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Daily Dose

Parents Ignore New Car Seat Recomendations

1.45 to read

I have been surprised at the number of parents I have seen lately, who are either unaware or choose to ignore the changes in car seat recommendations for children under the age of two.I have been surprised at the number of parents I have seen, who are either unaware or choose to ignore the changes in car seat recommendations for children under the age of two.

I try to discuss car seat safety at each check-up appointment, and have always been especially mindful of doing this at the one-year check up. A new policy (April 2011) by colleagues at the American Academy of Pediatrics recommends what I have been discussing for a while now: children up to age two should remain in rear-facing safety seats. The new policy is supported by research that shows children younger than 2 are 75% less likely to die or be severely injured in a crash if they are rear-facing. So how did we get here? Original recommendations (established in 2009), I had followed with my own patients. I discussed turning the car seat to a forward facing position if the child had reached 12 months and 20 pounds. Then in April, an article was published (Inj Prev. 2007;13:398-402), which was the first U.S. data to substantiate the benefits of toddlers riding rear facing until they are two years of age. This study showed that children under the age of two are 75 percent less likely to die or experience a serious injury when they are riding in a rear-facing. That is a fairly compelling statistic to keep that car seat rear-facing for another year! Studies have shown that rear-facing seats are more likely to support the back, neck, head and pelvis because the force of a crash is distributed evenly over the entire body. Toddlers between the ages of 12 and 23 months who ride rear facing are more than five times safer than toddlers in that same age group who ride forward-facing in a car seat. There has also been concern that rear-facing toddlers whose feet reach the back of the seat are more likely to suffer injuries to the lower extremities in a car accident. But a commentary written by Dr. Marilyn Bull in Pediatrics (2008;121:619-620) dispelled the myth with documentation that lower extremity injuries were rare with rear-facing seats. So, it has now been over two years since this data was published and recommended, and parents continue to say, “I just turned the seat around any way” or “I didn’t know.” I did go look at car-seats the other day and I noted that the labeling on the boxes had all been changed to recommend rear facing until two years or until a toddler reaches the maximum height and weight recommendations for the model. I take this to mean that some “small” toddlers could even rear face longer as they do in some European countries. For safety sake, rather than convenience, keep that car seat in the rear facing position. I wonder if they will begin putting DVD players and cup holders facing toward these toddlers, as that seemed to be a concern of many parents. Maybe this will make it “okay” to listen to music or talk while in the car rather than watching TV, at least until a child is older!! If you need references on car seats go to or Send your question or comment to Dr. Sue!

Your Child

Is Sleepwalking Inherited?


If you walk in your sleep, there’s a good chance that your child may do the same.

A recent Canadian study found that children of two sleepwalking parents have more than a 60 percent chance of developing the same condition.  For children of one sleepwalking parent, the odds were about 47 percent they too would be sleepwalkers.

"These findings point to a strong genetic influence on sleepwalking and, to a lesser degree, sleep terrors," the Canadian study authors wrote. "Parents who have been sleepwalkers in the past, particularly in cases where both parents have been sleepwalkers, can expect their children to sleepwalk and thus should prepare adequately."

It’s not uncommon for children to walk in their sleep when they are young, but they typically stop by the time they reach adolescents.  It usually happens when someone is going from the deep stage of sleep to the lighter stage. The sleepwalker can't respond during the event and usually doesn't remember it. In some cases, he may talk and not make sense. Sleepwalking can also start later in life according to researchers.

Sleep terrors are another condition that typically affects only children. They can be very disturbing for a parent to witness. A child may scream out during sleep and is intensely fearful.

In the new study, Dr. Jacques Montplaisir, of Hospital du Sacre-Coeur de Montreal, and colleagues examined connections between these conditions in parents and adults. They looked at almost 2,000 kids born in Quebec from 1997 to 1998.

The researchers found that 56 percent of the children (aged 1.5 to 13 years) had sleep terrors. Younger children were more likely to have sleep terrors, the study noted. Sleepwalking, meanwhile, affected 29 percent of kids aged 2.5 to 13 years. Sleepwalking was less common in the youngest kids, according to the study.

The odds of sleepwalking grew, depending on whether one or both parents were sleepwalkers. Only 23 percent of kids whose parents didn't sleepwalk developed the disorder.

According to the National Sleep Foundation, there is no specific treatment for sleepwalking.  Creating a safe sleep environment is critical to preventing injury during sleepwalking episodes. For example, if your child sleepwalks, don’t let him or her sleep in a bunk bed. Also, remove any sharp or breakable objects from the area near the bed, install gates on stairways, and lock the doors and windows in your home.

The study was published in the May edition of JAMA Pediatrics.

Sources: Randy Dotinga,




Your Baby

Fisher-Price Recalls Infant Cradle Swings


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 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 and click on Recalls & Safety Alerts for more information. 


Daily Dose

Summer Series: A Lesson in Pool Safety

1.15 to read

Every year, over 900 children (14 years and younger) drown in swimming pool mishaps. Unfortunately, most of these drownings are totally preventable. Swimming pool season is in full swing so it is a good time to reiterate pool safety. Studies have shown that nine out of the 10 children over the age of 1 who died were “supervised”.  The best way to prevent any drowning is by having fencing surrounding all pools. That means four feet high on all four sides. It is amazing how even a young toddler can unlock a door, or climb on a chair and undo a latch or climb out of an open window into a yard with direct access to a pool. Children are clever, quick and quiet when they want to be. Drownings are silent, and many times the last place a parent looks for their missing child is at the bottom of the pool, long after it is too late. So, after fencing a pool with a locking gate, you also need to have the appropriate equipment at the pool while your children are swimming. The first thing that should always be nearby is a telephone. There should also be an appropriate rescue floatation ring available. Anyone supervising a child should be a “designated supervisor” so that they are totally aware that they are in charge and should be within arm’s reach of the “non swimmer” child at all times. Optimally, the supervising adult is also CPR trained (a good summer activity for go take CPR class). Lastly, “The Virginia Graeme Baker Law” which is federal legislation passed in 2007, requires all pools to be retrofitted with new drains to avoid suction entrapment and drowning. Despite this act, it seems that not all pools, both public and private, have complied. It might be wise to inquire if your pool is updated, and new drains have been installed. At the same time it is a good idea to teach children to stay away from drains in general. Swimming is one of the highlights of summer for all ages, and safety is paramount!

Daily Dose

Safety Seat Debate Continues

With the recent comments by the AAP on the current research that children under the age of two years remain in rear-facing car seats, I have noted a lot of confusion.With the recent comments by the AAP on the current research that children under the age of two years remain in rear-facing car seats, I have noted a lot of confusion and parental commentary surrounding this recommendation. Although this is currently a recommendation, rather than a law, the studies are showing that the rear facing position is safer, and is especially protective of serious head and neck injuries. Recommendations still vary on a state-to-state basis, and would probably be easier to follow if there were national mandates and a consistent policy. For information on your state go to

Many parents with toddlers have already turned their children’s car seats to forward face after their first birthday. Parents have been concerned about the weight limits for rear facing car seats. Most of the convertible car seats (which can rear or forward face) have weight limits of 30

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

Recall: Tommee Tippee Electric Bottle and Food Warmers Due to Fire Hazard


Mayborn USA is recalling about 255,000 Tommee Tippee electric bottle and food warmers because they could overheat and catch fire, according to the U.S. Consumer Product Safety Commission.

This recall involves Tommee Tippee® Closer to Nature® electric bottle and food warmers, sold separately or as an accessory with the Complete Starter Kit or the All in One Newborn Set. The bottle and food warmer is white with a gray adjustable control dial located next to the on/off light. Tommee Tippee is stamped in gray on the front of the unit. It measures about 5 inches high, 5 ½ inches wide and 5 inches long. Bottle and food warmers included on this recall have “Min” or “0” stamped on the left-hand side of the control dial and have the UL logo and a six alpha-numeric batch code that begins with a number and ends with “GY” stamped on the underside. Consumers should visit to complete the free replacement registration form.

The firm has received six reports of bottle and food warmers overheating, melting, smoking and catching on fire; which resulted in $16,000 in property damage.

Consumers should immediately unplug and stop using the recalled bottle and food warmers and contact Mayborn for free replacement warmers.  

The product was sold at merchandise stores including Baby Depot, Baby Heaven, Bealls Outlet, BuyBuy Baby, CVS, Giant, Ideal Baby and Kids, Kohl’s, Marco Baby, Marshalls, Meijer, Ross Stores, Sam’s Club, Target, TJ Maxx, Toys R Us, Walgreens and Wal-Mart nationwide and online at,, and from July 2011 through April 2016 for about $21 for the individual bottle and food warmer and about $120 for the starter kit or newborn set.

Consumers can contact Mayborn online at and click on the recall button at the bottom of home page or toll-free at 844-340-3420 from 9 a.m. to 5 p.m. ET Monday through Saturday for more information.

This Mayborn recall follows another recent recall from the company. In May 2016, over 3 million Tommee Tippee Sippee Spill-Proof Cups were recalled due to the possibility of mold build-up in the removable, one-piece white valve.

Mayborn USA had received 3,066 reports of mold in the removable, one-piece, opaque valve of the Sippee cups, including 68 reports of children experiencing diarrhea, vomiting or other symptoms associated with drinking from a cup with mold in the valve.

Story sources:

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 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!

Your Baby

Half of U.S. Parents Using Unsafe Bedding for Infants


Parents are getting better about using loose bedding and leaving soft objects in their baby’s bed, but about half of U.S. infants are still sleeping with potentially hazardous bedding according to a new study.

Blankets, quilts and pillows can obstruct an infant’s airway and pose a suffocation risk according to the American Academy of Pediatrics (AAP).  This type of bedding is a recognized risk factor for sudden infant death syndrome (SIDS).

The researchers investigated bedding use from 1993 to 2010 from the National Infant Sleep Position study.

They found that from 1993 to 2010, bedding use declined, but remained a common practice. The rate of bedding use averaged nearly 86 percent in 1993-1995, and declined to 55 percent in 2008-2010. Prevalence was highest for infants of teen mothers (83.5 percent) and lowest for infants born at term (55.6 percent). Researchers also found that bedding use was highest among infants who were sleeping in adult beds, placed to sleep on their sides, or shared a sleep surface.

AAP recommends that the best place for a baby to sleep is in the same room as his or her parents and always in a crib, not in the same bed. The crib should be free from toys, soft bedding, blankets, and pillows.

Other safe sleep practices are:

•       Place your baby on a firm mattress, covered by a fitted sheet that meets current safety standards. For more about crib safety standards, visit the Consumer Product Safety Commission’s Web site at

•       Place the crib in an area that is always smoke-free.

•       Don’t place babies to sleep on adult beds, chairs, sofas, waterbeds, pillows, or cushions.

•       Toys and other soft bedding, including fluffy blankets, comforters, pillows, stuffed animals, bumper pads, and wedges should not be placed in the crib with the baby. Loose bedding, such as sheets and blankets, should not be used as these items can impair the infant’s ability to breathe if they are close to his face. Sleep clothing, such as sleepers, sleep sacks, and wearable blankets are better alternatives to blankets.

•       Place babies to sleep on their backs to reduce the risk of SIDS. Side sleeping is not as safe as back sleeping and is not advised. Babies sleep comfortably on their backs, and no special equipment or extra money is needed.

•       “Tummy time” is playtime when infants are awake and placed on their tummies while someone is watching them. Have tummy time to allow babies to develop normally.

•       Remove mobiles when your baby is able to sit up.

Study authors conclude that while the numbers have improved significantly, infants are still being put to bed in an unsafe sleeping environment; about half still sleep with blankets, quilts, pillows, and other hazardous items.

It’s not unusual that many parents may not be aware of the dangers of blankets, pillows and quilts in a baby’s bed. Lots of people were raised with all these items in the bed, but that was also before scientists began to understand SIDS better and the possible causes. True, many babies did fine before these alerts and safety suggestions became more popular but a lot of children also died – we just didn’t know why.  Parents today are able to access better infant safety information than their own parents.

The study, “Trends in Infant Bedding Use: National Infant Sleep Position Study 1993-2010” was published in the January issue of the journal Pediatrics.



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Talking with my patients during their check up.

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