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Daily Dose

Teen Driving

1:30 to read

 It’s funny that I often find myself reading articles in the newspaper or online, or even watching a TV segment, only to find that an “issue” that I have thought was important for years is “newsworthy” again.  The most recent example being on the topic of teenage drivers and the importance of parental involvement.

I feel like it was not too long ago that I was talking to my own sons about driving….and at that time Texas did not have a lot of rules around getting your driver’s license, besides being 16 an enrolled in school. (thankfully the laws in Texas have changed since then).  So after much discussion about the perils of teenage driving and knowing that the death rate due to an automobile accident topped the list for teens,  my husband and I  came up with a driving contract (which I have shared with too many to count), which clearly outlined the rules and expectations for our sons when they began to drive. I can also remember the oldest looking at the 3 page typed contract and announcing, “ I am not going to sign that!”.  If I remember correctly my husband’s calm reply was, “OK - then don’t drive”. He is a man of few words..but very convincing. 

Fortunately for us, all of our sons did sign the contract, knew the consequences and started off driving our family Suburban…and never had a serious accident (so many prayers as they pulled out of the driveway).  One son did back into a fence, and another hit a car in a parking lot….but I felt fortunate that that was the extent of their accident history.  

According to a recent article in the NY Times there is a time to be a helicopter parent, and that is when your “child” begins to drive.  “In 2013, just under a million teenage drivers were involved in police reported crashes, which resulted in 373,645 injuries and 2,927 deaths”.  These statistics are probably under-reported, and it is estimated that “one in four teens are going to be in a crash in their first six months of driving,” and one would hope that these would be minor “fender benders”, which as we told our sons, do count as an accident.

The biggest risk for a new teenage driver occurs when you add passengers to the car.  According to Dr. Nicole Morris at the University of Minnesota  “adding one non family passenger to a teenager’s car increased the rate of crashes by 44%, and that risk doubles with a second passenger and quadruples with 3 or more”. If your teen is not distracted by their passengers they are likely to be using their phones to stay in touch with their friends….either by text, talking or by checking their various social media sites….all while driving. Although teens state, “ I barely take my eyes off the road”, anything more than 2 seconds can be deadly. Better to turn off the phone and all notifications before your teen hits the road.

Teens should be reminded that driving is a privilege, and parents of teenage drivers need to have ongoing discussions surrounding expectations for obtaining the privilege of driving. Parents need to be knowledgable about teenage driving and their states’ laws - and enforce those, (too many parents of my patients seem to ignore some of the laws - such as limiting passengers in the car). Even if your state does not have laws regulating a step wise progression to full driving privileges (so called graduated driver’s licenses), parents may adopt their own to help ensure their teens safety. Earning more and more independence can be proven with time and a good driving record and the adage, “nothing good happens after midnight still stands”.  

If ever there is a time to be a hovering involved parent it when your child begins to drive - it has been proven to save lives.



Your Baby

Should Pregnant Women Buckle-Up?

2.00 to read

Should expectant mothers buckle up and make sure the air bag is turned on before driving or riding in a car?  Absolutely say researchers in a recent study by the Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC.

Many women are concerned that, in case of an accident, seat belts and /or air bags might harm their unborn child, but according to the study, expectant mothers who are not restrained during a car crash are more likely to lose the pregnancy than those who are.

According to the March of Dimes, nearly 170,000 pregnant women are involved in a motor vehicle accident each year.

"One thing we're always concerned about is (educating) patients on seatbelt use," said Dr. Haywood Brown, the chair of Obstetrics and Gynecology at Duke University Medical Center and senior author of the new study.

"Nonetheless, like all individuals, some choose and some do not choose to wear their seatbelt," he added.

For the study, Brown and his colleagues searched through the trauma registry at Duke University Hospital. They found 126 cases of women in their 2nd and 3rd trimesters that had been in a car crash and were cared for at the hospital between 1994 and 2010.

What they discovered was that 86 mothers were wearing a seat belt when the crash occurred. Of that group, 3.5 percent or (3) fetuses died.

12 mothers were not wearing a seat belt. Of the unrestrained group, 25 percent or (3) fetuses died. 

"The bottom line is, you've got to wear your restraint because it decreases the risk not only for your injuries but injury to your child," Brown told Reuters Health.

Where should the seat belt be placed? The American College of Obstetricians and Gynecologists recommends that the seat belt be fitted low across the hipbones and below the belly.

The March of Dimes offers more seat belt and air bag guidelines for pregnant women:

  • Always wear both the lap and shoulder belt.
  • Never place the lap belt across your belly.
  • Rest the shoulder belt between your breasts and off to the side of your belly.
  • Never place the shoulder belt under your arm.
  • If possible, adjust the shoulder belt height to fit you correctly.
  • Make sure the seat belt fits snugly.
  • Driving can be tiring for anyone. Try to limit driving to no more than 5-6 hours per day.
  • Never turn off the air bags if your car has them. Instead, tilt your car seat and move it as far as possible from the dashboard or steering wheel.
  • If you are in a crash, get treatment right away to protect yourself and your baby.
  • Call your health provider at once if you have contractions, pain in your belly, or blood or fluid leaking from your vagina.

Researchers found that first time mothers were the least likely to use a seat belt. Brown noted it's possible that the habit of buckling in children might prompt mothers to put on their own seatbelt.

Mothers-to-be also worry about airbags and whether they could harm the fetus if a crash causes deployment.

In the study, airbags came out in 17 of the accidents, and in those cases the mother was more likely to experience the placenta separating from the uterus - a condition that can be fatal for the mother or the fetus.

Another researcher, not involved in the study, suggested to Reuters Health that the severity of the accidents, and not the airbags, might have been the cause of the serious consequences.

Brown said some women will disarm the airbag for fear that it will damage the baby in case of a crash, but "it's not the smart thing to do because it will save your life if the airbag comes out."

A study, from researchers in Washington State, found that airbags did not increase the risk of most pregnancy-related injuries.

No one likes to think about the damage a car accident can cause, but the reality is that seat belts and air bags save lives. Mothers-to-be, like everyone else, should use theirs when driving or riding in a car. You may need to make some adjustments so that your seat belt fits safely and correctly and the air bag is not right up next to your stomach, but taking those few extra steps could mean the difference between life and death.

Sources: Kerry Grens,

Daily Dose

Swim Lessons Can Reduce Risk of Drowning

1:15 to read

Now that hot weather is with all of us, the issue of childhood drowning is an ever-present concern. The American Academy of Pediatrics recommends that after the age of five years, all children be taught to swim. The AAP does not recommend for or against swimming lessons as a measure to prevent drowning in children younger than five years. Between 2000 and 2005, 6,900 children died from non-boating accidental drowning. The rate of drowning was almost four times higher for children one to two years of age, and twice as high for those younger than five.

An article in Archives of Pediatric and Adolescent Medicine looked at the association between swimming lessons and risk of drowning specifically in the one to four year old age groups. Previous concerns had been raised about the potential for swimming lessons to increase the risk for drowning in younger children. This study provided good news that kids aged one to four who have taken formal swimming lessons have an 88% less risk of drowning. Researchers found that only three percent of the children who had drowned had taken swimming lessons. So with this news, it might be prudent to start swimming lessons at a younger age than previously thought.

But swimming lessons alone will not prevent drowning and even in this study, many of the older children who drowned were noted to have been proficient swimmers. It is still important to have other drowning prevention strategies in place including pool fencing (some parents with pools feel like their child will not be able to unlock a door and head to the pool and do not have a fence in place, and I totally disagree with that argument), constant and age appropriate adult supervision and training in CPR. Children are amazing at finding ways to unlock doors, and windows that lead outside and no parent can know where their child is for every minute of the day. If you have a pool and a child is missing always check the pool first, as a child can quietly slip into the water and lose consciousness in as little as two minutes and drown in five minutes.

That's your daily dose, we'll chat again tomorrow.

Daily Dose

Burns From Hot Surfaces!

1;30 to read

With the ongoing heat wave across many parts of the country which has hit Texas exceptionally hard, I have a new warning for parents (and kids).  My community has seen seen extremely high temperatures between 100-106 for the last two weeks. These temps have made everyone miserable and there have been many warnings about heat exhaustion and heat stroke, and ways to stay hydrated on the news.

Who knew that you needed to worry about burns other than sunburn? It seems that outdoor furniture, metal pool drain covers, and playground equipment have heated up with these unrelenting temperatures!  

So…what is this alluding to?  A patient just called me yesterday totally “freaking out” that her toddler had gone out to play in the backyard with his 3 year old brother. It was morning and not yet terribly hot, so she thought “best time to get out of the house and get some fresh air”.  The boys were climbing on their outdoor fire pit (as children often do) and he stepped on the edge, and immediately started to scream and cry. His mother, who also happens to be a pediatric nurse, initially thought something had stung him? When she picked him up he continued to cry as if in pain, but she could not see anything at all….until she looked at his feet. He had stood on the metal on the edge and immediately burned his feet, to the point of blistering on contact!  And, as you probably know, toddlers feet are typically flat (arches come later) so his “baby feet” had full contact with the metal and he sustained second degree burns to both feet.

When she got him to the ER they immediately started to treat his burns and pain (as burns are incredibly painful).   She said she did not know who was crying more…she or her child. Once things settled down she asked the ER doctor at Children’s Medical Center if this had ever happened before!  Unfortunately, the answer was yes.  They had seen several other serious burns to children who had come into contact with metal on playgrounds and around metal pool drain covers.

This precious little boy will ultimately be fine…..after many days of oral pain medication and routine bandage changes (some of which will actually be done as an outpatient at a burn unit). He will also never remember this.

So… this is a new warning for parents: watch out for the possibility of burns secondary to outdoor metal objects.  This photo is quite telling and painful to look at!  His mother called me today and sent a few new pictures with him smiling!


Family Road Trip!


With gasoline prices at a reasonable level, many families may choose to skip the hassles of flying and opt for a road trip this summer.

While it may be true, “The best made plans of mice and men often go awry”, it’s still necessary to prepare as best you can for a family road trip; whether it’s to the Grand Canyon, the beach, the grandparents or all of the above.

Before the trip, make sure that the car is in good condition. Have it checked out by a mechanic and any trouble spots fixed. The tires should have plenty of tread and the recommended amount of air for highway travel.

Once you’re ready for the big trip, here are some suggestions to help make it a little less stressful and more fun.

Packing the car:

·      Pack an easily accessible small bag that contains clothes for the next day, an extra change of clothes (for spills), PJs, a toothbrush, and anything else you need for that day and night. It will be much easier to grab than trying to rummage through the big suitcase.

·      Take your toddler or young child’s blanket and pillow. This is extra important if your road trip includes an overnight stay. Kids like their own stuff, particularly at bedtime in a strange place.

·      Babies and toddlers drop, spill, and spit up. Keep a roll of paper towels and a box of wipes in the front seat for easy cleanups. Keep a garbage bag handy too.

The Ride:

Boredom is probably the biggest instigator of trouble for kids packed into a tight space. Prepare to fight boredom with a few tricks of your own.

·      Snacks. Although it only provides a short respite, any quiet time is appreciated. Go light on the sugar – too much can backfire. Choose fresh or dried fruit, whole grain muffins, popcorn, cheese sticks, milk etc. In other words, something healthy and age appropriate.

·      Portable DVD players. These can be a lifesaver. Load up on your children’s favorite movies and don’t forget the headsets if you have different aged kids. Eleven year-olds and three year-olds don’t typically share the same taste in movies and video games. New DVDs they haven’t already seen are a bonus. Let the kids pick out what they want to watch ahead of time. And, make sure you have an extra set of headsets; you know someone is either going to lose a pair or break a pair. That’s a given.

·      If there is more than one adult traveling – one of you can get in the backseat for a while. A little face-to-face contact, some patty-cake, and a few tickling games go a long way toward distracting a cranky baby or a bored toddler.

·      Make sure some favorite toys are within easy reach. You might add a new toy or two your little one hasn’t seen before. Remember etch-a-sketch? Tech savvy youngsters are coming up with some amazing etchings these days!

·      Don’t forget to plan for stops. You'll have to stop for feedings, diaper changes, and stretching breaks. You'll be much less stressed if you accept that it may take twice as long to get there as it did in your pre-kid days and plan accordingly. Pre-teens and teens are going to need to move around too. Besides, sitting for an extended length of time isn’t good for anyone.

Oh, and someone is going to need a potty break soon after the pre-arranged stop has happened. Be patient and pull over, it’s really a lot easier and less taxing than a yelling match about “why didn’t you go when we stopped 30 minutes ago?”

·      If your trip requires an overnight stay somewhere, think about booking a motel that has an indoor pool. It may cost a little more, but it's something to look forward to, and it will help your children sleep better. If they sleep better, you’ll probably sleep better too.

·      Don’t forget about books (or e-books) for the kids that like to read. Coloring books for the younger ones, and brush up on some travel games the whole family can join in on. Here are a few tried and true suggestions. I Spy (I spy with my little eye, something red.) The License Plate Game. Keep a list of all the different state license plates you see. The goal is to list as many states as possible- although Hawaii might be a real challenge anywhere but in Hawaii. The Memory Game. Start a story with one sentence. The next person has to say that sentence then add his or her own sentence to the story. The story can change pretty quickly as everyone tries to remember all the previous sentences and then come up with a new one.

While road trips can be a challenge, they are always an adventure and often become fond memories, as kids grow older.

Have fun this summer and don’t forget to take lots of pictures!

Story source:


Daily Dose

Leaving Your Child Home Alone

1.00 to read

I get asked the questions a lot "At what age can I leave my child home alone?"  There is no simple answer but a progressibe one.

I tend to think most children are ready to spend 20-30 minutes alone at home between the ages of 10-11, but every child is different.  It depends on a number of things including how your child feels about being alone, the length of time, and if you and your child have discussed how to handle emergencies and getting a hold of you or a neighbor in case there is an emergency or even just a question that needs to be answered.  

Well, this topic brought up an interesting question, what do you do when you leave your child alone and there is not a home phone?  I have never even given that a thought as I am “old school” and still have that landline in my house. It just gives me a “good feeling” to know that it is there, even if it rarely rings. (although the kids know to call the home number as I typically turn off the cell as soon as I hit the door from work).   

More and more families have given up a home phone and I think this brings up so many different topics for discussion, but for starts how does your child call you when you leave them alone?  Or how do they call the trusty neighbor if they need something.  Do you get them a cell phone? Do you have to have an extra cell phone to have at home?  It seems to me that a home phone is important for just that reason. In case of an emergency, your child can pick up the phone and call for help, assistance or just a friendly voice. I don’t think they need a cell phone!  

Also, landlines are relatively inexpensive. Cell phones for 8,10, 11 year olds?  Sounds inappropriate and expensive.  Wouldn’t it be easier to keep a home phone so children can learn to answer a phone, use good phone manners, and when you are ready to let them stay at home by themselves for a few minutes, there is always a phone available. I don’t know, just seems easy solution to me.    

What do you think? I would love to hear from you!


Your Toddler

Long-Term Study Confirms Measles Vaccines Safe


Researchers in a 12-year-study, investigating the safety of two measles-containing vaccines have found them safe and effective.

The study included children between the ages of 12 to 23 months. Some of the children received the MMRV vaccine (measles –mumps-rubella-varicella). The others were administered the MMR + V vaccine (measles, mumps. rubella and varicella), but they received both the MMR and the V vaccines on the same day.

In total, the researchers at the Kaiser Permanente Vaccine Study Center in California looked at almost 125,000 MMRV doses and nearly 600,000 MMR + V doses.

Many parents are still concerned that there may be long-term health issues that are either introduced or triggered by the vaccines. Dr. Nicola Klein, co-director of the vaccine study center, said parents should feel confident in the vaccines’ safety.

"Our findings offer reassurance that adverse outcomes of measles-containing vaccines are extremely rare and unlikely, and that parents of 1-year-old children can choose MMR + V instead of MMRV vaccines to reduce the low risk of fever and febrile seizures," Klein said in a Kaiser Permanente news release.

The vaccines didn't increase children's risk of seven types of neurological, blood or immune system disorders. No other safety concerns were identified with either vaccine, according to the researchers.

Previous studies have suggested that the two vaccines are associated with fever and fever-related (febrile) seizures in one-year-old children. The study confirmed these previous findings. These types of seizures usually happen seven to 10 days after vaccination. The study also found that the MMRV is more likely to cause febrile seizures than MMR + V.

Febrile seizures, which happen during a fever, can be common in toddlers and young children. Although frightening to witness, seizures often don’t cause serious health problems. Having said that, anytime a child has an unexpected seizure, you should seek emergency help just in case.

The researchers emphasized the risks of febrile seizures from the vaccines is small; occurring in less than one of every 1,000 vaccine injections.

"This level of safety monitoring for vaccines can give the public confidence that vaccine surveillance is ongoing and that if a safety problem existed, it would be detected," Klein said in the news release.

The study was published online in the journal Pediatrics.

Source: Robert Preidt,

Your Child

Kid’s Severe Injuries linked to BB Guns, Paintball


A new study says that Paintball, airsoft and BB guns are responsible for causing severe and sometimes life-threatening injuries in children.

"The popular conception is that they are toys," said Dr. Nina Mizuki Fitzgerald, the lead researcher and a pediatric emergency medicine fellow at the University of Texas Southwestern Medical Center/Children's Health in Dallas. Not so, she said,   "Injuries can be extremely severe and [children] can have long-term deficits."

Fitzgerald and her team evaluated medical records of children seen at Children's Medical Center Dallas of non-powder gun accidents between 2010 and 2015. In all, 288 children, average age 11, were treated for the gun injuries, more than three-quarters of which involved a BB gun.

About one in four children had to undergo surgery for the injury. Nearly 45 percent had a foreign body injury (such as the BB). About 15 percent were hospitalized. In addition, one in 10 had a functional deficit that interfered with daily tasks, and the overwhelming majority of those were eye-related. Seven children had an eye injury so severe surgeons had to remove the eye, the researchers reported.

"The biggest take-away for parents is that kids should always be supervised when using non-powder guns," Fitzgerald said. And children should always wear eye protection, she stressed.

BB gun pellets often leave a small puncture mark, giving the impression that there is only a minor injury. But Fitzgerald warns parents that these injuries may need medical attention. "There may be a tiny puncture mark, and it doesn't look bad at all. But they can have severe internal injuries," she explained.

The study results are not surprising because they build on previous research that found the same, said Dr. Roberto Warman, director of pediatric ophthalmology at Nicklaus Children's Hospital in Miami. He has seen many such eye injuries in his years of practice, and recalls having to remove eyes that could not be saved. One child was only 3 years old, he added.

With paintball, kids may think the game is over, take off their eye protection, only to be shot by another child who hasn’t finished the game or shoots one last round. Collecting the paintball guns and then the goggles could help reduce that possibility, he suggested.

While some doctors think these activities should be banned for young children, others think education is the key to fewer accidents.

While it’s easy to think of these objects as toys, they are not. Experts agree that parents need to be informed that their children must wear goggles during the gun play and need to be supervised at all times.

Fitzgerald will present her findings at the American Academy of Pediatrics meeting in Washington, D.C. Studies presented at medical meetings are viewed as preliminary until published in a peer-reviewed journal.

Source: Kathleen Doheny,

Daily Dose

Drowning Is Silent!

1:15 to read

Summer is coming to an end, and many families will create memories this holiday weekend at the beach, lake, or pool. The first thing that comes to my mind (when I think of water) is safety!!  

Knowing that over 900 children between the ages of 1–14 die each year from drowning, the discussion of water safety is a necessary part of summer routines. Astoundingly, reports show that 9 out of 10 of those children who drowned were “under supervision”. The American Academy of Pediatrics has endorsed allowing children between the ages of 1-4 to take swimming lessons. It was previously thought that encouraging swimming lessons for children under the age of 4 years might actually contribute to increased drowning.   In fact, recent studies have suggested that children ages 1–4 may be less likely to drown if they have had formal swimming instruction. The AAP has not gone so far as to routinely recommend mandatory swimming lessons for this age group, but does endorse swimming lessons in younger children who are frequently exposed to water and are emotionally and physically able to participate.  

The AAP does not recommend formal “infant survival swimming lessons” for children under the age of 1 year. When I discuss water safety with my patients, I emphasize that drowning continues to be the second leading cause of death for children ages 1–19.  I often have interesting discussions with parents who have a backyard pool who do not believe that it is necessary to have a barrier around the pool. They will say, “we never let our child outside alone” or “he or she is always being supervised by an adult”.

As you might expect, these are usually first time parents who have yet to experience the cunningness of a toddler.  Just as our children watch us and learn how to feed themselves, or drink from a cup or climb out of a bed, they too watch us open a door, or take a stool out to reach something. A toddler is more than capable or figuring out how to reach a door handle even with a lock, or climb out a window to go outside and head straight for the pool. Drowning is SILENT!!  It is not like the movies with screaming and yelling. The child quietly goes beneath the water and sinks.  It only takes minutes and the consequences of drowning are devastating.  Even for a child who is found and resuscitated there may be a life-long brain injury and the worst case scenario, death.

All families with a pool should install a 4 sided fence that is at least 4 feet high to limit pool access. It must be difficult to climb and have a self-latching, self-closing gate. The arguments I hear about “landscape aesthetics” fall on deaf ears.  Every family should also know CPR. Sign your child up for swimming lessons, and have fun practicing flutter kicks and arm strokes. Just do it with an adult within arm’s reach of all new and novice swimmers and a fence around the pool!

That's your daily dose for today.  We'll chat again tomorrow!


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