Child Safety Blog

One in five American teenagers have an episode of depression before they turn 18. If untreated, adolescent-onset depression often returns during adulthood and becomes a chronic and persistent condition that is crippling and even life-threatening. One of the risk factors is having a depressed parent: that increases the odds of becoming depressed in one's teen years by two- to three-fold.

But an article appearing in the latest Journal of American Medical Association has good news, as reported by Shirley Wang of The Wall Street Journal: a multicenter trial conducted in 4 U.S. cities found that a group prevention program effectively reduced the risk of subsequent depression for a target group of teenagers.

The study involved 316 “at-risk” teenagers (ages 13-17). All had a history of clinical depression and parents who had had depressive disorders. The youths were assigned to either a group cognitive behavioral prevention program or usual mental health care. After 9 months of treatment, of the teenagers who were assigned to the group CB prevention program and whose parents were not depressed at the time of the study, only 11.7% had a new depressive episode. In contrast, among teenagers in usual care whose parents were not depressed at the time, 40% experienced another episode of depression.

Although the prevention program only worked for teenagers whose parents were not currently depressed, the new finding is still encouraging, shedding light on future research directions and clinical recommendations.

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Posted In: Mental Health

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With unlimited text messaging cell phone plans comes a surge in the number of texts sent from teenagers’ cells. Every day, an American teenager sends and receives, on average, almost 80 text messages. That’s 2,272 messages a month, sent from behind the wheel, in classrooms, or while crossing busy streets. This texting behavior worries doctors and psychologists for a host of reasons: Texting is blamed for increased risks of car accidents when teens keep their thumbs on the phones while driving, and now texting is believed responsible for direct issues with physical and mental health, reports Katie Hafner of the New York Times.

Although scientists have not had a chance to develop conclusive findings on the health effects of texting because the phenomenon emerged so recently, they already see that the behavior causes “anxiety, distraction in school, falling grades, repetitive stress injury and sleep deprivation.”

Dr. Martin Joffe, a pediatrician in Greenbrae, California, surveyed two local high schools and found many of the students regularly send hundreds of texts every day. When a text message comes in or goes out every few minutes, it’s almost impossible for a student to stay focused on his or her work. That results in, among other things, poorer school performance and disrupted sleep at night.

Teenagers often rely on text messaging to get immediate updates on their buddies’ lives because they are genuinely interested in what’s going on with their friends. Many of them also are driven by a fear of being “out of the loop,” says Michael Hausauer, psychotherapist in Oakland, California. The nonstop line of communication created by so much texting can, Mr. Hausauer worries, make teenagers feel “frightened and overly exposed.”

The 80-text per day “thumb exercise” may also result in musculoskeletal diseases often found in computer users, said Peter W. Johnson, associate professor of environmental and occupational health sciences at the University of Washington. “Intensive repetitive use of the upper extremities,” be it on the computer keyboard or on a cell phone, can lead to temporary or permanent musculoskeletal disorders.

Teachers and parents are often unaware of the extent to which texting has affected the children’s physical and mental health. But once they learn of the problem and impose some restrictions – such as a no-texting window overnight or a limited number of texts allowed each month – they can see visible improvements in the students’ grades and probably energy level too, from regained quality sleep.

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The FDA announced a voluntary recall of face paints by the distributor of the products, Oriental Trading Co., Omaha, Nebraska, reports Miranda Hitti of WebMD Health News. The recall decision was made after reports of adverse skin reactions from exposures that all occurred on the same day at an organized event. Children exposed to various colors of the face paints experienced adverse skin reactions, including rashes, itchiness, burning sensation and swelling on the area where the product was applied. Results of tests by an FDA laboratory indicated significant microbial contamination in most of the face paints.

The FDA is advising consumers to stop using these face paints, which were manufactured by a Shanghai, China company. The agency has also published a complete list of face paint products in this recall.

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Posted In: Product Liability , Toys

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Bisphenol-A, a chemical used to harden plastics, is found in many plastic containers even though it’s known to be linked to diseases. Bisphenol-A, or BPA, have been found in animal studies to accelerate puberty and increases risks of cancer. Babies can be exposed to traces of the chemical when it gradually leaks into the fluids from the plastic containers. BPA exposure can also result in health problems in adults, such as elevated risk of heart diseases and diabetes.

On May 13, 2009, Chicago’s City Council joined a handful of other jurisdictions in a unanimous decision to ban the sale of baby bottles and sippy cups that are made with BPA and intended for children under the age of 3, reports Karen Ann Cullotta of the New York Times.

One of the reasons why not more jurisdictions are banning BPA use in plastic containers is the lack of direct evidence that human exposure to this chemical is harmful to our health. So far, all the evidence for the adverse effects of exposure to BPA comes from animal research studies. FDA said last year that BPA levels found in products appeared to be safe – a conclusion condemned by a panel of scientific advisers to the agency, saying the FDA “ignored crucial studies and used flawed methods.”

To protect their children from exposure to BPA and its potential dangers, parents can turn to the BPA-free products that are already available at retailers.

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Posted In: Infants , Product Liability

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On May 1, 2009, the U.S. Consumer Product Safety Commission announced another recall of cribs made by Jardine Enterprises, the third safety recall since June 2008, reports Patricia Callahan of the Chicago Tribune. All three recalls involved cribs made in China and Vietnam.

The Jardine cribs in the recalls, mostly sold at Toys R Us and Babies R Us, are responsible for more than 30 reports of broken slats, one of the deadliest hazards of baby cribs. When a slat breaks, babies’ bodies slip through the gaps but their heads get stuck, resulting in strangulation and even death.

Parents can access a full list of recalled models at www.cpsc.gov. For those who bought one of the recalled cribs, a credit is available toward the purchase of a replacement.

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Posted In: Infant Mortality , Infants , Product Liability

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The Chicago Tribune uncovered federal safety test results of infant car seats that were never publicized or even made known to some of the infant-seat manufacturers, reported Chicago Tribune’s Patricia Callahan. In the frontal crash tests, a video showed the car seats flying off their bases, throwing baby dummies face-first into the back of the driver’s seat. The test reports also documented that almost half of the 66 seats that were tested in front crashes “either separated from their bases or exceeded injury limits.”

As a result of the Chicago Tribune’s investigations, the National Highway Traffic Safety Administration has ordered a thorough review of safety regulations for car seats and taken steps to make the safety test results more available to consumers. Before, parents could compare safety ratings for cars, but would have no way of comparing which car seats do better at protecting their babies. They would not have known that more expensive car seats are not necessarily safer, or that some smaller cars performed better than the larger ones in these collision tests.

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Posted In: Cars , Infant Mortality , Infants , Product Liability

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A study that tracked millions of schoolchildren shows that children are more likely to be obese when their schools are close to a fast food joint, reports Roni Rabin of New York Times. The study is headed by economists at the University of California and Columbia University, and spanned almost a decade.

Enrico Moretti, one of the study’s authors, indicated that the study does not explain why students closer to a fast food restaurant are more likely to become obese, but affirmed the “credible and unbiased” causal effect it establishes between obesity and fast food.

Providing one more piece of evidence that fast food contributes to child obesity, this study has implications for public policy, said Kelly Brownell, director of the Rudd Center for Food Policy and Obesity at Yale University. Neighborhoods and school district may choose to “zone out” fast food restaurants to protect their children’s health.

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Posted In: Childhood Nutrition

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Nearly two million American teenagers are afflicted with depression, and major medical groups are now recommending that pediatricians give a simple but detailed questionnaire to all their teenage patients to try to detect this condition so that treatment can be offered.

About 1 out of 20 teens suffer from depression, which has been linked to lower grades, more physical illness and drug use, as well as early pregnancy.

Questionnaires can accurately identify teens prone to depression, plus there's new evidence that therapy and/or some antidepressants can benefit them, according to a report from the U.S. Preventive Services Task Force, published in the April 2009 edition of the journal Pediatrics .

Accompanying the task force advisory in Pediatrics is a research review saying there have been few studies on the accuracy of depression screening tests, but the tests "have performed fairly well" among adolescents. Treatment can help with symptoms of depression, say the reviewers from Kaiser Permanente and the Oregon Evidence-Based Practice Center in Portland, Ore.

But careful monitoring is vital since there's "convincing evidence" that antidepressants can increase suicidal behavior in teens, according to the Preventive Services Task Force report.

The new recommendation reverses what the task force said in 2002, when it reported that there was not enough evidence to recommend for or against routine screening of adolescents for depression.

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Posted In: Mental Health

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Thirty-nine million prescriptions were written for American children in 2008 for drugs like Adderall and Concerta to treat attention deficit hyperactive disorder (ADHD), but new research suggests the drugs have only short-term benefit and may pose more harm to children than good if given for more than two years.

In a report in the Washington Post by Shankar Vendatam, scientists involved in a large federal study of the drugs sharply disagreed with one another about what the public should be told about their study results. One psychologist in the group of researchers said that parents needed to know that careful comparisons of the children in the study showed definite advantages of the drug treatment only in the first twenty-four months of use, and that longer use resulted in stunted growth, with drug-treated children typically an inch shorter and six pounds lighter than non-drug treated peers after 36 months of treatment. Another psychiatrist who participated in the study said long-term benefits were real but hard to demonstrate statistically.

The study is called the Multimodal Treatment Study of Children With ADHD (MTA). When its initial results were first published in 1999, a clear advantage was seen for behavior improvement in children who had taken the ADHD drugs in the first fourteen months of the study, compared to children who received only talk therapy or no treatment at all, and those results ignited a huge wave of popularity for the ADHD drugs with pediatricians and parents. But as the researchers have continued to follow the same children over the years, the advantage of drug therapy, at least as measurable statistically, disappeared.

Statistics, of course, do not necessarily apply in any one individual case. The take-away for parents is to be careful about any long-term use of drugs in their children and to continue to ask questions of doctors, and reach your own informed decisions about what to do.

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Posted In: Medication , Mental Health

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In vitro fertilization has generally been considered safe since the first IVF baby was born more than 30 years ago. But recent studies unveil a number of risks that couples considering the procedure should be aware of, reports Gina Kolata of the New York Times.

These IVF-related risks may include increased risk of low birth weight and premature birth, as well as severe birth defects like “a hole between the two chambers of the heart, a cleft lip or palate, an improperly developed esophagus, and a malformed rectum.” Studies indicate that IVF possibly give rise to abnormal genetic expression patterns that are responsible for these genetic disorders.

In addition to the more common birth defects, children born by IVF are also suspected to be at greater risk for other genetic disorders that are much rarer: Beckwith-Wiedemann syndrome (children with this syndrome are much more predisposed to childhood cancers of kidney, liver or muscle) and Angelman syndrome (severe mental retardation, motor defects and inability to speak).

Although certain risks of in vitro fertilization are beginning to surface, no finding is conclusive yet – these are preliminary studies that show “comparative risks,” but no “absolute risks” are known yet. Researchers are still in the process of discovering exactly what the risks are and what can be done to minimize them. More research reports will be available as scientists track the development and growth of babies born by IVF, and couples interested in fertility treatment should educate themselves about the risks in order to make informed decisions.

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Posted In: Birth Defects , Infants

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Researchers at Virginia Tech and Children’s National Medical Center found in a recent study that many young children in the District of Columbia may have been exposed to dangerous levels of lead during the water crisis from 2001 to 2004, reports the Washington Post’s Carol Leonnig.

The study, published last week in Environmental Science and Technology, contradicts the federal and DC health officials' repeated assurance that there was “no identifiable public health impact from elevated lead levels in drinking water.” The US Environmental Protection Agency and the DC Water and Sewer Authority cited a 2004 report issued by the Centers for Disease Control and Prevention, which found no increased blood lead level in households where high levels of lead were found in tap water.

The problem in the District of Columbia is that many homes still have lead pipes that run from the water main under the street to the home.

Lead-poisoned children are at risk of many permanent neurological damages, including irreversible IQ loss, developmental delays, aggression, and difficulty focusing in school. D.C. residents whose children were two-years-old or younger during the water crisis are encouraged to monitor their kids. To reduce the impact of lead poisoning, doctors recommend “healthful, calcium-rich diet and an enriching educational environment that includes reading to them regularly.”

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Posted In: Infants

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A nationwide study found that the rate of infants died of unintentional suffocation and strangulation in their first year of life has quadrupled between 1984 and 2004, reports Rob Stein of the Washington Post. Federal health officials are concerned that this surge of fatalities may be due to the increased number of mothers sharing beds with their babies.

Although bed-sharing fosters mother-child bonding and facilitates breastfeeding, it poses serious risks to babies. Deaths can occur when the adult rolls over a baby, or when blankets or pillows get in the baby’s airway.

A national survey found that bed-sharing was more common among younger and poorer women; another study shows that death rate from accidental strangulation and suffocation was three times as many among African Americans as Caucasians. This difference can be due to "economics" or "cultural beliefs," Stein quotes Clinton-Reid, chairperson of a committee that reviews infant deaths for the District's medical examiner. Some mothers just cannot afford a crib, and others believe that babies are safer sleeping with them.

For those who would like to have a crib for their babies but cannot afford one, there are nonprofit organizations that give away free cribs. As for mothers who want to continue bed-sharing with their babies, they should consult with their doctors for safer ways to sleep with their babies. Some general rules of thumb include the following (a more extensive list can be found on kidshealth.org):
• Put babies to sleep on their backs. (This has helped cut the number of deaths from Sudden Infant Death Syndrome.)
• Leave the baby’s head uncovered.
• Keep the bed away from draperies or blinds to prevent the baby from getting strangled by the cords.
• Ensure the mattress fits snug in the bed frame to prevent the baby from getting trapped in between.

It used to be taught that babies should be put to sleep on their stomachs, the thought being that they would be less likely to choke on regurgitated stomach contents. But the latest advice from the American Academy of Pediatrics is to lay the baby on its back. The educational program is called "back to sleep." Experts now recognize that many deaths from Sudden Infant Death Syndrome happened when babies turned their faces into their bedding and suffocated.

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Posted In: Infants

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