Your Toddler

Liquid Nicotine Poisonings up 300 percent!

2.00 to read

Most people are familiar with e-cigarettes. New e-cigarette stores are popping up almost every day. City councils around the country are debating the pros and cons of setting age limits to buy them and banning them in places where smoking cigarettes is already forbidden.

There’s another e-cigarettes related story that’s is much more alarming that is beginning to surface - the potentially deadly liquids that are often bought and used to refill the e-cigarette vaporizer.

These “e-liquids,” the key ingredients in e-cigarettes, are powerful neurotoxins. Tiny amounts, whether ingested or absorbed through the skin, can cause vomiting and seizures and even be lethal. A teaspoon of even highly diluted e-liquid can kill a small child.

According to an article in The New York Times, e-liquids are being mixed on factory floors and in the back rooms of shops.

Toxicologists warn that e-liquids pose a significant risk to public health, particularly to children, who may be drawn to their bright colors and fragrant flavorings like cherry, chocolate and bubble gum.

Many users, unaware of the toxicity of the ingredients, are casually leaving replacement bottles around the house where children are finding and ingesting them.

“It’s not a matter of if a child will be seriously poisoned or killed,” said Lee Cantrell, director of the San Diego division of the California Poison Control System and a professor of pharmacy at the University of California, San Francisco. “It’s a matter of when.”

Nationwide, the number of poison cases linked to e-liquids jumped to 1,351 in 2013, a 300 percent increase from 2012, and the number is on pace to double this year, according to information from the National Poison Data System. Of the cases in 2013, 365 were referred to hospitals - triple the previous year’s number.

As two examples, of the 74 e-cigarette and nicotine poisoning cases called into Minnesota poison control in 2013, 29 involved children age 2 and under. In Oklahoma, all but two of the 25 cases in the first two months of this year, involved children age 4 and under. That age group is considered typical.

The e-liquids are much more dangerous than tobacco because liquid is absorbed quickly into the skin, even in diluted concentrations. Initially, many of the e-cigarette brands were disposable devices that looked like regular cigarettes. However, many of the newer e-cigarette vaporizers are larger and can be refilled with liquid that is generally nicotine, flavorings and solvents.

Unlike nicotine gums and patches, e-cigarettes and their ingredients are not regulated. The FDA has said it plans to regulate e-cigarettes but has not disclosed how it will approach the issue.

Chip Paul, chief executive officer of Palm Beach Vapors, a company that operates 13 e-cigarette franchises, estimates that there will be sales of one to two millions liters of liquid used to refill e-cigarettes.

If you look online, you can buy e-liquids anywhere from a liter to 55 gallon containers with 10 percent nicotine concentration.

Mr. Paul said he was worried that some manufacturers outside the United States — China is a major center of e-cigarette production — were not always delivering the concentrations and purity of nicotine they promise. Some retailers, Mr. Paul said, “are selling liquid and they don’t have a clue what is in it.”

The nicotine levels in e-liquids can vary. Most range between 1.8 percent and 2.4 percent, concentrations that can cause sickness, but rarely death, in children. But higher concentrations, like 10 percent or even 7.2 percent, are widely available on the Internet.

A lethal dose at such levels would take “less than a tablespoon,” according to Dr. Cantrell, from the poison control system in California. “Not just a kid. One tablespoon could kill an adult,” he said.

Many people believe that e-cigarettes are a new and valuable tool in the battle to quit smoking. The science isn’t there yet to say whether they actually help or just replace conventional cigarette addiction. But one thing is for sure, if you have e-cigarettes and in particular, e-liquid refill containers in the home, they should be kept out of a child’s eyesight and reach.

Source: Matt Richtel, http://www.nytimes.com/2014/03/24/business/selling-a-poison-by-the-barrel-liquid-nicotine-for-e-cigarettes.html?_r=1

Your Toddler

Giving Makes Toddlers Happy

1.00 to read

You might assume that toddlers don’t like sharing their food or their things with others, but according to a new study – you’d be wrong.

Toddlers love to give because it makes them happy. I even love typing that sentence. How sweet is the thought of little happy toddlers sharing and laughing with each other?

A team of three psychologists at the University of British Columbia in Vancouver, Canada, gave toddlers some treats and a few minutes later asked the toddlers to give one of their treats to a puppet. The children were also given an extra treat and asked to give this to the puppet too.

The toddlers' reactions to these requests were videotaped and then rated for happiness. The researchers concluded that the toddlers showed greater happiness when they shared their own treat than when they shared the extra treat. This suggests that this behavior is emotionally rewarding for the children.

"People tend to assume that toddlers are naturally selfish," study lead author Lara Aknin said in a university news release. "These findings show that children are actually happier giving than receiving."

This study and others like it suggests that the good feelings we have when helping others is deeply ingrained in our psyche, beginning in early childhood. 

I wonder sometimes if we could all be a little more like these toddlers – enjoying the accomplishment of giving to others instead of so focused on ourselves – the world might just be a happier place.

 The study was published in the online journal PLoS One.

Source: http://news.yahoo.com/toddlers-happier-receive-study-180409974.html

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

Too Many Children Spend Little Time Outdoors

New research from Australia suggests that many children spend too little time outdoors and too much time in front of the TV.

If you think your child is slowly turning in to a couch potato, you may not be alone. New research from Australia suggests that many children spend too little time outdoors and too much time in front of the TV and a lack of suitable outdoor spaces may be partly to blame. The study looked at nearly 1,400 10- to 12-year-olds and found that 37 percent typically spent a half-hour or less being active outside. Few were outdoors for two hours or more on a typical day.

Researchers found that many children devoted at least two hours per day to the TV or computer screen, with 49 percent of boys and 36 percent of girls doing so. The researchers did find, however, that certain children were more likely to play outdoors for more than a half-hour at a time, namely those whose parents allowed them to walk around their neighborhood on their own. The finding suggests that when parents think their neighborhood is safe, children are more likely to get outdoor exercise, according to Dr. Li Ming Wen and colleagues at Sydney South West Area Health Service and the University of Sydney. Dr. Wen told Reuters Health that if more neighborhoods were safe, clean, walkable and offered public areas where children could play, that might allay parents' concerns and help kids be regularly active. Wen suggested that, when possible, parents not drive their children to school but allow them to walk. Having them walk with their friends, the researcher noted, may help ease parents' safety worries.

Your Toddler

Tips For Raising A Toddler

2.00 to read

Need help with your toddler? Here’s an easy guide with nine tips containing common mistakes and helpful remedies.

1. Be Consistent. Toddlers do best when they know what to expect, whether it's what time they bathe or go to bed or what consequences they'll face for misbehaving. The more consistent and predictable things are, the more resilient and agreeable a toddler is likely to be. Fix it: As much as you can, keep regular routines for your child. Consistency can be a challenge when parents (or other caregivers) don't see eye to eye. Not sure how best to react if your child dumps food on the floor or ignores bedtime? Sit down with your partner ahead of time to decide on an appropriate response -- and stick with it. "You don't want to send mixed messages," says Tanya Remer Altmann, MD, the author of Mommy Calls: Dr. Tanya Answers Parents' Top 101 Questions about Babies and Toddlers and a pediatrician in private practice in Los Angeles. "You really want to be consistent." 2. Focus on Family Time It's delightful to spend time with the whole family. But some parents go overboard on family time. "Kids cherish time alone time with one parent," says Thomas Phelan, PhD, a clinical psychologist in suburban Chicago and the author of several parenting books, including 1-2-3 Magic. "One-on-one time is fun for parents too, because there's no sibling rivalry to contend with." Fix it: What's a good way to spend one-on-one time with a toddler? Phelan recommends simply getting down on the floor together and playing. 3. Offering Too Much Help Some parents jump in to help a toddler who is having trouble doing something. Before you do, consider the possibility that by helping your child complete a puzzle or put on a shirt, you may be sending the message that he/she can't do it alone -- in other words, that the child is incompetent. "Parents who offer too much help may be sabotaging their young children's ability to become self-reliant," says Betsy Brown Braun, the Los-Angeles-based author of You're Not the Boss of Me. Fix it: "We need to teach children to tolerate struggle," Braun says. Of course, there's nothing wrong with offering praise and encouragement. "Be a cheerleader," Brown says. "Say, 'You can do this!'" 4. Talking Too Much Talking with toddlers is usually a terrific idea. But not when it's time to rein in errant behavior. Imagine a mom has just said "no" to her 2-year-old's request for a cookie. The child fusses. Mom explains that it's suppertime. The child grabs a cookie anyway. Mom takes it away, and tries again to explain herself to her now tearful child. Back and forth it goes, with mounting frustration on both sides. "Talking can lead to what I call the talk-persuade-argue-yell-hit pattern," Phelan says. "Toddlers are not adults in a little body. They're not logical, and they just can't assimilate what you are saying to them." Fix it: What's the smart way to lay down the law? Once you tell your toddler to do something, Phelan says, don't talk about it or make eye contact. If the child disobeys, give a brief verbal warning or count to three. If the child refuses to toe the line, give a time-out or another immediate consequence. No explaining! 5. Avoid Only Kiddie Food Does your toddler seem to eat nothing but chicken fingers and fries? Are goldfish crackers the only fish he or she eats? As some parents realize too late, toddlers fed a steady diet of nutritionally iffy kid's foods may resist eating anything else. Fix it: Encourage your child to try "grown-up" fare. "A good percentage of kids are willing to try a new food if they see mommy and daddy enjoying it," Altmann says. "If they push back, keep putting it on their plate. Some kids need to try things a dozen or more times before they take to it." Her advice:  As long as there's something your child can eat on the plate, don't worry. Do not allow yourself to become your child's short-order cook. 6. Getting Rid of the Crib Cribs do more than keep little ones safe. They promote good sleep habits. A toddler moved too soon into a "real" bed may have trouble staying in bed or falling asleep, and so may end up climbing into bed with mommy and daddy. "Some moms wear themselves out because they have to lie down with their child every night," Altmann says. "They don't realize they're the ones who set the pattern." Fix it: When is it time to get rid of the crib? When your child asks for a bed or starts climbing out of the crib. For most kids, that comes between the ages of 2 and 3. 7. Potty Training Some parents cajole their children into using the toilet when they think it's time -- and issue harsh reprimands when things go awry. That can lead to a power struggle. Fix it: "Children learn to use the toilet when they're ready," Altmann says. "The process shouldn't be rushed." But you can set the stage. Show your toddler the toilet. Explain its use. If you feel comfortable doing so, let your child watch you use the toilet -- and offer praise if he or she gives it a whirl. 8. Too Much TV Time Toddlers who watch lots of TV often have more trouble learning later on. And studies suggest that kids under the age of 2 can't really take in what's being displayed on TV and computer screens. Fix it: Keep your toddler busy with reading and other, more creative pursuits. Have conversations-and encourage talking as well as listening. "The longer you can hold off exposing your child to TV, the better," Altmann says. 9. Trying to Stop a Tantrum Some parents worry that an out-of-control child makes them seem like ineffectual parents. But all toddlers have tantrums. When they do, it's pointless to try to talk them out of it -- even if the drama is unfolding in front of company or in a public place. "When we are in public and dealing with a child, we feel judged," Braun says. "We feel like there is a neon sign over our heads saying we are incompetent parents." Fix it: Braun says parents must remember that the child matters more than the opinions of other people -- especially strangers.

Your Toddler

Daytime Nap Benefits Beyond Rest

A new small study shows that for children aged four and five, taking a nap during the daytime may help reduce hyperactivity, anxiety and depression.Any parent can testify that a child's naptime is also beneficial for the caregiver. Now a new small study shows that for children aged four and five, taking a nap during the daytime may help reduce hyperactivity, anxiety and depression.

The study of 62 children categorized them as either napping (77 percent) or non-napping (23 percent). Researchers found that those who didn't take daytime naps had higher levels of anxiety, hyperactivity and depression. The data was based on the parents' or caregivers' reporting of the child's typical weekday and weekend bedtime/wake time and napping patterns. Family demographics and behavioral assessments of the children were also included in the analysis. Researchers found that children who took naps did so an average 3.4 days a week. "There is a lot of individual variability in [the age] when children are ready to give up naps. I would encourage parents to include a quiet 'rest' time in their daily schedule that would allow children to nap if necessary," said lead author Brian Crosby, a postdoctoral fellow of psychology at Pennsylvania State University. In his research, Crosby also noted an optimal age for children to stop napping hasn't yet been determined.

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

Magnetic Toy’s Warning Labels Not Enough

1.30 to read

Current warnings labels on magnetic toys don’t seem to be effective in keeping powerful magnets out of the mouths of small children according to a survey by the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN.)

The NASPGHAN represents 1700 pediatric gastroenterologists in the U.S., Canada, and Mexico.

The doctors would like to see the magnets banned.  

“Many of our member physicians have had the unfortunate experience of removing these high-powered neodymium magnets from the gastrointestinal tract of innocent infants and children to reduce the risk of abdominal surgery,” said Athos Bousvaros, M.D., President elect of NASPGHAN. “It is simply unreasonable to suggest that product warnings are sufficient to prevent their accessibility to children and adolescents. The only solid way to prevent ingestion of these magnets is to ban them.”

Young children may think that the magnets are candy and older children and even teens use the magnets to mimic tongue piercings.

How dangerous are magnets if ingested?  If two or or more of these small magnets are swallowed they may attract two loops of bowel together and although the intestinal tract is pretty tough, it is no match for high powered magnets. The pinching together of the intestinal walls can cause bowel ulceration, perforations in the intestine and severe injury requiring surgery.

The Consumer Product Safety Commission (CPSC) filed a lawsuit against Maxfield & Oberton, the manufacturer of Buckyballs and Buckycubes, after the company refused to cease distribution of the high-powered, rare earth magnet products that have caused serious injury to children as a result of ingestion.

The company announced on Monday that that they have discontinued the controversial desk toy. The company claims the products were manufactured for and marketed to adults. The products will continue to be sold online until the current supply sells out.

Symptoms of magnet ingestion are abdominal pain, vomiting and fever. These are very common symptoms and may indicate a variety of illnesses. Initial evaluation can miss that magnets are the cause of the problem.  Unfortunately, delay in treatment may lead to an increased severity of consequences. If your child presents with these symptoms, and you know that there have been small magnets in the house, be sure to take your child to the doctor or the emergency room and tell the examining physician.

Sources: http://thechart.blogs.cnn.com/2012/10/23/doctors-warning-labels-on-magnetic-toys-arent-enough

http://www.naspghan.org/user-assets/Documents/pdf/Advocacy/July%202012/N...

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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Many parents asking if their child should receive MMR ahead of schedule to prevent measles.