Your Child

Heavy Children at Risk for Asthma Symptoms

Children who are overweight at age six to seven are at higher risk for having symptoms of asthma.Children who are overweight at age six to seven are at higher risk for having symptoms of asthma like shortness of breath and "twitchy" airways when they are eight years old a new study out of the Netherlands shows. However, children who are overweight at a younger age but reach a normal weight by age six or seven do not appear to have an increased risk for asthma symptoms.

"These findings suggest that being overweight may affect a child's development of asthma symptoms," Dr. Salome Scholtens from the National Institute for Public Health and the Environment in Bilthoven told Reuters Health. "However, if a previously overweight child develops a normal weight, then the asthma symptoms are less likely to persist. We propose that development of a normal weight might positively affect asthma symptoms in overweight children," Scholtens added. Each year until the age of 8, researchers had the parents of 3756 children report their children's weight and any episodes of wheezing or other breathing difficulties as well as the use of inhaled steroids. The researchers tested the children to see how sensitive their airways were to various inhaled allergens. When the children were eight years old, 7.3 percent wheezed, 9.6 percent had difficulty breathing and 7.1 percent had a prescription for an inhaled steroid in the preceding year. According to the investigators, children who were persistently heavy from a very young age and between ages six and seven were 68 percent more likely to have breathing difficulties and 66 percent more likely to have twitchy airways at age 8 than children who were leaner in childhood.

Your Child

Are Kid’s Sack Lunches Healthier?


For some kids who bring their lunch to school, a new study suggests that as far as nutrition goes, they’d be better off buying their meal at the school cafeteria.

Researchers found that student’s bag lunches typically contained foods that were higher in sodium and sugar with fewer vegetables and whole grains compared with standards set for school cafeterias.

The findings are not necessarily surprising, said the study's senior researcher, Karen Cullen, a professor at Baylor College of Medicine in Houston.

"Parents often pack lunches based on their children's preferences," she noted. Plus, she added, some other recent studies have found a similar pattern.

The study involved 12 elementary and middle schools in one Houston-area school district. Over two months, the researchers observed more than 300 students who brought their lunch from home -- noting what they ate and what they threw away.

On average, bag lunches were low on fruits and whole grains, and especially vegetables and milk.

School guidelines say kids should have three-quarters of a cup of vegetables (which really isn’t much) with every lunch. The average elementary school bag lunch had about one-tenth of that amount, according to the study.

Lunches brought from home also contained way too much sodium. The average bag lunch averaged 1,000 to 1,110 mg, versus a limit of 640 mg in elementary school lunches.

About 90 percent of the home lunches contained a dessert, sugary drink or snack chip. Guess what? Kids ate those items whereas between 20 and 30 percent of vegetables ended up in the garbage, according to the study.

Packing milk and palatable vegetables is tricky, noted Dr. Virginia Stallings, a pediatrician at Children's Hospital of Philadelphia who specializes in nutrition.

Giving your kids money to buy it at school can help solve the milk dilemma, said Stallings, who wrote an editorial published with the study. With vegetables, though, it can be challenging to go beyond carrot sticks, she added.

"I think that's one of the advantages of the school lunch," Stallings said. "Kids can have a hot meal, with cooked vegetables." She added that schools are working on making meals that are tasty without relying on salt, and expanding to include culturally diverse choices.

I don’t really think that kid’s attitudes have changed much about school lunches in the last few decades. As long as I can remember, kids eat what they want, trade foods with others and throw out the rest. They often gripe about their lunch food whether it comes from home or the school cafeteria.. That’s just what kids do.

So, if they are going to complain anyway you might as well fix them a lunch that will help them develop strong bones and hearts. The school systems have finally started paying attention to nutrition after all these years. They’re working on creative recipes that just might temp kids to eat better.

You already know that there are way too many American children that are eating poorly, not exercising and developing diabetes at a young age. It’s important what our children eat. Sometimes a school lunch is best and sometimes a lunch brought from home is best. Many times parents split the difference and do both.

Source: Amy Norton,

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

Protecting Your Family From The West Nile Virus

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On Monday, The Centers for Disease Control and Prevention (CDC) released a report saying that, in the United States, 2012 was the deadliest year on record for deaths attributed to the West Nile virus.

Texas led the nation, compromising 33 percent of all reported cases with 1,868 infections and 89 deaths. That was far above California, which had the second most reported cases at 479 and 20 deaths.

In the majority of West Nile virus cases, most people experience only minor symptoms such as fever and a mild headache. However, some people who become infected with the virus develop a life-threatening illness that includes inflammation of the brain.

Serious symptoms can include:

- High fever

- Severe headache

- Stiff neck

- Disorientation or confusion

- Stupor or coma

- Tremors or muscle jerking

- Lack of coordination

- Convulsions

- Pain

- Partial paralysis or sudden muscle weakness

Signs and symptoms of West Nile fever usually last a few days, but signs and symptoms of encephalitis or meningitis can linger for weeks, and certain neurological effects, such as muscle weakness, may be permanent.

If you or a family member experience any of these more severe symptoms see a physician immediately.

The CDC's Dr. Lyle Petersen says it's impossible to know what West Nile will do this summer. "It is very hard to predict," he said in a telephone interview with NBC News. "I can't tell you what the weather is going to be like this summer, for example." The virus is driven by weather; it's worse during hot, wet summers in temperate climates.

"What last summer's outbreak tells us is that West Nile is not going to go away," Petersen said. "Most places in the United States are at risk of having outbreaks."

Currently, there is no vaccine against the virus for people. Most infections occur in the warmer months when mosquitoes are active.

Adults over 50 are at the highest risk for serious infection, but if any family member is suspected of being infected with the virus he or she should be tested.

While children are typically at a much lower risk for infection (about 3 percent of cases reported) they are the most likely to be playing outside during the warmer months and should be protected against mosquito bites.

Some steps you can take to protect your children (and yourself) from mosquito bites are:

- Making sure to keep as much of their skin covered with clothing as possible, including a long sleeve shirt, long pants, socks, and a hat.

- Wearing light colored clothing, so as not to attract bugs.

- Avoiding using any scented soaps or other products on your children, since the fragrances can also attract insects.

- Using an insect repellent regularly. Commonly used insect repellents that can usually be safely used in children include those with less than 10% DEET, or others with citronella or soybean oil. New reports suggest that an insect repellent with 30% DEET is safe for kids too.

- Using window and door screens to prevent insects from getting inside your house.

- Empty standing water around your house where mosquitoes can breed.

- Avoid outdoor activities during peak mosquito biting times, from dusk (early evening) to dawn (early morning).

Parents shouldn’t be so fearful of their child getting the West Nile Virus that they don’t allow their children to play outside during the warm spring and summer months.  However, taking extra precautions to protect your child from mosquito bites just makes good sense.

Sources: Maggie Fox,

Vincent Iannelli, M.D.

Your Child

Exercise Can Cut Kids Risk For Diabetes

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A little exercise can make a big difference in a child’s life.  Twenty minutes a day may help lessen the risk of diabetes in kids according to a new study published in the Journal of the American Medical Association.

The clinical trial randomly assigned 222 overweight and inactive kids to three different activity groups.

One group was assigned to 20 minutes of execise a day. Another group was assigned 40 minutes a day while the third set of kids was told to continue with their normal physical activity. This group served as a control group for the trial.

Children who did low and high amounts of aerobic exercise had greater reductions in insulin resistance than those in the control group, along with greater decreases in overall body fat and abdominal fat, said Catherine Davis, of the Medical College of Georgia, and colleagues, in a journal news release.

The exercise-related reductions in diabetes risk factors occurred in both boys and girls, and in children of different races.

What was surprising is that the kids who benefited the most from the exercise didn’t change what they ate.

"I hope these findings will provide an impetus for changes in communities around the U.S. and the rest of the world that will focus attention on children's health," Davis said. "This can be done by providing welcoming, safe physical activity programs for children of all skill levels."

Not surprisingly, the kids who exercised longer had better values for markers of diabetes risk and had less body fat.

"This study helps to isolate the benefit of exercise in cutting down on diabetes risk and obesity in kids," said study co-author, Dr. B. Adam Dennis, an endocrinology fellow at Georgia Health Sciences University in Augusta, Ga.

The study suggests that schools should add a short amount of time to exercise during the day, for students. 20 minutes a day could be added through recess and gym classes. A 40 minute exercise plan might require an after school program.

Davis added that exercise is not just useful in cutting back diabetes risk and obesity, but it is also good for kids' brains. She cited a related study that showed that exercise improved cognition and math skills in kids.

Some schools focus their attention on the more athletic kids and the less physically fit kids get left behind.  Designing a physical fitness program that includes all kids could help students not only avoid obesity and diabetes but may help improve their ability to learn as well. That becomes a definite win-win situation.

While some exercise is better than none, more exercise is best of all.

Over one-third of American elementary school children are obese or overweight. It’s truly a national epidemic. Type2 diabetes is also increasing.  According to the American Diabetes Association about 1 in every 400 children and adolescents has diabetes. The possible long-term affects of diabetes include heart disease and stroke, high blood pressure, kidney disease, blindness and nervous system damage.

In lieu of that, at least 20 minutes of exercise a day sounds like the much better option.


Your Child

Should Sugar Be Labeled a Toxin?

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Here’s a question for you. Should sugar be labeled a toxin and regulated like alcohol and tobacco? There are some in the scientific community that say absolutely.

Robert Lustig M.D, Laura Schmidt PhD. and Claire Brindis DPH, all researchers in health policy, argue in an opinion piece called “The Toxic Truth About Sugar” in the February issue of the journal Nature that sugar and other sweeteners are so toxic to the human body that access to them should be strictly regulated, especially for children.

Although not calling for a complete ban on sugar, Lustig and his colleagues say there are certain regulations the government could apply.

"For both alcohol and tobacco, there is robust evidence that gentle 'supply side' control strategies which stop short of all-out prohibition -- taxation, distribution controls, age limits -- lower both the consumption of the product and the accompanying health harms," they wrote.

Lustig has long been a proponent of labeling sugar a toxin. Lustig and colleagues noted that sugar poses dangers similar to those of alcohol. Fructose, specifically, can harm the liver, they wrote, and over-consumption has been linked with all the diseases involved with metabolic syndrome: hypertension, high triglycerides, insulin resistance, and diabetes.

It also has the potential for abuse, they wrote, as it interferes with the signaling of hunger hormones leptin and ghrelin and tinkers with dopamine pathways. It exacts a great cost, they said, with the U.S. spending $65 billion in lost productivity and $150 billion on healthcare every year for problems related to metabolic syndrome.

Sugar has been called “empty calories” for a long time, but the researchers write it’s more than that. “There is nothing empty about these calories. A growing body of scientific evidence is showing that fructose can trigger processes that lead to liver toxicity and a host of other chronic diseases. A little is not a problem, but a lot kills—slowly.”

The U.S. population is already more than two-thirds overweight and about 75 percent of U.S. health-are dollars are spent on diet-related diseases, Dr. Lustig explains. The risk of liver failure, obesity, heart disease and diabetes are rising rapidly, and it seems drastic measures needs to take place in order for change.

“We’re not talking prohibition,” Dr. Schmidt says in a statement. “We’re not advocating a major imposition of the government into people’s lives. We’re talking about gentle ways to make sugar consumption slightly less convenient, thereby moving people away from the concentrated dose. What we want is to actually increase people’s choices by making foods that aren’t loaded with sugar comparatively easier and cheaper to get.”

Other researchers argue that other substances may be the cause of the obesity epidemic.

Some say that saturated fat, not sugar, is the root cause of obesity and chronic disease. Others say that it is highly processed foods with simple carbohydrates. Still others argue that it is a lack of physical exercise. It could, of course, be a matter of all these issues.

Sources:  /  /


Your Child

Twitter Ringworm Question

A twitter follower ask about treatment of ringworm.We received a "tweet" from a concerned dad.  He writes: I'm sure you receive thousands of questions, but I was wondering if putting a band aid on my daughter's ringworm (on knee) will impede healing?

Ringworm is very contagious and should be treated with an anti-fungal cream.  If you place a band aid over the infected area, it will hasten the healing process. Keep following your doctor's recommendation when using her medication.  Even when the rash appears to be getting better, continue the medication (per doctor's orders) as this will help prevent the fungus from coming back. If it looks like it is not getting better, call your pediatrician.

Your Child

Water an Easy Remedy for Overweight Kids

A new study indicates that the best way to help your child keep the weight off is to give them water instead of soda and other sugar-sweetened drinks. One analysis of the diets of American children and teenagers showed they drink, on average, 235 "empty" calories in sugar-sweetened beverages each day. When those drinks are cut out, the average child does not make up for them by eating or drinking more calories elsewhere, the researchers said. A second study by Dutch researchers found children would cut out sugary drinks before they would exercise or abandon snacks.

"The evidence is now clear that replacing these 'liquid calories' with calorie-free beverage alternatives both at home and in schools represents a key strategy to eliminate excess calories and prevent childhood obesity," Dr. Claire Wang of Columbia University in New York said in a statement. In the study published in the Archives of Pediatrics and Adolescent Medicine, Wang and her colleagues said they looked at data fro the 2003-2004 National Health and Nutrition Examination Survey that included detailed questions about diet. Every 1 percent drop in soft drink intake correlated to more than six fewer calories, they found.

Your Child

New Guidelines for Ear Infections

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When a child is in pain and crying, a loving parent wants nothing more than to make the pain go away.  Ear infections can be very painful and often a parent will request antibiotics to treat the infection from their pediatrician or family doctor.

The American Academy of Pediatrics (AAP) has issued new guidelines for identifying and treating childhood ear infections and would like to see fewer antibiotics prescribed.

The guidelines more clearly define the signs and symptoms that indicate an infection that needs treatment. They also encourage more observation, with follow-ups, instead of antibiotics. This would also include some children under the age of two. Most children with ear infections get well on their own and can be safely monitored for a few days.

For children with recurrent infections, the guidelines advise physicians and parents on when it is time to see a specialist.

"Between a more accurate diagnosis and the use of observation, we think we can greatly decrease the use of antibiotics," said the lead author of the new guidelines, Dr. Allan Lieberthal, a pediatrician at Kaiser Permanente Panorama City, in Los Angeles, and a clinical professor of pediatrics at the Keck School of Medicine at the University of Southern California.

The guidelines say that there are definitely times when antibiotics should be prescribed such as when children have a severe ear infection. Severe is defined as when a child has either a fever of 102.2 degrees or higher or is in significant pain. He or she has a ruptured ear drum with drainage, or an infection in both ears for kids two years or younger.  These account for fewer cases but studies have shown that children benefit from antibiotics given right away.

It’s been since 2004 since the last set of guidelines were issued. Those guidelines stimulated new research that has provided evidence for the new AAP guidelines that will appear in the March issue of Pediatrics.

Lieberthal said the biggest change is the definition of the diagnosis itself. Experts say that the new definition is more precise. Because of the different stages of ear infections, diagnosis can be tricky.

The AAP offers detailed treatment suggestions that encourage observation with close follow-ups as long as the child is not having severe symptoms, but leaves it up to the discretion of the physician whether or not to prescribe antibiotics.  Previous guidelines recommended that antibiotics be prescribed for children under two with ear infections.

Pain management is also an important component of the new guidelines. Antibiotics can take up to 2 days before they start to improve symptoms, so if a child has fever or pain they should be given pain relieving or fever reducing medications.

The new guidelines also state that children, even those with recurrent infections, shouldn't be on long-term daily antibiotics to try to prevent infections from occurring. Long-term antibiotic use has its own downfall. Children can develop a rash and diarrhea (causing dehydration.) The biggest concern is that the child will build up immunity to the antibiotic, making it ineffective over time.

When children have recurrent ear infections they should be referred to an ear, nose and throat specialist. Recurrent is defined as children who have three or more ear infections in a six-month period, or four or more infections in a one-year period (with at least one infection occurring in the previous six months.)

The new guidelines also recommend staying current on your child’s vaccine schedule, especially the pneumococcal conjugate vaccine (PCV), and the flu shot. "Studies show that anything that decreases viral infection will decrease the incidence of ear infections," Lieberthal said.

Many parents are beginning to see the logic of not over-using antibiotics, but some are still unaware of the dangers. Physicians may now be more assertive about watchful waiting and follow-ups when a child’s ear infection isn’t severe. That may not comfort the parent of a crying child in pain, but it may be the best approach for the child in the long run.

Sources: Serena Gordon

Michelle Healy


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