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Your Child

AAP Supports Flu Shots Instead of Nose Spray for Children

1:30

The American Academy of Pediatrics (AAP) says that health care providers should not use the live attenuated influenza vaccine (LAIV) in the upcoming 2016-’17 flu season due to poor effectiveness. The LAIV is the nasal spray version of the annual flu vaccine.

Instead, the AAP recommends health care providers use the inactivated vaccine given by injection for flu prevention in children.

Academy leaders say they support the interim recommendation released this week, by the CDC’s Advisory Committee on Immunization Practices (ACIP).

“We agree with ACIP’s decision today to recommend health care providers and parents use only the inactivated vaccine for this influenza season,” said AAP President Benard Dreyer, M.D., FAAP.

Health officials reported Wednesday that the spray performed dismally for the third straight year, while the traditional flu shot — the one that stings — worked reasonably well this winter.

“We could find no evidence (the spray) was effective,” said Dr. Joseph Bresee, a flu expert at the U.S. Centers for Disease Control and Prevention (CDC).

The AAP recommends children ages 6 months and older be immunized against influenza every year. Previously, the CDC and AAP had recommended either form of flu vaccine – the inactivated influenza vaccine (IIV) that is given by injection and is approved for all patients older than 6 months, or LAIV which is given by intranasal spray and is approved for healthy patients ages 2 through 49 years.

However, the new data presented to the ACIP showed that currently only IIV provides protection against flu. The ACIP assessed data from the past three influenza seasons and cited evidence of poor effectiveness of LAIV during this time period.

Two years ago, experts suggested health care providers use AstraZeneca’s FluMist nasal spray to protect children against the flu. This week, a federal advisory committee on immunization withdrew its endorsement of the vaccine.

“We do understand this change will be difficult for pediatric practices who were planning to give the intranasal spray to their patients, and to patients who prefer that route of administration,” said AAP CEO/Executive Director Karen Remley, M.D., M.B.A., M.P.H., FAAP. “However the science is compelling that the inactivated vaccine is the best way to protect children from what can be an unpredictable and dangerous virus. The AAP will be working with CDC and vaccine manufacturers to make sure pediatricians and families have access to appropriate vaccines, and to help pediatricians who have already ordered intranasal vaccines.”

During the winter that just ended, flu shots were nearly 50 percent effective against the flu strain that made most people sick. But FluMist didn’t work at all, CDC researchers said, citing preliminary results from a study of about 2,300 U.S. children.

Experts were particularly worried that FluMist hasn’t protected against H1N1, a type of flu that often causes more deaths and hospitalizations among children and young adults.

For now, health officials say that returning to the flu shot, instead of using the nasal spray, is the best option for preventing or minimizing the effects of the flu in children.

Story sources: http://www.aappublications.org/news/2016/06/22/InfluenzaVaccine062216

Mike Stobbe, https://www.washingtonpost.com/national/health-science/ouch-flu-spray-fails-again-flu-shots-work-better/2016/06/22/33e94216-38b5-11e6-af02-1df55f0c77ff_story.html

Daily Dose

4th of July Celebrations!

1:30 to read

The 4th of July weekend is here, which means many families will celebrate with a long weekend with other families and friends. Let’s remember the importance of making it a safe holiday!   

Of course the celebration includes fireworks which are definitely fun to watch, but at the same time, when they are used by consumers (many of whom are children and teens) rather than by trained professionals, there are many associated risks.  Being on call in the ER as a new doctor was one of the scariest and longest nights in my life...and I can remember seeing children with burns...several which were disfiguring. Burns remain one of my biggest fears.

In 2013 there were an estimated 11,400 people treated in emergency rooms for fireworks related injuries, and the risk of fireworks injury was highest for children ages 0- years, followed by children 10-14 years. I know that having fireworks in your backyard or on the beach is fun, but also dangerous. Although I was used to my boys saying, “ Mom, you tell us that everything that is fun is too dangerous...which not only included fireworks, but trampolines, and motorcycles.”  I am sticking to that.

The majority of fireworks related injuries were to the extremities followed by those to the head (eyes, ears, face).  The greatest number of injuries were caused by small firecrackers, sparklers, and bottle rockets. Did you know that a sparkler burns as hot as 1200 degrees F, while water boils at 212 degrees F and wood burns at 575 degrees F!! Even a left over sparkler may cause a significant burn to little hands.

Fireworks are best left to the “hands” of the experts. Fireworks are dangerous and can be unpredictable, especially in the hands of amateurs (including parents).  Public firework displays are equally enjoyable and are carefully planned and executed. Especially with drought conditions and fires already raging in parts of the U.S. it is especially important to be aware of the risk of inadvertently setting a small fire from a misguided bottle rocket.  That small fire may lead to an even bigger fire which destroys acres of land as well as puts firefighters themselves at risk. No one wishes for that scenario but there were over 17,500 fires caused by fireworks in previous years. 

Start planning your holiday fireworks viewing now....from a safe venue! Happy 4th!

Daily Dose

Drowning Is Silent!

1:15 to read

Summer is here and many families will spend time at the beach, lake, or pool. The first thing that comes to my mind (when I think of water) is safety!!  

Knowing that over 900 children between the ages of 1–14 die each year from drowning, the discussion of water safety is a necessary part of summer routines. Astoundingly, reports show that 9 out of 10 of those children who drowned were “under supervision”. The American Academy of Pediatrics has endorsed allowing children between the ages of 1-4 to take swimming lessons. It was previously thought that encouraging swimming lessons for children under the age of 4 years might actually contribute to increased drowning.   In fact, recent studies have suggested that children ages 1–4 may be less likely to drown if they have had formal swimming instruction. The AAP has not gone so far as to routinely recommend mandatory swimming lessons for this age group, but does endorse swimming lessons in younger children who are frequently exposed to water and are emotionally and physically able to participate.  

The AAP does not recommend formal “infant survival swimming lessons” for children under the age of 1 year. When I discuss water safety with my patients, I emphasize that drowning continues to be the second leading cause of death for children ages 1–19.  I often have interesting discussions with parents who have a backyard pool who do not believe that it is necessary to have a barrier around the pool. They will say, “we never let our child outside alone” or “he or she is always being supervised by an adult”.

As you might expect, these are usually first time parents who have yet to experience the cunningness of a toddler.  Just as our children watch us and learn how to feed themselves, or drink from a cup or climb out of a bed, they too watch us open a door, or take a stool out to reach something. A toddler is more than capable or figuring out how to reach a door handle even with a lock, or climb out a window to go outside and head straight for the pool. Drowning is SILENT!!  It is not like the movies with screaming and yelling. The child quietly goes beneath the water and sinks.  It only takes minutes and the consequences of drowning are devastating.  Even for a child who is found and resuscitated there may be a life-long brain injury and the worst case scenario, death.

All families with a pool should install a 4 sided fence that is at least 4 feet high to limit pool access. It must be difficult to climb and have a self-latching, self-closing gate. The arguments I hear about “landscape aesthetics” fall on deaf ears.  Every family should also know CPR. Sign your child up for swimming lessons, and have fun practicing flutter kicks and arm strokes. Just do it with an adult within arm’s reach of all new and novice swimmers and a fence around the pool!

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

Your Toddler

FDA Targets Unapproved Eardrops

1:30

For years, physicians may have been unknowingly prescribing unapproved eardrops used to treat ear pain and swelling, to parents for their children’s ear aches. The drugs have not been evaluated for safety, quality and effectiveness says the U.S. Food and Drug Administration (FDA).

The agency notified the drugs' makers to stop marketing the drops following a few reports of local allergic reactions of the ear, eye, face, neck and mouth. The drops can also cause itching, stinging, burning and irritation of the ear, according to an FDA news release.

"If we don't know whether these drugs have any benefits, we should not accept any possible risk of side effects," said the FDA's Dr. Charles Lee in the news release.

The FDA did not release the names of the companies or the medications involved, but did note, "unapproved prescription otic [ear] drug products containing the following ingredients are covered by this action:

·      Benzocaine;

·      Benzocaine and Antipyrine;

·      Benzocaine, Antipyrine, and Zinc acetate;

·      Benzocaine, Chloroxylenol and Hydrocortisone;

·      Chloroxylenol and Pramoxine;

·      Chloroxylenol, Pramoxine, and Hydrocortisone.

“Taking enforcement actions against these unapproved products will protect patients from unnecessary risks,” said Cynthia Schnedar, director of the Office of Compliance in the FDA’s Center for Drug Evaluation and Research. “There are many FDA-approved prescription products to treat ear infections, so we expect little or no impact on patients from the removal of these unapproved and potentially unsafe products.”

The labels on these products do not disclose that they lack FDA approval, and health care professionals may not be aware of their unapproved status.  The FDA’s action does not affect FDA-approved prescription otic products, or legally marketed otic products sold over-the-counter.

Unapproved prescription otic drug products are frequently given to young children suffering from ear infections and other conditions that cause ear pain and swelling. Patients taking unapproved drugs may be at greater risk because there is no proven safety or effectiveness information. These products may be contaminated or manufactured incorrectly, which could result in patients receiving the wrong dose, even when administered according to the labeled directions for use, the agency said.

The FDA recommends that you check with your doctor if you think your child may have been prescribed one of these products or has exhibited side effects. You can ask for an alternative medication that has been FDA approved.

Sources: Margaret Farley Steele, http://consumer.healthday.com/general-health-information-16/doctor-news-206/unapproved-ear-drops-targeted-by-fda-700970.html

http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm453348.htm

Your Toddler

Almost 60,000 Kids Treated Yearly for Accidental Medicine Poisoning

2:00

According to a new report issued by Safe Kids Worldwide, a non-profit organization dedicated to preventing unintentional childhood injuries, almost 60,000 U.S. children are accidently poisoned by medicines each year.

That's the equivalent of four busloads of children -- or one every nine minutes -- arriving at emergency departments every day because of medicine-related poisoning, according to Safe Kids Worldwide.

And nearly every minute each day a poison control center receives a call about a child who got into medicines, the report notes.

"We want parents and caregivers to remember that the first line of defense in preventing medicine poisoning is the family," Kate Carr, president and CEO of Safe Kids Worldwide, said in a news release from the group.

Since 1980, the amount of prescriptions filled has increased three-fold and consumers spend five times as much for over-the-counter drugs. Many families have numerous prescriptions in the home and Carr says parents and other adults need to be vigilant in protecting children from medication poisoning.

Safe Kids Worldwide has been instrumental in getting the word out about medication safety providing research, grants and media promotion. Carr says the efforts are paying off.

"Since Safe Kids and industry and government partners started getting the word out to parents about the importance of keeping kids safe around medicine, the number of ER visits has steadily declined. But there are still too many kids getting into medicine, so education needs to continue to be a priority for all," she added.

As you might suspect, curious toddlers are at the greatest risk for medicine poisoning. Kids aged 1 to 2 years account for 70 percent of ER visits for medicine poisoning, the report said. Parents and caregivers of toddlers need to be sure to store medicine where toddlers cannot reach them, Carr said.

Since medicines are kept in all sorts of places, sometimes they are left in spots that a child can easily access such as in purses, on tables and counters, in refrigerators, daily medicine boxes and in accessible cabinets.

These days, many children are being raised or cared for by grandparents. The report suggests, that grandparents may need safety reminders. In an analysis of ER data on children poisoned by medicines, the drugs belonged to grandparents in 48 percent of cases and to parents in 38 percent of cases.

"Look around your home, and in your purses, to make sure all medicine is out of reach of children," Carr explained.

The Safe Kids Worldwide website offers these tips for protecting children from accidental medicine poisoning:

·      Put all medicine up and away and out of sight. In 86% of emergency department visits for medicine poisoning, the child got into medicine belonging to a parent or grandparent.

·      Consider places where kids get into medicine. Kids get into medication in all sorts of places, like in purses and nightstands. Place purses and bags in high locations, and avoid leaving medicine on a nightstand or dresser. In 2 out of 3 emergency room visits for medicine poisoning, the medicine was left within reach of a child.

·      Consider products you might not think about as medicine. Health products such as vitamins, diaper rash creams, eye drops and even hand sanitizer can be harmful if kids get into them. Store these items up, away and out of sight, just as you would traditional medicine.

·      Only use the dosing device that comes with the medicine. Kitchen spoons aren’t all the same, and a teaspoon or tablespoon used for cooking won’t measure the same amount of medicine as a dosing device.

·      Write clear instructions for caregivers about your child’s medicine. When other caregivers are giving your child medicine, they need to know what medicine to give, how much to give and when to give it. Using a medicine schedule can help with communication between caregivers.  

·      Save the Poison Help line in your phone: 1-800-222-1222. Put the toll-free number for the Poison Control Center into your home and cell phones. You can also put the number on your refrigerator or another place in your home where babysitters and caregivers can see it. And remember, the Poison Help line is not just for emergencies, you can call with questions about how to take or give medicine.

Story source: Robert Preidt, http://consumer.healthday.com/public-health-information-30/poisons-health-news-537/60-000-kids-rushed-to-ers-for-accidental-medication-poisoning-each-year-709176.html

https://www.safekids.org

Daily Dose

Teen Driving

1:30 to read

 It’s funny that I often find myself reading articles in the newspaper or online, or even watching a TV segment, only to find that an “issue” that I have thought was important for years is “newsworthy” again.  The most recent example being on the topic of teenage drivers and the importance of parental involvement.

I feel like it was not too long ago that I was talking to my own sons about driving….and at that time Texas did not have a lot of rules around getting your driver’s license, besides being 16 an enrolled in school. (thankfully the laws in Texas have changed since then).  So after much discussion about the perils of teenage driving and knowing that the death rate due to an automobile accident topped the list for teens,  my husband and I  came up with a driving contract (which I have shared with too many to count), which clearly outlined the rules and expectations for our sons when they began to drive. I can also remember the oldest looking at the 3 page typed contract and announcing, “ I am not going to sign that!”.  If I remember correctly my husband’s calm reply was, “OK - then don’t drive”. He is a man of few words..but very convincing. 

Fortunately for us, all of our sons did sign the contract, knew the consequences and started off driving our family Suburban…and never had a serious accident (so many prayers as they pulled out of the driveway).  One son did back into a fence, and another hit a car in a parking lot….but I felt fortunate that that was the extent of their accident history.  

According to a recent article in the NY Times there is a time to be a helicopter parent, and that is when your “child” begins to drive.  “In 2013, just under a million teenage drivers were involved in police reported crashes, which resulted in 373,645 injuries and 2,927 deaths”.  These statistics are probably under-reported, and it is estimated that “one in four teens are going to be in a crash in their first six months of driving,” and one would hope that these would be minor “fender benders”, which as we told our sons, do count as an accident.

The biggest risk for a new teenage driver occurs when you add passengers to the car.  According to Dr. Nicole Morris at the University of Minnesota  “adding one non family passenger to a teenager’s car increased the rate of crashes by 44%, and that risk doubles with a second passenger and quadruples with 3 or more”. If your teen is not distracted by their passengers they are likely to be using their phones to stay in touch with their friends….either by text, talking or by checking their various social media sites….all while driving. Although teens state, “ I barely take my eyes off the road”, anything more than 2 seconds can be deadly. Better to turn off the phone and all notifications before your teen hits the road.

Teens should be reminded that driving is a privilege, and parents of teenage drivers need to have ongoing discussions surrounding expectations for obtaining the privilege of driving. Parents need to be knowledgable about teenage driving and their states’ laws - and enforce those, (too many parents of my patients seem to ignore some of the laws - such as limiting passengers in the car). Even if your state does not have laws regulating a step wise progression to full driving privileges (so called graduated driver’s licenses), parents may adopt their own to help ensure their teens safety. Earning more and more independence can be proven with time and a good driving record and the adage, “nothing good happens after midnight still stands”.  

If ever there is a time to be a hovering involved parent it when your child begins to drive - it has been proven to save lives.

 

     

Your Child

Are Soft Contact Lenses Safe for Teens and Children?

1:45

While many kids and teens that have to wear eyeglasses would like to switch to soft contact lenses, their parents may be wondering if they are safe for these age groups. The short answer is yes, according to a new review.

"In the past decade, there has been increasing interest in fitting children with contact lenses," said review author Mark Bullimore, an adjunct professor at the University of Houston College of Optometry.

He reviewed nine studies that included 7- to 19-year-olds who use soft contact lenses, to gauge the risk of corneal inflammation and infection. Called "corneal infiltrative events," these are usually mild, but about 5 percent involve a serious infection called microbial keratitis.

The studies revealed that children wearing contact lenses, typically, experience reactions similar to adults. In fact, one large study showed that events in younger children (8 to 12) were much lower than in teenagers from 13 to 17 years of age.

Also, researchers found that microbial keratitis was uncommon. One study actually found no cases in younger kids, and the teen rates of infection were the same as adults.

The difference may be attributed to the daily living habits of the age groups.  It's suspected that younger kids aren't showering or napping while wearing their contact lenses as often as teens do. Those behaviors increase the risk of corneal infiltrative events, Bullimore said.

Bullimore believes the findings should reassure parents about the safety of soft contacts for children and teens. They may improve young people's self-esteem and quality of life, and have been shown to prevent or slow progression of nearsightedness in children, he said.

"The overall picture is that the incidence of corneal infiltrative events in children is no higher than in adults, and in the youngest age range ... it may be markedly lower," Bullimore wrote in the review.

Parents can help kids avoid eye infections by supervising their youngster’s cleaning and wearing habits when using contact lenses, Bullimore added.

Soft contacts are now available with no age restrictions. Parents should talk with their child’s optician or optometrist for more information on transitioning from glasses to soft contacts.

The study was published in the journal Optometry and Vision Science.

Story source: Robert Preidt, https://consumer.healthday.com/eye-care-information-13/eye-and-vision-problem-news-295/soft-contact-lenses-safe-for-kids-and-teens-review-finds-723398.html

Daily Dose

Dealing with Tragedy

1.30 to read

I cannot stop thinking about the horrific tragedy in Newtown Connecticut.  As a parent, my heart is broken for the families in Newtown whose children, brothers, sisters and mothers were killed.  There really are no words to express the emotions we all have. 

At the same time, I worry about the many children who have seen or continue to see the images of this massacre.  Unfortunately, there continue to be mass shootings and tragedies that monopolize the news on air, online and in print making it hard to “shield” young children.  The news never stops and these events are all too common. 

But a parent’s job continues to be to try and make sure that children feel safe and secure.  Although it seems to be harder and harder to do these days, parents must continue to protect their children both physically and emotionally. This means telling your child to wear their seat belt, lock the door when you leave the house, wear your bike helmet, and to never play with matches...the list goes on and on.  

It also means having age appropriate discussions with your children about “stranger danger”, weather related disasters and now school lockdowns.  The discussions surrounding this latest national tragedy should be tailored to the age of the child, but regardless of their age, I think the discussion should always end with, “mommies and daddies are here to love and protect you and that will never change.”  

There is no way to process this tragedy nor is there a guide as to how to go forward.  Despite all of the news stories there are no answers, but only questions as to why? 

Hug your children, maybe grab an extra kiss and be thankful for your  family.  Let us also say a prayer for the community of Newtown, both those who were lost and for the living, for their grief is unimaginable.

 

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