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Daily Dose

Swim Lessons Can Reduce Risk of Drowning

1:15 to read

Now that hot weather is with all of us, the issue of childhood drowning is an ever-present concern. The American Academy of Pediatrics recommends that after the age of five years, all children be taught to swim. The AAP does not recommend for or against swimming lessons as a measure to prevent drowning in children younger than five years. Between 2000 and 2005, 6,900 children died from non-boating accidental drowning. The rate of drowning was almost four times higher for children one to two years of age, and twice as high for those younger than five.

An article in Archives of Pediatric and Adolescent Medicine looked at the association between swimming lessons and risk of drowning specifically in the one to four year old age groups. Previous concerns had been raised about the potential for swimming lessons to increase the risk for drowning in younger children. This study provided good news that kids aged one to four who have taken formal swimming lessons have an 88% less risk of drowning. Researchers found that only three percent of the children who had drowned had taken swimming lessons. So with this news, it might be prudent to start swimming lessons at a younger age than previously thought.

But swimming lessons alone will not prevent drowning and even in this study, many of the older children who drowned were noted to have been proficient swimmers. It is still important to have other drowning prevention strategies in place including pool fencing (some parents with pools feel like their child will not be able to unlock a door and head to the pool and do not have a fence in place, and I totally disagree with that argument), constant and age appropriate adult supervision and training in CPR. Children are amazing at finding ways to unlock doors, and windows that lead outside and no parent can know where their child is for every minute of the day. If you have a pool and a child is missing always check the pool first, as a child can quietly slip into the water and lose consciousness in as little as two minutes and drown in five minutes.

That's your daily dose, we'll chat again tomorrow.

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

Parenting

Back to School Road Safety Tips

2:00

Millions of U.S. children are starting a new school year and along with the joy and excitement comes traffic congestion.

It's never more important for drivers to slow down and pay attention than when kids are present – especially before and after school.

The National Safety Council offers these tips to drivers sharing the road with parents and caregivers dropping off or picking up their kids and school busses loading and unloading students.

If you’re dropping off your children, familiarize yourself with the specific drop off rules of your child’s school. More children are hit by cars near schools than at any other location according to the National Safe Routes to School program. These tips can apply to all school zones:

·      No double-parking. It blocks the visibility for other children and drivers.

·      Don’t load or unload kids across the street from the school

·      Carpool to reduce the number of vehicles at the school.

When you’re sharing the road with young pedestrians, remember these safety tips:

  • Don't block the crosswalk when stopped at a red light or waiting to make a turn, forcing pedestrians to go around you; this could put them in the path of moving traffic
  • In a school zone when flashers are blinking, stop and yield to pedestrians crossing the crosswalk or intersection
  • Always stop for a school patrol officer or crossing guard holding up a stop sign
  • Take extra care to look out for children in school zones, near playgrounds and parks, and in all residential areas
  • Don't honk or rev your engine to scare a pedestrian, even if you have the right of way
  • Never pass a vehicle stopped for pedestrians
  • Always use extreme caution to avoid striking pedestrians wherever they may be, no matter who has the right of way

Most likely, you’ll be sharing the road with school busses as well as other cars. A school bus is large, allow a greater following distance than if you were driving behind a car. It will give you more time to stop once the yellow lights start flashing. It is illegal in all 50 states to pass a school bus that is stopped to load or unload children.

  • Never pass a bus from behind – or from either direction if you're on an undivided road – if it is stopped to load or unload children
  • If the yellow or red lights are flashing and the stop arm is extended, traffic must stop
  • The area 10 feet around a school bus is the most dangerous for children; stop far enough back to allow them space to safely enter and exit the bus
  • Be alert; children often are unpredictable, and they tend to ignore hazards and take risks

Cars and busses aren’t the only vehicles on the road around a school; there are also kids on bikes.  On most roads, bicyclists have the same rights and responsibilities as drivers. Bikes can be hard to see though, particularly small ones with little riders. Children riding bikes create special problems for drivers because usually they are not able to properly determine traffic conditions. The most common cause of collision is a driver turning left in front of a bicyclist.

  • When passing a bicyclist, proceed in the same direction slowly, and leave 3 feet between your car and the cyclist
  • When turning left and a bicyclist is approaching in the opposite direction, wait for the rider to pass
  • If you're turning right and a bicyclists is approaching from behind on the right, let the rider go through the intersection first, and always use your turn signals
  • Watch for bike riders turning in front of you without looking or signaling; children especially have a tendency to do this
  • Be extra vigilant in school zones and residential neighborhoods
  • Watch for bikes coming from driveways or behind parked cars
  • Check side mirrors before opening your door

School zone speed lights will soon be or are already flashing, so you’ll have to retrain your eyes to look for them. By exercising a little extra care and caution, drivers and pedestrians can co-exist safely in school zones.

Story source: http://www.nsc.org/learn/safety-knowledge/Pages/back-to-school-safety-ti...

Your Child

2 Doses of Chickenpox Vaccine Almost 100 Percent Effective

2:00

Chickenpox is one of the most common childhood illnesses. It is a viral infection caused by the Varicella zoster virus and produces a painful, itchy rash with small, fluid-filled blisters.

It occurs most often in early spring and late winter and is highly contagious. Typically, chickenpox occurs in kids between 6 and 10 years of age.

A new study shows that among schoolchildren, two doses of the chickenpox vaccine is more effective than one.

Giving the first dose at age 1 and the second dose at ages 4 to 6 is nearly 100 percent effective in preventing the once common childhood disease, researchers have found.

"A second dose of varicella [chickenpox] vaccine provides school-aged children with better protection against the chickenpox virus, compared to one dose alone or no vaccination," said lead researcher Dana Perella, of the Philadelphia Department of Public Health.

Two doses of the vaccine protected against the moderate to severe chickenpox infections that can lead to complications and hospitalizations, she said.

Before routine chickenpox vaccination began in 1995, virtually all children were infected at some point, sometimes with serious complications. About 11,000 children were hospitalized each year for chickenpox, and 100 died annually from the disease, according to the CDC.

One-dose vaccination greatly reduced incidence of chickenpox, but outbreaks continued to be reported in schools where many kids had been vaccinated. That led the CDC in 2006 to recommend a second vaccine dose.

To evaluate effectiveness of the double- dose regimen, Perella and colleagues collected data on 125 children with chickenpox in Philadelphia and northern Los Angeles and compared them with 408 kids who had not had the disease.

They found that two doses of the vaccine was slightly more than 97 percent effective in protecting kids from chickenpox.

"With improved protection provided by two-dose varicella vaccination compared with one-dose only, continued decreases in the occurrence of chickenpox, including more severe infections and hospitalizations, are expected as more children routinely receive dose two between the ages of 4 and 6 years," Perella said.

For children with weakened immune systems that cannot take the vaccine, having their classmates and playmates protected by the vaccine helps protect them against the viral infection.

School vaccine requirements should include two-dose varicella vaccination, Perella said.

"In addition, 'catch-up' varicella vaccination is also important," she said. This applies to anyone over 6 who haven’t had a second vaccine dose, especially if they could be exposed to chickenpox or shingles - a painful condition in older people caused by reactivation of the chickenpox virus, she said.

Most healthy children who get chickenpox do not have serious complications from the illness. But there are cases when chickenpox has caused hospitalization, serious complications and even death.

A child may be at greater risk for complications if he or she:

·      Has a weakened immune system

·      Is under 1 year of age

·      Suffers from eczema

·      Takes a medication called salicylate

·      Was born prematurely

The report was published online March 14 and will appear in the April print issue of the journal Pediatrics.

Story sources: Steven Reinberg, http://www.webmd.com/children/news/20160314/two-dose-chickenpox-shot-gets-the-job-done-study-shows

http://www.parents.com/health/vaccines/chicken-pox/chickenpox-facts/

Your Child

Tips for Preventing Sports Injuries

1:30

The school year is about to wind down and it won’t be long before many kids will be signing up for summer sports programs.

If you’re child loves sports, there’s not a season where he or she can’t find one to participate in. Sports often help children stay in better physical shape, feel good about them selves and with team sports, enjoy social interaction and competition.

However, all sports have a certain amount of risks associated with them - some more than others. The more contact the sport provides, the greater the risk for a traumatic injury. Fortunately, traumatic injuries are rare and most sport injuries to young athletes are due to overuse.

The most common sport-related injuries are sprains (ligament injuries) , stress fractures( bone injuries)  and strains (muscle injuries).Since children’s bodies are still developing, any tenderness over a bone should be evaluated further by a medical provider even if there is minimal swelling or limitation in motion.

The American Academy of Pediatrics offers these tips to help reduce serious injuries in younger athletes:

•       Time off. Plan to have at least 1 day off per week from a particular sport to allow the body to recover. 

•       Wear the right gear.  Players should wear appropriate and properly fit protective equipment such as pads (neck, shoulder, elbow, chest, knee, shin), helmets, mouthpieces, face guards, protective cups, and/or eyewear. Young athletes should not assume that protective gear will always protect them when performing more dangerous or risky activities.

•       Strengthen muscles. Conditioning exercises during practice strengthens muscles used in play. 

•       Increase flexibility. Stretching exercises before and after games or practice can increase flexibility. Stretching should also be incorporated into a daily fitness plan.

•       Use the proper technique. This should be reinforced during the playing season. 

•       Take breaks. Rest periods during practice and games can reduce injuries and prevent heat illness.  

•       Play safe. Strict rules against headfirst sliding (baseball and softball), and spearing (football) should be enforced. 

•       Stop the activity if there is pain.

•       Avoid heat injury by drinking plenty of fluids before, during and after exercise or play; decrease or stop practices or competitions during high heat/humidity periods; wear light clothing. 

While physical injuries are easier to see, sports-related emotional stress can also cause problems for some children. The pressure to win at all costs can add a lot of emotional stress to children who are more interested in playing than always being first.

Not every team is going to win every game, and there will be times when kids involved in more singular sports won’t have a good day. It happens to everyone at some time or another; ask any pro athlete. Young athletes should be judged on effort, sportsmanship and hard work. They should be rewarded for trying hard and for improving their skills rather than punished or criticized for losing a game or competition.  The main goal should be to have fun and learn lifelong physical activity skills.

There are numerous sports that children can engage in and each one offers its own benefits. As parents, it’s important to encourage our children and keep them as healthy as possible.

Source: http://www.healthychildren.org/English/news/Pages/Tips-for-Sports-Injury-Prevention.aspx

Your Child

Asbestos Found in Children’s Crayons and Toys

2:00

Coloring with crayons has been an American tradition since the late 1800s.  Since that time, the wax crayon has been instrumental in teaching children how to draw and imagine the world in a rainbow of colors.

Although the words “non-toxic” appear on crayon boxes designated for children’s use, a new report from the Environmental Working Group (EWG) Action Fund says that asbestos fibers have been found in crayons and other toys sold in the United States.

The fibers were found in four brands of crayons and two children’s crime-scene toy fingerprint kits.

The contaminated crayons included Nickelodeon's Teenage Mutant Ninja Turtles crayons, Disney's Mickey Mouse Clubhouse Jumbo Crayons and Saban's Power Rangers Super Megaforce Jumbo Crayons and ones by Amscan, according to the new report.

Asbestos was also found in two crime lab toys: EduScience's Deluxe Forensics Lab Kit, and Inside Intelligence's Secret Spy Kit.

The U.S. National Institutes of Health (NIH) notes that asbestos, which is composed of long, thin mineral fibers, once was common in insulation material.

Though tiny and invisible to the naked eye, airborne asbestos fibers are easily inhaled. With time, scarring, inflammation and breathing impairment can occur, as can lung cancer and mesothelioma, a rare cancer of the lining of the lungs and abdomen, according to the NIH.

Asbestos is no longer widely used in manufacturing in the United States. It is banned in nearly all other developed nations, the research group said.

EWG hired an independent company, Scientific Analytical Institute from Greensboro, N.C., to conduct so-called transmission electron microscopy tests to look for asbestos. This is said to be the most sensitive and accurate method of testing available.

EWG said that a second independent lab reconfirmed the crayons and toys that tested positive.

"Just a couple of fibers can lodge in your lungs and be there forever," said Sonya Lunder, a senior analyst with the Washington, D.C. based group. "And there's very clear evidence that asbestos leads to two forms of cancer, and thousands and thousands of Americans have been killed by fiber exposure."

Former U.S. Assistant Surgeon General Richard Lemen welcomed the report.

"These are important findings, because asbestos is being placed in children's products," said Lemen, now an adjunct professor with Emory University's Rollins School of Public Health in Atlanta.

"Even if the absolute risk is relatively low, children are more vulnerable to toxic material and carcinogens," he said. "And because they are so young they have a longer latency in which to develop these diseases, which are known to be diseases that develop over time."

The crayons were purchased between February and May of this year at two national chains -- Party City and Dollar Tree -- in a suburban county near San Francisco. The group said it ordered the two crime scene toys through Amazon.com and Toys"R"Us.com.

For analysis, 28 brands of crayons were tested and 21 toy fingerprint kits. All the products that tested positive were made in China.

A spokeswoman for Toys "R" Us, which distributes the EduScience Deluxe Forensics Lab Kit, responded to the report, saying customer safety is the company's highest priority.

"We require that every product we carry meets or exceeds all applicable state and federal laws, industry standards, codes and requirements. At this time, we are reviewing the referenced report, along with supplier test reports, to ensure full compliance to our strict safety standards," Kathleen Waugh, vice president of corporate communications, said in a statement.

The tests discovered the highest concentration of asbestos was found in the toy crime-scene fingerprint kits.

If your child is one of the millions that play with crayons or the crime lab kits, be sure to check the brand to make sure they are not one of the contaminated products or kits that tested positive for asbestos.

Source: Alan Mozes, http://consumer.healthday.com/cancer-information-5/lung-cancer-news-100/asbestos-found-in-kids-crayons-toy-crime-kits-701117.html

 

 

 

 

Daily Dose

Teen Drivers

1.30 to read

As you know, when teens start to drive, I am a huge advocate for parent - teen driving contracts. I wrote my own contracts for my boys but I recently found a website that all parents who are getting ready to have teen drivers need to be aware of.

Injuries from motor vehicle crashes are the #1 cause of death for teens in the United States.  Studies have shown that having limits and boundaries in place for new drivers reduces the number of motor vehicle accidents that new drivers experience. Although not all states have “graduated driver’s licenses”, all parents can have discussions about the privilege and responsibility of driving and set their own guidelines for their new teen driver.

The website www.youngdriverparenting.org was developed by the National Institute of Child Health and Human Development and is an interactive site for both parent and teen.  The program is entitled “Checkpoints”.  The website includes teen driving statistics to help parents keep their teen drivers safe as well as giving information about state-specific teen driving laws.

The site has a great interactive component to help parents create their own parent-teen driving “contract” that addresses such things as teen driving hours, number of passengers allowed, and boundaries for driving. These parameters can be modified as the teen becomes more experienced and meets the “checkpoints” that were agreed to.  It is a great site as it not only gives you a template for the agreement, but sends emails as the allotted amount of time has passed for each step of the contract.  You don’t have to remember what you and your teen agreed to, they email you and then you and your child can revisit the agreement and expand it over time as your driver becomes more experienced.

Instead of handing out my “dog eared” old driving contracts that I wrote for my boys, I am now going to send my patients to this site (which is also being sustained by the American Academy of Pediatrics).  

Teen drivers whose parents are actively involved in monitoring their driving are not only less risky drivers but know ahead of time what their parent’s expectations are. Having a teen involved proactively with driving rules is far preferable to regretting that limits, boundaries and parental rules were not discussed prior to allowing your new driver on the road.

The website is not only free it is also evidence based, and within 5 - 10 minutes of reviewing the site a family is set to go with their own checkpoint agreement.  Here’s to teen driver safety!

Daily Dose

Uber & Teens

1:30 to read

Do you have Uber cars in your area?  I first found out about Uber (and I am only using them as an example) when my son lived in NYC and often used the car service. Later on I heard about college kids using Uber as well.  In that case, many college kids did not have cars and/or they were being “responsible” after being at a party.

But recently, in conversations with my adolescent patients, I have heard that high school kids are using Uber to come home after a party, or other social activities. In otherwords, their parents are not picking them up from the dance, concert, or party but are letting their children (often young girls) call Uber.  Where are their parents and what are they thinking?

I realize that once your child heads off to college you hope and pray that they are making good choices and are being safe. You don’t really plan on picking them up after an event or talk to them that same night about what they have been doing and with whom.  But when we had high school age children, my expectations were that we, the parents, were responsible for taking our teens to the party and to pick them up. Once they were driving the “rules” changed a bit in that they were then often driving themselves to an event and then would drive home and we would be up waiting for them to get home.  They always knew that we would be there when they got home and also that if there were any “issues” we were also available to pick them up. We talked a lot about underage drinking as well as driving and responsibility.  Never did I think they would call a cab or car service, nor was that idea ever broached, they were to call their parents.

So now that these “app” car services are available around the clock, are parents abrogating their responsibilities for parenting teens?  By allowing their teens to call a car service for their ride home, are parents seemingly not interested in where their child has been or who they have been with or what they have been doing before they get home?  You certainly can drop your child at a concert or party and tell them to text Uber to get a ride home, but does this parental non-participation quietly help to condone inappropriate, risky, teen behavior?

Although picking your child up at the end of the evening or checking on them when they pull in the driveway will never ensure that your teen does not get into trouble, I think it does help them think a bit more about having to interact with their parents at curfew time. This “worry” might help lead them to make a better decision about drugs, alcohol or whom they are hanging out with. Putting teens into the “hands” (cars) of strangers as their ride home just seems wrong. Parents be aware. 

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

 

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