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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

Uber & Teens

1:30 to read

Do you have Uber cars in your area?  I first found out about Uber (and I am only using them as an example) when my son lived in NYC and often used the car service. Later on I heard about college kids using Uber as well.  In that case, many college kids did not have cars and/or they were being “responsible” after being at a party.

But recently, in conversations with my adolescent patients, I have heard that high school kids are using Uber to come home after a party, or other social activities. In otherwords, their parents are not picking them up from the dance, concert, or party but are letting their children (often young girls) call Uber.  Where are their parents and what are they thinking?

I realize that once your child heads off to college you hope and pray that they are making good choices and are being safe. You don’t really plan on picking them up after an event or talk to them that same night about what they have been doing and with whom.  But when we had high school age children, my expectations were that we, the parents, were responsible for taking our teens to the party and to pick them up. Once they were driving the “rules” changed a bit in that they were then often driving themselves to an event and then would drive home and we would be up waiting for them to get home.  They always knew that we would be there when they got home and also that if there were any “issues” we were also available to pick them up. We talked a lot about underage drinking as well as driving and responsibility.  Never did I think they would call a cab or car service, nor was that idea ever broached, they were to call their parents.

So now that these “app” car services are available around the clock, are parents abrogating their responsibilities for parenting teens?  By allowing their teens to call a car service for their ride home, are parents seemingly not interested in where their child has been or who they have been with or what they have been doing before they get home?  You certainly can drop your child at a concert or party and tell them to text Uber to get a ride home, but does this parental non-participation quietly help to condone inappropriate, risky, teen behavior?

Although picking your child up at the end of the evening or checking on them when they pull in the driveway will never ensure that your teen does not get into trouble, I think it does help them think a bit more about having to interact with their parents at curfew time. This “worry” might help lead them to make a better decision about drugs, alcohol or whom they are hanging out with. Putting teens into the “hands” (cars) of strangers as their ride home just seems wrong. Parents be aware. 

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

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

Recall: Otteroo Baby Floats Due to Drowning Risks

1:00

Babies and young children can drown in less than 2 inches of water.  That’s why it is  vital that parents and caregivers never leave a baby or young child unattended while they are near or in water.

When bathing their infant, parents will sometimes attach a bath float to their child to help keep his or her head above water. While the float may offer some assistance, critics warn that the device can give parents a false sense of security that their child is protected from drowning.

Otteroo Corporation makes inflatable baby floats that are specifically designed for babies 8 weeks and up.

The company is recalling about 3000 units of their inflatable Baby Floats after receiving 54 reports of broken seems on the product. No injuries have been reported.

The Otteroo Inflatable Baby Float is an inflatable round ring made of clear and blue plastic material. It has two air chambers that fasten around a baby’s neck with a white buckle. The floats have a chin rest, two handles and two circular openings on the back of the ring to allow the device to expand as the child grows with age. There are three colorful balls that move freely around inside the ring.  The name “Otteroo” is imprinted on the top of the float in large, orange letters with an Otter logo.

Consumers should immediately stop using the recalled inflatable baby floats and contact the firm to receive a free replacement.

The floats were sold online at Otteroo.com and Amazon.com and Zulily.com from January 2014 through July 2014 for about $35.

Consumers can contact Otteroo Corporation at (415) 236-5388 from 9 a.m. to 5 p.m. PT Monday through Friday or online www.otteroo.com and click on “Safety” at the bottom of the page for more information.

According to their website, Otteroo is offering a free replacement for those who purchased the product manufactured in 2014 (NO: 002013001).

Sources: http://www.cpsc.gov/en/Recalls/Recall-Alerts/2015/Otteroo-Corp-Recalls-Inflatable-Baby-Floats/

http://otteroo.com/pages/safety-info

Your Baby

“Hard” Tap Water and Eczema in Infants

1:30

Previous studies have noted an association between “hard” tap water and eczema in schoolchildren, but a new study out of the U.K. suggests it may be linked to eczema in babies as well.

Water described as “hard” contains a high degree of minerals - specifically calcium, magnesium and manganese. It’s not considered hazardous, but it comes with a variety of unpleasant effects such as soap scum in sinks and bathtubs, spots on dishes and shower glass, clogged pipes from buildup and clothes that are left dingy after washing.

By some accounts, 85% of U.S. households have hard water.

If your child has eczema, then you know that it is a chronic condition marked by itchiness and rashes. It typically starts at about 6 months old and can last into adulthood.

The study included 1,300 3-month old infants from across the United Kingdom. Researchers checked hardness -- the water's mineral content -- and chlorine levels in the water supply where the babies lived.

Babies who lived in areas with hard water were up to 87% more likely to have eczema, the study found.

"Our study builds on growing evidence of a link between exposure to hard water and the risk of developing eczema in childhood," said lead author Dr. Carsten Flohr, from the Institute of Dermatology at King's College London.

One way to change the composition of hard water is by adding a water softener system to your household

There are several types of systems including salt-based Ion exchange softeners, salt-free softeners, dual tank and magnetic water softeners plus others.

While the other studies focused on school aged children, this is the first to look at the connection with eczema, hard water and babies, the researchers said.

The study wasn't designed to prove a cause-and-effect relationship, so further research is needed to learn more about this apparent link, Flohr added.

"We are about to launch a feasibility trial to assess whether installing a water softener in the homes of high-risk children around the time of birth may reduce the risk of eczema and whether reducing chlorine levels brings any additional benefits," Flohr said in a college news release.

The study was published recently in the Journal of Allergy and Clinical Immunology.

Story sources: Robert Preidt, https://www.nlm.nih.gov/medlineplus/news/fullstory_159150.html

http://extoxnet.orst.edu/faqs/safedrink/hard.htm

 

 

Parenting

Fourth of July Safety Tips

2:00

For Americans, it doesn’t get any more patriotic than Independence Day- or as most folks call it- July 4th.  The holiday celebrates the adoption of the Declaration of Independence, drafted by Thomas Jefferson, in 1776.

It’s traditionally been a high-spirited holiday with fireworks, casual family and friends’ gatherings, parades, lake and pool parties, music and lots of food. 

All these activities help build life’s memorable moments, however, the one memory you don’t want is a visit to the emergency room.

Here are some safety tips to keep in mind while enjoying the Fourth:

Fireworks: It’s really best to leave fireworks to the professionals, but if you’re planning on setting off some during the Fourth of July celebrations, follow these tips:

1. Be sure fireworks are legal in your area before using or buying them

2. Always have an adult supervise fireworks activities and never allow children to play with or ignite fireworks. Sparklers alone account for one quarter of emergency room fireworks injuries

3. If you set off fireworks, keep a bucket of water or fire extinguisher handy in case of malfunction or fire.

4. If fireworks malfunction, don’t relight them! Douse and soak them with water then throw them away.

5. Never ignite fireworks in a container, especially one that is glass or metal.

Grilling: Malfunctioning gas grills cause the majority of grill fires. In addition, thousands of people visit emergency rooms every year because they have burned themselves while barbecuing.

1.     Use your grill well away from your home and deck railings, and out from under branches or overhangs.

2.     Open your gas grill before lighting.

3.     Periodically remove grease or fat buildup in trays below your gas or propane grill so it cannot be ignited.

4.     Declare a three-foot "kid and pet-free zone" around the grill to keep them safe.

5.     Avoid loose clothing that can catch fire when cooking on the grill.

Water Safety: According to the Center for Disease Control and Prevention, about one in five people who die from drowning are children 14 and younger. For every child who dies from drowning, another five receive emergency department care for nonfatal submersion injuries.

1.     Never leave a young child unattended near water and do not trust a child’s life to another child; teach children to always ask permission to go near water.

2.     Have young children or inexperienced swimmers wear U.S. Coast Guard-approved life jackets around water, but do not rely on life jackets alone.

3.     Establish rules for your family and enforce them without fail. For example, set limits based on each person’s ability, do not let anyone play around drains and suction fittings, and do not allow swimmers to hyperventilate before swimming under water or have breath-holding contests.

4.     Even if you do not plan on swimming, be cautious around natural bodies of water including ocean shoreline, rivers and lakes. Cold temperatures, currents and underwater hazards can make a fall into these bodies of water dangerous.

5.     If you go boating, wear a life jacket! Most boating fatalities occur from drowning.

6.     Avoid alcohol use. Alcohol impairs judgment, balance and coordination; affects swimming and diving skills; and reduces the body’s ability to stay warm.

7.     Always keep a charged cell phone with you for emergency use, but do not get distracted using your phone to text, surf the net or reading emails.

July 4th is a historic holiday and one that holds a special place in America’s heart.  Make sure your 4th is memorable for all the right reasons.

Happy Independence Day!

Story sources: https://www.fema.gov/news-release/2016/06/30/ten-safety-tips-4th-july

https://www.cdc.gov/homeandrecreationalsafety/water-safety/waterinjuries-factsheet.html

http://www.iii.org/article/grilling-safely

 

Your Child

Asbestos Found in Children’s Crayons and Toys

2:00

Coloring with crayons has been an American tradition since the late 1800s.  Since that time, the wax crayon has been instrumental in teaching children how to draw and imagine the world in a rainbow of colors.

Although the words “non-toxic” appear on crayon boxes designated for children’s use, a new report from the Environmental Working Group (EWG) Action Fund says that asbestos fibers have been found in crayons and other toys sold in the United States.

The fibers were found in four brands of crayons and two children’s crime-scene toy fingerprint kits.

The contaminated crayons included Nickelodeon's Teenage Mutant Ninja Turtles crayons, Disney's Mickey Mouse Clubhouse Jumbo Crayons and Saban's Power Rangers Super Megaforce Jumbo Crayons and ones by Amscan, according to the new report.

Asbestos was also found in two crime lab toys: EduScience's Deluxe Forensics Lab Kit, and Inside Intelligence's Secret Spy Kit.

The U.S. National Institutes of Health (NIH) notes that asbestos, which is composed of long, thin mineral fibers, once was common in insulation material.

Though tiny and invisible to the naked eye, airborne asbestos fibers are easily inhaled. With time, scarring, inflammation and breathing impairment can occur, as can lung cancer and mesothelioma, a rare cancer of the lining of the lungs and abdomen, according to the NIH.

Asbestos is no longer widely used in manufacturing in the United States. It is banned in nearly all other developed nations, the research group said.

EWG hired an independent company, Scientific Analytical Institute from Greensboro, N.C., to conduct so-called transmission electron microscopy tests to look for asbestos. This is said to be the most sensitive and accurate method of testing available.

EWG said that a second independent lab reconfirmed the crayons and toys that tested positive.

"Just a couple of fibers can lodge in your lungs and be there forever," said Sonya Lunder, a senior analyst with the Washington, D.C. based group. "And there's very clear evidence that asbestos leads to two forms of cancer, and thousands and thousands of Americans have been killed by fiber exposure."

Former U.S. Assistant Surgeon General Richard Lemen welcomed the report.

"These are important findings, because asbestos is being placed in children's products," said Lemen, now an adjunct professor with Emory University's Rollins School of Public Health in Atlanta.

"Even if the absolute risk is relatively low, children are more vulnerable to toxic material and carcinogens," he said. "And because they are so young they have a longer latency in which to develop these diseases, which are known to be diseases that develop over time."

The crayons were purchased between February and May of this year at two national chains -- Party City and Dollar Tree -- in a suburban county near San Francisco. The group said it ordered the two crime scene toys through Amazon.com and Toys"R"Us.com.

For analysis, 28 brands of crayons were tested and 21 toy fingerprint kits. All the products that tested positive were made in China.

A spokeswoman for Toys "R" Us, which distributes the EduScience Deluxe Forensics Lab Kit, responded to the report, saying customer safety is the company's highest priority.

"We require that every product we carry meets or exceeds all applicable state and federal laws, industry standards, codes and requirements. At this time, we are reviewing the referenced report, along with supplier test reports, to ensure full compliance to our strict safety standards," Kathleen Waugh, vice president of corporate communications, said in a statement.

The tests discovered the highest concentration of asbestos was found in the toy crime-scene fingerprint kits.

If your child is one of the millions that play with crayons or the crime lab kits, be sure to check the brand to make sure they are not one of the contaminated products or kits that tested positive for asbestos.

Source: Alan Mozes, http://consumer.healthday.com/cancer-information-5/lung-cancer-news-100/asbestos-found-in-kids-crayons-toy-crime-kits-701117.html

 

 

 

 

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