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Your Child

Flu Shot Cuts Kids’ Risk for Hospital Visit

2:00

Getting your child vaccinated against the flu could substantially cut his or her chances of ending up in the hospital with a flu-related illness, according to a new study.

Canadian researchers analyzed the medical records of nearly 10,000 children, ages 6 months to under 5 years, over the four flu seasons between 2010 and 2014.

The results of the study showed that children vaccinated against the flu, ages 2 to 4 years, had a 67 percent reduced risk of hospitalization due to the flu. Children 6 months to 23 months had a 48 percent reduced risk.

Even children with only a partial vaccination (one dose of flu vaccine during their first flu season) still had a lower risk of flu-related hospitalization.

"Influenza can cause serious illness, especially in young children, but there hasn't been a lot of research that has examined the magnitude of the influenza vaccine's effectiveness at preventing kids from getting really sick and being hospitalized," said study senior author Jeff Kwong, a scientist at Public Health Ontario.

"This research paper helps fill that gap by showing how effective the influenza vaccine can be at protecting young kids against serious complications from influenza infections," Kwong said in an agency news release.

The U.S. Centers for Disease Control and Prevention (CDC) recommends that everyone 6 months of age and older get a seasonal flu vaccine.

Children, particularly younger than 5 years old, are at a higher risk for serious flu-related complications, the CDC warns.

The flu season in the U.S., on an average, begins in October and is in high gear during December and January; peaking in February. It can last as late as May.

The CDC has issued a few changes in the 2017-2018 flu-season:

  • The recommendation to not use the nasal spray flu vaccine (LAIV) was renewed for the 2017-2018 season. Only injectable flu shots are recommended for use again this season.
  • Flu vaccines have been updated to better match circulating viruses (the influenza A(H1N1) component was updated). Women may receive any licensed, recommended, and age-appropriate flu vaccine.
  • The age recommendation for “Flulaval Quadrivalent” has been changed from 3 years old and older to 6 months and older to be consistent with FDA-approved labeling.

Other changes in the 2017-2018 flu-season recommendations and vaccines can be found at https://www.cdc.gov/flu/about/season/flu-season-2017-2018.htm.

Some children 6 months through 8 years of age will require two doses of flu vaccine for adequate protection from flu. Children in this age group who are getting vaccinated for the first time will need two doses of flu vaccine, spaced at least 28 days apart. Children who have only received one dose in their lifetime also need two doses. Your child’s doctor or other health care professional can tell you if your child needs two doses of flu vaccine.

To protect children younger than 6 months old from getting the flu, the people around them should be vaccinated. Also, studies have shown that flu vaccination of the mother during pregnancy can protect the baby after birth from flu infection for several months.

Story sources: Robert Preidt, https://consumer.healthday.com/infectious-disease-information-21/flu-news-314/flu-shot-could-help-your-kid-avoid-hospital-728509.html

https://www.cdc.gov/flu/about/season/flu-season-2017-2018.htm

 

Your Child

ADHD: Behavioral Therapy First Before Drugs

1:30

Researchers have been studying the possible benefits of using behavioral therapy as a first choice in treatment for children with attention-deficit hyperactivity disorder (ADHD).

One paper found that children’s ADHD problems improve quicker when behavioral therapy is started initially instead of medications, the New York Times reported. . Another paper noted that this treatment progression is less expensive over time.

If the effectiveness of the behavior therapy-first approach is confirmed in larger studies, experts say it could change standard medical practice for children with ADHD, which currently favors medications as first-line treatments.

Medications were most effective when used as supplemental, second-line treatment for children with ADHD who required the drugs. In many cases, the drugs were effective at doses lower than normally prescribed, according to the findings in the Journal of Child & Adolescent Psychology.

"We showed that the sequence in which you give treatments makes a big difference in outcomes," study co-leader William Pelham Florida International University, told The Times.

"The children who started with behavioral modification were doing significantly better than those who began with medication by the end, no matter what treatment combination they ended up with," he said.

Some experts noted that the research focused on behaviors and not some of the other complications associated with ADHD such as attention and learning problems.

"I think this is a very important study, and the take-home is that low-cost behavioral treatment is very effective, but the irony is that that option is seldom available to parents," Mark Stein, a professor of psychiatry and pediatrics at the University of Washington, told The Times.

One resource for more information on finding a specialist in behavioral and cognitive therapies is, http://www.abct.org/Home. Click on the “Find a CBT Therapist” link.

Another online resource is, www.additudemag.com, which offers information on the program, COPE (Community Parent Education) and how to locate one in your community.

Story Source: WebMD News from HealthDay, http://www.webmd.com/add-adhd/childhood-adhd/news/20160218/behavioral-therapy-adhd

Your Baby

Toxic Chemicals Found in Baby Foods

2:00

Most parents naturally assume that store-bought baby foods and formulas are well regulated and safe for their babies to consume. That may not be the case says a recent study released by the Clean Label Project. In fact, many of these products may contain high-levels of toxins, researchers said.

For the study, Clean Label Project, a non-profit which advocates for transparent labeling of products, looked at the top-selling formulas and baby food as well as emerging national brands based on Nielsen data. Of about 530 products that the researchers tested, 65 percent were found positive for arsenic, 58 percent for cadmium, 36 percent for lead, and 10 percent for acrylamide.

The highest toxin level found was arsenic. It is associated with cardiovascular conditions, developmental defects, diabetes, neurotoxicity, skin lesions, and even cancer, was present in nearly 80 percent of infant formulas. Rice-based baby food such as snack puffs, tend to have the highest levels of arsenic.

In 2016, the U.S. Food and Drug Administration proposed a limit of 100 parts per billion of arsenic in infant rice cereal, but isn't enforcing that limit. Rice often absorbs arsenic from contaminated soil as it grows in the environment.

"It is important for consumers to understand that some contaminants, such as heavy metals like lead or arsenic, are in the environment and cannot simply be removed from food," said Peter Cassell, a FDA spokesperson.

BPA was also found, although many companies now advertise as PBA free. Sixty-percent were found positive for the industrial chemical bisphenol A.

Lead, known for its’ devastating impact on children’s health, was found in 36 percent of the products. Low levels of lead in children's blood have been connected to lower IQs, slowed growth, behavioral problems, hearing issues and anemia, according to the Environmental Protection Agency.

Gerber, Mead Johnson (Enfamil), Plum Organics all released statements following the study assuring customers their products adhere to strict safety standards. Gerber said its foods "meet or exceed U.S. government standards for quality and safety." Mead Johnson said it specifically monitors the presence of many materials, including arsenic, cadmium, lead, BPA and acrylamide to ensure "safety and high quality." Plum, who also stressed products are "completely safe," said over the past year, it's created "new, more robust guidelines for contaminants in our products" and is in the process of implementing those rules.

Jaclyn Bowen, executive director of Clean Label Project, said, "The baby industry needs to do a better job in protecting America’s most vulnerable population,"

The researchers found that mainstream brands, which include Enfamil, Gerber, Plum Organics, and Sprout, were among the worst offenders that scored two out of five in the report on toxic metals.

A more in-depth review of the study can be found on http://www.cleanlabelproject.org/product-ratings/infant-formula-baby-food/

Story sources: Ashley May, https://www.usatoday.com/story/news/nation-now/2017/10/25/these-baby-foods-and-formulas-tested-positive-arsenic-lead-and-bpa-new-study/794291001/

Allan Adamson, http://www.techtimes.com/articles/214847/20171025/baby-food-and-infant-formulas-tested-positive-for-arsenic-lead-and-other-toxic-chemicals.htm

Your Baby

Britax Recalls Car Seat Chest Clips Due to Infant Choking Hazard

1:30

Faulty chest clips on more than 100 models of Britax Care Safety car seats are being voluntarily recalled because the clips could break off and create a choking hazard for infants.

The company says that no injuries have been reported, but it has received complaints of chest clips breaking.

The recall will affect more than 200,000 car seats. However, Britax stresses that the car seats are still safe to use until a replacement kit is obtained. 

The chest clip is on the Britax B-Safe 35, B-Safe 35 Elite, and BOB B-Safe 35 infant seats.

The products were manufactured between Nov. 1, 2015, and May 31, 2017. To see the model numbers that are included in the voluntary recall, or to check the serial number of your seat, visit the company’s website set up for this recall at www.bsafe35clip.com. You can find the serial numbers on the "Date of Manufacture" label on the lower frame of the seat.

Britax is offering to replace the chest clip with a free kit that contains a new clip made from a different material. The kit comes with step-by-step instructions for replacement. Consumers are advised to routinely check their current chest clip until a replacement arrives.

Story sources: Alexandria McIntire, http://www.webmd.com/children/news/20170623/recall-britax-car-seat-chest-clip

Ashlee Kieler, https://consumerist.com/2017/06/21/britax-recalls-207000-carseats-over-chest-clips-that-can-break/

Daily Dose

Pool or Trampoline? The Safety Debate

1:15 to read

Do you have a pool or trampoline in your yard? Both pools and trampolines are fun for children, and both pose dangers as well. I saw a patient today who asked me my opinion of trampolines. It seems that she and a friend, both of whom have elementary school age children, are having a "discussion" about trampolines. My patient is totally against having a trampoline in her yard, although she has a pool. Her friend says that it is safer to have a trampoline than a pool. And so their debate continues.

Both pools and trampolines are fun for children, and both do pose dangers. But as my own children often told me "according to you Mom, everything that is really fun, is dangerous!" The biggest issue surrounding children playing in pools and jumping on trampolines is parental supervision. When children are taught safety and are given rules to follow that are then enforced, they may have fun and be safe at the same time. Pools are fenced, and gated. Parents watch their children swim. This is usually the party line. But trampolines also require the same amount of supervision and many parents don't realize this.

Most trampoline injuries occur when children are unsupervised. Many serious trampoline accidents occur when children of disproportionate weights are doubling jumping and the smaller child becomes a missile and is thrown from the trampoline when serious neck injuries may occur. Trampolines are also safest when they are buried in the ground or have safety nets on the side. Letting children jump unsupervised is as dangerous as swimming alone.

So, I can't resolve this friendly discussion, but I do know that both pools and trampolines require parental supervision and strict safety rules to ensure the safest possible experience. And yes, they are both fun! That's your daily dose, we'll chat again soon.

Your Child

Helping Children Cope With Frightening News Events

2:30

Gone are the days when most Americans got their news from 3 or 4 sources around the evening dinner hour. Today, thousands of news reports (some real, some fake) instantly flood our phones, computers, TVs and radios, sometimes with real time graphic images.

While some news events may be difficult for even adults to comprehend (with all our life experience and knowledge about current affairs), children don’t have that advantage when they hear and see things that feel threatening to their safety and family stability.

The Journal of American Medical Association, (JAMA) Pediatrics, has published a free online patient’s page dedicated to How to Talk to Your Children About Tragedies in the News.

The amount of information available on current events is almost instant. Sometimes parents don’t have a chance to screen what their children see and hear, so it’s important to know how to talk with your children about what they are experiencing.

The JAMA article is broken down into different age groups. Your approach should differ depending on your child’s age and ability to understand complicated situations.

A good place to start in discussing a tragic event is by asking what your child has already heard. After you listen carefully, you can ask what questions they have. It is important to be honest about what happened and to focus on the basics. It is not necessary to share every detail, and it is important to avoid speculating about what might happen next. Listen closely to your child for misinformation or underlying fears. Remind your child that you are there for him or her and will keep them safe. A key underlying message for parents to convey is, “It is ok if this bothers you; we are here to support each other.”

For very young children, news events can be frightening because they don’t understand context. Children may wonder; is this going to happen to us? Is this happening in our neighborhood? Are my friends ok? Are we next? News media coverage can include graphic images and sounds. It is best to share information with children by discussing it rather than showing the media coverage. Young children may have more questions about whether they are truly safe and may need help separating fantasy from reality. Some children may become clingy or regress in behavior such as wetting the bed or sucking their thumbs. It is important to be patient and to support your child if he or she reacts in this way. Do not ignore your child’s fears or brush them off. Realize that children see the world from a different perspective.

For older children and teenagers, it may be more difficult to avoid exposure to these events in the news. Kids on social media outlets often see stories and videos on their phones while at school or out with friends.- before you have a chance to preview the news. When there is a concerning news event and you have the opportunity, try to preview it before showing it to them so that you know what to expect and what key points to discuss. Then watch it together. Older children and teenagers may want more information about the tragedy and the recovery efforts. They may have opinions about the causes as well as suggestions to prevent future tragedies or a desire to help those in need. Listen to what they say and validate their concerns. If they’ve already seen something tragic, again, ask them what they think about it and talk about their concerns and what they see as a next step in coping.

Other ways you can help your child manage unsettling news are:

  • Be a calm presence. It is okay for children to see adults be sad or cry, but consider excusing yourself if you experience intense emotions.
  • Reassure your child of his or her safety. Consider reviewing your family’s plans for responding to an emergency.
  • Maintain the routine. To give your child a sense of normalcy, keep up your family’s usual dinner, homework, and bedtime routine.
  • Spend extra time together. This can foster your child’s sense of security. Encourage your child to express his or her feelings.
  • When possible, do something to help. Consider ways that you and your family can help survivors and their families.

Like adults, some children may have difficulty with events for a variety of unexpected reasons. Think back to 9-11. How many of us were prepared to watch the towers collapse and the horror and anguish of the families that were missing relatives and friends in the buildings? How we feared that there was a possibility that our country was under attack. It was one of the most devastating events our country has ever experienced in the modern age of instant media information.

Time has helped us put that day in perspective, but the repeated showing of the planes flying into the towers gave many Americans PSTD symptoms. It was almost too much to comprehend. Remember that when your child is scared or anxious about a current event. Help them realize that tragedies do happen, but we can and most often, do survive.

Some signs that a child is not coping well include sleep problems, physical complaints such as feeling tired, having a headache or stomachache, or just feeling unwell. Changes in behavior may include regressive behavior such as acting more immature or being less patient, and mental health concerns like sadness or heightened depression or anxiety. Sometimes it can be hard to tell if a child is reacting in a typical way to a tragic event or if there is something else going on.

Talk with your child’s pediatrician if you are concerned about your child’s reaction.

These are uncertain times. Everyone seems to be a bit on edge, wondering when the next shoe will drop. Have a plan on how to talk to your youngster about current events. Most of all have patience and be a good example of calmness and reassurance; that no matter what happens, you have their best interests at heart.

Story source: http://jamanetwork.com/journals/jamapediatrics/fullarticle/2646851

 

Your Child

Kids and Holiday Stress

2:00

Adults know that the holidays are most likely going to include several stressors such as never enough time to get everything done, family gatherings, money woes, traffic and gift shopping.

Kids feel stress too during the holiday frenzy, but sometimes they don’t have enough life experiences to know how to handle it or what to call some of the overwhelming feelings they may have.

During the holidays, there are lots of fun activities and events going on, both at home and at school. And while that can be a good thing, the reality is that all that hustle and bustle means schedules are often out of whack, bedtimes get pushed back, and routines are disrupted.

As a result, it’s inevitable that kids may feel some degree of holiday stress.

There are ways you can help your child glide through the holidays with less stress. Number one is to be an example of what you want to child to be. So, being calm is not only going to benefit you, but your child as well. This requires mindfulness about what is actually going on around you, what expectations you have and what you are projecting. As with so many situations, the way parents handle an issue can set the tone for how their kids will behave. If you let holiday stress get to you, your kids will definitely pick up on it, and child anxiety is more likely to be a problem in your house. To minimize anxiety in children during the holidays, take steps to handle your own stress and anxiety.

Overstimulation, tiredness and hunger can cause children to stress-out. It’s hard even for grown-ups to deal with noise and lots of stimulation when they’re not feeling their best; kids get hungry more often and become tired more easily, and may understandably have a tough time being on their best behavior. They are more likely to experience holiday stress when they’re exhausted or hungry. Take healthy snacks with you and schedule breaks to sit, relax and re-group when visiting malls or holiday celebrations.

Children like routine. The holidays can disrupt routines that are comforting and reliable, causing kids to feel anxious. To minimize holiday stress in your kids, try to get routines back on track once an event or party is over. For instance, if a school holiday concert or a church gathering goes past your child’s bedtime, try to stick to quiet, calm activities the next day and get your child to bed on time the next night.

Let’s face it; we all overindulge during the holidays. Too much sugar and simple carbohydrates can play havoc with our moods and weight. Kids are particularly sensitive to these food interruptions. Whenever possible, offer healthy snacks, such as air-popped popcorn or apple slices with cheese and crackers and limit cookies and candy to after-snack treats.

One way for kids to beat stress is to get moving. Fresh air and exercise are essential for boosting mood and re-setting the spirit, which can alleviate holiday stress and anxiety in children. Make sure you schedule some time to get your child outside to run around and play.

If your child is old enough, ask him or her to join in with decorating and holiday tasks. If you have to shop, ask your child to help you look for an item at the store (fun stocking stuffers for cousins, for example). Giving your child a task will not only boost his or her self-esteem, it’ll help by offering a beneficial distraction.

Creating a little quiet time during the holidays is helpful to parents and kids alike. Find a quiet corner and read a book with your child or create holiday pictures for grandma and grandpa. Take a walk outside in nature, away from noise and crowds and obligations.

A great antidote for holiday stress and the bloated commercialism of the season is helping others, whether it’s by shoveling a neighbor’s sidewalk, volunteering or by wrapping presents for needy kids at your local church. The season of giving takes on more meaning when the giving is your time and love.

Story source: Katherine Lee, https://www.verywell.com/holiday-stress-and-anxiety-in-children-620516

Daily Dose

Toddler Constipation

1:30 to read

I get so many questions about toddlers and constipation.  Constipation relates to stool frequency and consistency.  It is important to understand that everyone has different bowel habits and not all children will have a stool every day.  While some children will have several stools a day another may have a stool every 2 -3 days. Both of these scenarios may be normal and not an indicator of problem.  At the same time, stool consistency is important. If your child has  hard, dry, pebble like stools ( rocks rather than softer snakes or blobs ) this may be an indicator of constipation. Everyone will occasionally have a hard stool, but this should not occur consistently. Lastly, it should not be painful to pass the stool. While toddlers may grunt or push, or even start to “hide” to poop, it should not cause real pain.

With all of that being said, it is not uncommon for toddlers to become constipated as they often are also becoming picky eaters. Due to this “phase”,  some young children will drink too much milk in place of eating meals and this may lead to constipation. Your toddler should be drinking somewhere between 12 -18 ounces of milk per day.  Many children also load up on other dairy products like cheese, yogurt and cottage cheese, which while healthy, may also lead to too much dairy intake and contribute to constipation.

Water intake is also important to help prevent constipation. If your child is drinking too much milk, substitute some water as well.  It is a balancing act to make sure your child is getting both milk and water. If necessary I will also put the smallest amount of apple or prune juice in the water. By the age of 1 year, your child should no longer have a bottle as their main source of nutrition is no longer in the liquid form!

Fiber is also important so offer plenty of whole grains and limit the “white foods” that toddlers love (yes, the bread, cereal, pasta). If you always buy whole wheat pasta and whole grain breads your children will never know the difference. Stay away from processed white foods whenever possible.  It is also easy to throw flax seed or bran into muffins or smoothies (disguising fiber). I also sometimes use Metamucil cookies (they are pre made) and may even resort to dot of icing smeared on it and offer it as a cookie for snack, along with a big glass of water.

Fruits and veggies are a must…even if you think your child won’t eat them! Your toddler needs 2 servings of fruits and veggies every day and rotate what you offer them.  You will be surprised at how one day they may refuse something and they next they will eat it. Don’t give up on fruits and veggies,  it may literally take years for your child to eat peas…but if they aren’t offered a food repetitively they will probably never it eat. I know a lot may get thrown to the floor but just clean it up and persevere.  Not only will this help their stools but their long term healthy eating habits as well.

Movement is also important to help keep the bowels healthy and “moving”.  Making sure that your toddler is moving seems crazy, as they are on the go all of the time.  But with an older child make sure they are getting plenty of time for play and exercise outside or in…and not just sitting in front of a screen.

Lastly, for short term issues with constipation it is also okay to try using milk of magnesia (MOM) or even Miralax….but ask your doctor about dosing in toddlers.   

Your Toddler

12 Tips to Make a Home Safer for the Grandkids

2:00

Grandparents and grandkids are two-way blessings. Grandchildren benefit from having a close relationship with their grandparents. They have an extra pair of eyes to watch over them and a lot of hugging and spoiling.

Grandparents get the joy of being around their grandchildren, watching them grow and develop and yes- spoiling them.

Many younger families depend on grandparents to supplement with childcare. Some grandparents are the preferred choice for day care. And of course, sometimes it’s just a family visit.

Not all grandparents think about making their home safer for the grandkids because they aren’t always around them. They may not be aware of what to look for or what to do to make their home safer for little ones. It may have been a long time since a grandparent has had to think about having a child in the house. A lot more information is quickly available regarding child safety than in years past.

The American Association for Retired Persons (AARP) recently published an article with tips for making a home safe for grandchildren. Reading it reminded me of when my child was little and the visits our family used to have with my husband’s parents and mine. I never thought about having a list of suggestions to help them safeguard their home for our child. Most of the time there wasn’t a problem, but occasionally there were big safety issues that they just hadn’t thought about.

If you’ve been thinking about how to talk with yours or your spouse’s parents about making their home more kid-proof – here’s some excellent tips from “ Grandparent Central”, AARP:

1. Keep meds out of reach. About 38 percent of child-poisoning cases involve grandparents' medications, so clear all drugs from countertops, tables and drawers. Put a childproof lock on the medicine cabinet. Make sure your purse is not within reach of your grandchild.

2. Get rid of crib-clutter. Not long ago, cribs were filled with such things as stuffed toys, little pillows, bumper pads and blankets. Nowadays, more people are aware that these items can present a suffocation hazard and are best left out of the crib

3. Baby should sleep on back. Make sure that baby is sleeping on his or her back and not face down or on their side in the crib.

4. Lock up detergent pods. These colorful packets of liquid laundry or dishwasher soap look like candy. They can pose "a serious poisoning risk to young children," says a study in the journal Pediatrics. If you use these products, make sure they are locked in a cabinet and cannot be accessed by curious little hands.

5. Make furniture tip-proof. Flat-screen TVs and modern furniture are particularly prone to tipping if little ones try to pull themselves up. Attach anti-tip brackets or straps to safely secure these items. And don't forget outlet covers, drawer locks, stairway gates, and edge and corner guards for furniture.

6. Walkers and wheelchairs. These items may look like toys to a young child. Make sure they are either out of sight or that someone keeps an eye on the child if they seem a little too intrigued by them.

7. Keep guns under lock and key. One of the most important tips! If you're among the 1 in 3 Americans with a gun, always keep it unloaded in a locked cabinet, with the ammunition stored separately.

8. Be present when your grandchild is with your pet. According to the Centers for Disease Control and Prevention (CDC), more than 77,000 children under age 10 are treated each year in emergency rooms for dog bites.

9. Guard pools and drains.  Always keep your cell phone with you when your grandchild is in the pool in case you need to call 911. If you've got a backyard pool or hot tub, you likely know to prevent access with a childproof gate. But you may not be aware of the danger of drains: Suction forces can be powerful enough to trap small children underwater.

10. Watch all water. Since toddlers' heads are heavy in proportion to bodies, they can easily be pulled down. That's why even an inch of standing water is dangerous. Put a childproof lock on the toilet and drain bathwater immediately.

11. Stove safety. When kids are around, use back burners and always keep handles of pots and pans turned in.

12. Beware of choking hazards. 5 of the most overlooked choking hazards for young children are mini-batteries, jewelry, refrigerator magnets, pen caps and loose change. Five items you may not typically think about.

These 12 tips are obviously good for every family household but may be particularly helpful when someone is not used to having children at their house for extended periods of time.

Grandparents and grandchildren often share a special bond that can grow even more secure and stronger when the home safe during their visit.

Story source: Bulletin staff, http://www.aarp.org/home-family/your-home/info-2016/home-safety-tips-grandkids.html

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Potty training can be tricky.

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