Twitter Facebook RSS Feed Print
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!

 

Daily Dose

Summertime Can Mean Snakebites

1:15 to read

Due to wet weather, snakes are being oushed out into the open. What does it mean? There is a higher risk of being bitten by a snake. News reports have families on alert: snakes are being pushed out into the open.  More snakes mean the potential for more snakebites.  I have never treated a patient with a snakebite and thought they were quite uncommon. Unfortunately, a rattlesnake bit a friend of mine (they are out of the hospital and doing well) so upon review I have learned a lot more about venomous snakebites.

There are actually over 45,000 snakebites reported in the U.S. each year. The majority of these are due to non-poisonous snakes and often requires little or no treatment. The days of the old Cowboy movies showing rope tourniquets being applied to the area of the bite and the cutting and “sucking” of the venom are over! Don’t start practicing “movie medicine” if you find yourself dealing with a snakebite. There are about 8,000 venomous snakebites reported each year. Fortunately, with these large numbers and the advent of anti-venom, only six to eight people die each year secondary to a venomous snakebite. Unfortunately, due to their smaller size, children do not handle snakebites as well as adults, and the fatality rate is higher in children.

In the U.S. 99% of poisonous snakebites are by the subfamily pit viper, which includes rattlesnakes, copperheads and cottonmouths (YUCK). The other species of poisonous snake found in the U.S. is the coral snake. I am not going to detail the specific treatment for each type of bite, but if a snake bites your child the first thing to do is to determine if it was a poisonous snake. Non-poisonous snakebites cause minimal pain, no swelling and really only require local wound care with irrigation and antibacterial soap. If the bite is thought to be from a poisonous snake the child should be transported to the nearest hospital. Do not put a tourniquet around the bite, apply ice or suction the area of the bite as these are all thought to cause more tissue damage than benefit.

Pit viper bites typically cause symptoms of swelling, bruising and progression within minutes of the bite. Children typically have more severe symptoms with nausea, vomiting, sweating, muscle weakness and clotting abnormalities, all of which are a medical emergency. Anti-venom should be delivered within four hours of the bite and will be given until improvement in systemic symptoms is achieved. All of this is done in the ICU setting. That’s your daily dose, we’ll chat again tomorrow.

Send your question or comment to Dr. Sue right now!

Your Child

Is MiraLAX Safe for Young Children?

2:30

Constipation is a common problem in kids. It can become a painful elimination process if not treated quickly. Children will sometimes “hold” their poop to avoid the experience, making the situation worse.

Pediatricians often prescribe MiraLax for treatment. MiraLax contains PEG 3350, which is not habit-forming and is easy to give to kids because it has no taste or odor. You can mix it in their beverages, and they typically won't complain.

MiraLax is not a natural product. It does not completely clean a colon out, like an enema does, but it works well enough to unclog a child. Over time, constipation can cause other serious health consequences, so the condition needs to be treated promptly.

While the majority of children do fine when given MiraLax, a group of parents have reported dramatic changes in their child’s personality after being given the laxative.

For the past few years, the Children's Hospital of Philadelphia (CHOP) has quietly been conducting an FDA-grant funded study into parents' reports of devastating side effects from their kids' use of the over-the-counter constipation relief drug.  

But until that study is completed, the hospital won't comment on the experiences of individual families.

A FaceBook page called, Parents Against MiraLax (PEG 3350) has been created, and more than 3,500 people have joined to organize and voice concerns about PEG 3350.

When the FDA grant was awarded to CHOP in early 2014, the federal agency disclosed that MiraLAX powder contains small amounts of Polyethylene glycol 3350 (PEG 3350), which may under certain conditions degrade into ethylene glycol or diethylene glycol — toxic ingredients found in antifreeze.

"The Food and Drug Administration has received a number of reports of adverse events in children taking PEG products," the FDA said in its grant description. "The Agency has conducted a review that documented a number of reports of neurological and psychiatric events associated with chronic PEG use in children. A number of these pediatric patients received an adult dose of PEG (17 grams) for a duration ranging from a few days to a couple of years."

MiraLAX, manufactured by Bayer, is not recommended for patients under the age of 17, but the FDA concluded that it is often suggested to parents in clinical practice.

Bayer has responded in a statement, referencing existing clinical studies confirming the long and short-term safety of PEG 3350 in pediatric patients, though the company acknowledged the product is not labeled for use in the pediatric population.

An article in the New York Times, published in 2015, reported that the FDA had raised questions about the safety of an “an adult laxative routinely given to constipated children, “ sometimes for years.

The article also mentioned that buried in the FDA’s brief to researchers, it had tested eight batches of MiraLax and found tiny amounts of ethylene glycol (EG) and diethylene glycol (DEG), ingredients in antifreeze, in all of them. The agency said the toxins were impurities resulting from the manufacturing process.

Those tests were conducted in 2008, but the results were not disclosed. Jeff Ventura, an F.D.A. spokesman, said batches were tested because “many of the reported adverse events were classic symptoms of ethylene glycol ingestion.”

Psychiatric illnesses like those reported in children taking the laxatives have also been observed in cases in which a child took substantial amounts of ethylene glycol. Some children taking MiraLax chronically (over long periods of time) also have developed acidic blood, according to F.D.A. records, which can be a consequence of ingesting EG.

MiraLAX primarily is recommended for short-term use up to seven days to relieve constipation. The FDA does not approve chronic use, although many use it regularly or even daily to treat severe issues with digestion.

The North American Society of Pediatric Gastroenterology, Hepatology and Nutrition and the American Academy of Pediatrics said in statement after the study began, that they welcome “an investigation into the safety of treatment through data and research in the prolonged use of PEG 3350.”

A timeline for the CHOP study results is not immediately known.

For many children, MiraLax works well as a short-term laxative. However, parents should discuss the dosage and the pros and cons of giving it to the their child with their pediatrician.

Story sources: Michael Tanenbaum, http://www.phillyvoice.com/chop-leading-fda-study-parents-alarming-claims-about-over-counter-drug-miralax/

Catherine Saint Louis, https://www.nytimes.com/2015/01/06/science/scrutiny-for-a-childhood-remedy.html?_r=1

Steve Hodges, MD, http://www.parents.com/blogs/parents-perspective/2015/01/07/health/is-miralax-safe-for-kids-an-expert-weighs-in/

Daily Dose

Summer Series: A Lesson in Pool Safety

1.15 to read

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

Daily Dose

Importance of Booster Seats

The Texas Legislature is sending a bill to Governor Rick Perry that will change booster seat laws. The current law requires that children under five years of age and 3 feet 9 inches tall be in a car seat. The new law will require that children under the age of eight years or 4 feet 9 inches tall be restrained in a car seat. Car accidents are the leading cause of death for children in this age group and experts testified that changing the booster seat law would reduce the risk of life threatening injury by up to 60%.

The extra height provided by a booster seat allows the seat belt to be positioned correctly, across the child's pelvis. Without the booster the seat belt is often placed across the child's abdomen or neck, or even behind the shoulders and neck and puts them at risk for head, neck and abdominal injuries. Correct positioning of the belt is essential for maximum protection. Forty other states have similar laws requiring booster seat use. This bill will not go into effect in Texas until 2010, but don't wait until then to get your child a booster seat. Many parents already have their children in booster seats, but if not, put this at the top of your "to do list". If your children balk at the idea, tell them that it is for their protection and it is now a law! That's your daily dose, we'll chat again tomorrow.

Your Child

“Opt-Out” of Letting Schools Sell Your Child’s Personal Information!

2:00

If your child is in school, you may have unknowingly given the school the right to sell your child’s private information to data brokers and marketing companies. It happens every year and many parents don’t know they could have signed a form preventing the sale.

Schools are allowed by federal law to sell your child’s personal information to anyone unless you fill out an “opt-out “ form. If you don’t fill it out, personal information such as your child’s name, address, email, telephone number, age, gender, height and weight and photo can be sold.

Not only can your child be subjected to a ridiculous amount of advertising from marketing companies, anyone can use that information to locate your child if they really want to find him or her. They can also contact your child through personal emails or phone and have a picture to identify them.

"Directory information may sound innocuous, but it can include sensitive information about each student that is quite detailed," said Pam Dixon, executive director of the World Privacy Forum. "And after the school releases this data, it is considered to be public information and you've lost control of it. I don't think most parents know this."

Under the Family Educational Rights and Privacy Act of 1974 (FERPA), a student's directory information includes home address, email address, telephone number, date and place of birth, height and weight, the clubs or sports teams they've joined - even a photograph.

FERPA was written before the creation of the Internet, when a student's personal information was stored in a file cabinet and privacy was not such a big issue. Today, the data is just what a stalker, abuser or identity thief needs.

FERPA also gives parents the right to see what “directory information” the school has about their children. You have a right to block or limit access to that information. But, the window of time you can do that is short, sometimes just a few weeks after school begins. Once the time frame expires, you cannot stop the release of your child’s personal information until the next school year.

This is especially important for domestic violence survivors who are hiding from their abuser. Information that's released without their knowledge could jeopardize their safety.

"When there are situations where the survivor has left with the child and has custody of the child and they're living elsewhere, they want to know that their abuser doesn't know where they are living," said Kaofeng Lee, deputy director of the Safety Net Project at the National Network to End Domestic Violence. "If this information is available, the abuser could get access to where this child is going to school which will pinpoint exactly where the family is now living and make it possible to find them."

Many schools do not do a good job in letting parents know about the form. Some have even neglected to provide the form to parents and some schools have worded the forms in such a way as to discouraged parents from signing them.

It’s a battle for your child’s data and parents need to be aware that they have the right and the means to protect that information from getting out to marketing firms and individuals.

Congress is scheduled to review FERPA to see what further privacy protections are needed to keep students and families’ information private in the digital age. Until then, parents have to seek out and make sure that the opt-out forms are signed, sealed and delivered.

A warning to parents; this isn’t a one-time fix either. You must sign these forms every year that your child attends school.

Source: Herb Weisbaum, http://www.nbcnews.com/business/consumer/student-privacy-n423466

 

 

 

Your Child

Zip Lining Safety Tips

1:45

From the mountains of Costa Rica to over waterfalls in Hawaii, zip lining has become a vacation acivity destination. Zip lining operations can also be found in  summer camps, zoos, fields in the middle nowhere, people’s backyards and lots of other exotic and not-so- exotic locations.

Here’s how they work. A zip line consists of a pulley suspended on a cable, typically made of stainless steel and mounted on an incline. A rider sits in a harness attached to a pulley. At the top of the slope, the user propels forward and gravity does the rest. Depending on your location, it can be quite a thrilling ride to the base.

One of the keys to a safe zip lining experience is knowing something about the company and the operator of the ride. Before you harness your child into a zip line at camp or during a family vacation, ask the operator questions about the ride’s safety and look around. Not every company follows the same safety rules. Though there are currently no national standards for zip line construction and operation, many states have them, and any legitimate operator should also adhere to the standards set by the Association for Challenge Course Technology or the Professional Ropes Course Association.

Here are some questions you can ask:

·      If the operation is inspected, how often and by whom.

·      What is the company’s safety record?

·      What training the operators have.

·      Is a safety demonstration included?

Check the area out once you arrive. Do the operators look professional? Look at the equipment provided, including carabiners, ropes, harnesses and helmets. Are they well maintained? Look at the course itself. Do the lines look free from wear and tear? How about the platforms? Do they look sturdy? Do they have guardrails?

Once on the course, make sure you're strapped onto a safety line at all times — not just while you're zipping through space. (Some places require that you have two safety lines hooked on.) Many accidents occur by a simple step off a platform. So if you're on the course (which often means many feet off the ground), you should be safely attached to a line that will catch you if you fall. Also, watch out for other adventurers and the guides. Don't get in their way.

Make sure everyone in the family who is zip lining wears a helmet and has closed-toe shoes.

Nearly 17,000 zip line injuries were treated in emergency rooms from 1997-2012, and most of those injuries were in the last four years, according to a 2015 study by Gary A. Smith, M.D., Dr.P.H., FAAP, and colleagues at Nationwide Children’s Hospital. About half the injuries involved children under 10 years old. Another 33% involved children ages 10-19 years. The study noted that many zip lines are not regulated, and there are no uniform safety standards.

The increase in the number of zip line injuries in children is “an epidemic by any definition,” according to Dr. Smith, past chair of the American Academy of Pediatrics (AAP) Council on Injury, Violence and Poison Prevention.

“If kids are using them, you really need to make sure they’re using them in places where people are trained, they know what they’re doing and the zip lines have been constructed in a way that they’re not going to fail,” said Dr. Smith.

Backyard zip line kits sold online and in stores also have been linked to injuries. Earlier this year, the Consumer Product Safety Commission recalled a backyard zip line kit (http://1.usa.gov/1XoHrFs) because of a design flaw that made it easy for the cable to separate from the line, causing riders to fall. Riders suffered head injuries and bruises. Another recall was issued in 2014 for backyard zip line trolleys (http://1.usa.gov/1RT6uaY) that released unexpectedly. No injuries were reported. Authors of the 2015 study warned against buying and installing backyard zip lines.

The AAP does not have a policy on zip lines and children. However, Dr. Smith suggested the following safety precautions:

·      Requiring riders to wear a helmet, harness and gloves;

·      Training operators;

·      Inspecting and maintaining equipment regularly; and

·      Posting rules and requiring participants to follow them.

“If done correctly, these and other types of outdoor amusements that are there for the thrill … can be done in a safe enough way that it’s reasonable for children to use them,” Dr. Smith said.

Story sources: Trisha Korioth, http://www.aappublications.org/news/2016/07/07/ZipLines070716

John Donovan, http://www.mnn.com/lifestyle/eco-tourism/stories/6-things-do-you-go-zip-lining

Daily Dose

Baby Bling Can Be Dangerous!

1.15 to read

I recently saw a TV segment on “blinging” your baby and toddler. It seems that the latest craze is decking out not only little girls, but also little boys. Being the mother of three sons I can understand wanting to “dress up” boys as well (little boy clothes can be a bit boring) but a few of the models on TV were wearing necklaces. 

Now, a boy wearing a necklace doesn’t bother me at all, but a baby or toddler with a necklace worries me!  This isn’t about gender, rather about safety.  

A necklace is a real choking and strangling danger for babies and young children. I know that many parents receive necklaces for their babies on the occasion of a baptism and in some cultures an infant is given a necklace made of string or beads to wear soon after birth. 

But, whenever a baby comes into my office with a necklace on I discuss the possibility, even if remote, of the child suffocating if the necklace gets caught or twisted around the child’s neck. There is no reason to even risk it! 

Baby bling is great if you want to put your child in cute shirts, hats, or even trendy jeans. Go for it!  But I would never put a necklace on a child. It is akin to the adage about peanuts...when should a child be allowed to eat peanuts?  When they can spell the word!  

We pediatricians are no longer worried about peanut allergies in the young child, it is the choking hazard that is the real concern. It’s the same for a necklace. Let your child wear it when they can spell the word, or put it on when your 3 year old plays dress up, but take it off once finished. There is no need to ever have a young child sleep in anything like a necklace, or anything that has a cord until they are much older. 

Children ages 4 and under, and especially those under the age of 1 year, are at the greatest risk for airway obstruction and suffocation.  So, put the necklace back in the jewelry box for awhile. You can re-wrap for re-gifting and re-wearing at a later date. Safety before bling! 

Your Baby

Gerber Recalls Two Batches of Organic Baby Foods

1:30

Gerber Products Company is voluntarily recalling specific Organic pouch products after identifying a packaging defect that may result in product spoilage during transport and handling.

The two kinds of Gerber Organic 2nd Foods Pouches being recalled are: Pears, Carrots and Peas and the other is Carrots, Apples and Mangoes, the company said.

“Consumers may notice that, in some cases, the pouches are bloated and product inside may have an off taste or odor. There have been three consumer reports of temporary gastrointestinal symptoms, however, we have been unable to confirm that these are related to the product. Consumers should not use the product, since it does not meet our high quality standards,” the company said in a statement.

The products were distributed at U.S. retailers nationwide and through on-line stores. Consumers who purchased pouches with UPCs, batch codes and expiration dates listed below, are encouraged to contact the Gerber Parents Resource Center at 1-800-706-0556 anytime day or night for a replacement coupon.

Replacement coupons are being offered for the following products:

GERBER® Organic 2ND FOODS® Pouches –Pears, Carrots & Peas, 3.5 ounce pouch UPC 15000074319

Best By dates/batch codes

•       12JUL2016 51945335XX

•       13JUL 2016 51955335XX

GERBER® Organic 2ND FOODS® Pouches- Carrots, Apples and Mangoes, 3.5 ounce pouch UPC 15000074395

Best By dates/batch codes

•       13JUL2016 51955335XX

•       14JUL2016 51965335XX

Consumers can also find more information on the Gerber Products Company website at https://www.gerber.com/recall-march-2016

Story source: http://www.fda.gov/safety/recalls/ucm492260.htm#recall-photos

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

Are vaccines safe for pregnant moms?

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.