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Daily Dose

Water Safety

1:30 to read

Memorial Day weekend is almost here and that means summer water activities. While the pool is a great place to stay cool it is also unfortunately associated with drowning.  Drowning is the leading cause of death in children between the ages of 1-4 years and is the second leading cause of accidental death for children under the age of 14.  

 

Drownings are more likely to happen not at the child’s own home, but while a child is at a swim party, or a neighbors house.  Drowning is a SILENT event. While most people think of drowning being noisy with lots of splashing and screaming (as depicted on TV and movies), children rarely scream, call for help or thrash around. They quietly go under water…..and don’t come back up.

 

Statistics show that in 35% of drownings there is no adult supervision, and 57% of drownings occur in residential pools.  About 40% of children drown when not swimming , but after accidentally falling into the water. I have witnessed this myself when filming a segment on pool safety at my own pool! The toddler, who was standing right next to me, slipped and fell right into the pool….but I was literally standing less than an arm’s length away, witnessed the entire event and pulled him right back out of the pool…both of us wet and scared!!! It only takes a second for this to happen.

 

The AAP now recommends that children begin formal swim lessons at younger ages as the risk of drowning is reduced by 88% with formal swim lessons.  The AAP does not endorse “survival swimming” lessons for young children. 

 

Drowning is preventable!! Make sure that your children have adult supervision whenever they swim, and don’t let children swim alone. Even teens can drown and should not swim alone….

When attending pool events, whether at home or away, designate an adult to be the “water watcher” so that no one assumes someone else is responsible. The “water watcher “is dedicated to one task, supervising the children…so no texting, socializing, drinking etc. while on duty.

 

Protecting children around the pool also means having the correct equipment!  Pools should all be enclosed by a non-climbable fence with a self locking gate, which ensures that no one can wander into the pool before there is adult is on duty!  Children who do not know how to swim should wear a Coast Guard approved personal flotation device , and not water wings or floaties. The pool deck should also have appropriate water rescue equipment ready, which includes pool noodles, safety rings and a first aid kit. Keep a phone nearby as well for ready access to call 911 if an emergency should occur. 

 

Swimming is fun and a great way to exercise. Don’t forget the sunscreen and make sure to re-apply throughout the day. Have a good Memorial Day and a safe start to summer!!! 

Daily Dose

How to Treat Poison Ivy

1.15 to read

With the long weekend here, many families are enjoying the outdoors. But with outdoor activity, your children may develop summer rashes like poison ivy, poison oak or poison sumac. Each plant is endemic to different areas of the country, but unfortunately all 50 states have one of these pesky plants. Teach your children the adage “leaves of three, let it be”, so they come to recognize the typical leaves of the poison ivy.

The rash of poison ivy (we will use this as the prototype) is caused by exposure of the skin to the plant sap urushiol, and the subsequent allergic reaction. Like most allergies, this reaction requires previous exposure to the plant, and upon re-exposure your child will develop an allergic contact dermatitis. This reaction may occur anywhere from hours to days after exposure, but typically occurs one to three days after the sap has come into contact with your child’s skin and they may then develop the typical linear rash with vesicles and papules that are itchy, red and swollen. Poison ivy is most common in people ages four to 30. During the spring and summer months I often see children who have a history of playing in the yard, down by a creek, exploring in the woods etc, who then develop a rash. I love the kids playing outside, but the rash of poison ivy may be extremely painful especially if it is on multiple surface areas, as in children who are in shorts and sleeveless clothes at this time of year. The typical fluid filled vesicles (blisters) of poison ivy will rupture (after scratching), ooze and will ultimately crust over and dry up, although this may take days to weeks. The fluid from the vesicles is NOT contagious and you cannot give the poison ivy to others once you have bathed and washed off the sap. You can get poison ivy from contact with your pet, toys, or your clothes etc. that came in contact with the sap, and have not have been washed off. If you know your child has come into contact with poison ivy try to bath them immediately and wash vigorously with soap and water within 5

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Daily Dose

Too Much Tanning

1.00 to read

With my previous posts on sun safety, I thought that it was a good time to discuss those who don’t heed the warnings about the risks of overexposure to ultraviolet radiation and are addicted to tanning. 

We all saw the pictures of the New Jersey mom who seemed to live in a tanning bed, and the media termed her “tanorexic”. I also take care of plenty of teens who seem to fall into this category as well. They are easy to spot as they are tan throughout the year, even on areas they “shouldn’t be”. 

There is actually data to show that tanning changes brain activity.  Researchers at University of Texas Southwestern Medical Center did a study with participants who used tanning beds.  They found that brain activity and blood flow in tanners is similar to that seen in people addicted to drugs and alcohol.  The rewarding effects in the brain may be due to an opiod release that occurs during tanning.  If frequent tanners missed tanning sessions they experienced withdrawal like symptoms and related that they were compelled to continue the tanning behavior. 

While UVA and UVB radiation both play a role in the development of skin cancer, artificial ultraviolet radiation (UVR) is used most commonly in tanning beds and sun lamps. Compared with solar radiation, artificial UVR contains 10 to 15 times the amount of radiation.  This is concerning as there are more than 1 million Americans (many of whom are teens) who use artificial tanning methods each day, putting them at even more risk for the development of skin cancer. 

If estimates are correct and more than 25% of lifetime sun exposure occurs within the first 18 years of life, avoiding artificial tanning would seem to be prudent. There are melanoma studies showing that artificial UV light exposure increases the risk of developing melanoma by 74% so why would you allow your teen to tan?  In many states bills have been passed to regulate  tanning access to minors.  But even with these laws in effect, some parents continue to “sign” to allow their children to tan, I know this from my own patients.  

So, while tanning may make you feel “good” for the short term, like many other things in life it is not good for the long term. Just another topic for discussion with your teen. 

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

Daily Dose

The Joy of Fun Summer Activities

1:15 to read

While doing summer checkups and discussing everyone's summer plans I started thinking that I should really be asking about some of the basics like summer and all of the wonderful activities to do. We have talked about swimming and camps and staying abreast of academic work, but what about the basics of summer? The good, old-fashioned leisure time activities that we all used to do. While doing summer checkups and discussing everyone's summer plans I started thinking that I should really be asking about some of the basics.

So here are the things that come to my mind: Basic summer skills for all of us to remember and to teach. All of this is free, easy and are really akin to life skills that all children should probably master at some point in their childhood.

  • Jumping rope
  • Riding a bike (of course with a helmet)
  • Skipping a stone
  • Pumping a swing
  • Blowing bubbles
  • Catching a ball
  • Throwing a ball (don't think I have still mastered this, wonder if it is too late?)
  • Turning a somersault
  • Playing hopscotch
  • Playing four square
  • Learning how to float on your back
  • Fly a kite
  • Catching fire flies

Don't feel pressured to do this all at once, as childhood is a long time. But enjoy the time spent with your children accomplishing these simple pleasures. Why don't you let me know things that you think of and that you feel are essential skills of summer? I am sure I have missed many. That’s your daily dose, we’ll chat again tomorrow.

Send your question or comment to Dr. Sue!

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Daily Dose

Hot Car Deaths

1:30 to read

Did you know that heat stroke is the second leading cause of non-traffic fatalities among children, with the first being backover deaths.  As the summer temperatures are rising these tragic accidents become all too frequent.  

My home state of Texas leads the country in child vehicular heat stroke deaths, followed by Florida and California.  But children who are trapped in vehicles have died in milder climates as well. The temperatures outside may be as low as 60 degrees, but the inside of a car heats up quickly, with 80% of the increase in temperature happening in the first 10 minutes. The reason for this is due to physics.....the sun’s short-wave radiation is absorbed by dark dashboards and seats...the heated objects including child seats then emit long wave radiation which heats a vehicle’s interior air.  All of this leads to tragedy.

A child’s thermoregulatory system is not the same as an adult’s, and their body temperatures will warm 3 -5 times faster.  When a child’s body temperature rises to about 107 degrees or greater, their internal organs begin to shut down.This scenario can then lead to death. If you see a child who has been left in a hot car call 911...every minute matters.

The greatest percentage of these tragic deaths are totally unintentional.  These parents are not “bad parents” or “child abusers”, they are loving, good parents who simply forgot that their child was in the car. On average there have been around 37 deaths per year due to vehicular heat stroke and in most cases this is not due to reckless behavior but simply to forgetfulness.  Parents and caregivers both admit to “just forgetting” a child was in the car.  It truly can happen to anyone.

So, how can you remember that your precious, quiet, sleeping child is in back seat. Make it a routine to always look in the back seat before you lock and leave the car.  Try putting your purse, briefcase, or cell phone in the back seat as a reminder to look for your child. Lastly, if your child is in childcare, have a plan that the childcare provider will call you if you have not notified them that your child will not be coming to school,  and they don’t show up.

Daily Dose

Stop Bugs from Biting!

1:30 to read

We are in the throes of mosquito season and with concerns about Zika, West Nile Virus and ckikungunya it is a good time to revisit insect repellents.  The mosquito threat from Aedes mosquitos is especially relevant in the southern and southeastern parts of the United States as these are the mosquitos which carry both Zika and chikngunya. The Culex mosquito species which carries West Nile Virus has been found in all of the continental United States. 

One of the best way to prevent disease is by controlling the mosquito population which means eliminating areas where mosquitoes breed. This means draining standing water!! I find myself outside draining flower pot saucers after watering or an unexpected summer thunderstorm. I am also always changing the dogs water bowl. I am trying to be vigilant about eliminating standing water.

It is also important to try and limit exposure to mosquitos during dusk and dawn which is the prime time for getting bitten, but with that being said, the Aedes mosquitoes seem to be around all day. Wearing protective clothing which is light in color with long sleeves and long pants is  helpful, but is hard to do when it is over 100 degrees everyday and your children want to play outside. 

So, insect repellents are an important part of protecting your children from bites and possible disease exposure ( although children typically do better with these mosquito born viruses than pregnant women, adults and the elderly). There are many products out there to choose from but the insect repellents with DEET have been studied for the longest period of time.

When picking an insect repellent you want to make sure they have been proven to work (efficacy), they should be non-irritating and non toxic and preferably won’t stain your clothes. Cost is also an important consideration.

DEET has been the most widely used ingredient and has been studied and has good safety and efficacy data. DEET works not only against mosquitoes but also ticks, chiggers, fleas, gnats and some biting flies.  Repellents contain anywhere from 5 - 100% DEET, but the AAP recommends that children use products containing up to 30% DEET. There is no evidence that DEET concentrations above 50% provide any greater protection. DEET has also been shown to be safe when used in pregnant women which is particularly important with possible Zika exposure.

Picardin is another repellent that has been widely studied. It comes in concentrations of 5-20% and is odorless, does not damage clothing and has low risk for skin irritation.  The AAP recommends using products for children that contain up to 10% picardin. 

Oil of eucalyptus has been shown to be effective in preventing mosquito bites but it is not approved for use in children under 3 years of age.

Citronella and other oils have shown very little efficacy against mosquito bites and are not recommended.

So, when choosing a product I would start with a lower DEET or picardin concentration depending on your child’s exposure and go up in concentration as needed. Typically, the higher the concentration of DEET or picardin the longer the protection. As you know, some people seem to be bitten more often than others (all sorts of hypothesis about this) so you may use different products on different family members depending on age, frequency of getting bitten and expected exposure ( i.e.. playing in the yard vs a camping trip).

Once again, start reading the labels and then apply the repellent to skin and clothing. Do not use a combination insect repellent and sunscreen, they should be applied separately.  After the kids come in from playing at the end of the day a good bath with soap and water is important  to wash off the repellent.

Daily Dose

Water Safety

1:15 to read

I was reminded of the importance of pool safety after watching the news and hearing that 3 children were found in a nearby apartment pool, under water and unresponsive.  

There are about 3,500 fatal unintentional drownings per year, which is about 10 deaths per day.  Drowning is the second leading cause of death in children ages 1-14 years.  For every child who dies from drowning, there are 4 non-fatal drowning victims who suffer severe and life changing injuries.

Drowning is preventable!!  Although many people think of drowning victims screaming and yelling, drowning is actually quick and silent.  It only takes seconds (the time to grab a towel, or answer the phone) and a child may become submerged. Most drownings also occur in family pools.  Because I have always had a fear of drowning we did not build a pool until our boys were all older than 10 years and were excellent swimmers ( was I a bit over zealous with swim lessons and swim team, maybe...)?  Children as young as 2-3 years can safely begin swim lessons and begin the process of mastering how to tread water, floating and basic swim strokes. 

Another rule for safe swimming is “never swim alone!”.  Teach your children the importance of the buddy system when they are swimming, even in a backyard pool. Adults need to be designated “water watchers” and know that they are responsible for watching the children in the pool and will never leave them unattended. The “water watcher” should regularly scan the bottom of the pool, and will need to have a phone at the pool for emergency use only.  Adult water watchers have only 1 job...to watch the pool, no poolside chatting or distractions. It is a big job!

Anyone with a pool or who is a caregiver of children who are swimming needs to become CPR certified.  CPR skills can save lives and prevent brain damage.   

Lastly, if you have a pool you need layers of protection - which  means a barrier around your pool. I have heard many a family tell me that their child “could never get out the door to the pool, it has several locks and an alarm”.  Despite the best of intentions, no parent can watch their child 24 hours/day.  Toddlers have been known to push a stool over to unlock a door, or a door is inadvertently left unlocked or ajar. Remember, it only takes seconds for a child to become submerged. 

By the way, I am following my own advice and a pool fence is going up to protect our granddaughter...the bigger the better.

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