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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 www.usa.safekids.org.

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 Danger in BPA Bottles

I have been getting plenty of question about BPA in your-baby bottles.I recently received an email from a parent who’s 4 year old son is a patient of mine, and she is pregnant and due with a your-baby girl in the next month. On top of all of that she is also a pediatrician. At any rate, her question was regarding BPA (bisphenol A) in bottles, and whether I thought she should throw out bottles that she had used with her son in favor of newer bottles. I will tell you that her son is a perfectly delightful, bright, inquisitive and developmentally normal little boy and he received breast milk and formula from BPA containing bottles.

With that information, and knowing that I am thrifty, I thought long and hard and decided that in my opinion I would toss the old bottles in favor of the newer BPA free bottles. The top manufacturers of your-baby bottles voluntarily stopped using BPA in their bottles at the end of 2008. These bottles include, Dr. Brown, Avent, Playtex, Evenflo and numerous others. It is easy to find BPA free bottles that are well marked and most large chain stores are no longer selling your-baby bottles containing BPA. The cost involved to replace old bottles seems minimal, and the data regarding the safety of BPA to infants and children continues to be released with more ongoing studies underway. There will be more data available in the coming months and years. The Endocrine Society who held their annual meeting last week presented “worrying” evidence about the effects of BPA , including the statement that “endocrine disruptors (which includes BPA) do have effects on male and female development, prostate cancer, thyroid disease, and cardiovascular disease”. There are concerns that infants and children may be particularly susceptible to BPA and possible long term effects on brain development and behavior. So, with these recent studies and more concern regarding the levels of BPA found in your-baby bottles as well as comparison data of exposure to BPA between breast and bottle fed infants, it seems prudent to me to purchase newer bottles that are BPA free. Cross this issue off of the mother worry list. The cost of new bottles is minimal as compared to future concerns about BPA. That's your daily dose for today. We'll chat tomorrow!

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

 

Parenting

Kidde Recalls 4.6 Million Fire Extinguishers

1:30

A lot of families have fire extinguishers in their homes in case of a small fire. Kidde makes one of the more popular brands and is recalling 4.6 million of their plastic valve disposable fire extinguishers.

A faulty valve component can cause the disposable fire extinguishers not to fully discharge when the lever is repeatedly pressed and released during a fire emergency, posing a risk of injury.

This recall involves 31 models of Kidde disposable fire extinguishers with Zytel® black plastic valves. The recalled extinguishers are red, white or silver and are either ABC or BC rated. The ratings can be found to the right of the nameplate. 

Manufacture dates included in the recall are July 23, 2013 through October 15, 2014. A 10-digit date code is stamped on the side of the cylinder, near the bottom. Digits five through nine represent the day and year of manufacture in DDDYY format.

Date codes for recalled units manufactured in 2013 are XXXX 20413 X through XXXX 36513 X and 2014 are XXXX 00114 X through XXXX 28814 X.

A complete list of the nameplate affixed to the front of the fire extinguishers is located on their website at  www.kidde.com.

Kidde has received 11 reports of the recalled fire extinguishers failing to discharge as expected. No injuries have been reported.

The fire extinguishers were sold at Home Depot, Menards, Walmart and other department, home and hardware stores nationwide, and online from August 2013 through November 2014 for between $18 and $65, and about $200 for model XL 5MR.

Consumers should immediately contact Kidde for a replacement fire extinguisher at Kidde toll-free (855) 283-7991 from 8 a.m. to 5 p.m. ET Monday through Friday, or online at www.kidde.com and click on Safety Notice for more information.

Daily Dose

Vaccine Safety

The MMR (measles, mumps and rubella) vaccine and Varivax (chickenpox) vaccine have both been licensed and recommended for many years. These vaccines are typically given to children between the ages of 12-15 months, and then again between 4-5 years.

In 2005, a new vaccine was released which combined MMR and Varivax  (MMRV) which reduced the number of needle sticks a child would receive from their routine immunizations. Vaccine safety is always a paramount concern and even after a vaccine is FDA approved there continues to be “post licensing” monitoring of the vaccine, looking for any reported adverse events. After the release of MMRV in 2005, there were noted to be an increase in the number of febrile seizures occurring within 10 days of receiving the combination vaccine.  As a result, the use of this combination vaccine was suspended in 2008 and then resumed in early 2010. A study released in the July issue of Pediatrics now looks at the vaccine safety data that was accumulated on MMRV post licensure,  and analyzed data on over 459,000 children who had been vaccinated between 2000 and 2008. In the retrospective study, 83,000 children received MMRV and 376,000 with separate MMR and Varivax vaccines. The study found that children between the ages of 12–23 months have about double the risk of developing a febrile seizure 10 days after receiving MMRV than those children that received separate MMR and Varicella vaccines. MMRV vaccination was associated with an estimated 4.3 additional seizures per 10,000 doses during the 7–10 days post vaccine. As discussed in previous blogs, febrile seizures are fairly common and are typically harmless to a child, but cause a lot of anxiety and fear for parents.  (my own son had a febrile seizure as a toddler).  The American Academy of Pediatrics endorses the use of single or combination vaccine for MMR and Varivax. The fact that there may be a greater likelihood (albeit small) for a child to develop a febrile seizure post MMRV vaccination needs to be discussed with parents as there is not going to be a “right” answer as to vaccine preference. Some parents would prefer minimize needle sticks and would opt to receive MMRV, while others would prefer to have MMR and Varivax given separately to minimize any risk of  an adverse event. Due to the fact that the increased seizure risk was seen in children between 12-23 months, one might advocate to use the separate vaccines for the initial series and the combination vaccine in the older child (who would probably vote to get one less STICK). Protecting against measles, mumps, rubella and chickenpox is the most important issue at hand.  Discuss the pros and cons of the combination vaccine with your own doctor, but be reassured that vaccines are continually being monitored for safety as well as efficacy. That's your daily dose for today.  We'll chat again tomorrow. Send your question to Dr. Sue.

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!

Your Child

Frito-Lay Recalls Pretzels Due to Peanut Residue

2:00

Many children, who are allergic to peanuts and other nuts, consume pretzels as a snack.

Frito-Lay announced they are voluntarily recalling certain Rold Gold Tiny Twists, Rold Gold Thins, Rold Gold Sticks and Rold Gold Honey Wheat Braided due to a potential undeclared peanut allergen.

This recall is the direct result of a recent recall by a Frito-Lay supplier of certain lots of flour for undeclared peanut residue. The Rold Gold products subject to the recall may have been produced using the recalled flour and, as a result, these Rold Gold products may contain low levels of undeclared peanut residue. More information about the flour recall can be found on the FDA’s website at: http://www.fda.gov/Food/RecallsOutbreaksEmergencies/SafetyAlertsAdvisories/ucm504002.htm.

The affected Rold Gold packages are sold in retail stores and via foodservice and vending customers throughout the United States, and have “guaranteed fresh” dates ranging from June 28, 2016 - August 23, 2016 on the front of the package. Directly underneath the “guaranteed fresh” date is a 9-digit manufacturing code that includes the numbers “32” in the second and third position (example: x32xxxxxx).

The following products with the above-described “guaranteed fresh” dates and manufacturing codes are impacted:

•       Rold Gold Tiny Twists - 1 oz. , 2 oz., 16 oz. and 20½ oz.

•       Rold Gold Thins - 4 oz. and 16 oz.

•       Rold Gold Sticks - 16 oz.

•       Rold Gold Honey Wheat Braided - 10 oz.

It is important to note that products that do not include 32 in the second and third positions of the manufacturing code are not impacted.

The Rold Gold Tiny Twists are also included in select multipack offerings. The impacted multipacks have “use by” dates on the front of the package. Directly next to or underneath the “use by” date is a 11-digit manufacturing code that will include the letter combination AM, TO, QH, QC or SW in the second and third position (example: xAMxxxxxxxx). The impacted products have different, varying “use by” dates, including:

•       20 count Baked & Popped Mix -- “use by” dates ranging from May 31 - July 26, 2016

•       20 count SunChips & Rold Gold Mix -- “use by” dates ranging from June 14 - August 9, 2016

•       32 count Fun Times Mix -- “use by” dates ranging from June 14 - August 9, 2016

•       30 count Baked & Popped Variety Pack -- “use by” dates ranging from June 14 - August 9, 2016

•       30 count Home Town Favorite Variety Pack -- “use by” dates ranging from May 31 - July 26, 2016

To date, Frito-Lay has received no reports of illness related to the products covered by this recall. No other Rold Gold products or flavors are impacted. Frito-Lay has informed the FDA of our actions.

Consumers with any product noted above can return the product to retailer for a full refund, or contact Frito-Lay Consumer Relations (9 a.m. - 4:30 p.m. CST, Mon.-Fri.) at 1-888-256-3090 or www.pretzelrecall.com.

Story source: http://www.fda.gov/Safety/Recalls/ucm505365.htm

 

Daily Dose

Crib Deaths

1:15 to read

Crib bumpers may cause deaths and should never be used!  A recent study in The Journal Pediatrics looked at the incidence of crib bumper related deaths from 1985- 2012.  The authors reviewed data from the U.S. Consumer Product Safety Commission (CPSC) and found that there were 3 times more bumper deaths reported in the last 7 years than the 3 previous time periods that had been reviewed. Bumper pads caused 48 suffocations of which “ 67% were due to the bumper alone and not clutter in the crib, and 33% of the deaths were due to wedgings between a bumper and another object in the crib”.  An additional 146 infants had sustained injuries from the bumpers, which included choking on the bumper ties or near suffocation.  

The study also looked at the number of CPSC reported deaths compared with those from the National Center for the Review and Prevention of Child Deaths, 2008- 2011. When using that data the total number of deaths increased to 77. 

While bumpers had been marketed to prevent a baby from falling out of a crib or to keep a baby’s arms or legs from getting stuck between the crib rails, in reality they cause injury and death.  In 2012 a national standard was revised which required that crib bumpers must be 2 inches in thickness or less.  At that time the thought was that “thinner bumpers” would be less likely to cause suffocation. But the recent study found that 3 of the deaths occurred in cribs that had thinner bumpers.   

According to Dr. N.J. Scheers, the lead author in the study, “these deaths are entirely preventable” if bumpers were not used and were not widely available.  But when flipping through a baby store catalog, or even shopping for cribs, parents  and grandparents) see beautiful cribs that are adorned with bumper pads!!  So, if they cause death why are they being sold?  Mixed messages are very hard for parents to understand. Concrete recommendations and guidelines save lives.  

Several cities and states have already banned the sale of crib bumpers and the CPSC is currently in the process of publishing new recommendations on how crib bumpers should be regulated. 

I don’t see the need for any more studies to show that bumper pads may cause deaths and injuries.  Clear guidelines from the AAP state, “bare cribs are the best”  and “all infants should be put to sleep on their backs”.  Save your money and your baby’s life…no bumpers.

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

 

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