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Your Child

AAP Supports Flu Shots Instead of Nose Spray for Children

1:30

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Daily Dose

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.  

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Your Baby

Britax Recalls Car Seat Chest Clips Due to Infant Choking Hazard

1:30

Faulty chest clips on more than 100 models of Britax Care Safety car seats are being voluntarily recalled because the clips could break off and create a choking hazard for infants.

The company says that no injuries have been reported, but it has received complaints of chest clips breaking.

The recall will affect more than 200,000 car seats. However, Britax stresses that the car seats are still safe to use until a replacement kit is obtained. 

The chest clip is on the Britax B-Safe 35, B-Safe 35 Elite, and BOB B-Safe 35 infant seats.

The products were manufactured between Nov. 1, 2015, and May 31, 2017. To see the model numbers that are included in the voluntary recall, or to check the serial number of your seat, visit the company’s website set up for this recall at www.bsafe35clip.com. You can find the serial numbers on the "Date of Manufacture" label on the lower frame of the seat.

Britax is offering to replace the chest clip with a free kit that contains a new clip made from a different material. The kit comes with step-by-step instructions for replacement. Consumers are advised to routinely check their current chest clip until a replacement arrives.

Story sources: Alexandria McIntire, http://www.webmd.com/children/news/20170623/recall-britax-car-seat-chest-clip

Ashlee Kieler, https://consumerist.com/2017/06/21/britax-recalls-207000-carseats-over-chest-clips-that-can-break/

Daily Dose

Food Allergies at Halloween

1:30 to read

Halloween is just around the corner and for children with food allergies or sensitivities it is sometimes challenging to go trick or treating.  In the United States 1 in 13 children has a food allergy and for some children even the tiniest bit of their allergen can cause a severe reaction!!

So…have you heard about the Teal Pumpkin Project? It was introduced several years ago to enable children with food allergies to enjoy a fun and safe trick or treating experience….with no fear of being exposed to allergens.  

Nuts, milk, soy, wheat and egg are a few of the most common allergens in children  and adults). So many Halloween candies may contain many of these ingredients, and many of the miniature versions of popular candy that is given out on Halloween may not be labelled as to their ingredients. At times the “snack” size treat may even contain a different ingredient than the usual size candy bar.  Even with diligence it may be difficult for parents to determine if the candy in question is safe.

The Teal Pumpkin Project promotes having non-food treats available for children with food allergies. By putting a teal colored pumpkin on your front porch along with the traditional pumpkins and jack o lanterns, you let families know that you have special treats for a food allergic child, or for any child where candy may present a problem. In this way trick-or-treating is inclusive for everyone and the teal pumpkin ( or a poster with a teal pumpkin ) is an easy way for kids and parents to spot the houses that are participating.

Children love to get stickers, glow sticks, pencils, chalk and small toys are all suitable options for kids who have food allergies or intolerances, or for any child who prefers not to have candy. Kids get so much candy you may be the hit of the block by having a different basket for them to choose from.

Remember, if you are getting a food item for another child in your family to make sure that all candy has been unopened and to avoid choking hazards (like nuts and popcorn) for younger children

Be safe, have fun and look for a teal pumpkin….I am going to go buy some spray paint to turn one of my orange pumpkins into blue!!!  Fun project for a family and neighborhood to do together - a block of teal pumpkins!

 

Your Baby

Recall: Oball Baby Rattles Due to Choking Hazard

1:30

About 680,000 Kids ll Inc. Oball baby rattles have been recalled due to choking hazards.

This recall involves Oball Rattles in pink, blue, green and orange with model number 81031 printed on the inner surface of one of the plastic discs and on the packaging. The balls have 28 finger holes and measure four inches in diameter.

Embedded in the rattles are a clear plastic disc with all orange beads and two clear plastic discs with beads of varying colors on the perimeter.

Only rattles with date codes T0486, T1456, T2316, T2856 and T3065 located on a small triangle on the inner surface of the rattle are included in the recall.

The first three numbers represent the day of the year and the last digit represents the year of production.      

The firm has received 42 reports of the plastic disc breaking releasing small beads including two reports of beads found in children’s mouths and three reports of gagging.

Consumers should immediately take these recalled rattles away from young children and contact the firm to receive a full refund.

The rattles were sold at Target, Walgreens, Walmart and other retailers nationwide and online at Amazon.com, Babyhaven.com, Diapers.com, ToysRUs.com, Walgreens.com and other online retailers from January 2016 through February 2017 for between $5 and $7.  

Consumers can contact Kids II toll-free at 877-243-7314 from 8 a.m. to 5 p.m.  ET Monday through Friday or visit www.kidsii.com and click on “Recalls” at the bottom of the page for more information.

Story source: https://www.cpsc.gov/Recalls/2017/Kids-II-Recalls-Oball-Rattles

Your Baby

Updated Safety Guidelines for Infant Sleeping

2:00

Elaborate beddings and plush accessories may look stylish and cute in a newborn nursery however, pediatricians know that these things should never be part of a baby’s sleeping environment. Getting new parents to understand why this type of bedding can be dangerous for babies is one of the reasons that the American Academy of Pediatrics (AAP) has updated and issued new safety guidelines.

Nineteen evidence-based recommendations aimed at protecting infants up to 1 year of age are featured in SIDS and Other Sleep-Related Infant Deaths: Updated 2016 Recommendations for a Safe Infant Sleeping Environment, an AAP policy statement and technical report from the Task Force on Sudden Infant Death Syndrome.

Safe sleep recommendations include placing infants on their backs to sleep; using a firm sleep surface; room sharing without bed sharing; avoiding exposure to smoke, alcohol and illicit drugs; breastfeeding; routine immunization; and using a pacifier.

Every year, about 3,500 infants die from sleep-related deaths. Soon after the “Back to Sleep” campaign debuted in 1994, the SIDS rate declined, but it has leveled off in recent years. Ninety percent of cases occur before an infant turns 6 months of age, with peak incidence between 1 and 4 months.

Most parents know the importance of placing babies on their backs to sleep; the focus now is on the total sleep environment.

“I think the back-to-sleep message has gotten out loud and clear,” said Rachel Y. Moon, M.D., FAAP, lead author of the statements and chair of the task force. “When you ask parents, almost every parent knows — whether they are doing it or not is a different thing. We have been less successful at getting people to not sleep with their babies … and much less successful in getting the soft bedding away from babies.”

The dangers of bed-sharing and soft bedding are two problems that Moon says are often misunderstood.

“For the soft bedding, everybody thinks if it’s soft, then it can’t hurt the baby. But soft bedding is actually really a problem because it’s so soft they sink into it. People will often use pillows to ‘cushion’ the babies, and babies sink into them. …That’s very dangerous.”

It’s similar with bed-sharing, she said. “Some parents also think if baby is right next to them, they can tell if there is a problem … and protect the baby,” Moon noted.

A simple ABC formula can help remind new parents and caregivers of safe sleeping actions.

Michael H. Goldstein, M.D., FAAP, a neonatologist and task force member, lays out the “ABCs”:

 A for the baby sleeping alone

for back sleeping

C for sleeping in an uncluttered crib (or play-yard or bassinet)

“Outside of these, one of the biggest things I would really like to see people take away from the updated recommendations is that no matter what, babies should never sleep on a couch, especially with another person,” Dr. Goldstein said. Babies can get wedged between the adult and the cushions.

Other messages in the guidelines deal with sleeping with an infant, swaddling, breastfeeding and pacifiers.

Breastfeeding, along with the use of a pacifier after breastfeeding is established, also is a key recommendation. “We don’t know if people realize that (by breastfeeding) you reduce the risk of SIDS about 50%,” Dr. Goldstein said.

Parents also are advised to be vigilant about environments out of the home. A study in the November issue of Pediatrics found out-of-home settings are more likely to have certain risk factors for sleep-related deaths, including level placement for sleep and location in a stroller or car seat instead of a crib or bassinet

One of the most important milestones for parents and caregivers is when baby sleeps through the night However, it’s normal and appropriate for newborns to wake up a couple of times during the night, especially if breastfeeding, said Dr. Goldstein. Babies will eventually sleep through the night, but not till their little bodies are ready.

Below are the 2016 infant sleep recommendations for parents, caregivers, researchers, pediatricians and media outlets:

1. Place infants on their back to sleep for every sleep period until they are 1 year old. This position does not increase the risk of choking and aspiration.

2. Use a firm sleep surface.

3. Breastfeeding is recommended.

4. Infants should sleep in the parents’ room, close to the parents’ bed but on a separate surface designed for infants, ideally for the first year, but at least for the first six months.

5. Keep soft objects and loose bedding out of the infant’s sleep area.

6. Consider offering a pacifier at naptime and bedtime.

7. Avoid smoke exposures during pregnancy and after birth.

8. Avoid alcohol and illicit drug use during pregnancy and after birth.

9. Avoid overheating and head covering in infants.

10. Pregnant women should obtain regular prenatal care.

11. Infants should be immunized according to the recommended schedule.

12. Avoid using commercial devices that are inconsistent with safe sleep recommendations, such as wedges and positioners.

13. Don’t use home cardiorespiratory monitors as a strategy to reduce SIDS risk. 

14. Supervised tummy time while the infant is awake can help development and minimize positional Plagiocephal (flat head syndrome).

15. There is no evidence to recommend swaddling to reduce the risk of SIDS.

16. Health care professionals and staff in newborn nurseries and neonatal intensive care units as well as child-care providers should endorse and model recommendations to reduce SIDS risk.

17. Media and manufacturers should follow safe sleep guidelines in messaging and advertising.

18. Continue the Safe to Sleep campaign, focusing on ways to further reduce sleep-related deaths.

19. Research and surveillance should continue on all risk factors.

Parents and caregivers can find more information about the “Safe to Sleep” program at: http://www.healthychildcare.org/pdf/sidsparentsafesleep.pdf

Story source: Alyson Sulaski Wyckoff, http://www.aappublications.org/news/2016/10/24/SIDS102416

Your Baby

Is Your Baby Safer Sleeping in a Box?

2:00

Is your baby safer sleeping in a box instead of a crib? Some parents think so and are ditching the traditional infant crib for a specially made cardboard box.

The Baby Box Co., is a Los-Angeles based business that is partnering with hospitals across the U.S. to give away free “baby boxes” to new parents.

The parents also receive a 15- minute educational video about safe sleeping habits for infants. Also included in the box are infant clothing, a mattress, a fitted sheet plus $150 worth of baby necessities.

While relatively novel in the U.S., the baby-box isn’t a new idea.  It’s modeled after a program in Finland that began more than 70 years ago. Baby boxes are aimed at curbing infant mortality rates by promoting safe sleeping practices for newborns.

New Jersey adopted the first statewide baby box program; distributing a total of 105,000 boxes. And now, Ohio has joined up, along with hospitals in Philadelphia and San Antonio, Texas.

Proponents of baby boxes say the combination of educational tools and free resources will bring America's infant mortality rate closer to those found in wealthy Nordic countries.

The goal of the Baby Box program is to bring the rate of children dying from Sudden Infant Death syndrome (SIDS) down. SIDS is usually attributed to sleep-related accidents such as strangulation, suffocation or entrapment. In 2015, the Center for Disease Control (CDC) reported about 3,700 infants died from SIDS.

The U.S. saw a drastic decline in its infant mortality rate since 1994, when the CDC launched its "Back to Sleep" campaign urging parents to have their infants sleep on their backs rather than stomachs, but disadvantaged groups still tend to be affected by SIDS more than others.

In Finland, Baby Boxes have had a dramatic impact on infant mortality since the program was launched in 1949. In the 1930s, the country's infant mortality rate was 65 deaths per 1,000 infants. Beginning in 1949, that number has shrunk to 3.5 deaths per 1,000 births— a decrease that's credited in part to baby boxes. Comparatively, the United States had an infant mortality rate of about 5.8 deaths per 1,000 births in 2016.

One University of Chicago study found that primarily lower socioeconomic groups drive the higher infant mortality rate in the U.S. after the mother and child leave the hospital. Contributing factors may include health coverage insurance and the mother’s amount of education.

What else can be done to curb infant mortality rates?

Some experts argue that policies geared toward enhanced post neonatal care for mothers of low socioeconomic status would be most effective in combating the U.S. infant mortality rate.

Universal home nurse visits, available in a number of European countries such as Finland and Austria, are one option. A provision of the Affordable Care Act offers money for a number of similar programs, such as the Nurse Family Partnership founded in 1977 in New York.

The program, which sought to rein in infant deaths in the U.S., provides low-income, first-time mothers with registered nurses who visit their homes to provide assistance and child health education for mothers.

According to the Baby Box Co. website, Baby Boxes are not only available through some hospitals, but also direct to consumer.

Story source: Avalon Zoppo, http://www.nbcnews.com/news/us-news/hospitals-u-s-give-away-free-baby-boxes-curb-infant-n732421

http://www.babyboxco.com

Daily Dose

Remember the Rules of Boating Safety

A tragic boating accident in our area during a Boy Scout outing to the lake has reminded me and many other parents of the necessity of following safe boating rules. While summer is here many families may have the opportunity for a boating outing. The best time to discuss boating safety and rules with your children is prior to even going on a boat.

Then another review of boating safety, (I would include jet skis in this too) should happen just before launching the boat on the water. Children of all ages should be taught boating safety and there should never be assumptions that they have heard all of the rules before. With the excitement of the day, many children and adolescents need to be continuously reminded of safe boating rules to ensure an accident free experience. All children and adults should have a Coast Guard certified life preserver (personal flotation device, PDF) and children should wear them at all times. In my opinion, adults should too, and model behavior for the kids. Whistles

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