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Your Teen

Alcohol-Branded Clothing & Accessories Linked to Youth Alcohol Use

2:00

The T-shirts, handbags, backpacks, hats, jackets and sunglasses we wear and carry all say a little something about who we think we are or would like to be. Clothing with slogans and photos, accessories with name –brands or specific designs help express, at least a small way, how we connect with others and want others to connect with us.

From politics to religion to music and movies – we’re not likely to wear something that we philosophically disagree with. That’s pretty much true in all age groups.

So, what does it mean when teens proudly wear clothing and carry products with alcohol-brands up front and center?

According to a large review of different studies on the topic, teens that own caps, shirts, and other merchandise displaying alcohol logos are more likely to drink.

Australian researchers reviewed results from 13 studies looking at alcohol-branded merchandise and teen alcohol use. The research included more than 26,000 kids and teens, mostly from the United States.

Four studies looked specifically at young people who hadn't started drinking alcohol. Those who owned alcohol-branded merchandise were more likely to start drinking a year later, the researchers said.

While the study doesn’t prove causation (teens will drink if they own alcohol-branded items), it does show an association between the two activities.

"It is possible that owning the merchandise makes young people more likely to drink, or that young people who drink are more likely to want to own the merchandise, or a combination of these effects," explained study leader Sandra Jones. She's director of the Centre for Health and Social Research at Australian Catholic University in Melbourne.

Dr. Victor Strasburger, lead author of the American Academy of Pediatrics' Children, Adolescents, and Advertising policy statement, said, "The studies showed that this ownership contributes to onset of drinking, not the amount of drinking.”

“But we know that when teenagers begin drinking, they tend to binge drink, not use good judgment, and drive when drunk or intoxicated," he added.

Because of the study’s findings, Jones believes that promotional alcohol-branded products encourage drinking among adolescents.

"As they transition through adolescence, young people are developing their sense of identity," she said.

"The things that they wear, carry, and consume help to create and convey their desired identity. There is increasing evidence that brands facilitate this by allowing the young person to take on and project the desirable characteristics that are associated with that brand. These characteristics and brands then become a part of their sense of self, as well as the way that others see them," Jones said.

In addition to hats, caps and T-shirts, other examples of alcohol-related products include accessories, such as bags, backpacks, belts, lighters, sunglasses, wallets and key rings. Other promotional items include drinking glasses, utensils, cooler bags, bottle openers and coffee cups, the researchers said.

Depending on the study, ownership of such items ranged from 11 percent to 59 percent of the young participants. Ownership was higher among older children and males, the researchers said.

Most of the studies didn't find any gender differences. But two studies did find that the association between branded merchandise and drinking issues was actually stronger for girls.

Jones noted that company policies and regulations could help prevent the availability of such products for teens. She recommended restricting the sale of alcohol promotional products where the sale of alcohol is allowed, that alcohol-branded clothing not be made in children’s sizes and toys and gimmicks that appeal to children be discontinued.

Jones also noted that it’s not only up to businesses and government to regulate the availability of these products to kids, but parents as well.

"Many of these items are given away for free at promotional events or as gifts with purchase, and parents may hand them on to their children -- or allow others to do so -- without processing the fact that they are providing their child with extended exposure to an advertisement for an alcohol brand," she said.

Strasburger said the media are often irresponsible when it comes to alcohol. "They depict alcohol use as normative behavior, or a solution for complex problems, or show being drunk as funny," he said. "We spend something like $5 million on alcohol advertising every year, then we wonder why so many teenagers drink. It's not rocket science."

The findings were publised online in the April 1st edition of the journal Pediatrics. 

Story source: Don Rauf, http://consumer.healthday.com/kids-health-information-23/kids-and-alcohol-health-news-11/booze-branded-merchandise-may-spur-teen-drinking-709478.html

 

 

 

Daily Dose

Epi Pen Controversy

1;30 to read

I have more than several patients who have had serious allergic reactions (anaphylaxis) to a variety of things…including insects (fire ants, bees) as well as foods (peanuts, tree nuts, fruits, shellfish). All of these children need to have epinephrine auto injectable pens (EpiPen) on hand in case of “accidental” exposure to the allergen and a subsequent life threatening allergic reaction.  These medical devices are seldom used ( thank goodness), but need to be replaced every 12-24 months and should always be readily available in case of an emergency.

For the longest time it was not a “big” issue (cost wise) to write prescriptions for these allergic children and to make sure that they had several EpiPens on hand. This included having them available at home, school, in the mothers purse or in the car or in the gym bag…many people also wanted “extras” to have at the grand- parents house or at the lake house…etc.  So….I would write a script for the EpiPen 2 pack and the family might get 4-5 sets to disperse to the appropriate people. Prior to 2009 the cost was less than $100/two pack. 

It was several years ago that a few families started talking to me about the expense of these devices and also how quickly they seemed to expire…in fact we started asking the pharmacist to look at the expiration dates and to try and dispense the ones that had the longest expiration, in hopes of saving some expense.  At that time there were also two companies that were making the epinephrine devices.  

Then in the last year parents started calling me complaining that the EpiPens were becoming cost prohibitive and “did they really need to keep filling them?”….especially seeing that they had never needed to use one?  Of course I replied that “by the grace of God” and their vigilance they had not needed one, but YES, they indeed needed to continue to have them on hand.  In many cases families reduced the number that they bought and tried to make sure that they handed them off if their child left home….terribly hard I would think to keep up with.

This issue came into view most recently as parents across the country started complaining to not only their physicians, but to the pharmacy, their insurers and the drug maker Mylan Pharmaceuticals….why in the world had the price jumped to over $600? In retrospect, the price had been raised 15% twice a year over the past 2 years!  ( It was also pointed out that this was a 6 fold price increase in the past decade).

I do know that epinephrine has been around for a long time and the drug itself is not that expensive, and is used everyday in hospitals around the country….but the EpiPen auto injector which allows “anyone” to inject the medicine into a muscle without any measuring etc. has become cost prohibitive for many families, even some of those with insurance. It seems that Mylan Pharma  is setting prices “based on whatever the market may bear” and not on the fact that the drug is new or expensive to produce…

This is one of the times that all parents with children who need to carry an EpiPen need to contact their representatives in Congress, as well as their insurers to see if the public can be influential in trying to remedy this situation.  The public will have to let their concerns and voices be heard…

Just as I am writing this, Mylan has announced an “instant savings card” for those people who are paying out of pocket and help for those who do not have the means to buy the EpiPen….but this does not correct the problem as a whole. While the discount may be helpful for some, but not all, it is not the answer to the ever growing problem of exorbitant drug costs in this country. I have several families who are going to try and buy the EpiPen while on trips to Mexico and Canada. I have no idea of the costs there…but worth a try.  

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Heart Healthy Kids

Heart Health

Your Baby

Preparing for Twins or Triplets

1:45

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Fight the Flu

Fight the Flu

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

Doctors May Unknowingly Discourage HPV Vaccine for Preteens

2:00

The majority of physicians say that the HPV vaccine given to preteens, before they become sexually active, can help prevent infections with viruses that can cause cervical, penile and anal cancers as well as genital warts.

However, about 27 percent of doctors may inadvertently discourage parents from having their preteens vaccinated against human papillomavirus (HPV), according to a new study, because they don’t recommend the vaccine strongly enough.

Pediatricians and family physicians deliver the bulk of HPV vaccines. Some of these physicians do not offer the vaccines as strongly as they do when urging parents to vaccinate against meningococcal disease or to get tetanus, diphtheria, and pertussis booster shots, the study reported.

The study, which is based on a national online survey of 776 doctors, found a quarter did not strongly endorse the need for HPV vaccination with the parents of the 11- and 12-year-olds under their care.

Nearly 60 percent were more likely to recommend the vaccine for adolescents they thought were at higher risk of becoming infected — perhaps because the doctors knew or suspected they were sexually active — than for all 11- and 12-year-olds.

“You kind of get the sense that some [health care] providers see this as a somewhat uncomfortable situation,” said lead author Melissa Gilkey, a behavioral scientist in the department of population medicine at Harvard Medical School.

Many parents don’t like to think about the possibility of their child having sex, particularly when they are only 11 or 12 years old. The vaccine is actually meant to provide protection for when they are older. That’s why it is recommended before a child typically begins engaging in sexual activity. Studies have also shown preteens get the best immune response to the vaccines.

Evidence generated by one of Gilkey’s earlier studies suggests it’s not necessarily parents that are squeamish about the vaccination, but physicians that overestimate a parent’s response when the vaccination is urged. 

 “It’s not necessarily that physicians always are negative about it. But it’s kind of that HPV vaccine may get damned with faint praise, if you will,” Gilkey said. “Compared to the way that they recommend these other vaccines, parents may suspect that there’s something wrong with it.”

The aim of the research is to help figure out why HPV vaccination rates remain disappointingly low. The CDC reported that in 2014, 40 percent of adolescent girls and 22 percent of adolescent boys had received the recommended three doses of HPV vaccine. The agency says girls and boys should have all three doses by their 13th birthday.

According to the study, how the information is presented has an impact on how well it is received. Doctors who started conversations about the HPV vaccination by telling parents the vaccines protect against cancers and genital warts gave stronger recommendations than those who opened saying HPV viruses are sexually transmitted.

The study was published Thursday in Cancer Epidemiology, Biomarkers and Prevention, a journal of the American Association for Cancer Research.

Although Gilkey declared no conflicts of interest, the senior author of the study, Noel Brewer of the University of North Carolina, has received research funding and speaker fees from companies that sell HPV vaccines.

Source: Helen Branswell, https://www.bostonglobe.com/lifestyle/health-wellness/2015/10/21/study-says-doctors-inadvertently-discourage-hpv-vaccines/LuJaMFoEupeOeYrrUOlYRN/story.html

 

 

 

 

 

Daily Dose

What New Babies Need

1:30 to read

I have many friends whose own children are now having babies and they always ask, “what all do we need to have/buy for a new baby these days?”  While many things have changed since I had my own children, many have not,  and I still think “less is more” is a good adage to follow, especially for a newborn.  We all have a tendency to buy too much, or the “latest and greatest” only to find out that it is not necessary.

Carseat - a rear facing car seat is a must for your newborn!!!  Look at all of the reviews on line and pick which seat works best for you.  Do you want one with a base that you can also clip on to a stroller?  Remember your baby will sit in a rear facing car seat until 2 years. This is one item I would spend my money on!!

The baby needs a place to sleep so buy a crib and a good mattress.  If you are going to have more than one baby I would buy something that will last through several children. I like having a crib (rather than a toddler bed), as your baby will be in the crib for several years and then can move to a regular bed…no need for an “in between”.  Do not use an “old” crib that has drop sides, due to safety concerns. So that means the one that I had kept in the garage (from my kids) was a throw away! I usually move the first child to a bed when I need the crib for the next baby…no specific age. Bumpers are no longer recommended, so that saves money too!

Changing table or dresser for the millions of diaper changes.  It is so helpful to not have to bend over each time. I would also buy a diaper cream (Dr. Smiths, Destin or Butt paste) to have on hand….your baby will probably get a diaper rash at some time during their time in a diaper.

Baby bath tub: while you can bathe your baby in the sink, the newer bathtubs do make it easier for a newborn and you can use it in the tub as well until your baby can sit up alone. Remember, you will NEVER leave your child in the tub alone…even with all of the seats, rings and things  that they sell to support your baby!!  For bathing I like gentle bath wash like Cetaphil, Cerave, and Eucerin products….good for all skin types.  Pick one!

Swaddle blankets: WOW there are a million on the market and they all “claim” to help your baby to sleep better. I don’t think any of the products say “it will also takes weeks to months for your baby to sleep through the night” , no matter what you use.  I do like the thin swaddle blankets as they are useful for a number of things besides swaddling. Once you have your baby have the nurses show you how to swaddle (quick and easy).  The Miracle Blanket, Woombie and Halo also make it easy to swaddle as well. Pick one (or two) and stick with that.  Remember, your baby is going to be put in their crib on their back whether swaddled or not!! NO TUMMY SLEEPING.  

Diaper Bag: again their are a million out there in all shapes, sizes and price points. In the beginning you need to have a pad for changing (you will end up changing that baby all sorts of weird places), diapers, burp clothes, wipes…as your baby gets bigger you will have bottles, cups, toys all shoved in there too. All of my patients seem to have a travel size Purell strapped to the side of the bag as well. I would get a bag that you can wipe out as there will be spills of all sorts of stuff in that bag I assure you!  Somehow, over time you go back to “less is more” and the diapers end up in your purse!!  

So…that is a start. Will do another post on some other products in the future. 

 

 

Your Teen

Teens More Stressed Than Adults

2.00 to read

Teens are feeling more stressed than adults and it’s affecting every aspect of their lives according to the results from a new national survey.

The 2013 “Stress in America” survey involved responses from 1,950 adults and 1,018 teens. Teens reported that during the school year an average stress level of 5.8. That is way above 3.9, which is considered a normal level of stress. Even during the summer months, when the stress level typically decreases, teens averaged a 4.6 score. Ten was the highest score on the stress scale.  

Adults reported more stress as well with an average of 5.1 on the scale.

Teens reported that their main stressor was school, with one out of ten saying that stress led to lower grades. Money was the top reason given for stess among adults, followed by work and the economy.

Thirty-one percent of the teens reported feeling overwhelmed and thirty percent said they feel depressed or sad. Adolescent girls were more likely to feel down from stress than boys, which holds true in the adult population with more women reporting feeling depressed than men. 

 This is the first time the group has focused on teen stress. Other research has studied teen depression and other mental health concerns, but officials say this may be the most comprehensive national look at stress in teens to date. Despite anecdotal reports of high stress, researchers say stress itself in adolescents hasn't been studied broadly; global comparisons have focused on adult stress rather than teens.

Teens reported feeling irritable, angry, nervous, anxious and tired at around the same rate as adults. More than one-third of teens said they were exhausted due to the stress in their lives, and 25 percent skipped a meal because of the added pressure.

Teens seem to realize they are not doing enough to manage their stress with four out of 10 reporting that weren’t actively working towards finding positive ways to cope with their stress and thirteen percent saying that they didn’t do anything to help deal with the added pressure on their lives.

“It is alarming that the teen stress experience is so similar to that of adults. It is even more concerning that they seem to underestimate the potential impact that stress has on their physical and mental health,” APA CEO and executive vice president Norman B. Anderson said in a press release.  “In order to break this cycle of stress and unhealthy behaviors as a nation, we need to provide teens with better support and health education at school and home, at the community level and in their interactions with health care professionals.”

Like adults, stressed kids are not getting enough sleep, overeating, and not exercising.

“When spending time with teens, we can encourage them to exercise, eat well, get the sleep they need and seek support from health care professionals like psychologists to help them develop healthier coping mechanisms for stress sooner rather than later,” said Anderson.

How parents handle stress impacts how their children are able to handle stress. Family dinners together or time that is specifically set aside for family discussions provide a good opportunity to discuss what is going on in each others lives. Talk to your kids about your day and what events caused you stress, what you learned from them and how you handled them. Ask your child to be honest about the kinds of things that make them feel overwhelmed or stressed. It’s not a parent’s job to try and protect their children from everything that is unpleasant, but to teach them positive coping mechanisms so they can grow into healthy and happy adults.

Source: Michelle Castillo, http://www.cbsnews.com/news/stress-in-america-survey-reveals-teens-feel-more-pressure-than-adults/

Sharon Jayson, http://www.usatoday.com/story/news/nation/2014/02/11/stress-teens-psychological/5266739/

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DR SUE'S DAILY DOSE

A few life lessons & fun with Elf on the Shelf!

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