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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

Thimerosal In Flu Vaccines

Confusion about thimerosal in flu vaccinesI received an email from a reader who “had a problem with my statement about vaccines being thimerosal free”.  Since 2001 all vaccines given to children under the age of 6 are thimerosal free, with the exception of the influenza vaccine.

She is correct in pointing out that influenza vaccines may contain a minimal amount of thimerosal (a mercury based preservative), but influenza vaccines are also available thimerasol free.  The LAIV (live nasal vaccine/flumist), is also thimerasol free and is available for use in children 2 and older.

Although injectable influenza vaccines may contain a minimal amount of thimerosal, the amount is negligible and is deemed safe by both the FDA and the CDC. Infants are not receiving a series of vaccines containing thimerasol, and at most would receive 2 influenza vaccines after they are 6 months of age during the first season that they are vaccinated, and subsequently would receive one dose per year thereafter.  There are also thimerasol free influenza vaccines available (this year both seasonal and “swine flu” vaccines) for use. By the time a child is 2 years of age, they would at most have received 3 doses of an influenza vaccine that had  0.01% thimerasol or less which would be between <1 mcg – 25 mcg/0.5ml vaccine dose. (Do you know how much mercury is in the fish you eat or other products you consume daily?)  After the age of 2 parents may choose to have their child immunized for influenza with the LAIV nasal vaccine that is also thimerasol free. As with many things in life one must weigh the risk benefit ratio, in this case of giving a vaccine that contains minimal thimerasol. In my opinion the science has quite eloquently proven that there is not a link between the preservative thimerasol and autism. With that being said,  I also believe that the risk of an infant developing flu and having complications from their infection, far outweighs any hypothetical or anecdotal concern about thimerasol. As I have said before, we know what does not cause autism and it was not thimerasol in vaccines. In fact the rate of diagnosis of autism has gone up, rather than down, since thimerasol was removed from vaccines. We need to continue to devote research dollars to finding the cause of autism. In the meantime, I stand corrected and wanted to give all of you more detailed information about thimerasol and influenza vaccines. That's your daily dose.  We'll chat again tomorrow! Send your question to Dr. Sue! (click here)

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!

Daily Dose

Life Jackets!

1:15 to read

Summer is here and that means many of my patients are taking off to the beach or the lake to escape the heat and enjoy some water activities.  I recently saw a patient who told me that had just gotten a new boat and were looking forward to getting the kids out on the water.  This brought up the subject of life vests. 

When taking your children on a boat it is important that you have life vests for everyone. It is a law that all children under 13 years of age wear a “coast guard approved” life vest when on a boat that is being operated. This designation is very important, as many of the “life vests” that parents buy are not approved for boating…this includes “water wings” and some of the “cute” wearable t-shirts with life preservers sewn into them. 

Once you have found “coast guard approved” life jackets you might let your child help pick out the one they like the best and that is comfortable. This is important as it will ensure that they are both safe and comfortable. Children’s life jackets are sized by weight, so you might always have a few extras in case a friend or two comes along at the last minute.

Infants life jackets are are a bit different and have a strap that runs between their legs and extra flotation behind the head which guarantees that the baby floats face up at all times. I can attest to this important safety feature as my husband took our son on a little boat one summer day at a friends lake house. The lake was small enough that I could actually see them from the house as they rowed out to try to catch a fish. It was two men and a toddler on the boat…and I watched in horror as our 14 month old (now 32 year old) son leaned over the side of the boat to look at the fish and fell right into the dark murky Texas lake!!  Fortunately, we had followed the boating RULES and he was wearing his bright orange coast guard certified life jacket and bobbed right up to the surface…with a huge scared look on his face!  We have many pictures of our boys in the life jackets every time they set foot on a boat...including this one!

Lastly, get in the habit of applying sunscreen before you even set off for the dock and then have the children put on their life jackets. Kids can just as easily fall off the dock into the water as you prepare to get on the boat.  I would also encourage them to wear a hat for additional sun protection.

A day of boating is a great family activity and there is a lot a child can learn on board as well…how to navigate with a boating chart or GPS coordinates, how to watch for buoys or other water markings and all of the boating jargon.

Bon Voyage! 

Your Teen

Are Kids Safe With Cell Phones at Crosswalks?

Before you buy that cell phone for your child to keep them safe when they are away from you, parents need to be aware.

Before you buy that cell phone for your child to keep them safe when they are away from you, parents need to be aware. A new study shows that kids who talk on a cell phone may be more likely to step into traffic. The study says children should learn to end phone conversations before they step up to the curb and prepare to step into traffic. Research done at the University of Alabama at Birmingham also shows that older children and more experienced users also don't navigate streets as well while on a cell phone and younger children tended to find gadgets more distracting.

"Kids this age are just learning to cross the street on their own," says David Schwebel, an associate professor and vice chair in the department of psychology at the University of Alabama at Birmingham. A third of the 20 million 8- to 12-year-olds in the United States already have a cell phone, with more than half of "tweens" expected to be carrying them by the end of next year, according to market researchers. In the study, which appears in the February 2009 issue of Pediatrics, researchers followed 77 pre-teens individually as they navigated a virtual reality street crossing. The children were first allowed to familiarize themselves with the street scene before actually starting the test. The children were then asked to run through the simulation 12 times, six while on the phone and six while undistracted. The researchers found that children speaking on a cell phone were 43 percent more likely to be hit or to have a close call in the simulated street crossings than kids who weren't on the phone. Researchers also kept track of how many times a child looked left and right before stepping into the street and found that number fell by 20 percent when a phone conversation was going on. There was no difference between boys or girls. "I don't think this means parents should taken phones away from their kids, " says Schwebel. "I encourage families to get cell phones for their children. They're more helpful than harmful, if they're used in a safe way."

Your Teen

Newer Cars Safer for Teen Drivers

2:00

One of the most exciting days in a teen’s life is when he or she gets their driver’s license. It’s also one of the scariest for parents. Parents know that it takes time and experience to become a competent driver. Teens often believe that because they can stop at stop signs, put on their seat belt, Parallel Park and stay in a well-defined lane, they are competent enough.

Unfortunately, that’s not the case.  The Centers for Disease Control and Prevention (CDC), list motor vehicle crashes as the leading cause of death for U.S. teens.  Seven teens –ages 16 to 19- die every day from motor vehicle injuries.  According to a new study, more teens could survive serious auto accidents if they are driving newer cars.

While older cars may be less expensive, newer models are more likely to come with better standard safety features. Larger and heavier cars may also offer more protection.

"We know that many parents cannot afford a new vehicle," said the study's lead author, Anne McCartt, senior vice president for research at the Insurance Institute for Highway Safety. "Our message to parents is to get the most safety they can afford."

Researchers analyzed data from 2008 to 2012 from the U.S. Fatality Analysis Reporting System, which included information on 2,420 drivers ages 15 to 17 and 18,975 drivers ages 35 to 50.

The majority of teens that died (82%) were in cars that were at least 6 years old. A smaller, but significant proportion of teens (31%) were in cars 11 to 15 years old. For comparison, fatally injured teens were almost twice as likely as their middle-aged counterparts to be driving a car that was 11 to 15 years old.

Researchers say that they can’t prove that older cars driven by teens actually increase the risk of death if they are in a motor vehicle accident. However, there is good reason to think that teens would be safer in newer cars.

Older cars have older seatbelts that can wear and tear with age. Airbags were not required in cars till 1997 and 1998 for trucks. Today, they are standard equipment. The biggest safety upgrade though, has been the addition of electronic stability control.

Ultimately, McCartt said, though newer model cars tend to have more safety features, protecting your teens is not as straight forward as just steering clear of older vehicles. "We did find older vehicles that met our safety criteria," she said.

Still, it's a rare older vehicle that has electronic stability control — an important safety feature that helps drivers keep control in extreme maneuvers, McCartt said. "That's something that is standard on new cars since it was a requirement starting in 2012," she added.

Extreme maneuvers can quickly happen when something unexpected happens while driving. There are also plenty of distractions that can take your eyes off the road such as reading or replying to a text, eating or drinking while driving, cell phone calls, Changing CDs or radio stations, video watching, looking at or entering data for a GPS, talking to passengers. The list goes on. These distractions are certainly not limited to teens, but they have the least experience behind the wheel.

The Insurance Institute for Highway Safety (IIHS) has compiled a list of affordable used vehicles that meet important safety criteria for teen drivers that can be found at http://www.iihs.org/iihs/ratings/vehicles-for-teens.

They also have a list of recommendations to consider when purchasing a car for a teenager. They are:

•       Young drivers should stay away from high horsepower. More powerful engines can tempt them to test the limits.

•       Bigger, heavier vehicles are safer. They protect better in a crash, and HLDI analyses of insurance data show that teen drivers are less likely to crash them in the first place. There are no mini-cars or small cars on the recommended list. Small SUVs are included because their weight is similar to that of a midsize car.

•       Electronic stability control (ESC) is a must. This feature, which helps a driver maintain control of the vehicle on curves and slippery roads, reduces risk on a level comparable to safety belts.

•       Vehicles should have the best safety ratings possible. At a minimum, that means good ratings in the IIHS moderate overlap front test, acceptable ratings in the IIHS side crash test and four or five stars from the National Highway Traffic Safety Administration (NHTSA).

Most teens will eventually get their driver’s license – that’s a given.  If a teen is still a minor, it’s up to the parents or responsible guardians to help choose a car that will give them the best chance of survival if an accident should happen. That choice may include a newer model.

The study was published online in the journal, Injury Prevention.

Source: Linda Carroll, http://www.nbcnews.com/health/kids-health/cheap-old-car-might-carry-deadly-cost-teens-study-n271321

http://www.cdc.gov/motorvehiclesafety/teen_drivers/teendrivers_factsheet.html

http://www.iihs.org/iihs/ratings/vehicles-for-teens

Your Child

Talking to Your Child About Tragic News Events

2:00

Another tragedy has taken place, this time a terrorist attack in Paris, France.  Children, adolescents and adults have lost their lives or been seriously injured while out for an evening of fun, errands or romance.  Media outlets have been covering the events, sometimes showing graphic video or photos from the bloody scenes.

When children view these images or hear the stories, they can become scared and worried that the same thing will happen to them. 

Whenever catastrophic local, national or global events take place, it’s easy to assume that your child doesn’t really know what is going on or understand the gravity. But, in this age of instant and abundant information, they most likely do. Children are very sensitive to their parents and friends’ feelings. They are more tuned in than you might think.

Children sense when their parents are really worried, whether they're watching the news or talking about it with others. No matter what children know about a crisis, it's especially disconcerting for them to realize that their parents are scared, angry or shocked.

When bad things happen, children want to know what is going on.  It doesn’t have to be an international event. Local tragedies such as a flood, tornado, shooting, kidnapping, suicide, house fire or car wreck can be more frightening to children than events taking place across the world or in another state.

So, how do you talk with your child about such unhappy and threatening things? I’ve turned to Mr. Rogers to share with you his calming and thoughtful insights. The first time he addressed this topic was after Robert Kennedy’s assassination. Parents and educators turned to him for guidance then and his advice still holds true today.

In times of crisis, children want to know, "Who will take care of me?" They're dependent on adults for their survival and security. They're naturally self-centered. Their world is small and their life experience is limited. They need to hear very clearly that their parents are doing all they can to take care of them and to keep them safe. They also need to know that people in the government, in their community and in the world, and other people they don't even know, are working hard to keep them safe, too.

One of the ways young children express feelings is through play. However, sometimes events that happen are violent, so parents need to be nearby to redirect play if it takes a turn in that direction. More nurturing play can help children process the different activities and needs that happen around certain types of events. Play involving being a doctor or nurse in a hospital setting or creating a pretend meal for emergency workers or families can help children understand that there are good people and helpful actions that also take place when something bad happens.

When children are scared and anxious, they might become more dependent, clingy, and afraid to go to bed at night. Whining, aggressive behavior, or toilet accidents may be their way of asking for more comfort from the important adults in their lives. Little by little, as we adults around them become more confident, hopeful and secure, our children can experience a more calming sense of security.

When shocking event happens, it’s easy to get drawn into watching the news for hours and hours. Think back to 9-11 when there was non-stop coverage for days with repeated video of the towers being hit and falling. It created post-traumatic stress disorder, nation-wide. As hard as it is for adults to assimilate, it’s even harder for children. Once you have the information, turn the TV off or find something else for your kids to watch. Monitor their online activity as well to see if they are seeing too much graphic information or too many stories of “What if this happened here?”

Exposing ourselves to so many tragedies can make us feel hopeless, insecure, and even depressed, feelings that even young children can sense. We help our children-and ourselves-if we're able to limit our own television viewing. Our children need us to spend time with them-away from the frightening images on the screen.

Limiting our child’s media exposure doesn’t mean we don’t talk about what has happened with them.

Even if we wanted to, it would be impossible to give our children all the reasons for such things as war, terrorists, abuse, murders, fires, hurricanes, and earthquakes. If very young children ask questions, our best answer may be to ask them, "What do you think happened?" If the answer is, "I don't know," then the simplest reply might be something like, "I'm sad about the news, and I'm worried. But I love you, and I'll take care of you."

If we don't let children know it's okay to feel sad and scared, they may try to hide those feelings or think something is wrong with them whenever they do feel that way. They certainly don't need details of what's making us sad or scared, but if we can help them accept their own feelings as natural and normal, their feelings will be much more manageable for them.

Your child’s age and emotional IQ should be your guide on how much detail you go into when discussing tragic events. Very young children do not need a lot of detail. Children 7 and under are most concerned with safety. They need to know that you and they are secure. That’s why it important to keep the TV at a minimum for kids in this age group. They can identify strongly to pictures of other young children in peril or crying because they’ve lost someone dear to them. At this age, kids are most concerned with separation from you.  Assure them that you are watching out for them and will protect them.

Children between the ages of 8 and 12 will often notice the morality of events.  You may have to explain the basics of prejudice, bias, and civil and religious strife. But be careful about making generalizations, since kids will take you at your word. This is a good time to ask them what they know, since they'll probably have gotten their information from friends, and you may have to correct facts. This age group will most likely be online more. While it’s still important to keep news viewing under control, online viewing and searching should be monitored as well. It’s a good age to discuss lots of views and opinions about events. Read stories together and then ask them what they think.

Teens will probably get their news independently of you. Talking to them can offer great insights into their developing senses of justice and morality. It will also give you the opportunity to throw your own insights into the mix, but don’t dismiss their opinions or insights just because they may not be the same as yours. They will shut down communication quickly if they feel their ideas are not being valued.  Discuss the ways that different media covers events. Again, ask them what they think.

Having to discuss tragic or scary events with our children isn’t new. Generations of parents have had to address various topics from volcano eruptions that wiped out an entire city to the Holocaust to the cold war. But how we get our information has changed dramatically. Media in one form or another is prolific with gory images and misinformation available at the touch of finger. So parents have to react quicker and with more assurance and details than they would probably like. But that’s what we do. We protect our children in all ways, as best we can, with loving and clear information.

Sources:  http://pbskids.org/rogers//parentsteachers/special/scarynews-thoughts.html

Carolyn Knorr, https://www.commonsensemedia.org/blog/explaining-the-news-to-our-kids

 

Your Child

Backpack Safety Tips for Kids & Parents

1:30

Backpacks have almost become a part of every student's uniform.  They’re not only filled with schoolbooks but often clothes, pencils and papers, notebooks, lunches, phones, computers and an assortment of other items.  All that stuff adds up in the amount of weight resting on your child’s back and shoulders.

When used correctly, backpacks can be a good way to distribute excess weight evenly. However, backpacks that are too heavy or are worn incorrectly can cause problems for children and teenagers. Improperly used backpacks may injure muscles and joints. This can lead to severe back, neck, and shoulder pain, as well as posture problems.

The American Academy of Othopaedic Surgeons (AAOS) has these backpack tips for helping your child avoid injuries and soreness from almost every day use.

Choosing the right backpack:

When choosing a backpack, look for one that is appropriate for the size of your child. In addition, look for some of the following features:

               ·      Wide, padded shoulder straps

•       Two shoulder straps

•       Padded back

•       Waist strap

•       Lightweight backpack

•       Rolling backpack

Injury Prevention:

To prevent injury when using a backpack, do the following:

•       Always use both shoulder straps when carrying the backpack. The correct use of both of the wide, well-padded shoulder straps will help distribute the weight of the backpack across the child�s back.

•       A cross-body bag can also be a good alternative for carrying books and supplies.

•       Tighten the straps to keep the load closer to the back.

•       Organize the items: pack heavier things low and towards the center.

•       Pack light, removing items if the backpack is too heavy. Carry only those items that are required for the day, and if possible, leave unnecessary books at home or school.

•       Lift properly by bending at the knees when picking up a backpack.

Tips for Parents:

Parents also can help.

•       Encourage your child or teenager to tell you about numbness, tingling, or discomfort in the arms or legs, which may indicate poor backpack fit or too much weight being carried.

•       Watch your child put on or take off the backpack to see if it is a struggle. If the backpack seems too heavy for the child, have them remove some of the books and carry them in their arms to ease load on the back.

•       Do not ignore any back pain in a child or teenager.

•       Talk to the school about lightening the load. Team up with other parents to encourage changes.

•       Encourage your child to stop at his or her locker when time permits throughout the day to drop off or exchange heavier books.

•       If your child has back pain that does not improve, consider buying a second set of textbooks to keep at home.

Backpacks are great for carrying school bound objects – they help kids keep organized and help prevent assignments and school information from being lost. Because they can carry so much, it’s easy for them to become overloaded for your child’s size and muscle strength. Make sure your little one isn’t carrying too big a load and knows how to properly lift and strap on his or her backpack.

Story source: http://orthoinfo.aaos.org/topic.cfm?topic=A00043

 

Daily Dose

Stranger Danger

1.30 to read

We had a question via our iPhone App from an aunt who wanted to talk to her twin 4 year old nephews about “stranger danger”. Unfortunately, this topic has been in the news quite frequently lately with child abduction cases being reported all around the country. The National Center for Missing and Exploited Children has numerous resources for educating children about safety.  Interestingly, most perpetrators are not actually strangers, but are often someone the parents or another adult knows and may have been around the child on occasion. So, it seems that “stranger danger” may not be the appropriate term to use when teaching our children, especially younger, children about safety. It is important that the conversation about safety begins with children at young ages. It is often easier to use teachable moments to begin the conversation with young children.  Talk to your child about “safe” strangers, as it is hard for a child to understand why you are talking to grocery store clerks, or people on the playground in the park, and yet they are strangers. It may be best to teach a child to watch out for dangerous behaviors from adults, rather than saying “never talk to strangers”.  Talk about adults who might approach them for directions, or to find a missing pet and role play as to what they should  do. At the same time, teach them that they can turn to “strangers” such a store clerks or mothers with children for help if they are scared. While talking about this subject use a calm reassuring manner.  You do not want to make your child “too” anxious as most people they will meet are not dangerous, and children do need to interact and trust numerous people around them that they will meet in  different situations. Another good way to discuss the issue of “stranger danger” is by reading books to young children that deal with the issue. Several good books that I like are:  The Berenstein Bears Learn About Strangers; A Stranger in the Park; I  Can Play it Safe.  There are many other books out there too, so head to your library  or your local bookstore to get some more recommendations. The librarians are often helpful with finding “age appropriate” books.  Lastly, this is not a one time conversation, but should be discussed at different ages and stages of your child’s That's your daily dose.  We'll chat again tomorrow.

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