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Daily Dose

Burns From Hot Surfaces!

1;30 to read

With the ongoing heat wave across many parts of the country which has hit Texas exceptionally hard, I have a new warning for parents (and kids).  My community has seen seen extremely high temperatures between 100-106 for the last two weeks. These temps have made everyone miserable and there have been many warnings about heat exhaustion and heat stroke, and ways to stay hydrated on the news.

Who knew that you needed to worry about burns other than sunburn? It seems that outdoor furniture, metal pool drain covers, and playground equipment have heated up with these unrelenting temperatures!  

So…what is this alluding to?  A patient just called me yesterday totally “freaking out” that her toddler had gone out to play in the backyard with his 3 year old brother. It was morning and not yet terribly hot, so she thought “best time to get out of the house and get some fresh air”.  The boys were climbing on their outdoor fire pit (as children often do) and he stepped on the edge, and immediately started to scream and cry. His mother, who also happens to be a pediatric nurse, initially thought something had stung him? When she picked him up he continued to cry as if in pain, but she could not see anything at all….until she looked at his feet. He had stood on the metal on the edge and immediately burned his feet, to the point of blistering on contact!  And, as you probably know, toddlers feet are typically flat (arches come later) so his “baby feet” had full contact with the metal and he sustained second degree burns to both feet.

When she got him to the ER they immediately started to treat his burns and pain (as burns are incredibly painful).   She said she did not know who was crying more…she or her child. Once things settled down she asked the ER doctor at Children’s Medical Center if this had ever happened before!  Unfortunately, the answer was yes.  They had seen several other serious burns to children who had come into contact with metal on playgrounds and around metal pool drain covers.

This precious little boy will ultimately be fine…..after many days of oral pain medication and routine bandage changes (some of which will actually be done as an outpatient at a burn unit). He will also never remember this.

So… this is a new warning for parents: watch out for the possibility of burns secondary to outdoor metal objects.  This photo is quite telling and painful to look at!  His mother called me today and sent a few new pictures with him smiling!

Your Child

Kid’s Severe Injuries linked to BB Guns, Paintball

2:00

A new study says that Paintball, airsoft and BB guns are responsible for causing severe and sometimes life-threatening injuries in children.

"The popular conception is that they are toys," said Dr. Nina Mizuki Fitzgerald, the lead researcher and a pediatric emergency medicine fellow at the University of Texas Southwestern Medical Center/Children's Health in Dallas. Not so, she said,   "Injuries can be extremely severe and [children] can have long-term deficits."

Fitzgerald and her team evaluated medical records of children seen at Children's Medical Center Dallas of non-powder gun accidents between 2010 and 2015. In all, 288 children, average age 11, were treated for the gun injuries, more than three-quarters of which involved a BB gun.

About one in four children had to undergo surgery for the injury. Nearly 45 percent had a foreign body injury (such as the BB). About 15 percent were hospitalized. In addition, one in 10 had a functional deficit that interfered with daily tasks, and the overwhelming majority of those were eye-related. Seven children had an eye injury so severe surgeons had to remove the eye, the researchers reported.

"The biggest take-away for parents is that kids should always be supervised when using non-powder guns," Fitzgerald said. And children should always wear eye protection, she stressed.

BB gun pellets often leave a small puncture mark, giving the impression that there is only a minor injury. But Fitzgerald warns parents that these injuries may need medical attention. "There may be a tiny puncture mark, and it doesn't look bad at all. But they can have severe internal injuries," she explained.

The study results are not surprising because they build on previous research that found the same, said Dr. Roberto Warman, director of pediatric ophthalmology at Nicklaus Children's Hospital in Miami. He has seen many such eye injuries in his years of practice, and recalls having to remove eyes that could not be saved. One child was only 3 years old, he added.

With paintball, kids may think the game is over, take off their eye protection, only to be shot by another child who hasn’t finished the game or shoots one last round. Collecting the paintball guns and then the goggles could help reduce that possibility, he suggested.

While some doctors think these activities should be banned for young children, others think education is the key to fewer accidents.

While it’s easy to think of these objects as toys, they are not. Experts agree that parents need to be informed that their children must wear goggles during the gun play and need to be supervised at all times.

Fitzgerald will present her findings at the American Academy of Pediatrics meeting in Washington, D.C. Studies presented at medical meetings are viewed as preliminary until published in a peer-reviewed journal.

Source: Kathleen Doheny, http://www.webmd.com/children/news/20151023/paintball-bb-guns-can-severely-injure-kids-study-finds

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

Popular Gift: Hoverboards Are Catching Fire

2:00

One of the hottest gifts this Holiday season is the Hoverboard, but more and more are hot not because they are popular, but because they have burst into flames. The gliding boards have caught fire in the U.S. and throughout Europe.

Both the National Association of State Fire Marshals and the UK's National Trading Standards are raising a red flag on hoverboards, claiming that they are blowing up across the world.

The national Fire Marshals organization issued an advisory recently, warning that these explosions are "not a unique occurrence," H. Butch Browning Jr., the president of the group's Board of Directors said in a statement.

"The sheer number of incidents occurring around the country, and abroad, is what prompted our organization to address this serious issue on a national level," he said.

Hoverboards are marketed to all age groups with some specifically designed for children.

A Louisiana family lost their home a day after 12-year-old Hayden Carbo got a FitTurbo hoverboard for his birthday.  The toy exploded and burned the boy's bedroom and home to a crisp.

"It was like a firework. I saw sparks just flying and before I could yell, the house is on fire," his mother, Jessica Horne said.

On Nov. 28, an 11-year-old Florida girl barely escaped being burned while riding the explosive $300 toy. "She felt it get hot, she jumped off, and it was in flames," Pamela Levine, the girl's mother, told KSHB-TV.

The United Kingdom has taken aggressive moves in clamping down on hoverboards. Officials have detained 15,000 of the devices due to “major safety risks.” Many of the hoverboards had non-compliant plugs without fuses, which can cause the boards to overheat or catch fire.

Cheaper China made knock-offs seem to be the worst of the lot. The less expensive prices are tempting to many people, but even these aren’t cheap. The more expensive models can sell for $1500 -$1700, while the cheaper ones sell for between $350-$500.

If you’re considering buying one of these products for your family, the National Fire Marshal Association offers these safety recommendations:

·      Make sure the hoverboard is compliant with federal standards, inspections, and certifications, it will have a mark on it or indicate such on its packaging, on the device itself, or on its charging equipment. Devices not bearing a mark indicating compliance likely have not been tested to meet minimum safety standards.

·      When buying online, verify that the device meets applicable standards. There are many of these products on the market, and many may not meet this country's inspection and safety requirements. Those that do will indicate such on the packaging, and on the device or its charging equipment.

·      Buy a device with a warranty, or buy it in person at a brick and mortar store. If you are buying online, buy from a reputable source. Also, check with your retailer regarding the safety of the device you are purchasing.

When charging your self-balancing scooter or hoverboard:

·      After it has been used, give the device time to cool off prior to charging.

·      Do not leave the device unattended while it is charging. Someone should be able to observe the device during its recharging time.

·      Do not overcharge the device; follow manufacturer's recommended charging times and do not leave device plugged into an outlet overnight.

·      Do not use imitation electrical chargers, as they may be unsafe.

·      Keep to one plug per socket.

The segue-way like boards are becoming more and more popular, and the desire to own one is high. Like any other in-demand item, knock-offs move quickly into the marketplace.  These unregulated and expensive hoverboards can be dangerous to your home and family. If your child has a hoverboard, make sure an adult is always present when they ride or charge it.

Sources: Alfred NG, http://www.nydailynews.com/news/world/hoverboards-blowing-uk-officials-article-1.2457027

Jeremy Gray, http://www.al.com/news/index.ssf/2015/12/hoverboard_safety_fire_marshal.html

 

Parenting

Preventing Carbon Monoxide Poisoning

2:00

This is the time of year when accidental carbon monoxide (CO) poisoning happens the most. For families in cold climates or dealing with disasters such as flooding, tornados or loss of electricity for long periods of time, gasoline powered generators or heaters can be a godsend. But they also require special care to prevent carbon monoxide poisoning.

Carbon monoxide is a colorless, odorless, tasteless toxic gas that is a product of the incomplete combustion of carbon-based fuels. Unintentional carbon monoxide poisonings accounted for approximately 400 to 500 deaths (all ages) and more than 15,000 emergency department visits in the United States annually according to the AAP Council on Environmental Health.

Proper installation and maintenance for the use of combustion appliances can help to reduce excessive carbon monoxide emissions along with carbon monoxide detectors.

Many non-fires related CO poisonings come from automobiles left running in a closed garage- sending toxic fumes into the house.

Other ways carbon monoxide poisoning occurs may surprise you. Improperly maintained chimneys and flues can crack and leave a buildup that causes problems with venting CO fumes. Wood stoves that are not fitted correctly can leak CO into living rooms and bedrooms. Kerosene heaters reduce oxygen in rooms. They require good ventilation to operate safely. Carbon monoxide, carbon dioxide, nitrogen dioxide, and sulphur dioxide can be emitted from improper use of kerosene heaters. These fumes become toxic in large quantities and put vulnerable individuals at risk, such as pregnant women, asthmatics, people with cardiovascular disease, the elderly, and young children. Charcoal grills put off an enormous amount of CO; they should never be used indoors.

The Centers for Disease Control and Prevention (CDC) offers guidance for protecting families from CO poisoning with these tips:

Fuel-Burning Appliances

•       Forced-air furnaces should be checked by a professional once a year or as recommended by the manufacturer. Pilot lights can produce carbon monoxide and should be kept in good working order.

•       All fuel-burning appliances (eg, gas water heaters, gas stoves, gas clothes dryers) should be checked professionally once a year or as recommended by the manufacturer.

•       Gas cooking stove tops and ovens should not be used for supplemental heat.

Fireplaces and Woodstoves

•       Fireplaces and woodstoves should be checked professionally once a year or as recommended by the manufacturer. Check to ensure the flue is open during operation. Proper use, inspection, and maintenance of vent-free fireplaces (and space heaters) are recommended.

Space Heaters

•       Fuel-burning space heaters should be checked professionally once a year or as recommended by the manufacturer.

•       Space heaters should be properly vented during use, according to the manufacturer’s specifications.

Barbecue Grills/Hibachis

•       Barbecue grills and hibachis should never be used indoors.

•       Barbecue grills and hibachis should never be used in poorly ventilated spaces such as garages, campers, and tents.

Automobiles/Other Motor Vehicles

•       Regular inspection and maintenance of the vehicle exhaust system are recommended. Many states have vehicle inspection programs to ensure this practice.

•       Never leave an automobile running in the garage or other enclosed space; Carbon monoxide can accumulate even when a garage door is open.

Generators/Other Fuel-Powered Equipment

•       Follow the manufacturer’s recommendations when operating generators and other fuel-powered equipment.

•       Never operate a generator indoors or near an open window when the generator is outdoors.

Boats

•       Be aware that carbon monoxide poisoning can mimic symptoms of seasickness.

•       Schedule regular engine and exhaust system maintenance.

•       Consider installing a carbon monoxide detector in the accommodation space on the boat.

Carbon monoxide poisoning can mimic other illnesses – so it’s good to be aware of the symptoms, especially if you have any of the heating sources or gasoline powered motors mentioned above.

Signs and symptoms of carbon monoxide poisoning may include:

  • Dull headache
  • Weakness
  • Dizziness
  • Nausea or vomiting
  • Shortness of breath
  • Confusion
  • Blurred vision
  • Loss of consciousness

The symptoms may be subtle, but the condition is life threatening. If you suspect CO poisoning, seek emergency medical care immediately and make sure your child is getting fresh air as soon as possible.

Story sources: https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/Children-and-Disasters/Pages/Protecting-Children-from-Carbon-Monoxide-Poisoning.aspx

http://www.mayoclinic.org/diseases-conditions/carbon-monoxide/basics/definition/con-20025444

 

Your Baby

Exercising During Pregnancy

2:00

If you’re pregnant, you may be wondering if you should start or continue exercising. The answer is a resounding, yes!

Regular exercise throughout your pregnancy can help you stay healthy, improve your posture and help decrease common discomforts such as backaches and fatigue.

There is even evidence that physical activity may help prevent gestational diabetes, relieve stress and build more stamina needed for labor and delivery.

All of these benefits are good things.

If you were physically active before your pregnancy, there’s no need to stop. However, don’t try to exercise at your former level; instead, do what's most comfortable for you now. Low impact aerobics are encouraged versus high impact.

Check with your obstetrician for guidance if you are a competitive athlete, you may need specialized monitoring.

What if you have never been into exercise, should you start now that you are pregnant?  Absolutely!

You can safely begin an exercise program during pregnancy after consulting with your health care provider, but do not try a new, strenuous activity. Walking is considered safe to initiate when pregnant.

The American College of Obstetrics and Gynecology recommends 30 minutes or more of moderate exercise per day on most if not all days of the week, unless you have a medical or pregnancy complication.

While exercise is great for most moms-to-be, there are some women who should not exercise during pregnancy. They are women with medical problems such as asthma, heart disease or diabetes. If you have one of these conditions, check with your OB/GYN about your options and follow his or her recommendations.

Exercise may also be harmful if you have a pregnancy-related condition such as:

           ·      Bleeding or spotting

           ·      Low placenta

           ·      Threatened or recurrent miscarriage

           ·      Previous premature births or history of early labor

           ·      Weak cervix

Talk with your health care provider before beginning an exercise program. Your health care provider can also give you personal exercise guidelines, based on your medical history.

Most exercises are safe to perform during pregnancy as long as you don’t overdo it.

The safest and most productive activities are swimming, brisk walking, indoor stationary cycling, step or elliptical machines, and low-impact aerobics (taught by a certified aerobics instructor). These activities carry little risk of injury, benefit your entire body, and can be continued until birth.

What about jogging, tennis and racquetball? All these activities require balance and coordination– which may change as you progress during your pregnancy.  If you’re healthy and have discussed these sports with your OB/GYN, go ahead and enjoy, but in moderation.

There are certain exercises that can be harmful during pregnancy. What exercises should be avoided? They are:

·      Holding your breath during any activity.

·      Activities where falling is likely (such as skiing and horseback riding).

·      Contact sports such as softball, football, basketball, and volleyball.

·      Any exercise that may cause even mild abdominal trauma such as activities that include jarring motions or rapid changes in direction.

·      Activities that require extensive jumping, hopping, skipping, bouncing, or running.

·      Deep knee bends, full sit-ups, double leg raises, and straight-leg toe touches.

·      Bouncing while stretching.

·      Waist-twisting movements while standing.

·      Heavy exercise spurts followed by long periods of no activity.

              ·      Exercise in hot, humid weather.

Stretching exercises can help make the muscles limber and warm, which can be helpful during pregnancy.

Kegal exercises can help strengthen the muscles that support the bladder, uterus and bowels. By strengthening these muscles during your pregnancy, you can develop the ability to relax and control the muscles in preparation for labor and birth.

Tailor exercises strengthen the pelvic, hip, and thigh muscles and can help relieve low back pain.

Many health providers have DVDs, websites or exercise pamphlets with instructions and examples available for their pregnant patients. There are also classes with instructors trained in leading exercise programs specifically for pregnant women.

What should a pregnancy program consist of?

A total fitness program should strengthen and condition your muscles. Don’t forget to drink plenty of water and never exercise to the point of exhaustion.

Exercising during pregnancy has many advantages, but there are warning signals you should look out for. Stop exercising immediately and contact your health provider is you:

             ·      Feel chest pain.

             ·      Have abdominal pain, pelvic pain, or persistent contractions.

             ·      Have a headache.

             ·      Notice an absence or decrease in fetal movement.

             ·      Feel faint, dizzy, nauseous, or light-headed.

             ·      Feel cold or clammy.

            ·      Have vaginal bleeding.

            ·      Have a sudden gush of fluid from the vagina, or a trickle of fluid that leaks steadily.

            ·      Notice an irregular or rapid heartbeat.

           ·      Have sudden swelling in your ankles, hands, face, or calf pain.

           ·      Are short of breath.

           ·      Have difficulty walking.

           ·      Have muscle weakness.

The big question many women have after delivery is – when can I start working off these extra pounds? It’s best to start fitness routines gradually and follow your health provider’s recommendations. Too often, women who have just given birth are inundated with images of celebrities who look as though they have dropped 50 pounds and returned to their former sleek selves within weeks after delivery. However they accomplish this (think spandex & a personal trainer that works you relentlessly), it’s not necessary or even healthy to try to capture your former body immediately.

Most women can safely perform a low-impact activity one to two weeks after a vaginal birth (or three to four weeks after a cesarean birth). Do about half of your normal floor exercises and don't try to overdo it.

Exercising during pregnancy is not a “one routine fits all” kind of thing. You can strengthen your muscles and reap the benefits of exercise while pregnant, just do it under the guidance of your health provider. He or she knows your limits, your medical history and will be able to help you achieve the best results.

Story source:

Traci C. Johnson, MD, http://www.webmd.com/baby/guide/exercise-during-pregnancy.

 

 

Your Baby

CDC Warning: Dangerous Germ Found in Powdered Infant Formula

2:00

The Centers for Disease Control and Prevention (CDC) issued a new warning about Cronobacter contamination in powdered infant formulas.

Because powdered infant formula is not sterile, it can sometimes contain Cronobacter — formerly known as Enterobacter sakazakii — a germ found naturally in the environment that can survive in very dry conditions, the CDC reports.

Cronobacter bacteria can cause severe blood infections or meningitis, an inflammation of the membranes that protect the brain and spine. If infected, infants two months of age and younger, are most likely to develop the infection.

Infants born prematurely and those with weakened immune systems are also at increased risk for serious sickness from Cronobacter, the CDC warns.

In infants, the sickness generally starts with fever and usually includes poor feeding, crying or very low energy. Very young infants with these symptoms should be taken to a doctor.

In some outbreak investigations, Cronobacter was found in powdered infant formula that had been contaminated in the factory. In other cases, Cronobacter might have contaminated the powdered infant formula after it was opened at home or elsewhere during preparation, according to the CDC.

Because Cronobacter lives in the general environment, it’s likely there have been other sources of this rare sickness.

Using current methods, manufacturers report that it is not possible to get rid of all germs in powdered infant formula in the factory. Powdered infant formula can also be contaminated after the containers are opened. Very young infants, infants born prematurely, and infants whose bodies have trouble fighting off germs are at highest risk.

The CDC offers these tips on protecting your infant:

·      Breastfeed: Breastfeeding helps prevent many kinds of sicknesses among infants. Almost no cases of Cronobacter sickness have been reported among infants who were being exclusively breastfed.

·      If your baby gets formula, choose infant formula sold in liquid form, especially when your baby is a newborn or very young. Liquid formulations are made to be sterile and therefore should not contain Cronobacter germs.

·      If you use powdered infant formula, follow these steps:

1      Clean up before preparation

Wash your hands with soap and water.

Clean bottles in a dishwasher with hot water and a heated drying cycle, or scrub bottles in hot, soapy water and then sterilize them.

Clean work surfaces, such as countertops and sinks.

2      Prepare safely

Keep powdered formula lids and scoops clean and be careful about what they touch.

Close containers of infant formula or bottled water as soon as possible.

Use hot water (158 degrees F/70 degrees C and above) to make formula.

Carefully shake, rather than stirring, formula in the bottle.

Cool formula to ensure it is not too hot before feeding your baby by running the prepared, capped bottle under cool water or placing it into an ice bath, taking care to keep the cooling water from getting into the bottle or on the nipple.

3      Use up quickly or store safely

Use formula within two hours of preparation. If the baby does not finish the entire bottle of formula, throw away the unused formula.

If you do not plan to use the prepared formula right away, refrigerate it immediately and use it within 24 hours. Refrigeration slows the growth of germs and increases safety.

When in doubt, throw it out. If you can’t remember how long you have kept formula in the refrigerator, it is safer to throw it out than to feed it to your baby.

Story Source: http://www.foodsafetynews.com/2016/04/125714/#.VyJvoat5ylA

 

Your Toddler

Detergent Pods Causing Severe Eye-Damage to Kids

1:45

Warnings have been out for a while on the dangers of small children getting their hands on laundry detergent pods that often look like packets of candy. The main threat has been poisoning, but another problem has surfaced; vision threatening burns, according to a new study.

Researchers analyzed data from the U.S. Consumer Product Safety Commission and looked at eye injuries caused by chemical burns or conjunctivitis among 3 to 4 year olds between 2010 and 2015.

They found that more than 1,200 preschoolers in the United States suffered eye burns from these single-use detergent pods. In 2012, only 12 such burns were reported. By 2015, that number was almost 500.

"These pods look like toys, they look like candy, and kids are finding them, playing with them, puncturing them, and the chemicals inside the pods are getting into their eyes," said lead researcher Dr. R. Sterling Haring, from the Johns Hopkins University Bloomberg School of Public Health in Baltimore.

The injuries often occur when children are playing with the pods and they break, squirting liquid into their eyes. Eye burns can also happen when the soap gets on children’s hands and they touch their eyes, Haring said.

"Laundry detergent pods are playing a large and growing role in chemical eye burns among small children," he said.

As a proportion of all chemical burns to the eye among kids, burns from these liquid laundry pods rose from less than 1 percent in 2012 to 26 percent in 2015, Haring said.

"I am expecting the number of burns in 2016 to be higher than 2015. These numbers have grown every year," he said.

The American Cleaning Institute (ACI), an industry trade group, has voluntarily introduced improved safety standards for many of these products. New guidelines call for pods that can withstand squeezing pressure from a child. The pods also have a bitter substance on their outer layer to keep children from swallowing their contents. And packaging of the pods is now opaque so the laundry pods can't be seen from outside the packaging, the group said. Many detergent manufacturers have already begun making some of these changes.

One reason the detergent pods can be so dangerous is because the chemicals used are alkaline instead of acidic. Alkaline chemicals are more likely to cause lasting damage than acidic chemicals, Haring said.

The effects of alkaline chemicals can be devastating to a young child’s vision.

"The detergent can burn the cornea, leaving a scar that can impair vision or potentially cause blindness," Haring said. "In the most severe cases, children may need a corneal transplant to restore vision."

If a child has a chemical burn, step one is to rinse the eye with cool water under a faucet for 20 minutes, Haring said.

"Call 911 or take the child to an emergency room, but do it after you rinse the eye for 20 minutes," he said. "That is the first step, and that's the most important step. The longer those chemicals sit on the eye, the higher the likelihood they are going to leave a lasting burn and threaten vision.”

Detergent pods have become very popular because they are convenient, but parents and caretakers sometimes forget that they are packed with dangerous chemicals. These pods need to be kept in an area where small children cannot see them or reach them.

The report was published online in the journal JAMA Ophthalmology.

Story source: Steven Reinberg, http://www.webmd.com/parenting/news/20170202/laundry-detergent-pods-linked-to-eye-burn-danger-in-kids#1

 

Your Baby

Never Leave a Child Unattended in a Car Seat, Swing or Bouncer

2:00

Placing an infant in a car seat, swing or bouncer as a substitute for a crib can be a fatal decision. These objects work fine when used properly for their intended purpose, but when a child is left unattended – they can quickly turn deadly according to a new study.

Using these devices as directed and not as substitutes for a crib would reduce the risk of death, according to lead author Dr. Erich K. Batra of Penn State College of Medicine in Hershey, Pennsylvania.

“The overarching advice goes back to a more basic message of safe sleep,” Batra told Reuters Health. “In an infant, a safe sleep environment includes the ABCs: they sleep alone, not in bed between parents, on their backs, and in a crib or bassinet without any loose bedding.”

The study reviewed young children’s death in devices like car seats, swings and bouncers and found that most were due to suffocation by improper positioning or strangulation in straps.

The researchers reviewed the reports of 47 deaths of children under two years old that happened in car seats, bouncers, swings, strollers or slings and were recorded by the U.S. Consumer Product Safety Commission between 2004 and 2008.

The study used only reports submitted by consumers or manufacturers, so the number of deaths may actually be higher.

Most of the deaths occurred in car seats (31 of 47). Five happened in slings, four each in swings and bouncers and three in strollers.

About half of deaths in car seats were due to strangulation by the straps, while the other half were caused by suffocation due to positioning, the authors reported in The Journal of Pediatrics.

Strap strangulation usually happens when the restraints are not fastened as directed, Batra said. Whenever a child is in a car seat, the harness should be secured.

“If people leave an older infant or young toddler in a car seat and undo the straps thinking that it makes them more comfortable, that’s a significant hazard,” he said.

“A child properly secured in a car seat is in very little risk of danger,” he said.

However, many times the child falls asleep in the car seat and a parent or caregiver decides to bring the car seat, with baby still attached, into the home.

Dr. Shital N. Parikh, an orthopedic surgeon at Cincinnati Children’s Hospital Medical Center in Ohio, has studied the risk factors for injury in these devices in infants up to age one. He also found car seats to be the most common setting.

“The commonest mechanism of injury was infants falling from car seats when not used in the car, used in the home,” Parikh told Reuters Health. Often parents would bring the car seat in the house while the infant still slept, undo the straps and place it on an elevated surface, he said.

Even four-month-old babies are mobile enough to wiggle out of the top straps and fall, or topple the whole seat from an elevated surface, he said.

“These are very simple things, very basic things,” Parikh said. “The basic idea is that you use (the devices) for their intended purpose only. For infants, you should not use it to make them sleep or carry them around if it’s not intended for that.”

Batra notes that baby in slings need to be “visible and kissable,” as a sling may put baby’s head in a hazardous position.

It only takes four to five minutes for an unattended baby to suffocate in one of these devices.

“That is one of the things we need to draw attention to,” Batra said. Sometimes a few minutes unattended is all it takes.

“If your infant is sleeping and you’re not observing them, then they need to be in a safe sleeping environment,” adhering to the ABCs, he said.

While it may seem safe to leave a baby in a car seat, swing, sling or bouncer for a few minutes unattended, go ahead and place the child in his or her crib. It may wake them up if they are sleeping, but it’s much safer than allowing them to continue to sleep in a device that was never intended for that purpose.

Source: Kathryn Doyle, http://www.reuters.com/article/2015/04/29/us-car-seat-infant-safety-idUSKBN0NK21E20150429

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