In the News
December 15, 2011
MMR VACCINE IS SAFE
A study from Canada examining the records of over
270,000 children showed that there were no serious adverse reactions
to the MMR vaccine. Eight to 12 days after the shot, there were
reactions common to the vaccine such as fever and a slight rash.
Those reactions are actually evidence that the vaccine is doing its
job and children are creating immunity to the infections
COMMENT:
There is no reason to delay or refuse the MMR,
even though we have a few patients who do this. There have been
outbreaks of measles in the US and it is just a matter of time
before some unfortunate child dies from it.
The absurd assertion that it can cause autism has been disproven
over and over. This study is reassuring about side effects.
December 5, 2011
ATVS ARE DANGEROUS TO CHILDREN
There are approximately 9 million ATVs in the US
weighing an average of 600 pounds. There are 900 deaths each year
from ATVs, almost half of them in children. In addition, 35,000
young people need to be seen in emergency rooms and about 3 out of 4
have multiple injuries that can lead to life long problems.
The American Academy of Pediatrics, the Academy of Orthopedic
Surgeons and American College of Surgeons all recommend that these
vehicles only be used by children over age 16 The ATV industry, on
the other hand, suggests limiting engine size to less than 70 cc for
children 6-11 and less than 90 cc for those 12-15.
COMMENT:
We have seen our share of serious ATV injuries.
The industry itself does not want to lose business so they pare down
the engine size recommendations. Just think, however, if you would
let your 6 year old drive a car.
ATVs go fast over dangerous, irregular terrain. There is no exercise
involved. Please think about hiking with the family instead.
November 28, 2011
Snug This Winter
November 1, 2011
OUTDOOR TIME MAY HELP CHILDRENS VISION
Studies that involved over 10,000 children looked
at time spent outdoors as well as time spent doing near work such as
studying and computer games and the relationship to near
sightedness.
Near sighted children spent an average of 3.7 fewer hours per week
outdoors than those with normal vision or far sightedness. Each
additional hour of outdoor play reduced the chance of
nearsightedness by 2%. There was no relationship to time spent in
near work.
COMMENT:
At least close work does not impair vision. Reading in a poorly lit room does not either, despite what my mother said.
October 30, 2011
CHANGING DIET IN CHILDHOOD HELPS ADULT HEALTH
Researchers in Philadelphia studied adults nine
years after they participated in a dietary study. They had been
encouraged to lower fat consumption and increase fiber by eating
fruits, vegetables and whole grains.
Few study participants met the criteria for metabolic syndrome belly
fat, high cholesterol and triglycerides and high blood sugar and
blood pressure. Compared to those who did not participate, blood
pressure and blood sugar was significantly lower in those who were
part of the intervention.
COMMENT:
The problem with childrens health is we have to make sure that what we are doing really has a positive effect later in life. More studies like this will come out in the next years. Following people forward has much more validity than asking them to recall what they ate, or did.
October 9, 2011
STAND UP DESK BURN CALORIES
Four first grade classrooms in Texas were
enrolled in a study in which two classes used desks at which
children could stand or sit. What the children chose to do was up to
them. The other 2 had conventional desks. The children wore arm
bands to measure physical activity and calories burned.
Among the students with the stand up desks, after 12 weeks, 70%
chose to stand all the time and 30% stood for 75% of the time. More
importantly, the stand up students burned 17% more calories than the
sitting students, and those who were overweight burned even more.
COMMENT:
The only negative is that the standup desks are more expensive than the traditional ones. However, just think of all the fidgeting that this might relieve. They did not study academic performance differences but I have a feeling that less motionlessness and sleepiness and more physical activity might also have an effect.
September 19, 2011
FLU VACCINE IS SAFE OVER THE LONG TERM
We know in the short term that flu vaccine is
safe, but what about the multiple doses children receive over years?
A study from multiple teaching hospitals around the US analyzed
66,000 children between age 2 and 5 from 2002 to 2006 who received a
total of 91,000 vaccinations.
They investigated the rate of medically attended events, or
reactions serious enough to require medical intervention. The only
significant finding was a handful of children developed allergic
reactions to the vaccine after the fifth dose, which is found with
any multiply administered substance.
Another study from the Centers for Disease Control found that of the
115 children who died from flu related causes last year, less than 1
in 4 had been vaccinated.
COMMENT:
The major issues of reactions were soreness at
the injection site. Some children showed fever or stomach problems
1-3 days following the injection.
The point is that flu vaccine is safe and effective. Even normally
healthy children can die from the flu. Please come in if you have
not already.
September 1, 2011
GOOD NEWS ABOUT BANANAS
Bananas are often one of the first foods we feed
children and most of them continue to like it.
Researchers at the University of London studied 2600 children
between 5 and 10 and tracked them to see who developed asthma
symptoms. Those who ate a banana a day were 34% less likely to
develop wheezing.
COMMENT:
I do not know if they factored in how likely children were to develop asthma based on family history and their own allergy history. Nevertheless, it can't hurt to have a banana.
August 1, 2011
CHICKENPOX VACCINE HAS SAVED LIVES
Before the chickenpox vaccine was licensed in
1995, there were 3-4 million cases of chickenpox each year. What
many people do not know is that more than 100 died and 11-12,000
cases were hospitalized for serious complications.
Since the vaccine entered the picture, there has been a 97% drop in
the death rate. Even more impressive is the fact that no infants
under one year died of the disease. This age is particularly
susceptible to serious complications and they are not yet immunized.
That means that the vaccinated population is protecting the most
vulnerable.
COMMENT:
We still experience some reluctance from parents
to vaccinate their children for an illness that the parent had and
survived with no complications. Even if you just consider the
discomfort of the child, lost sleep and prolonged work absence
necessary for parents to care for children with chickenpox, it makes
sense. Parents who are not immune risk serious illness as well.
Also, vaccination makes it much less likely that the child will get
debilitating shingles later in life.
July 30, 2011
EXERGAMING MAY GET YOUR COUCH POTATO UP
Video games have been one of the suspects in the
obesity epidemic. Getting your screen addicted child up and moving
to help prevent overweight sometimes falls on deaf ears or is a
losing proposition with a child already overweight.
Researchers at Brigham Young University and the University of
Massachusetts compared treadmill walking with various active video
games such as Nintendi Wii, Dance Dance Revolution and others. They
found that not only was there significant energy expenditure with
these games but it made no difference if children were overweight or
not.
COMMENT:
This study only measured energy used over 10 minutes of intense play. Nevertheless, an active video game, especially one that involves the whole family, cannot be anything but good.
July 27, 2011
HELP FOR THE WANDERING CHILD
Some children, especially those who are autistic
or otherwise mentally handicapped as well as adults with dementia
are at risk for wandering. They may leave the house unobserved,
leave your side outside or just disappear. If they are lost, the
first 24 hours are crucial.
A bracelet called the EmSeeQ is available either as a watchband type
or one that requires two hands to remove.
When the wearer wanders off, a toll free hotline activates the
device and emergency personnel can trace the person.
It costs about 25 dollars a month for the service as well as a
modest cost for the device.
For more information, visit
www.emfinders.com.
COMMENT:
It seems to me that this is a solution before a problem develops.
June 29, 2011
IF YOU WANT YOUR CHILD TO SLEEP, TURN OFF THE ELECTRONICS
A study of 612 children from age 3 to 5 found
that some sleep problems can be related to video games and tv at the
end of the day.
The more time they spent watching tv or playing video games, the
more likely they were to have difficulty falling or staying asleep.
There was also a difference in the timing: those who spent 30
minutes or more with electronics after 7 pm were more at risk for
sleep problems than those who were exposed earlier in the evening.
Sleep problems were even more common for children who had
televisions in their rooms.
COMMENT:
The American Academy of Pediatrics and Valencia Pediatrics recommend that no children have televisions in their rooms. Also, bedtimes should be a time to wind down. Baths, reading a book and quiet conversation are much more conducive to sleep than the rapidly changing lights of a screen. Also, if there are children of various ages, the shows watched tend to be for the older children. The younger ones may experience more scary or disturbing images that can disrupt their sleep.
June 17, 2011
GOOD NEWS ABOUT HPV (THE CERVICAL CANCER) VACCINE E
A report from Australia compared cervical abnormalities in women from 12 to 26 years before and after the introduction of the hpv vaccine. The incidence of abnormalities fell by 50% in those vaccinated under age 17 but not in the older age groups. The study was conducted several years after the introduction of the vaccine.
COMMENT:
There are still parents who are reluctant to immunize their teen aged girls. It is important for you to understand that 1) the immune response is better in younger women, 2) it takes approximately 10 years from exposure to the virus before cancer appears and 3) even if your daughter remains a virgin till her marriage, chances are her husband is not. For all those reasons, please vaccinate your daughters.
June 10, 2011
"Don't let swimmers ear keep you out of the water"
June 6, 2011
ENERGY DRINKS AND SPORTS DRINKS FOR CHILDREN
Sports drinks like Gatorade that are designed to
replace water and salts lost with vigorous exercise are fine for
children and teens if they have a lot of aerobic activity. As a
beverage to accompany lunch, however, they are not appropriate.
Because of the sugar content, they can add to excess calories. Water
or milk are just fine.
Energy drinks, on the other hand, should not be taken at all by
children and teens according to the American Academy of Pediatrics.
Some of these contain more than 500 mg of caffeine, the amount in 14
cans of caffeinated soda. In addition, manufacturers add chemicals
that boost the effect of caffeine.
Side effects of so much caffeine include rapid heart rate, elevated
blood pressure, sleep problems, and concentration issues. Half the
overdoses of caffeine reported in 2007 were in people under 19,
although how many were due to energy drinks is not clear.
If your child is tired, arrange for more rest, not an energy drink.
COMMENT:
I just watched the French Open tennis match and there can be few sports with more exertion than that. The competitors, as far as I could tell, drank water on the sidelines. Take a tip from them and use water for your little athlete.
April 24, 2011
GOOD NEWS AND BAD NEWS ABOUT TEEN PREGNANCY
The good news is that the teen birth rate in the
US is the lowest it has been for decades. It has declined 37% over
the past 20 years.
The bad news is that 400,000 teens still give birth and the US is as
much as 9 times higher than similar countries. Almost half of teens
report that they have sex and 14% of girls and 10% of boys do not
use birth control.
COMMENT:
The teen pregnancy rate in Holland is close to
zero, and it is a socially and politically liberal country. Why? One
of the reasons is that sex is treated like any other topic of
conversation with families. They publicly advertised birth control
40 or 50 years ago when the US was still afraid to even talk about
it.
Study after study shows that the more teens know about sex and birth
control the longer they delay it and the fewer partners they have.
Do not think that you had the one conversation and said, “Don’t do
it’” and your job is done.
You can bring up the topic indirectly: “What do your friends think
about having sex at this age?” “Have any of your friends had sex?
How do you feel about that?” We know it is difficult for parents to
deal with this but being as open as you can manage will protect your
child.
April 11, 2011
THIRD HAND SMOKE AFFECTS CHILDREN
We all know about second hand smoke especially
living in California. Third hand smoke is the residual chemicals in
clothes, hair and skin.
Investigators studied 252 children under 18 months who lived with
smokers. They measured nicotine levels in childrens hair. Even if
the parents restricted smoking to other rooms or next to open
windows, 83 percent of the childrens hair samples showed nicotine
levels.
COMMENT:
Several years ago I was asked if the odor of tobacco smoke that clings to a smoking grandparents clothing was harmful to a child. At that time, we did not know about third hand smoke; my answer at the time was that it might make the smell of tobacco pleasant and comforting to a child. Now we know that it is also harmful.
March 28, 2011
BREAST FEEDING GIVES MOTHERS THE SAME SLEEP AS BOTTLE FEEDING
New parents are generally sleep deprived just by
virtue of having a new baby who does not respect night hours. Do
breast feeding mothers get less sleep than those feeding their
infants formula?
A study involving 80 mothers, mostly white, married and well
educated, were studied when their infants were 2 to 13 weeks.
Infants were breast fed, formula fed or both. Although 70% of
infants were exclusively breast fed at the beginning, that dropped
to 34% at 12 weeks, which parallels the general population.
COMMENT:
The study involved sleep time, quality of sleep
and daytime fatigue among other factors.
There was no difference among the three groups. In other words,
whatever feeding method you choose, you are going to be just as
tired.
March 1, 2011
VITAMIN D AND ALLERGIES
Research at Einstein College of Medicine showed
that children with low levels of vitamin D have an increased chance
of allergies. They studied over 3,000 children and 3,000 adults.
This did not hold true for adults but it did for children.
Children and adolescents were 2.4 times more likely to react to
ragweed, oak, dog, cockroach and foods such as peanuts compared to
those with normal levels of vitamin D.
COMMENT:
The requirement for 400 units of vitamin D daily
for children and adults was established decades ago. While the study
was well run, it was done in Denver, with a more powerful sun
exposure than in most urban areas. Also, we have encouraged parents
to slather sunscreen on children, preventing the action of sunlight
on skin to convert vitamin D.
The current recommendation is for at least 600 units/day. If your
child is not a milk drinker, ask us about checking levels and
recommending a supplement. Low levels of vitamin D in adults is
associated with several issues, including diabetes, osteoporosis and
some neurological issues.
February 23, 2011
MIXING CAFFEINE AND ALCOHOL IS NOT SAFER
Young people are drinking alcoholic beverages
containing caffeine in the belief that the caffeine will mitigate
the effects of alcohol.
In a laboratory study, those who drank beer containing caffeine
performed no better than those with similar alcohol levels without
caffeine.
COMMENT:
Besides trying to reduce the effect of alcohol,
teens are taking energy drinks to give themselves a boost.
Some of these contain several times the caffeine in a cup of coffee.
While too much coffee is a health hazard, at least coffee is usually
consumed hot and more slowly.
Caffeine can raise blood pressure, disturb sleep and, among pregnant
women, can increase risk for miscarriages, stillbirths and
underweight infants. In addition, the false sense of security by
drinking caffeine and alcohol can lead to engaging in risky behavior
such as driving.
February 20, 2011
VAPOR RUB DOES HELP
A study of 138 children between 2 and 11 years
with colds showed that rubbing their chest with a vapor rub allowed
them to sleep better.
The study had some children given no treatment, some with plain
petroleum jelly rubbed on their chests and some with the vapor rub.
In order for parents to not be able to tell if they were using the
active rub or a placebo, they were instructed to rub some of the
vapor rub under their noses before treating their children.
Although the camphor in the vapor rub can be toxic to a child, they
would have to ingest about 4 teaspoons for a child under 6 to be
harmed. Some mild skin irritation was seen with the vapor rub.
COMMENT:
We know that the side effects of cough and cold
preparations make them unacceptable for small children, Not only
does this study show some benefits of the rub, but it might mean
better sleep for parents of a child with a cold.
Does this translate to any benefit from putting the same chemicals
in a vaporizer? That study has not been done.
February 2, 2011
ANOTHER REASON TO STOP SMOKING
A study from Germany found that children who live
with second hand smoke have higher blood pressure in childhood.
They studied over 4,000 4-7 year olds and found significant
elevations in blood pressure in those children who lived with smoke.
This elevation was true even in the face of other risk factors such
as overweight and was greater in those whose mothers smoked during
pregnancy.
High blood pressure in childhood has been shown to continue into
adulthood.
COMMENT:
Third hand smoke is now described the chemicals
that cling to fabrics and hair give toxic chemical to children as
well. When I enter an exam room I can smell tobacco smoke and
immediately ask, Who smokes?
If you smoke, it increases the likelihood that your child will as
well. There are so many programs for support while you stop the
Industry Health Network, for example, has a program called Picture
Quitting, California has 1-800-NOBUTTS. Just taking a medicine or
applying a patch or chewing nicotine gum, while helpful, is not as
effective as a program that offers support and guidance through the
process.
January 5, 2011
CHICKENPOX VACCINE IS IMPORTANT
Most people with chickenpox are merely miserable
with itching, headache, fever and blisters all over. Although the
vast majority recover without problems, a certain number will
develop pneumonia, brain inflammation (encephalitis) and serious and
potentially life threatening skin infections.
The Center for Disease Control compared the number of
hospitalizations before and after the introduction of the chickenpox
vaccine. The number decreased by over 70% in both children and
adults after the vaccine was widely given.
COMMENT:
The week we received our first shipment of the vaccine we had 2 children in UCLA on respirators because of complications of chickenpox. Many parents express doubt about how necessary this vaccine is after all, they had it as children and they recovered. While the numbers for serious complications are lower than for diseases like measles or HIB meningitis, wouldnt you want to protect your child from serious illness?
January 2, 2011
TEEN AGERS LIE (ARE YOU SURPRISED?)
Two studies came out about the same time. One
checked on how accurate adolescents reporting of drug use was and
the other whether teens who claimed to be celibate had sexually
transmitted diseases.
Adults have been shown in the past to under report their drug use. A
study from Childrens Hospital of Michigan screened 400 youths at age
14. There was a strong reassurance from teens that their information
would be confidential and not shared with parents. Nevertheless,
biological markers for tobacco, cocaine, alcohol, cocaine, marijuana
and opiates showed that use was many times more than they admitted
to. In addition, parents often did not know even when those teens
admitted to drug use.
A study of 14,000 young people conducted at Emory University
screened them for gonorrhea, Chlamydia and trichomonas. The vast
majority of positive tests came back from teens who admitted having
had sex. However, 60 of 118 young people who said they had never had
intercourse tested positive.
COMMENT:
Some parents are reluctant to give children the
HPV vaccine, for example, because the children have pledged not to
have sex until they are married. Even if that child abstains, the
partner they marry may be carrying HPV because they forgot or are
afraid to admit to having sex in the past.
The interesting thing is that over and over studies show that the
rate of STDs is about the same for children who pledge virginity
till marriage and those who do not. Abstinence pledges do not work.
What does work is medically accurate education and open discussion
within the family that goes beyond "Just don't do it". Planned
Parenthood has a good book called Lets Talk About S-E-X.
December 15, 2010
GOOD NEWS AND BAD NEWS ABOUT TEEN DRUG USE
The good news is that binge drinking in teens is
the lowest at any time since 1975. Tobacco use has declined compared
to the 1990s although it has not budged for several years. The bad
news is that marijuana use has exceeded tobacco use in grades 8, 10
and 12 and continues to rise.
Other drugs such as OxyContin and ecstasy have also increased.
COMMENT:
The debate over legalizing marijuana may
contribute somewhat to childrens attitudes toward marijuana but that
is not the culprit. Drugs are easy to score on any junior high and
high school campus. This places our children, whose brains are still
developing, at increased risk over adults for long term effects.
Why do some children use and others dont? The answer is complicated,
some teens are masking anxiety or depression, some are pressured by
peers, some are trying to deal with divorce, school problems or
other stressors. If there is a family history of drug or alcohol
problems your child is at increased risk.
The important thing is to be vigilant and pay attention if your
child is withdrawn, starts doing poorly in school, seems not to
enjoy what was previously a source of fun or shows any other signs.
Trust your instincts and, if you are concerned, check it out.
December 8, 2010
LOW SUGAR CEREALS WIN AGAIN
We all know that many children love high sugar
cereals. If we feed them low sugar cereal, does the sugar they add
eliminate their value?
Half of the children at a summer camp were given sugared cereal and
the other half low sugar cereal and allowed to add as much sugar and
fruit as they wanted. The children in the high sugar cereal group
consumed twice as much sugar as those who ate low sugar cereal and
those children were also more likely to add fruit to their bowls.
COMMENT:
Remember that you are the authority for what food comes into your house. Resist the tantrums your offspring may throw in the cereal aisle. Even if you allow them to add some sugar to their Cheerios, they are still ahead of the game, especially if you provide fruit as well.
November 8, 2010
DO NOT BE AFRAID OF PRESERVATIVES
Children with eczema, other chronic skin
conditions or diaper rashes need creams and lotions to keep their
skin under control. Many people consider preservative to be a dirty
word and use organic and preservative free creams and lotions for
their children.
However, a recent study showed that those without preservatives can
be a bacterial hot house. Children with broken skin are more prone
to allow bacteria to invade, and using a contaminated product can
increase that risk, especially for staph germs. Even those products
with preservatives can become contaminated, although the risk is
less.
COMMENT:
To reduce the risk:
Always wash your hands before using a product.
Use those with FDA approved preservatives
Avoid contact with the nozzle or opening of the tube (use a piece of
gauze, for example, to apply)
Refrigerate products that do not have preservatives
October 25, 2010
TWO IMPORTANT WARNINGS FROM THE FDA
The Food and Drug Administration issued two
warning recently:
Sleep positioners are touted by their manufacturers to keep infants
on their backs and prevent SIDS. The reverse is true. They can
actually suffocate babies when they roll over and catch their faces
under the pillow or between the pillow. The risks far outweigh the
benefits.
I saw one product that said on the package something like:
To keep the baby in the position APPROVED BY THE AMERICAN ACADEMY
OIF PEDIATRICS. This implies the product is approved and that is not
true.
The FDA says We don't think parents should buy them, we don't think
they should use them, we don't think stores should sell them, we
don't think manufacturers should make them.
The other warning is that sale of over-the-counter chelation agents
which have been touted for treating ailments such as autism and
heart disease are illegal.
COMMENT:
Medical chelation has been used appropriately for heavy metal overloads such as lead, iron, etc. Although chelation has not been proven to help in autism, some doctors use it for patients. Although this is an off-label use, at least it is being done under medical supervision. For a list of the manufacturers involved go to News releases, FDA, October 14, 2010.
October 19, 2010
ATVS ARE NOT FOR KIDS
There has been a 150% increase in serious
injuries from ATVs in children under 17 from 1999-2006.
ATVs are dangerous for children because of poor stability with high
centers of gravity, low pressure tires and heavy weight. Although
adult sized ATVs are not supposed to be sold for childrens use, an
undercover investigation showed that only 63% of dealers followed
that recommendation. Seven out of ten dealers in one survey sold
adult vehicles for 12-13 year old children.
From 1982 to 2008 there were over 500 deaths in California from
ATVs, 95% in children under 17.
Although helmets save lives, an abysmally low percentage of riders
wear them. The state of California only requires them on public
lands.
COMMENT:
I personally think that children should not be allowed to drive anything including ATVs, Jetskis and any other motorized machine until they are old enough to drive. Do you really think that it is worth risking your childs life to bounce over dunes?
September 23, 2010
CHARACTERS AFFECT CHILDREN'S FOOD PREFERENCES
Three to six year olds were presented with graham
crackers, gummy snacks and carrots. They tasted 2 samples of each,
one with a character like Dora, Scooby Doo or Shrek and the other
without. Just over half the children preferred the taste of the
sample with the character but 3 out of 4 said they would want their
parents to buy the one with the character.
This is consistent with an earlier study of three year olds in a
similar experiment. They were presented with carrots, hamburgers and
french-fries. They overwhelmingly preferred the ones in Mac Donalds
wrappers, even though the foods were the same.
COMMENT:
Besides the fact that many of us consider advertising to children unethical from the get go, these studies illustrate the subversive effect that advertising can have on childrens diets. Please limit television and do not give in to products that are sold with characters that are calorie dense, nutrition light.
September 13, 2010
CAR SEATS ARE A HAZARD OUTSIDE OF THE CAR
The Consumer Product Safety Commission studied
injuries to children related to car seats that were not involved in
car crashes. Between 2003 and 2007, over 43,000 injuries were
treated in emergency rooms. The average age at injury was 2-4
months. Half occurred at home and the vast majority had head
injuries.
The most common reason for injury was falling out of the seat,
falling from elevated surfaces and overturning on surfaces such as
the floor.
COMMENT:
Car seats save childrens lives but they are not intended to be used anywhere else. Putting your infant on the kitchen counter in the car seat or any seat for that matter, is a recipe for disaster. We see infants who have been hurt like this and it is preventable.
August 18, 2010
BACK TO SCHOOL/BACK TO LICE
Lice are an unavoidable complication of school
days. Although they are contagious and disgusting, first of all
realize that they do not cause any disease. Lice do not jump or fly;
they crawl, so sharing combs, hats, batting helmets and other
materials transmit it. Make sure that you are not seeing flakes of
dandruff that can be mistaken for lice. If you are not sure, come
in.
First try the over the counter treatments. Use as directed and
repeat the treatment at day 9. Use a fine-toothed comb, which
usually comes with the treatment, to remove the “nits”, or egg
cases, from the child’s hair. Wet combing with water or Cetaphil
lotion is usually effective. If over the counter treatment does not
work, call for a prescription.
The American Academy of Pediatrics has issued a statement that
reiterates their position that schools should not have a “no nits”
policy, in which they refuse to allow a child back who still has egg
cases on the hair. It is unnecessarily harsh and excludes children
from school when they might miss important segments of their
education. If the nits are an inch or so from the root of the hair,
the egg cases are dead.
COMMENT:
Parents have told us that they have used treatment for 3 or 4 or even 7 days in a row. Not only is this ineffective but it can cause the lice to become resistant to treatment and can be irritating to the scalp. Use the treatments only as suggested and control your disgust.
July 26, 2010
WHY YOUR TEEN STAYS UP LATE AND CANNOT GET UP IN THE MORNING
During the teen years, most children should get
about 9 to 9.5 hours of sleep. The problem is that the daily energy
cycle in teens is different from younger children. They have their
peak energy in the late evening. Then they have to get up at 6:30
for school. Sleeping late on the weekends does not help and can even
be counterproductive for their sleep/wake cycle.
The consequences of sleep deprivation include poor grades, driving
accidents, overweight and a dependence on stimulants like caffeine
to get through the day.
Numerous studies have shown that allowing teens to start their day
later improves these issues. The problem is often that after school
activities and part time jobs depend on the time school is over.
A study from a Rhode Island high school delayed the start time by 30
minutes and shortened the time for non-academic programs by 5-10
minutes so as not to extend the school day. This relatively slight
change produced a marked change in the students; they reported less
daytime sleepiness, less depression, better motivation. Some
students, when seeing how much better they felt, actually made sure
they got more sleep every day.
Although school officials are notoriously reluctant to change
routines, the teachers and administrators noticed the improvement in
students and voted overwhelmingly to continue the 30 minute delay.
COMMENT:
This change does not solve all the problems of tired adolescents. For example, some of them still did not get enough sleep and many still overslept on the weekends, making Monday mornings unchanged. Nevertheless, it seems to me one small step to improve the chaos of adolescent life.
July 19, 2010
TO BANK OR NOT TO BANK
If you are pregnant you have probably received
solicitations from for profit companies offering to arrange to save
your babys cord blood. It may be touted as biological insurance. I
recently received an email from a former patient who moved away.
(Grand patients are one of the blessings of a long career.) She
wanted to know whether she should opt to bank her babys cord blood.
She was confused because she couldnt find any consensus among
authorities. The reason she could not find a consensus is that as of
now there is none.
Should you do it? Cord blood contains stem cells, that can be
transplanted to treat blood, metabolic, immunologic or malignant
disorders. They are not useful for a vast array of medical
conditions yet although in the future that will probably change. As
of now, the disorders for which stem cells are useful are a few
specific conditions. If a child develops leukemia, for example, his
or her own cells are not useful because those are already programmed
to turn into leukemia; those of a matched sibling without leukemia
might be.
There are various studies around the country examining the
usefulness of cord blood stem cells in other conditions. For
example, the Medical College of Georgia is studying whether
infusions of stem cells can help children with cerebral palsy.. As
more and more of these are reported to be successful, cord blood
will be more desirable. The chances of a child needed his or her
own stem cells is quite small. However, the probability of someone
else being able to use those cells is more and more common.
Saving cord blood for possible future use is a highly individual
decision. If your family has a history of certain genetically
transmitted diseases or malignancies, talk with your pediatrician
and/or a genetic counselor. Seek information from a specialist
treating the disease that runs in your family. If you are not at
high risk, the choice is not clear. The chance of needing these
cells with no risk factors is estimated anywhere from 1 in 5,000 to
1 in 100,000. Not zero but not high.
COMMENT:
Private cell banks charge an initial cost and a
yearly maintenance fee, which are not inconsiderable. Also, private
stem cell banks are not rigorously controlled, so some units have
been contaminated, have low cell counts or are otherwise unusable.
Public cord banks collect the blood, store it in a central location
and list it on the Be The Match Registry where it is available for
patients who need transplants. The public banks do not charge for
collection and storage but only charge for matched patients who need
a transplant. Go to
http://bloodcell.transplant.hrsa.gov/ or
www.bethematch.org.
The American Academy of Pediatrics (AAP.org) has a detailed section
for parents with a list of questions and answers (Healthy
Children.org/cord blood banking). If you want to save your babys
cord blood you must prepare for it before your due date so the
delivery room is set up to capture it. Several weeks before give the
information to your obstetrician and to the hospital where you will
deliver. If there is a life threatening emergency for you or your
baby around your delivery the procedure may fall by the wayside.
If you have a good amount of disposable income and want to do it
privately without a medical reason, fine. But if it is a sacrifice
and you do not have a medical history that makes it advisable, think
twice before going the private route but do consider the public
option.
June 26, 2010
WHOOPING COUGH MAKES A COMEBACK
Whooping cough (pertussis) is deadly for infants.
It not only makes them devastatingly sick and puts them in the
hospital for weeks, but it can cause lung and brain damage and can
kill them. Unlike polio, which has been almost completely eradicated
in the Western world, pertussis is alive and well and dwells in the
coughs that older children and adults get. Although most have been
vaccinated, immunity to pertussis wanes over the years.
The first series of vaccines includes pertussis in three DTaP shots.
They are given at 2, 4 and 6 months. The problem is that children
are not immune until they have received all three. Before that,
adults who are carrying the bacteria can infect their babies.
In California, cases of pertussis have quadrupled since last year
and 5 infants, all under 3 months, have died.
COMMENT:
What can you do to protect your children?
Ideally, pregnant women and fathers should receive the
tetanus/pertussis booster vaccine during pregnancy. Your
obstetrician should offer it or you can ask for it. If not during
pregnancy, then get it in the hospital before you go home or at the
latest at the first post partum visit. Older children in the
household, caregivers (including day care workers), grandparents and
any other people in the household should receive it as well,
preferably before the baby comes home or earlier.
April 30, 2010
BEWARE OF INTERNET INFORMATION
Researchers checked out information on the
internet on MMR vaccine and autism, HIV infection and breast
feeding, mastitis and breast feeding, infant sleep position and
managing green vomit.
Less than half (39%) of websites gave accurate information, 11% were
inaccurate, and 49% did not give pertinent advice. The most
inaccurate were sites dealing with MMR and autism and HIV and breast
feeding. News sites were accurate only 55% of the time, and
sponsored sites were uniformly inaccurate.
COMMENT:
Information gleaned from the internet is the bane
of our existence. Parents are often frightened away from or at least
confused about accepted and beneficial treatment for their children.
Please do not just Google something and think the information is
gospel. Sites such as CDC.gov, AAP.org and children’s hospital
websites have accurate and timely information. When all else fails,
ask us.
April 28, 2010
ANOTHER – AND UNEXPECTED – ADVANTAGE OF BREAST FEEDING
A study from Naples, Italy of 450 infants under 3
months who were given their first DTP or Prevnar vaccines showed
that infants who were exclusively breast fed had less than half the
risk of fever after the shots than those who were bottle fed.
Infants who were fed both breast and bottle fell in between.
Parents kept diaries of body temperature and feeding for 3 days
after vaccines. In the breast fed group, 25% of breast fed babies
had fever, in the infants fed both bottle and breast 31% had fever
and in bottle fed babies 53%.
COMMENT:
The reason for this is not apparent and the question remains why this should be. Nevertheless, here is another reason to maintain exclusive breastfeeding in your infant for at least the first 6 months. This is the period when many vaccines are given.
April 08, 2010
IF YOU WANT GRANDCHILDREN, IMMUNIZE YOUR SONS
In 1969, the MMR vaccine (measles, mumps and
rubella) was introduced and almost immediately the incidence of
mumps declined 99% in the US. In the 1990’s, because of the
publicity of an unproven and invalid link with autism and other
disorders, immunization rates fell from 91% to 58% in some areas.
In 2001, there were almost no cases of mumps in England and Wales.
In 2004, there were 56,000 cases. Almost ½ of men who come down with
mumps can have orchitis, or an inflammation of the testicles. This
can lead to reduced or complete infertility. Even if the testicles
do not seem affected, 24% of adults and 38% of teens have abnormal
sperm 3 years later.
COMMENT:
We try to convince parents that the consequences of the diseases we are preventing are thousands of time more dangerous than the few side effects of vaccines. Here is another reason not to withhold the MMR from your children.
March 26, 2010
ARE TOYS VIRUS FARMS?
Parents worry that in pediatric waiting rooms,
just as in preschools and day care centers, toys may be a source for
spreading infection among children. A study from the University of
Virginia examined viral particles on soft and hard toys, books and
magazines in pediatricians’ waiting rooms. About 20% of the toys
harbored virus particles. They persisted even after cleaning,
possibly because there are crevices and hidden spots on some toys.
The longer the viral material was on the toy, the less it was
transmitted to fingers. In other words, fresh viruses are stronger
than stale ones.
This study did not establish, however, whether or not these viral
particles caused infection in the children.
COMMENT:
When we moved to our new office we decided not to
have any toys because it was not possible to keep them clean enough.
We have a heap of books for children instead.
This study found NO viral particles on the magazines and books they
tested. Hooray!
March 17, 2010
DOES YOUR CHILD NEED VITAMIN D?
Although breast milk is the perfect food for
babies, recent studies have shown that the amount of vitamin D they
get may not be adequate.
The current recommendation from the American Academy of Pediatrics
is that infants should get 400 International units/day. Fewer than
1out of 4 babies, both formula and breast fed, receive that much.
Formula is fortified with vitamin D, but a baby must eat more than
34 ounces a day to meet the requirement.
COMMENT:
The studies that I have seen all come from the
east coast, the Midwest or Scandinavian countries that do not have
the extravagant amount of sunlight we have in California. Sunlight
plays a role in manufacturing vitamin D through the skin.
Nevertheless, if you are nursing or if your infant does not drink 34
or more ounces of formula a day, it is a good idea to give a daily
vitamin. The easiest is one that has vitamins A, C and D made for
infants. Give one dropper full directly in the baby’s mouth at a
feeding.
Addendum: a study just
came out (May, 2010) that reported the same findings in Georgia, a
sunbelt state. Therefore it is probably true for us as well.
March 05, 2010
NIGHT TERRORS
By Dr. Mike
About once a week, a parent comes into the office
and asks me about a scary phenomenon: their child has been waking up
at night, frightened and unable to be consoled or comforted. These
are called night terrors, (also called sleep terrors or pavor
nocturnus) and can be very worrisome for parents. The child
seemingly awakens from sleep in a panic, sometimes screaming or
crying and cannot be calmed down. The child might appear confused
and might not recognize the parent. In actuality, the child is
still asleep.
Night terrors are a disorder of arousal, similar to sleepwalking and
sleep talking. They can be inherited and can occur in up to 5% of
children.
They can happen at any age, but are most common from 1-8 years old.
Most children outgrow them. Sometimes they are brief, and sometimes
they can last as long as 30 minutes. They differ from nightmares in
that Night Terrors usually occur in the early part of the night, the
first 4 hours. Also, a child can usually recall what scared
him in his nightmare, while a child usually has no memory of having
a night terror.
Your pediatrician will be able to recognize simple night terrors versus
something that needs further intervention. Night terrors are
harmless and therefore no treatment is usually necessary. They are
often triggered in children who are overtired, so making sure your
child gets enough sleep can help to prevent them. Your goal during a
terror is to try to get your child to return to normal sleep by
trying to soothe or comfort him, but most importantly, protecting
them from injury as they might flail in bed, fall down a stairwell,
or run into a wall. Also, make sure to alert and educate
babysitters of your child’s possible sleep disturbance.
There has been some success to halting night terrors if parents wake
their child up before the usual time of occurrence, thus altering
the child’s sleep patterns. This has to be repeated for a week.
COMMENT:
This topic has personal significance for me, as my 3 year old daughter has been having night terrors for over a year. They do seem to be more frequent when she has not been getting adequate sleep. They are more of a nuisance than anything else, as she wakes the household up during a terror. And, even though we might get rid of her night terrors by altering her sleep patterns, I am sure I speak for a lot of parents when I say that the last thing I would ever do is wake up my daughter once I finally got her to sleep!
March 03, 2010
GIRL ATHLETES ARE WOMEN WINNERS
In 1972, a federal law called Title IX was passed which required equal opportunities for girls in sports. Since that time, six times more girls became involved with sports. Aside from better physical health, we have seen that girls in sports have better grades, higher self esteem and lower teen pregnancy rates.
Two studies, one from the University of Pennsylvania and the other from the University of Illinois, showed that benefits carry over into adult life. At 20-25 years later, sports girls had a 7% lower risk of obesity. That might seem small, but other interventions cannot claim as good an outcome. In addition, educational level and employment statistics were better for girl athletes later in life.
COMMENT:
These are encouraging statistics, but there is
more to be done. While ½ of all boys play sports, only one in 3
girls do. In other words, we have not reached equality.
One of the misconceptions is that a girl needs to be competitive to
benefit from sports. There are activities in which a girl can better
herself in the course of working for a team – swimming and track
come to mind, where improving individual statistics is an
accomplishment.
Get your girl moving. Your whole family can hike or bike ride
together without spending a lot of extra time and money going to
events.
February 08, 2010
POISONINGS
By Dr. Mike
Americans are using medicines more than ever.
This increases the potential for overdoses, especially in children.
Data from poison control centers shows that over the last decade the
proportion of calls for medication overdoses in children 5 or
younger has been increasing.
A study in The American Journal of Preventative Medicine showed that
over 70,000 emergency room visits per year are for accidental
medication overdoses in children 18 and younger versus half that
number per year for accidental exposures to non-medication products,
such as cleaners and pesticides. The study showed the vast majority
of the medication overdoses occurred while the child was
unsupervised. The most common medications are acetaminophen (the
active ingredient in Tylenol), cold and cough medicines,
antidepressants, and anti-inflammatory medicines (i.e., Motrin and
Advil).
COMMENT:
Remember, put all medicines out of the reach of children and make sure cabinets, drawers and medicine cabinets are child proofed.
February 01, 2010
WHEN TO POTTY TRAIN
A study from Children’ Hospital in New Brunswick,
New Jersey suggests that the ideal time for potty training is 27-32
months. Those trained later were more likely to have problems after
age 4 such as accidents when having the urge to urinate.
The average age at which a child is potty trained has increased from
26 months in 1980 to 36 months in 2003.
This may be due to the convenience of disposable diapers, which make
it easier to change children.
You can wait till your child shows signs of readiness, you can bring
the child to the toilet at set times and hope to catch something,
or, as some parents do, use a combination of both methods. The
researchers found no difference in the method of training and the
likelihood of wetting and accidents later. Timing is more important
than technique.
Children show signs of readiness when they can pull down their
pants, stay dry for several hours especially during naps, when they
signal that they are going with facial expressions or other
behaviors and when they can follow simple directions. If you try
before your child is ready, especially if your child resists, you
may lose the battle. And it should not be a battle.
COMMENT:
If it is not working, back off for a few weeks and try again. But do not wait much past 2 ½ to at least try.
January 25, 2010
Newborn Care: FOOD ALLERGIES
By Dr. Mike
The rate of reported food allergies in children is increasing. As reported in Pediatrics, the number of doctor visits and hospitalizations because of food allergies has increased. This might represent an increase in awareness by doctors and parents rather than more allergic disease. wborn Care: Food Allergies
COMMENT:
Can we help prevent food allergies in
children?
Approximately 90% of allergic reactions to food are caused by 8
different food types: milk, eggs, peanuts, tree nuts, soy, wheat,
shellfish and fish. Overall, studies have not shown that women who
excluded eggs, peanuts, milk and fish while pregnant have children
with fewer allergies than those without a restricted diet. Also,
there is a lack of evidence to support that giving these foods to
babies will cause, promote or worsen allergies.
There is, however, evidence that exclusive breast feeding for the
first 3-4 months of life as well as continued breast feeding while
introducing these allergenic foods might help with decreasing the
amount of allergic problems in your child. Therefore, breast feed
your newborn as long as you can. The American Academy of Pediatrics
recommends at least a year and longer if possible.
All information given is not a substitute for
the advice of your pediatrician, primary care provider or trained
health professional. Always consult with your pediatrician or
health care professional.
December 31, 2009
INTRODUCING SOLID FOODS – MAYBE NOT WHAT WE THOUGHT
A study from Finland challenges our previous
ideas about whether it is wise to delay introducing certain foods to
infants in order to reduce the chances of allergy.
For many years we have been cautiously starting with rice cereal and
avoiding things like wheat and eggs until a child is older. Their
study showed that, far from preventing allergy, delaying the
introduction of these foods increased the chances of food and
inhalant allergies at age 5. eas.
COMMENT:
This is only one study and a small one at that.
Nevertheless, our dogmas about foods for infants have been
increasingly challenged. We used to say that infants should avoid
citrus, for example, but there is no evidence for citrus being
harmful. Some of the experts on nutrition at a recent convention of
the American Academy of Pediatrics were quoted as saying that the
first food an infant is fed could be meat – anything that is
nutritionally dense.
The reason we recommend against unprocessed milk in the first year
if an infant is not breastfed is that it might cause bleeding in the
intestine. The recommendations to breast feed at least a year and
use formula if not still stands.
December 24, 2009
SEX TALKS WITH YOUR CHILDREN NEED TO BE DONE SOONER
The Rand Center and UCLA conducted a study
involving 141 families with children aged 13 to 17. They identified
24 areas of sex and sexuality including body changes, how women
become pregnant, condoms, how to refuse sex and birth control and
homosexuality.
They studied families at the beginning of the study and at 3, 6 and
12 months. They asked teens and parents what they had discussed and
asked the teens about activities such as hand holding, genital
touching or oral sex and intercourse.
Although 70% of boys, for example, said they had not discussed
condoms or birth control with their parents, only half the parents
said they had not discussed that. More than ½ the parents had not
discussed over half the topics while their children had already
engaged in some advanced activities. There were similar disparities
in other areas.
COMMENT:
One thing that this study shows is that parents
may think they talked about something because they brought it up
once in passing. Usually the parent is uncomfortable, the child
senses that and not much dialogue is created.
It is difficult to talk about these things but this study shows that
talking should begin sooner than parents think. In my personal
experience many children are more sexually involved than their
parents have any idea of. You are the best source of information and
guidance. There is not just one talk that you should have and cross
that off the list of your parental duties.
Bring topics up over the years – in the car, on a walk, at lunch,
even at the dinner table. Of course you have to fashion these
discussions according to the child’s age. Twelve year olds may be
grossed out by a discussion of birth control so that is not
appropriate, but just talk about a pregnant family member, for
example, and ask whether they think the person is the right age to
have a child and why. That can open up the topic. Use a tv show or
movie to discuss issues. If your children saw Juno, what did they
think of the way that was handled? A good way to ease in is to ask
what their friends think of or say about something.
Studies show over and over that the more informed children are the
later they initiate sex and the fewer partners they have. Remind
yourself of that whenever you cringe from a topic.
December 19, 2009
RELIABLE CHILDREN’S HEALTH WEBSITE
The American Academy of Pediatrics has had a
website for years but it combined information for parents and
professionals and was sometimes not as accessible for parents as it
might be.
They have just launched healthychildren.org, designed just for
parents. It includes sections for specific age groups, hot topics
and, most importantly, scientifically accurate information.
COMMENT:
One of the most frustrating aspects of caring for
children for us is fighting the misinformation rampant on the
internet. Recently, for example, one of our mothers said to me, “The
H1N1 vaccine is controversial, isn’t it?”
“What’s the controversy?” I asked.
“My friend’s sister said that.” Her friend’s sister is not a health
professional and heaven only knows where she got that but it seems
to have made the rounds.
Remember, anyone can post anything. Hopefully you will refer to this
site and/or check any information further with your pediatrician if
you need to. ut.
December 07, 2009
WINDOWS BLINDS AND CHILDREN
About one child a month dies from strangulation
by window blind or curtain cords in the US and about 1,000 children
a year strangle from all causes, such as clothing drawstrings. The
Consumer Product Safety Commission recalled 90,000 shades this
October because of strangulation hazards.
The problem is that the world is designed for the convenience of
adults. Children climb on a chair to look out the window or reach
for a cord that is near their crib. Even Roman shades may have a
hidden cord on the back.
COMMENT:
If you have cords that loop, cut them apart, put
knots in the ends and loop them up out of children’s reach. Inspect
cords at relatives' homes (especially when visiting at the holidays)
and at daycare.
Avoid buying clothing with drawstrings and if you already have some
pull the strings out.
November 30, 2009
VACCINES and TYLENOL
Many families worry when their babies receive
vaccines. Some of the concerns are the pain and possible side
effects from the shots. I break down normal vaccine reactions into
two main types.
The first is a local reaction: mild redness and/or swelling at the
injection site. This very common, normal reaction will usually
subside in the first day or so. Applying a cool compress may be
helpful to reduce the inflammation. Severe swelling or redness that
is spreading is not normal and should be seen by your doctor.
The second normal vaccine reaction, which is usually more concerning
to the family, is a more systemic reaction. This is when the baby's
immune system is "turned on" from the vaccination and the baby might
feel cranky and/or develop a fever for the first 24-48 hours after
the shots. This is a normal, expected side effect that does not
happen every time, but is not worrisome or unexpected.
If the fever persists, is very high, or the baby seems extremely
irritable or lethargic, your doctor should be notified.
Frequently, parents try to prevent the fever and
crankiness by pre-medicating their babies with Tylenol
(acetaminophen).
In the past, this practice was not discouraged. In fact, the CDC's
advisory panel says it is reasonable to pre-medicate children at
high risk for developing seizures, which can be triggered by fevers.
However, a recently published study showed slightly lower protective
antibody levels from vaccines in infants who were pre-medicated with
Tylenol versus infants who did not receive Tylenol.
The effect of the decreased levels might be small, as the vast
majority of the pre-medicated infants did achieve protective
antibody levels after their booster doses. Even so, the evidence in
the study does point to stopping the practice of pre-medicating to
try to prevent this reaction.
Of importance, there is no evidence that the same decrease of
antibody levels occurs when a fever reaction is treated by Tylenol.
COMMENT:
In summary, not pre-medicating with Tylenol, but giving it if fever develops might give the best benefit of immunization.
November 19, 2009
MUSIC LYRICS IN THE NEWS
It’s almost impossible to tell what is being sung when adults tune in to their children’s music. Many lyrics are sexually explicit or violent.
COMMENT:
To find out what your children are hearing, enter “music lyrics” on any search engine and you will get a list of resources.
November 17, 2009
GENES IN THE NEWS
After surgery everybody experiences pain. A
recent study showed that a particular gene determines how much pain
a child suffers.
Investigators in Switzerland analyzed ABCB1 genes in 137 children
between 4 and 16 who underwent surgery. One variation of the gene
was associated with protection against high pain and another with
extreme pain sensitivity; those with the one reported 70% less pain
and the other had 30% more pain.
COMMENT:
It has been said often that nobody can feel
another’s pain. This study shows that we may be genetically
predisposed to feeling more or less pain. I am sure this continues
into adulthood, which is why some people need more pain relief than
others.
When I was in training, genetics was basically the double helix.
The field has now exploded. Genes have been described for social
resilience (children who can come out of abuse and neglect and
survive well). We know there are genes for autism (no, not the MMR):
a recent study of twins showed that identical twins are
overwhelmingly likely to both have not only autism but the same type
and same problems, while fraternal twins are not.
This study is only one of many that will describe our individual
characteristics in the future. What this one can do is let doctors
know from the beginning whether more or less pain medication is
needed to keep the patient comfortable.
OCTOBER 20, 2009
BOOSTER SEATS SAVE CHILDREN
Statistics from 16 states between 1998 and 2007 show that children in belt positioning booster seats were about half as likely to suffer injuries in a crash. There was no difference whether the seat had a backrest or not.
Children should remain in booster seats until they are at least 8 years old or 4’8” tall.
COMMENT:
We receive questions periodically about the age and/or size changes for various safety seats in cars. The American Academy of Pediatrics has a constantly updated section on its website AAP.org for car seat information at all ages and sizes.
You may be surprised at the 8 years or 4 foot 8 rule but keep your children in those booster seats even if they think they are too big. Laws about booster seats are not enacted in all states but where they are there is a 40% increase in their use and subsequent decrease in injury.
SWINE FLU
There is so much information flying around about seasonal and swine flu. We are providing you with links that may help you to understand (see below).
It is disturbing to us that a recent survey showed that only half of parents will immunize their children against the H1N1 or swine flu. It is especially important if there is a small infant in your household who is too young to be vaccinated but is at risk for serious complications of both seasonal and swine flu. In that case, parents, siblings, other household members and care givers must be vaccinated to protect the infant.
http://www.publichealth.lacounty.gov/docs/FluComp-Eng.pdf
http://www.publichealth.lacounty.gov/docs/PriorityGrp-Eng.pdf
OCTOBER 5, 2009
TELEVISION AS A PHYSICAL HAZARD FOR CHILDREN
You are probably used to material suggesting that too much time in front of the tv is bad for children. Another aspect of television’s harmful effects is that it can be a source of injury.
National Children’s Hospital and Ohio State studied statistics from 8506 patients under age 17 who suffered injuries from furniture tip overs 1990 through 2007. There were 300 deaths. From these statistics they estimated how many cases nationwide occurred.
Over a quarter of a million children were probably treated for these injuries, about 15,000 per year and most of them were in children under 6. Half of the injuries in children under 9 were from televisions falling on them, while 30% of children 15-17 were hurt by televisions. Most injuries were to the head and neck and fractures of the legs.
COMMENT:
Televisions are larger and heavier each year. Small children climb up and tip them over while older children tend to run into them in the course of horseplay. In our area, another cause for injury is earthquakes. In the last big one we had a patient badly hurt by a tv falling on him.
Not only televisions but any heavy piece of furniture such as a dresser should be secured to the wall with straps or braces. Keep televisions far back from the edge on furniture designed to hold their weight and keep attractive objects off the tops of furniture.
SEPTEMBER 21, 2009
BROKEN LEGS FROM SLIDES
The charts and xrays of 58 toddlers who broke
their tibia (the lower bone in the leg) over one year were reviewed.
They were seen in an emergency room or an orthopedist’s office.
Eight of these occurred while playing on a playground slide. The
average age was 20 months.
All of these happened while going down the slide on the lap of an
adult. None of them went down the slide alone.
COMMENT:
I think parents probably feel they are protecting
their child by going down together because the child is too young to
do it alone. The problem is that the larger adult creates a force
and speed that is enough to break a child’s bone.
If your child is too small to use a slide alone, find something else
to play on.
SEPTEMBER 6, 2009
SHORT IS ALL RIGHT
Previous studies have suggested that children who
are short may suffer emotional and social difficulties because of
their height. There are problems with several of these studies. For
example, some included only children from academic endocrinology
clinics who are abnormally short for medical reasons. Some used only
parents perceptions.
Previous studies have suggested that children who are short may
suffer emotional and social difficulties because of their height.
There are problems with several of these studies. For example, some
included only children from academic endocrinology clinics who are
abnormally short for medical reasons. Some used only parents
perceptions.
In a study from the University of Michigan and other centers, 712
boys and girls in the sixth grade were studied and teachers’ and
children’s perceptions were included. Children were considered short
if they were below the 10th percentile for their age.
In terms of behavior problems, depression, peer relationships
and popularity, there were no differences between short and normal
height children. The short children reported a slightly higher rate
of teasing but it was not significant.
COMMENT:
Children will tease each other about
anything – fat, thin, tall, short, red hair, curly hair – you name
it. Shortness is only a cause for concern if children stop growing
or grow more slowly than they should. In those cases, we should look
for a medical reason. I recently dealt with a tiny girl whose mother
– who is only 5 foot one herself, expressed concern about her
daughter’s size.
“It’s hard to overcome your genes,” I said.
“But I don’t wear jeans,” the little girl said.
Don’t forget, Dr Mike is not the tallest man in the world and
everyone loves him.
AUGUST 20, 2009
PET DOORS CAN BE FATAL TO TODDLERS
The Consumer Product Safety Commission has recorded about 100 cases of near drowning (when a child survives after being resuscitated), drowning, or other injuries to children who fit through pet doors. The problem is probably more widespread than their statistics show because in drowning cases the way the child left the home is not required in the report.
Homeowners should know about the requirements for fencing around a pool but having a door that can close is deemed adequate for the side of the pool near the house. With a pet door, it is not.
What you can do: you can go to the expense of adding a fence at least 48 inches on the house side of the pool. A cheaper alternative is an electronic pet door, which only allows the animal with an electronic collar to use the door and children cannot open it. The price range is $125 to about $200 depending on the size of the dog. See PetSafe Electronic Smart Door on the internet for details.
COMMENT:
It always seemed to me that a pet door would be attractive to a small child. Toddlers love to fit into tiny spaces. I have no pets – I don’t even have a green plant in my home, but houses with children, pets and pools can be a tragedy waiting to happen.
AUGUST 8, 2009
ANOTHER WAY TELEVISION MAKES CHILDREN FAT
At the Rudd Center for Food Policy and Obesity at
Yale, 118 children aged 7-11 were given bowls of Goldfish crackers
and left alone to watch a cartoon. During the commercials, some saw
ads for games and entertainment; others saw commercials for
unhealthful, sugary or fat laden snacks.
Children who saw the food spots ate 45% more crackers than the ones
who saw the non food commercials.
COMMENT:
Advertisers have long maintained that they are merely promoting brand preference, not eating in general. This study and others like it put the lie to that. What this means to you:
-
Limit TV time to less than 1-2 hours/day.
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Do not allow eating during TV watching.
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Concentrate watching on non-commercial programs or TIVO and fast forward through commercial aimed at children.
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Keep TV’s out of children’s rooms.
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