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Daily Dose

No Screen Summer!

1:30 to read

Kicking off the summer and I have had a few parents announce that they have decided to have a “screen free” summer. When I asked them what this meant they said NO “ipads, phones, computers” for the summer and they have vowed that they will spend more time outside playing, reading, going on “field trips” and enjoying more family time.

 

I am thrilled that I have seen more than one family who has decided to adapt this summer rule and this means that the parents are also going to forgo a lot of unnecessary screen time. That is a difficult summer for parents as well.

 

Now…with that being said, there are some exceptions….namely car trips and travel. For those trips the I-pad or phone will be allowed but once the destination has been reached…they are going to be back on the “do not use” feature.

 

So far …week one…these families have already been enjoying the screen free decision and they have explored the library, the Arboretum and even the art museum. But, even if you don’t Iive in a big city you can find all sorts of things to do…start your own book club, go fishing, plan a lemonade stand or go visit a nursing home to brighten a elderly person’s day.  There are so many different opportunities, some of which your child can do on their own, and others which will involve the family.

 

It also doesn’t have to be “all or nothing”!! Especially if you have older kids. Maybe small steps with “screen free” days on alternate days. Or certain parts of the day devoted to family time and being screen free. There are many ways to approach a “screen free” summer without making it miserable and a constant struggle. Any commitment to taking some time away from the screen will be beneficial for everyone.

 

Let me know know how it goes….Be creative!

Your Baby

“Hard” Tap Water and Eczema in Infants

1:30

Previous studies have noted an association between “hard” tap water and eczema in schoolchildren, but a new study out of the U.K. suggests it may be linked to eczema in babies as well.

Water described as “hard” contains a high degree of minerals - specifically calcium, magnesium and manganese. It’s not considered hazardous, but it comes with a variety of unpleasant effects such as soap scum in sinks and bathtubs, spots on dishes and shower glass, clogged pipes from buildup and clothes that are left dingy after washing.

By some accounts, 85% of U.S. households have hard water.

If your child has eczema, then you know that it is a chronic condition marked by itchiness and rashes. It typically starts at about 6 months old and can last into adulthood.

The study included 1,300 3-month old infants from across the United Kingdom. Researchers checked hardness -- the water's mineral content -- and chlorine levels in the water supply where the babies lived.

Babies who lived in areas with hard water were up to 87% more likely to have eczema, the study found.

"Our study builds on growing evidence of a link between exposure to hard water and the risk of developing eczema in childhood," said lead author Dr. Carsten Flohr, from the Institute of Dermatology at King's College London.

One way to change the composition of hard water is by adding a water softener system to your household

There are several types of systems including salt-based Ion exchange softeners, salt-free softeners, dual tank and magnetic water softeners plus others.

While the other studies focused on school aged children, this is the first to look at the connection with eczema, hard water and babies, the researchers said.

The study wasn't designed to prove a cause-and-effect relationship, so further research is needed to learn more about this apparent link, Flohr added.

"We are about to launch a feasibility trial to assess whether installing a water softener in the homes of high-risk children around the time of birth may reduce the risk of eczema and whether reducing chlorine levels brings any additional benefits," Flohr said in a college news release.

The study was published recently in the Journal of Allergy and Clinical Immunology.

Story sources: Robert Preidt, https://www.nlm.nih.gov/medlineplus/news/fullstory_159150.html

http://extoxnet.orst.edu/faqs/safedrink/hard.htm

 

 

Daily Dose

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

National Safety Month

1:30 to read

June is National Safety Month…just in time for summer! It is a good reminder for all of us to try and prevent any injuries in our children. I do know from my own pediatric office that we see more injuries during the summer months. Whether it is from falls, bike accidents, pool incidents, household poisonings or burns, our phones stay busy.

 

So..this is the perfect time to re-think child proofing your home. Make sure that stairs are gated, both top and bottom. Cabinets need to have child proof latches to protect children from getting into breakable or sharp objects as well as medicines or household products that may be poisonous.  Put the number for Poison Control in your phone….1-800-222-1222. I am often surprised that a parent calls our office about a child who has “gotten into “ a possible poison…the first call should be to Poison Control. Keep the number posted in the house as well so a babysitter may also have it if necessary.

 

Learning to ride a bike a is “life skill” for sure….but that also includes learning to wear your helmet. I see most young children in our neighborhood who are still under the eye of a parent with a bike helmet, but once they are older I often see kids without helmets. Just saw a neighbor’s child ride down the street this evening..no helmet!!  Bike helmets are like a seat belt…not optional. Many “tween” boys will “debate” with me during their check ups about the need for a helmet,  as they tell me “ I am a great bike rider and don’t have wrecks”. Teach your children what the word ACCIDENT means and that just like a car…you never know what “the other guy may do”.  Accidents are NEVER planned and a bike helmet protects the head and brain. We can “fix” the broken arm or stitch a leg…but cannot “fix” a brain injury.

 

Texting and driving is unsafe and may even be illegal in your state. Texas just passed a law prohibiting texting and driving….but teens (and adults)  need to be reminded on a regular basis that texting is not allowed!!  Texting while driving is a leading cause of accidents and I just saw a mother who is pregnant, and was in the office with her 1 year old…she had just been involved in accident that totaled her car.  She was hit from behind by a teen who had been texting and never slowed down.  Fortunately both mother and child were buckled up and were not seriously injured.  If your child is found to be texting while they are driving you should have some serious consequences with both revoked driving privileges and no phone for a while. 

 

Lastly, this is a good month to remember to check your medicine cabinet and throw away any expired or unused medication.  There are some pharmacies that are having events where you can bring in expired medications and they will dispose of them properly. The number one place that  teens find drugs is in the home…keep all narcotics locked up and dispose of any unused medications!! I have had more than several parents who have told me that “drugs” had disappeared from their medicine cabinets after their own kids had had a lot of friends over…and who knows who may be “seeking” prescription medications. Locks on medicine cabinets and liquor cabinets are a must for families. 

What about taking a family first aid course at your local YMCA or Red Cross and spend a day getting your own family first aid kit together.  This is a great way to spend some time together and a productive activity. Have a fun and safe summer!!

Your Toddler

Is Your Child a Biter?

2.00 to read

At some time or another your sweet child is going to bite or wallop someone, most likely another kid. And yes, it's embarrassing to have to pull your child off another or to apologize to grandma because her grandchild just took a chunk out of her arm. 

Know that you’re not alone - all kids bite and /or hit. The key to stopping aggression in children is teaching them that there are alternative ways to handle frustration and biting is not acceptable behavior.

Not all biting stems from anger. The younger the child, the less chance that biting is an aggressive behavior. It can also be a simple case of exploration. Young children bite for many reasons, from painful gums because they are teething to seeing what kind of reaction they get. Children between the ages of one and three typically go through a biting phase they eventually outgrow.

While biting may be a normal phase kids go through, it’s something you want to discourage.

Let’s look at some of the reasons kids bite.

  • They're in pain. When babies bite, typically it's because they're teething. They're just doing it to relieve the pain of their swollen, tender gums.
  • They're exploring their world. Very young children use their mouths to explore, just as they use their hands. Just about everything infants or toddlers pick up eventually winds up in their mouths. Kids this age aren't yet able to prevent themselves from biting the object of their interest.
  • They're looking for a reaction. Part of exploration is curiosity. Toddlers experiment to see what kind of reaction their actions will provoke. They'll bite down on a friend or sibling to hear the surprised exclamation, not realizing how painful the experience is for that person.
  • They're craving attention. In older kids, biting is just one of several bad behaviors used to get attention. When a child feels ignored, discipline is at least one way of getting noticed -- even if the attention is negative rather than positive.
  • They're frustrated. Biting, like hitting, is a way for some children to assert themselves when they're still too young to express feelings effectively through words. To your child, biting is a way to get back a favorite toy, tell you that he or she is unhappy, or let another child know that he or she wants to be left alone.

So, how do you prevent or teach your child that they can’t go through life biting others?

You start with consistent prevention and move on to discipline if they are older.

  • If your baby is teething, make sure to always have a cool teething ring or washcloth on hand so he or she will be less likely to sink teeth into someone's arm.
  • Avoid situations in which your child can get irritable enough to bite. Make sure that all of your child's needs -- including eating and naptime -- are taken care of before you go out to play. Bring along a snack to soothe your child if he or she gets cranky from being hungry.
  • As soon as your child is old enough, encourage your child to use words such as “I'm angry with you" or "That's my toy" instead of biting. Other ways to express frustration or anger include hugging (not hitting) a stuffed animal or punching a pillow. Sometimes redirection is helpful; shortening activities or giving your child a break can help prevent the rising frustration that can lead to biting and other bad behaviors.
  • Give your child enough of your time throughout the day (for example, by reading or playing together), so he or she doesn't bite just to get attention. Extra attention is especially important when your child is going through a major life change, such as a move or welcoming a baby sibling. If your child is prone to biting, keep an eye on any playmates and step in when an altercation appears to be brewing.

You’ve done all that is possible to prevent another biting situation, and low and behold your child is biting another. What do you do then?

When your child bites, firmly let your child know that this behavior is not acceptable by saying, "No. We don't bite!" Explain that biting hurts the other person. Then remove your child from the situation and give the child time to calm down. It’s important that you remain calm.

Seeing your child bite another is naturally going to create an unpleasant reaction in you. As soon as you witness a biting episode, your body tenses, your heart races, and even if you don't actually scream, you really want to. The angrier you are, the tenser the situation becomes. You are much more likely to strike your child when you let your anger get the best of you. Take a deep breath, assess the situation and intervene calmly. Remove your child, let him or her calm down and explain (yes, once again) that biting is not going to be tolerated. If your child is old enough to understand time-out, this is a good time to use it. If not, remove the child from the temptation. Playtime is over.

One way some parents handle biting is to bite their own child to show them how painful it can be. Doing what you are telling your child not to do sends a mixed message. It’s similar to hitting your child and then saying “don’t hit others.” Most likely your child will experience how painful it is because another child will bite them someday.

The point is not so much that biting is painful, the action itself is unkind, unproductive and wrong.

When biting becomes a habit or continues past the age 4 or 5, it may stem from a more serious emotional problem. This is the time to ask for help from your pediatrician, family doctor or a child psychologist.

If your child is bitten, wash the area with soap and water. If the bite is bleeding and the wound appears to be deep, call your child’s doctor. The bite may need medical treatment, which could include antibiotics or a tetanus shot or both.

Biting is a horrible habit to get into and a difficult one to stop. Start teaching your child early that momma and daddy are not putting up with it and that there are better ways to explore the world and handle frustration.

Source: http://www.webmd.com/parenting/guide/stop-children-from-biting

Your Child

Frito-Lay Recalls Pretzels Due to Peanut Residue

2:00

Many children, who are allergic to peanuts and other nuts, consume pretzels as a snack.

Frito-Lay announced they are voluntarily recalling certain Rold Gold Tiny Twists, Rold Gold Thins, Rold Gold Sticks and Rold Gold Honey Wheat Braided due to a potential undeclared peanut allergen.

This recall is the direct result of a recent recall by a Frito-Lay supplier of certain lots of flour for undeclared peanut residue. The Rold Gold products subject to the recall may have been produced using the recalled flour and, as a result, these Rold Gold products may contain low levels of undeclared peanut residue. More information about the flour recall can be found on the FDA’s website at: http://www.fda.gov/Food/RecallsOutbreaksEmergencies/SafetyAlertsAdvisories/ucm504002.htm.

The affected Rold Gold packages are sold in retail stores and via foodservice and vending customers throughout the United States, and have “guaranteed fresh” dates ranging from June 28, 2016 - August 23, 2016 on the front of the package. Directly underneath the “guaranteed fresh” date is a 9-digit manufacturing code that includes the numbers “32” in the second and third position (example: x32xxxxxx).

The following products with the above-described “guaranteed fresh” dates and manufacturing codes are impacted:

•       Rold Gold Tiny Twists - 1 oz. , 2 oz., 16 oz. and 20½ oz.

•       Rold Gold Thins - 4 oz. and 16 oz.

•       Rold Gold Sticks - 16 oz.

•       Rold Gold Honey Wheat Braided - 10 oz.

It is important to note that products that do not include 32 in the second and third positions of the manufacturing code are not impacted.

The Rold Gold Tiny Twists are also included in select multipack offerings. The impacted multipacks have “use by” dates on the front of the package. Directly next to or underneath the “use by” date is a 11-digit manufacturing code that will include the letter combination AM, TO, QH, QC or SW in the second and third position (example: xAMxxxxxxxx). The impacted products have different, varying “use by” dates, including:

•       20 count Baked & Popped Mix -- “use by” dates ranging from May 31 - July 26, 2016

•       20 count SunChips & Rold Gold Mix -- “use by” dates ranging from June 14 - August 9, 2016

•       32 count Fun Times Mix -- “use by” dates ranging from June 14 - August 9, 2016

•       30 count Baked & Popped Variety Pack -- “use by” dates ranging from June 14 - August 9, 2016

•       30 count Home Town Favorite Variety Pack -- “use by” dates ranging from May 31 - July 26, 2016

To date, Frito-Lay has received no reports of illness related to the products covered by this recall. No other Rold Gold products or flavors are impacted. Frito-Lay has informed the FDA of our actions.

Consumers with any product noted above can return the product to retailer for a full refund, or contact Frito-Lay Consumer Relations (9 a.m. - 4:30 p.m. CST, Mon.-Fri.) at 1-888-256-3090 or www.pretzelrecall.com.

Story source: http://www.fda.gov/Safety/Recalls/ucm505365.htm

 

Daily Dose

Hot Car Deaths

1:30 to read

Did you know that heat stroke is the second leading cause of non-traffic fatalities among children, with the first being backover deaths.  As the summer temperatures are rising these tragic accidents become all too frequent.  

My home state of Texas leads the country in child vehicular heat stroke deaths, followed by Florida and California.  But children who are trapped in vehicles have died in milder climates as well. The temperatures outside may be as low as 60 degrees, but the inside of a car heats up quickly, with 80% of the increase in temperature happening in the first 10 minutes. The reason for this is due to physics.....the sun’s short-wave radiation is absorbed by dark dashboards and seats...the heated objects including child seats then emit long wave radiation which heats a vehicle’s interior air.  All of this leads to tragedy.

A child’s thermoregulatory system is not the same as an adult’s, and their body temperatures will warm 3-5 times faster.  When a child’s body temperature rises to about 107 degrees or greater, their internal organs begin to shut down.This scenario can then lead to death. If you see a child who has been left in a hot car call 911...every minute matters.

The greatest percentage of these tragic deaths are totally unintentional.  These parents are not “bad parents” or “child abusers”, they are loving, good parents who simply forgot that their child was in the car. On average there have been around 37 deaths per year due to vehicular heat stroke and in most cases this is not due to reckless behavior but simply to forgetfulness.  Parents and caregivers both admit to “just forgetting” a child was in the car.  It truly can happen to anyone.

So, how can you remember that your precious, quiet, sleeping child is in back seat. Make it a routine to always look in the back seat before you lock and leave the car.  Try putting your purse, briefcase, or cell phone in the back seat as a reminder to look for your child.

Lastly, if your child is in childcare, have a plan that the childcare provider will call you if you have not notified them that your child will not be coming to school,  and they don’t show up.

Your Child

Your Child’s First Day at School

1:45

While I may have forgotten a lot of things in my life, I remember my first day of school. I was so excited because I actually recognized someone. Her name was Donna. We’d met in a department store a week earlier. We had both picked out the same umbrella, but there was only one – she said I could have it. We’ve been friends for life.

When my daughter began school, she experienced all the same emotions I had those many years ago; scared, excited and uncertain where to go and what to do next. She found a friend also and they wandered the halls together.

Some school districts have already begun their new school year, but for many kids - the bell will ring in the next couple of weeks.

Children aren’t the only ones that are anxious as the first day rolls around – parents can get quite nervous and have that feeling that their little one is growing up so fast- trust me I know. It’s a normal “things are about to change” emotion.

One tip I’d like to suggest before your little one starts school is to share your own first day memories with your child as well as pictures. It’s amazing how comforting it is for a child to know that their parents did the same thing at their age and lived to tell about it!

To help make the first day of school a little less scary for your child, here are some other tips from https://www.healthychildren.org:

•       Point out the positive aspects of starting school: It will be fun. She will see old friends. She will meet new friends. Refresh her memory about previous years, when she may have returned home after the first day with high spirits because she had a good time.

•       Remind your child that he is not the only student who is a bit uneasy about the first day of school. Teachers know that students are anxious and will be making an extra effort to make sure everyone feels as comfortable as possible.

•       Talk about the kinds of interesting things he will learn in the months ahead.

•       Buy him or her something (perhaps a pen or pencil) that will remind her you are thinking of them while they are at school, or put a note in their lunch-box.

•       Reassure your child that if any problems arise at school, you will help re­solve them. (If problems do occur, get involved as soon as possible.)

•       Find another child in the neighborhood with whom your youngster can walk to school or ride with on the bus. If your child is not going to ride a school bus and you feel it is appropriate, drive your child (or walk with her) to school and pick her up the first day.

•       Encourage him to look for new students in his classroom or in the play­ground, invite them to join the group for a game, and ask them about their interests.

•       After school, show your child some special attention and affection. Give him or her a hug and ask what happened at school. Did she have fun? Did he make any new friends? Does she need any additional school supplies (notebooks, rulers, erasers) that you can shop for together?

In addition to the suggestions listed above, your child may need some extra support if he or she is starting school in a new location. Here are some suggestions to make the transition easier.

•       Talk with your child about his or her feelings, both their excitement and their con­cerns, about the new school.

•       Visit the school with your child in advance of the first day. Teachers and staff are usually at school a few days before the children start. Peek into your child's classroom, and if possible, meet the teacher and principal. You might be able to address some of your child's concerns at that time. She may have no questions until she actually sees the building and can vi­sualize what it will be like. (When you formally register your child in the new school, bring her immunization record and birth certificate; usually school records can be sent directly from school to school once you sign a "release of information" form.)

•       Try to have your child meet a classmate before the first day so they can get acquainted and play together, and so your child will have a friendly face to look for when school begins.

•       Do not build up unrealistic expectations about how wonderful the new school will be, but convey a general sense of optimism about how things will go for your child at the new school. Remind him that teachers and other students will be making an extra effort to make him feel welcome.

•       If your child sees another student or a group engaged in an activity she is interested in, encourage her to ask if she can participate.

•       As soon as you can, find out what activities are available for your child in addition to those that occur during school itself. Is there a back-to-school picnic or party planned? Can he or she join a soccer team? (For community sports programs, sign-ups often begin weeks or even months before the start of the season.)

It’s been many years since my first day at school but I remember it well. Your child’s life is about to change forever, but that’s a good thing-another milestone in life’s progression. Give him or her a hug, wipe away the tears and smile a big smile. Let them know you trust them and are proud of them. Then go ahead and shed a few tears of your own when you’re back in the car. Yes, they are growing up fast. 

Story source: https://www.healthychildren.org/English/ages-stages/gradeschool/school/Pages/Making-the-First-Day-of-School-Easier.aspx

 

Daily Dose

Elf on the Shelf

1:00 to read

“Tis the season”, and many of the families I care for have gotten out their “Elf on the Shelf” to help keep the season as merry and harmonious as possible. I think “TEOTS” is genius, as it is a fun way to use positive reinforcement during the holidays as behavior modification.  That elf needs to stay around a bit longer…but then it would lose the appeal.  The anticipation of the elf arriving plays a major role don’t you think?  

 

With the arrival of the elf I get to hear all of the cute family elf stories during the month of Dec. I also noticed that “TEOTS” has some new “gadgets” and outfits to add to the fun, such as a zip line to swing from and suctions boots so he/she can climb up walls. Ingenious right? Surely they will soon have an array of elf outfits so the elf can have some choices to wear during zip lining.

 

During the last year there was also a lot of discussion about what our children were hearing on the news and during presidential debates etc. It doesn’t matter your political affiliation, children were picking up on a lot of what was going on.  Even children whose parents were paying attention to all of the bullying during the debates and atrocious sound bites on the news by limiting TV and electronics told me that their children still overheard things. They were concerned about the messages that both candidates were sending…especially to children.  

 

So…when one of my families took out “TEOTS”  their son, who is almost 3, decided it was the year to name him. “Of course you can name your elf they said”.  The next day he announced that the was looking for the elf and asked his mother, “where is Donald Trump?”. She was a bit confused…until he returned holding the the elf and proudly announced, “ I found The Donald”!!

 

Out of the mouths of babes. More elf stories this month for sure!!

 

 

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