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Daily Dose

The Heat is Taking a Toll on Many

1:15 to read

This is a follow up last week’s Daily Dose on the toddler who burned his feet after playing outside on a very hot day. He has been being treated with daily dressing changes and debridement of the skin from the blistering on his feet. HIs mother called to tell me that the first few days were “BRUTAL” and extremely painful as the doctors popped the blisters and removed dead skin and then would scrub the area to prevent infection. His mother was also doing bandage changes at home.

But after those first horrible days, he is no longer having to go for “burn therapy” and she is managing the dressing changes on her own. She is fortunate to be a nurse, but having to change your own child’s dressings is a daunting task for any parent, even one who has done dressing changes before.

Her son is also now off all pain medication except for over the counter acetaminophen and ibuprofen, and is smiling and playing with his older brother. He is still not walking and is being “carried to and fro”, it seems that he realizes his feet have tender new skin.  The doctors also feel as is he will not have any significant scarring over the long term.  

The triple digit heat is continuing in many parts of the country and I just read about another child in Texas who died after being left in a car.  Remember, put something in the front seat to remind yourself that your child is in the car with you. A sleeping quiet baby can be momentarily forgotten when a parent is distracted….and even minutes in a hot car may be deadly.

Be aware of the many risks associated with these extreme temperatures, and make sure that your children have shoes on whenever they are going to be outside!!  Hoping that these extreme temperatures will moderate over the next few weeks…especially as children are heading back to school!

Your Baby

Thousands of Head Injuries Related to Strollers and Baby Carriers

2:00

According to a new report, between 1990 and 2010, an estimated 316,000 children five years or younger suffered injuries from strollers and baby carriers that were serious enough to land them in the ER.

The analysis found that in 1990, fewer than one in five accidents in strollers or baby carriers resulted in traumatic brain injuries or concussions. But by 2010, 42 percent of children in stroller accidents and 53 percent of babies in carrier accidents who were treated in emergency rooms were found to have suffered a brain injury or concussion.

The higher rate of brain injuries does not necessarily mean that strollers and carriers are more dangerous now than in the 1990s. It could be that physicians and other medical care providers have become more aware of traumatic brain injury and concussion and are reporting these types of injury, said Kristin J. Roberts, the study’s co-author and a research associate in the Center for Injury Research and Policy at Nationwide Children’s Hospital in Columbus, Ohio.

The data showed that the majority of the injuries (55 percent) occurred in children who were younger than 1 year old, and most of the injuries occurred when children fell from a stroller or carrier or when they tipped over. The head and face most commonly took the brunt of the falls.

“It’s not uncommon to see a child who has fallen out of a carrier that was placed on a bed or a child who was not strapped into a stroller,” said Dr. Leslie Dingeldein, a pediatric emergency physician at Rainbow Babies & Children’s Hospital in Cleveland, Ohio.

While the study showed that an average of 17,187 children each year end up in hospital emergency rooms because of stroller and carrier injuries, overall injury rates associated with these accidents declined over the 21-year period studied.

Roberts also noted that the incidences of stroller and carrier accidents might be even higher because the data doesn’t include injuries treated at pediatricians’ offices, private urgent care facilities or at home.

The study authors noted that in 2014, the Consumer Product Safety Commission issued updated standards that addressed potential stroller-related hazards such as hinges, brakes, buckles, structural integrity and stability. The new standards went into effect in September of 2015, after the study’s data collection period.

“The good news for parents who rely on strollers and carriers is that new federal mandatory safety standards for these products address many of the risks to children identified in this study,” Elliot Kaye, chairman of the safety commission, said in an email to the New York Times.

The Mayo Clinic offers these safety tips when baby is in a stroller:

•       Stay close. Don't leave your baby unattended in his or her stroller.

•       Be careful with toys. If you hang toys from a stroller bumper bar to entertain your baby, make sure that the toys are securely fastened.

•       Buckle up. Always buckle your baby's harness and seat belt when taking him or her for a stroller ride.

•       Use your brakes. Engage your stroller brakes whenever you stop the stroller.

•       Properly store belongings. Don't hang a bag from the stroller's handle bar, which can make a stroller tip over.

•       Take caution when folding. Keep your baby away from the stroller as you open and fold it, since small fingers can get caught in stroller hinges. Always make sure the stroller is locked open before you put your child in it.

•       Keep it out of the sun. During hot weather, don't let your baby's stroller sit in the sun for long periods of time. This can cause plastic and metal pieces to become hot enough to burn your baby. If you leave the stroller in the sun, check the stroller's surface temperature before placing your baby in the stroller.

•       Check for recalls. Return the stroller warranty card so that you'll be notified in case of a recall. If you're considering a used stroller, make sure the stroller hasn't been recalled.

The report was published in the journal Academic Pediatrics.

Story sources: Rachel Rabkin Peachman, http://well.blogs.nytimes.com/2016/08/17/more-head-injuries-reported-for-babies-in-stroller-accidents/

http://www.mayoclinic.org/healthy-lifestyle/infant-and-toddler-health/in-depth/stroller-safety/art-20043967?pg=2

Your Baby

Fisher-Price Recalls Infant Cradle Swings

1:30

Fisher-Price is recalling three models of their cradle swings: CHM84 Soothing Savanna Cradle 'n Swing, CMR40 Sweet Surroundings Cradle 'n Swing, and CMR43 Sweet Surroundings Butterfly Friends Cradle 'n Swing.

The swings have two different swinging motions - rocking side-to-side, or swinging head-to-toe, and six different swing speeds from low to high. The product number is located on the seat under the pad. 

When the seat peg is not fully engaged the seat can fall unexpectedly, posing a risk of injury to the child.

Fisher-Price has received two reports of a seat peg coming out from the seat, causing the seat to fall. No injuries have been reported.

Consumers should immediately stop using the recalled cradle swing and contact Fisher-Price for revised assembly instructions.

The infant cradle swings were sold at buybuyBaby, Target and other stores nationwide and online at Amazon.com and other websites from November 2015 through March 2016 for about $170.

Consumers can contact Fisher-Price at 800-432-5437 from 9 a.m. to 6 p.m. ET Monday through Friday, or online at www.service.mattel.com and click on Recalls & Safety Alerts for more information. 

Source: http://www.cpsc.gov/en/Recalls/2016/Fisher-Price-Recalls-Infant-Cradle-Swings/#remedy

Parenting

Tips for Family Thanksgiving Travel

2:00

Whether you’re traveling through the woods or over the highways and skyways to grandma’s house, Thanksgiving travel can be a challenge for families.

Here are a few tips to make the trip a little less stressful.

·      Don’t forget to pack your patience! With over 47.8 million Americans expected to travel at least 50 miles this Thanksgiving, the highways and airports are going to be overflowing with folks trying to make it to their destinations. If you’re one of the many families transporting children from one point to the next, your patience will be tested! Don’t forget to take deep breaths when plans don’t go quite as expected. Make the journey as important as the destination.

·      Be prepared. Fill the car with gas before your travel day. If you’re flying, get to the airport with plenty of time to check in and get the kids settled before your flight leaves. Rushing at the last minute is guaranteed to add more stress and short tempers.

·      Don’t forget the toys and car chargers. Whether you’re traveling by air, train or car – at some point your children are going to be bored and in need of a distraction. Tablets, phones or DVD players can keep them entertained for hours. For toddlers and young children, their favorite blankie or toy can ease the discomfort of being strapped in a seat for long periods of time.  Bring along a never before opened game or book. Discovering something new can be a great amusement!

·      Travel light. The fewer suitcases you have to keep track of, the better. Over-packing can also compete with precious space in the car or cost you a bundle of money at the airport.

·      Bring snacks and water. Everyone is likely to get a little hungry and grouchy during a road trip. If stopping along the way isn’t an option, pack some healthy snacks and water to fill the belly between destinations.

·      If traveling by car, expect delays and find pit stops ahead of time. Is there any road in the United States that isn’t under construction at some point? Expect road delays and know where you can pull off for a quick pit stop. Trying to find a place on-the-fly might not work when someone has to go the bathroom! You know your family best, planning ahead for breaks could prevent some unwanted “accidents.” There are travel websites that can help you plan your route. On Thanksgiving Day, options may be more limited. Check ahead for locations that will be open and are family friendly.

·      Check the weather. One of the biggest causes of travel interruptions is weather delay on the roads and at the airports. Wherever your destination, know what weather to expect when you get there and on the way. It may be sunny and warm where you live but snowy and cold where you are going. If an anticipated trip looks too dangerous because of icy roads or snowstorms, consider cancelling and planning on getting together with the extended family at some other time.

Visiting with family and friends on Thanksgiving Day to acknowledge all of our blessings and even our challenges, is a wonderful tradition. But there are times it’s simply not possible to make the celebration. That’s ok. Real life doesn’t always accommodate plans for a certain date designated as a holiday. New family traditions are often created when something stands in the way of fulfilling old traditions.

Here’s to you and your family – however you choose to spend the holiday- Happy Thanksgiving!

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

McDonald’s Recalls Kid's “Step-iT” Wristbands Due to Burns, Skin Irritations

1:30

About 29 million of McDonald’s “Step-iT” activity wristbands have been recalled in the U.S. due to skin irritations or burns to children.

The recall involves “Step-iT” activity wristbands, which come in two styles—“Activity Counter” and a motion-activated “Light-up Band.” The Activity Counter comes in translucent plastic orange, blue or green and features a digital screen that tracks a child’s steps or other movement. The Light-up Band comes in translucent plastic red, purple, or orange and blinks light with the child’s movement. Both styles of activity wristbands have a square face with the words “STEP-iT” printed on them and a button to depress and activate the wristband. The back of the square face contains the etched words “Made for McDonald’s.” 

The company has received more than 70 reports of incidents, including seven reports of blisters, after wearing the wristbands.

Consumers should immediately take the recalled wristbands from children and return them to any McDonald’s for a free replacement toy and either a yogurt tube or bag of apple slices.

The wristbands were distributed exclusively by McDonald’s restaurants nationwide, from August 9, 2016 to August 17, 2016 with Happy Meals and Mighty Kids Meals. 

Consumers can contact McDonald’s at 800-244-6227 from 7 a.m. to 7 p.m. CT daily, or online at www.mcdonalds.com and click on “Safety Recall” for more information. 

You can see all the models recalled on http://www.cpsc.gov/en/Recalls/2016/McDonalds-Recalls-Step-iT-Activity-Wristbands/

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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Daily Dose

Water Safety

1:15 to read

I was reminded of the importance of pool safety after watching the news and hearing that 3 children were found in a nearby apartment pool, under water and unresponsive.  

There are about 3,500 fatal unintentional drownings per year, which is about 10 deaths per day.  Drowning is the second leading cause of death in children ages 1-14 years.  For every child who dies from drowning, there are 4 non-fatal drowning victims who suffer severe and life changing injuries.

Drowning is preventable!!  Although many people think of drowning victims screaming and yelling, drowning is actually quick and silent.  It only takes seconds (the time to grab a towel, or answer the phone) and a child may become submerged. Most drownings also occur in family pools.  Because I have always had a fear of drowning we did not build a pool until our boys were all older than 10 years and were excellent swimmers ( was I a bit over zealous with swim lessons and swim team, maybe...)?  Children as young as 2-3 years can safely begin swim lessons and begin the process of mastering how to tread water, floating and basic swim strokes. 

Another rule for safe swimming is “never swim alone!”.  Teach your children the importance of the buddy system when they are swimming, even in a backyard pool. Adults need to be designated “water watchers” and know that they are responsible for watching the children in the pool and will never leave them unattended. The “water watcher” should regularly scan the bottom of the pool, and will need to have a phone at the pool for emergency use only.  Adult water watchers have only 1 job...to watch the pool, no poolside chatting or distractions. It is a big job!

Anyone with a pool or who is a caregiver of children who are swimming needs to become CPR certified.  CPR skills can save lives and prevent brain damage.   

Lastly, if you have a pool you need layers of protection - which  means a barrier around your pool. I have heard many a family tell me that their child “could never get out the door to the pool, it has several locks and an alarm”.  Despite the best of intentions, no parent can watch their child 24 hours/day.  Toddlers have been known to push a stool over to unlock a door, or a door is inadvertently left unlocked or ajar. Remember, it only takes seconds for a child to become submerged. 

By the way, I am following my own advice and a pool fence is going up to protect our granddaughter...the bigger the better.

Parenting

Norovirus Prevention: Tips for Swimming in Untreated Waters

2:00

With summer around the corner, lots of families will be headed to the lake for picnics, fishing and swimming. And not to rain on anyone’s parade, but every parent should be aware that the Norovirus loves untreated waters just as much as you and the kids do.

What is Norovirus? Noroviruses are a group of viruses that cause inflammation of the stomach and large intestine lining. They are the leading cause of gastroenteritis in the U.S.; In other words, severe vomiting and diarrhea.

Noroviruses are the same viruses that give you food poisoning – but they can also be active in waters that are untreated with chlorine such as lakes and ponds.

A norovirus outbreak in July 2014 was linked to a lake near Portland Oregon, and sickened 70 people. Those who swam in the lake were 2.3 times more likely to develop vomiting or diarrhea than those who visited the park but didn’t go in the water. More than half of those who got ill were children between 4–10 years old.

Experts believe the outbreak began after a swimmer infected with norovirus had diarrhea or vomited in the water and other swimmers swallowed the contaminated water. To prevent other people from getting sick, park officials closed the lake to swimmers for 10 days.

“Children are prime targets for norovirus and other germs that can live in lakes and swimming pools because they’re so much more likely to get the water in their mouths,” said Michael Beach, Ph.D, CDC’s associate director for healthy water. “Keeping germs out of the water in the first place is key to keeping everyone healthy and helping to keep the places we swim open all summer.”

Swimmers can help protect themselves, their families and friends by following a few easy and effective steps: 

Keep the pee, poop, sweat, and dirt out of the water!

•       Don’t swim if you have diarrhea or have been vomiting

•       Shower before you get in the water

•       Don’t pee or poop in the water

•       Don’t swallow lake or pool water

Every hour—everyone out!

•       Take kids on bathroom breaks

•       Check diapers, and change them in a bathroom or diaper-changing area–to keep germs away from the water.

Noroviruses, like other viruses, don't respond to antibiotics, which are designed to kill bacteria. No antiviral drug can treat noroviruses, but in healthy people the illness should go away on its own within a couple of days.

Children and the elderly are most susceptible to dehydration. Children should be given an oral rehydration solution (such as Pedialyte) to replace lost fluids and electrolytes. Avoid giving your child sugary drinks, which can make diarrhea worse, as well as caffeinated beverages, which can dehydrate them further.

Norovirus is very contagious and can be spread through contaminated food, water, or surfaces.

Summer is a time when families have more opportunities to have fun and spend time together. You can help make sure your picnic or day at the lake doesn’t include the side effects from a norovirus by adhering to the health safety prevention tips listed above.

Sources: http://www.physiciansbriefing.com/Article.asp?AID=699479

http://www.cdc.gov/media/releases/2015/a0514-norovirus-from-swimming.html

http://www.webmd.com/children/norovirus-symptoms-and-treatment

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