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Your Child

Asbestos Found in Children’s Crayons and Toys

2:00

Coloring with crayons has been an American tradition since the late 1800s.  Since that time, the wax crayon has been instrumental in teaching children how to draw and imagine the world in a rainbow of colors.

Although the words “non-toxic” appear on crayon boxes designated for children’s use, a new report from the Environmental Working Group (EWG) Action Fund says that asbestos fibers have been found in crayons and other toys sold in the United States.

The fibers were found in four brands of crayons and two children’s crime-scene toy fingerprint kits.

The contaminated crayons included Nickelodeon's Teenage Mutant Ninja Turtles crayons, Disney's Mickey Mouse Clubhouse Jumbo Crayons and Saban's Power Rangers Super Megaforce Jumbo Crayons and ones by Amscan, according to the new report.

Asbestos was also found in two crime lab toys: EduScience's Deluxe Forensics Lab Kit, and Inside Intelligence's Secret Spy Kit.

The U.S. National Institutes of Health (NIH) notes that asbestos, which is composed of long, thin mineral fibers, once was common in insulation material.

Though tiny and invisible to the naked eye, airborne asbestos fibers are easily inhaled. With time, scarring, inflammation and breathing impairment can occur, as can lung cancer and mesothelioma, a rare cancer of the lining of the lungs and abdomen, according to the NIH.

Asbestos is no longer widely used in manufacturing in the United States. It is banned in nearly all other developed nations, the research group said.

EWG hired an independent company, Scientific Analytical Institute from Greensboro, N.C., to conduct so-called transmission electron microscopy tests to look for asbestos. This is said to be the most sensitive and accurate method of testing available.

EWG said that a second independent lab reconfirmed the crayons and toys that tested positive.

"Just a couple of fibers can lodge in your lungs and be there forever," said Sonya Lunder, a senior analyst with the Washington, D.C. based group. "And there's very clear evidence that asbestos leads to two forms of cancer, and thousands and thousands of Americans have been killed by fiber exposure."

Former U.S. Assistant Surgeon General Richard Lemen welcomed the report.

"These are important findings, because asbestos is being placed in children's products," said Lemen, now an adjunct professor with Emory University's Rollins School of Public Health in Atlanta.

"Even if the absolute risk is relatively low, children are more vulnerable to toxic material and carcinogens," he said. "And because they are so young they have a longer latency in which to develop these diseases, which are known to be diseases that develop over time."

The crayons were purchased between February and May of this year at two national chains -- Party City and Dollar Tree -- in a suburban county near San Francisco. The group said it ordered the two crime scene toys through Amazon.com and Toys"R"Us.com.

For analysis, 28 brands of crayons were tested and 21 toy fingerprint kits. All the products that tested positive were made in China.

A spokeswoman for Toys "R" Us, which distributes the EduScience Deluxe Forensics Lab Kit, responded to the report, saying customer safety is the company's highest priority.

"We require that every product we carry meets or exceeds all applicable state and federal laws, industry standards, codes and requirements. At this time, we are reviewing the referenced report, along with supplier test reports, to ensure full compliance to our strict safety standards," Kathleen Waugh, vice president of corporate communications, said in a statement.

The tests discovered the highest concentration of asbestos was found in the toy crime-scene fingerprint kits.

If your child is one of the millions that play with crayons or the crime lab kits, be sure to check the brand to make sure they are not one of the contaminated products or kits that tested positive for asbestos.

Source: Alan Mozes, http://consumer.healthday.com/cancer-information-5/lung-cancer-news-100/asbestos-found-in-kids-crayons-toy-crime-kits-701117.html

 

 

 

 

Your Child

School Kids Benefit From Mindfulness Programs

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Mindfulness is purposely paying attention to the present moment in a nonjudgmental way. A new study says that adding a mindfulness based stress reduction program to middle schools may help reduce kid’s stress and trauma.  

"High-quality structured mindfulness programs have the potential to really improve students' lives in ways that I think can be really meaningful over the life course," said lead author Dr. Erica Sibinga of the Johns Hopkins School of Medicine in Baltimore.

Children in many U.S. cities are at an increased risk of stresses and traumas due to the effects of community drug use, violence, multigenerational poverty, limited education and economic opportunities, Sibinga and her colleagues write in the journal Pediatrics.

 The study involved 300 students, in grades five through eight, at two Baltimore public schools. Children were randomly selected for either a twelve - week mindfulness based stress reduction program or health classes to take during the school day.

Nearly all the students were from low-income families and African-American.

The mindfulness program contained material about meditation, yoga and the mind, body connection; practice of those techniques; and group discussion.

The program helped the children be aware of their response to what was happening to them at the time.

"It allows them to not only know what is happening, but to stop and take three breaths and figure out how they want to respond to what is happening the present moment," Sibinga told Reuters Health.

By the end of the program, children in the mindfulness program had lower levels of general health problems, depression, recurrent thoughts about negative experiences and other symptoms of stress and trauma compared to the children enrolled in the health classes only.

Sibinga said the differences would be enough for the students to notice in their day-to-day lives.

The researchers acknowledge some limitations to the research, like children missing some classes and possibly being exposed to mindfulness practices outside the sessions.

While Sibinga acknowledged that she couldn’t say if the program would have the same results in other student populations, she suspected there would be benefits.

The next step is to look at how to spread the program to other schools, and look at how the program may work, she said.

"It doesn’t get us off the hook of trying to reduce the sources of trauma in our urban life," she said. But the study suggests adding structured mindfulness programs in urban settings would be beneficial, she added.

Some private schools in the U.S. have already implemented mindfulness classes in their school programs and have reported positive effects such as fewer behavioral problems and an increased ability to focus during class on school work.

Sources: Andrew M. Seaman, http://www.reuters.com/article/us-health-mindfulness-stress-school-idUSKBN0U12MY20151218

 

Your Child

Can Your Child Hear You?

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You may think your child isn’t listening to you, but in fact, he or she may not hear you.

Twelve percent of U.S. children between the ages of 6 and 19 suffer from noise-induced hearing loss – that’s about 5.2 million children – according to the Centers for Disease Control (CDC).

About 2 to 3 out of every 1,000 U.S. children are born with a detectable level of hearing loss in one or both ears.

Many hearing experts have suspected that long-term hearing loss begins in childhood and now studies have shown how common hearing impairment is among kids.

"Historically, people have been looking only at adult hearing loss and assuming that this is not a problem among children," said Amanda Niskar, a nurse at the CDC and lead author of a study released last summer. "What we have found here for the first time is that this is not true. [Hearing loss] is a progression, and it starts when you're very young."

Some hearing experts say the problem of hearing loss in kids will likely worsen, considering rising levels of environmental noise.

One of the most common contributors to kid’s hearing loss is loud music. Regular exposure to loud noises can damage nerve cells in the ear called hair cells. As the name suggests, these cells have tiny hairs that detect sound vibrations and turn them into signals sent to the brain. But while soft noises only cause the hairs to vibrate, loud noises can break them.

Brief instances of exposure to loud noise may only temporarily damage these hairs. Niskar said two hours of loud music on headphones or seven minutes next to the speakers at a rock concert result in damage that may last for only a few days. However, chronic exposures can damage the hair cells — and hearing — permanently.

Loud toys can also cause hearing impairment. The American Speech-Language-Hearing Association (ASLH) discusses toy noise on their website www.asha.org.

“Some toys are so loud that they can cause hearing damage in children. Some toy sirens and squeaky rubber toys can emit sounds of 90 dB, as loud as a lawn mower. Workers would have to wear ear protection for similarly noisy sounds on the job.

The danger with noisy toys is greater than the 90-dB level implies. When held directly to the ear, as children often do, a noisy toy actually exposes the ear to as much as 120 dB of sound, the equivalent of a jet plane taking off. Noise at this level is painful and can result in permanent hearing loss.

Toys that pose a noise danger include cap guns, talking dolls, vehicles with horns and sirens, walkie-talkies, musical instruments, and toys with cranks. Parents who have normal hearing need to inspect toys for noise danger.

Before purchasing a new toy, listen to it. If the toy sounds loud, don’t buy it.”

Good advice to help protect your child’s hearing.

What are the signs and symptoms of hearing loss in kids? Each child is different, but there are some symptoms such as:

Signs in Babies

•       Does not startle at loud noises.

•       Does not turn to the source of a sound after 6 months of age.

•       Does not say single words, such as “dada” or “mama” by 1 year of age.

•       Turns head when he or she sees you but not if you only call out his or her name. This sometimes is mistaken for not paying attention or just ignoring, but could be the result of a partial or complete hearing loss.

•       Seems to hear some sounds but not others.

Signs in Children

•       Speech is delayed.

•       Speech is not clear.

•       Does not follow directions. This sometimes is mistaken for not paying attention or just ignoring, but could be the result of a partial or complete hearing loss.

•       Often says, “Huh?”

•       Turns the TV volume up too high.

If you suspect your baby may have a hearing problem, make sure that he or she has a hearing screening. It’s easy and not painful. Older children should have their hearing tested before entering school any time there is a concern about the child’s hearing. Children who do not pass the hearing screening need to get a full hearing test as soon as possible.

With Christmas and holiday shopping in full swing, make sure to test the toys you buy for your child if they produce a noise and check to see that they are not too loud for your little one to be around.

Hearing loss can affect a child’s performance in school and personal relationships. If you have any suspicions that your child is having difficulty hearing the sooner he or she is checked, the better. There are many excellent therapies for hearing loss now as opposed to even a decade ago.

Sources: Dan Childs, http://abcnews.go.com/Health/story?id=117355

http://www.cdc.gov/ncbddd/hearingloss/facts.html

http://www.asha.org/public/hearing/Noisy-Toys/

Your Child

Concussion Symptoms Continue Long After Injury

2.00 to read

Symptoms such as headache, dizziness and blurry vision typically show up right after a child suffers a concussion. In a study from the emergency medicine division at Boston Children’s Hospital, researchers have found that emotional and mental symptoms, such as irritability and frustration may show up much later and hang around longer.

 "Patients and their families should expect the physical symptoms that they experience after a head injury to get better over the next few weeks, but that emotional symptoms may come on later, even as the physical symptoms subside," said lead researcher Dr. Matthew Eisenberg.

"Only by knowing what symptoms can be expected after a concussion can we help reassure patients and families that what they experience is normal, know when to seek additional help, and make sure that children are taking appropriate precautions in regard to school and sports to achieve a full recovery," Eisenberg added.

For the study, 235 children and young adults, ages 11 to 22, who were treated for concussion at a pediatric ER, answered questionnaires about their injury and were followed for three months after their visit. Patients were monitored until all their symptoms were gone. During that time they were asked about symptoms, sports activity and school and athletic performance.

The most common physical symptoms were headache, dizziness and fatigue, which tended to start right after the injury and got better over time. Researchers found that most of the children also had mental symptoms, such as difficulty concentrating and taking longer to think.

Eisenberg’s team noted that a majority of the children recovered within two weeks, however, 25 percent still had headaches a month after their injury. More than 20 percent said they were fatigued and 20 percent reported taking longer to think.

For many, emotional symptoms -- such as frustration and irritability -- were not as common right after the injury, but developed later, the study authors noted.

Dr. John Kuluz, director of traumatic brain injury and neurorehabilitation at Miami Children's Hospital, said, "It takes longer than people think to fully recover from a concussion. My experience is that kids who still have symptoms two weeks after a concussion are going to have a very hard time, and it's going to be a struggle to get them to the point where they have no symptoms."

Kuluz recommends that parents make sure concussion symptoms are not ignored and their kids receive prompt and continued treatment. He suggests physical therapy to work on balance and helping with any vision problems.

He also recommends keeping children out of school for a couple of days after the injury and then gradually letting them get back to normal activities.

Kuluz tries to get kids back to school for half a day or as much as they can tolerate until they get better. Children should not start sports again until all symptoms have disappeared and then only gradually, he added.

This study was published online and in print in the journal Pediatrics.

Another recent study looked at the effects of concussion and years of repeated hits to the brains of college football players.

Researchers found that players who had been diagnosed with concussions and those who had been playing football for years had smaller hippocampuses – a part of the brain that is critical to memory. A smaller hippocampus has been linked to depression, schizophrenia and chronic traumatic encephalopathy (CTE).

The symptoms of CTE, which tend to set in years after the last traumas, often include memory loss, aggression and dementia.

“Boys hear about the long-term effect on guys when they’re retired from football, but this shows that 20-year-olds might be having some kind of effect,” said Patrick Bellgowan, the study’s senior author from the Laureate Institute for Brain Research in Tulsa, Oklahoma.

Concussion studies seem to be popping up everywhere, and for good reason. For too many years, a concussion injury wasn’t given much attention. The common train of thought was that if you play rough sports and you get hit - you shake it off and get back in the game. That philosophy applied whether you were 10 or 30 years old.

Then professional players began to exhibit early onset dementia and depression. Teens began to complain of constant headaches and feeling out of sorts. College players had difficulty concentrating and vision problems.

Parents demanded answers and researchers began looking at concussion and its long-term impact on the brain. The new studies shed a bright light on why these symptoms were troubling.

Most young athletes will not become professional players in their chosen sport or even play on college teams. Eventually, the helmets and pads will be passed on to the next group of excited young athletes and children will choose other activities or graduate into   the “real world”.

What these types of studies tell us is that long after the games are over, children who suffer concussions may experience serious long-term effects.

The symptoms can be so similar to typical teen behavior that they get overlooked. Kids get headaches, they get tired, they forget things and they have emotional outbursts. But if your child has suffered a concussion or even a very hard hit and you notice these symptoms don’t go away, take him or her to see a concussion specialist. They may or not be related to a more serious brain injury, but a missed opportunity for treatment may change your child’s future in ways that no one ever expected.

Sources: Steven Reinberg, http://consumer.healthday.com/general-health-information-16/injury-health-news-413/kids-concussion-symptoms-can-linger-long-after-injury-687715.html

Andrew M. Seaman, http://www.reuters.com/article/2014/05/13/us-brain-health-football-idUSKBN0DT24720140513

 

 

 

Your Child

Are Kids Too Wired?

2.00 to read

In an effort to keep up with my tech-savvy patients and their parents, I read a study from a well-known software maker that confirmed something we all know: are kids are extremely wired.

The company solicited 2,200 mothers to answer a survey looking at skills their children have; such as riding a bike or tying a shoe as well as those very important early childhood skills such as how to use an I-Pad or Smartphone.  21% of four-five year olds knew how to use a Smartphone or I-pad application, only 14% of those same kids could tie their shoes.

For children two–five years old, 69% could operate a computer mouse, 58% could play a computer game but only 52% knew how to ride a bike. Seems incredible to me that  more kids have computers than bicycles? 25% of two-five year olds could open a Web browser, only 20% knew how to swim.  Technology is definitely changing the world, but is it all beneficial?

The company's CEO commissioned the survey to show how young children are interacting with technology. He emphasized that parents need to be educating their young children about their online world and need to be promoting internet/online safety at very young ages. It used to be “when do I have the sex talk” now it is being replaced with ”how soon do I need to talk about online safety and technology?”. 

The most disturbing aspect of this study is that it suggests that our children are way too wired and may be missing out on simple, yet important life skills.

I myself have seen many a two year old open their parent’s iPad and turn on a movie while in the exam room.   They can recognize different icons and switch between applications but are not yet capable of talking in complete sentences. Some of these children are the same ones who at two years, are not yet putting themselves to sleep at night, cannot sleep through the night and still have a bottle or pacifier!

Some parents are convinced that their child may not be capable of mastering these normal developmental milestones, while at the same time are thrilled about their child’s computer skills. This seems a little mixed up to me. Priorities sometimes get confused.

Technology is important and will continue to be so, but what if the computer is “down” and you need to write a story with pencil and paper, or draw a picture without the benefit of a computer screen? There are certainly many life skills to be mastered; riding a bike, pumping a swing and playing catch.

The race to teach kids technology and to help them compete in our constantly “wired” world may be detrimental to a child’s physical and emotional health. All parents need to remember to “turn off the technology” and get back to basics. There is time for both.

Your Child

Are Some Kid’s Behavioral Issues Really Medical Problems?

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If a child has a cold, rash or any other number of other physical problems, just about every parent is willing to take them to the doctor for treatment. But parents typically don’t seek medical treatment when their child’s anxiety; depression, tantrums or inability to organize their homework are beyond the norm according to a new poll.

A recent University of Michigan C.S. Mott Children’s Hospital National Poll on Children’s Health finds that many parents of children age 5-17 don’t discuss behavioral or emotional issues that could be signs of potential health problems with their doctors.

According to the poll, more than 60 percent of parents definitely would talk to the doctor if their child was extremely sad for more than a month, only half would discuss temper tantrums that seemed worse than peers or if their child seemed more worried or anxious than normal. Just 37 percent would tell the doctor if their child had trouble organizing homework.

Almost half of the parents polled said they didn’t see these types of behavioral issues as medical problems. Another 40 percent said they prefer to handle the problems themselves and 30 percent said they would rather talk to someone other than a doctor.

“Behavioral health and emotional health are closely tied to a child’s physical health, well-being and development, but our findings suggest that we are often missing the boat in catching issues early,” says Sarah J. Clark, M.P.H., associate director of the National Poll on Children’s Health and associate research scientist in the University of Michigan Department of Pediatrics.

“Many children experience challenges with behavior, emotions or learning. The key is for parents to recognize their children’s behavior patterns and share that information with the doctor. Unfortunately, our findings suggest that parents don’t understand their role in supporting their children’s behavioral health.”

Behavioral health problems, also known as mental health problems, affect boys and girls of all ages and can have an impact on their learning, social interactions and physical health.

Some behavioral and emotional issues are short lived and mild – typical childhood behaviors and responses.  However, some behaviors can be signs of long-term problems such as depression, attention deficit-hyperactivity disorder (ADHD), anxiety, mood and behavior disorders or substance abuse. All of these are medical issues that can and should be addressed by physicians or pediatric medical therapists.

“Some behavioral and emotional changes are just part of a child’s natural growth and development and just part of growing up,” Clark says. “However, health care providers rely on parents to describe how children act in their regular, day-to-day lives outside of the doctor’s office in order to identify situations or behaviors that may be signs of larger problems. This conversation between doctors and parents is an essential step that allows providers to assess the severity of the problem, offer parents guidance on strategies to deal with certain behaviors and help families get treatment if needed.”

Many children need help dealing with school stresses such as homework, test anxiety, bullying or peer pressure. Other kids can benefit from an objective third party to help sort out their feelings about family issues, particularly if there is a major transition going on such as divorce, a move or a serious illness. These significant events can trigger behavioral problems that can be addressed and worked through with a therapist.

Sometimes unseen medical issues can be tied to over-anxiousness, depression or ADHD that can be diagnosed and treated successfully under a physician’s care.

If a parent suspects that their child is withdrawing from the family or experiencing panic attacks or prolonged sadness, it’s a good idea to make sure your child has a complete physical and to discuss their symptoms with your pediatrician or family doctor.

The poll was part of a household survey conducted exclusively for GfK Custom Research for C.S. Mott Children’s Hospital. Methods used were typical for previous published studies. The sample was subsequently weighted to reflect population figures from the Census Bureau and do not represent the opinions of the University of Michigan, the University of Michigan Health System, or the C.S. Mott Children’s Hospital National Poll on Children’s Health.

Sources: University of Michigan Health System, http://newswise.com/articles/temper-anxiety-homework-trouble-are-medical-issues-many-parents-don-t-realize-it

http://kidshealth.org/parent/emotions/feelings/finding_therapist.html#cat145

Your Child

Trying to Guilt Kids into Exercising Doesn’t Work

1:45

 

Experts often discuss how kids aren't getting the proper amount of exercise they need to be healthy. But, trying to guilt children into exercising often results in the opposite desired effect according to a new study.

Researchers from the University of Georgia found that middle school students were less likely to be physically active if they didn't feel in control of their exercise choices or if they felt pressured by adults to get more exercise.

Kids who felt that whether they exercised or not was their own choice were much more likely to choose to exercise, the researchers said.

"Can we put these children in situations where they come to value and enjoy the act of being physically active?" lead author Rod Dishman, a professor of kinesiology, said in a university news release.

Dishman and his colleagues said they are looking for ways to help more children identify themselves as someone who likes to exercise.

"Just like there are kids who are drawn to music and art, there are kids who are drawn to physical activity. But what you want is to draw those kids who otherwise might not be drawn to an activity," Dishman said.

So how do you get your child to exercise? Make it about fun, not exercise says Dishman..

“The best thing is to do it because it's fun. It's the kids who say they are intrinsically motivated who are more active than the kids who aren't," Dishman concluded.

Children's activity levels typically fall 50 percent between fifth and sixth grades, the authors noted in the September issue of the journal Medicine & Science in Sports & Exercise.

Using guilt as a motivator seldom achieves the desired result, no matter whether it’s exercising or any other choice. Playing the guilt card with kids only makes them resent what you are trying to get them to do and more often than not, they will do the opposite.

Building a lifetime of healthy choices never began with a guilt trip. Being creative and adding an element of fun and challenge will achieve more than coercion through guilt. 

Children need to identify themselves as someone who wants to exercise instead of someone forced to exercise. The best results have been achieved when families make exercise a part of their daily routine and treat it like anything else they enjoy doing together.

Source: Robert Preidt, http://www.webmd.com/children/news/20150923/want-your-kids-to-exercise-skip-the-guilt

 

Your Child

Healthier Choices for Students in School Lunch Lines

1:30

School lunches have changed over the years and in many school cafeterias, food options are healthier than ever before, according to a new study.

Elementary school cafeterias are offering more vegetables, fresh fruit, salad bars, whole grains and more healthy pizzas, while the availability of high-fat milks, fried potatoes and regular pizza has decreased, researchers report.

"School food service programs have worked hard to improve the nutritional quality of school lunches, and largely have been very successful," said lead researcher Lindsey Turner, director of the Initiative for Healthy Schools at Boise State University, in Idaho.

Although in some schools food choices are improving, that’s not the case everywhere. Turner noted that more work needs to be done to make sure every student has the same healthy choices in the lunch line.

In the study of more than 4,600 elementary schools that are part of the U.S. National School Lunch Program, researchers found that school lunches improved significantly between 2006-2007 and 2013-2014.

Despite improvements in food choices, disparities were still found. For example, schools in the West were more likely to offer salad bars than schools in the Northeast, Midwest or South, the researchers found.

Schools with a majority of black or Hispanic children were less likely to offer fresh fruit than schools with a preponderance of white students.

Also, schools in poor areas were less likely to offer salads regularly.

Over the course of the study, Midwestern schools slightly reduced offering pre-made salads in favor of salad bars, but Southern schools were more likely to offer pre-made salads and less likely to have salad bars, the researchers found.

On the other side of offering healthier foods is choosing to eat those foods. Just because there are better food options available, doesn’t mean that kids will eat them. One expert noted that it takes time and effort for kids to change their eating habits. It not only has to look good, it has to taste good.

"It is not only important to improve the quality of school lunches but to make these foods attractive, tasty, easily seen and accessible," said Samantha Heller, a senior clinical nutritionist at New York University Medical Center, in New York City.

Studies have found that putting fresh fruit in a nice bowl, in a conveniently located, well-lit area in the school cafeteria increased sales of fruit by 102 percent, she noted.

"A brightly lit, hot-and-cold salad bar filled with colorful fresh fruits, vegetables, beans and nuts, mushroom and spinach pizza, and veggie tacos center-stage in the lunchroom would be very attractive to students and staff alike," Heller said.

This approach works well at home, too, she added.

"Kids are more likely to grab healthy foods like cut-up melon, carrots, peppers, edamame and hummus when they are upfront and easy to grab in the fridge," Heller said.

The study was published in the journal Preventing Chronic Disease.

Story source: Steven Reinberg, http://consumer.healthday.com/vitamins-and-nutrition-information-27/food-and-nutrition-news-316/america-s-school-lunches-getting-healthier-study-709097.html

Your Child

What to Do If Your Child Is Choking

2.30 to read

It’s more common than you probably think. On average over 12,000 children a year, under the age of 14, are treated in hospital emergency rooms for food-related choking. That’s about 34 kids a day according to a new study.

The most common choking hazards appear to be hard candy, followed by other types of candy, then meat and bones. The study noted that most of the young patients were treated and released, but around 10 per cent were hospitalized.

"These numbers are high," said Dr. Gary Smith, who worked on the study at Nationwide Children's Hospital in Columbus, Ohio.

What's more, he added, "This is an underestimate. This doesn't include children who were treated in urgent care, by a primary care physician or who had a serious choking incident and were able to expel the food and never sought care."

The estimated 12,435 children ages 14 and younger that were treated for choking on food each year also doesn't include the average 57 pediatric food-choking deaths reported by the U.S. Centers for Disease Control and Prevention annually, the researchers noted.

Smith and his colleagues analyzed injury surveillance data covering 2001 through 2009.

They found that babies one year old and younger accounted for about 38 percent of all childhood ER visits for choking on food. Many of those infants choked on formula or breast milk.

Children who choked on hotdogs, nuts and seeds were the most likely to be hospitalized.

"We know that because hot dogs are the shape and size of a child's airway that they can completely block a child's airway," Smith told Reuters Health, noting that seeds and nuts are also difficult to swallow when children put a lot in their mouths at once.

Supervision is the most important choking prevention. Parents or guardians should make sure that a small child’s food is cut up into manageable bites that can be easily chewed and swallowed. An example might be grapes and raisins. A whole raisin is probably okay to be given to a toddler, but a grape should be sliced.

What should you do if your child is choking?

For children ages 1 to 12:

1. Assess the situation quickly.

If a child is suddenly unable to cry, cough, or speak, something is probably blocking her airway, and you'll need to help her get it out. She may make odd noises or no sound at all while opening her mouth. Her skin may turn bright red or blue.

If she's coughing or gagging, it means her airway is only partially blocked. If that's the case, encourage her to cough. Coughing is the most effective way to dislodge a blockage. If the child isn't able to cough up the object, ask someone to call 911 or the local emergency number as you begin back blows and chest thrusts. If you're alone with the child, give two minutes of care, then call 911.

On the other hand, if you suspect that the child's airway is closed because her throat has swollen shut, call 911 immediately. She may be having an allergic reaction to the food.

Call 911 immediately is your child is turning blue, unconscious or appears to be in severe distress.

2. Try to dislodge the object with back blows and abdominal thrusts.

If a child is conscious but can't cough, talk, or breathe, or is beginning to turn blue, stand or kneel slightly behind him. Provide support by placing one arm diagonally across his chest and lean him forward.
Firmly strike the child between the shoulder blades with the heel of your other hand. Each back blow should be a separate and distinct attempt to dislodge the obstruction.

Give five of these back blows.

Then do abdominal thrusts

Stand or kneel behind the child and wrap your arms around his waist.

Locate his belly button with one or two fingers. Make a fist with the other hand and place the thumb side against the middle of the child's abdomen, just above the navel and well below the lower tip of his breastbone.
Grab your fist with your other hand and give five quick, upward thrusts into the abdomen. Each abdominal thrust should be a separate and distinct attempt to dislodge the obstruction.

Repeat back blows and abdominal thrusts Continue alternating five back blows and five abdominal thrusts until the object is forced out or the child starts to cough forcefully. If he's coughing, encourage him to cough up the object.

If the child becomes unconscious If a child who is choking on something becomes unconscious, you'll need to do what's called modified CPR. Here's how to do modified CPR on a child:

Place the child on his back on a firm, flat surface. Kneel beside his upper chest. Place the heel of one hand on his sternum (breastbone), at the center of his chest. Place your other hand directly on top of the first hand. Try to keep your fingers off the chest by interlacing them or holding them upward.

Perform 30 compressions by pushing the child's sternum down about 2 inches. Allow the chest to return to its normal position before starting the next compression.

Open the child's mouth and look for an object. If you see something, remove it with your fingers. Next, give him two rescue breaths. If the breaths don't go in (you don't see his chest rise), repeat the cycle of giving 30 compressions, checking for the object, and trying to give two rescue breaths until the object is removed, the child starts to breathe on his own, or help arrives.

A good rule of thumb for parents and guardians is to take a CPR class. Many hospitals and clinics also offer classes on what to do if your child is choking.

Sources: Genevra Pittman, http://www.reuters.com/article/2013/07/29/us-choking-food-idUSBRE96S04K20130729

http://www.babycenter.com/0_first-aid-for-choking-and-cpr-an-illustrated-guide-for-child_11241.bc

 

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