to me that voices from outside of the womb would sound muffled from inside. Of course, I don’t remember my in utero experience so I don’t really know how words sound.

Over the years though, scientists have continued to examine how and what babies learn before they are born.

A recent study by researchers at the University of Helsinki in Finland have determined that fetuses not only hear and recognize voices but they can become familiar with different words and different pitches used when saying those words.

The study involved 33 moms-to-be, and examined their babies after birth. While pregnant, 17 mothers listened at a loud volume to a CD with (2), four-minute sequences of the made-up words “tatata” or “tatota.” The words were said with several different pitches. The moms-to-be listened to the recordings beginning at 29 weeks of pregnancy -about 7 months along- until birth. They heard them around 50 to 71 times.

Following birth, researchers tested the babies for normal hearing and then performed an electroencephalograph (EEG) brain scan to see if the newborns would respond to the made-up words and different pitches. And sure enough, the brain scans showed increased activity from the babies who had been listening to the CD in utero when the words were played to them after birth. Not only did they respond to the words, but also seemed to recognize the different pitches used when they heard them.  

The babies born to the mothers who had not listened to the CDs while pregnant showed little reaction to the words or pitches.

 “We have known that fetuses can learn certain sounds from their environment during pregnancy,” Eino Partanen, a doctoral student and lead author on the paper, said via email.

“We can now very easily assess the effects of fetal learning on a very detailed level—like in our study, [we] look at the learning effects to very small changes in the middle of a word.”

Some experts believe the finding shows that not only can a third-trimester fetus hear and recognize voices; he or she can also detect subtle changes and process complex information.

“Interestingly, this prenatal exposure also helped the newborns to detect changes which they were not exposed to: the infants who have received additional prenatal stimulation could also detect loudness changes in pseudo words but the unexposed infants could not,” Partanen says.

“However, both groups did have responses to vowel changes (which are very common in Finnish, and which newborns have been many time previously been shown to be capable of).”

You may be wondering why is it even important that scientists know if fetuses can recognize voices or words.  Partanen says because sounds heard in utero may shape the developing human brain in ways that affect speech and language development after birth.

“The better we know how the fetus’ brain works, the more we’ll know about early development of language,” Partanen says. “If we know better how language develops very early, we may one day be able to develop very early interventions [for babies with abnormal development].” 

An abstract for the Finnish study is published on the Proceedings of the National Academy of Sciences website.

Does talking and singing to your baby before it’s born actually stimulate his or her brain activity and increase language learning? Some experts say definitely yes, others say it has no impact. But really, most moms and dads enjoy baby bump bonding whether it’s productive or not. And who knows, maybe your pre-born hears you loud and clear. 

Source: Meghan Holohan, http://www.nbcnews.com/health/unborn-babies-are-hearing-you-loud-clear-8C11005474

Your Child

Sleep: New Recommendations for Different Ages

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We all know how important a good night’s sleep is to being able to function well the next day. But how much sleep is really enough? How much we prefer is a personal choice, but how much we really need is now more concrete. 

After web analytics showed the vast popularity of the category, How Much Sleep Do We Really Need? on the National Sleep Foundation's (NSF) website, a panel of experts set about to reassure that the information provided there was the most accurate and up to date.

"Sleep duration was basically one of the most visited pages on the NSF website, and it wasn't really clear how those recommendations for the ranges had been arrived at," Max Hirshkowitz, Ph.D., chair of the National Sleep Foundation Scientific Advisory Council, told The Huffington Post.

The National Sleep Foundation decided to look at its recommendations and see if they should make any adjustments. After analyzing more recent literature on the subject, they came to the conclusion that an updating was due.

The panel of six sleep-experts and 12 medical experts conducted a formal literature review. The panel focused on the body of research surrounding sleep duration in healthy human subjects that had been published in peer-reviewed journals between 2004 and 2014. From the 312 articles reviewed, the experts were able to fine-tune existing sleep duration recommendations as detailed below:

  • Newborns (0-3 months): 14-17 hours (range narrowed from 12-18)
  • Infants (4-11 months): 12-15 hours (range widened from 14-15)
  • Toddlers (1-2 years): 11-14 hours (range widened from 12-14)
  • Preschoolers (3-5): 10-13 hours (range widened from 11-13)
  • School-Age Children (6-13): 9-11 hours (range widened from 10-11)
  • Teenagers (14-17): 8-10 hours (range widened from 8.5-9.5)
  • Young Adults (18-25): 7-9 hours (new age category)
  • Adults (26-64): 7-9 hours (no change)
  • Older Adults (65+): 7-8 hours (new age category)

“This is the first time that any professional organization has developed age-specific recommended sleep durations based on a rigorous, systematic review of the world scientific literature relating sleep duration to health, performance and safety,” Charles A. Czeisler, Ph.D., M.D., professor of sleep medicine at Harvard Medical School and chairman of the board of the National Sleep Foundation, said in a statement.

During sleep, your brain and body recharge. Lack of sleep can have short-term and long-term effects. Studies have shown that children and teens that do not get enough sleep have trouble concentrating in school, are more prone to drinking and drug use and are more likely to have behavioral issues. They are also more likely to suffer from depression.

Too little sleep can also affect growth and your child’s immune system – making it harder to fight off an illness.

For adults, if you’re able to function well on the amount of sleep you typically get, then that’s probably the right amount for you. However, for children, the NSF’s recommendations are a good resource for making sure your kids are getting enough sleep. If you find that your child is getting the recommended amount of sleep but is still groggy or lacks energy or focus during the day, talk to your pediatrician or family doctor to see if there may be something else that is causing these symptoms.

Sources: Sarah Klein, http://www.huffingtonpost.com/2015/02/02/how-much-sleep-durations-changes_n_6581628.html

Your Child

Make It a Safe Summer!

2:30

Summer is a time when lots of family create life-long memories. Vacations offer a chance for everyone to get away from the daily grind and explore someplace new. Some families choose to spend the summer closer to home with a “staycation.” You can still relax, have fun and spend time together without the added expense of travel.

One experience a family doesn’t want to have is when someone is injured or worse or falls ill during the summer break. To help make summer is a little safer remember these common sense safety tips.

Water Safety: Probably the number one danger to children in the summer is drowning.

·      Make sure your child learns how to swim.

·      Never leave your child unattended around water. We know it sounds strict, but there is no room for compromise on this one. Babies can drown in as little as one inch of water.

·      Drowning is silent. Always watch your child when they are in a pool, lake, ocean or pond.

·      Have a flotation device nearby to toss into the water for a child to grab if they are tired or in danger.

·      If you cannot swim, make sure that there is an adult who can swim with you when your children are in the water.

·      Put the cell phone away, forget about all the other things you have to do and give young children 100 percent of your attention when they are near or around water.

·      Keep pool areas fenced and locked when no one is in the pool.

·      Empty all tubs, buckets, containers and wading pools immediately after use. Store them upside down and out of children’s reach.

·      Keep toilet lids closed and use toilet seat locks to prevent drowning. It’s also a good idea to keep doors to bathrooms and laundry rooms closed. 

·      Parents have a million things to do, but learning CPR should be on the top of the list. It will give you tremendous peace of mind – and the more peace of mind you have as a parent, the better.

Hot Cars: Another danger for small children is hot cars. When a child dies or is injured in a hot car, it’s one of the most preventable tragedies. Parents and caregivers can forget they have a small child in the back seat of a car, or they can leave them in the car not realizing how fast the temperature will rise in a very short time. Occasionally, a child will enter a parked car and accidently lock themselves in. 

·      Always look before you lock your car.

•       Always check the back seats of your vehicle before your lock it and walk away.

•       Keep a stuffed animal or other memento in your child’s car seat when it’s empty, and move it to the front seat as a visual reminder when your child is in the back seat. Put something you’ll need in the back seat- like a briefcase or purse.

•       If someone else is driving your child, or your daily routine has been altered, always check to make sure your child has arrived safely.

•       Never leave a child unattended in a car. Opening windows will not prevent heatstroke. Heatstroke can happen on cloudy days and when the temperature outside is below 70 degrees.

•       If your traveling with several children, do a head count – see each child- before locking or leaving the car.

•       If your child is missing, check your car first thing.

If you see an unattended child alone in a car, take action!. Don’t wait more than a couple of minutes for the driver to return. If you see a child is unresponsive or in distress; call 911. Get the child out of the car then spray the him or her with cool water (not an ice bath). If the child is responsive, stay with them until help arrives. Send someone else to find the driver.

Food Safety: Who doesn’t love a good picnic or grilled meal? However, food borne illnesses are not something you’ll enjoy.

•       Keep cold foods cold.

•       Don’t keep any foods at room temperature longer than 2 hours -- or 1 hour if it’s warmer than 90 degrees.

•       Don’t reuse platters that have held raw meat until you wash them thoroughly.

•       Keep your grill away from buildings and branches.

•       Don’t let grease build up.

•       Never leave your grill unattended.

•       Keep kids and pets away.

•       Does yours use propane? Test for leaks before the season starts. If you ever smell gas while you’re cooking, get away from the grill and call the fire department.

Bug Bites: Summer brings bugs, ticks, bees, mosquitoes, fire ants, chiggers, spiders and other pests.

Mosquitoes are more than a bother. They can spread West Nile virus. Most people who get the virus have no symptoms at all. But very serious and sometimes fatal illness can happen in less than 1% of those infected.

The only way to avoid West Nile is to avoid mosquito bites. Wear mosquito repellent and, if weather permits, long pants and long sleeves outside from dusk to dawn.

At home, get rid of standing water in birdbaths, buckets, and tire swings. They’re breeding grounds for mosquitos.

A bite from a tick is not usually a big deal, but the wrong type of tick can cause real problems. Ticks can cause diseases such as Lyme disease and Rocky Mountain spotted fever, a bacterial infection that occurs mostly in the South Atlantic region in the U.S. If the family is trekking in wooded areas. Make sure that everyone is: 

•       Wearing light-colored long pants, so it’s easier to spot ticks.

•       Tucks their pants into socks or high-top boots or tape them to boots.

•       Wearing a hat and long-sleeved shirt, tucked in.

•       Sprays or rubs insect repellent on the tops of boots, exposed area of socks, and pants openings (inside cuffs, waistband, and fly).

•       Using insect repellant with DEET on your exposed skin.  For children, choose a repellent with no more than 10% to 30% concentration of DEET. If your pets go outside, check them regularly for ticks so they don't bring them in the house.

Fire ants have a painful bite and some children are allergic to them. Check your yard for fire ant mounds and if you find any, have them removed professionally.

If you’ve ever had chigger bites, you know how miserable they are. Keep your grass cut short and use bug repellent. Shoes and socks also offer some protection.

During bug season, a good repellent is going to be your best bet to protect your child and yourself from many of these pesky critters.

Shark Attacks: If you’re headed to the ocean, sunburn is more likely to be a problem for your child than a shark bite, however, this year is quickly on the way to setting a record for shark attacks. Here are some ways to lessen the risks.

•       Avoid being in the water at twilight, when sharks are most active.

•       Don’t go in the water if you’re bleeding.

•       Don’t wear shiny jewelry when you swim. It could look like fish scales to a shark.

•       Know that sharks are sometimes near the shore. Sandbars can trap them close to the beach at low tide.

•       Skip swimming after heavy rains, which may move some freshwater fish, including sharks, into areas they would not otherwise frequent.

Sunburn: Summertime can mean sunburn time as well. Not only are they painful; but sunburns can do more damage to the skin long after it has healed. Children are more prone to sunburn because of their delicate skin.

Try to keep your child out of the sun when the peak ultraviolet rays occur (between 10 A.M. and 4 P.M.).

In addition, follow these guidelines:

•       Always use a sunscreen to block the damaging ultraviolet rays. Choose a sunscreen made for children with a sun protection factor (SPF) of at least 15. (Check the label.) Apply the protection 15 to 30 minutes before going out. Keep in mind that no sunscreens are truly waterproof, and thus they need to be reapplied every one and a half to two hours, particularly if your child spends a lot of time in the water. Consult the instructions on the bottle. 

•       Dress your child in lightweight cotton clothing with long sleeves and long pants. 

•       Use a beach umbrella or similar object to keep her in the shade as much as possible. 

•       Have her wear a hat with a wide brim. 

•       Babies under six months of age should be kept out of direct sunlight. If adequate clothing and shade are not available, sunscreen may be used on small areas of the body, such as the face and the backs of the hands.

Heat Exhaustion: Too much heat can make you or your child very sick. Take special care with children and the elderly, because their bodies don’t cool as well. Kids are particularly at risk for heat cramps when they aren't drinking enough fluids.

Although painful, heat cramps on their own aren't serious. Cramps can be the first sign of more serious heat illness, so they should be treated right away to help avoid any problems.

Don’t let your child play outside during the hottest part of the day. Make sure they have plenty of fluids and a cool place to rest. If you suspect your child is suffering from heat exhaustion, call 911. Symptoms can include:

•       Increased thirst

•       Weakness

•       Fainting

•       Muscle cramps

•       Nausea and/or vomiting

•       Irritability

•       Headache

•       Increase sweating

•       Cool, clammy skin

•       Elevation of body temperature, but less than 104°F (40°C)

Protect Your Feet!

One minute you’re strolling barefoot. The next, you’re in pain. Puncture wounds happen more often in summer, when bare feet meet nails, glass, toothpicks, and seashells. 

The biggest problem is infection. Heat, swelling, and drainage are signs that need quick medical attention. You may also need to update your tetanus shot. 

These are just a few tips to help prevent some serious summertime injuries. Sometimes the problems are just an annoyance, other times they can be fatal. Summer is about fun and family time together. Just use common sense and follow these simple rules for a safer summer.

Sources: http://www.webmd.com/a-to-z-guides/ss/slideshow-summer-health-hazards?print=true

http://www.safekids.org/watersafety

http://www.safercar.gov/parents/InandAroundtheCar/heatstroke.htm

 

Daily Dose

Being a Dad

1:30 to read

Seeing that this is the week of Father’s Day (have you made your card or shopped yet?), I thought this was a good time to discuss some recent data that might be of interest to men….especially those who may be planning a family in the near future. 

For years research has shown that maternal age may contribute to birth defects and chromosomal abnormalities, including Down’s syndrome.. It has also been known that a pregnant woman’s health and habits may also affect their unborn baby’s health, therefore  woman are instructed to stop smoking and drinking alcohol while trying to get pregnant as well as throughout their pregnancy.

Dr. Joanna Kitlinska a researcher from Georgetown University has been studying how men’s age as well as their habits might also impact a child.  Her findings have shown a link between men who are over 40 years- “advanced paternal age”  and the incidence of autism as compared to fathers under 30 years of age.  Studies have also found that older fathers are more  likely to have children who develop schizophrenia.  Researchers wonder if this link may be due to changes in a father’s genes as they age….but to date this is unclear. “Biological clocks” and a woman’s decision to delay a pregnancy until their career is established (or for a myriad of reasons) may now be a decision that men will face as well.  Could both aging eggs and sperm play a role in genetic abnormalities? 

Smoking seems to be another habit that may somehow affect a man’s sperm and could potentially lead to genetic abnormalities in a child. 

While fetal alcohol spectrum disorders are known to be found in women who have consumed alcohol throughout their pregnancy,  researchers have also noted that 3 out of 4 children diagnosed with FAS also have alcoholic fathers.   Could their father’s excessive use of alcohol have also played a role in their developing brain?  This association has been found even if the mother did not drink alcohol during her pregnancy. Again, did the alcohol affect a father’s sperm and genes which was passed on to their child?

So…bottom line, it is important that “fathers to be” are equally invested in a healthy lifestyle when they are planning on having children.  It goes without saying that smoking, drinking, and even obesity and stress are not good choices for anyone …..but the fact that these choices may affect a future child are good reasons for both fathers, and mothers to be aware of this research when they are planning a family. 

 

Your Teen

Preventing ACL injuries in Young Athletes

2.00 to read

A new report states that young athletes are more susceptible to serious and potentially debilitating knee injuries. 

An increasing number of American children and teens are tearing up their knees, particularly kids who are involved in sports such as basketball, soccer, volleyball and gymnastics.  The most dangerous injury is a tear in the anterior cruciate ligament (ACL), which provides stability to the knee.

Specific types of training can reduce the risk of an ACL tear by as much as 72 percent, the report from the American Academy of Pediatrics (AAP) says.

"Neuromuscular training programs strengthen lower-extremity muscles, improve core stability and teach athletes how to avoid unsafe knee positions," lead author Dr. Cynthia LaBella, medical director and associate professor of pediatrics at Northwestern University Feinberg School of Medicine, and a member of the academy's council on sports medicine and fitness, said in an academy news release.

The AAP recommends that coaches who run these types of sports programs should learn more about the exercises that can help athletes strengthen their muscles and encourage their athletes to use them.

The risk of ACL injury among young athletes increases at age 12 for girls and age 14 for boys. The largest numbers of ACL injuries occur in female athletes ages 15 to 20. After an ACL tear, girls are much more likely to have surgery and less likely to return to sports than boys, experts said.

"After puberty, girls have a 'machine motor mismatch,'" report co-author Timothy Hewett, professor and director of research at Ohio State University's sports medicine department, said in the news release. "In contrast, boys get even more powerful relative to their body size after their growth spurt. The good news is that we've shown that with neuromuscular training, we can boost the power of girls' neuromuscular engine, and reduce their risk of ACL injuries."

Before some of the newer less-invasive surgical treatments were available, surgery was often delayed until the child’s skeletal structure was fully mature. Now though, improved treatment can avoid impact to the developing growth plates, which means that they can have surgery to stabilize the knee.

Overall, ACL surgery is about 90 percent successful in restoring knee stability, according to the report published online April 28 and in the May print issue of Pediatrics.

"In many cases, surgery plus rehabilitation can safely return the athlete back to sports in about nine months," report co-author Dr. William Hennrikus, professor of pediatric orthopedic surgery at Penn State Hershey Bone and Joint Institute, said in the news release. "Parents who are considering surgery for their child should seek out a pediatric orthopedic surgeon with sports medicine training."

ACL tears can have long-lasting effects. People who suffer an ACL tear are up to 10 times more likely to develop early-onset degenerative knee osteoarthritis, which can lead to chronic pain and disability, the report said. "This is important, because it means athletes who suffer an ACL tear at age 13 are likely to face chronic pain in their 20s and 30s," LaBella said.

If your child participates in any of these sports, check with your child’s coach to see if they are providing the appropriate amount of muscle strengthening exercises to fortify your child’s knee support system.

If you feel they are not getting any or enough of these needed exercises, consider enrolling your child in a muscle strengthening exercise program or begin doing them together at home.

Source: Robert Preidt, http://www.philly.com/philly/health/topics/HealthDay687065_20140428_Training_Programs_Protect_Young_Athletes_From_ACL_Tears__Report.html#cPXEpJy1wK9xQl6s.99

Your Child

Household Bleach Causing Flu and Infections in Kids?

1:30

One of the most popular disinfectants used in household cleaning is bleach. From cleaning wipes to straight out of the bottle, bleach is used to clean surfaces, remove mold and brighten clothes.

As far back as 3000 B.C. a form of bleach was used to brighten white clothes. Shakespeare even made reference to bleaching in 1598. But it was around 1913 that bleach was touted as a disinfectant. In many of today’s households, products containing bleach are used as a surface sanitizer to kill bacteria.

A new study from the Netherlands says the cleaning agent may increase children’s risk for flu, tonsillitis and other infections. The study did not prove cause and effect, but suggested that bleach and other similar cleaning products may be contributors to these types of illnesses.

The study was led by Lidia Casas, of the Center for Environment and Health at KU Leuven in Leuven, the Netherlands. Her team looked at more than 9,000 children, aged 6 to 12, in the Netherlands, Finland and Spain.

Those whose parents used bleach to clean their homes at least once a week had higher rates of respiratory and other types of infections. Specifically, Casas and colleagues found that these children had a 20 percent higher risk of having the flu at least once in the previous year, a 35 percent higher risk of recurrent tonsillitis and an 18 percent higher risk for any recurrent infection.

According to the study’s authors, airborne components of bleach and similar products may irritate the lining of children's lungs, triggering inflammation and making it easier for infections to take hold. Or, bleach may somehow suppress the immune system, making infections more likely, the team said.

The American Cleaning Institute (ACI), which represents makers of bleach and bleach products, responded quickly to the study.

"Since there was no data presented on the children's actual exposure to bleach -- nor any diagnoses of actual diseases -- the authors are merely speculating," the ACI said in a statement. The group also said that disinfecting household surfaces with bleach can protect people from bacterial infection.

Responses to the study from medical specialists have been mixed.

"While this study observes higher respiratory effects of bleach on children, it is not a cause-and-effect study, and other factors or household cleaners may be involved," said Dr. Len Horovitz, a pulmonary specialist at Lenox Hill Hospital in New York City.

"There is evidence that high concentrations of bleach can cause asthmatic reactions when ventilation is not adequate, but the leap to increased incidence of infections is less clear," he said.

Dr. Jacqueline Moline, vice president of population health at North Shore-LIJ Health System in Great Neck, N.Y., noted, "These results are in line with other studies that show the impact of cleaning products on the health of young children."

Moline also said that parents might want to consider using a different product for household cleaning, "the take-home message from this study is that one should be prudent in the use of harsh household cleaners with bleach or other chemicals, especially in homes with young children, and seek out less toxic or harsh products to clean the home."

The study was published online in the April edition of the journal Occupational & Environmental Medicine.

Source: Robert Preidt, http://consumer.healthday.com/respiratory-and-allergy-information-2/asthma-news-47/could-household-bleach-raise-kids-risk-for-flu-other-infections-698036.html

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