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Your Teen

Stop Yelling at Your Teenager!

2.30 to read

I’m going to go out on a limb and say that anyone who has a child has yelled at him or her at one time or another. As parents, we’ve all lost our patience when we believe our child is misbehaving. If ever there is a time when parents and kids are standing at the crossroad of “Listen to me” and “I don’t need to”, it’s during the teenage years.

Tempers often ignite with harsh words being said.  

While you may be trying to make an important point, aggressive yelling and screaming only pushes your child away and may be doing much more harm than good according to a new study.

An analysis involving nearly 1,000 two-parent families and their adolescent children suggests that such harsh verbal lashings not only don't cut back on misbehavior, they actually promote it.

The end result: an uptick in the kind of adolescent rage, stubbornness and irritation that escalates rather than stops or prevents disobedience and conflict.

"Most parents who yell at their adolescent children wouldn't dream of physically punishing their teens," noted study author Ming-Te Wang, an assistant professor with the department of psychology at the University of Pittsburgh School of Education. "Yet, their use of harsh verbal discipline -- defined as shouting, cursing or using insults -- is just as detrimental to the long-term well-being of adolescents," he said.

"Our findings offer insight into why some parents feel that no matter how loud they shout, their teenagers do not listen," Wang added. "Indeed, not only does harsh verbal discipline appear to be ineffective at addressing behavior problems in youth, it actually appears to increase such behaviors."

Wang and his co-author, Sarah Kenny of the University of Michigan, report their findings in the current issue of the journal Child Development.

The researchers were particularly interested in kids between 13 and 14 years old so they focused on 976 primarily middle-class families in Pennsylvania with young adolescent offspring, all of whom were already participating in a long-term study exploring family interaction and adolescent development. A little more than half the families were white, while 40 percent were black.

The teen participants were asked to disclose recent behavioral issues such as in-school disturbances, stealing, fighting, damaging property or lying to their parents.

Their parents were asked how often they used harsh verbal discipline such as yelling, screaming, swearing or cursing at their child. Most importantly, if they called their child names like “dumb” or “lazy.”

The teens were also asked to what degree they felt “warmth” in their relationship with their parents. Researchers inquired about the amount of parental love, emotional support, affection and care the kids felt like they received from their parents. Both teens and parental depression were tracked.

The study points out that the children who were on the receiving end of the harsh verbal attacks experienced an increase in anger and a drop in inhibitions. Those two reactions prompted an intensification of the very things that parents were hoping to stop – such as lying, cheating, stealing or fighting.

"Parents who wish to modify their teenage children's behavior would do better by communicating with them on an equal level," Wang said, "and explaining their rationale and worries to them. Parenting programs are in a good position to offer parents insight into how behaviors they may feel the need to resort to, such as shouting or yelling, are ineffective and or harmful, and to offer alternatives to such behaviors."

Parents get frustrated with their children and vice versa. None of us behave perfectly all the time. Raising your voice because you are frustrated is one thing, name calling and screaming is quite another.

Imagine if you were at work and your boss screamed at you, called you names and cursed at you because he or she didn’t like how you did something. That may have actually happened to you – remember how you felt, or think about how you would feel. Humiliated, angry and sad are the most common reactions people have.  

Children are trying to find their way in life; parents are their guides. The next time you feel you’re on the verge of screaming or saying hurtful things to your child - walk away. Give yourself time to cool down and find a better way to communicate.

People say kids are resilient and get over things quickly. Many are able to bounce back when bad things happen, but that saying is too often used to excuse bad behavior on a parent’s part. If you’ve crossed the line with your child, say you’re sorry and come up with better ways to handle your frustration and anger.

Words and tone matter and the best teaching method is by example. You can help your child learn what love, patience, tolerance, compassion and respect are by being an example of those very qualities.

Source: Alan Moses, http://consumer.healthday.com/kids-health-information-23/misc-kid-s-health-news-435/yelling-at-insulting-teens-can-backfire-on-parents-study-679863.html

Your Teen

What do Energy Drinks Actually Do to the Body?

2:00

There’s been a lot of discussion over whether caffeine-spiked “Energy Drinks” are really safe for consumption, particularly for kids and young adults.  Although many manufacturers add the advisory statement “not recommended for children, pregnant or nursing women and persons sensitive to caffeine” on their label, it often goes ignored.

The Substance Abuse and Mental Health Services Administration reports that as these drinks have become more popular, the incidences of caffeine related overdoses and deaths have increased.

In one heartbreaking example, 14-year-old Anais Fournier died from cardiac arrest due to caffeine toxicity after consuming two 24- ounce cans of Monster energy drink a day apart.

While the Food and Drug Administration (FDA) has been investigating whether there is causal link to the drinks and health problems, Mayo Clinic researcher Anna Svatikova and her colleagues wanted more information about exactly what happens in your body after you consume one of the drinks.

She and her team recruited 25 volunteers. All were young adults age 18 or older, nonsmokers, free of known disease, and not taking medications. They were asked to drink a 16-ounce can of a Rockstar energy drink and a placebo -- with the same taste, texture, color and nutritional contents but without the caffeine and other stimulants -- within five minutes on two separate days.

The energy drink had the following stimulants: 240 mg of caffeine, 2,000 mg of taurine and extracts of guarana seed, ginseng root and milk thistle. All typical ingredients associated with energy drinks.

Researchers took numerous measurements first before they drank and 30 minutes after. With the placebo, there was very little change. With the energy drink, however, many of the changes were marked:

•       Systolic blood pressure (the top number) - 6.2 percent increase

•       Diastolic blood pressure (the bottom number) - 6.8 percent increase

•       Average blood pressure - 6.4 percent increase

•       Heart rate - none

•       Caffeine in blood - increase from undetectable to 3.4 micrograms/mL

•       Norepinephrine level (the stress hormone, which can give you the shakes when you have too much caffeine) in blood - increase from 150 pg/mL to 250 pg/ML

Writing in JAMA, the researchers said that these changes may predispose those who drink a single drink to increased cardiovascular risk.

This may explain why a number of those who died after consuming energy drinks appeared to have had heart attacks.

They also exposed the volunteers to two-minute physical, mental, and cold stressors after consuming the energy drinks to see how that might affect blood pressure and other body functions.

The physical stressor involved asking participants to squeeze on a handgrip; the mental one to complete a series of mathematical tasks as fast as possible; and the cold one immersing their one hand into ice water. Interestingly, there was no further change.

Another thing that is typically overlooked when people choose one of these drinks is the serving size. A 16-ounce can is two servings. A 24-ounce can has three servings. Caffeine and sugar content is often listed per serving. But honestly, how many people drink a third or half a can at a time? Besides caffeine, other stimulants are often added to energy drinks such as Ginseng and Guarana. Most people have no idea what they are, what they do and if they negatively interact with medications.

The American Beverage Association defends the drinks and said in a statement  that "there is nothing unique about the caffeine in mainstream energy drinks, which is about half that of a similar sized cup of coffeehouse coffee" and that drinking coffee would have produced similar effects.

“The safety of energy drinks has been established by scientific research as well as regulatory agencies around the globe. Just this year the European Food Safety Authority (EFSA) confirmed the safety of energy drinks and their ingredients after an extensive review," the organization said.

It’s up to parents to decide whether these drinks are beneficial to their family or if they should re-think purchasing one for themselves or their child. A family discussion about the pros and cons of energy drinks with pre-teens and teenagers could give the kids the information they need to make a good choice.

Source: Ariana Eunjung Cha, http://jama.jamanetwork.com/article.aspx?articleID=2469194

Your Child

Botox Injections for Young Migraine Sufferers?

1:45

Botox injections are typically thought of as beauty enhancers for adult men and women, but a small study in California, suggests that the injections may also help children find relief from migraines. 

The new findings are based on testing among just nine children, aged 8 to 17. Currently, Botox is only approved as an adult migraine treatment and research has shown that for some people, it’s been effective.

The new study may provide hope for a young migraine sufferer looking for an alternative treatment, since the one approved preventative medication, topiramate, is only available to adolescent patients.

"When children and teens have migraine pain, it can severely affect their lives and ability to function," said study author Dr. Shalini Shah, chief of the division of pain medicine at the University of California, Irvine, 

"They miss school, their grades suffer and they are left behind, often unable to reach their full potential," she added in an American Society of Anesthesiologists' news release. "Clearly, there is a need for an alternative treatment for those who haven't found relief.”

After the treatments with Botox, Shah noted, "we saw improvement in functional aspects in all of the children and teens. In fact, one patient was hospitalized monthly for her migraine pain prior to Botox treatment and was expected to be held back in school. After treatment, she only has one or two migraines a year, and is excelling in college."

Researchers said that before treatment, the participating patients experienced migraines between roughly eight and 30 times per month.

The kids and teens were given Botox shots to the front and back of the head and the neck every 12 weeks for five years. Once treated, the study volunteers had migraines between two and 10 times a month.

Researchers said the patients experienced less pain and the duration of the migraine attacks decreased. No severe side effects were reported and another study is already being launched.

Shah recently presented the findings at a meeting of the American Society of Anesthesiologists in Boston. Findings presented at meetings are typically viewed as preliminary if they haven't been published in a peer-reviewed journal.

Story source: Alan Mozes, https://consumer.healthday.com/kids-health-information-23/adolescents-and-teen-health-news-719/botox-may-offer-new-hope-for-young-migraine-sufferers-727788.html

Your Teen

Is Technology Sabotaging Teen's Sleep?

2:30

For the first time in history, we have adolescents that have never known an age without cell phones, tablets and computers. These marvels of technology have been a part of their lives from birth and they spend an extraordinary amount of time engaged with them. 

All their texting, posting and web surfing is robbing teens of the much needed sleep they need to think and function clearly, according to a new study.

Experts say teenagers need at least nine hours of sleep a night to be engaged and productive during the day. Anything less can cause daytime sleepiness and interfere with school or daily activities.

How much sleep is today’s teen actually getting? Researchers analyzed a pair of long-term, national surveys of more than 360,000 eighth- through 12th-graders to find out.

One survey asked 8th-10th- and 12th-graders how often they got at least seven hours of sleep. The other asked high school students how long they slept on a typical school night.

In 2015, 4 out of 10 teens slept less than seven hours a night. That's up 58 percent since 1991 and 17 percent more than in 2009 when smartphone use started becoming more mainstream, the researchers said.

"Teens' sleep began to shorten just as the majority started using smartphones. It's a very suspicious pattern," said study leader Jean Twenge, a psychology professor at San Diego State University.

The more time students reported spending online, the less sleep they got, according to the recent study published in the journal Sleep Medicine.

Teens that were online more than five hours a day were 50 percent more likely to be sleep-deprived than classmates who limited their time online to about an hour.

Studies have shown that the light emitted by smartphones and tablets can interrupt the body’s natural sleep –wake cycle.  The bright light can make the brain think that it’s daylight and time to stop producing melatonin, a hormone that cues to the body to sleep. By disrupting melatonin production, smartphone light can disrupt your sleep cycle, almost like an artificially induced jet lag. That makes it harder to fall and stay asleep.

If smartphones, tablets and computers are one of the causes for teens’ sleep deprivation, experts agree that moderate use can help change that. Everyone -- young and old alike -- should limit use to two hours each day, the researchers advised in a San Diego State University news release.

It’s not only the light from smartphones that can disrupt your ability to fall asleep, but the content you’re reading. Social media has a way of pulling teens into a discourse or “following” marathon that can eat up those precious hours of rest.

The best solution for electronic sleep deprivation is to make sure your teen puts his or her phone away and shuts down the tablet or computer at least an hour before bedtime.

Story sources: Mary Elizabeth Dallas, https://teens.webmd.com/news/20171020/smartphones-screens-sabotaging-teens-sleep

Kevin Loria, Skye Gould, http://www.businessinsider.com/how-smartphone-light-affects-your-brain-and-body-2017-7

Your Baby

Toxic Chemicals Found in Baby Foods

2:00

Most parents naturally assume that store-bought baby foods and formulas are well regulated and safe for their babies to consume. That may not be the case says a recent study released by the Clean Label Project. In fact, many of these products may contain high-levels of toxins, researchers said.

For the study, Clean Label Project, a non-profit which advocates for transparent labeling of products, looked at the top-selling formulas and baby food as well as emerging national brands based on Nielsen data. Of about 530 products that the researchers tested, 65 percent were found positive for arsenic, 58 percent for cadmium, 36 percent for lead, and 10 percent for acrylamide.

The highest toxin level found was arsenic. It is associated with cardiovascular conditions, developmental defects, diabetes, neurotoxicity, skin lesions, and even cancer, was present in nearly 80 percent of infant formulas. Rice-based baby food such as snack puffs, tend to have the highest levels of arsenic.

In 2016, the U.S. Food and Drug Administration proposed a limit of 100 parts per billion of arsenic in infant rice cereal, but isn't enforcing that limit. Rice often absorbs arsenic from contaminated soil as it grows in the environment.

"It is important for consumers to understand that some contaminants, such as heavy metals like lead or arsenic, are in the environment and cannot simply be removed from food," said Peter Cassell, a FDA spokesperson.

BPA was also found, although many companies now advertise as PBA free. Sixty-percent were found positive for the industrial chemical bisphenol A.

Lead, known for its’ devastating impact on children’s health, was found in 36 percent of the products. Low levels of lead in children's blood have been connected to lower IQs, slowed growth, behavioral problems, hearing issues and anemia, according to the Environmental Protection Agency.

Gerber, Mead Johnson (Enfamil), Plum Organics all released statements following the study assuring customers their products adhere to strict safety standards. Gerber said its foods "meet or exceed U.S. government standards for quality and safety." Mead Johnson said it specifically monitors the presence of many materials, including arsenic, cadmium, lead, BPA and acrylamide to ensure "safety and high quality." Plum, who also stressed products are "completely safe," said over the past year, it's created "new, more robust guidelines for contaminants in our products" and is in the process of implementing those rules.

Jaclyn Bowen, executive director of Clean Label Project, said, "The baby industry needs to do a better job in protecting America’s most vulnerable population,"

The researchers found that mainstream brands, which include Enfamil, Gerber, Plum Organics, and Sprout, were among the worst offenders that scored two out of five in the report on toxic metals.

A more in-depth review of the study can be found on http://www.cleanlabelproject.org/product-ratings/infant-formula-baby-food/

Story sources: Ashley May, https://www.usatoday.com/story/news/nation-now/2017/10/25/these-baby-foods-and-formulas-tested-positive-arsenic-lead-and-bpa-new-study/794291001/

Allan Adamson, http://www.techtimes.com/articles/214847/20171025/baby-food-and-infant-formulas-tested-positive-for-arsenic-lead-and-other-toxic-chemicals.htm

Your Baby

Homemade or Commercial Baby Food- Which is Best?

1:45

A new study from the U.K. looked at homemade baby food versus commercial baby food bought in grocery stores. They both come up winners in some categories and losers in others.

The researchers wanted to assess how well homemade and commercially available readymade meals designed for infants and young children met age specific national dietary recommendations.

Once thought to be the ideal baby food, homemade meals turned out to be higher in calories and fat and more time-consuming to prepare, but less expensive and higher in nutrients and variety. Commercial baby food came in more convenient, lower in calories, total fats and salt but was more expensive and lacked variety. Sugar content was about the same in both foods.

Each option had upsides and downsides. For example, home-cooked food had higher nutritional content, but 50% of homemade meals also exceed calorie recommendations, and 37% exceeded the recommendations for calories from fat, reported a research team led by Sharon Carstairs, a PhD student at the University of Aberdeen in Scotland.

Only 7% of the commercial baby food evaluated exceeded calorie recommendations, and less than 1% exceeded recommendations for calories from fat, Carstairs and colleagues reported in Archives of Disease in Childhood.

Researchers compared the store-bought meals with 408 recipes for home-cooked infant meals obtained from best-selling published cookbooks. The investigators entered the recipe ingredients into dietary analysis software to calculate the nutritional composition of the recipes per 100 grams.

A chief limitation of the study was that it only analyzed the recipes for homemade meals and did not take into account how these meals might be prepared in "real life."

"Parents may use cookbooks prescriptively or only as guidance, and thus the nutritional content of home-cooked recipes can vary greatly, and this can be augmented further by natural variations in the nutritional composition of raw ingredients," Carstairs and colleagues noted.

In addition, "the authors may have overestimated the values for salt within home-cooked recipes as it was often cited as optional; these results should thus be considered with caution."

The study reassures parents that it is okay to give homemade food to babies being weaned from breast milk or formula, Lauri Wright, PhD, of the University of South Florida College of Public Health and a spokesperson for the Academy of Nutrition and Dietetics, told MedPage Today.

"This is an important study, because in the United States parents think they have to do the commercial foods. Parents are afraid their child will miss out on nutrients if they don't give the specialized baby food."

The greater variety offered by homemade food may result in healthier taste preferences later in life, Wright added. "We used to think that taste preference developed at age 4 or 5, but we now know that taste preferences develop with the introduction of these first solid foods."

The bottom line from this study is that both types of baby food are acceptable; each comes with its own pros and cons. Just like with any other meal, how your homemade baby food is prepared is the key to whether it’s going to be healthy or not for baby. Understanding the guidelines for nourishing infant food and knowing the nutritional values of the foods you use, can help you prepare a wholesome meal for baby. Commercial baby foods also offer convenience and lower calories and fats. A mix of both will probably suit most families very well.

Story source: Medpage Today staff, http://www.medpagetoday.com/pediatrics/generalpediatrics/59228

 

 

Your Teen

Study: ADHD Drugs Don’t Increase Heart Problems for Kids

1.30 to read

A new study suggests that Ritalin and similar drugs, used to treat attention deficient hyperactivity disorder (ADHD), do not raise the risk of serious heart problems, stroke or sudden death.

That’s very good news for children who take ADHD drugs and their parents.

In the new study, researchers looked at the diverse medical records of 1.2 million children, ages 2-24 years old. They checked health records for evidence of heart problems, including heart attacks, strokes and sudden cardiac deaths, in children who were currently taking the drugs or who had taken Ritalin or Adderall in the past.

"We don't see any evidence of increased risk," said Dr. William Cooper of Vanderbilt University, whose study was published in the New England Journal of Medicine.

In 2006, U.S. and Canadian regulators received a number of reports of heart attacks, strokes and sudden cardiac arrest in children taking ADHD medications. This study is the first of three commissioned by the Food and Drug Administration. Also because of concerns about possible heart related problems, the American Heart Association issued guidelines suggesting that children who were just starting to take the drugs should be tested for potential underlying heart problems.

"There's such strong feelings around these drug and whether they are overused in children who might be helped by behavioral therapy alone,” Cooper said. "The potential safety questions have added another layer of concern."

The study was aimed at resolving safety questions. The team found no increased risk of heart problems for either current or past users of the drugs. Yet because there were so few cases of serious heart problems -- just 81 -- the study may not have been large enough to detect it.

But even if there were a risk of heart problems, it is extremely slight, Cooper said.

In a guidance document issued on Tuesday, the FDA said it continues to recommend that the drugs not be used in patients with serious heart problems. It added that patients should be monitored for changes in heart rate or blood pressure.

More than 5 million children in the United States have been diagnosed with ADHD.  Whether children are being over medicated or should even be taking stimulants at all to treat ADHD has long been a controversial subject. Some organizations and parents believe that supplying children with stimulants to treat ADHD is harmful.

For those parents that believe ADHD drugs are helping their children focus better in school and live more productive lives, this recent study should offer some reassurance that the drugs do not contribute to heart problems.

 "This study would suggest that their risk is remarkably low. And that's good news," noted Dr. Cooper.

Daily Dose

New Concussion Guidelines

1:30 to read

A really interesting study was published in Pediatrics online entitled “Benefits of Strict Rest After Acute Concussion”.  The guidelines for treating a concussion continue to be debated and that is what makes this study thought provoking.  

This was a “randomized controlled study”  which followed 88 patients between the ages of 11 and 22 years who had been diagnosed with a concussion.  45 of the patients were given instructions for 5 days of strict rest at home with no school, no work and no physical activity.  They were then allowed to have a “stepwise return to activity”.  The other 43 patients were told to “rest” for 1-2 days after which time they could  return to school also follow a “stepwise return to activity”.

Interestingly, there was no clinically significant difference in the  neurocognitive or balance outcomes between the two groups.  In fact the group that was “advised to rest for 5 days” reported more daily post concussive symptoms and slower resolution of symptoms than those who were told to rest for 1-2 days.  

This was a small study and does not mean that everyone should be treated the same way. In fact, when seeing a patient who has sustained a concussion each person seems to be a bit different.....as one could expect when discussing a “brain injury”.  No two brains are exactly alike...at least for the time being...who knows what will happen one day with genetics

In my own limited practice I have found that “very few” tweens and teens subscribe to the complete rest theory...that is no school, but also no TV, no computer and no videos or smart phones....WHAT??? No social media for 5 days?  You would have to put most of them on an isolated “post concussion island” to ensure they disconnect.  

The study authors also wondered if patients reported more symptoms after having strict rest recommended.  It seems plausible that I too might notice a few more symptoms when just sitting there wondering if my head hurts or if I seem to be more fatigued.

Subjective symptoms are always difficult to quantify...which makes treating a concussion more problematic.  I think erring on the conservative side and restricting “return to play” for a longer period seems to be of more importance than any other recommendation, including “5 days of strict rest”. In the meantime this is an interesting study....with more data to surely follow. 

 

Your Teen

Acne Gel Linked to Rare Side Effect

1:45

Nearly all teens will get acne at one time or another. For those that get severe acne, it can be devastating to their self-esteem. While acne isn’t a serious health problem, it’s not something that is easy to hide.

For a lot of teens, over-the–counter face washes and drying agents help keep acne under control. For more serious acne, families often turn to a dermatologist for prescription medicine.

In certain people, Aczone- the skin gel version of the drug Dapzone -may lead to a rare blood disorder called methemoglobinemia according to a new study.

That’s what a 19 year-old female in Pittsburgh was using to treat her acne before she entered the emergency room with a headache, shortness of breath, and blue lips and fingers. At first, her doctors were at a loss as to what was causing her condition.

The patient had been using a “pea-size” amount of Aczone on her face twice daily during the previous week and didn’t think to tell the doctors about it when questioned about any medications she was taking.

"We went over all her meds and herbal supplements," said Dr. Greg Swartzentruber, a medical toxicology fellow at the University of Pittsburgh Medical Center. "And we couldn't come up with a cause, even after interviewing her and her family. Aczone was just never mentioned."

Topical medicines can have systemic adverse effects on people, but many patients don’t think about topical creams or gels when asked about medications they are on by their doctor.

The study authors noted that prior research has shown that Dapsone pills, in very rare instances, can trigger methemoglobinemia, the abnormal production of a red blood cell protein that delivers oxygen throughout the body.

But the current case appears to be the first time that this condition has been associated with Aczone, the skin gel version of Dapsone, they said.

Dapzone pills have been available for decades and were once used to treat leprosy. In 2005, the FDA approved Aczone - the 5 percent topical cream – for acne treatment use. Dapzone and Aczone have been very effective for treating acne.

However, if someone has the rare genetic defect that makes it impossible to properly metabolize the drugs, it can cause serious health problems.

"The blood cells blow up, basically," said Dr. Darrell Rigel, a clinical professor of dermatology with New York University Medical Center in New York City. Rigel added. "The prevalence of this deficiency is very low. Maybe it affects less than 1 percent of the population, but those that have it can end up with serious problems."

Doctors were finally able to diagnose the young woman’s illness through a urine test. She was successfully treated and released from the hospital after two days.

Rigel noted that dermatologists who prescribe Aczone have a responsibility to always screen patients for this issue. "And patients have to know that when they're asked to give their drug history they can't forget their topicals," he said.

The young woman’s case was described in a letter published in the New England Journal of Medicine.

Source: Alan Mozes, http://www.webmd.com/skin-problems-and-treatments/acne/news/20150129/acne-gel-linked-to-rare-side-effect-doctors-warn

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