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Health blog

Children and Obesity

Most parents know about the epidemic of childhood obesity. Childhood obesity has more than tripled over the past three decades, putting children at risk for maladies, such as high blood pressure, that used to affect older people. Nearly one-third of today’s children are overweight or obese.

Causes of Childhood Obesity
How did so  Read More 
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Children and Television

The American Academy of Pediatrics recommends no television for children younger than two years old.

There’s no doubt that watching age-appropriate television in moderation can help educate children. Preschoolers learn their alphabet and numbers from television, while older children learn about nature and life in other countries. But watching too much television is  Read More 
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Children and Falls

All parents want their children to be safe and secure – especially at home. Yet thousands of children are treated in emergency rooms each year after sustaining falls in the home and elsewhere.

According to the Centers for Disease Control and Prevention, falls are the leading cause of non-fatal injuries for all children from birth  Read More 
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When it's Time for Antibiotics

Since antibiotics became widely available in the mid 1940’s, they have saved millions of lives. Before antibiotics, small cuts could lead to serious infections. Pneumonia could turn deadly overnight. And soldiers died far more often from infected battlefield wounds than from the injury itself. Antibiotics – medications that fight bacteria – were the miracle drugs of their time.  Read More 
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Children and Fevers

What parent hasn’t been awakened at night by a crying baby or a cranky toddler only to discover that the child has a fever? The ever-present parental worry machine kicks into gear. Is the fever too high? Is it dangerous? Do you need to take your child to an urgent care clinic or  Read More 
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Choking Hazards in Young Children

Most parents are pretty savvy when it comes to knowing about choking in young children. Even so, at least one child dies every five days in the U.S. from choking on food, and another ten thousand children are seen in an emergency room each year for choking. Choking is the fourth leading cause of accidental death in children one to nine years of age (surpassed by motor vehicle injuries, drowning, and fires/burns).

While food is the most common cause of choking, toys and small household items also present a choking hazard. Manufacturers must label small toys as being unsuitable for infants and toddlers, but food, of course, carries no warning.

The American Academy of Pediatrics and the American Academy of Otolaryngology joined forces in a campaign to help parents recognize common choking hazards in young children and how to prevent them. A study of data from nearly fifty children’s hospitals around the world found the ten foods most commonly associated with fatal airway obstruction are: hot dogs, hard candy, nuts, grapes, meat, cookies and biscuits, carrots, apples, popcorn and peanut butter.

Other high-risk foods for choking include sticky candy, cheese cubes (and other cubed food), seeds, whole grapes, cherries, chewing gum, marshmallows, pretzel nuggets, small sausages and other round foods that could occlude a child’s small airway.

Choking from food is largely preventable with appropriate supervision and food preparation. Supervision means that you should never leave a small child unattended while eating. A choking child cannot call out for you if you’re in the next room. Children should sit up straight when eating, should have a sufficient number of teeth for the intended food, and the muscular and developmental ability needed to chew and swallow chosen foods. Children with certain neurological or developmental problems may be unable to safely eat foods that children without such conditions can eat.

Young children should eat while sitting in a quiet calm environment with continual supervision. They should not eat while standing, walking, running, playing, lying down, or when they are sleepy. They should refrain from eating while riding on a bike or as a passenger in a vehicle. They should not play games such as catching thrown food in the mouth or stuffing the mouth full of food. Young children are easily distracted and may not pay full attention while they are eating.

Food preparation means cutting foods into age appropriate sizes, especially round foods that could easily occlude the child’s airway (especially grapes and hot dogs). Remove seeds or pits from fruits. It is safer for young children to eat their fruit and vegetables cooked rather than raw. Peanut butter should be thinly spread on bread so it doesn’t form a glob that cannot be swallowed. Offer fluids with meals, but be sure the child has completely chewed and swallowed any food before drinking.

Certain toys and household items pose a special risk of choking. Latex balloons are extremely dangerous to young children. If inhaled, the latex can form an airtight seal over the child’s airway. Other problematic items include coins, marbles, toys with small parts, small balls, pen or marker caps, tiny button-type batteries, magnets, screws, stuffing from a bean bag toy, and jewelry such as rings and earrings. Make sure children cannot get into trash cans that may hold a variety of small objects of interest to a curious toddler.

Be sure other caregivers such as sitters, older siblings, and grandparents know about choking hazards. Ideally, parents and anyone who cares for young children should know child CPR and the Heimlich maneuver.

Read instructions from the Mayo Clinic at: www.mayoclinic.com/health/first-aid-choking/FA00025
or view a video in which a first responder demonstrates the Heimlich at: www.youtube.com/watch?v=LrPfzux2rI4&feature=related.

When it comes to childhood choking, nothing beats supervision and knowledge.

References: “Choking Hazards Campaign,” American Academy of Otolaryngology, at: www.entnet.org/HealthInformation/Choking-Campaign.cfm; “Prevention of Choking among Children,”

American Academy of Pediatrics, at: http://aappolicy.aappublications.org/cgi/content/full/pediatrics;125/3/601; and “Preventing Choking in Children,” American Academy of Pediatrics at: www.entnet.org/HealthInformation/upload/Preventing-Choking-in-Children-News-Article.pdf.  Read More 
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Sports Drinks and Energy Drinks Are Not for Children

Sports Drinks and Energy Drinks Are Not for Children

Your eight-year old daughter just finished soccer practice and she’s hot and sweaty. Your ten-year-old son scored a home run and he’s as hot and sweaty as your daughter is. They come to you for something to drink and you hand them each a nice, cold sports drink. After all, they need to rehydrate and to replenish electrolytes lost in exercise. That’s a good thing, right?

Not according to the American Academy of Pediatrics (AAP). Sports drinks, which contain water, carbohydrates, minerals, electrolytes, and flavoring, are generally unnecessary for children. In the face of today’s burgeoning childhood obesity, most children don’t need the extra calories that sports drinks contain. Additionally, they may promote tooth decay. Sports drinks are inappropriate for meals and in the school lunchroom as well. Instead, provide water after sporting activities – about four to six ounces for every fifteen to twenty minutes of exercise. Offer water, low-fat milk or 100% juice with meals. Save the sports drinks for teen athletes engaged in prolonged, vigorous physical activities.

And how about those popular caffeine-filled energy drinks? The AAP recently released a report about the danger that high energy drinks pose to children and teens. These drinks are the fastest growing segment of the U.S. beverage industry, topping $9 billion each year in sales. Between 30% and 50% of young people say they drink energy drinks, and marketing is often directed at this population.

So what’s wrong with a little caffeine pick-me-up? A standard eight ounce cup of coffee contains between 100 and 200 milligrams of caffeine, with colas and soft drinks having about half that amount. Energy drinks typically contain a large amount of caffeine. The energy drink NOS has about 260 mg of caffeine while a drink called 5150 Juice has 500 mg. Monster Energy has 160 mg of caffeine in a can, and Red Bull has 76 mg. The Food and Drug Administration requires beverage makers to put the caffeine content on labels, and manufacturers are compliant.

However, caffeine is not the only stimulant in energy drinks. They also contain various herbal additives such as guarana, taurine, ginseng, gingko, and others. The FDA does not require the caffeine or stimulant properties of these additives to be on labels. According to the AAP, this means the actual amount of caffeine or stimulant in an energy drink is unknown. The additives may also interact with each other in unexpected ways that make the drink potentially more hazardous than if it only contained caffeine.

When consumed by children and teens, these products have caused seizures, heart problems, high blood pressure, behavioral issues and even sudden death. The sugar in such drinks can interfere with blood sugar control in young diabetics. The caffeine and additives may interact in unexpected ways with prescription medications. The AAP report cites one case where four middle grade students shared one can of Redline energy drink and had to be transported to the emergency room with heart problems, low potassium, and high blood sugar.

The AAP concludes that energy drinks have no benefit to children and may put young consumers at risk for serious health problems. Does all this mean that your teen can’t have any caffeine? The AAP recommends caffeine intake for adolescents and children should not exceed 100 mg per day. That equates to one cola or very small cup of coffee per day. Every parent should decide whether or not even a small amount of caffeine is appropriate for their child.

References: American Academy of Pediatrics Policy Statement. Clinical Report: Sports Drinks and Energy Drinks for Children and Adolescents: Are They Appropriate? Pediatrics. June 1, 2011. http://pediatrics.aappublications.org/content/127/6/1182.full.html.

Mayo Clinic: Caffeine Content for Coffee, Tea, Soda & more: www.mayoclinic.com/health/caffeine/AN01211.

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Watch Out for Summer Sun

Summer’s here and like so many other people, you and your children might be planning some together time in the sun. Maybe it’s a trip to the lake, the mountains, or maybe you’re headed to the nearest beach. Before leaving home, take a few minutes to talk about the sun and how to prevent damaging sunburn.

The ultraviolet radiation (UV radiation) found in sunlight is the primary cause of skin cancer. Having even one blistering sunburn as a child increases the risk for melanoma, the most deadly form of skin cancer. More than one million Americans are diagnosed with skin cancer each year. If they’re lucky, it’s “only” basal cell or squamous cell cancer, potentially disfiguring but seldom fatal. However, melanoma kills about 8,650 people per year and its incidence is steadily increasing. It’s now the second most common cancer among teens and young adults.

Sunlight is not the only source of UV radiation. Many young people turn to tanning beds. The tanning industry sometimes denies that UV radiation from tanning beds is harmful. Yet in 2009, the World Health Organization’s cancer research agency moved tanning beds to the carcinogenic (cancer-causing) category. Included in the same category are asbestos, cigarettes, and plutonium! According to the American Academy of Pediatrics, tanning beds may produce 10 to 15 times more UV radiation than the midday sun. Many states are considering laws to prohibit people under 18 from using tanning beds.

Here are some ways to decrease the risk of skin cancer caused by excessive UV radiation. Limit sun exposure between 10:00 am and 4:00 pm when the sun is at its brightest. Scientists developed the UV index to guide people about the risk of UV radiation at any given location on any given day. The risk runs from low to extreme. For example, a sunny day in Sacramento, California on May 6, 2011 showed a UV index of 9 (very high.) Check the UV index for your area at: www.epa.gov/sunwise/uvindex.html.

Use this mantra to limit UV radiation: Slip-Slop-Slap . . . and Wrap. Slip into a long-sleeved cotton shirt to cover as much of the skin as possible. Slop on sunscreen every two hours. A Consumer Reports poll found that one fourth of Americans rarely or never use sunscreen on their children. And often people who do use it, don’t use enough. Use about one ounce for an adult, proportionately less for children. Apply sunscreen half an hour before going outside, and reapply every two hours. Slap on a wide-brimmed hat to protect the scalp, neck, and ears. Wrap UV-blocking sunglasses around your face. Children should wear real sunglasses, not toy plastic ones.

Be especially careful when taking children to the mountains, beaches, and lakes. UV radiation increases 4% to 5% for every 1000 feet in elevation. For example, Lake Tahoe is about 6,000 feet high, meaning that people are exposed to as much as 30% more UV radiation than in California's Central Valley. Keep in mind that water, sand, and snow reflect sunlight, making for a dangerous double-whammy dose of UV radiation.

Take care of yourself and the young people in your life. Tanned skin is damaged skin. While ultraviolet radiation is not the only cause of skin cancer, it is the only cause that is completely preventable.


For more information: American Academy of Dermatology: www.aad.org; American Cancer Society: www.cancer.org; Skin Cancer Foundation: www.skincancer.org.

References: American Academy of Pediatrics Policy Statement – Ultraviolet Radiation: a Hazard to Children and Adolescents: http://pediatrics.aappublications.org/cgi/content/full/127/3/588; and Goldsmith C, USA Today Health Reports: Skin Cancer; Lerner Publishing, 2011.
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Hit in the Head Much? Concussion in Children and Adolescents.

A concussion is an injury to the brain caused by trauma that results in the brain sloshing through its protective fluid and hitting the inside of the skull. Concussion can result from motor vehicle or bicycle accidents, sports injuries, falls, etc. It may lead to a loss of consciousness, altered mental status, or behavioral changes. Young athletes are more susceptible to the effects of a concussion than adults are because their brains are still developing.

A new study finds that more than a quarter million visits to emergency rooms during a four year period were due to sports-related concussion among 8 to 19 year olds, representing a 200% increase over the past decade.

The injuries were most common in ice hockey, football, basketball, baseball, and soccer. Football has the highest incidence of concussion, but girls have higher concussion rates than boys in similar sports. The numbers may be much higher as some coaches or parents don’t seek care for what they view as minor injuries. Young athletes may tend to minimize their injury and strive to return immediately to the game.

The American Academy of Pediatrics published guidelines on sports-related concussions (see source below). Among the recommendations are:

•Children or adolescents who sustain a concussion should always be evaluated by a physician and receive medical clearance before returning to play.

•After a concussion, all athletes should be restricted from physical activity until they are asymptomatic at rest and with exertion. Physical and cognitive exertion, such as homework, playing video games, using a computer or watching TV may worsen symptoms.

•Symptoms of a concussion usually resolve in 7 to 10 days, but some athletes may take weeks or months to fully recover.

Good medical management is essential for reducing the risk of long-term complications of concussion, such as learning disabilities, memory problems, and chronic headaches. Preventive measures include wearing protective headgear, adhering to the rules of the sport, and educating parents, athletes, and trainers about the dangers of concussion. Don’t ignore head injuries in young people. And remember, never give children under 18 aspirin without the express instruction of a physician due to the rare but potential life-threatening condition called Reye Syndrome that has been associated with its use in young people.

For more information see my continuing education module for nurses at: http://ce.nurse.com/CE617/Sports-Related-Concussions/. The module is free for anyone to read.


(Halstead ME and Walter KD. “Sport-Related Concussion in Children and Adolescents,” Pediatrics, 126(3), 597-614.)

www.aap.org/advocacy/releases/aug3010studies.htm#sportconcussions

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Energy Drinks: Not for Children and Teens

The American Academy of Pediatrics (AAP) released a report in February about the danger that high energy drinks pose to children and teens (viewable in its entirety at: http://pediatrics.aappublications.org/cgi/content/abstract/peds.2009-3592v1). These drinks are the fastest growing segment of the U.S. beverage industry, topping $9 billion annually in sales. Between 30% and 50% of young people admit to consuming energy drinks, and marketing is often directed at this population.

So what’s wrong with a little caffeine pick-me-up? A standard eight ounce cup of coffee contains between 100 and 200 milligrams of caffeine, with colas and soft drinks having about half that amount. Energy drinks typically contain a large amount of caffeine. The energy drink NOS has about 260 mg of caffeine while a drink called 5150 Juice has 500 mg. The Food and Drug Administration requires beverage makers to put the caffeine content on labels, and manufacturers are compliant.

However, caffeine is not the only stimulant in energy drinks. They also contain various herbal additives such as guarana, taurine, ginseng, gingko, kola nut, and yerba mate. The FDA does not require the caffeine or stimulant properties of these additives to be on labels. According to the AAP, this means the actual amount of caffeine or stimulant in an energy drink is unknown. The additives may also interact with each other in unexpected ways that make the drink potentially more hazardous than if it only contained caffeine.

When consumed by children, teens, and young adults, these products have caused seizures, heart problems, stroke, high blood pressure, behavioral issues, and even sudden death. The high sugar content may worsen diabetes, and the caffeine and additives may interfere with prescription medications. The AAP report cites one case where four middle grade students shared one can of Redline energy drink and had to be transported to the emergency room with heart problems, low potassium, and high blood sugar.

The AAP concludes that energy drinks have no benefit to children and may put young consumers at risk for serious health problems. Some countries have limited or regulated the sale of energy drinks to young people. Does all this mean that your teen can’t have any caffeine? The AAP recommends caffeine intake for adolescents and children should not exceed 100 mg per day. That equates to one cola or one small coffee per day. Every parent should judge whether even a small amount of caffeine is appropriate for their child.
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