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Your Teen

Fewer Teens Having Sex, More Using Contraception

2:00

With the abundance of sexualized media directed at teens today, you might get the impression that they are constantly on the prowl to “hook up.” That’s not the case according to a new government study.

"The myth is that every kid in high school is having sex, and it's not true," noted Dr. Cora Breuner, a professor of pediatrics at Seattle Children's Hospital, who reviewed the findings. "It's less than half, and it's been less than half for more than 10 years," she said.

Sexual intercourse among teens has declined again after rates stabilized between 2002-2010, according to the National Center for Health Statistics report on teen sexual activity and contraceptive use released recently by the Centers for Disease Control and Prevention (CDC).

While the numbers aren’t exactly low enough to ease many parents’ minds, they are better than in previous years.

The study found that 42 percent of girls and 44 percent of boys - aged 15 to 19 - reported having sex at least once. That’s a huge decline from the peak of 1988 when 57 percent of teens between the ages of 15 and 19 reported having had sex.

And Breuner said that finding is nothing new. Going back to 2002, fewer than half of older teens told researchers that they are sexually active, federal data show.

Researchers also found that a higher percentage of teens having sex are involved in a relationship that is ongoing.

Three out of four girls participating in the study, said they were "going steady" with their first sexual partner, and a little more than half of the boys said the same. By comparison, only 2 percent of girls and 7 percent of boys said they lost their virginity to someone they just met.

"There's this myth that kids hook up quite a bit and have sex with someone they literally just met," Breuner said. "This dispels that myth, that our teenagers are having sex with people they don't know."

The statistics come from in-person interviews conducted with more than 4,000 teenagers across the United States between 2011 and 2015. Participation was voluntary and required parental permission, but responses were anonymous.

Today’s teens are more aware of and better educated about the dangers of sexually transmitted diseases such HIV and AIDS. Back in 1988, 51 percent of girls and 60 percent of boys between 15 and 19 said they were sexually active, but those numbers dropped to today's levels after word spread of a sexually transmitted disease that could kill, Breuner said.

Teens are also more concerned about the long-term consequences of pregnancy. Nine out of ten participants in the study said they use some form of birth control. Contraception is widely available now; particularly condoms and teens have better access to all forms of birth control than in decades before.  

At the same time, parents have become more at ease with talking about sex and making sure their teens engage in smart sex, Breuner added.

"Parents honestly to their credit were much more willing to talk about this with their teenagers and were more proactive in making sure they had access to contraceptives," she said.

The study was published in the June edition of the CDC’s National Health Statistics Report.

Story sources: Dennis Thompson, http://www.upi.com/Health_News/2017/06/22/Study-Most-US-teenagers-arent-having-sex/4041498137424/

Shamard Charles, M.D., http://www.nbcnews.com/health/kids-health/waiting-right-one-teens-having-sex-later-cdc-finds-n775236

 

 

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Codeine & Children

1:30 to read

I order to keep us all safe, the FDA is constantly monitoring drugs and their side effects.  For many years codeine was prescribed for children for pain relief as well as to suppress coughs.  Over the last few years there has been more and more discussion about limiting the use of narcotics in children, but I continue to see some children who come from seeing other physicians and have received a prescription that contains codeine.

 

The FDA just issued new warnings against using prescription codeine in children and adolescents. The FDA reviewed adverse event reports from the past 50 years and found reports of severe breathing problems and 24 deaths linked to codeine in children and adolescents. Genetic variation in codeine metabolism may lead to excessive morphine levels in some children.

 

The FDA also performed a literature review which noted excessive sleepiness and breathing problems, including one death, in breast-fed infants whose mothers used codeine.

 

Due to these findings the FDA is now recommending that “codeine should not be used for pain or cough in children under 12 years of age”. They have also issued a warning that codeine should not be used in adolescents aged 12-18 “who are obese or have conditions associated with breathing problems, such as obstructive sleep apnea or severe lung disease”. In retrospect, codeine was prescribed to more than 800,000 children younger than11 years in 2011. Amazingly, codeine is currently available in over-the-counter cough medicines in 28 states.  

 

Lastly, the FDA “strengthened the warning” regarding codeine and breast feeding. They now recommend that breast- feeding women do not use codeine…which may change the post delivery pain protocol. Nonsteroidal anti-inflammatories (Ibuprofen) and acetaminophen (Tylenol) are preferred and are effective for mild to moderate postpartum pain. As a pediatrician it is important that I discuss this with new breast-feeding mothers as well. 

Daily Dose

Lead Testing

1:30 to read

Lead exposure is young children may lead to long term consequences. Therefore, blood lead level testing has been recommended for all children at their 1 and 2 year check ups. Most doctors offices either prick a child’s finger or heel to draw the blood for testing, and many use an in office machine to perform the test.  

 

Some of the blood testing is performed by Magellan Diagnostics and the F.D.A. just announced that the 3 minute test run in many doctor’s offices could “yield inaccurate results when used on blood drawn from a vein”.  The F.D.A. went on to say “that there was no evidence at this point that the finger and heel prick methods have provided inaccurate results, and for some reason only venous blood has been associated with inaccurate readings”. 

 

I have already been getting some calls and emails from concerned parents wondering if their child needs to have repeat testing performed.  Fortunately, in our office we have routinely used capillary blood from a finger stick. We test that specimen for both lead and also a hemoglobin test to look for anemia.  You would probably remember a “venous blood draw” as it requires finding a vein (usually in the crook of the arm) and actually using a needle and syringe to draw the blood sample…a lot more difficult than a finger stick, especially in a squirming toddler.

 

We are all exposed to some lead in our environment, and lead levels under 5 mcg/dl as being “safe”.  If a child’s screening lead level is higher than 5, then most doctors will draw a venous sample to confirm the elevated levels and to then try to determine if the lead exposure is coming from the home, school, or environment. Infants and young children are especially vulnerable to the effects of long term lead exposure and lead poisoning, especially during periods of rapid brain growth and development. High lead levels may lead to long term effects on IQ and performance as well as affecting other body systems.

 

If your child is under the age of 6 years and you are concerned about the accuracy of their lead testing, you should call your doctor’s office and inquire if they had testing done on venous or capillary blood.  If there are concerns it would be appropriate to draw another sample from capillary blood or sent to an outside lab.  It is estimated that most of the testing performed in a doctor’s office was done on Magellan equipment which is used by about 10,000 pediatricians throughout the country.

 

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10 Reasons Teens Act The Way They Do

2:30

Anyone in the midst of raising a teen knows that the adolescent years can be some of the most difficult to get through and understand.

As a parent or guardian of a teenager that wants to be more independent, but also needs supervision and guidance, the times can be challenging indeed.

If that’s the position you find yourself in, you may be asking – what’s going on in that youngster’s brain? Actually, there’s a lot happening!

There are several scientific reasons an adolescent brain can be similar to a toddler’s: After infancy, the brain's most dramatic growth spurt occurs in adolescence. Here’s 10 things you may not know about your teen’s brain.

10. Critical period of development. Adolescence is generally considered to be the years between 11 and 19. It’s easy to see the outward changes that occur in boys and girls during this time, but inside, their brains are working on overdrive.

"The brain continues to change throughout life, but there are huge leaps in development during adolescence," said Sara Johnson, an assistant professor at the Johns Hopkins Bloomberg School of Public Health.

Parents should understand that no matter how tall their son has sprouted or how grown-up their daughter dresses, "they are still in a developmental period that will affect the rest of their life," Johnson told LiveScience

9. The growing brain. Scientists used to believe the greatest leap in neuronal connections occurred in infancy, but brain imaging studies show that a second burst of neuronal sprouting happens right before puberty, peaking at about age 11 for girls and 12 for boys.

The adolescent's experiences shape this new grey matter, mostly following a "use it or lose it" strategy, Johnson said. The structural reorganization is thought to continue until the age of 25, and smaller changes continue throughout life.

8. New Thinking Skills. This increase in brain matter allows the teenager to become more interconnected and gain processing power, Johnson notes.

If given time and access to information, adolescents start to have the computational and decision-making skills of an adult. However, their decisions may be more emotional than objective because their brains rely more on the limbic system (the emotional seat of the brain) than the more rational prefrontal cortex.

"This duality of adolescent competence can be very confusing for parents," Johnson said, meaning that sometimes teens do things, like punching a wall or driving too fast, when, if asked, they clearly know better.

Sound familiar?

7.  Teen tantrums. While teens are acquiring amazing new skills during this time, they aren’t that good at using them yet, especially when it comes to social behavior and abstract thought.

That’s when parents can become the proverbial guinea pig. Many kids this age view conflict as a type of self-expression and may have trouble focusing on an abstract idea or understanding another's point of view.

Particularly in today’s heavy media influenced world, teens are dealing with a huge amount of social, emotional and cognitive flux says Sheryl Feinstein, author of Inside the Teenage Brain: Parenting a Work in Progress (Rowman and Littlefield, 2009.)

That’s when they need a more stable adult brain (parents) to help them stay calm and find the better path.

6. Intense emotions. Remember the limbic system mentioned earlier (the more emotional part of the brain)? It’s accelerated development, along with hormonal changes, may give rise to newly intense experiences of rage, fear, aggression (including towards oneself), excitement and sexual attraction.

Over the course of adolescence, the limbic system comes under greater control of the prefrontal cortex, the area just behind the forehead, which is associated with planning, impulse control and higher order thought.

As teens grow older, additional areas in the brain start to help it process emotions and gain equilibrium in decision-making and interpreting others. But until that time, teens can often misread parents and teachers Feinstein said.

5. Peer pressure. As teens become better at abstract thinking, their social anxiety begins to increase.  Ever wonder why your teen seems obsessed with what others are thinking and doing?

Abstract reasoning makes it possible to consider yourself from the eyes of another. Teens may use this new skill to ruminate about what others are thinking of them. In particular, peer approval has been shown to be highly rewarding to the teen brain, Johnson said, which may be why teens are more likely to take risks when other teens are around.

Friends also provide teens with opportunities to learn skills such as negotiating, compromise and group planning. "They are practicing adult social skills in a safe setting and they are really not good at it at first," Feinstein said. So even if all they do is sit around with their friends, teens are hard at work acquiring important life skills.

4. Measuring risk.  "The brakes come online somewhat later than the accelerator of the brain," said Johnson, referring to the development of the prefrontal cortex and the limbic system respectively.

At the same time, "teens need higher doses of risk to feel the same amount of rush adults do," Johnson said. Not a very comforting thought for parents.

This is a time when teens are vulnerable to engaging in risky behaviors, such as trying drugs, sex, getting into fights or jumping into unsafe water.

So what can a parent do during this risky time? "Continue to parent your child." Johnson said. Like all children, "teens have specific developmental vulnerabilities and they need parents to limit their behavior," she said.

It’s when being a parent to your child instead of trying to be their “friend” is more difficult but much more important for their physical and emotional safety.

3. Yes, parents are still important. According to Feinstein, a survey of teenagers revealed that 84 percent think highly of their mothers and 89 percent think highly of their fathers. And more than three-quarters of teenagers enjoy spending time with their parents; 79 percent enjoy hanging out with Mom and 76 percent like chilling with Dad. That’s not 100%, but it’s probably more than you thought.

One of the tasks of adolescence is separating from the family and establishing some autonomy, Feinstein said, but that does not mean a teen no longer needs parents – even if they say otherwise.

"They still need some structure and are looking to their parents to provide that structure," she said. "The parent that decides to treat a 16 or 17 year old as an adult is behaving unfairly and setting them up for failure." 

Listening to your teen and being a good role model, especially when dealing with stress and the other difficulties life can present, can help your teen figure out their own coping strategies.

2. Sleep. Ah, yes, sleep. Although teens need 9 to 10 hours of sleep a night, their bodies are telling them a different story. Part of the problem is a shift in circadian rhythms during adolescence: It makes sense to teen bodies to get up later and stay up later, Johnson said.

But due to early bussing and class schedules, many teens rack up sleep debt and "become increasingly cognitively impaired across the week," Johnson said. Sleep-deprivation only exacerbates moodiness and cloudy decision-making. And sleep is thought to aid the critical reorganization of the teen brain.

"There is a disconnect between teen’s bodies and our schedules," Johnson said.

Shutting down the electronics an hour before bedtime has been shown to help teens as well as adults get to sleep quicker and sleep better. No computer, TV, video games or cell phones.

1.The “I am the Center of the Universe” syndrome. You may have noticed that your teen’s hormones are causing quite a bit of havoc. Experts say that’s to be expected. But you may still wonder- what the heck is going on with my kid?

The hormone changes at puberty have huge affects on the brain, one of which is to spur the production of more receptors for oxytocin, according to a 2008 issue of the journal Developmental Review.

The increased sensitivity caused by oxytocin has a powerful impact on the area of the brain controlling one’s emotions. Teens develop a feeling of self-consciousness and may truly believe that everyone is watching him or her. These feelings peek around age 15.

While this may make a teen seem self-centered (and in their defense, they do have a lot going on), the changes in the teen brain may also spur some of the more idealistic efforts tackled by young people throughout history.

"It is the first time they are seeing themselves in the world," Johnson said, meaning their greater autonomy has opened their eyes to what lies beyond their families and schools. They are asking themselves, she continued, for perhaps the first time: What kind of person do I want to be and what type of place do I want the world to be?

Until their brains develop enough to handle shades of grey, their answers to these questions can be quite one-sided, Feinstein said, but the parents' job is to help them explore the questions, rather than give them answers.

And there you have it. Teen’s brains are exploding with new data, confusing signals and dueling desires. It’s a tough time in one’s development- but rest assured, what you teach them by example and compassion as well as how you gingerly help guide them will last a life-time. Even when you do the best you can, there are no guarantees that they will turn out the way you’re hoping they will – they are after all- individuals with a will and a mind of their own. But now you know a little more about why your teen acts the way they do.

Story Source: Robin Nixon, http://www.livescience.com/13850-10-facts-parent-teen-brain.html

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