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Daily Dose

The Danger in BPA Bottles

I have been getting plenty of question about BPA in your-baby bottles.I recently received an email from a parent who’s 4 year old son is a patient of mine, and she is pregnant and due with a your-baby girl in the next month. On top of all of that she is also a pediatrician. At any rate, her question was regarding BPA (bisphenol A) in bottles, and whether I thought she should throw out bottles that she had used with her son in favor of newer bottles. I will tell you that her son is a perfectly delightful, bright, inquisitive and developmentally normal little boy and he received breast milk and formula from BPA containing bottles.

With that information, and knowing that I am thrifty, I thought long and hard and decided that in my opinion I would toss the old bottles in favor of the newer BPA free bottles. The top manufacturers of your-baby bottles voluntarily stopped using BPA in their bottles at the end of 2008. These bottles include, Dr. Brown, Avent, Playtex, Evenflo and numerous others. It is easy to find BPA free bottles that are well marked and most large chain stores are no longer selling your-baby bottles containing BPA. The cost involved to replace old bottles seems minimal, and the data regarding the safety of BPA to infants and children continues to be released with more ongoing studies underway. There will be more data available in the coming months and years. The Endocrine Society who held their annual meeting last week presented “worrying” evidence about the effects of BPA , including the statement that “endocrine disruptors (which includes BPA) do have effects on male and female development, prostate cancer, thyroid disease, and cardiovascular disease”. There are concerns that infants and children may be particularly susceptible to BPA and possible long term effects on brain development and behavior. So, with these recent studies and more concern regarding the levels of BPA found in your-baby bottles as well as comparison data of exposure to BPA between breast and bottle fed infants, it seems prudent to me to purchase newer bottles that are BPA free. Cross this issue off of the mother worry list. The cost of new bottles is minimal as compared to future concerns about BPA. That's your daily dose for today. We'll chat tomorrow!

Your Child

Hand Sanitizers Poisoning Young Children

2:00

Poison control centers across America have been seeing an increase in calls about children who are getting very sick from drinking hand sanitizers. Poison control officials are warning parents and school officials about this dangerous trend involving small children, basically getting drunk, on hand sanitizer.

“A doctor called us about a week and a half ago about two cases he saw the same day at the ER,” says Gaylord Lopez, PharmD, director of the Georgia Poison Center. “It was a 5- and a 6-year-old.”

The first patient, a 6-year-old girl, was picked up after school stumbling and slurring her words. She’d also fallen and hit her head. Her mother drove her straight to the ER, where doctors found out she’d eaten two to three squirts of strawberry-scented hand sanitizer from a big container sitting on her teacher’s desk.

Her blood alcohol level was 1.79, almost twice what would be considered the legal limit in an adult.

The second case was a 5-year-old boy, who came in with a blood alcohol level of 2.0. The culprit was hand sanitizer.

Lopez checked the national data and saw these cases were part of an unrecognized trend. In 2010, U.S. poison centers got more than 3,600 calls about kids under age 12 eating hand sanitizers. By 2013, that number had swelled to more than 16,000 calls.

“That’s a 400 percent increase,” Lopez says. “I was surprised more than anyone.”

Many of the hand sanitizer bottles come in bright colors and the sanitizer itself smells like bubble gum and other tasty treats such as lemonade and vanilla. All aromas a child might mistake for the real thing.

The big problem with these products are that they can be anywhere from 40 to 95 percent alcohol.

Drinking even just little bit can make kids intoxicated. It’s like drinking a shot or two of hard liquor.

“You and I don’t have any problem sending our kids with hand sanitizer in their backpacks. But what if I told you that was twice as potent as vodka. That’s like a parent sending a bottle of whiskey or rum to school,” Lopez says.

Alcohol poisoning can cause a child’s heart rate, blood pressure and breathing to slow. They may stagger, seem sleepy and vomit. Their blood sugar can drop rapidly leading to seizures and coma.

Lopez says hand sanitizers are often included in the list of school supplies parents should send to school. He says many adults he’s talked to don’t realize that hand sanitizers contain so much alcohol, or they don’t realize that it’s the kind of alcohol that can cause intoxication.

“I wanted to get the word out. Parents should be aware. Teachers should be aware.”

If you have hand sanitizer at home, keep it out of the reach of young children. If you send hand sanitizer with your child to school- especially during the flu and cold season- use the wipes instead.

You can learn more about hand sanitizer poisoning by calling the American Association of Poison Control Center for free advice at 1-800-222-1222.

If you suspect your child may have ingested sanitizer and is showing any of the above symptoms, take your child to the hospital immediately.

Source: Brenda Goodman, MA, http://www.webmd.com/children/news/20150915/hand-sanitizers-poisoning-kids

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July 4th

Have a safe & fun July 4th!

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.  

Daily Dose

Teens & Safe Driving

1.30 to read

Teenage driving and specifically driving safety is getting more and more traction in the news. The National Highway Traffic Safety Administration has just launched the 5 To Drive campaign to reinforce last week’s "National Teen Driver Safety Week".  All of these campaigns are encouraging parents to initiate discussions with their teen drivers about safety. 

I have long been a propionate of driving contracts and luckily my three sons  abided by the contract and never had a “significant” accident. There were a few of the “I backed into the fence”, or “I just didn’t see the car when I backed out of the parking space”, but beyond that we were blessed with accident free teen years.  I also believe that they were maybe a bit more cautious because they had to pay for 1/2 of their insurance premium each year, as well as having other perks (like gas) tied to their grades.  Having some of their own hard earned money in the game made them realize consequences for accidents would also mean higher insurance premiums and more money out of their wallets.  

The NHTSA safety topics for parents to discuss with their teens are: 

No cell phone use or texting while driving - no exceptions
No extra passengers - parents also need to follow their own state laws on this topic as graduated drivers licenses enforce different lengths of time before allowing teens any extra passengers (which are definitely distracting)
No alcohol
No driving or riding without a seat belt 
No speeding 

There were 2,105 teen drivers involved in fatal crashes in 2011 and 45% of the teens involved died in those wrecks as well. The topics for parents to discuss with their teens are on the list as all of these behaviors seen in adolescent drivers are known to contribute to the high death rate among teens. 

Another recent study from Children’s Hospital of Philadelphia in collaboration with State Farm Insurance found that “teenagers were 50% less likely to crash when parents set clear rules, kept track of their teens activities and did so in a supportive manner”.

Take the time to discuss the safe driver rules and model behavior while you are at the wheel as well. Distracted driving affects everyone.....as I continue to remind myself to stay off the phone in the car, even though I finally did get hands free for the phone.  

Your Child

Tips for Preventing Sports Injuries

1:30

The school year is about to wind down and it won’t be long before many kids will be signing up for summer sports programs.

If you’re child loves sports, there’s not a season where he or she can’t find one to participate in. Sports often help children stay in better physical shape, feel good about them selves and with team sports, enjoy social interaction and competition.

However, all sports have a certain amount of risks associated with them - some more than others. The more contact the sport provides, the greater the risk for a traumatic injury. Fortunately, traumatic injuries are rare and most sport injuries to young athletes are due to overuse.

The most common sport-related injuries are sprains (ligament injuries) , stress fractures( bone injuries)  and strains (muscle injuries).Since children’s bodies are still developing, any tenderness over a bone should be evaluated further by a medical provider even if there is minimal swelling or limitation in motion.

The American Academy of Pediatrics offers these tips to help reduce serious injuries in younger athletes:

•       Time off. Plan to have at least 1 day off per week from a particular sport to allow the body to recover. 

•       Wear the right gear.  Players should wear appropriate and properly fit protective equipment such as pads (neck, shoulder, elbow, chest, knee, shin), helmets, mouthpieces, face guards, protective cups, and/or eyewear. Young athletes should not assume that protective gear will always protect them when performing more dangerous or risky activities.

•       Strengthen muscles. Conditioning exercises during practice strengthens muscles used in play. 

•       Increase flexibility. Stretching exercises before and after games or practice can increase flexibility. Stretching should also be incorporated into a daily fitness plan.

•       Use the proper technique. This should be reinforced during the playing season. 

•       Take breaks. Rest periods during practice and games can reduce injuries and prevent heat illness.  

•       Play safe. Strict rules against headfirst sliding (baseball and softball), and spearing (football) should be enforced. 

•       Stop the activity if there is pain.

•       Avoid heat injury by drinking plenty of fluids before, during and after exercise or play; decrease or stop practices or competitions during high heat/humidity periods; wear light clothing. 

While physical injuries are easier to see, sports-related emotional stress can also cause problems for some children. The pressure to win at all costs can add a lot of emotional stress to children who are more interested in playing than always being first.

Not every team is going to win every game, and there will be times when kids involved in more singular sports won’t have a good day. It happens to everyone at some time or another; ask any pro athlete. Young athletes should be judged on effort, sportsmanship and hard work. They should be rewarded for trying hard and for improving their skills rather than punished or criticized for losing a game or competition.  The main goal should be to have fun and learn lifelong physical activity skills.

There are numerous sports that children can engage in and each one offers its own benefits. As parents, it’s important to encourage our children and keep them as healthy as possible.

Source: http://www.healthychildren.org/English/news/Pages/Tips-for-Sports-Injury-Prevention.aspx

Your Toddler

Almost 60,000 Kids Treated Yearly for Accidental Medicine Poisoning

2:00

According to a new report issued by Safe Kids Worldwide, a non-profit organization dedicated to preventing unintentional childhood injuries, almost 60,000 U.S. children are accidently poisoned by medicines each year.

That's the equivalent of four busloads of children -- or one every nine minutes -- arriving at emergency departments every day because of medicine-related poisoning, according to Safe Kids Worldwide.

And nearly every minute each day a poison control center receives a call about a child who got into medicines, the report notes.

"We want parents and caregivers to remember that the first line of defense in preventing medicine poisoning is the family," Kate Carr, president and CEO of Safe Kids Worldwide, said in a news release from the group.

Since 1980, the amount of prescriptions filled has increased three-fold and consumers spend five times as much for over-the-counter drugs. Many families have numerous prescriptions in the home and Carr says parents and other adults need to be vigilant in protecting children from medication poisoning.

Safe Kids Worldwide has been instrumental in getting the word out about medication safety providing research, grants and media promotion. Carr says the efforts are paying off.

"Since Safe Kids and industry and government partners started getting the word out to parents about the importance of keeping kids safe around medicine, the number of ER visits has steadily declined. But there are still too many kids getting into medicine, so education needs to continue to be a priority for all," she added.

As you might suspect, curious toddlers are at the greatest risk for medicine poisoning. Kids aged 1 to 2 years account for 70 percent of ER visits for medicine poisoning, the report said. Parents and caregivers of toddlers need to be sure to store medicine where toddlers cannot reach them, Carr said.

Since medicines are kept in all sorts of places, sometimes they are left in spots that a child can easily access such as in purses, on tables and counters, in refrigerators, daily medicine boxes and in accessible cabinets.

These days, many children are being raised or cared for by grandparents. The report suggests, that grandparents may need safety reminders. In an analysis of ER data on children poisoned by medicines, the drugs belonged to grandparents in 48 percent of cases and to parents in 38 percent of cases.

"Look around your home, and in your purses, to make sure all medicine is out of reach of children," Carr explained.

The Safe Kids Worldwide website offers these tips for protecting children from accidental medicine poisoning:

·      Put all medicine up and away and out of sight. In 86% of emergency department visits for medicine poisoning, the child got into medicine belonging to a parent or grandparent.

·      Consider places where kids get into medicine. Kids get into medication in all sorts of places, like in purses and nightstands. Place purses and bags in high locations, and avoid leaving medicine on a nightstand or dresser. In 2 out of 3 emergency room visits for medicine poisoning, the medicine was left within reach of a child.

·      Consider products you might not think about as medicine. Health products such as vitamins, diaper rash creams, eye drops and even hand sanitizer can be harmful if kids get into them. Store these items up, away and out of sight, just as you would traditional medicine.

·      Only use the dosing device that comes with the medicine. Kitchen spoons aren’t all the same, and a teaspoon or tablespoon used for cooking won’t measure the same amount of medicine as a dosing device.

·      Write clear instructions for caregivers about your child’s medicine. When other caregivers are giving your child medicine, they need to know what medicine to give, how much to give and when to give it. Using a medicine schedule can help with communication between caregivers.  

·      Save the Poison Help line in your phone: 1-800-222-1222. Put the toll-free number for the Poison Control Center into your home and cell phones. You can also put the number on your refrigerator or another place in your home where babysitters and caregivers can see it. And remember, the Poison Help line is not just for emergencies, you can call with questions about how to take or give medicine.

Story source: Robert Preidt, http://consumer.healthday.com/public-health-information-30/poisons-health-news-537/60-000-kids-rushed-to-ers-for-accidental-medication-poisoning-each-year-709176.html

https://www.safekids.org

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

Car Seat Safety

1:30 to read

I recently received a text from a patient who asked if she could turn her 17 month old child’s car seat around and have it forward facing in the back seat. She said that her car seat instructions read “may forward face after the child weighs 20 lbs”.

 

Not long after that, another patient came in for her 18 month check up and during the course of the check up I always ask about car seat position.  I remind them that they should continue to have their child in a rear facing car-seat until they 2 years of age.  The child’s mother said that she had turned the car seat around to forward facing because the child “did not like rear facing”.  Interesting discussion with a toddler.

 

So, this just so happens to be Child Passenger Safety Week and National Car Seat Check Saturday as well. What a better time to remind parents that the safest way to restrain your child who is under the age of 2 years (depending on your carseat height and weight restrictions)  is in a rear facing car seat.  

 

In a recently published article in the journal Pediatrics, about 38% of 17-19 months olds were not following AAP recommendations to ride in a rear-facing car seat. The recommendations were changed in 2011 as studies found that young children in a forward-facing car seat were 5 times more likely to be seriously injured than those in a rear-facing seat. 

 

In the study many of the families involved who had their children forward-facing often said that they “thought their child was too tall or too heavy to be rear-facing”. Others commented that “their feet were touching the back seat and they looked uncomfortable”. 

 

Interestingly, your child has been in a rear-facing car seat since birth, so it is strange that they “prefer” to forward face.  Kind of like being in the middle seat of an airplane, if you have never been seated on the aisle you don’t know the difference in seats.

 

If you are concerned about the appropriate car seat for your child or how to install it, this is a good week to have a car seat expert help make sure that your child is riding in the safest car seat possible. If your child is under the age of 2…that also means rear facing!  

 

 

 

 

 

  

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