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Daily Dose

Media Exposure is Everywhere

1.15 to read

It’s interesting how many new topics there are to discuss during a child’s check up. I am sure that 10-15 years ago, I was not spending a part of each child’s well visit discussing “screen time”. I begin this discussion early on, even before the child is “watching TV” as a child under the age of 2 gets a lot of “secondhand” media exposure. 

I find that some new parents have the TV on all day, tuned into CNN or CNBC (just to name a few) and the images on the screen are often not age appropriate nor is the language. Suddenly their toddler is asking about death, tornadoes, wars and carnage. A 2 year old is too young to understand a lot of this, but they know it is scary.  They may also develop sleep disturbances as this age related to the scary images. 

As the child is older, the images flashing across the news screen all day continue. But the older child can grasp the concepts a bit better, but instead of being truly scared, they become anxious.  I see too many 5- 0 year old children who now worry that the approaching thunderstorm means a tornado, or going to school might mean getting shot.  Although these types of tragedies are all too real, fortunately they are not a day-to-day occurrence and I don’t think an elementary age child needs to be afraid to leave their parent’s to go to school for fear of being shot. 

The same goes for the older child. Many of my tween and teen patients have a TV in their bedroom. (I ask this question at every visit beginning at age 2). I often hear that “their TV is not connected to cable”. It is not only the cable channels anymore that have inappropriate content for children of all ages. 

The tween is bombarded by live news images of children being killed around the world, or of sexually explicit images as well. Even a “good vigilant” parent cannot always know what their 14 old might find on the TV that is in their own room. 

I can’t tell you how many times a day I recommend that a parent take the TV out of their child’s bedroom. Some parents think I am crazy, and many teens want to duct tape my mouth shut, but study after study shows that there is no need for media in a child’s room. I even hear that the child “earned the TV for good behavior. Reward their behavior in another way! I tell all of my patients that they can have a TV in their own room, (gasps from some parents while I say that), but they will be in their own college dorm or home before they do. 

Remember to try and limit your child’s screen time to less than 1-2 hours/day, (even if only as secondhand media). Watch TV with your child and discuss the content in an age appropriate manner.  Lastly, keep the media in the family room and not a child’s bedroom. 

That’s your daily dose for today.  We’ll chat again tomorrow.

Your Teen

“See it before you sign it”. Fire Safety for Off College Campus Living

1:45

Whether it’s in the spring, fall, winter or summer, many college kids will eventually move to off campus living quarters. Parents and students typically have time to do research on the areas around campus that are for rent. However, there are some fire prevention safety tips that you might not have thought about.

The best advice to help keep your college student safe is… don’t sign on the dotted line until you’ve actually seen the apartment or house.

Why? Because about seven people every year, die in fires in dorms, fraternities, sororities and off-campus housing.

Since 2000, nearly 120 people have died in campus fires, according to a U.S. Fire Administration (USFA).

Off-campus housing tops the list for fires.

Most (94 percent) fatal campus fires took place in off-campus housing, according to incidents examined by USFA between 2000 and 2015.

The U.S. Consumer Product Safety Commission (CPSC) has teamed up with USFA, the National Fire Protection Association (NFPA) and Campus Firewatch to help get this warning out. Don’t sign a contract for housing until you see it yourself. That goes for Mom and Dad too. See it, take a housing tour and make sure you look for:

#1 Working smoke alarms

Make sure there are working smoke alarms on every level and inside each bedroom. Smoke alarms save lives. Fire sprinklers add lifesaving protection too.

USFA found that smoke alarms were missing or did not have batteries in 58 percent of fatal campus fires. None of the fatal fire locations had fire sprinklers.

#2 Two ways out of each room for a safe escape. Make sure all windows and doors open easily. You need to be able to get out if there is a fire. Two ways out are best.

#3 Campus or off-campus housing that can handle today’s electric power needs.

Laptop computers, phones, televisions and coffee makers take a lot of power. Some older homes may not be able to handle all the electrical demand by today’s students. USFA found that electrical issues caused 11 percent of the fires.

#4 Be in the know.

Make sure that your college student knows how to be responsible around alcohol and smoking. The USFA study found these two things involved in the majority of the fires.

Also, if your child is going to be cooking his or her own meals, a discussion about keeping an eye on the food when it is cooking and avoiding distractions is a necessity.

College is a time of new and exciting beginnings. Be sure to “See it before you sign it” for off-campus housing so that an overlooked danger doesn’t have a chance to bring precious college years to an abrupt and devastating end.

Story source: http://onsafety.cpsc.gov/blog/2016/04/04/see-it-before-you-sign-it/

Daily Dose

New Sleep Guidelines for Your Baby

1:30 to read

I am sure that many of you heard about the latest recommendations on infant sleep that the American Academy of Pediatrics has released. The latest policy statement from the AAP recommends that all infants sleep in their parents room, but not in the parents bed,  for at least the first 6 months of life and preferably for the first year!!  This is big news and quite a change from the previous sleep recommendations which were published in 2011.

 

All of the latest recommendations regarding sleep are intended to help to reduce the incidence of SIDS (Sudden Infant Death Syndrome), which is the leading cause of death for children under the age of 1 year. SIDS in one of the greatest fears of all parents. While “the back to sleep” campaign has reduced the incidence of SIDS, there are still over 3,500 babies in the U.S. who die suddenly and unexpectedly every year while sleeping. (this includes some from suffocation and strangulation and not SIDS).

 

In addition, the recommendations re-iterate that the baby should not co-sleep with their parents, but should be in a crib or bassinet with a firm sleep surface, in the parents’ room. These new recommendations, may be driven by the reality that breast feeding mothers are exhausted and often fall asleep while nursing their baby. If the mother is sitting in a chair or on the couch and falls asleep the baby may be at risk of suffocation if they roll into a cushion or fall down between pillows. If the mother is in bed breast feeding and accidentally falls asleep at least the baby is on a firm surface - make sure when you do breast feed your baby in bed to remove all loose blankets and pillows in the area around your baby prior to feeding - just in case.

 

Although it has been a long ago, I always put our infants in their own cribs to sleep -  you might say I was obsessed. One night, shortly after the birth of our 3rd child I found myself on my hands and knees looking under the bed. When my husband was awakened and asked me “what are you doing?” I replied…”looking for the baby!” He then reminded me that I had put the baby in his crib in the nursery right after I had finished breastfeeding him.  I truly had no memory and thought he had fallen under our bed!! This, from someone who had previously stayed up for 36 hours during residency working in the hospital and thought I could handle sleep deprivation- clearly not true!! I just remember the feeling of being frantic! 

 

The AAP continues to recommend that the crib be essentially bare - in other words, no bumpers, no blankets, no stuffed toys, just the fitted crib sheet. The baby should always be placed on their back to sleep…once your baby learns to roll from back to front ( which typically happens after they have learned to roll tummy to back), they may be left to sleep on their tummy. Even with a baby in your room you cannot get up all night to keep trying to keep them from rolling over!  

 

The AAP does recommend using a pacifier for sleep times ( I am a huge pacifier fan as you know). The only problem with a pacifier is convincing The Parents that it is time to “get rid of the paci” once their baby is over a year old….. sometimes hard to sell that concept.

 

Lastly, the APP reiterated that they do not support the use of any of the devices sold to new parents to help “prevent”  SIDS. In other words, all of the technology being marketed including  “anti-SIDS mattresses, home cardiorespiratory monitors, and even fancy video monitors.  While many a well intentioned parent will invest a lot of unnecessary money and time trying to make the baby safe during sleep, the mantra “less is more” is now the best way to ensure safe sleep for your baby. I remind parents that there will be plenty of ways to spend that money  - start the college savings!

 

 

 

 

Daily Dose

Your Teen's Eating Habits

1:30 to read

While seeing patients one evening, I saw a 15 year old boy who had come in complaining of feeling dizzy and tired. It was the end of school as well, so he was busy with studying and finals.  This is the kind of patient that is typically given a 15 minute appointment.....but needs a lot more than that to figure out what is going on.

He was with his father who said that his son had not had a fever, had not otherwise been ill with cough or cold symptoms. Upon further questioning the teen said he was just tired and thought he might faint....although he had not.  He had gone to school that day. He was not involved in athletics and had no history of previous syncope (fainting). There was not a history of sudden cardiac death in the family. He also had a fraternal twin who was healthy. He usually tried to get about 6-8 hours of sleep a night. He denied drug or alcohol use. He had not had weight loss. HIs exam was entirely normal with normal vital signs.

But, when questioned about his eating habits he informed me that he was a vegan.  His father sat there quietly while I discussed his son’s choices.  He said that he had decided to be a vegan about a year prior, and that he rarely ate with his family. When I asked him to give me an idea of a typical breakfast, lunch and dinner I was amazed at what I heard. He really only ate “junk food”. He ate sugary cereal for breakfast, he might eat a veggie burrito for lunch, and he would often eat another fast food burrito or taco for dinner. He did not eat fruit at all. His Dad said that everyone else in the family ate “normal” meals, and that they were offered to his son as well.

I am writing this to illustrate one of the problems I see with teens who decide to become vegetarians or vegans etc, but really are just what his Dad so correctly stated are “junk food vegans or vegetarians”.

After a lengthy discussion and some lab work,  he was sent home with instructions to research ways to improve his diet even as a vegan, which in turn would probably help his fatigue. He was also stressed about the end of school.... which was another discussion as well!

Both eating issues and stress cause teens to have a lot of complaints of fatigue and feeling blah...I see them all day long. This adolescent agreed to   come back in a month with his diary of meals and he is going to see our nutritionist over the summer.

He was a delightful young man....and I was only an hour behind...but at least we got to the bottom of the problem.

Daily Dose

Teachable Moments are Everywhere

1.15 to read

I am laughing! Why? Because I’m playing several conversations in my head that I have had with my patients recently and how they have misinterpreted what I have said.  I must admit, they are teachable moments for me as a pediatrician and a mom.

Once a child is potty trained and if they are having urinary complaints, I will order a urinalysis to check that the child is not having an infection. I will say to the 4 or 5 year old, “it is time to pee-pee in the cup”. Some children are fairly independent by then and they insist on going to the potty by themselves. This happened recently when a 5 year old little boy insisted that he could “do it by myself”. His mother and I walked him to the bathroom where I handed him the cup and a wipe and told him to clean himself and get the urine in the sterile cup.  He shut the door.

A few minutes later the door opened and there stood a proud little boy, but no urine cup in his hands! Thinking he must have left the cup in the bathroom, his mom and I searched high and low. Still no cup!

After a few minutes I said, “I told you to pee-pee in the cup.  What happened?”  He looked at me quite confused (as I was too) and said that he had?  He then proceeded to take me back into the bathroom and he walked us through how he had gotten his urine specimen. Not only had he “pee-pee’d” in the cup, he washed his hands, poured out the urine and put the cup back on the stack of urine cups!  Point being, I had not said “ get your pee-pee in the cup AND bring it back to us!”  Bright boy, concrete thinker, and stupid doctor!

Now, I know that it is important to give clear directions to this very capable group of newly independent children. Why would you bring urine back out of the bathroom, right?  Of course that makes no sense. Might even get you in trouble at home!

Teachable moment:  give your children very clear instructions at any age as they are more than capable of following through when they know the expectations.  I think this really goes for children of all ages, seems to work well with my college aged boys too!  I need to remember this!

I have a few more teachable moments on their way.  Stay tuned!

Your Child

Safety Recalls: Finger Paints, Baby Bathtubs, Strollers and More

2:00

The American Academy of Pediatrics’ (AAP) online Gateway issue has listed several children’s products that have been recalled due to health and safety concerns.

The list includes

·      Sargent Art tempera finger paints, Lil’ Luxuries Whirlpool, Bubbling Spa & Shower

·      Peg Perego’s 850 Polaris Sportsman ATV-style ride on toy

·      Mamas & Papas’ Armadillo Flip and Armadillo Flip XT strollers

·      Fiddle Diddles LullaBelay adjustable car seat strap system

·      Chimparoo brand Trek baby carriers

Sargent Art tempera finger paints: About 2.8 million units of paint have been recalled. The paint can contain harmful bacteria, putting children with weak immune systems at risk of serious illness. Those with healthy immune systems may not be affected.

Recalled are 13 types of Sargent Art tempera and finger paints. All colors and sizes of the following types of paints are recalled: Art-Time brand of tempera paint, washable finger paint, washable fluorescent finger paint, washable fluorescent tempera paint, washable glitter finger paint, washable paint and fluorescent tempera paint.

Sold at: Hobby Lobby, Wal-Mart and other stores nationwide and online at Amazon.com and ShopSargentArt.com from May 2015 to June 2016 for $1 to $8.

Stop using the paints and contact the company for a refund at 800-827-8081 or visit www.sargentart.com.

Lil’ Luxuries Whirlpool, Bubbling Spa & Shower: About 86,000 units have been recalled. Fabric slings can come off the infant bathtubs, and infants can fall or drown.

Lil’ Luxuries Whirlpool, Bubbling Spa & Shower is a battery-operated whirlpool bath with motorized jets intended for use with children from birth to 2 years. The product has a fabric sling on a plastic frame onto which the infant is placed for bathing. The fabric sling on the tub does not have a white plastic clip to attach the headrest area of the fabric sling to the plastic frame. Recalled bathtubs have numbers 18840, 18850, 18863 or 18873 with date codes starting with 1210, 1211, 1212, 1301, 1302, 1303, 1304, 1305, 1306, 1307 or 1308, which stand for the two-digit year followed by the two-digit month, on the fabric sling.

The products were sold at Toys R Us/Babies R Us and other juvenile product specialty stores nationwide from October 2012 through October 2013 for about $60. The tubs also might have been sold secondhand.

Stop using the fabric sling in the tub, and contact the company for a replacement sling with a white plastic attachment clip. You can call 844-612-4254 or visit http://bit.ly/2f1wQNG.

Peg Perego’s 850 Polaris Sportsman ATV-style ride on toy, About 3,000 toys were recalled. A relay on the circuit board can fail causing the vehicle’s motor to overheat and catch fire.

Recalled are Peg Perego’s 850 Polaris Sportsman ride-on, 24-volt battery-operated toy vehicles for children ages 5 to 7 years. The ATV-style vehicles for two people are silver, red and black and have four wheels, a flip-up backrest for the back passenger and a front and rear luggage rack. Vehicles with date codes 651016, 651017, 651020, 651021, 651022, 651023, 651024, 651027, 651028, 651029, 651030, 660304, 660305, 661123, 661124, 661125 and 661130 are recalled. The date code is under the vehicle seat. Sportsman Twin and 850 EFI are printed on the side and Polaris is on the side of the seat.

Items were sold at online retailers including Amazon.com, Cabelas.com, Target.com, ToysRUs.com and Walmart.com from October 2014 through April 2016 for $500 to $600.

Remedy is to Contact Peg Perego for a replacement circuit board with instructions, including shipping. Call 877-737-3464, email 850recall@pegperego.com or visit https://us.pegperego.com/cs/recalls/.

Mamas & Papas’ Armadillo Flip and Armadillo Flip XT strollers: About 3,000 strollers have been recalled. A loose latch on the stroller can cause the infant in the seat to tip back unexpectedly and possibly fall out when facing the parent.

Recalled are Mamas & Papas’ Armadillo Flip and Armadillo Flip XT strollers. All models are folding strollers for one infant. They come in black, teal and navy and weigh about 22 pounds. Lot number ranges for recalled Armadillo Flip strollers are 00814 through 00416. Lot number ranges for the Flip XT are 01214 through 00416. The number is printed on the sewn-in label on the stroller.

Strollers were sold at Albee Baby, Babies ‘R’ Us, Buy Buy Baby and other stores nationwide and online at www.mamasandpapas.com and www.amazon.com from December 2014 through July 2016 for $500.

Stop using the strollers and contact the company for a repair at 800-309-6312 or visit www.mamasandpapas.com/us.

Fiddle Diddles LullaBelay adjustable car seat strap system: About 250 units have been recalled. The carabiners attached to the strap system have small parts inside that can come loose and be swallowed and choked on by young children.

The Fiddle Diddles LullaBelay adjustable car seat strap system with model number LB1001 includes two fabric straps, carabiner hardware, a mesh car seat cover and a tote bag. The carabiners are used to hang a car seat from a shopping cart. The model number is printed on the straps.

They were sold at Amazon.com from November 2015 through June 2016 and Fiddlediddles.com from May through June 2015 and at Zoolikins stores in Arizona from November 2015 through June 2016 for about $40.

You can contact the company for a repair kit with three new carabiners. Call 888-741-2957, email info@fiddlediddles.com or visit http://fiddlediddles.com/replacement-kit.html.

Chimparoo brand Trek baby carriers: About 130 units are being recalled. The carriers’ side strap can loosen unexpectedly from the buckle, and the child can fall out.

Recalled are Chimparoo brand Trek baby carriers that allow the user to carry a baby tummy to tummy, on the hip or on the back. The 100% twill fabric carriers were sold in 18 solid, striped and pattern color combinations. The carriers attach to the wearer’s body with adjustable straps made of polypropylene webbing and plastic buckles. “Chimparoo” is printed on the upper right hand corner of the carrier. “Trek” is embroidered on the belt.

The carriers were sold at Children’s boutique stores, such as Granola Babies, of Costa Mesa, Calif., Eat/Sleep/Play, of Summerville, S.C., and Top to Bottom, of Omaha, Neb., and online at www.Amazon.com and www.Chimaparoo.ca from May through July 2016 for about $170.

Contact the company for a replacement buckle for the baby carrier’s side-buckle. Call 855-289-5343, email safety@Chimparoo.com or visit www.Chimparoo.ca/en/recall.

Story source: Trisha Korioth, at http://www.aappublications.org/news/2016/11/17/HealthAlerts111716

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

Digital Technology & Your Children

1:30 to read

I somehow stumbled upon a recent article in the UK Mirror in which Bill Gates was being interviewed. It caught my eye as it began with “As you wrestle the tablets from your square-eyed kids for the 10th time today, it might be reassuring to hear the king of Silicon Valley shares your worries”.

 

The discussion surrounding our children and the use of cell phones and the appropriate age to give a child a phone always brings up various opinions. Some parents feel that their 6 -8 year old elementary school child “needs a cell phone for safety reasons”. Other parents think that their child “doesn’t need a phone until they drive.” Lastly, there are parents who think their child gets a cell phone when “they can pay for it”.  These are only a few of the various responses I have heard from my own patient’s parents….I am sure there are a million more. 

 

Well, it seems Bill Gates, one of the greatest technology innovators of all time, “banned his kids from having mobile phones until they were 14 years old”.  During the interview he also stated that he “forbids cell phones at the dinner table”.  It sounds like Bill Gates runs a pretty tight ship in his own home..with some well founded rules,  while weighing the pros and cons of the use of electronics with his children.

 

Many parents tell me that all of these electronics are necessary for homework and social media also allows their child to stay in touch with their friends…which again is quite true. At the same time Bill Gates commented that he and his wife “often set a time after which there is no screen time…which also helps his children (now ages, 20, 17 and 14) get to sleep at a reasonable hour”. It sounds as if Bill Gates has been reading the studies about screen time and sleep…and how the two may actually affect one another and is a believer!

 

So I now think that I will quote Bill Gates and “suggest” to parents that they not rush to buy their child a cell phone until they are around 14. It also makes a great deal of sense to monitor their usage and to continue to make sure that family time, including dinner time is a “cell free zone”. He emphasizes that using it to an excess, for any reason, is just not a good idea.

 

He is also a big believer in vaccines!!! Go Bill Go!

 

 

 

Daily Dose

Happy Thanksgiving!

1:30 to read

This is the week that really kicks off the holiday season and for me it often begins with reflection.  I am often guilty of not appreciating the many blessings that I have, and rather focus on just getting through one day at a time. But as I reflect, I realize that I have so much to be grateful for and much of that gratitude is for my family.

When you are in the throes of parenting, I think it is sometimes hard to appreciate many of the blessings that we have as families. As parents we are anxious for the next stage, whether that is having a baby sleep through the night or wanting your child to talk, start school, begin to read, or finish their college applications. Parenting is so often about looking ahead rather than living in the moment.

It is sometimes hard to take a breath and sit on the floor and play with your baby, or let your elementary school child read you a book at bedtime, or enjoy editing your high school student’s next paper (why was that always a Sunday night at 9 pm event?).  But, from someone who has been there, sit back, take a breath, put down your electronics and appreciate whatever stage your child is in right now!  For this too shall pass...

Why not take a minute during Thanksgiving and ask each one of your children what they are thankful for, and write their answers down on a note card to file away to read years from now. It is fun to see their answers and how their gratitude changes with age....some of their answers are funny, others are quite thought provoking.

As our family grows, now with a granddaughter and a new daughter in law, I find myself trying to take my own advice. We are fortunate to be gathering together for Thanksgiving and I am going to “re-start” the tradition with their comments on paper... No more trying to remember what they said and no videos either. Just a note card that each of us will write on and a box to keep the cards in.  One day our adult children and their children can read all of these comments...and be thankful for family. 

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