Your Toddler

Toddler Snoring May Indicate Behavioral Problems

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Everyone snores at one time or another, even babies. Most of the time we have an occasional snort... maybe three or four. Children may snore because they have a stuffy nose, a cold, allergies or enlarged tonsils, but persistent snoring could indicate more.  

According to a new study focused on two and three year olds, persistent snorers are more likely to have behavioral problems such as hyperactivity, attention issues and depression.

Researchers studied 249 mother-child pairs and found the children who snored at both age 2 and age 3 were nearly 3.5 times more likely to have signs of behavioral issues when compared with those who did not snore at these ages, or who only snored during one of those years. Mothers were asked to report how often their child “snored loudly.”

The children were divided into 3 categories:

Non-snorers – those who snored less than once a week.

Transient-snorers – those who snored more than 2 times a week at age 2 or 3, but not both.

Persistent-snorers - those who snored more than 2 times a week at ages 2 and 3.

All the children were assessed for behavioral problems based on the Behavior Assessment System for Children, an extensively validated behavior questionnaire.

Among the children who snored at both ages, 35% showed signs of behavioral problems. Only 10% percent of non-snorers and 12% of transient snorers showed behavioral problems.

The findings show the importance of getting good sleep, the researchers said.

"We know that if you take away naps for preschoolers, and then give them challenging tasks, they're grumpier," said lead study author Dean Beebe, director of the neuropsychology program at Cincinnati Children's Hospital Medical Center.

From a neurological standpoint, lack of proper sleep inhibits the development of pathways between neurons in the brain, Beebe said. "We're talking about a brain that is constantly remodeling through early childhood, with connections being strengthened and weakened," he said. Fixing the underlying cause of snoring can help to reverse these effects, but because parents don't realize the problems with snoring, it often goes untreated.

Experts have also noted that many parents think that snoring is a sign of a deep restful sleep when in fact, it's often just the opposite. 

Dr. Sangeeta Chakravorty, director of the pediatric sleep evaluation center at Children's Hospital of Pittsburgh, wasn't surprised by the findings. "Snoring impacts sleep, and sleep loss impacts behaviors," she explained.

But, she noted that the study wasn't able to determine whether the behavior problems were just because the children were tired, or if their snoring was significant enough to cause a chronic lack of oxygen, because the study only included information from the children's mothers. There were no objective data, such as oxygen levels throughout the night.

Chakravorty added that snoring in this age group is actually common. She said enlargement of the adenoids was the biggest cause of snoring, followed by enlarged tonsils. Nasal allergies can also cause snoring, as can abnormalities in the facial structure or the structure of the airway. And obesity can cause snoring in children like it does in adults.

Researchers also found that persistent children snorers were more likely to have been exposed to environmental tobacco smoke, and come from lower socioeconomic households.

Both experts recommended bringing up any persistent snoring with your child's pediatrician. "If you hear your child snoring more than three to four times a week in the absence of an upper respiratory infection [cold], and it lasts more than a month, seek help from the pediatrician," Chakravorty said.

The study was published in the journal Pediatrics.

Sources: http://www.msnbc.msn.com/id/48648962/ns/health-childrens_health/#.UCqmK46f_zJ

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http://health.usnews.com/health-news/news/articles/2012/08/13/snoring-toddlers-may-have-more-behavior-problems

Your Toddler

Recall: Step2® Whisper Ride Touring Wagons™

1.45 to read

They’re popular, colorful, fun and possibly dangerous. The Step2® Whisper Ride Touring Wagons™, sold exclusively at Toys R Us, are being recalled due to a fall hazard.

The removable blue seat backs can detach and allow the child in the wagon to fall out.

This recall involves Step2® Whisper Ride Touring Wagons. The two-seat plastic wagon is 25-inches wide by 41.25-inches long by 20-inches high with blue seats, a tan wagon base and a red canopy.  The Step2 logo appears on the canopy and on the side of the wagon base.

Incidents/Injuries

Step2 has received 29 reports of the seat back detaching, 28 of which resulted in children falling out of the wagon.  Fourteen of these resulted in bumped heads and nine resulted in bruises, scratches or lacerations.  

Remedy

Consumers should immediately stop using the wagon and inspect it to determine if the seat belt is attached to the removable blue seat back.  If so, the wagon is included in this recall. Consumers with the recalled wagons should contact Step2 to obtain a free repair kit.  

Sold exclusively at

Toys R Us stores nationwide and online at ToysRUs.com from February 2013 to August 2013 for about $130.

Manufacturer

The Step2® Company, LLC of Streetsboro, Ohio

Manufactured in

USA

Contact Step2 toll-free at (866) 860-1887 between 8 a.m. and 5 p.m. ET Monday through Friday or visit the firm’s website at www.step2.com and click on “Product Recall” for more information.

Resource: http://www.cpsc.gov/en/Recalls/2014/Step2-Recalls-Ride-On-Wagon-Toys

Step2 touring wagon recall

Step2 touring wagon recall

 

Your Toddler

Toddler Dies From Liquid Nicotine Poisoning

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The Fort Plain, New york police called the death a “tragic accident” after investigating the case of a 1-year-old who was rushed to the hospital after being found unresponsive in his home. The toddler died from ingesting liquid nicotine, also known as e-liquid, the key ingredient in e-cigarettes.

A lot of smokers, including teenagers, are switching from regular cigarettes to e-cigarettes and are now getting their nicotine fix by inhaling a vapor.  However, e-cigs are expensive and in an effort to cut costs, many will purchase vials of liquid nicotine to refill their e-cigarette; sort of like buying a carton of cigarettes instead of a couple of packs a day.

Liquid nicotine contains high levels of concentrated nicotine. It doesn’t take but a little bit to make someone very sick. The powerful stimulant can be accidently ingested or absorbed through the skin.  Even a teaspoonful of e-liquid can kill a child. Lesser amounts can cause seizures and other dangerous symptoms.

Like cigarettes, liquid nicotine should always be kept out of the reach of children and pets. Many of the vials come in bright colors with flavors such as bubblegum, strawberry, vanilla and chocolate - kids will be tempted to taste it. E-liquids are not regulated and do not have childproof caps. If carelessly left where a child or pet can find it, the results can quickly turn deadly.

Health officials are concerned that more fatal accidents could happen if steps aren’t taken to protect children.

"One teaspoon of liquid nicotine could be lethal to a child, and smaller amounts can cause severe illness, often requiring trips to the emergency department," the American Association of Poison Control centers in a statement, ABC News reported. "Despite the dangers these products pose to children, there are currently no standards set in place that require child-proof packaging."

In recent years, there's been a sharp rise in the number of liquid nicotine-related calls to U.S. poison control centers. Signs of consumption of liquid nicotine can include vomiting, increased heart rate, decreased blood pressure, convulsions and, in extreme cases, loss of the ability to breathe or death.

The police in this case, said they weren’t sure that the e-liquid that killed the toddler was associated with an e-cigarette and so far, no charges have been filed in the death of the child. It was just a tragic accident.

Recent studies point out that electronic cigarette use is on the rise with high-school students. Some teens say they are using them to help stop smoking, while others are giving them a try for the first time- even though they don’t smoke. Researchers noted in the Centers for Disease Control and Prevention (CDC) survey, that even middle-school student use rose from 2.7% to 3% in 2013.

How do kids purchase liquid nicotine? It’s readily available on the Internet. All you do is fill in a birth date and you’re in. You can buy a gallon of the stuff if you have the money. You can also purchase little bottles to fill from your bulk buy. It’s that simple.

While adults may be more likely to keep their liquid nicotine vials put away, teens don’t often think of the consequences of leaving theirs on the floor, on a desk, on the bed, in a purse on the sofa, in a backpack on the kitchen table – wherever they usually drop their stuff - for a small child to find. 

In New York, the toddler’s death has prompted a call for changes in how liquid nicotine is packaged; requiring childproof caps and someone must be least 18 years old to purchase it at a store.

This is not a pro or con e-cigarette use article. It’s a warning for anyone that uses liquid nicotine to be very aware of where you leave your vial. This may have been the first reported case of a toddler dying from nicotine poisoning; let’s all do our part to make it the last.

Source: http://www.webmd.com/parenting/news/20141215/toddler-dies-liquid-nicotine

Your Toddler

HGH May Benefit Kids with Cystic Fibrosis

Although Human Growth Hormone is not a cure for the disease, researchers discovered that it reduced the number of hospitalizations among those who have the disease.A new study from the University of Connecticut suggests that recombinant human growth hormone could be a promising tool in treating cystic fibrosis.

Although rhGH is not a cure for the disease, researchers discovered that it reduced the number of hospitalizations among those who have the disease. The study, published Monday in the journal Pediatrics, was produced by the UConn/Hartford Hospital Evidence-based Practice Center and was funded by the U.S. Department of Health and Human Services. While the study offers insights on managing the disease, there's not enough evidence yet on whether rhGH treatments could extend the lives of those with cystic fibrosis.

 "It's intuitive that it might be beneficial as far as length of life goes, but we won't be able to go ahead and tell that just yet," said one of the researchers, Craig Lapin of UConn's Department of Pediatrics and the Connecticut Children's Medical Center. Cystic Fibrosis affects multiple organs. Lungs are clogged with a thick mucus, which can lead to lung infections. The disease also affects the pancreas, making it difficult for the body to absorb food, which significantly stunts growth and often leads to early deaths. The researchers studied cases of children and adolescents, with cystic fibrosis going back to the 1990s, who received an injection of human growth hormone every day for six months to a year.

 In the 1950s, children with cystic fibrosis generally died before age 8. But with antibiotics and other medical advances, the median age for people with the disease increased to 37 by 2008.

"As the kids with cystic fibrosis are living longer and longer, a lot of these ancillary problems are become more apparent," said C. Michael White, director of the Evidence-based Practice Center and lead author of the study. In the cases studied, the researchers found that human growth hormone added 1.25 inches in height and three pounds to the patients. That growth also resulted in larger internal organs, particularly the lungs, making breathing easier.

 HGH also appears to improve the mineral content in bones, making them stronger. "

For those who received human growth hormone, White said, annual hospitalizations decreased by half, from about three hospitalizations per year to one and half.

 HGH therapy can be expensive, but fewer hospitalizations should balance out the expense.

 "Hopefully, this is going to encourage cystic fibrosis care providers to use it more frequently in patients at the lower end of weight and of short stature," Lapin said of the findings. A daily injection can be difficult for a child who is already taking several other medications, White said, but going to the hospital fewer times might make up for it.

 "I could see that, for a lot of kids, the injections would become just part of the daily routine," he said. "They would probably be a lot less scary than hospitalizations."

Your Toddler

Rear-facing Car Seats Protect Older Children

Children under four years of age fare better in motor vehicle accidents when they are riding in rear-facing rather than forward-facing car seats.Children under four years of age fare better in motor vehicle accidents when they are riding in rear-facing rather than forward-facing car seats, according to a report published online in the British Medical Journal. Infants are typically switched from a rear- to a forward-facing seat when they reach about 20 pounds, which occurs at roughly 8 months of age for an average boy, study authors Dr. Elizabeth A. Watson and Dr. Michael J. Monteiro, from Royal Surrey County Hospital, Guildford, UK, note. They add, however, that growing evidence suggests it may be best to delay the switch until four years of age.

For example, some data shows that many fatalities in young forward-facing riders could have been averted with a rear-facing seat. An analysis of US National Highway Traffic Safety Administration data of 870 children involved in crashes from 1998 to 2003 found that through 23 months of age, better protection from all crash types was provided with rear-facing seats. In terms of specific injuries, recent crash test results suggest that rear- rather than forward-facing seats provide better protection of the lower neck and chest, the authors note. In another crash simulation study, it was concluded that manufacturers should developed rear-facing seats for children up to four years old. Watson and Monteiro note that in contrast to forward-facing seats, rear-facing seats provide full alignment of the head, neck, and spine, so that crash forces are dispersed over these areas rather than centered on one site. The message for healthcare professionals, the authors say, is that they should recommend rear-facing car seats for children under four years of age. To fully address the issue, however, seat manufacturers and retailers need to "increase the availability of rear-facing car seats for children over 20 pounds."

Your Toddler

What’s In Infants and Toddler’s Prepackaged Food?

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As a parent, you may have assumed that pre-packaged food for infants and toddlers surely must be healthy; I mean really, what kind of a company would knowingly put these innocents at risk for long-term health issues? If that has indeed been your assumption, then you may be surprised to learn the results of a new study using a comprehensive analysis of foods sold for infants and toddlers by the Centers for Disease Control and Prevention (CDC).

However, if you’ve ever read the confusing Nutritional Facts list on such products, you may not be surprised at all.

The health culprits contained in children’s food products are sugar and sodium. A little is fine, too much is a health disaster waiting to happen in the form of diabetes, obesity and heart disease. The harsh reality is that some of these products have more sodium and sugar in them than adult food products.

We’re not talking about natural sugars and sodium contained in food, but added sugar and salt to make the foods “taste better”.

The CDC’s study showed that about one-third of prepared dinners made for toddlers contained at least one kind of added sugar as well as 97% of breakfast pastries and cereal bars. Researchers found that 88% juices and other drinks marketed for infants and toddlers contained added sugars.

On the sodium spectrum, 72% of toddler dinners were found to be way over the recommended limit, with an average of 2,295 milligrams of sodium per meal. The Institute of Medicine recommends that toddlers consume no more than 1,500 mg of sodium per day.

Some foods marketed to infants and toddlers had more sodium than comparable adult foods. Among 34 types of savory snacks for infants and toddlers – a category that includes crackers, some types of rice cakes and mini-hot dogs sold in jars – the average concentration of sodium was 486 mg per 100 grams of food. In comparison, salted potato chips intended for adults have about 450 mg of sodium per 100 grams, the researchers noted in their study, which was published by the journal Pediatrics.

When you take a hard look at what children are eating these days, and the lack of recommended physical activity, it’s no surprise that 23% of American kids between the ages of 2 and 5 (yes, that young) are either overweight or obese. With the added sodium in their diets, obese children are at an increased risk of high blood pressure, which can lead to heart disease (the No.1 cause of death in the U.S.), and other health problems. These health issues are starting to show up in teenagers, where once they didn’t develop till much later in life.

The CDC researchers set out to better understand the amount of sodium and sugar in prepared foods designed for infants and toddlers. They scoured a commercial database that includes nutrition information on more than 200,000 prepared foods. They also walked the aisles of Wal-Marts, Targets, Costcos and supermarkets in the Atlanta area to find additional products for their analysis. Altogether, they included 1,074 food items for infants and toddlers in their sample.

The good news is that not all of their findings negative. For instance, among 657 infant vegetables, fruits, dry cereals, dinners and ready-to-serve items that combined mixed grains with fruit, all but two were considered low in sodium. In addition, more than 80% of the 582 fruit, vegetable, soup and dinner items for infants had no added sugars.

However, food content began to change after kids turned 1 and moved on to toddler foods. Cereal bars, fruit and dry fruit snacks for this age group were still low in sodium, but most contained at least one type of added sugar. The most common additive listed was “fruit juice concentrate”, a somewhat creative name for squeezing out most of a fruit’s water and fiber so that only the fruit sugar is left.

The authors of the study expressed concern that starting children on high sodium and sugar foods when they are little could set them up for a lifetime of poor eating habits.

So what can you do as a parent? Become a label investigator before purchasing pre-packaged food for your child (or yourself for that matter).

When reading the Nutrition Facts label on a food, check for four things:

·      How many servings are contained in the product. Oftentimes a product – even a small one- contains more than one serving.

·      The sodium content per serving

·      The sugar content per serving

·      The list of ingredients.  Added sugars may have names such as high fructose syrup, corn syrup, fruit juice concentrate, maltose, dextrose, sucrose, honey and maple syrup. Added sodium may be listed as monosodium glutamate (MSG), sodium nitrite, and sodium bicarbonate (baking soda)

Look at where these items fall in the list of ingredients.  Ingredients are listed in order of the quantity they contribute to the overall food. When you see any ingredient listed first or at the top of the list, there’s a lot of it in the food.

For this study, the data on sodium and sugar came from the Nutrition Facts labels that appear on food packages. These aren’t necessarily accurate because the U.S. Food and Drug Administration allows the figures on the label to be off by as much as 20%, the researchers noted. 

Source: Karen Kaplan,  http://www.latimes.com/science/la-sci-sn-infant-toddler-foods-salt-sugar-20150202-story.html

Your Toddler

Making Time Outs Work for You and Your Child

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It’s not going out on a limb to say that at eventually, mom or dad will resort to the “time out” rule when their little one is behaving badly. And that’s a good thing. 

Time-outs can be very effective in helping children learn how to change their behavior as long as they are not overused and handled correctly.

What is a time-out? Basically, a time-out is when a child is separated from others for behavior that is unacceptable such as throwing a full-out tantrum, continuingly refusing to obey a command, or biting, hitting or kicking someone. 

When used correctly, a time out can teach a child how to modify his or her behavior in a more acceptable way. However, problems can arise when parents don’t know how or when to use time outs effectively.

Time outs should be used as positive and consistent discipline, not as a form of punishment. Time outs separate a child from positive feedback when they are intentionally acting up. It gives them the space and time to settle down and associate the behavior with the consequence.

A time out should consist of a designated place in the home where the child is safe and can be seen. The place should be quiet and away from the activity that caused or included the behavior. Many parents have a stool, chair or step on standby for time outs. The area needs to be boring and not have “reward” objects such as TVs, toys, or computers present.

How long should time outs last? Many follow conventional wisdom that when a child demonstrates unacceptable behavior, he or she should be separated from the activity for a number of minutes equal to his or her age.

Time outs should be used to help a child calm down and think about the behavior that got them there.

The American Academy of Pediatrics (AAP) says it's okay to give children as young as 1 a time-out – but it's best only as a last resort. Until he's a little older, your child may not have the self-control and reasoning skills to make a traditional time-out effective. Instead, think of a time-out as the "quiet time" your toddler needs to calm down and get his or her emotions under control. It’s also a time when parents can get their own emotions under control as well.

If you’re child is capable of understanding that certain behaviors are not going to be tolerated, and yet they are right in the middle of acting out one of those behaviors, that’s when a time out should be implemented.

You want your child to associate the behavior with the consequence. Calmly tell your child in no more than 10 words why they are in time out. As soon as he or she calms down, reward them with positive attention.

Children whine, cry and sulk – those are not reasons to put them in time out. Time outs are for intentional behavior such as biting or continuing to break rules.

What's helpful about a time-out is that it can defuse and redirect an escalating situation in an unemotional way. It lets you teach your child without setting a negative example, the way yelling or hitting does.

Parents tend to over explain a situation to a child, that’s why it’s important to keep the wording simple and direct. Over-talking the problem also tends to make the parent more agitated when the behavior doesn’t change. Being calm when putting your child in time out not only de-escalates the situation but also helps your child relax and think about their behavior. If you’re screaming and jerking your child to the time out area, they are more likely to be frightened and / or defiant than contemplative.

When the time-out is over, give your child a hug. A sign of affection demonstrates that he or she is still worthy of your love even though the behavior is unacceptable.

What if your child won’t stay in the time out zone? Toddlers are going to give you a challenge- that’s their nature. Power struggles can easily get out of hand. Until your toddler can appreciate the need to follow rules, limit the use of time-outs. Otherwise he or she won't understand why she's being corrected, and you may get frustrated and abandon the strategy prematurely.

You might actually consider “practicing” time outs with your child. Say your little one is revved up and on the edge of losing it- this might be a good time to grab a favorite book and sit down together. This is more like a “time-in” that associates positive attention to calming down before the behavior gets out of control.

When your child can follow simple directions and has a slightly longer attention span, they’re ready for a more traditional time-out. Between ages 2 and 3, you'll probably notice that he or she is better able to understand cause and effect.

But don't spring the tactic on them in a burst of frustration – a time-out works best if it's explained ahead of time. Use simple terms: "When you get too wild or act in a way that Mommy and Daddy don't think is a good idea, I will call, 'Time-out.' That means you will sit in this chair for a little while until you can calm yourself down."

Some parents find it useful to act this out or to use a doll or teddy bear to demonstrate taking a time-out.

Time outs are not miracle cures for unacceptable childhood behaviors. They are one tool parents can use to help educate their children about cause and effect. Parenting is a balancing act between positive reinforcement and consistent discipline.

When a child is very young, redirecting their attention to something more appropriate or fun may be the best approach. The key is to always keep your expectations realistic.

Sources: Paula Spencer, http://www.babycenter.com/0_time-outs-how-to-make-them-work-12-to-24-mo_12252.bc?page=1

http://www.news-medical.net/news/20150320/Time-outs-can-train-children-to-behave-better.aspx

Your Toddler

Would You Choose the Chubby Toddler?

2.00 to read

Once upon a time having a chubby toddler was a sign of prosperity. Parents, grandparents and friends loved to pinch the little one’s plump cheeks and say something along the lines of “look at those fat little legs and cheeks… how adorable!”

Little fat legs and cheeks are no longer a sign of wealth or health. They’re more likely to be an indicator of obesity or morbid obesity in a baby or toddler. Amazingly, many moms still believe that chubby equals cute and that their roly-poly child will eventually grow out of the “baby fat.”

According to a new study, parents of overweight toddlers mistakenly think their children are normal weight, and mothers of normal weight or underweight children wish their little ones were plumper. 

The findings were based on a study that involved 281 mothers from low-income households who had children between ages 12 and 32 months. Mothers were shown seven silhouettes of toddlers of various sizes, and asked to choose the silhouette that best matched their child.

About 30 percent of children were considered overweight by the researchers, based on a ratio of the child's weight and length.

About 70 percent of all mothers in the study were inaccurate in their assessments of their child's size, meaning they chose a silhouette that was at least two sizes larger or smaller than their child's true size.

Mothers of underweight children often knew their child was not healthy—they were 9.5 times more likely to choose the silhouette that matched their child's body size compared with mothers of healthy-weight children.

About 70 percent of mothers of healthy-weight children, and 80 percent of mothers of overweight children said they were satisfied with their child's body size. Four percent of mothers of overweight children even wished their child were even larger, the researchers said.

"That suggests we may have a lot of parents who are trying to fatten up their babies," said Dr. Eliana Perrin of the University of North Carolina at Chapel Hill School of Medicine, who wrote a commentary on the research in the journal Archives of Pediatrics & Adolescent Medicine.

Because mothers in the study were primarily from low-income households, and most were overweight or obese themselves, the findings may not be an indication of the population as a whole, the researchers said.

"There's this misperception that a chubby infant or toddler is a healthy infant or toddler," said study researcher Erin R. Hager, of the University of Maryland School of Medicine's Department of Pediatrics, Growth and Nutrition. In addition, with so many overweight and obese kids in the United States, the view of what is a normal may be shifting, and now larger is the new norm, Hager said.

Researchers also noted that doctors should also help parents be more aware of what constitutes a healthy weight for toddlers.

The only real way for parents to know if their child is overweight is to plot their weight and length on a growth chart for their age, Hager said. Children are considered overweight if they fall in the 85th to 94th percentiles of the growth charts, and obese if they are in the 95th percentile or higher.

The child’s pediatrician or family doctor could be adding to the parent’s confusion.

When doctors use the charts, they tend to plot weight and height separately, and without both pieces of information, parents end up not knowing that their child is above normal size for his age, Hager said.

A recent study found more than 75 percent of parents of overweight children said that their doctors never told them that their child was overweight.

The concern among scientists is that children's eating habits are shaped when they are very young, said Dr. Stephen Cook, a member of the Executive Committee of the Section on Obesity for the American Academy of Pediatrics and associate professor of pediatrics at the University of Rochester Medical Center.

"Kids who gain weight as toddlers tend to hold onto weight longer and tend to be overweight and obese in adolescence and adulthood," said Cook, who conducted a similar study in older children.

Some researchers feel that with the epidemic of obesity in this country, people are losing the ability to discern what is a healthy weight and what is overweight or obese. That’s not good news for adults or children. But as more information becomes available for parents to research and read, awareness is slowly improving. If you’re concerned your child is carrying too many pounds for his or her height and weight, check with your pediatrician or family doctor and ask for an evaluation.

Sources: http://www.myhealthnewsdaily.com/2557-toddler-body-size-overweight.html

http://www.msnbc.msn.com/id/47329655/ns/health-childrens_health/#.T6lnse0zJnZ

Your Toddler

Pain Patch, Serious Threat to Young Children

2.00 to read

For people who suffer with severe chronic pain, a slow released Fentanyl skin patch offers a respite from agony. However, the powerful pain reliever can be deadly for young children who accidently get a hold of a discarded or unopened patch.

The U.S. Food and Drug Administration has issued a Drug Safety Communication to warn parents, caregivers and health care workers about the dangers of accidental exposure to and improper storage and disposal of fentanyl patches.

In 2012, a toddler in Deerfield, Massachusetts accidently ingested a fentanyl patch after visiting a family member in a nursing home. The child’s great-grandmother was on fentanyl patches for pain. The boy’s parents believe the patch was improperly discarded and either stuck to a Halloween candy bucket or his toy truck while he was playing on the floor. The child ingested the patch 2 or 3 days after the visit and died from an overdose. An autopsy found the patch in the boy’s throat.

The FDA is aware of 32 cases of children who were accidentally exposed to fentanyl since 1997, most of them involving children younger than age 2. There have been 12 deaths and 12 cases requiring hospitalization.

"These types of events are tragic; you never want this to happen. We are looking for ways that we can help prevent this from happening in the future," Dr. Douglas Throckmorton, deputy director of FDA's Center for Drug Evaluation and Research, said in an agency news release. "This reinforces the need to talk to patients and their families to make sure that these patches are stored, used and disposed of carefully."

The fentanyl patches contain a powerful opioid narcotic and are sometimes given to patients who are suffering from cancer and for other debilitating pain causing conditions that have not responded to non-fentanyl pain relievers. The brand name is Duragesic.

A fentanyl overdose -- caused when a child either puts a patch in his or her mouth or applies it to the skin -- can cause death by slowing breathing and increasing levels of carbon dioxide in the blood, the FDA said.

Other overdose symptoms for fentanyl may include:

-       Extreme weakness or dizziness

-       Pinpoint pupils

-       Cold and clammy skin

-       Weak pulse

-       Fainting

The FDA said Monday that it approved changes to the Duragesic patch so the name of the drug and its strength will be printed on the patch in long-lasting ink in a clearly visible color. The agency added that it has asked manufacturers of the generic versions to make the same changes. The previous ink color varied by strength and was not always easy to see.

If you have Duragesic patches in your home make sure that they are properly discarded and that young children are not able to reach them. Older children, such as adolescents should not have access to them as well. A combination of alcohol and fentanyl can quickly become deadly.

Fentanyl is the strongest legal narcotic available. The U.S. government classifies it as a Schedule II Controlled Substance and highly addictive.

Source: http://children.webmd.com/news/20130923/pain-patches-children?printing=true

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