Your Toddler

Toddlers’ Meals and Snacks Packed with Salt

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New research from the Harvard School of Public Health says that one in 10 Americans die from eating too much salt. . Excessive salt consumption is linked to cardiovascular disease and has traditionally been associated with older adults. However researchers noted that younger people are now showing the same health problems from too much salt such as high blood pressure, stroke and heart attack.

The problem is that salt is used in just about all packaged and processed foods. Over the years producers have added more and more salt for flavoring,

And now a new study now shows that meals and snacks marketed to toddlers have more than the recommended amount of sodium, meaning that children as young as one are most likely eating far too much salt early in life.

There is scientific evidence that a child’s salt intake is related to whether he or she will develop high blood pressure (hypertension) as an adult. Hypertension is a major risk factor of heart disease – the number one killer of men and women in the United States.

"The good news is that commercial foods for babies, when they start complimentary feeding from 4 to 12 months ... are relatively low in sodium," explains Joyce Maalouf, the study's lead author and a fellow at the National Center for Chronic Disease Prevention and Health Promotion at the Centers for Disease Control and Prevention.

"But the products marketed to toddlers were significantly higher in sodium: more than 75% of the toddler meals and snacks had high sodium content."

The research team reviewed more than 1,100 products marketed to babies and toddlers and sold in grocery stores. If a product had more than 210 milligrams of sodium preserving it was defined as high in sodium. The rating is based on guidelines by the Institute of Medicine and MyPlate.gov.

Some meals tested as high as 630 milligrams of sodium per serving. Cereals and savory snacks tested highest in sodium compared to cereal bars and fruit snacks.

Name brands were not named in the study, but Maalouf said "We're talking meals that are pre-packed ... like mac and cheese, pasta with meat sauce, pizza, or chicken and vegetables".  He noted that the meals are not frozen meals but the kind that are microwavable.

"These meals are not the only meal that kids will eat," says Maalouf. "They're growing, they're always snacking. So they're eating seven to eight servings and meals per day."

Nutritionist suggest that parents read the labels on any prepackaged foods they buy for their child, and shop the outer aisles of the grocery store where fresh vegetables, fruits, dairy, and fresh meat and poultry are kept.

The study was presented at the American Heart Association’s Epidemiology and Prevention/Nutrition, Physical Activity and Metabolism 2013 Scientific Sessions in New Orleans.

Source: Caitlin Hagan,  http://thechart.blogs.cnn.com/2013/03/21/meals-and-snacks-for-toddlers-heavy-in-sodium/

Your Toddler

Jogging Strollers Recalled

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This recall involves sport v2 and classic v1 model single-seat jogging strollers. The three-wheel strollers have a metal frame, cloth seat and a canopy. The sport v2 model stroller was sold in red, orange, green, black, charcoal, navy and in graffiti print. Sport v2 serial numbers included in the recall are 0308/0001 to 0510/0840. Phil and Ted’s Jogging Strollers are being recalled in the US and Canada because the hinge mechanism poses laceration and amputation risks.

The U.S. Consumer Product Safety Commission and Health Canada, in cooperation with the firm named below, today announced a voluntary recall of the following consumer product. Consumers should stop using recalled products immediately unless otherwise instructed. It is illegal to resell or attempt to resell a recalled consumer product. Name of Product: Jogging Strollers Units: About 22,000 in the United States and 7,200 in Canada Importer: Phil&Teds USA Inc., of Fort Collins, CO Hazard: When folding and unfolding the stroller, a consumer’s finger can become caught in the hinge mechanism, posing amputation and laceration hazards. Incidents/Injuries: phil&teds has received three reports of incidents resulting in injuries to the adult users including a finger tip amputation and two reports of lacerations. Description: The classic v1 model strollers were only sold in red. Serial numbers for the classic v1 are 0308/0001 to 0510/0906. The first four digits of the serial number is a month/year date code and the last four digits are for the individual stroller. Serial numbers are printed on the inside of the folding hinge. The phil&teds logo is located on the crotch piece of the harness on both models. Sold by: Specialty juvenile stores nationwide from May 2008 through July 2010 for between $350 and $450. Manufactured in: China Remedy: Consumers should immediately stop using the recalled strollers and contact phil&ted USA to arrange for the shipping of a free hinge-cover kit and repair instructions. Consumer Contact: For additional information, contact phil&teds USA at (877) 432-1642 between 9 a.m. and 7 p.m. ET Monday through Friday or visit the company’s website at www.philandteds.com/support

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Your Toddler

Preschool Lunch Isn’t Always Nutritious

Parents may be sacrificing nutrition by giving their children the food they like when packing their preschoolers lunch. That's one of the conclusions of a new study in the January 2009 issue of the Journal of the American Dietetic Association. The study found that 71 percent of packed lunches didn't have enough fruits and vegetables and that one in four preschoolers didn't get enough milk with lunch.

"What we found primarily was that parents weren't sending in as many fruits and vegetables and whole grains as they should, and the number of milk servings was low, too," said study author Sara J. Sweitzer, a registered dietician and a doctoral candidate at the University of Texas at Austin. The study was triggered by a recent change in Texas day-care regulations that allow day-care programs to stop providing meals and snacks. A subsequent survey found that about half of child-care centers in two Texas counties had chosen to do just that. But they survey also reported that directors of those centers said that children were being given chips, prepackaged lunches and "junk food" by their parents. Vegetables, fruits and whole grains were rarely included. To determine whether or not these results were true, Sweitzer and her colleagues interviewed the parents of 74 children from five day-care centers. All of the children were between three and five years old and most were white and from families headed by two adults. The children's lunches were observed for a three-day period so the researchers could accurately assess the nutritional content. 67 percent of the parents interviewed said they packed nutritious food, even though they thought their child probably wouldn't eat them. 63 percent said they packed foods they knew their child would eat. Milk was available at the child-care center, but the child had to request it. According to the study, only 29 percent of the packed lunches contained adequate fruits and vegetables and only 20 percent of the children had a milk serving at lunch. 11 percent didn't get enough whole grains. "Fruits and vegetables and whole grains need to be presented on a regular basis," said Sweitzer, adding, "With chronic disease issues such as type 2 diabetes on the rise, this becomes a very key time to educate this child about nutrition." The easiest thing to do, she suggested, is to pack up some of the previous night's dinner to be reheated in a microwave, which is usually available at child-care centers.

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Your Toddler

Magnets in Toys Pose Broad Dangers

Parents need to be better warned about potential health risks and symptoms of children swallowing toys with magnets.When giving your child toys this holiday season, parents need to be better warned about potential health risks and symptoms of children swallowing toys with magnets. That is the warning from a new study conducted by the Cincinnati Children's Hospital Medical Center. When ingested, multiple magnets can stick together across a bowel wall, leading to infection in the digestive tract, the need for surgery and even death. The study also found that parents often don't seek medical attention for a child who has swallowed a magnet as quickly as necessary.

The findings are based on the analysis of 121 magnet-swallowing cases in 21 counties and were published online in the journal Pediatric Radiology. "The majority of swallowed magnetic objects were components of toy sets, including many well-known brands," study author Dr. Alan Oestreich, a professor of radiology at Cincinnati Children's, said in a hospital news release. "Many of the children represented in the survey were 5 years of age or younger and dependent on their parents or guardians to ensure they do not have access to multiple small magnets." The authors urged parents to pay particular attention when buying toys for small children as written warnings are not mandatory on toys containing magnets. Symptoms of ingested magnets can be mild and flu-like, but nausea, vomiting, cramps or abdominal pain should be given medical attention.

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Your Toddler

Rashes Prompt Warning over Baby Clothing

A warning has been issued to parents about Carter's Inc. your-baby garments with tag-less labels.A warning has been issued to parents about Carter's Inc. your-baby garments with tag-less labels after about 400 children developed rashes on their backs after wearing the clothes. The warning applies to about 110 million garments from the fall 2007 line according to Carter's. The affected clothing includes knit items such as body suits, shirts and PJs. According to the Consumer Products Safety Commission, the clothes were made in various foreign countries and were sold at Carter's retail stores and a department and national chain stores.

The CPSC advises that children should stop using these garments if they develop a rash. More Information: Carter's Inc. More Information: Consumer Product Safety Commission

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Your Toddler

Toddler Sleep, Eating Problems, Often Go Together

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So-called behavioral insomnia, where a young child regularly resists bedtime or has trouble staying asleep, is common -- seen in up to 30 percent of children between the ages of 6 months and 3 years.

A similar percentage have problems at mealtime, ranging from being an overly "fussy" eater to having a full-fledged "feeding disorder" - in which, for instance, parents can't get their child to follow any regular eating schedule, or the food refusal affects a child's weight.

It might not be surprising to many parents that sleeping and eating issues often go hand-in-hand. But the new study, published in the journal Pediatrics, is the first to show this may be true.

Among parents of 681 healthy kids 6 months to 3 years old, Israeli researchers found that those whose child had behavioral insomnia were more likely than other parents to say their child had eating issues as well.

And parents whose children were diagnosed with a feeding disorder were more likely to say they had trouble getting their child to sleep at night.

When asked if mealtime was a "problem," one-quarter of parents of children with insomnia said that it was; that compared with nine percent of other parents.

Similarly, 37 percent of parents whose children had an eating problem said that sleep was also an issue. In contrast, only 16 percent of other parents said the same.

Young children's eating and sleeping habits are the two most common concerns parents bring to their pediatricians, write the researchers, led by Dr. Riva Tauman of Tel Aviv Medical Center.

The current findings, they say, suggest that doctors should be aware that the two issues commonly go together, and help parents find ways to manage both.

The standard way to address behavioral insomnia is for parents to change their children's nighttime routine. That usually means setting a regular bedtime and certain rituals, like reading a story, that let a young child know bedtime is coming.

With eating problems, experts generally suggest that parents try to get kids interested in mealtime from an early age -- gradually introducing a variety of healthy, colorful foods, for instance, and making the eating environment pleasant but without any distractions like TV.

The current findings are based on 58 children who had been diagnosed with behavioral insomnia, 76 with a feeding disorder, and 547 who were studied for comparison.

Parents of children with insomnia were more likely to also report feeding "problems" -- worrying, for example, that their child was not eating enough or not growing properly.

Similarly, parents of children with feeding disorders were often worried about their child's sleep; and compared with other parents, they reported that their children got to bed almost an hour later, and slept for fewer hours each night.

It's possible, according to Tauman's team, that parents of young children with feeding disorders are more sensitive to sleep issues -- and vice-versa.

But they say it's also likely that parenting practices, like a lack of consistency in enforcing rules, underlie both problems.

On the positive side, the researchers note, that means that getting help for one issue could help parents manage both.

Tips for getting your child to sleep:

Stick to a bedtime. "Don't wait until your baby is rubbing his eyes or yawning to put him to bed," says Marc Weissbluth, MD, author of Healthy Sleep Habits, Happy Child. "By then he's overtired." If you notice your child winding down at 8 p.m., make that his/her bedtime.

Get into the routine. Thirty minutes to an hour before bedtime, start a calming ritual that may include giving a bath and reading a story or two.

Put your baby in his/her crib awake. If your child is routinely rocked to sleep at bedtime, what happens when she wakes up alone at 3 a.m.? Answer: She cries. "All infants and toddlers wake two to six times a night," says Parents advisor Jodi Mindell, PhD, coauthor of Take Charge of Your Child's Sleep. "They need to know how to put themselves back to sleep."

Swaddle for the first three months. Research shows that 
infants who are swaddled wake up less and sleep longer than
 other babies.

Tune out. If your baby seems sensitive to household sounds, try running a white-noise machine or a fan in her room.

Let the sun in. Expose your baby to about 30 minutes of light each morning. Why? Light suppresses the release of the sleep hormone melatonin; this helps set her internal clock -- making it easier for her to fall asleep at night.

Your Toddler

Treating and Preventing Burns

Burns are one of the most painful injuries a child can suffer. Knowing how to recognize the degree of a burn, and the proper treatment, can make a huge difference in how well the burn will heal.

Burns are divided into four different levels. 1st degree burns are minor and heal quickly. Symptoms are redness, tenderness, and soreness (like most sunburns). 2nd degree burns are serious injuries. First aid and medical treatment should be given as soon as possible. Symptoms are blistering (like a severe sunburn), pain, and swelling. 3rd degree burns (also called full-thickness burns) are severe injuries. Medical treatment is needed right away. Symptoms are white, brown, or charred tissue often surrounded by blistered areas. There may be little or no pain at first. 4th degree burns are severe injuries that involve skin, muscle, and bone. These often occur with electrical burns and may be more severe than they appear. They may cause serious complications and should be treated by a doctor right away. Call your pediatrician if your child suffers anything more than a minor burn. ALL electrical burns and any burn on the hand, foot, face, genitals, or over a joint worse than 1st degree should receive medical attention right away. There are many different causes of serious burns in children, including sunburn, hot-water scalds, and those due to fire, electrical contact, or chemicals. All of these can cause permanent injury and scarring to the skin. Chemicals that cause burns also may be absorbed through the skin and cause other symptoms. Call the Poison Help Line (1–800–222–1222) or your pediatrician after washing off all the chemicals. Treatment Your immediate treatment of a burn should include the following. - As quickly as possible, soak the burn in cool water. Don’t hesitate to run cool water over the burn long enough to cool the area and relieve the pain immediately after the injury. Do not use ice on a burn. It may delay healing. Also, do not rub a burn; it can increase blistering. - Cool any smoldering clothing immediately by soaking with water, then remove any clothing from the burned area unless it is stuck firmly to the skin. In that case, cut away as much clothing as possible. - If the injured area is not oozing, cover the burn with a sterile gauze pad or a clean, dry cloth. - If the burn is oozing, cover it lightly with sterile gauze if available and immediately seek medical attention. If sterile gauze is not available, cover burns with a clean sheet or towel. - Do not put butter, grease, or powder on a burn. All of these so-called home remedies actually can make the injury worse. When treating a burn at home, watch for any increase in redness or swelling or the development of a bad odor or discharge. These can be signs of infection, which will require medical attention. Prevention Most burns that are not fatal are not related to fires. Most often, these are scalds from hot liquids—for example, when a child turns over a cooking pot upon himself, or turns the knobs on a bathtub faucet so that hot water flows on him. Children also sometimes suffer burns by touching a hot iron, a coil on an electric stove, a curling iron, hot barbecue charcoal, or fireworks. - Install smoke detectors in hallways outside bedrooms, the kitchen, living room, and near the furnace, with at least one on every floor of the house. Test them every month to be sure they work. It is best to use alarms that have long-life batteries, but if these are not available, change batteries at least annually on a specific date that you’ll remember (such as January 1 of each year). - Practice home fire drills. Make sure every family member and others who care for your children in your home know how to leave any area of the home safely in case of a fire.. - Have several working fire extinguishers readily available. Place fire extinguishers around the home where the risk of fire is greatest, such as in the kitchen, furnace room, and near the fireplace. - Teach your children to crawl to the exits if there’s smoke in the room. (They will avoid inhaling the smoke by staying below it.) - Purchase a safety ladder if your home has a second story, and teach your children how to use it. If you live in a high-rise building, teach your children the locations of all exits and make sure they understand never to use the elevator in a fire. (It can become trapped between floors or open on a floor where the fire is burning.) Agree on a family meeting point outside the house or apartment so you can make certain everyone has gotten out of the burning area. - Teach your children to stop, drop, and roll on the ground if their clothing catches fire. - Avoid smoking indoors. - Do not leave food cooking on the stove unattended. - Lock up flammable liquids in the home. It is best to store them outside the home, out of children’s reach, and away from heat or ignition sources. - Lower the temperature of your water heater to below 120 degrees Fahrenheit (48.9 degrees Celsius) to prevent hot water scalds and burns. - Don’t plug appliances or other electrical equipment into extension cords if they place too much “amperage” or load on the cord, thus creating a potentially unsafe situation. - Keep matches and lighters away from children, locked and out of reach. - Avoid all fireworks, even those meant for consumer use.

Your Toddler

Poor Safety Ratings For Some Booster Seats

More than a dozen car booster seats do a poor job of positioning children to fit in their seat belts according to a new review.More than a dozen car booster seats do a poor job of positioning children to fit in their seat belts according to a new review by the Virginia-based Insurance Institute for Highway Safety and the University of Michigan Transportation Research Institute. IIHS president Adrian Lund said the 13 boosters given a poor rating "may increase restraint use by making children more comfortable, but they don't position belts for optimal protection." Child seat manufacturers said their products meet and exceed federal regulations. Two of the seats on the list have been discontinued since the evaluation was done.

This is the first time the institute issued evaluations for booster seats. The group said it chose not to review crash protection because the seats simply elevate children so lap and shoulder belts are well-positioned to restrain them. Typically, booster seats are used by children between the ages of four and eight. The seat belt should be routed across a child's lower hip and mid-shoulders instead of the abdomen because the liver and spleen are more vulnerable to injuries. Ten seats were named "best bets," meaning they were most likely to correctly position seat belts. Parents should not interpret the evaluations to mean that poorly rated booster seats are not effective says Dr. Kristy Arbogast, a researcher of child passenger safety issues at The Children's Hospital of Philadelphia. "The biggest disservice this would do is to encourage people to move out of booster seats because we know they're an effective restraint, we know they reduce the risk of injury and the risk of fatality." Arbogast suggested parents buying a new booster seat should try it out in their car and see how the seat belt fits on their child. Government recommendations calls for car seats for children up to 40 pounds and booster seats for children over 40 pounds until they are eight years old or 4 feet 9 inches tall. The government also recommends that all children ride in the back seat until age 13. More Information: Insurance Institute for Highway Safety

Your Toddler

Parents Ignore New Car Seat Recomendations

1.45 to read

I have been surprised at the number of parents I have seen lately, who are either unaware or choose to ignore the changes in car seat recommendations for children under the age of two.I have been surprised at the number of parents I have seen, who are either unaware or choose to ignore the changes in car seat recommendations for children under the age of two.

I try to discuss car seat safety at each check-up appointment, and have always been especially mindful of doing this at the one-year check up. A new policy (April 2011) by colleagues at the American Academy of Pediatrics recommends what I have been discussing for a while now: children up to age two should remain in rear-facing safety seats. The new policy is supported by research that shows children younger than 2 are 75% less likely to die or be severely injured in a crash if they are rear-facing. So how did we get here? Original recommendations (established in 2009), I had followed with my own patients. I discussed turning the car seat to a forward facing position if the child had reached 12 months and 20 pounds. Then in April, an article was published (Inj Prev. 2007;13:398-402), which was the first U.S. data to substantiate the benefits of toddlers riding rear facing until they are two years of age. This study showed that children under the age of two are 75 percent less likely to die or experience a serious injury when they are riding in a rear-facing. That is a fairly compelling statistic to keep that car seat rear-facing for another year! Studies have shown that rear-facing seats are more likely to support the back, neck, head and pelvis because the force of a crash is distributed evenly over the entire body. Toddlers between the ages of 12 and 23 months who ride rear facing are more than five times safer than toddlers in that same age group who ride forward-facing in a car seat. There has also been concern that rear-facing toddlers whose feet reach the back of the seat are more likely to suffer injuries to the lower extremities in a car accident. But a commentary written by Dr. Marilyn Bull in Pediatrics (2008;121:619-620) dispelled the myth with documentation that lower extremity injuries were rare with rear-facing seats. So, it has now been over two years since this data was published and recommended, and parents continue to say, “I just turned the seat around any way” or “I didn’t know.” I did go look at car-seats the other day and I noted that the labeling on the boxes had all been changed to recommend rear facing until two years or until a toddler reaches the maximum height and weight recommendations for the model. I take this to mean that some “small” toddlers could even rear face longer as they do in some European countries. For safety sake, rather than convenience, keep that car seat in the rear facing position. I wonder if they will begin putting DVD players and cup holders facing toward these toddlers, as that seemed to be a concern of many parents. Maybe this will make it “okay” to listen to music or talk while in the car rather than watching TV, at least until a child is older!! If you need references on car seats go to http://www.nhtsa.dot.gov or http://www.seatcheck.org Send your question or comment to Dr. Sue!

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