Twitter Facebook RSS Feed Print
Daily Dose

National Safety Month

1:30 to read

June is National Safety Month…just in time for summer! It is a good reminder for all of us to try and prevent any injuries in our children. I do know from my own pediatric office that we see more injuries during the summer months. Whether it is from falls, bike accidents, pool incidents, household poisonings or burns, our phones stay busy.

 

So..this is the perfect time to re-think child proofing your home. Make sure that stairs are gated, both top and bottom. Cabinets need to have child proof latches to protect children from getting into breakable or sharp objects as well as medicines or household products that may be poisonous.  Put the number for Poison Control in your phone….1-800-222-1222. I am often surprised that a parent calls our office about a child who has “gotten into “ a possible poison…the first call should be to Poison Control. Keep the number posted in the house as well so a babysitter may also have it if necessary.

 

Learning to ride a bike a is “life skill” for sure….but that also includes learning to wear your helmet. I see most young children in our neighborhood who are still under the eye of a parent with a bike helmet, but once they are older I often see kids without helmets. Just saw a neighbor’s child ride down the street this evening..no helmet!!  Bike helmets are like a seat belt…not optional. Many “tween” boys will “debate” with me during their check ups about the need for a helmet,  as they tell me “ I am a great bike rider and don’t have wrecks”. Teach your children what the word ACCIDENT means and that just like a car…you never know what “the other guy may do”.  Accidents are NEVER planned and a bike helmet protects the head and brain. We can “fix” the broken arm or stitch a leg…but cannot “fix” a brain injury.

 

Texting and driving is unsafe and may even be illegal in your state. Texas just passed a law prohibiting texting and driving….but teens (and adults)  need to be reminded on a regular basis that texting is not allowed!!  Texting while driving is a leading cause of accidents and I just saw a mother who is pregnant, and was in the office with her 1 year old…she had just been involved in accident that totaled her car.  She was hit from behind by a teen who had been texting and never slowed down.  Fortunately both mother and child were buckled up and were not seriously injured.  If your child is found to be texting while they are driving you should have some serious consequences with both revoked driving privileges and no phone for a while. 

 

Lastly, this is a good month to remember to check your medicine cabinet and throw away any expired or unused medication.  There are some pharmacies that are having events where you can bring in expired medications and they will dispose of them properly. The number one place that  teens find drugs is in the home…keep all narcotics locked up and dispose of any unused medications!! I have had more than several parents who have told me that “drugs” had disappeared from their medicine cabinets after their own kids had had a lot of friends over…and who knows who may be “seeking” prescription medications. Locks on medicine cabinets and liquor cabinets are a must for families. 

What about taking a family first aid course at your local YMCA or Red Cross and spend a day getting your own family first aid kit together.  This is a great way to spend some time together and a productive activity. Have a fun and safe summer!!

Daily Dose

National ASK Day!

1:30 to read

Today is all about guns!!!  Unfortunately we seem to  awaken nearly every day to news of gun violence and death in our country.  Firearm-related deaths are the third leading cause of death overall among U.S. children ages 1-17 years, and the second cause of injury-related death, only behind car crashes.  Those are grim statistics.  

 

June 21st, the first day of summer is alway designated as National ASK day…which stands for “Asking Saves Kids”.  This a day to remind me and all pediatricians to ask my patients if they:

 

#1 have a gun in the home?

#2 Is it locked and away from children?

 #3 Is the ammunition stored separately?  

 

A new study being published in the July issue of Pediatrics showed nearly 1,300 children die and 5,790 are treated for gunshot wounds each year. Of those children who die, 53% were due to homicide, 38% were suicide and 6% were unintentional firearm deaths, while 3% were due to “other intent”.   Not surprisingly to me, 82% of all child firearm deaths were in boys. Firearm suicides among children are going up and have increased by 60% since 2007.Sadly, I had a patient who is one of those statistics. 

 

While the politics about gun control continue ….this is not about politics but rather about guns in the home being a threat to children and how to protect our children.  

 

Parents routinely ask other parents about safety before dropping their child off to play or spend the night …”is your pool fenced?”  “do you have a dog and is it friendly?”, “do you let your 8 year old child watch PG-13 movies?”, “how do you handle electronics in the home?”, “do you know my child has food allergies?”, “are you going to be home with the children?”…..the list is long. I think in these times…especially with more and more people buying firearms for their home…it is time to routinely ask about guns in the home!!! 

 

Just one question might save a child’s life!!

 

Daily Dose

Pool or Trampoline? The Safety Debate

1:15 to read

Do you have a pool or trampoline in your yard? Both pools and trampolines are fun for children, and both pose dangers as well. I saw a patient today who asked me my opinion of trampolines. It seems that she and a friend, both of whom have elementary school age children, are having a "discussion" about trampolines. My patient is totally against having a trampoline in her yard, although she has a pool. Her friend says that it is safer to have a trampoline than a pool. And so their debate continues.

Both pools and trampolines are fun for children, and both do pose dangers. But as my own children often told me "according to you Mom, everything that is really fun, is dangerous!" The biggest issue surrounding children playing in pools and jumping on trampolines is parental supervision. When children are taught safety and are given rules to follow that are then enforced, they may have fun and be safe at the same time. Pools are fenced, and gated. Parents watch their children swim. This is usually the party line. But trampolines also require the same amount of supervision and many parents don't realize this.

Most trampoline injuries occur when children are unsupervised. Many serious trampoline accidents occur when children of disproportionate weights are doubling jumping and the smaller child becomes a missile and is thrown from the trampoline when serious neck injuries may occur. Trampolines are also safest when they are buried in the ground or have safety nets on the side. Letting children jump unsupervised is as dangerous as swimming alone.

So, I can't resolve this friendly discussion, but I do know that both pools and trampolines require parental supervision and strict safety rules to ensure the safest possible experience. And yes, they are both fun! That's your daily dose, we'll chat again soon.

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.

 

Daily Dose

Lead Found in Baby Food

1:30 to read

I know many of the parents of the children I care for are concerned about the latest news from the Environmental Defense Fund which showed that about 20% of baby food samples tested over a 10 year period had detectable levels of lead.

 

This non profit group looked at data that the FDA had collected from 2003-2013 which included 2,164 baby food samples. While none of the baby food samples seemed to exceed the FDA’s “allowable” levels of lead, it is still quite concerning. At the same time the FDA is in the process of reviewing their standards to reflect the latest science surrounding the potential risks to young children who are exposed to lead.  

 

While lead testing is routinely performed in young children (1 and 2 yrs), the CDC currently  considers a blood lead level greater than 5 micrograms/deciliter as elevated, but no lead level is “safe”. 

 

Lead exposure has been shown to have neurocognitive effects - which means IQ, the ability to pay attention and academic achievement…and the effects cannot be corrected.

 

The study did not name baby foods by brand.  Root vegetables (carrots are one) had the highest rate of lead detection (65% of samples), followed by crackers and cookies (47%) and the then fruits and juices (29%). Only 4% of the cereal samples contained lead.

 

This report will cause a lot of parental anxiety, but really doesn’t tell us much about what to do?  Lead based paint is still the number one source of lead exposure, followed by water, which may also have contributed to lead in food…. but there is still lots of be determined.

 

In the meantime, the take home message is “feed your babies and toddlers a wide variety of baby foods” and when possible eat fresh foods. One hypothesis is that baby foods are more processed which may contribute to the higher lead content.  It is easy to cook and “mush” up your own food to feed your baby and it really does not require a fancy food processor.  If you can mush it your baby can eat it!!! The only concern about the introduction of food is basically it has to be soft enough not to be a choking hazard. So no whole nuts, chunks of meat, uncooked hard veggies…you get the idea.

 

Just because your baby doesn’t seem to like certain foods, don’t get stuck feeding them just a few foods…but continue to offer a variety of healthy foods..some of which they may eat more of than others. Every day will be different.

 

So…don’t go throw away all of your baby foods but think if you might be able to substitute fresh foods, don’t offer fruit juices to your babies and toddlers and most importantly eat healthy foods. That’s the best thing for you and your child.  

Your Child

Powerful Narcotic Approved for Children

1:45

OxyContin is a powerful narcotic that is typically prescribed for adults who are in moderate to severe pain. It’s an opioid, similar to heroin that is the long-released formula of oxycodone. It can be highly addictive and is tightly regulated as a prescription.  For people who suffer from chronic or severe pain it is a potent drug that offers temporary relief.

The Food and Drug Administration (FDA) has approved limited use of OxyContin for children as young as 11 years old. Children with moderate pain are sometimes prescribed smaller doses of morphine or non-opioid drugs. Fentanyl patches (Duragesic) , a synthetic opioid analgesic, is prescribed for severe pain relief to children.

Dr. Sharon Hertz, director of new anesthesia, analgesia and addiction products for the FDA, said studies by Purdue Pharma of Stamford, Connecticut, which manufactures the drug, "supported a new pediatric indication for OxyContin in patients 11 to 16 years old and provided prescribers with helpful information about the use of OxyContin in pediatric patients."

Because of OxyContin’s highly addictive properties, it is popular among addicts and drug dealers. Five years ago, Purdue reformulated the drug to make it more difficult for patients or users to crush the pills for a quick high.

Hertz noted that the FDA was putting strict limits on the use of OxyContin in children.  Unlike adults, children must already have shown that they can handle the drug by tolerating a minimum dose equal to 20 milligrams of oxycodone for five consecutive days, she said.

"We are always concerned about the safety of our children, particularly when they are ill and require medications and when they are in pain," she said. "OxyContin is not intended to be the first opioid drug used in pediatric patients, but the data show that changing from another opioid drug to OxyContin is safe if done properly."

 Parents, understandably, are concerned about giving their child such strong medications. Addiction and overdose are the two main worries parents specifically express when faced with the possibility of their child being put on these types of drugs. However, when children are given opioids to relieve pain, they are not seeking the "high" associated with the medication, they are given the medication in safe, consistent and controlled amounts. Generally, children look forward to reducing or stopping the medication as this indicates improvement in their pain control.

If children develop a physical dependence over several weeks, easing off the medication gradually as the pain diminishes can prevent withdrawal symptoms. Physical dependence should not be confused with addiction.

Overdose is extremely rare in children taking opioids for pain relief. If overdose does occur, it can be treated with an antidote called naloxone.

Children as well as adults sometimes need a strong drug to ease or stop severe pain associated with disease or surgery. The approval of limited OxyContin use for children gives them the benefits of pain relief when overseen and provided by the physicians in charge of their care.

Sources: M. Alex Johnson, http://www.nbcnews.com/health/health-news/fda-approves-oxycontin-children-young-11-n409621

Michael Jeavons, MD, http://www.aboutkidshealth.ca/en/resourcecentres/pain/treatment/pages/opioids-safety-and-side-effects.aspx

 

Your Teen

Teens Drive Better With More Sleep

1.45 to read

The study, published in Journal of Clinical Sleep Medicine, compared school start times and automobile crash rates for students aged 16 to 18 years in Virginia Beach, Va., where high school classes began between 7:20 a.m. and 7:25 a.m., to students at schools in adjacent Chesapeake, Va., where classes started between 8:40 a.m. and 8:45 a.m. A new study suggests that getting an extra hour of sleep at night could help your teen drive safer.

The study, published in Journal of Clinical Sleep Medicine, compared school start times and automobile crash rates for students aged 16 to 18 years in Virginia Beach, Va., where high school classes began between 7:20 a.m. and 7:25 a.m., to students at schools in adjacent Chesapeake, Va., where classes started between 8:40 a.m. and 8:45 a.m. What they discovered was that the earlier risers may not be very alert while behind the wheel and were more prone to sleep loss and daytime sleepiness. The study's lead author, Dr. Robert Vorona, said that starting high school later in the morning might make young drivers more alert simply because they get more sleep. There were 65.8 automobile crashes for every 1,000 teen drivers in Virginia Beach, and 46.6 crashes for every 1,000 teen drivers in Chesapeake. The comparisons were made in 2008 and were similar to results in 2007. "We believe that high schools should take a close look at having later start times to align with circadian rhythms in teens and to allow for longer sleep times," said Vorona who is an associate professor of internal medicine at Eastern Virginia Medical School. "Too many teens in this country obtain insufficient sleep. Increasingly, the literature suggests that this may lead to problematic consequences including mood disorders, academic difficulties and behavioral issues." An extra hour of sleep could also improve attention levels, reduce mistakes and performance according to another study in the April edition of the Journal of Clinical Sleep Medicine. The Israeli study of 14-year-old, eighth-grade students found those teens that slept 55 minutes longer each night performed better on tests that require attention. So just one more hour of sleep can make a big difference in how teens drive, and perform in school. Instead of the 7 or 8 hours of sleep recommended for adults, teens should think in terms of about 9 hours per night. With school schedules and other activities it can be a challenge to set aside that much time. It is also a good idea to get this amount of sleep on a daily basis and not skimp during the week and then try to make it up on the weekend.

Daily Dose

Fire Safety Month

October is 'National Fire Safety' month and a great opportunity to review fire safety within your own home.October is ‘National Fire Safety' month and a great opportunity to review fire safety within your own home. I did not realize that fire and burns are the third leading cause of injury related deaths in the home. I do remember having a fire in our own home when I was a child and how frightening it was. Because of that, I have always been "freaky" about fire in my own home. Fires happen quickly, quietly and studies show that you only have about 3 minutes to get out of the house after a fire breaks out.

So... this month you should have a family fire drill, which requires a plan in case of fire. Where will you meet, how do you get out of the house if you cannot get out of your room, crawling out of the house on your hands and knees if necessary etc. Rehearsing what you will all do makes it second nature if a fire ever really happens. We do this in the hospital and the office too, kind of like a "mock code" for cardiac arrests. Preschool children learn about STOP, DROP, and ROLL if there is a fire and their clothes should be involved. Review this with your children. Install smoke alarms in all bedrooms and make sure the batteries are checked. Changing batteries with the clock changes each year is a great reminder. Talk to your kids about 911 and how and when to call, and teach them their address once they are between thee and five years of age. Prevention is the key, and planning ahead is the best remedy to prevent a disaster. That's your daily dose, we'll chat tomorrow. More Information: Home Safety Council

Your Child

Positioning an Unconscious Child

1:45

Children that have lost consciousness and are placed on their sides have lower odds of needing to stay in the hospital, according to a new European study.

"This is just a simple part of the first aid and resuscitation techniques that anyone can be taught," said Dr. Elizabeth Murray, who was not involved with the new study but is an expert in pediatric emergency medicine at the University of Rochester Medicine’s Golisano Children’s Hospital in New York.

The “recovery” position has the patient on their side, with the mouth facing downward to allow any fluid to drain. The researchers say this position should be used on unconscious children who are breathing normally with already cleared airways.

The researchers looked at data on 553 infants and children up to age 18 who were brought to 11 pediatric emergency rooms across Europe for loss of consciousness in 2014.

As reported in the Archives of Disease in Childhood, the average age was about three years. The average time spent unconscious was about two minutes, although about a third of the group had lost consciousness for more than 20 minutes.

About one in five patients had an existing condition like epilepsy. And about half of the patients had previously lost consciousness.

About 26 percent of parents had put their children into the recovery position, with about 70 percent of those parents reporting they'd learned that technique from doctors or first aid classes.

Those who were put into the recovery position were ultimately 72 percent less likely to be admitted to the hospital than those who weren't put in the position.

More than half of the parents had tried other potentially dangerous techniques to bring their child out of an unconscious state, such as shaking or slapping them.

Those parents said they had learned those techniques from other family members or from media outlets such as TV shows or the movies.

"You can understand why a family member would do anything to make it stop," said Murray. "Just like fever or other medical conditions, there are remedies or potentially folklore that can be passed down."

Kids whose parents used a potentially dangerous technique to try to restore consciousness had twice the odds of being admitted to the hospital, according to the researchers, who were led by Dr. Sebastien Julliand of Paris Diderot University in France.

Murray told Reuters Health that parents who don’t know what to do in this kind of situation, should call 911 and speak to an emergency operator. "It’s really important to remember that the majority of dispatchers in our 911 system can give advice over the phone," she said.

Source: Andrew M. Seaman, http://www.reuters.com/article/us-health-pediatrics-recovery-idUSKCN0V32SY

 

Pages

Please fill in your e-mail address to be included in our newsletter.
You may opt out at any time.

 

DR SUE'S DAILY DOSE

When your child loses a tooth.

Please fill in your e-mail address to be included in our newsletter.
You may opt out at any time.

 

Please fill in your e-mail address to be included in our newsletter.
You may opt out at any time.