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Parenting

Helping Kids Cope With Tragic Events

2:00

Another all too common tragedy has saddened the hearts of Americans this week. Just 35 days after a man opened fire on a crowd of concertgoers in Las Vegas, killing 58 people and wounding nearly 500 others, another mass killing has taken place. This time in the small community of Sutherland Springs, Texas, leaving 26 people dead and 10 critically injured.  About half of the victims were children, according to news reports. This follows a terrorist attack in New York City on Halloween that killed 8 people. The heartbreak and numbers are gut wrenching to think about.

These kinds of horrific events can make the world seem like a terrifying place, particularly for kids.

How can you help your child cope with such frightening news? As a parent or a caregiver, how you react can have a strong impact on how your child views his or her own safety.

Dr. Jennifer Caudle, an associate professor at Rowan University School of Osteopathic Medicine in Stratford, suggests that parents shield their children from news reports.

"Children may become upset by news coverage," Caudle said. So monitor and limit what they see, hear or read. This may reduce their anxiety and help them deal with these unsettling events, she explained.

Other suggestions include:

  • Ask your child what they have already heard about the event. 
  • Provide the facts but try not to make judgments about the situation. 
  • Avoid upsetting details, and reassure children that people are working hard to make things better for everyone. 
  • Don't pressure kids to talk about the events, but encourage them to share their feelings by talking, drawing or writing. 
  • Let children know they can come to you for information and that they are free to ask questions. 
  • Remind children that their home is a safe place. 
  • Let children know that people may react differently to hard-to-understand events.

If your child or adolescent seems to be obsessing over the events and is having a hard time putting things in perspective, they may need professional help. 

"Problems with sleeping, changes in appetite or behavior, mood changes and new physical complaints, such as stomach aches and headaches, could -- in some children -- be a sign that they are having a difficult time coping," she said. "If this is the case, make sure your child sees a health care professional."

The National Institute of Mental Health (NIMH) says that it is important to let your child know that you will do your best to take care of him or her, that you love them and it’s okay for them to feel upset or sad.

NIMH also offers these tips:

  • If your child is having trouble sleeping give them extra attention, let them sleep with a light on, or let them sleep in your room (for a short time).
  • Try to keep normal routines, for example, reading bedtime stories, eating dinner together, watching TV together, reading books, exercising, or playing games.

Unfortunately, these types of tragedies don’t appear to being going away anytime soon. But, you can help your child (and yourself) by reminding them that although there are some people that might want to inflict harm on others, most people are loving and kind. They want a safe place for children to grow up in and they are doing their best to make this world a better place.

Story sources: Mary Elizabeth Dallas, https://consumer.healthday.com/mental-health-information-25/child-psychology-news-125/helping-children-cope-when-a-mass-tragedy-strikes-728263.html

https://www.nimh.nih.gov/health/publications/helping-children-and-adolescents-cope-with-violence-and-disasters-parents/index.shtml

Your Toddler

Does Parents’ Obesity Impact Toddlers’ Developmental Skills?

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Children, whose parents are obese, may show signs of developmental delays by the time they are 3 years old, according to a new study.

The specific developmental problems seem to differ depending on whether the mother, father or both parents are obese, according to researchers from the U.S. National Institute of Child Health and Human Development.

"Specifically, mothers' obesity was associated with a delay in achieving fine-motor skills, and fathers' obesity in achieving personal and social skills -- that includes skills for interacting with others," said lead researcher Edwina Yeung. She's an investigator in the institute's division of intramural population health research.

"When both parents were obese, it meant longer time to develop problem-solving skills," she added.

Not everyone agrees with the researchers’ conclusion. At least one pediatric neurologist suggests that the results don’t necessarily prove a direct cause and effect.

And Yeung acknowledges the same. "We used observational data, which doesn't allow us to prove cause and effect, per se," she explained.

What the researchers found was interesting though. Compared with children of normal-weight mothers, children of obese mothers were 67 percent more likely to fail a test of fine-motor skills (using their hands and fingers) by age 3.

In addition, children of obese fathers were about 71 percent more likely to fail tests of personal and social skills, which may indicate how well they relate to and interact with others, by age 3, the researchers said.

Children whose mother and father were both obese were nearly three times more likely to fail tests of problem-solving ability by age 3, according to the researchers’ findings.

Most research into understanding child health and development has focused on mothers and their pregnancies. "Our findings suggest that factors from fathers may also play a role and deserve attention," Yeung said.

One child health expert doesn't think obese parents should be overly concerned by this study.

"Children of obese parents are not doomed to have developmental problems," said Dr. Ian Miller. He is a pediatric neurologist and director of Neuroinformatics at Nicklaus Children's Hospital in Miami.

There’s a long list of other conditions that can also impact the brain such as lead-poisoning, sickle cell disease, iron-deficiency anemia, autism, epilepsy or cerebral palsy—any of which can cause developmental problems, Miller said. He isn't ready, however, to add obesity to that list.

But, obesity may increase the risks of these health problems, Miller says. The probability for developmental problems is low among all children, including those of obese parents. "It's not a 'sky is falling' type of scenario," he said.

For the study, Yeung and her colleagues collected data on more than 5,000 women and their children who were part of the Upstate KIDS study, which sought to determine if fertility treatments could affect child development from birth through age 3.

The women were enrolled in the study about four months after giving birth in New York state, excluding New York City, between 2008 and 2010.

About one in five pregnant women in the United States is overweight or obese, Yeung said.

To check the children's development, parents completed the Ages and Stages Questionnaire after doing a series of activities with their children, Yeung said.

The test doesn't diagnose specific problems, but is a screen for potential problems, so that children can be referred for further testing, she explained.

The children were tested at 4 months and six more times through age 3 years. Mothers also gave information on their health and weight, both before and after pregnancy, and the weight of their partners, Yeung said.

More studies are needed to further examine if there is a link between obese parents and their offspring’s developmental skills, Yeung said.

The report was published online Jan. 2 in the journal Pediatrics.

Story Source: Steven Reinberg, http://www.webmd.com/children/news/20170103/can-parents-weight-hinder-toddlers-development#1

Your Child

Adult and Childhood ADHD Two Different Disorders?

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A couple of recent studies are taking a new look at the differences in adult and childhood ADHD.

They suggest that adult ADHD is not just a continuation of childhood ADHD, but that the two are different disorders entirely.

In addition, the researchers say that adult-onset ADHD might actually be more common than childhood onset.

The two studies used similar methodology and showed fairly similar results.

The first study, conducted by a team at the Federal University of Rio Grande do Sul in Brazil, evaluated more than 5,000 individuals born in the city of Pelotas in 1993. Approximately 9 percent of them were diagnosed with childhood ADHD — a fairly average rate. Twelve percent of the subjects met criteria for ADHD in adulthood — significantly higher than the researchers expected — but there was very little overlap between the groups. In fact, only 12.6 percent of the adults with ADHD had shown diagnosable signs of the disorder in childhood.

The second study, which looked at 2,040 twins born in England and Wales from 1994-5, found that of 166 subjects who met the criteria for adult ADHD, more than half (67.5 percent) showed no symptoms of ADHD in childhood. Of the 247 individuals who had met the criteria for ADHD in childhood, less than 22 percent retained that diagnosis into adulthood.

These reports support findings from a third study from New Zealand, published in 2015. Researchers followed subjects from birth to age 38. Of the patients who showed signs of ADHD in adulthood in that study, 90 percent had demonstrated no signs of the disorder in childhood.

While the results from these studies suggests that the widely accepted definition of ADHD – a disorder that develops in childhood, is occasionally “outgrown” as the patient ages- may need to be reassessed.

However, not everyone is on board with the recent findings. Some experts suggest that the study’s authors may have simply missed symptoms of ADHD in childhood in cases where it didn’t seem to become apparent until adulthood.

“Because these concerns suggest that the UK, Brazil, and New Zealand studies may have underestimated the persistence of ADHD and overestimated the prevalence of adult-onset ADHD, it would be a mistake for practitioners to assume that most adults referred to them with ADHD symptoms will not have a history of ADHD in youth,” write Stephen Faraone, Ph.D., and Joseph Biederman, M.D., in an editorial cautioning the ADHD community to interpret the two most recent studies with a grain of salt. They called the findings “premature.”

In both of these studies and in previous research, adult ADHD has been linked to high levels of criminal behavior, substance abuse, traffic accidents and suicide attempts. These troubling correlations remained even after the authors adjusted for the existence of other psychiatric disorders — proving once again that whether it develops in childhood or adulthood, untreated ADHD is serious business.

Both of the studies challenge conventional beliefs that childhood onset ADHD is more likely to continue into adulthood. Many experts would like to see more research on this topic to verify these findings

The two studies were published in the July 2016 issue of JAMA Psychiatry.

Story source: Devon Frye, http://www.additudemag.com/adhdblogs/19/12040.html

Your Child

Kids Who Specialize In One Sport Have More Injuries

Kids who came to the clinic with injuries played organized sports an average of 11 hours a week, compared with fewer than nine hours in the uninjured group. Although the researchers did not specifically look at this, Jayanthi said he has noticed that more highly specialized sports such as tennis, gymnastics and dance tend to be linked to more severe overuse injuries.Because a child’s body is still growing, children who specialize in only one sport suffer repetitive injuries more often, a new study says.

In fact, kids are twice as likely to get hurt –playing just one sport- as those who play multiple sports said Dr. Neeru Jayanthi, medical director of primary care sports medicine at Loyola University Chicago Stritch School of Medicine. "We saw a pretty significant difference with this intensity of training, along with specialization," said Jayanthi. The findings are slated to be presented Monday at the American Medical Society for Sports Medicine annual meeting in Salt Lake City. Research presented at medical meetings should be viewed as preliminary. "It's been accepted for the last five years or so that kids who are not super-specific do better. They're cross-trained, so they're conditioned for other movements," said Dr. Kory Gill, an assistant professor at Texas A&;M Health Science Center College of Medicine. Jayanith’s research team had done earlier studies on 519 junior tennis players and found that the kids who only played tennis were more likely to get hurt. Jayanthi wanted to see if the same findings extended to other sports. "As a physician, you get frustrated seeing kids come in with injuries that keep them out for two to three months. It's devastating," said Jayanthi, who recently saw a young gymnast with a knee injury that will keep her off the mat for at least three months. Here, the researchers looked at 154 young athletes, average age 13, who played a variety of sports. Eighty-five of the participants came to the clinic for treatment for a sports injury, while 69 were just getting sports physicals. The investigation ranked each athlete on how specialized they were, basing the score on factors like how often they trained in one sport, whether they had given up other sports to practice just one, and if they trained 8 months a year or more to compete more than 6 months a year on one sport. What they discovered was that 60.4 percent of the athletes who had been injured were specialized in one sport, compared with only 31.3 percent who came in for physicals. Kids who came to the clinic with injuries played organized sports an average of 11 hours a week, compared with fewer than nine hours in the uninjured group. Although the researchers did not specifically look at this, Jayanthi said he has noticed that more highly specialized sports such as tennis, gymnastics and dance tend to be linked to more severe overuse injuries. Why did these injuries occur? "One reason is repetitive use of the same muscle group and stressors to growing areas, for example, the spine," explained Jayanthi, who stressed that the findings were preliminary. His team, in collaboration with Children's Memorial Hospital in Chicago, plans to enroll more athletes in follow-up research, and those athletes will be evaluated every six months for three years, to look more closely at how intense training can affect a young athlete's body during growth spurts. "Second is exposure risk," he added. "If you're getting really good at one sport, the intensity increases because you are getting better. People are developing adult-type sports skills in a child's body. The growing body probably doesn't tolerate this." Younger children -- those who have not entered high school -- tend to be especially vulnerable as their bodies are still growing, said Gill, who recommended that kids cross-train and condition for other movements, or just play another sport. "I tell parents to let kids be kids and play multiple sports," he said. "See what they're good at and what they enjoy." By high school, when bodies are more mature, specializing is safer, he added. When children play different sports in different seasons, they are using a wide range of motions and muscles. But when they begin playing one sport year-round, the risk of overuse injuries increases.

Daily Dose

Should Children Lift Weights?

I am often asked by both young patients and their parents if children can participate in weight lifting and strengthening exercises.

I think the appropriate term is strength training and conditioning, rather than weight lifting, which connotes competition and the need for heavier and heavier weights. When done appropriately, strength training and conditioning is great for kids of all ages, and really encourages being physically fit. Weightlifting is not appropriate for a growing child as it can put too much strain on the tendons and cartilage. This is especially true when kids become competitive about lifting bigger and bigger weights at the risk of long-term injury. Allowing children to weight lift in hopes of “bulking up” or “building the biggest muscles” before pubertal development and their growth spurt is inappropriate. All of that can be deferred for the post pubertal athlete. On the other hand, an age appropriate strength training and conditioning program may actually be protective of a child’s joints by increasing their muscle strength and their endurance. By participating in supervised and structured strengthening programs, a child as young as eight may improve their endurance, body awareness and balance, all of which are beneficial. A strength-training program can be done without weights, as in resistance training, by simply using the child’s body weight. Examples of this would be abdominal crunches, push-ups and pull-ups. These are great ideas for the younger children. For older children free weights or resistance bands may be added. Parents or coaches who are familiar with the use of free weights should always supervise. Start out with lighter weights, and make sure that the child can do at least 10 repetitions with the weight, if not, drop to a lower free weight. Have the adult watch the child for form and technique and supervise any increase in weights or repetitions. There are also many programs through local gyms and YMCA’s tailored just for kids to participate in strength training. When beginning a conditioning program encourage your child to have a warm up period, with a little aerobic activity like walking or running as this his will help to warm the muscles and prevent injury. After the strength training it is equally important to have a cool down period with gentle stretching. Many children enjoy working out with their parents and this can become a family activity (we can all use the exercise) to promote coordination, healthy bones, joints, cholesterol and blood pressure. Most importantly make it fun! That’s your daily dose, we’ll chat again tomorrow.

Your Baby

Skip Hop recalls 130,000 Nightlight Soothers

1:45

Skip Hop makes adorable little nightlights that are often placed in infants and children’s bedrooms to help lull them to sleep. Two models of the popular nightlights are being recalled due to shock hazard.

This recall involves 130,000 of Skip Hop’s Moonlight & Melodies owl and elephant nightlight soothers that play melodies or nature sounds and project images. They have a USB wall power adapter and cord. The white and gray owl soothers measure about 5.5 by 4.5 by 6 inches. The white elephant soother measures about 7 x 4.2 x 5.7 inches. The soothers have a sound speaker on each side and operation buttons at the top or the back. The Skip Hop logo is on the underside of the soother.

Skip Hop is aware of reports that the power adapter can break, including one electrical shock incident.

Consumers should immediately stop using the recalled nightlight soothers and contact Skip Hop for instructions on returning the USB wall power adapter with a prepaid shipping label and receive a free repair kit which includes a free USB wall adapter.

The Skip Hop products were sold at Babies R Us, Buy Buy Baby, Target and other retailers nationwide and online at Skiphop.com and Amazon.com from July 2016 through August 2017 for approximately $40.

Consumers can contact Skip Hop toll-free at 888-282-4674 from 9 a.m. to 5 p.m. ET Monday through Friday, email at recall@skiphop.com or online at www.skiphop.com and click on Product Recalls at the bottom of the page for more information.

Story source: https://www.cpsc.gov/Recalls/2017/Skip-Hop-Recalls-Nightlight-Soothers#

Your Baby

Type1 Diabetes and Celiac Disease

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Celiac disease is a serious immune disorder that can occur in children and adults. The disease causes the immune system to attack the lining of the small intestine when gluten is consumed, according to the Celiac Disease Foundation. Gluten is a protein found in wheat. Celiac disease may develop any time after wheat or other gluten containing foods are introduced into the diet, typically after 6-9 months of age.

New research suggests that parents of young children with type1 diabetes should be on the lookout for symptoms of celiac disease as well.

The study found these youngsters appear to face a nearly tripled risk of developing celiac disease autoantibodies, which eventually can lead to the disorder.

"Type 1 diabetes and celiac disease are closely related genetically," explained study author Dr. William Hagopian.

"People with one disease tend to get the other. People who have type 1 diabetes autoantibodies should get screened for celiac autoantibodies," Hagopian said. He directs the diabetes program at the Pacific Northwest Research Institute in Seattle.

Symptoms of celiac disease include stomach pain and bloating, diarrhea, vomiting, constipation, weight loss, fatigue and delayed growth and puberty.

Dr. James Grendell is chief of the division of gastroenterology at NYU Winthrop Hospital in Mineola, N.Y. He explained why knowing ahead of time that celiac may be developing can be helpful. 

"Early diagnosis of celiac disease is important to initiate treatment with a gluten-free diet to prevent complications, particularly growth retardation in children," he said.

"Other significant complications include iron-deficiency anemia, osteoporosis and a form of skin rash. Less common, but potentially lethal, complications include lymphoma and carcinoma of the small intestine," Grendell added.

Treatment for the disease is avoiding eating or drinking anything that contains gluten. Fortunately these days, there are many products that typically contain gluten but are now offered gluten-free. These products usually cost more than their gluten counterparts, but offer more of a variety in the diet.

While the study did find a link between type1 diabetes and celiac disease, that doesn’t mean that type1 diabetes necessarily causes celiac disease.

However, parents should be aware that if their child has type1 diabetes, he or she should be screened for celiac disease. Early intervention with the proper diet can increase the possibility of a good outcome as their child ages.

Story source: Serena Gordon, https://consumer.healthday.com/diabetes-information-10/type-i-diabetes-news-182/where-there-s-type-1-diabetes-celiac-disease-may-follow-727354.html

Your Baby

Baby's First Tooth!

Many dentists like to see a child by age one, not because there are a lot of problems to detect, but because it’s a good time to help parents learn more about dental health care and to establish a good relationship with the child.After all the crying, and teething fits, midnight trips to the crib, and endless time soothing and rubbing gums.... it’s finally here. Baby’s first tooth!  It’s also time to start thinking about your child’s dental health, and baby’s first visit to the Dentist.

It is generally recommended that an infant sees a dentist by the age of 1 or within 6 months after his or her first tooth comes in.

Many dentists like to see a child by age one, not because there are a lot of problems to detect, but because it’s a good time to help parents learn more about dental health care and to establish a good relationship with the child. The average age for continuing visits is about 2 to 2.5 years old depending on your child’s dental heredity and overall health. Many dentists like to see children every 6 months to build up the child's comfort and confidence level in visiting the dentist, to monitor the development of the teeth, and promptly treat any developing problems. What Happens at the First Dental Visit? The first dental visit is usually short and involves very little treatment. This visit gives your child an opportunity to meet the dentist in a non-threatening and friendly way. Some dentists may ask the parent to sit in the dental chair and hold their child during the examination. The parent may also be asked to wait in the reception area during part of the visit so that a relationship can be built between your child and your dentist. During the exam, your dentist should check all of your child's existing teeth for decay, examine your child's bite, and look for any potential problems with the gums, jaw, and oral tissues. If indicated, the dentist or hygienist will clean any teeth and assess the need for fluoride. He or she will also educate parents about oral health basics for children and discuss dental developmental issues and answer any questions. Topics your dentist may discuss with you might include: 1. Good oral hygiene practices for your child's teeth and gums and cavity prevention 2. Fluoride needs 3. Oral habits such as thumb sucking, tongue thrusting, lip sucking. 4.  Developmental milestones 5. Teething 6. Proper nutrition You will be asked to complete medical and health information forms concerning the child during the first visit. Come prepared with the necessary information. What's the Difference Between a Pediatric Dentist and a Regular Dentist? A pediatric dentist has at least two additional years of training beyond dental school. The additional training focuses on management and treatment of a child's developing teeth, child behavior, physical growth and development, and the special needs of children's dentistry. Although either type of dentist is capable of addressing your child's oral health care needs, a pediatric dentist, his or her staff, and even the office décor are all geared to care for children and to put them at ease. If your child has special needs, care from a pediatric dentist should be considered. Ask your dentist or your child's doctor what he or she recommends for your child. When Should Children Get Their First Dental X-Ray? There are no hard-and-fast rules for when to start dental X-rays. Some children who may be at higher risk for dental problems. Children prone to baby bottle tooth decay or those with cleft lip or palate should have X-rays taken earlier than others. Usually, most children will have had X-rays taken by the age of 5 or 6. As children begin to get their adult teeth around the age of 6, X-rays play an important role in helping your dentist. X-rays allow your dentist to see if all of the adult teeth are growing in the jaw, to look for bite problems and to determine if teeth are clean and healthy. Once a child’s diet includes anything besides breast-milk or baby formula, erupted teeth are at risk for decay. The earlier the dental visit, the better the chance of preventing dental problems. Children with healthy teeth chew food easily and smile with confidence. Start your child now on a lifetime of good dental habits.

Parenting

Day Care Doesn’t Boost Weight Gain in Kids

1:45

With three out of five American children in some type of daycare arrangement, parents are often concerned about whether their child is eating a healthy diet when they can’t supervise what they are being served.

Previous studies have suggested that kids in daycare were more likely to gain excess weight, but a new study says other factors linked to obesity were not considered in earlier research.

"When we implemented these more sophisticated analytical approaches, we found that association really went away," said study author Dr. Inyang Isong, an instructor at Harvard Medical School and a pediatrician with Boston Children's Hospital.

"We cannot say that sending a child to day care makes your child overweight ," Isong continued. "We just don't have enough evidence to say that."

Given that so many children are in daycare, the updated analysis is good news for parents.

 Pediatricians and parents have had longstanding concerns that childcare might increase a young one’s risk of gaining weight, said Dr. Allison Driansky, an attending pediatrician at Cohen Children's Medical Center in New Hyde Park, N.Y.

Most states do not have strict regulations regarding diet and exercise provided at day care, Isong and Driansky said.

"The concern was anytime you take control out of a parent's hands about what a child is eating or what a child is doing during a day, that could lead to obesity," Driansky said. "Not every parent is lucky enough to have a top-of-the-line day care. I think there was some concern that the day care wouldn't cooperate with what a parent wants for their child."

The new study included data from about 10, 700 U.S. children from diverse social, economic and ethnic backgrounds.

Factors such as the child’s gender, race, age and weight of the mother, family economic and social status, how many parents lived at home and the quality of the neighborhood were included in the analysis.

While the results pointed to no association between daycare and weight gain, Isong noted that this study "is not in any way full proof." Such proof would involve a clinical trial in which children would be randomly assigned to either childcare or home care.

The study did however offer a more detailed look at daycare and weight gain.

"We tried to control for a vast array of factors that could influence decisions to place children in child care," Isong said. "When we controlled for all those factors, the association went away."

Parents have the final say in what their children eat and do when they are not in daycare. Parents can encourage their little ones to be active, play outdoors and when old enough, find a sport they enjoy. Sugary drinks (including juices) should be limited and plenty of fruits and vegetables encouraged. Many experts recommend that children not watch TV before the age of two and that it be limited to 1 hour a day after that.

The study was published online in the October edition of the journal Pediatrics.

Story source: Dennis Thompson, http://www.webmd.com/children/news/20161010/day-care-doesnt-encourage-weight-gain-in-kids#2

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