April 18, 2014

Cholesterol Report Reinforces Screening Schedule for Kids

Most people don’t associate heart disease with children, and although it’s relatively rare, certain risk factors in childhood can increase a kid’s chances of developing heart and blood vessel problems as they get older. Some studies have shown that narrowing and hardening of the arteries can even begin in childhood.

Last month’s annual Scientific Session of the American College of Cardiology presented disturbing research about kids at risk for developing cardiovascular problems — approximately 1 in 3 children between the ages of 9 and 11 who received cholesterol screenings showed borderline or high results.

As summarhref="http://www.sciencedaily.com/releases/2014/03/140328085530.htm?utm_source=feedburner">ScienceDaily.com, the study was one of the largest of its kind, involving outpatient clinic visits of the Texas Children's Pediatrics Associates. It examined more than 12,700 medical records of children whose routine physical exams included screening for cholesterol.

The study’s lead researcher, Dr. Thomas Seery, a pediatric cardiologist, said "The sheer number of kids with abnormal lipid profiles provides further evidence that this is a population that needs attention and could potentially benefit from treatment. But we can only intervene if we diagnose the problem."

Seery said it’s important to identify kids with high levels of blood cholesterol/fats and to lower their blood values in order to stave off the chances of future disease.

The study showed that boys were more likely than girls to have elevated total cholesterol, low-density lipoprotein (LDL, or "bad" cholesterol) and triglycerides (blood fats), but girls had lower high-density lipoprotein (HDL, or "good" cholesterol).

No surprise that obese children were more likely to have elevated total cholesterol, LDL and triglycerides, and lower HDL than were kids who weren’t obese.

You don’t know if your child’s values are normal, of course, unless they’re measured. The National Heart Lung and Blood Institute guidelines recommend universal cholesterol screening of children between the ages of 9 and 11, and again between 17 and 21. That practice is endorsed by the American Academy of Pediatrics. (See our blog, “Cholesterol Tests for Kids.”)

Like all screenings, however, this one isn’t without concern for overtreatment if a result isn’t precisely within what’s considered normal. Seery’s aware of that. "There is concern by some in the medical community that children will be started on medication unnecessarily," he said. So the first line of defense against rising blood cholesterol is for youngsters to adopt a healthful diet and to exercise regularly.

Seery said that cholesterol-lowering drugs usually aren’t necessary except for 1 or 2 children in 100 who have very high cholesterol, usually because of a genetic disorder. Such problems, including inherited high cholesterol, can be detected in childhood, but might be underdiagnosed. But if blood is tested at the recommended ages, it will be found.

The universal pediatric screening guidelines were initiated at the end of 2011, during the second year of the research. So one of the study’s limitations might be that we don’t know if testing was ordered for everybody, as a matter of course, or only for select subjects chosen for their individual risk factors or family history of premature heart disease.

Other studies have demonstrated that screening based on family history alone can overlook children who have abnormally high cholesterol. So further research is needed in order to determine how many health-care providers are following the guidelines, and how consistently they do so.

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April 11, 2014

The Cost of a Car Seat Defect Was a Child’s Life

More than two years after a horrendous accident in which an infant lost her life because of a defective car seat, federal authorities are still diddling around in their investigation and the car seat manufacturer, Graco, continues to blame its customers.

The story was reported in sad detail on The Safety Record.

In August 2011, Samika Ramirez was driving with her 2-year-old, Leiana Marie Ramirez. When the car started to swerve, Ramirez pulled to the left side of the parkway and turned on her flashers. The divided road had only a narrow shoulder. She was about to call the auto club when another driver rear-ended her car.

It caught fire, and Ramirez tried frantically to unbuckle her daughter, but couldn’t release the harness of the Graco Nautilus child safety seat. With flames engulfing her car, passersby Ramirez pulled out of the car, and Leianna was burned alive.

More than a year later the National Highway Traffic Safety Administration (NHTSA) opened an investigation. The results are still pending, but the the Graco Nautilus and 17 other models with buckles difficult to unlatch were recalled. Some consumers told NHTSA that they had to cut the belt webbing to release their children from the seat.

From the beginning, according to The Safety Record, Graco conceded that it was “keenly aware of the issue.” It had received more than 6,100 complaints about it, but said that the difficult of getting a kid out of a seat was merely “a consumer frustration and a consumer experience that Graco has been working to improve.”

So far, Graco hasn’t acknowledged that the defect caused a horrific death, not to NHTSA, not in a defect and noncompliance report, not in NHTSA’s Early Warning Reports.

In 2005, Graco paid a $4 million fine after the U.S. Consumer Product Safety Commission (CPSC) cited its long history of failing to report injuries and deaths. “Even now,” The Safety Record reports, “with the initial recall expanded and under a Special Order to answer all questions truthfully, Graco comforts its customers on its website:

Graco can assure you there have been no reported injuries as a result of the harness buckles used on Graco car seats. We want to stress that our car seats are safe and effective in restraining children. And, the safest way to transport a child is always in a car seat."

NHTSA wouldn’t comment to The Safety Record, but did confirm that the investigation remains open. Christine Spagnoli, an attorney representing the Ramirez family, says that Graco’s failure to acknowledge Leiana’s death undermines the recall, and calls it a consumer safety issue.

“[B]y saying something false to the public,” she said, “they’re trying to save money, at the expense of kids getting hurt.”

After NHTSA began investigating, Graco started blaming consumers, saying they allowed food, drink and bodily fluids to muck up the buckle apparatus, making it difficult for the button to release the metal tongues. Graco said they were just frustrated with the “perception” of difficulty, that they unlatched the harness incorrectly and that the complaint rate was approximately 1 in 1,000.

The feds weren’t buying it, and expressed concern that the malfunction of the quick-release mechanism created “an unreasonable safety condition in that the unlatching of the buckle and/or the extracting of the child would take an excessive amount of time, or may not be possible at all in a post-crash or other emergency situation where time is a critical factor.

"Additionally, First Responders or Good Samaritans, who are unfamiliar with the buckles operation or its sticking characteristics, also may not be able to unlatch the buckle.”

They called Graco’s claim that a child could be removed even when he or she was still buckled “unsustainable” in a post-crash situation.

The to-and-fro between the company and the investigators is as wearying as it is painfully slow. Consumers shopping for child car seats might want to keep in mind, as The Safety Record recounts, that Graco has a history of denial, foot-dragging and responsibility-shifting when it comes to the requirements of NHTSA’s early warning reporting, which compels manufacturers to supply access to recall information.

Graco is obligated to report “any claim against and received by the manufacturer. Claims are merely requests or demands for relief related to a crash, the failure of a component or system, or a fire originating in or from a vehicle. These claims are unverified allegations. They may help NHTSA identify a possible defect, but in and of themselves the claims are not evidence of a defect.”

To see the Graco car seat models that have been recalled, link here.

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April 4, 2014

C. Diff Infections in Kids Linked to Overuse of Antibiotics

Antibiotics can be lifesavers. And they can be life-threatening.

The dangers of overprescribing and overusing antibiotics are well known (see our blog, “CDC Report on Antibiotic Resistance Sounds Ominous Note.”), and now there are disturbing new signals that they can pose a dire threat to children.

According to a report in Pediatrics, most Clostridium difficile (C. diff) infections in children might be linked to antibiotics prescribed by doctors.

Considered a “super bug” — that is, an unusually strong and difficult to eradicate microbe — C. diff is a bacteria that causes intestinal infections and severe diarrhea. It’s painful and can be deadly. More than 17,000 children in the U.S. contract C. diff infections each year.

The Pediatrics study showed that antibiotic use was associated with nearly 3 in 4 C. diff infections, even though the drugs weren't taken because of C. diff.

As summarized on AboutLawsuits.com, researchers analyzed data from C. diff cases of nearly 1,000 children between 1 and 17 years old. They were from 10 different U.S. regions.

More than 7 in 10 cases involved bouts of diarrhea. In more than 7 in 10 of those cases, doctors had prescribed antibiotics to treat other conditions within the previous 12 weeks. The subjects had not tested positive for C. diff within the previous eight weeks. No deaths were linked to the C. diff cases.

The highest incidence of infection was found among white children between 1 and 2 years old.

The study was not conclusive about the cause of the infections, but it did demonstrate a strong association between the C. diff and antibiotic use.

Most of the children in this study had taken antibiotics for ear, sinus or upper respiratory infections. Half of all antibiotics prescribed to children for respiratory infections are not required, noted AboutLawsuits.com. Because antibiotics also destroy beneficial bacterial that can protect against infections, taking them unadvisedly — for a viral infection (the drugs address only bacteria, not viruses) or for a problem that, given time, rest and other less aggressive measures, will resolve on its own — invites a larger threat.

The story refers to a study last year that found that doctors prescribed antibiotics in 6 of 10 cases of sore throat; only 1 in 10 cases can be treated effectively with them.

So although parents are desperate to address their child’s pain, discomfort and fever, they shouldn’t routinely ask for an antibiotic prescription for most common childhood infections. And the new study shows that the danger might be even worse than we thought.

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March 28, 2014

Worth Reading: The Return of Measles

Measles was a big deal when I was a kid, but it trailed off dramatically after the vaccine was introduced in the early 1960s. Now it's coming back, thanks to the widespread but badly mistaken view among some parents of vaccine-age children that (a) the vaccine can cause things like autism, and (b) measles is not that big a deal. The truth is that measles is a potential killer and there is no valid research linking any childhood vaccines to autism.

Here's a useful overview on measles, what parents need to know, and what the public health community can do now to instill healthy respect for it, from Dr. Paul Offit, an infectious disease specialist at Children's Hospital in Philadelphia.

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March 28, 2014

E-Cigarettes Pose Long-Term Addiction Threat to Teens, and Short-Term Risk of Poisoning

Electronic cigarettes are increasingly popular as substitutes for tobacco cigarettes, but as we wrote last year, it’s not clear if they are an acceptable alternative to the more traditional nicotine delivery systems. It’s also not clear if they might help smokers quit tobacco. And if smoking e-cigarettes has risks, it’s not clear exactly what they are, and how harmful.

But according to a recent study published in JAMA Pediatrics, e-cigarettes might very well serve as gateway devices for adolescents to begin cultivating a nicotine addiction. And that's not good.

E-cigarettes are battery powered devices that look like fat pens. They have a reservoir for liquid nicotine that, when heated, becomes vapor that users inhale, just like a tobacco cigarette. They’re available in multiple colors and often are flavored with a wide range of options, including bubble gum and peanut butter.

As explained on AboutLawsuits.com, the JAMA study was conducted by researchers from the University of California, San Francisco Center for Tobacco Control Research and Education. They surveyed more than 40,000 middle and high school students across the United States.

Another new report on the "e-liquids" that supply the nicotine in e-cigarettes has disturbing information for any concerned parent. As the New York Times reported last week:

These “e-liquids,” the key ingredients in e-cigarettes, are powerful neurotoxins. Tiny amounts, whether ingested or absorbed through the skin, can cause vomiting and seizures and even be lethal. A teaspoon of even highly diluted e-liquid can kill a small child.

But, like e-cigarettes, e-liquids are not regulated by federal authorities. They are mixed on factory floors and in the back rooms of shops, and sold legally in stores and online in small bottles that are kept casually around the house for regular refilling of e-cigarettes.

Evidence of the potential dangers is already emerging. Toxicologists warn that e-liquids pose a significant risk to public health, particularly to children, who may be drawn to their bright colors and fragrant flavorings like cherry, chocolate and bubble gum.

And get this quote from a toxicologist in the Times article:

“It’s not a matter of if a child will be seriously poisoned or killed,” said Lee Cantrell, director of the San Diego division of the California Poison Control System and a professor of pharmacy at the University of California, San Francisco. “It’s a matter of when.”

In the JAMA Pediatrics study, use of e-cigarettes among kids doubled from 2011 to 2012, from about 3 in 100 to 6.5 in 100. The teens who used e-cigarettes were less likely to abstain from smoking tobacco cigarettes a month, six months and a year later.

About 1 in 5 middle schoolers and 7 in 100 high schoolers who used e-cigarettes had never smoked regular cigarettes. So some teens are introduced to nicotine addiction through e-cigarettes, the researchers concluded, and are on the road to long-term addiction.

The teens who smoked tobacco and who also used e-cigarettes were more likely to intend to quit smoking within the next year, but they actually were less likely to do so. Experimental cigarette smokers also were less likely to abstain from smoking tobacco if they tried e-cigarettes.

As we noted in our blog, manufacturers of e-cigarettes market them specifically to the teenage demographic — it’s a rich new market!

As AboutLawsuits notes, e-cigarettes are not regulated by the FDA, and more than 40 state attorneys general have appealed to the agency to do so. More than 20 states ban the sale of e-cigarettes to minors, and many ban them in certain areas, as they do tobacco cigarettes.

A report released last autumn by the Centers for Disease Control and Prevention (CDC) found that regular use of e-cigarettes among middle and high school students has more than doubled over the past few years.

A study last year in Nicotine & Tobacco Research concluded that e-cigarettes might expose nonusers involuntarily to nicotine but not to toxic tobacco-specific combustion products. It also said that more research is needed to evaluate the health consequences of secondhand exposure to nicotine, especially among children, pregnant women and people with cardiovascular conditions.

And although it lacks regulatory muscle, the FDA did issue a health warning about the devices nearly five years ago, warning consumers of potentially toxic chemicals in the solution.

So no matter how you slice it, adults should be cautious about taking up electronic cigarettes, and they should be “never” events for kids.

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March 21, 2014

Well Child Appointments Can Pose Illness Risks

Generally, you bring your child to the doctor to help him or her feel better, not worse. But a recent study published in the journal Infection Control and Hospital Epidemiology shows an increased risk of flu-like illnesses for the kid and the family after a doctor’s appointment for an annual exam or vaccination.

The risk, the study suggests, translates to more than 700,000 potentially avoidable illnesses every year.

As explained on ScienceDaily.com, the researchers used 12 years’ of data from the Agency for Healthcare Research and Quality's (AHRQ) Medical Expenditure Panel Survey to analyze trends of 84,595 families. The analysis included demographic, office-based, emergency room and outpatient records. They found that well-child visits for children younger than 6 increased the probability of a flu-like illness within two weeks for the youngsters or their families. The increase was fairly minor — just more than 3 in 100 — but still notable.

In a commentary accompanying the report, Dr. Lisa Saiman, a pediatrician and public health practitioner, offered some context: “The true costs of ILI [influenza-like illness] are much higher, as many more cases are likely to result in missed workdays or school days. Furthermore, ILI visits are associated with inappropriate antimicrobial use.”

Most people are aware of the large number of prescriptions for antibiotics that are ill-advised, and that their overuse leads to stronger microbes that are better able to resist them. (See our blog, “CDC Report on Antibiotic Resistance Sounds Ominous Note.”)

The possibility of exposing your family to illness doesn’t mean you shouldn’t take your kids to their well-child appointments; it means you should be aware of the risks, and ask your doctor and office staff what measures have been taken to minimize them.

"Well child visits are critically important,” said the study’s lead author. “However, our results demonstrate that health-care professionals should devote more attention to reducing the risk of spreading infections in waiting rooms and clinics. Infection control guidelines currently exist. To increase patient safety in outpatient settings, more attention should be paid to these guidelines by health-care professionals, patients, and their families."

The authors are talking about measures such as sufficient office cleaning, cough etiquette and hand hygiene compliance.

"Even with interventions, such as the restricted use of communal toys or separate sick and well-child waiting areas,” they said, “if hand-hygiene compliance is poor, and potentially infectious patients are not wearing masks, preventable infections will continue to occur.”

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March 14, 2014

Sleep-Inducing Machines Might Invite Hearing Problems

It seems like such a good idea. As so many get-the-kid-to-sleep tricks do. But new research shows that using a machine that produces soothing sounds to lull a baby to sleep might damage his or her hearing.

A study published in Pediatrics last month analyzed 14 popular sleep machines at maximum volume and found that they produced between 68.8 to 92.9 decibels from 30 centimeters away. That’s about how far one might be placed from an infant’s head. Three of the machines exceeded 85 decibels, which is what the National Institute for Occupational Safety and Health deems the threshold of workplace safety for adults over the course of an eight-hour shift.

One of the baby machines was so loud that two hours of use would exceed workplace noise limits.

At 100 centimeters away, all the machines tested still were louder than the 50-decibel limit set in 1999 by an expert panel for an hour’s exposure in hospital nurseries in 1999.

“These machines are capable of delivering noise that we think is unsafe for full-grown adults in mines,” Dr. Blake Papsin told the New York Times. He is senior author of the study, and the chief otolaryngologist (disorders of the ear, nose and throat) at the Hospital for Sick Children in Toronto.

“Unless parents are adequately warned of the danger, or the design of the machines by manufacturers is changed to be safer, then the potential for harm exists, and parents need to know about it,” Dr. Gordon B. Hughes, the program director of clinical trials for the National Institute on Deafness and Other Communication Disorders, told The Times.

Newborn brains are learning to differentiate sounds at different pitches even during sleep, according to Lisa L. Hunter, scientific director of research in the division of audiology at Cincinnati Children’s Hospital. “If you’ve conditioned them to white noise, there’s every indication that they might not be as responsive as they otherwise should be to soft speech,” she told The Times.

The idea behind infant sleep machines is that their white noise or nature sounds drown out the normal ambient sounds that can disturb a baby’s sleep — voices, vehicle noise, music, etc. The machines come in many forms, including embedded in stuffed animals, and frequently are recommended by parenting books and websites.

Even some sleep experts advise parents to use them all night, every night, and many parents say their babies become so used to the sounds of rainfall or birds that they will not nap without them.

Despite their apparent potential to damage hearing, sleep machines can be used safely, according to the researchers. Papsin suggested placing the devices farther away, lowering the volume and using them for shorter periods to deliver less sound pressure to the baby. That means you should be wary of the models designed to be affixed to the crib.

The researchers also recommended that device manufacturers limit the maximum noise level of infant sleep machines.

Dr. Marc Weissbluth, a pediatrician and author of “Healthy Sleep Habits, Happy Child,” agreed that you don’t necessarily have to throw out the baby noise machine with the bath water. He told The Times that parents could use one, if they were careful. “If it’s too close or it’s too loud, this might not be healthy for your baby,” he said. But “a quiet machine that’s far away may cause no harm whatsoever.”

Maybe. But one Times reader posted an interesting comment to the story: “If the sound of a sleep machine is dangerously loud, I hate to think about all of the noise my premie was exposed to while in the n.i.c.u. [neonatal intensive care unit] for several weeks. Constant beeping, lights on, etc. I don't think she's worse for the wear, but hospitals need to be much more mindful about all of the environmental noise babies are exposed to in the n.i.c.u.”

To learn more about babies and sleep, see our blog, “Getting Your Baby to Sleep.”

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March 7, 2014

Taking Tylenol During Pregnancy Might Elevate Risk of Child with ADHD

As if it weren’t difficult enough to follow all the rules for improving the chances of both a safe pregnancy and a healthy baby, now there’s evidence that pregnant women who take acetaminophen (Tylenol and many other brands) to relieve pain or reduce fever might be raising the risk of bearing a child later diagnosed with attention deficit hyperactivity disorder (ADHD).

A study published in JAMA Pediatrics showed a 40% higher chance of such a diagnosis for children whose mothers took acetaminophen during pregnancy versus those who didn’t.

As explained by the Los Angeles Times, the study doesn’t establish that prenatal exposure to acetaminophen caused the observed increase in diagnosed hyperactivity disorders, prescriptions for ADHD medications or emotional problems in children reported by parents. But the study was designed to address shortcomings of other studies that find an association between an environmental exposure and the appearance of a specific outcome years later.

More than 64,000 Danish mothers and their children were study subjects. Information was collected about pregnant subjects’ acetaminophen use long before problems in their children’s learning or behavior would have become evident. That enabled researchers to avoid what’s called “recall bias” — you can’t pre-judge something you don’t know will happen.

Pediatric subjects were studied from their first trimester in utero for as long as 15 years. In addition to surveying parents about their children’s strengths and weaknesses, the researchers used comprehensive, reliable databases (registries of physician diagnoses and dispensed pharmacy prescriptions) to measure ADHD within the population.

The study concluded that the probability of a child developing ADHD symptoms severe enough to require medication jumped by more than 60% if his or her mother took acetaminophen during the last two trimesters of pregnancy; it rose by almost 30% if acetaminophen was taken only in the third trimester. If mom took the drug during only the first trimester, the increased risk was about 9%.

Because a pregnant woman’s high fever and infection can be dangerous for her fetus, an editorial accompanying the study advised that women and their doctors shouldn’t reject acetaminophen solely based on this study. It said that more information is needed on how acetaminophen might promote ADHD later, when and who is most likely to be affected. The current findings, it advised, “should be interpreted cautiously and should not change practice.”

So what’s a prospective mother to do?

Even medicine deemed safe carries risks, and doubly so for pregnant women. The safest approach is to take the lowest possible dose as seldom as possible, said Dr. Daniel Kahn, a maternal-fetal health specialist interviewed by The Times. He was not involved in the study.

If it doesn’t work, you have to discuss options with your doctor. Kahn added that the study “certainly wouldn’t stop me from treating a fever,” noting that unchecked fevers have been associated with several poor health outcomes in babies, including lowered IQs.

Acetaminophen has gotten some bad publicity of late, largely due to confusing dosing. To understand how to make the most of this medicine without undue risk, see our blog, “Understanding Acetaminophen and How to Make It Safer.”

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February 28, 2014

The Facts About Fever

Parents are wired to beware of fever in their children. But their fear often is misplaced.

According to Melissa Arca, a pediatrician writing on KevinMD.com, a moderately elevated temperature is not necessarily a bad thing; in fact, it can be beneficial. Lots of kid problems cause fever — the flu, colds, croup, ear infections…. The better you understand the reasons a child is feverish, and the purpose fever serves, the better you will be able to determine a minor problem from one that your doctor should address.

Arca offers four fever facts that should help you tell the difference between one that needs hot soup, and one that needs a doctor’s care.

1. Fever is a symptom, not a disease.

Fever is a reaction to illness. It’s a warning to rest and drink fluids. Treating your child’s fever won’t “cure” whatever infection he or she is fighting. “Think of it like disabling your car’s ‘oil change needed’ light,” Arca suggests. “Sure, you can turn off that light but it doesn’t negate the fact that your car’s oil still needs changing.”

Even if you suppress the fever — for example, with ibuprofen — the child still needs time to rest and recover from the infection.

2. Fever can wax and wane for three or four days.

Most fevers persist for a few days before they completely depart. So even if you treat it with acetaminophen or ibuprofen, expect it to recur after a few hours. That’s normal.

3. The number on the thermometer is not as important as how your child looks and feels.

Arca knows that most parents get a little panicked when their child’s temperature reaches 103 or 104. But that number does not communicate the seriousness of the illness. So resist the panic. Give the child a fever reducer for comfort and keep him or her well-hydrated. Fever makes the heart beat faster and increases the child’s insensible water loss (fluids lost through the skin and respiratory tract). Keep a bottle of water by the bed, and anywhere else your child is resting.

Remember, the goal is to help the child feel better, not to get rid of the fever.

4. A true fever is a temperature of 100.4°F (38°C) or higher.

Children’s temperatures naturally fluctuate throughout the day. So knowing what is a true fever is important.

In summary, resist the urge to treat a slight temperature elevation. Remember, says the National Institutes of Health, fever is an important part of the body's defense against infection because most bacteria and viruses that cause infections in people thrive at 98.6 °F. Many infants and children develop high fevers with minor viral illnesses, and although that’s a signal of the body waging battle, the fever is a weapon favoring the child. So unless you’re dealing with a temperature of 102°F or higher fever, let the fever run its course and provide comfort through fluids.

Brain damage from a fever generally doesn’t occur with fever less than 107.6 °F (42 °C). Untreated fevers caused by infection seldom exceed 105 °F unless the child is overdressed or trapped in a hot place.

Arca says these red flags demand a pediatrician’s intervention:

  • infants younger than 3 months with rectal temperatures of 100.4°F or higher;

  • fever that persists more than five days;

  • your child just doesn’t look well, is having difficulty breathing or has had a febrile seizure (one caused by fever);

  • your child’s fever is 105°F or higher. Although such a high temperature usually isn’t harmful, it merits a call to the pediatrician and the right dose of acetaminophen or ibuprofen.

Because acetaminophen, especially, can be harmful to youngsters, see our blog about proper dosages here.

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February 21, 2014

How to Avoid a Shopping Cart Injury

Parents with kids in tow welcome the use of shopping carts to contain the offspring as well as the merchandise. But as a recent report by NBC News notes, the convenience of a cart should come with a big dose of caution.

According to a study recently published in Clinical Pediatrics by Nationwide Children’s Hospital in Ohio, 66 children are hurt in shopping cart mishaps every day. “That’s one child injured badly enough every 22 minutes to go to the emergency room, or more than 24,000 children a year,” said NBC.

Voluntary safety standards for shopping carts were implemented in 2004, and they’ve had about as much effect as you would expect — none. In fact, it’s worse than none. The number of concussions each year resulting from shopping carts injuries to children younger than 15 jumped nearly 90% — almost double — according to data collected from 1990 to 2011 by Dr. Gary Smith, director of Nationwide’s Center for Injury Research and Policy.

“This is a setup for a major injury,” Smith told NBC. “The major group we are concerned about are children under 5.”

Newborns to 4-year-olds accounted for more than 8 in 10 injuries. More than 7 in 10 accidents were by falling out of the carts. Other common accidents were running into a cart, and carts tipping over.

It’s easy for a parent to focus on the shopping if he or she believes the child is secure, but a moment’s inattention can be tragic. “A wiggly baby in an infant seat or a toddler reaching for a bright box of cereal can easily cause a fall that results in serious injury,” NBC explained. “Children’s center of gravity is high, their heads are heavy and they don’t have enough arm strength to break a fall.”

Smith said the lack of stability standards for U.S. shopping carts that have been adopted in other countries is a contributing factor to the high incidence of injury. But that doesn’t means parents can’t improve the safety of a shopping trip. To be safe:

  • If possible, choose alternatives to placing your child in a shopping cart.

  • Always use using the shopping cart safety belts. Ensure that the child is snugly secured in the straps and that his or her legs are placed through the leg openings. If parts of the cart restraint system are missing or are not working, choose another cart.

  • Use a cart that has a child seat low to the ground, if one is available.

  • Make sure your child remains seated.

  • Stay with the cart and your child at all times.

  • Don’t place infant carriers on top of shopping carts. If the child isn’t old enough to sit upright in the shopping cart seat, use a front- or back-pack carrier, or a stroller.

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February 14, 2014

Youthful Binge Drinking: Spotting It and Getting Help

Sometimes children experiment with alcohol. Some of them will become binge drinkers. Knowing the signs is the first stop in arresting this harmful behavior before it ruins someone’s life or academic career. And knowing where to get help can prevent a long-term problem.

Drinking too much, according to the National Institute on Alcohol Abuse and Alcoholism, either on a single occasion or over time, can harm health in many ways. It interferes with brain, heart, liver and pancreas function. It can increase the risk of developing certain cancers. It can weaken the immune system and leave the drinker more vulnerable to disease and infection.

Alcohol abuse can be disproportionately dangerous for young, “social” binge drinkers, according to the health resources page on InsuranceQuotes.org. If binge drinking becomes a habit, it can cause emotional and physical health problems that can undermine success in school, work or relationships. If a child’s grades and friendships slide, alcohol can seem like a good way to escape.

Binge drinking isn’t only a threat to one’s health, it’s expensive. According to InsuranceQuotes, in California, for example, the cost of a first time DUI for a teenage driver is at least $45,435. Most of that cost is about increased car insurance rates for years after the infraction. If someone’s injured during a DUI, it’s even more costly.

If your child exhibits any of these signs, he or she might have a drinking problem requiring your intervention:

  • mental confusion or stupor;

  • vomiting;

  • seizures;

  • slow (fewer than eight breaths per minute) or irregular (10 seconds or more between breaths) breathing

  • hypothermia (cool to the touch, pale or bluish skin color).

Because blood alcohol levels can continue to rise even when someone stops drinking or is passed out, don’t wait to seek medical help.

There are many resources to get help for your young drinker. Colleges and universities recognize the appeal of drinking to some students, and policies exist on many campuses to facilitate the reporting of alcohol or drug abuse without fear of punishment. Find out what your child’s school does in these instances from Students for Sensible Drug Policy (SSDP). Other resources include:

Because drinking affects everyone in the family and circle of friends, you might want the support and guidance offered by these organizations:

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February 7, 2014

Potential Help for Colicky Babies … and Their Parents

Even with the best of babies, parents of newborns live in a state of exhaustion. If your kid has colic, you’re pretty much a zombie. But scientists have found a noninvasive treatment that might help everybody in the family to feel better.


Yes, it’s a trendy nutritional supplement, but according to a recent study in JAMA Pediatrics, as well as some previous studies in Europe, these “good bacteria” can reduce crying in colicky babies. The JAMA study suggests that probiotics might even prevent colic.

"We do find that the baby who took the probiotic since the first week of life, they develop less number of colic and constipation in the first month of life so they improve at least the symptoms," Dr. Flavia Indrio, a pediatric gastroenterologist at the University of Bari in Italy who led the JAMA study, told NPR.

What causes colic is not clear, but according to NPR, it affects between 8 and 15 out of 100 babies. It can be so bad as to cause depression in parents, and even thoughts of infanticide.

The babies in the JAMA study were given a form of Lactobacillus reuteri, a friendly bacteria that seems to help their digestive systems mature properly. There are countless ways to compound probiotics, and the trick is to find the right one.

"There are a number of effects that we know probiotics can have," Dr. Robert Shulman, professor of pediatrics at Baylor College of Medicine, told NPR. Many probiotics seem to affect the immune system, improve the lining of the intestine and influence the balance of bacteria living in the digestive system.

But "[W]e don't really know in babies with colic exactly how these probiotics are working," he said, and cautioned that much more research is required before babies are routinely given probiotics. The bacteria seem safe, but studies also must confirm that it’s too early to know for sure that their use has no long-term risks.

So if you see probiotics in your grocery story or pharmacy marketed as a colic remedy, be skeptical, but probably not alarmed — they’re more likely to be useless than possibly harmful.

Other than treatment for colic, probiotics are being studied to treat a range of conditions in adults from eczema to inflammatory bowel disease.

If you don’t want to take supplements but do want to boost your intake of these beneficial bacteria to help digest food, make vitamins and maybe help protect against, eat yogurt (with live cultures), sauerkraut, kimchi and other fermented foods.

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