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Your Toddler

Tricycles Cause Almost 9500 Injuries a Year

2:00

The brightly colored, tripled wheeled tyke-bikes may appear pretty harmless, but tricycles injuries send thousands of children to the hospital every year according to a new study.

Researchers found that lacerations were the most common type of injury kids suffered.  

But in an indication that some kids might need more or better quality protective gear, researchers also estimated that about 30 percent of injuries were to the head and another 8 percent involved the elbow, noted lead study author Sean Bandzar.

“Head injuries in particular are very common with any kind of moving toy and that’s why we recommend helmets, and based on our findings I would also encourage parents to have kids wear elbow pads,” said Bandzar, a researcher at the Medical College of Georgia in Augusta.

Based on the 328 tricycle injuries reported by participating hospitals in 2012 and 2013, researchers estimated that there were about 9,340 injuries nationwide during the two-year study period.

The total included 2,767 injuries to the head and 767 at the elbow, as well as 1,880 accidents damaging the face, 954 hurting the mouth and 483 harming the lower arms, researchers estimated.

The study noted that on average, three year-olds were the typical age group injured and one to two-year olds, made-up slightly more than 50 percent of the cases.

Boys made up almost two-thirds of the cases.

With this age group, it came as no surprise that about 72 percent of the injures occurred at home.

There were a couple shortcomings of the study, the authors acknowledge in the journal Pediatrics, is that researchers lacked data on how accidents happened, whether kids wore helmets or other protective gear, what types of tricycles children rode and whether adults were present.

It’s also possible that the study didn’t have data on enough accidents to draw broad conclusions about tricycle injuries nationwide, said Dr. Gary Smith, president of the Child Injury Prevention Alliance and a professor of Pediatrics, Emergency Medicine and Epidemiology at The Ohio State University in Columbus.

“Tricycles are safe, especially if a few simple steps are taken to prevent injuries,” Smith, who wasn’t involved in the study, he told Rueters by email.

Children should always wear helmets any time they are on wheels above a hard surface – including tricycles, skateboards, scooters, skates and bicycles, Smith said. Tricycle riders in particular should only ride in areas separated from cars, and when parents can keep a close eye on them.

“Tricycles are somewhat riskier than other toys children use but that doesn’t mean they are highly risky toys,” said David Schwebel, a researcher at the University of Alabama at Birmingham.

While Schwebel, who wasn’t involved in the study, echoed the need for parental supervision, he also stressed that tricycles can be good for kids.

“Tricycles are valuable tools to help children develop critical gross motor skills like balance, coordination and strength,” Schwebel said by email. “Any tricycle, when used carefully in a supervised situation, is likely to be a positive activity for children.”

Source: Lisa Rapaport, http://www.reuters.com/article/2015/09/14/us-health-children-tricycle-injuries-idUSKCN0RE1TQ20150914

 

Your Child

Good Sleep Habits Help Kids Succeed in School

1:30

If you’ve ever been sleep deprived, you know how difficult it can be to focus and get through the demands of the day.

So it’s not surprising that a new study says that children, who have good sleeping habits by the age of five, do better when they start school.

However, what may surprise you is that according to the National Sleep Foundation, a 2004 poll revealed that 69 percent of children 10 and under experience some type of sleep problem such as insomnia, nightmares, restless legs syndrome, sleep terrors, sleepwalking and sleep apnea.

For this study, researchers reviewed the sleep behavior of nearly 2,900 children in Australia from birth until they were 6 or 7. They found that one-third had mounting sleep problems in their first five years that put them at added risk for attention disorders and emotional and behavioral problems in school.

"The overwhelming finding is it's vital to get children's sleep behaviors right by the time they turn five," researcher Kate Williams said in a Queensland University of Technology news release. Williams is on the faculty in its School of Early Childhood.

For many families, today’s social and home environment is a roller coaster ride; creating solid routines, winding down and focusing on good sleep habits has almost become a lost art.

Williams and her team found that children with increasing sleep problems in early childhood were apt to be more hyperactive and to have more emotional outbursts in the classroom.

"If these sleep issues aren't resolved by the time children are 5 years old, then they are at risk of poorer adjustment to school," she noted.

There are lots of online tips for helping children develop good sleeping habits. These are usually in every list:

·      No video games, TV or electronic gadgets for at least an hour before bed.

·      Set a bedtime and stick to it that allows for plenty of sleep.

·      Follow a routine – brush teeth, wash hands and face and settle in for sleep. Reading a book to your little one can help relax them.

·      Make sure their room is dark and cool when it’s time for light’s out.. If your child needs a night light, place it in the hallway or bathroom and leave the door ajar. Turn it off once they are asleep.

·      Avoid giving your child candy or food right before bedtime. Certain foods can be stimulating and creating the habit of eating before bed or during the night is a hard one to break.

·      Make sure your child is comfortable. Pajamas should not restrict movement. Blankets shouldn’t be so heavy as to cause them to be hot or too warm.

Story sources: Robert Preidt, http://consumer.healthday.com/kids-health-information-23/education-news-745/children-sleep-school-qut-release-batch-2570-708848.html

https://sleepfoundation.org/sleep-topics/children-and-sleep

Your Teen

Serious Burns Caused By E-Cigarette Explosions

1:45

Many family members have e-cigarettes inside their homes, pockets and purses. As more adults try to quit smoking traditional cigarettes, the use of electronic smoking devices (e-cigarettes) is rapidly increasing.  Several recent studies show that not only are adults experimenting with e-cigarettes, but also teens and preteens are attracted to the candy-flavored gadgets through peer pressure, advertising and celebrity endorsements.

One aspect of e-cigarette use that hasn’t gotten a lot of attention, until now, is that these devices can un-expectantly explode causing severe burns to the face and other areas of the body.

According to a research letter published in the New England Journal of Medicine, electronic-cigarette devices are randomly exploding, burning and injuring people near them when they detonate.

The University of Washington Regional Burn Center in Seattle has treated 22 people for burns and other injuries caused by exploding e-cigarettes since October 2015, lead author Elisha Brownson, M.D., a burn/critical care surgical fellow at the hospital, told HealthDay.

The lithium-ion batteries used in e-cigarettes, Brownson said, cause the explosions. These rechargeable batteries charge a heating coil that brings liquid nicotine and flavorings to the boiling point inside the device, creating an inhalable vapor. Batteries in some of the devices are overheating, causing a fire or an explosion, she said.

The first Seattle case Brownson treated was a man in his 20s using an e-cigarette while driving. The device exploded in his mouth, blowing out several front teeth. She said she has since treated a variety of burns and blast injuries caused by e-cigarettes, including patients with flame burns covering 10 to 15 percent of their total body surface.

"We see a lot of patients who have burns on their thigh and their hands. That's when the device has exploded in their pocket, and they're using their hands to get the device out and away from them," Brownson said. "There also have been a lot of injuries to the hands and face when people have had explosions as they've been using them. Patients tell us they had no idea this could happen. They've had little to no warning that the device is going to explode."

The flame-burn injuries have required extensive wound care and skin grafting, and exposure to the alkali chemicals released from the battery explosion has caused chemical skin burns requiring wound care.

Why do these devices explode? NBC News put the question to Venkat Viswanathan, an assistant professor of mechanical engineering at Carnegie Mellon University in March of 2016.

“The electrolyte inside the battery is basically the equivalent of gasoline, so when these batteries short out, there's a surge of heat that causes this flammable electrolyte to combust and explode."

Well-made lithium-ion cells have a very small risk of failure. But the cheaper cells "have a much greater chance of having a manufacturing defect," which increases the likelihood for failure, Viswanathan said.

The risk goes up if the cells are overcharged or charged too quickly. This can happen if the e-cig comes with a poorly designed charger or the user switches chargers. Well-made lithium-ion batters have fail-safe mechanisms to prevent these problems. Poorly made ones do not. Just because a charger plugs into that e-cig doesn't mean you should use it.

E-cigarettes remain largely unregulated. Until recently, the Food and Drug Administration (FDA) had made little headway in the regulation of e-cigarettes. However, the FDA has recently extended regulatory authority to cover all tobacco products, including e-cigarettes, although the prospects for battery regulation remain unclear. While these explosions were previously thought to be isolated events, the injuries among our 15 patients add to growing evidence that e-cigarettes are a public safety concern that demands increased regulation as well as design changes to improve safety. In the meantime, both e-cigarette users and health care providers need to be aware of the risk of explosion associated with e-cigarettes, the paper’s researchers noted.

Story sources: http://www.physiciansbriefing.com/Article.asp?AID=715566

Herb Weisbaum, http://www.nbcnews.com/business/consumer/what-s-causing-some-e-cigarette-batteries-explode-n533516

http://www.nejm.org/doi/full/10.1056/NEJMc1608478

Daily Dose

Exercise Can Maintain Heart Health

1.30 to read

Moms and dads...you have an exercise plan but what about your kids? Your child's heart health is important too! Heart health is based on genetics, diet and lastly exercise. (For adults and my teen patients as well, need to add smoking and drinking to the discussion).  

While I start talking about healthy eating during infancy the discussion about exercise comes a bit later.  If you have a toddler you know they “exercise”.....all day long, and never stop except to sleep! But as our children get older, once again it is up to the parents to model behavior, including exercise. 

I regularly ask, “how much time does your child play outside?” (I know it is much harder in winter months), “what does your child do for exercise outside of school?” and “do you exercise as a family?’”.  Once a child is older, say 5 or so, I include them in the questioning as well as they are a wealth of information. I ask them “if they ride a bike”....they love to tell me about taking off their training wheels. Then I ask “who they ride with and where do they go?”.  I also ask about bike helmets, you would be amazed at how many children tell me that they wear a helmet, but their parents don’t! (HINT HINT to parents). 

I find that most children under the age of 10 or so do get a fair amount of exercise, but as they get older many have stopped playing sports outside of school and have chosen to spend more time being sedentary.  They are not just watching TV, but have found other interests like music, art, drama, chess and even computer programming.  All of that is great, but children still need exercise and many schools have cut PE programs especially once you get to middle school and high school. This means that parents once again may have to encourage exercise, for the whole family. Walking the dog, family bike rides, tennis matches, front yard kickball or badminton.  Get the family exercising together....they may not even realize. 

The hardest group I have to encourage to exercise are my teens who are just not athletes (I can sympathize).  We all have our talents, but for some sports are not it.  I find myself asking my teenage patients, how much exercise they get and so many say, “None”.  Many say, “walking between classes” is all of their exercise, and the idea of walking to school is long gone for most.  Many of my teens start to gain weight after puberty and have to be reminded that we all stop growing....so you can’t keep gaining weight. Exercise has to be done on a regular basis...again it is about lifestyle. 

So, heart health and exercise should be a focus for families year round, see if you can get your family moving as we head into spring!

Your Baby

Obese During Pregnancy Linked to Obesity in Offspring

2:00

Not every time, but often, you’ll see obese couples and their kids are either obese or on the threshold of obesity. While adults have the power and the life experience to understand the health issues associated with obesity, their children – depending on their age- are reliant on on their parents making healthy choices for them.  

 Is generational obesity inherited or a case of families making poor choices where food and exercise are concerned – or both?

Researchers from the University of Colorado School of Medicine wondered if children born to obese moms might be predisposed to being obese due to their womb environment.

The team of scientists analyzed stem cells taken from the umbilical cords of babies born to normal weight and obese mothers. In the lab, they coaxed these stem cells to develop into muscle and fat. The resulting cells from obese mothers had 30% more fat than those from normal weight mothers, suggesting that these babies’ cells were more likely to accumulate fat.

No cause and effect was established, but the scientists noted that further research was needed. “The next step is to follow these offspring to see if there is a lasting change into adulthood,” says the lead presenter, Kristen Boyle, in a statement.

She and her colleagues are already studying the cells to see whether they use and store energy any differently from those obtained from normal-weight mothers, and whether those changes result in metabolic differences such as inflammation or insulin resistance, which can precede heart disease and diabetes.

Other studies have found a high correlation between parents’ Body Mass Index (BMI) numbers and their children ‘s BMI, particularly between mothers and their kids. Further, the BMI of grandmother’s and their grandchildren is also high.

What is a healthy weight gain for a pregnant woman? It depends on how much you weigh before getting pregnant.

The guidelines for pregnancy weight gain are issued by the Institute of Medicine (IOM); most recently in May 2009. Here are the most current recommendations:

•       If your pre-pregnancy weight was in the healthy range for your height (a BMI of 18.5 to 24.9), you should gain between 25 and 35 pounds, gaining 1 to 5 pounds in the first trimester and about 1 pound per week for the rest of your pregnancy for the optimal growth of your baby.

•       If you were underweight or your height at conception (a BMI below 18.5), you should gain 28 to 40 pounds.

•       If you were overweight for your height (a BMI of 25 to 29.9), you should gain 15 to 25 pounds. If you were obese (a BMI of 30 or higher), you should gain between 11 and 20 pounds.

•       If you're having twins, you should gain 37 to 54 pounds if you started at a healthy weight, 31 to 50 pounds if you were overweight, and 25 to 42 pounds if you were obese.

These recent findings point out again, how important it is for pregnant women to consider the possible long - term health affects on their unborn offspring when making decisions about their own health.

The report was presented in May to the American Diabetes Association.

Sources: Alice Park, http://time.com/3906135/obese-moms-wire-kids-obesity-during-pregnancy/

http://www.babycenter.com/0_pregnancy-weight-gain-what-to-expect_1466.bc

 

Parenting

Holiday Decorating Safety Tips

1:45

Millions of American families will enjoy the beauty and fun of decorating a Christmas tree and hanging lights this Holiday season.  Whether you choose an artificial tree or a fresh tree, there are steps you can follow to make sure that your tree and decoration space are safe.

Many house fires occur during November and December when Christmas lights and candles are pulled out and used. Not only are fires a hazard, but plenty of people end up in an emergency room due to injuries from falls, lacerations, back strains and children ingesting foreign objects.

The Consumer Protection Safety Commission has a great list of tips to help you make safety a priority.

1. Take special care with sharp, weighted, or breakable decorations. Lacerations were among the top reported decoration–related injuries last year.

2. Avoid trimmings that resemble food or candy that may tempt a child to mouth or swallow them.

3. Place decorations with small removable parts that can pose a choking hazard to young children out of reach.

4. Purchase only holiday light sets that bear the marking of a safety-testing laboratory. Fires sparked by holiday lights caused 10 deaths last year.

5. Examine new and old light sets for damage. Discard sets with cracked or broken sockets, frayed or exposed wires, and loose connections.

6. Keep burning candles in sight and away from places where kids and pets can knock them over. Between 2010 and 2012, candles were the source of an estimated 6,500 residential fires annually, causing 80 deaths, 650 injuries, and $237 million in property loss per year.

7. Place lighted candles away from items that can catch fire, such as trees, other evergreens, decorations, curtains and furniture.

8. Look for a label that reads “fire resistant” when purchasing an artificial tree. Check live trees for freshness. If the tree is fresh, the needles should stay in place and not break. It should be hard to pull them off the branches. Check the trunk to see if it is sticky. If so, it's definitely fresh. Check for loose needles by banging the tree up and down on the ground. Expect some needles to fall off but if a lot fall off, move to another tree. One that loses a lot of needles is no longer fresh and could be dry enough to be a fire hazard.

9. Place live Christmas trees away from heat sources, and keep trees well watered.

10. Read “Ladder Safety 101” for tips to prevent ladder falls this season. You may think you know everything there is to know about using a ladder, but even the “experts” can make mistakes and wind up in the ER.

It’s easy to get complacent when decorating for the holidays; it’s something a lot of families do year after year often using the same decorations. After a certain amount of time, these decorations can become worn and damaged. Make sure your holiday doesn’t turn into a visit to the emergency room or worse by brushing up on some simple safety tips.

Source: http://onsafety.cpsc.gov/blog/2015/12/07/tis-the-season-to-decorate-safely/

 

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

Parenting

Why Moms-To-Be Might Want to Hire a Doula

2:00

Ever heard of a doula?  You’re not alone if the answer is no.  The word “doula” comes from the ancient Greek meaning “ a woman who serves.”

According to DONA International, a doula is now used to refer to a trained and experienced professional who provides continuous physical, emotional and informational support to the mother before, during and just after birth; or who provides emotional and practical support during the postpartum period.

A recent study found that women with doula care had 22% lower odds of giving birth prematurely, and were less likely to have a C-section. (Among the women with doulas, 20.4% gave birth via cesarean, compared to 34.2% of women without doulas.)

For pregnant women, doulas can offer emotional and physical support throughout the pregnancy and labor; either in a hospital setting or at home.  There are also doulas that are certified to help mothers postpartum.

While many people may not have heard of doulas, they are beginning to gain some recognition.  TIME Magazine recently published an article on the 4 reasons why moms-to-be should consider hiring one.  The author spoke with Jada Shapiro, founder of the doula referral service, Birth Day Presence, in New York City.

1. They provide extra care and support:

Although every doula has a unique approach, their main role is to care for the mom-to-be. 

“Doulas offer continuous support to women both during pregnancy and after childbirth,” Shapiro explains.

“In a way, we are trying to recreate what was typical in old-world communities when women were surrounded by a vast support system of female friends and relatives during pregnancy.”

And while doulas are not medical professionals, they possess a wealth of knowledge about pregnancy and childbirth that can be extremely helpful for expectant moms.

“We work closely with our clients to de-mystify pregnancy terminology and help women interpret their options,” says Shapiro. 

That said, one of the most common misconceptions about doulas is that they interfere with a woman’s obstetrician. Shapiro says it’s important to note that this is not the case. “Doulas complement the care a woman receives from her doctor,” she says. “We don’t get in the way of medical decisions.”

She also adds that while many people believe you can only work with a doula if you want a medicine-free birth, this is also untrue: Women with all kinds of birth plans can find it helpful to consult a doula during their pregnancy.

2. They can assist with pain management:

Moms-to-be are well aware of the stories of pain during labor and delivery as well as the growing physical un-comfortableness that comes with being pregnant.

“Doulas are well-trained in physical comfort and can offer a wide range of pain relief techniques and tools,” says Shapiro, including acupressure, hydrotherapy, birthing balls, massage, and suggesting position changes during labor. Doulas can also help moms relax with soothing imagery, music, and breathing exercises.

This individualized level of care can help moms feel a little calmer during one of the most physically and emotionally challenging days of their lives. “I believe that many mothers just feel generally more cared for and less alone during the experience of childbirth with the help of a doula,” Shapiro says.

 

3.They provide support to both moms and their partners:

“Something I hear from many of my clients is that they can’t believe how intimate their childbirth experience was, even with a doula there,” says Shapiro.

She adds that because childbirth can be such an overwhelming experience for families, having the support of a third party can be just as useful for partners as it is for moms-to-be: 

“Doulas can help recall important information from midwife or doctor appointments, lend a helping hand if mom needs a massage, or just generally absorb some of the stress from the partner,” she says. “In this way, a doula can allow partners to be fully present in the experience.”

4. They’re there for you on the big day:

“Doulas are typically on-call 24/7 during a client’s ‘due window’ of 36 to 42 weeks,” says Shapiro.

When a woman goes into labor, her doula will be available for physical and emotional support both while she’s laboring at home as well as accompanying her to the hospital.

And in addition to the aforementioned relaxation and pain relief techniques, doulas know a lot about childbirth (Shapiro, for example, has attended “more than 350” births in her 13 years as a professional doula).

“During labor, doulas might suggest alternate positions; encourage different non-medical techniques to potentially help speed up dilation, such as walking around; and just generally act as a sounding board for difficult medical decisions,” she says.

If you’re interested in learning more about doulas, you can check out the DONA International website at www.dona.org. It has information on where you can find a certified doula and how the process works.

Sources: Kathleen Mulpeter, http://news.health.com/2016/01/28/what-is-a-doula-4-reasons-pregnant-women-might-want-one/

Parenting

Calming Kid’s Pre-Surgery Anxiety: iPads or Drugs?

1:00

Once you think about it, it makes a lot of sense; a new study shows that iPads work as well as sedative drugs to calm anxious kids before surgery.

Researchers assessed 112 children between 4 and 10 years old in France who had day surgery requiring general anesthesia. Twenty minutes before receiving the anesthesia, 54 kids were given the sedative midazolam and 58 were handed an iPad to distract them.

Guess what they found. The anxiety level for both groups was about the same. However, iPads conferred none of the side effects of sedatives, the researchers said. Also, they said the kids given iPads were easier to anesthetize.

"Our study showed that child and parental anxiety before anesthesia are equally blunted by midazolam or use of the iPad," said Dr. Dominique Chassard and colleagues at Hospital Femme-Mere-Enfant in Bron, France. "However, the quality of induction of anesthesia, as well as parental satisfaction, were judged better in the iPad group."

As any parent knows, iPads and other tablets offer an endless amount of entertainment to help children relax. From music to cartoons to games, there are plenty of programs available to take a child’s mind off of the current situation.  It’s not surprising they would work to help alleviate anxiety before something as scary as surgery. 

The study was to be presented this week at the World Congress of Anesthesiologists meeting in Hong Kong. Researched presented at medical meetings is considered preliminary.

Story source: Robert Preidt, http://www.webmd.com/parenting/news/20160830/ipads-calm-surgery-bound-kids-as-well-as-sedatives

 

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