Your Child

Bounce House Safety

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For many young kids, bounce houses are magical places where you can vault through the air, land on a pillow and take flight again.  They’ve become a very hot item for kid’s parties and backyard play areas. Many clubs, schools and organizations use them for fundraising.

While they can be great fun under the right circumstances, the rise in injuries to young children has increased an astonishing 1500 percent from 1995 to 2010.  In 2012, a team led by the Center for Injury Research and Policy published the first comprehensive study of such injuries in the journal Pediatrics. Researchers found that 31 children per day were seen in emergency departments for “an inflatable bouncer-related injury.”

On average, they found that the patient was about seven years old, and most commonly sustained some kind of fracture or sprain to a leg or an arm. Almost 20% of the cases involved head and neck injuries. Kids usually got hurt while falling inside the bouncer—rather than out of it—often into another kid of a different size.

Bounce houses and moonwalks have grown in popularity over the last two decades and can now be purchased at stores like Costco and Sam’s. These DYI items are typically not as well made as commercial houses and do not come with anchors that are long and strong enough to withstand robust winds.

Because bounce houses have become so popular, there are a lot more amusement rental companies sprouting up. Drew Tewksbury, a senior vice president at insurance broker Britton Gallagher, developed an insurance program for amusement rentals like bounce houses. He says that trying to set up such playthings without professional operators and attendants is a “recipe for disaster.” He also says that the question of liability is always determined on a case-by-case basis, depending on where the bouncy house is, who set it up, whether waivers were signed and whether instructions were followed.

Currently there are voluntary guidelines for how to set up and operate a bounce house set out by ASTM International. Nearly 20 states, Tewksbury says, have passed legislation making those guidelines mandatory, rules that cover everything from the number of attendants one must have present to how deeply stakes must be pounded into the ground and how strong winds can be before all children are forced to get out.

If you’re considering renting or purchasing a bounce house for your child, there are safety guidelines set by the Child Injury Prevention Alliance that should be applied.

Injury prevention tips:

  • Limit bouncer use to children 6 years of age and older.
  • Only allow a bouncer to be used when an adult trained on safe bouncer use is present.
  • The safest way to use a bouncer is to have only one child on it at a time.
  • If more than one child will be on the bouncer at the same time, make sure that the children are about the same age and size (weight).

Proper use:

  • Take off shoes, eyeglasses and jewelry and remove all sharp objects from your pockets before entering the bouncer.
  • No rough play, tumbling, wrestling or flips. Stay away from the entrance or exit and the sides or walls of the bouncer while you are inside of it.
  • If the bouncer begins to lose air, stop play and carefully exit the bouncer.

Two recent bounce house events have brought home how quickly fun can turn into tragedy.  In mid-May, New York kindergartners playing inside a bounce house, were suddenly tossed 15 feet into the air when the bounce house was picked up by a strong gust of wind. Three children were injured, two seriously. A similar incident occurred in Colorado where two children were also injured.

Despite what may seem like a new rash of freak accidents, children with bounce-house injuries have been regular customers in the nation’s emergency rooms for years—and they’re only getting more frequent. Safety experts have been arguing for years that tougher safety guidelines need to be in place.

When the weather turns warm and school is out, bounce houses and moonwalk rentals and purchases increase.  If you’re thinking about one of these for your kids this summer, make sure that there is a well trained attendant on site and follow the Child Injury Prevention Alliance’s guidelines. If the wind picks while your child is in a bounce house, have them get out. It’s better to be safe than sorry.

Sources: Kate Steinmetz,

Your Child

Returning to School After a Concussion

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Football legend, Brett Favre, recently talked about being concerned over memory lapses he’s been experiencing. He believes the lapses may be a result of the numerous concussions he suffered as a professional football player. He joins an ever-expanding group of ex-NFL players that report serious memory issues as well as depression, anxiety, suicidal thoughts and devastating diseases. Many of the ex-players believe that the frequent concussions they received are at the root of their mental health problems.

As more and more adult sports figures talk about their concussion related medical problems, the spotlight shifts to concern for young student athletes and protecting them from experiencing concussions.  From grade school through college, experts have been creating and implementing programs to prevent concussions as well as guidelines for when a student can return to participate in sports after receiving a concussion.

Researchers are now beginning to explore another side to student concussions – when should a student resume classwork?

The American Academy of Pediatrics (AAP) has issued recommendations for “return to learn”, a checklist to alert doctors, school administrators and parents to potential cognitive and academic challenges to students who have suffered concussions.

“They’re student athletes, and we have to worry about the student part first,” said Dr. Mark E. Halstead, the lead author of “Returning to Learning Following a Concussions,  a clinical report in this week’s Pediatrics.

People tend to associate children’s concussion only with sports related activities, but that leaves out a whole other group of kids that get concussions for a variety of reasons. From skateboarding to car-accidents, from tree climbing to slipping off a curb while texting and not watching where you’re walking – there are lots of ways you can sustain a brain injury.

The brain needs time to heal and requires rest after an injury. Experts have come up with a game plan for when to return to physical activities, but what about “cognitive rest” for tasks such as studying, taking tests and reading? Researchers aren’t sure how long the brain needs to rest before returning to schoolwork.

Experts have not identified at what point mental exertion impedes healing, when it actually helps, and when too much rest prolongs recovery. Although many doctors are concerned that a hasty return to a full school day could be harmful, this theory has not yet been confirmed by research.

The student’s pediatrician, parents and teachers should communicate about the incident, the recommendations said, and be watchful for when academic tasks aggravate symptoms such as headaches, dizziness, sensitivity to light and difficulty concentrating. The academy acknowledged that case management must be highly individualized: “Each concussion is unique and may encompass a different constellation and severity of symptoms.”

Most students have a full recovery within three weeks, the article said. But if the recovery seems protracted, specialists should be consulted.

Schools can have a positive impact on a child’s recovery by helping students ease back into the regular curriculum.  To alleviate a student’s headaches, for example, schedule rests in the school nurse’s office; for dizziness, allow extra time to get to class through crowded hallways; for light sensitivity, permit sunglasses to be worn indoors. Students accustomed to 45-minute classes might only be able to sit through 30 minutes at the outset, or attend school for a half-day.

“Parents need to follow up with schools and make sure plans are being followed,” Dr. Halstead said.

It may take a month before a child is ready to resume full school involvement.

Dr. Matthew F. Grady, a pediatric sports medicine specialist at Children’s Hospital of Philadelphia who may see 50 patients with concussions a week during the fall sports season, often suggests that before students return to class, they should first try modest amounts of school work at home, to identify if and when symptoms recur.

“But that ramping-up period will depend on the severity of the concussion and the cognitive demands on the student,” he said.

If your child has suffered a concussion, talk to your pediatrician or family doctor about a medical plan to help your child return to his or her studies. Notify your child’s school and let the proper authorities know about the concussion and your physician’s recommendations when your child is ready to return.

Source: Jan Hoffman,

Your Child

Halloween Safety Tips

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You can tell we’re entering the holiday season by the plethora of gaudy displays going up in mega grocery stores and malls.  Enormous bags of candy are already filling the shelves and in less than two weeks kids will be hitting the streets carrying on the tradition of celebrating Halloween.

Along with the kid’s fun comes parental responsibility. You can’t protect your child from everything, but there are some tips for keeping your little ones safe.

You can start by preventing fires and burns.

  • Select flame retardant materials when buying or making costumes.
  • Choose battery-operated candles and lights instead of open-flame candles.

The next step is make sure your child can see clearly where they are going and can be seen.

  • Trim costumes or clothing with reflective tape. Many costumes are dark in color and can’t easily be seen by drivers.
  • Give your child a small flashlight or glow stick to carry with them if they are trick- or- treating after dusk.

Store bought costumes rarely fit properly, so you may need to make some adjustments.

  • Adjust costumes to ensure a good fit. Long skirts or capes can drag on the ground and cause falls.
  • Secure hats, scarves and masks to ensure that your child can see everything that is going on around them. Also, check to see that nothing is keeping your child from breathing properly. Masks and some super-hero helmets can fit too tightly, making it hard to breathe.
  • Make sure that swords, canes or sticks are not sharp.

Colored contacts have become popular with some older children. Often the packets these contacts come in have advertising on the package claiming that, “One size fits all.” They don’t.  These lenses are illegal in some states, but can be found online. They may cause pain, inflammation, and serious eye infections. Avoid these at all costs.

How old should children be before they can be unaccompanied by an adult? There is no correct answer to that question. An adult should always accompany young children. When your child is about ten, they may start asking to go with their friends. There are some questions to think about before you decide to let them.

  • What is your child’s maturity level? Do they normally act pretty responsible and make good choices?
  • Who are the friends they want to go with and what is their maturity level?
  • What area are they going to be trick-or-treating in?  Will it be local or in an area your child may not be familiar with?
  • What time do they plan to start and be back home? Give your child a definite time.

Whether your child is with you or out with friends make sure someone has a charged cell phone with them.  You want be prepared in case of an emergency.

Halloween has changed over the years and lots of parents now take their children to specific places that host Halloween parties and activities, but whether it’s in a controlled environment or out on the streets, it’s still smart to keep safety first.


Dr. Karen Sherman,

Your Child

Kids and Caffeine

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While sipping on a coffee-laced Frappuccino, I’m reading about a current study on caffeine and kids. It made me think about my own dependence on caffeine and when it started. For as long as I can remember, my parents would drink several cups of coffee in the morning before going to work, and even as late as right before they retired for the night.  I suspect my mother had a cup while I was busy being born.

I can’t remember exactly when I joined the family coffee drinking ritual, but I know I was pretty young.  Fall and winter demanded hot steaming cups of coffee and iced coffee helped cool the torturous Texas summers. Spring was a combination of both. Sometimes I think that by now, there’s probably coffee bean residue percolating in my blood stream. 

I kind of wish that I’d never started drinking coffee, because it’s the caffeine I really crave- not necessarily the taste of the brew.  When I’ve tried to quit, my body and mind rebels with headaches and bad attitudes. Which brings me back to the study on kids and caffeine.

Researchers from the U.S. Centers for Disease Control and Prevention (CDC) found that children and teens are now getting less caffeine from soda, but more from caffeine-heavy energy drinks and coffee.

"You might expect that caffeine intake decreased, since so much of the caffeine kids drink comes from soda," said the study's lead author, Amy Branum, a statistician at the CDC's National Center for Health Statistics. "But what we saw is that these decreases in soda were offset by increases in coffee and energy drinks."

Not too long ago, energy drinks were just a fad, something that was more likely to give you the shakes than boost your energy level. That was before they were tweaked and bottled or canned in fruity flavors, sugary beverages and clever advertising. Once kids (and adults) got a taste of the “new and improved” tasty stimulates, the caffeinated beverages began to become a part of every day life – at least Monday through Friday when school and work beckoned.

"In a very short time, they have gone from basically contributing nothing to 6 percent of total caffeine intake," Branum said.

“Energy drinks have more caffeine than soda,. That's their claim to fame," she said. "That's what they're marketed for."

So, what effect does excessive caffeine intake have on our kids? Scientists are not sure yet. There are concerns and a lot of questions about the possible adverse consequences for kids who are still developing.  Caffeine addiction, obesity from sugar heavy beverages, high blood pressure, rapid heart beats and anxiety are some of the side –effects researchers are exploring. 

Using data from the 1999 to 2010 National Health and Nutrition Examination Survey, Branum's team estimated that 73 percent of American children consume some level of caffeine each day.

Although much of their caffeine still comes from soda, the proportion has decreased from 62 percent to 38 percent. At the same time, the amount of caffeine kids get from coffee rose from 10 percent in 2000 to 24 percent in 2010, the researchers found.

The American Academy of Pediatrics (AAP) states that energy drinks are never appropriate for children or adolescents and in general, caffeine-containing beverages, including soda, should be avoided. The AAP suggests that children should drink water or moderate amounts of juice instead.

The genie is probably out of the preverbal bottle as far as some adolescents and college-aged kids are concerned.  Although, if they are more aware of the possible health risks associated with excessive caffeinated beverages, they may decide to look at healthier energy producing sources such as exercise, meditation and more rest.

Where parents can have the most influence is with their younger children.  Refraining from purchasing caffeinated products (there’s even “energy” gum) and keeping them out of the home is a good first step.

And by all means, avoid introducing your kids to coffee at a young age. It might seem kind of cute, but twenty years down the road, they may wish you hadn’t slid that first cup of java their way.

The report was published in the February edition of the online journal Pediatrics.

Sources: Steven Reinberg,

Your Child

Air Fresheners and Children’s Health

1.45 to read

One of the most popular indoor air pollutants is the store bought air freshener. As you have probably found out by now, they don’t really “freshen” the air; instead they often mask odors with synthetic fragrances.

Air fresheners are sold as room sprays, plug-in deodorizers, odor neutralizers, air-sanitizers and aromatherapy candles. They are typically placed or sprayed in kitchens, bathrooms, bedrooms, living rooms and baby nurseries.

You might be surprised to learn what is in these products.

According to the Environmental Protection Agency (EPA), air fresheners contain four basic ingredients: formaldehyde, petroleum distillates, p- dichlorobenzene, and aerosol propellants.

These chemicals can cause headaches, rashes, dizziness, migraines, coughing, allergies and asthma. The potent substances are not good for anyone, but particularly children whose bodies and immune systems are still developing.

Studies have shown that children and adults with allergies are more likely to be chemically sensitive to artificial fragrances and the more toxic chemicals in these products can trigger asthma attacks.

Air fresheners are also highly flammable and strong irritants to the eyes, skin and throat. Solid fresheners can cause death if accidently ingested by children or pets.

There are more natural ways to freshen up indoor air:

Baking soda is one of those products that's been around forever. Baking soda absorbs odors. Sprinkle on the carpet, let sit for 5 minutes then vacuum. You can also fill small bowls and with baking soda and place in rooms where odors accumulate- putting them out of reach of children.

White vinegar is an excellent deodorizer and disinfectant. Use a solution of 1 part vinegar to 4 parts water to eliminate smells. You can also use this mixture for mopping and cleaning floors. Always check a small surface of the area you want to clean first to make sure that the vinegar will not damage it. 

Another recipe for cleaning is 1 teaspoon of baking soda, 1 teaspoon of lemon juice and 2 cups of hot water in a spray bottle.

Aromatic herbs such as Lavender, Rosemary, Mint, and Basil can be made into sachets and placed in drawers and closets. In the kitchen you can boil your favorite mixture to cleanse and refresh the air.

Air fresheners have become a big-seller in the consumer world, but that’s probably because most people are not aware of what’s actually in them.


Your Child

Dangerous Toys Still on the Shelves

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With Black Friday, Cyber Monday and the typical holiday shopping frenzy upon us, many parents and grandparents have started or will be buying presents for the little ones in their family.

While most toys meet government set safety standards, there are always a few that seem to slip through the cracks. U.S. Public Research Group (U.S. PIRG), a consumer group that pushes for toy safety and looks for common hazards in toys, just released its report “Trouble in Toyland” outlining toys that they consider dangerous.

The number one offender this year is “The Captain America Soft Shield”, for ages 2 and older, which they say contains 29 times more lead than allowed by law.

Exposure to lead can affect almost every organ and system in the human body, especially the central nervous system.  Lead is especially toxic to the brains of young children and can cause permanent mental and developmental impairments; it has no business being in children’s products.

The current federal legal lead standard is 100 parts per million (ppm), though the American Academy of Pediatrics recommends a lead limit of 40 ppm.

"You can still find hazardous toys made by big brands and sold by big retailers," says Edmund Mierzwinski, consumer program director for the group.

Among toys highlighted in the report are some made by toy giants Hasbro and Mattel.  The group purchased toys and tested them from major retailers including Walmart, Kmartand , Toys R Us and Babies R Us.

The report lists the Fisher-Price “Loving Family Outdoor Barbeque” as a danger because of plastic food items so small and realistic that toddlers could choke on them.

The report notes that there is not a comprehensive list of unsafe toys available for review, but warns parents to "examine toys carefully for potential dangers before you make a purchase." Below is from the U.S.PIRG “ Trouble in Toyland “ report.

Other Toxics in Toys

The current federal legal standard limits six kinds of phthalates to 1,000 ppm, and limits the amount of antimony and arsenic, cadmium and other elements that can leach out of toys. We found toxic chemicals including phthalates, antimony, and cadmium. “The Ninja Turtles Pencil Case” was found to contain 150,000 ppm of one of six phthalates banned from toys, as well as excessive levels (600 ppm) of the toxic metal cadmium.

Choking Hazards

Choking - on small toy parts, on small balls, on marbles and on balloons - continues to be the major cause of toy-related deaths and injuries. Between 2001 and 2012, more than 90 children died from choking incidents.

This year we found several toys that contained small parts or “near small part” toys. The toys containing small parts contained improper labels and might be mistakenly purchased for children under 3. The toys containing near small parts support our argument that the small parts test should be made more protective by making the test cylinder larger.

We also found some toy foods including both near small parts and other rounded ball-like foods that would fail the small ball test although they are technically subject to the less-stringent small parts test. Toy foods pose a special hazard, because they look to small children like something that should be eaten.

Five different Littlest Pet Shop toys made by Hasbro were cited in the report as potential choking hazards because of parts that can detach from the toy. There are no small-part warnings on the toys. The toys were purchased by U.S. PIRG at Walmart and Kmart. Hasbro spokeswoman Julie Duffy responded in a statement: "The entire Littlest Pet Shop line is age graded for children 4 years and older. The Littlest Pet Shop figures do not pose a choking hazard as regulations for small parts apply to products for under 3 years of age."


Magnet toys made with neodymium iron boron magnets, such as the Buckyball magnets that are the subject of a CPSC court action, are still available and continue to cause accidents. CPSC staff have estimated that between 2009 and 2011 there were 1,700 emergency room cases nationwide involving the ingestion of high powered magnets.  More than 70% of these cases involved children between the ages of 4 and 12.

We also found ellipsoid toy magnets that nearly fit in the small parts cylinder, and are classified as a novelty “finger-fidget” toy. These magnets are smooth and shiny and sold in pairs; striking them together causes them to vibrate and produce a singing sound, making them appealing to children. CPSC has reported gastroenterological injuries associated with ellipsoid magnets.  If the magnet had fit in the small parts test cylinder, it would be banned for sale to children under 14. These, instead, were labeled “8 and up.”

Noisy Toys

Research has shown that a third of Americans with hearing loss can attribute it in part to noise. The third National Health and Nutrition Examination Survey showed that one in five U.S. children will have some degree of hearing loss by the time they reach age 12. This may be in part due to many children using toys and other children’s products such as music players that emit loud sounds.  The National Institute on Deafness and Other Communication Disorders advises that prolonged exposure to noise above 85 decibels will cause gradual hearing loss in any age range. Toys that are intended to be held close to the ear, are not to exceed 65 decibels. Toys that held within close range (in a lap or on a table) are not to exceed 85 decibels.

We found toys on store shelves that exceeded the limit of 65 decibels for toys held close to the ear. The “Chat & Count Smart Phone”, for example, produces sound measuring higher than 85 decibels when measured at 2.5 centimeters, and children may hold such toys pressed up against the ear.

Over the past five years, stronger rules have helped get some of the most dangerous toys and children’s products off the market.  Improvements made in 2008’s Consumer Product Safety Improvement Act (CPSIA) tightened lead limits, phased out dangerous phthalates, and required independent third party testing.  However, not all toys comply with the law, and holes in the toy safety net remain.

As for toys that may contain lead, the U.S.PIRG offers this advice,  “Parents should continue to be vigilant about metals in toys as they may contain lead or cadmium above the mandatory safety limits. The Centers for Disease Control (CDC) recommends that all children be screened for exposure to lead. A simple and inexpensive blood test can determine whether or not a child has a dangerous level of lead in his or her body. The test can be obtained through a physician or public health agency.”


Bruce Horovitz,

Your Child

Concussions May Last Longer in Girls

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New research suggests that girls who suffer a concussion may have more severe symptoms that last longer compared to boys.

No one seems to know why there is a difference, but other studies have come to the same conclusion.

"There have been several studies suggesting there are differences between boys and girls as far as [concussion] symptom reporting and the duration of symptoms," said Dr. Shayne Fehr, a pediatric sports medicine specialist at Children's Hospital of Wisconsin.

In his new study, Fehr also found those differences. He tracked 549 patients, including 235 girls, who sought treatment at a pediatric concussion clinic.

Compared to the boys, the girls reported more severe symptoms and took nearly 22 more days to recover, said Fehr, also an assistant professor of pediatric orthopedics at the Medical College of Wisconsin.

In the new study, Fehr tracked patients from 10 to 18 years old. All were treated between early 2010 and mid-2012. Each patient reported on their symptoms, how severe they were and how long it took from the time of the injury until they were symptom-free.

Girls reported more severe symptoms and took an average of 56 days to be symptom-free. In comparison, the boys took 34 days. Overall, the time to recovery was 44 days when boys and girls were pooled.

The length of time it took for patients to fully recover from concussion is quite a bit longer than people usually think.

"Commonly you hear that seven to 10 days [for recovery] is average," Fehr said.

The patient’s who were part of this study went to concussion clinics, so their injuries may have been more acute.

Fehr did not find age to be linked with severity of symptoms. Most of the injuries -- 76 percent -- were sports-related, with football accounting for 22 percent of the concussions.

The top five reported symptoms were headache, trouble concentrating, sensitivity to light, sensitivity to sound and dizziness. Boys and girls, in general, reported the same types of symptoms, Fehr said, but the girls reported more severity and for a longer time period.

Fehr will present the findings at the American Medical Society for Sports Medicine this week. Studies presented at medical meetings are typically viewed as preliminary until published in a peer-reviewed journal.

Whether it’s a boy or a girl that suffers a concussion, it's important to be seen by a doctor and not return to play prematurely, which can be dangerous or even fatal, according to the American Academy of Pediatrics.

Anyone with a history of concussion is also at higher risk for another injury.

Source: Kathleen Doheny,

Your Child

Study: Obesity May Be Set By Age 5

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A new study says that children who are overweight at the age of five are four times more likely to be obese by age fourteen than five-year-olds who are at a healthy weight.

The new data came from the Early Childhood Longitudinal Study conducted by the U.S. National Center for Education Statistics. The study involved 8000 children whose height and weight were tracked seven times between 1998, when they were in kindergarten, to 2007.

Overall, 27 percent of kids in the study were overweight or obese when they started school and that ratio increased to 38 percent by eighth grade.

"Half of childhood obesity occurred among children who had become overweight during the preschool years," researchers led by Solveig Cunningham of Emory University in Atlanta wrote.

"If we're just focused on improving weight when kids are adolescents, it may not have as much of an impact as focusing on the preschool-age years," Cunningham told Reuters Health. The study "doesn't tell us what to do about it, but it helps tell us when we need to think creatively about what to do."

Research has shown that the rate of childhood obesity rose from about 4 percent in the early 1960s to more than 15 percent by 2000. Most of that research was done in adolescents.

"However, since many of the processes leading to obesity start early in life, data with respect to incidence before adolescence are needed," the researchers noted in the New England Journal of Medicine.

Interestingly, the obesity rate rose rapidly between first and third grade, from 13 percent to almost 19 percent. Between fifth and eighth grades, the rate didn’t increase significantly.

About 32 percent of kids who were overweight when they entered kindergarten had become obese by age 14. That compared to 8 percent of normal-weight kindergarteners.

Not all of the healthy weight five-years-old, continued to maintain a normal weight by the time they were teens, "Half of obese eighth graders do start out at normal weight," Cunningham said.

Other studies have said a child’s chances of becoming overweight or obese may start as early as babyhood.

While roughly 11 percent of babies born weighing 8.8 pounds or less were obese by kindergarten, the rate was almost 23 percent for those born weighing more. By eighth grade, about 20 percent of children born with low or normal weights were obese and just over 31 percent of children with high birth weights were obese.

Experts say that the best thing that parents can do is to feed their kids in a healthy way from birth throughout their childhood. And of course, be a good example of someone who has a sensible relationship with food and lives a healthy lifestyle.

Source: Gene Emery,

Your Child

Concussions in Young Girl’s Soccer

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As a parent, you already know that soccer is one of the most popular sports of younger athletes. On any given weekend you’ll find teams of kids on the field kicking and heading soccer balls. If you have a young daughter that plays soccer, you may be surprised to learn that she is more likely to suffer a concussion than her high school counterpart.

Researchers found that pre-teen and early teen girls are very vulnerable to concussions and many play through their injury instead of seeking medical attention.

Although awareness has increased about sports related concussions, little research has been done on middle school athletes, especially girls, noted study co-author Dr. Melissa Schiff, a professor of epidemiology at the University of Washington School of Public Health in Seattle.

In a new study, Schiff and her colleagues evaluated 351 soccer players from 2008 to 2012, between the ages of 11 and 14. Researchers found 59 concussions. A concussion is defined as a traumatic injury to the brain after a blow, shaking or spinning. In the study, the girls' symptoms included headache, dizziness, drowsiness and concentration problems.

High school or college women’s soccer reported fewer injuries than the middle school students.

Experts recommend those who have a concussion be evaluated by a doctor or other health care professional trained in the injury, but Schiff found that ''56 percent were never evaluated." Experts also advise that players not return to practice or games until symptoms disappear, but 58 percent of the players in the study continued to play even with symptoms persisting, she said.

In this study, the researchers randomly selected 33 of 72 elite teams from four youth soccer clubs in the Puget Sound region of Washington State. Players reported injuries and symptoms.

Researchers noted that players colliding with each other caused half of the concussions and 30 percent were from heading the ball. Heading involves hitting the ball with the forehead to redirect the ball during play. While heading was a major contributor to concussions, Schiff thinks it’s unrealistic to think that it will be banned. "It's part of the soccer sport," she said.

However, it was found to result in concussion 23 times more often in a game than in practice. One suggestion, she said, is to teach middle school athletes heading in practice but tell them not to do it in games until they are older. The researchers speculate that younger players' less mature brains and weaker neck muscles, along with poorer heading technique, may contribute to the number of concussions.

In 2009, the Zackery Lystedt law was passed in Washington State requiring athletes under the age of 18 be removed from play when they are suspected of sustaining a concussion. Since the study began earlier than 2009, the law wouldn’t have affected some of the girls.

Concussions aren’t a surprise in the game of soccer. It can be a rough and tumble sport. Players, parents and coaches need to pay attention to the symptoms associated with concussions and make sure that athletes are removed from the game and diagnosed and treated as soon as possible.

Sources: Kathleen Doheny,


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