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Your Child

FDA Bans Certain Cough Medicines for Kids

2:30

 

The U.S. Food and Drug Administration (FDA,) has added strict restrictions to the use of children’s cough medicines that contain opioids, such as codeine or oxycodone.

"After safety labeling changes are made, these products will no longer be indicated for use to treat cough in any pediatric population and will be labeled for use only in adults aged 18 years and older," the FDA said in a news release.

The country is in the middle of an opioid abuse epidemic that is devastating families in just about every state. An updated Boxed Warning label will also warn adult users "about the risks of misuse, abuse, addiction, overdose and death, and slowed or difficult breathing that can result from exposure to codeine or hydrocodone," the agency added.

FDA Commissioner Dr. Scott Gottlieb said the agency is concerned about exposing children to opioids unnecessarily.

“We know that any exposure to opioid drugs can lead to future addiction. It's become clear that the use of prescription, opioid-containing medicines to treat cough and cold in children comes with serious risks that don't justify their use in this vulnerable population,” Gottlieb said in the press release.

The new rules announced Thursday were "based on an extensive review of available data and expert advice," the agency said.

They go much further than the 2017 labeling rules -- restricting use of codeine-containing products to everyone under the age of 18, and including cough-and-cold products that contain a second drug, the opioid oxycodone.

In any case, there's little that can or should be done to ease most children's cough and colds, the FDA said.

"Experts indicated that although some pediatric cough symptoms do require treatment, cough due to a cold or upper respiratory infection typically does not require treatment," the agency said. "Moreover, the risks of using prescription opioid cough products in children of all ages generally outweigh the potential benefits."

The press release also pointed to known side effects of opioid medications, "drowsiness, dizziness, nausea, vomiting, constipation, shortness of breath and headache."

The FDA recommends that parents currently using these medications for their child should speak with their child’s doctor about alternative therapies

It's always important to read medicine labeling, too -- even if it's not obtained by prescription.

"Caregivers should also read labels on non-prescription cough and cold products," the FDA said, because "some products sold over-the-counter in a few states may contain codeine or may not be appropriate for young children."

Story source: EJ Mundell, Health Day Reporter, https://www.webmd.com/drug-medication/news/20180111/fda-bans-opioid-containing-cough-meds-for-kids#1

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

CPR

1:00 to read

I was seeing a newborn the other day and the parents had a great idea. Their baby had spit up and they were concerned about how to clear his airway.  When we discussed how to hold the baby to clear the airway they had the great idea of having a CPR “teaching party” for a group of their friends who also had young babies!

 

I do encourage new parents (actually all parents and even grandparents) to take a CPR class. I am fortunate that we have yearly CPR class in our office which keeps us all up to date. 

 

It is fairly easy to find local CPR classes either through the YMCA, the American Heart Association and often through the hospital where you deliver your baby.  But, in these cases you have to take the class on “their schedule”. What a great idea to host a party with your friends and hire a certified CPR instructor to come to you!!

 

You know I do like to “isolate” my newborn patients from crowds (for 6-8 weeks), but it is fun to gather with other parents of newborns to get some social interaction. If everyone brought their baby, and a dish for dinner, it could be a mini dinner party followed by CPR training….ending with wine!

 

So…let’s start planning CPR parties, I may even do one for my friends who are becoming grandparents!

 

 

Parenting

“10 Worst Toys” List for 2017

2:00

Since 1973, an annual list of the top 10 most dangerous toys has been issued by the Boston based non-profit organization, World Against Toys Causing Harm, Inc. (W.A.T.C.H.)

This year’s list includes such favorites as fidget spinners, a Wonder Woman Battle-Action Sword and a Spider-Man Drone.

Strings, small parts, rigid surfaces, projectile pieces and toys that emit toxic substances are all potentially unsafe when it comes to toys, warned WATCH President Joan Siff and Director James Swartz at a press conference.

"It's alarming that there are so many toys out there that are unsafe," Siff told USA TODAY. "These are not the only ones." Since December, there have been 15 toy recalls in the U.S., according to Siff. 

The Toy Association, an industry group, says the lists are unnecessary and only create panic among consumers.

Both sides agree that parents should examine toys before giving them to children to look for any potential hazard.

Here’s this year’s WATCH list:

1.     Itty bittys baby plush stacking toy by Hallmark. The Consumer Product Safety Commission issued a recall on the product on Aug. 31 because of the small fabric hats and bows that were detachable and posed a choking hazard. But WATCH said they purchased the toy online after the recall was announced.

2.     Pull Along Pony by Tolo Toys Limited. WATCH said the product violates a federal law that requires that strings on playpen and crib toys be less than 12 inches long. The Tolo toy’s cord is 19 inches long. But the Toy Association said pull-along toys are an exception to this rule because the purpose is to teach motor skills.

3.     Wonder Woman Battle-Action Sword by Mattel. The nonprofit warns consumers that the stiff plastic sword can cause facial damage or other injuries to children.

4.     Hand Fidgetz Spinners by Kipp Brothers. Fidget spinners are meant for antsy kids, but WATCH said many come with small parts that can easily become loose or pulled off.

5.     Spider-Man Spider-Drone Official Movie Edition by Marvel and Skyrocket Toys. The drone comes with rapidly moving blades to help propel it into the air. The toy comes with a warning to keep moving parts away from fingers, hair, eyes and other body parts. WATCH said this is dangerous for children, which the drone is marketed toward.

6.     Nerf Zombie Strike Dreadbolt Crossbow by Hasbro and Nerf.com. The crossbow toy can cause eye and facial injuries. WATCH said the crossbow is inappropriate for small children.

7.     Slackers Slackline Classic Kit by Brand 44.This outdoor tightrope is marketed as an activity for all ages but comes with a warning of “severe injury,” including a chance for “strangulation hazard, especially with children.”

8.     The Oval Xylophone by Plan Toys Inc. and Plan Creations. The wooden instrument can be found online and is marketed to children as young as 12 months old. WATCH said that the toy does not come with a warning regarding the 9-and-a-half-inch-long stick, which could be placed in the child’s mouth and obstruct the child’s airway.

9.     Jetts Heel Wheels by Razor USA. The mini-roller skate-like devices are meant to be attached to the back of a child’s shoes to create the effect of a rear-wheel roller skate. The product comes with sparklers on the back that spark while moving. The manufacturer warns users to “keep sparks away from eyes, hair, exposed skin and clothing. Sparks can burn.”

10. Brianna Babydoll by Melissa & Doug. The dolls are marketed to children as young as 18 months, but have removable clothes and ponytail holders, which WATCH said could be a choking hazard.

Some parents may find the list helpful and others may think it’s nothing to get worked up about. The best advice seems to be to consider your child’s playing habits and age. Some kids are harder on toys than others. Infants and toddlers like to pull things apart and put things in their mouths – look for choking hazards. Inspect the toys with safety in mind and don’t assume that a well-known brand’s toys are always safe. Keep abreast of product safety recalls by the U.S. Consumer Product Safety Commission at https://www.cpsc.gov

Story source: Kellie Ell, https://www.usatoday.com/story/money/retail/2017/11/14/10-worst-toys-of-2017-list/862445001/

 

 

Your Baby

Good News! More Infants Placed in Car Seats Correctly

2:00

More parents and caregivers are getting the message and placing their infants and toddlers in car safety seats correctly, according to new research.

For years, the American Academy of Pediatrics (AAP) has aggressively urged parents and caregivers to put their children in rear-facing car seats until they are at least two years old. The AAP’s education policy seems to be paying off.

The study found that infants placed in rear-facing car seats increased from 84% in 2009 to 91% in 2015. The percentage of toddlers aged 12-17 months being placed in rear-facing car seats also increased dramatically from 12% to 61% during the same time period.

"This study shows that child passenger safety education has been a success in making sure young children are positioned correctly in the car, but there is still room for improvement," Dr. Joseph O'Neil, medical director of the Automotive Safety Program at Riley Hospital for Children, Indiana University Health, said in a press release.

The researchers also found that the use of booster-seat use decreased from 72% to 65% for older kids from 4 to 7 years old during that time.

The study findings suggest educational programs to improve child passenger safety could focus on the gaps identified by the study, including the recommendation to keep children rear-facing in safety seats through age 24 months, to use booster seats through age 8, and the recommendation that children sit in the back seat through age 13.

Safercar.org has a video and step-by-step instructions on how to properly install a rear-facing car seat for baby’s safety.

AAP also offers “Tips for Parents,” in video and written media, for shopping for car seats.

The study will be presented today at the AAP’s National Conference & Exhibition in Chicago.

This research is good news for children! Proper use of rear –facing car seats and booster seats are the first line of defense in keeping children safer when they’re riding in your car.

Story source: Amy Wallace, https://www.upi.com/Health_News/2017/09/14/Study-shows-more-infants-toddlers-placed-in-car-seats-correctly/9381505417976/

Your Toddler

Bathroom Safety Tips

1:45

While most of us may not think of a bathroom as a dangerous place, it often is where home injuries occur. From infants to the elderly, bathrooms are notorious for being places one can slip and fall, drown, be scalded and even electrocuted.

Young children are particularly vulnerable to accidents in the bathroom. The simplest way to avoid bathroom injuries is to make sure that an adult is always with an infant, toddler or young child when he or she is in the room. This may mean installing a latch on the door at adult height so the child can't get into the bathroom when you aren't around. Also, be sure any lock on the door can be unlocked from the outside, just in case your child locks him or herself in.

Here are 5 tips to help prevent bathroom injuries to young children:

1      Supervision: Children can drown in only a few inches of water, so never leave a young child alone in the bath, even for a moment. If you can't ignore the doorbell or the phone, wrap your child in a towel and take him along when you go to answer them. Bath seats and rings are meant to be bathing aids and will not prevent drowning if the child is left unattended. Never leave water in the bathtub when it is not in use. It's also important to have anything and everything you think you'll need within arm's reach before getting down to business. So that you don’t have to step away from your child, have items such as soap and shampoo, washcloths, a towel or two, moisturizer for infants, diapering supplies and a change of clothes within reach.

2      Slips and falls: Install no-slip strips on the bottom of the bathtub. Put a cushioned cover over the water faucet so your child won't be hurt if he bumps his head against it. Get in the habit of closing the lid of the toilet, and get a toilet lid lock. A curious toddler who tries to play in the water can lose his balance and fall in. Potty-training is a time when parents should be in the bathroom to make sure curious toddlers don’t decide to play with the toilet water.

3      Water temperature: To prevent scalding, adjust your water heater so the hottest temperature at the faucet is no more than 120 degrees Fahrenheit (48.9 degrees Celsius). Test the water with your wrist or elbow to check that it feels warm, not hot. When your child is old enough to turn the faucets, teach him to start the cold water before the hot.

4      Medicine and toiletry storage: Keep all medicines in containers with safety caps. Remember, however, that these caps are child-resistant, not childproof, so store all medicines and cosmetics high and out of reach in a locked cabinet. Don't keep toothpaste, soaps, shampoos, and other frequently used items in the same cabinet. Instead, store them in a hard-to-reach cabinet equipped with a safety latch or locks.

5      Electric appliances: If you use electrical appliances in the bathroom, particularly hair dryers and razors, be sure to unplug them and store them in a cabinet with a safety lock when they aren't in use. It is better to use them in another room where there is no water. An electrician can install special bathroom wall sockets (ground-fault circuit interrupters) that can lessen the likelihood of electrical injury when an appliance falls into the sink or bathwater.

Every year, young children are injured or die in bathrooms. Many families never think to lock a bathroom door when no one is in it, but making sure there is a lock in place and is used may prevent an unnecessary tragedy. 

Story source: https://www.healthychildren.org/English/ages-stages/baby/bathing-skin-care/Pages/Preparing-Your-Bathing-Area.aspx

 

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.

Daily Dose

Testing Your Child's Lead Levels

It is estimated that about 1.5% of U.S. children have high blood lead levels.I received an email via our iPhone App from a mom who was concerned about lead poisoning. Ironically, it came at a time when I was reading an article on reducing lead exposure in children.

Despite awareness of the risks to young children who have lead exposure and changes in regulatory policies regarding lead in gasoline, paint, plumbing components and food cans, it is still estimated that about 1.5% of U.S. children have blood lead levels greater than 10mcg/dL which is considered high, while almost 14% of children had lead levels of 5-9mcg/dL. You should be aware of the mounting evidence that there may be subtle effects on IQ at lead levels within these ranges. One of the problems is there is not a uniform policy on who (which children) and when to screen for lead exposure. The Centers for Disease Control and Prevention states that states should develop policies based on their data of lead exposure. They also recommend universal screening for newly arrived refugee children from six months to 16 years old. Federal guidelines require that all children enrolled in Medicaid be screened. But many states do not recommend routine lead screening, and I am sure many parents are not clear on their state's guidelines, as they do not make front-page news. The American Academy of Pediatrics recommends universal screening if there are not state guidelines. This screening is recommended at 12 and 24 months of age, so basically at your child's one and two year checkup. This timing is chosen as it reflects historical data of blood lead levels peaking at this age, when children are putting everything into their mouths. We routinely screen our patients at their one and two year old visit and surprisingly find several per year in the 5 - 10 mcg/dL level and on a rare occasion on in the teens. The majority has levels under 5mcg/dL. Ask your doctor if your child has been screened. It is an easy test and may be another number worth knowing. That's your daily dose, we'll chat again tomorrow. Send your question to Dr. Sue!

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Your Child

Kids: Safe Lawn Care

2:00

This is the time of year when kids are most likely to be playing in the yard. Daylight hours are longer and winter’s chill is fading fast or gone.  It’s also the time when insects and weeds make an appearance, demanding some type of control.

All pesticides, herbicides, and insecticides are toxic on some level. Along with killing pests and weeds, they can also harm you, your children, your pets, and any wildlife on your lawn.

Researchers have noted that young children are especially at risk from pesticides. Their bodies and immune systems are still developing. They are also more likely to spend time outside on the lawn, playing or crawling and coming in contact with any pesticides used there.

As population growth and sub-division building increases, these chemicals have increased in usage.

 However, pesticides, herbicides and insecticides are not the only ways to have a welcoming lawn and insect control. If you must use some pesticides, you can help keep your family safe by using them with care, and only when needed.

Lawn care starts with the basics. When your lawn is healthy, there’s less of a chance for weeds and pests. Pests often mean that the soil is lacking nutrients. Without healthy soil, grass and other plants have a harder time growing and staying healthy. A soil test will tell you what the pH level is and whether your soil needs extra nutrients. Most grasses do best in a soil with a pH between 6.5 and 7.0. If you find that your soil needs help or a pH adjustment, you can add nutrients as needed.

Compost is a healthier option for adding nutrients than many chemical fertilizers. Most lawns can use a good fertilizing at least once a year. You can top-dress with a quarter- to a half-inch of compost. Or look for fertilizer that's labeled "slow release" or "natural organic" fertilizer.

A soil test will tell you what the pH level is and whether your soil needs extra nutrients. Most grasses do best in a soil with a pH between 6.5 and 7.0. If you find that your soil needs help or a pH adjustment, you can add nutrients as needed.

You can also do online research about what kind of grass grows best in your part of the country. County extension offices often have an abundance of material on grasses, flowers and tree types that your area is compatible with and need less watering.

Mowing can have a dramatic effect on lawns. By leaving your grass a little longer -- usually between 2 ½ and 3 ½ inches -- you can usually improve your lawn's health. This is because the leaves of longer grass have more access to sunlight, which helps the grass grow thicker and create deeper roots.

Longer grass is better for your soil, since it provides more shade and helps the soil retain moisture. It also makes it more difficult for weeds to grow.

When pests appear, many experts agree that integrated pest management (IPM) is the most effective and environmentally friendly way to control pests. Basically, this means using holistic ways to treat pests when possible, such as mowing your lawn higher to shade out weeds or planting more disease-resistant types of grasses or plants, and only using pesticides when needed.

Here are a few suggestions to try before you reach for the pesticide:

- Give nature a little time to work. Damaged parts of your lawn may bounce back over time. And most lawn and garden pests have natural enemies that will help control pests. For example, ladybugs and praying mantises eat other bugs while not damaging your lawn or garden.

- Pull out weeds using a long-handled weed puller. It's usually easier than by hand.

- Vinegar can also be used to kill weeds.

- Mulch garden beds to prevent weeds.

- Remove diseased plants so the problem doesn't spread.

If you do decide to use a pesticide, follow these guidelines to help keep your family safe:

- Make sure you know what kind of pest you're dealing with so you can choose the right type of pesticide. Your local extension agent or other local lawn expert can help you identify the problem. There are also organic lawn and pest care companies.

- Don't treat the whole lawn if it’s unnecessary. Use pesticides just where you have the problem.

- Read the label on the pesticide carefully and follow the instructions.

- Wear gloves, and long pants and sleeves while using the pesticide to protect your skin. Wash clothing separately before wearing them again.

- Keep children and pets away from the area for the time recommended on the label.

- If you hire a lawn care service, find one that uses an IPM approach to lawn care or uses organic or chemical-free processes.

Fleas and ticks are some of the most annoying pests during summer and can be difficult to control. 

Fleas and ticks prefer a moist environment. Overwatering is an invitation to these pests. One of the safest ways to treat your yard is the application of Diatomaceous Earth (often just called DE). Diatomaceous earth, which is available at garden centers, is crushed rock that contains the fossilized remains of diatoms, an alga. The hard-shelled alga grates against the fleas and kills them mechanically, not chemically. Don’t buy the DE that is intended for pools; it has been chemically treated and isn’t for use around pets. DE is easy to use by sprinkling areas in the yard where fleas are likely to congregate, such as your dog’s favorite hangouts. Wear a filter mask when spreading the fine powder and keep your dog inside while treating the yard.

Another natural way to treat your yard is by using beneficial nematodes, microscopic round worms that are safe for your family and your pets. Along with fleas, nematodes kill weevils, crane flies, grubs, corn borers, and other vegetable garden pests. The nematodes are microscopic so you won’t see them; you’ll purchase them on a small sponge that contains about one million live nematodes, enough for about 3,000 square feet of yard space.

After soaking the sponge in water, you’ll spray the yard with the mixture. You can purchase the nematodes as far in advance as about a week prior to the yard application; just keep the package in the refrigerator until you are ready to use it.

Organic lawn care can be a little more laborious at the beginning, but as your soil becomes healthier– less and less time is needed to maintain it.

Having a safer lawn may mean that you learn to live with a weed or two. But even healthy lawns have a few weeds and pests. Knowing that your kids are safe when playing hide-and-seek or leapfrog should make any weeds that do pop up a little easier to tolerate.

Story sources: http://www.webmd.com/children/lawn-care#1

Paris Permenter, John Bigley http://www.petsafe.net/learn/10-ways-to-prevent-pests-naturally

 

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