Posted On: December 26, 2011

Another Warning on Baby Acetaminophen (Tylenol)

If you give your baby acetaminophen to reduce fever and pain, pay close attention to the packaging.

Several months ago, we reported about the FDA’s interest in more accurate dosing information for children’s Tylenol . It’s still a hot topic. Last week, the feds issued a warning about the potential for dosing errors with liquid acetaminophen for infants. As explained on MedPage Today, in 2009 the FDA recommended introducing a new, single strength version of the drug. Adverse event reports from babies given the drug indicated that the problem was dosing errors.

Many manufacturers who made liquid acetaminophen in different strengths agreed to produce only a single concentration—160 mg/5 mL. The quantities refer to how much of the active ingredient (160 mg) is in each dose (5 mL). But the effort to simplify appears to have complicated things.

The recommendation to produce only a single dose was voluntary, and not every manufacturer followed it. Acetaminophen strengths of 80 mg/mL and 80 mg/0.8mL are still available for purchase. Some consumers have both versions of the drug, and some of the newer packaging is similar to the old. For the Little Fevers brand, the FDA noted, “both boxes … say ‘New’ on the front, but only one of the contains the new concentration of liquid acetaminophen.”

Parental tip: If your package of liquid acetaminophen includes a dropper, that’s the older version. The 160 mg/5 mL products include an oral syringe that is supposed to make dosing more precise. To eliminate the risk of giving the wrong dose, use only products with the syringe, and dispose of any other liquid acetaminophen. If you’re uncertain how to measure, contact a pharmacy or your doctor’s office.

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Posted On: December 20, 2011

Adults Are Worrying More than Kids Are Sexting

We’ve all heard stories about the unthinking transmission of sexually explicit material via telephone texts. We’ve even been a bystander to the more notorious episodes (two words: Anthony Weiner).

But when the willing participants in such naughty trafficking are children, there is less smirking and more worrying.

But a recent study in the journal Pediatrics concluded that kids don’t text sex stuff as much as conventional thought suggests.

“Sexting”—sending or receiving risqué or even explicit photos or videos on a cellphone—is legally fraught when it involves a minor. It’s a criminal offense. It’s child pornography.

Researcher Kimberly J. Mitchell co-authored two studies in Pediatrics, one of which estimates that in 2008-2009, police in the U.S. investigated 3,500-some cases of sexual images sent by adolescents. In 1 of 3 of those cases, an adult received them.

But there doesn’t appear to be an epidemic of kids sending naked photos of themselves to here, there and everywhere, including the Internet. As a story on Reuters.com noted, youth sexting isn’t as common as earlier polls indicated.

A 2008 survey by the National Campaign to Prevent Teen and Unplanned Pregnancy found that 1 in 5 teens has sent or posted online nude or semi-nude pictures or videos of themselves. Mitchell and her colleagues got much smaller numbers in a 2010 national survey. According to phone interviews with more than 1,500 children 10 to 17 years old, only 2.5 in 100 had appeared in or produced nude or nearly nude photos or videos. And only 1 in 100 did so if only sexually explicit material -- naked breasts, genitals or rear ends -- was included. Around 6 or 7 in 100 adolescents said they'd received such images or videos.

"Overall, our results are actually quite reassuring," Mitchell told Reuters. "With any sort of new technology that kids become involved in there is a tendency to become easily alarmed. What we are instead seeing is that sexting may just make some forms of sexual behavior more visible to adults."

Her advice to parents is to make sure their kids understand the legal risks (being busted for transmitting child porn) and the digital risk of Internet exposure. If someone is a sexting recipient, delete the text immediate and certainly don’t redistribute it.

A spokesman for the National Campaign to Prevent Teen and Unplanned Pregnancy was gratified by the study’s finding, but also a bit skeptical. Bill Albert told Reuters the numbers didn’t surprise him because researchers surveyed younger kids as well as teenagers. As he pointed out, "I wonder if teens are being as truthful as they might be. … It's a good opportunity to sit down with your kid and talk about it."

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Posted On: December 15, 2011

The No. 1 Cause of Kids' Visits to Emergency Rooms, and What Parents Can Do

What sort of misadventure do you think brings most young children into the emergency room? Most people would guess car accidents. Most people would be wrong.

It’s poisoning by drugs. According to the National Capital Poison Center, this stark reality is the result of more children having access to and swallowing prescription drugs at home.

More adults are using prescription medication, especially of the pain-killing variety such as oxycodone, hydromorphone, morphine, methadone and fentanyl. And older children with chronic conditions are adding to the prescription drug bottom line with meds to treat their attention deficit disorders and, increasingly, Type 2 diabetes.

The danger to the wee ones simply reflects the law of averages: The more medicines present in young children’s homes, the greater the likelihood they will find and swallow them.

The most dangerous prescription medicines for children are those that treat:


  • diabetes;

  • pain (opioids, or narcotics);

  • anxiety, muscle spasms and sleep problems;

  • heart disease and high blood pressure.


Medicines should be locked up, but that can be tough if the rightful patient requires frequent dosing. Travel also complicates safe storage. And even the most vigilant parent gets interrupted and distracted while taking medicines.

To minimize the incidence of childhood poisoning, researchers such as those involved in a Journal of Pediatrics study propose that packaging limit the amount of drug available (children can’t open many child-resistant blister packs at one time). Liquid medicines as well could be dispensed in single-dose containers.

Other poison-prevention measure suggested by the Poison Center:


  • Use child-resistant packaging. Replace caps tightly after use.

  • Lock all medicines up high, out of sight and reach of children.

  • Take medicines when children aren’t looking—children imitate adults.

  • When traveling, ensure that medicines are locked away from children.


If you think a child may have swallowed too much medicine or someone else’s medicine, call the poison center immediately at 800-222-1222.

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Posted On: December 9, 2011

Apple Juice for Kids: A Caution for Parents

We often take issue with careless, shallow and/or misleading media reports about health and safety issues. But in one high-profile case, the flashy TV doc got it right.

Consumer Reports investigated the claim of Dr. Mehmet Oz ("The Dr. Oz Show"), and found that, indeed, 1 in 10 of the juices tested contained more arsenic than is allowed in drinking water. One problem, investigators said, is that juice and similar beverages have no standards for arsenic content. Inorganic arsenic (that is, arsenic that does not occur naturally in some fruits) is carcinogenic. Lead content also was problematically high in many juices.

The EPA limits arsenic in drinking water to 10 parts per billion (ppb), and some health experts say that’s too high. According to AboutLawsuits.com, The FDA told Consumer Reports that it’s considering arsenic standards for juice. In September, the website reported, the FDA “believed apple juice consumption posed little or no risk, but since then it has received eight apple juice test samples with total arsenic levels of up to 45 ppb.”

Because arsenic and lead disproportionately damage smaller, growing brains, the American Academy of Pediatrics advises:


  • Don’t give infants younger than six months any kind of juice.

  • Limit juice for children 6 years and younger to six ounces a day.

  • Limit juice for children older than 6 years to 12 ounces a day.

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Posted On: December 4, 2011

HPV Vaccination Now Recommended for Boys

The FDA has approved two vaccines to ward off infection by some strains of the human papillomavirus (HPV), which can cause cancer. But until recently, the shot was promoted only for girls. (The vaccine is useless unless given before the onset of sexual activity.)

But the federal Advisory Committee on Immunization and Practices (ACIP) recently issued a recommendation that boys and young men also receive the vaccination to protect against genital warts and anal cancer. Males are at a lower risk of developing cancer from HPV, but they can transmit HPV to their partners.

We recently wrote about the lag in HPV vaccination for young people, but that was before the ACIP issued its recent report. The more often parents are made aware of the solid science, the more likely they are to protect their children’s future health.

According to a Kaiser Family Foundation fact sheet, HPV infection in the U.S. is widespread, with more than 6 million new infections annually. Approximately half of all sexually active men and women will get HPV at some point in their lives.

Currently, the vaccines are administered in three doses over 6 months, but research is underway to determine whether two might be sufficient to provide protection.

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