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Your Child

Young Kids Still Being Injured or Killed in ATVs Accidents

2:30

Despite safety warnings from pediatricians and child health experts, children under 16 are still driving or riding as passengers on all-terrain vehicles.  The number of young kids being injured or killed in ATV accidents has not changed much in recent years, according to a new study.

Since 2000, the American Academy of Pediatrics (AAP) has recommended that ATV use be restricted to youth aged 16 years and older who wear helmets, don’t take passengers and steer clear of roads.

“Too many young children are driving these machines - equivalent to a motorcycle in many ways,” said senior study author Dr. William Hennrikus, medical director of the Pediatric Bone and Joint Clinic at Penn State College of Medicine in Hershey, Pennsylvania. 

“Children should not drive an ATV until they’re over 16, just like driving a motorcycle,” Hennrikus said by email to Reuters. “Helmets should always be worn, just like a motorcycle.”

For the study, researchers examined data on 1,912 patients under age 18 who were injured while using an ATV and treated at trauma centers in Pennsylvania from 2004 to 2014. 

During this period, 28 children died in ATV crashes, a mortality rate of roughly one per every 100,000 kids in the population, researchers calculated.

Fewer than half of the children were wearing helmets and a street or roadway was were 15% of the crashes happened. Rural areas tend to have more ATV crashes.

Being a passenger or being pulled by the ATV was a factor in almost one in four injuries, the study also found. 

Half of the kids involved in ATV crashes were 14 or younger, and about 6 percent were no more than 5 years old. 

Boys accounted for three in every four patients.

Limitations of the study include the possibility that researchers underestimated injuries and deaths because they only looked at trauma center patients, not children who were treated elsewhere or died before they ever reached a trauma center.

Experts agree that age isn’t the only factor parents should consider when letting their child drive an ATV.

“Parents need to think not just about their child’s size, but also their ability to think, to react to emergency situations and to maintain safe, cautious control of a very powerful vehicle,” said David Schwebel, a sports injury researcher at the University of Alabama at Birmingham who wasn’t involved in the study.

All across the country children are riding on or driving ATVs with sometimes-serious consequences. Just in the past few months a 12-year old boy from New York died from injuries in an ATV crash. A 15-year old boy in Illinois was killed and his passenger, his 12-year old sister, was seriously injured when he lost control of the ATV. A 14-year old boy was killed in New Jersey after losing control and crashing his ATV into another 14-year olds ATV; 2 other children were seriously injured from that crash. None of the children were wearing helmets or seatbelts. 

“Helmets absolutely have to be used for any ride, even short, apparently safe ones,” Schwebel said by email. “Passengers should never ride on ATVs unless the ATV is designed for more than one person.”

While ATVs can be dangerous for adults, they pose a much higher risk for children.

“Children are not developmentally capable of operating these heavy, complex machines,” Sandra Hassink, president of the AAP, said. “The American Academy of Pediatrics warns all parents that no child under the age of 16 should drive or ride an ATV.”

Story source: Lisa Rapaport, http://www.reuters.com/article/us-health-children-atv-injuries-idUSKBN1A422F

https://www.aap.org/en-us/about-the-aap/aap-press-room/pages/AAPCFAATVs.aspx

 

Daily Dose

National ASK Day!

1:30 to read

Today is all about guns!!!  Unfortunately we seem to  awaken nearly every day to news of gun violence and death in our country.  Firearm-related deaths are the third leading cause of death overall among U.S. children ages 1-17 years, and the second cause of injury-related death, only behind car crashes.  Those are grim statistics.  

 

June 21st, the first day of summer is alway designated as National ASK day…which stands for “Asking Saves Kids”.  This a day to remind me and all pediatricians to ask my patients if they:

 

#1 have a gun in the home?

#2 Is it locked and away from children?

 #3 Is the ammunition stored separately?  

 

A new study being published in the July issue of Pediatrics showed nearly 1,300 children die and 5,790 are treated for gunshot wounds each year. Of those children who die, 53% were due to homicide, 38% were suicide and 6% were unintentional firearm deaths, while 3% were due to “other intent”.   Not surprisingly to me, 82% of all child firearm deaths were in boys. Firearm suicides among children are going up and have increased by 60% since 2007.Sadly, I had a patient who is one of those statistics. 

 

While the politics about gun control continue ….this is not about politics but rather about guns in the home being a threat to children and how to protect our children.  

 

Parents routinely ask other parents about safety before dropping their child off to play or spend the night …”is your pool fenced?”  “do you have a dog and is it friendly?”, “do you let your 8 year old child watch PG-13 movies?”, “how do you handle electronics in the home?”, “do you know my child has food allergies?”, “are you going to be home with the children?”…..the list is long. I think in these times…especially with more and more people buying firearms for their home…it is time to routinely ask about guns in the home!!! 

 

Just one question might save a child’s life!!

 

Your Child

Zip Lining Safety Tips

1:45

From the mountains of Costa Rica to over waterfalls in Hawaii, zip lining has become a vacation acivity destination. Zip lining operations can also be found in  summer camps, zoos, fields in the middle nowhere, people’s backyards and lots of other exotic and not-so- exotic locations.

Here’s how they work. A zip line consists of a pulley suspended on a cable, typically made of stainless steel and mounted on an incline. A rider sits in a harness attached to a pulley. At the top of the slope, the user propels forward and gravity does the rest. Depending on your location, it can be quite a thrilling ride to the base.

One of the keys to a safe zip lining experience is knowing something about the company and the operator of the ride. Before you harness your child into a zip line at camp or during a family vacation, ask the operator questions about the ride’s safety and look around. Not every company follows the same safety rules. Though there are currently no national standards for zip line construction and operation, many states have them, and any legitimate operator should also adhere to the standards set by the Association for Challenge Course Technology or the Professional Ropes Course Association.

Here are some questions you can ask:

·      If the operation is inspected, how often and by whom.

·      What is the company’s safety record?

·      What training the operators have.

·      Is a safety demonstration included?

Check the area out once you arrive. Do the operators look professional? Look at the equipment provided, including carabiners, ropes, harnesses and helmets. Are they well maintained? Look at the course itself. Do the lines look free from wear and tear? How about the platforms? Do they look sturdy? Do they have guardrails?

Once on the course, make sure you're strapped onto a safety line at all times — not just while you're zipping through space. (Some places require that you have two safety lines hooked on.) Many accidents occur by a simple step off a platform. So if you're on the course (which often means many feet off the ground), you should be safely attached to a line that will catch you if you fall. Also, watch out for other adventurers and the guides. Don't get in their way.

Make sure everyone in the family who is zip lining wears a helmet and has closed-toe shoes.

Nearly 17,000 zip line injuries were treated in emergency rooms from 1997-2012, and most of those injuries were in the last four years, according to a 2015 study by Gary A. Smith, M.D., Dr.P.H., FAAP, and colleagues at Nationwide Children’s Hospital. About half the injuries involved children under 10 years old. Another 33% involved children ages 10-19 years. The study noted that many zip lines are not regulated, and there are no uniform safety standards.

The increase in the number of zip line injuries in children is “an epidemic by any definition,” according to Dr. Smith, past chair of the American Academy of Pediatrics (AAP) Council on Injury, Violence and Poison Prevention.

“If kids are using them, you really need to make sure they’re using them in places where people are trained, they know what they’re doing and the zip lines have been constructed in a way that they’re not going to fail,” said Dr. Smith.

Backyard zip line kits sold online and in stores also have been linked to injuries. Earlier this year, the Consumer Product Safety Commission recalled a backyard zip line kit (http://1.usa.gov/1XoHrFs) because of a design flaw that made it easy for the cable to separate from the line, causing riders to fall. Riders suffered head injuries and bruises. Another recall was issued in 2014 for backyard zip line trolleys (http://1.usa.gov/1RT6uaY) that released unexpectedly. No injuries were reported. Authors of the 2015 study warned against buying and installing backyard zip lines.

The AAP does not have a policy on zip lines and children. However, Dr. Smith suggested the following safety precautions:

·      Requiring riders to wear a helmet, harness and gloves;

·      Training operators;

·      Inspecting and maintaining equipment regularly; and

·      Posting rules and requiring participants to follow them.

“If done correctly, these and other types of outdoor amusements that are there for the thrill … can be done in a safe enough way that it’s reasonable for children to use them,” Dr. Smith said.

Story sources: Trisha Korioth, http://www.aappublications.org/news/2016/07/07/ZipLines070716

John Donovan, http://www.mnn.com/lifestyle/eco-tourism/stories/6-things-do-you-go-zip-lining

Your Baby

Recall: Otteroo Baby Floats Due to Drowning Risks

1:00

Babies and young children can drown in less than 2 inches of water.  That’s why it is  vital that parents and caregivers never leave a baby or young child unattended while they are near or in water.

When bathing their infant, parents will sometimes attach a bath float to their child to help keep his or her head above water. While the float may offer some assistance, critics warn that the device can give parents a false sense of security that their child is protected from drowning.

Otteroo Corporation makes inflatable baby floats that are specifically designed for babies 8 weeks and up.

The company is recalling about 3000 units of their inflatable Baby Floats after receiving 54 reports of broken seems on the product. No injuries have been reported.

The Otteroo Inflatable Baby Float is an inflatable round ring made of clear and blue plastic material. It has two air chambers that fasten around a baby’s neck with a white buckle. The floats have a chin rest, two handles and two circular openings on the back of the ring to allow the device to expand as the child grows with age. There are three colorful balls that move freely around inside the ring.  The name “Otteroo” is imprinted on the top of the float in large, orange letters with an Otter logo.

Consumers should immediately stop using the recalled inflatable baby floats and contact the firm to receive a free replacement.

The floats were sold online at Otteroo.com and Amazon.com and Zulily.com from January 2014 through July 2014 for about $35.

Consumers can contact Otteroo Corporation at (415) 236-5388 from 9 a.m. to 5 p.m. PT Monday through Friday or online www.otteroo.com and click on “Safety” at the bottom of the page for more information.

According to their website, Otteroo is offering a free replacement for those who purchased the product manufactured in 2014 (NO: 002013001).

Sources: http://www.cpsc.gov/en/Recalls/Recall-Alerts/2015/Otteroo-Corp-Recalls-Inflatable-Baby-Floats/

http://otteroo.com/pages/safety-info

Parenting

Happy July 4th!

1:30

This July Fourth marks 240 years since the adoption of the Declaration of Independence and a new nation was formed. It’s one of the biggest and most commemorative holidays of the year. For many American families, the day will be celebrated with friends, flags, good food, parades, music, reunions, water play, fireworks displays and numerous other festive activities.

It’s a great day for patriotic fun with family and friends, but don’t forget about safety and the pets.

Food preparation, sun exposure, water activity, fireworks and our precious pets all require extra attention on this very special holiday!

Drink plenty of water and limit alcohol consumption- especially if children need looking after.

Protect against food poisoning by following these simple rules:

•       Clean: Make sure you clean all surfaces, utensils, and hands with soap and water.

•       Separate: When grilling, use separate plates and utensils for raw meat and cooked meat and ready-to-eat foods (like raw vegetables) to avoid cross-contamination.

•       Cook: Cook foods to the right temperature by using a food thermometer. That’s the only way to know it’s a safe temperature. Remember, burgers should be cooked to 160°F.

•        Chill: Chill raw and prepared foods promptly if not consuming after cooking. You shouldn’t leave food at room temperature for longer than two hours (or 1 hour if outdoor temperatures are above 90° F), so if you’re away from home, make sure you bring a cooler to store those leftovers.

Lots of families will be enjoying water activities at the beach or lake on July Fourth. Make sure your family plays it safe by:

•       Making sure the children – and even adults – always have a life jacket on when in the water or on a motorized water vehicle (boat, jet ski, etc.)

•       Never letting your children swim alone. An adult should always be present and paying attention.

•       Always stepping feet first into shallow water and never try to dive.

•       Reviewing safe boating practices.

•       Always having a phone handy should an emergency arise.

•       Knowing your limits when it comes to water.

Daylight hours are longer during the summer and the sun’s rays can be intense. If possible, limit your exposure to the sun between 10:00 am and 4:00 pm. Children are particularly susceptible to sunburn, so make sure they have plenty of sunscreen on. And once again, make sure you and the kids are drinking plenty of water! Watch for signs of heat stroke – rapid, weak pulse, fast, slow breathing, and hot, red skin.

Fireworks and the Fourth of July go hand-in-hand. The best way to protect the family from fireworks injuries is by attending a sponsored and controlled city or community fireworks event. Leave the explosions to the experts and enjoy the nighttime display!

If your city or county allows personal fireworks and you plan on having a few at the house, make sure safety is your first priority.

Fireworks can be dangerous, so in order to prevent injuries and deaths that are related to fireworks, here are a few firework safety tips to follow this Fourth of July:

·      Children should never be allowed to ignite or play with fireworks.

·      An adult should always be supervising firework activity.

·     A fire extinguisher, garden hose or bucket of water should always be on hand in the event of a mishap or fire.

·     No one should ever try to pick up or re-ignite a firework that did not ignite properly or fully the first time around.

·     Fireworks should only be lit one at a time and the person lighting them should immediately move away from the firework after lighting it.

And don’t forget about the four-legged family members! Pets don’t associate fireworks with celebrations and most are terrified of the loud explosions and whistles they produce.  Board or keep your pets indoors.

Make sure that lighter fluid and matches are out of your pet’s reach. While it’s tempting to feed your pets left over scraps, keep them on their regular diet. Keep citronella candles, insect coils and tiki torch oil products out of reach. These products can be poisonous to pets. And make sure that your pets have identification tags on them in case they escape. Having your pet chipped is inexpensive and provides a good way for owners to be tracked down in the event that a pet does run away.

July Fourth is a true American tradition. Here’s to having a fun and safe celebration!

Story sources: http://www.aspca.org/pet-care/general-pet-care/fourth-july-safety-tips

http://www.armymwr.com/july4th-safety.aspx

http://blogs.usda.gov/2012/07/02/four-food-safety-tips-for-the-fourth-how-to-protect-your-family-from-a-surprising-july-4th-danger/

 

 

Your Teen

Teens: Fatal Car Crashes Down

2:00

It seems like there are far too many studies reporting bad outcomes where teens are involved; too much drinking, eating, smoking and risky behaviors.

However, a recent study concludes that fatal car crashes involving teens have dropped by over half in the last decade. Researchers believe one reason may be that more teenagers are receiving driving licenses attached with restrictions.

"Many factors are probably at play, but there is wide agreement the graduated licensing programs are an important contributor to the decline in fatal crashes," lead study author Ruth Shults, an injury prevention researcher at the U.S. Centers for Disease Control and Prevention in Atlanta, said in an to email to Reuters Health.

Graduated licenses may limit teens from diving at night as well as restrict how many teenage passengers can ride in a car with a teen driver.

Shults says that may be partly responsible for reducing the overall crash rate by 20 to 40 percent.

According to the Centers for Disease Control and Prevention (CDC), the number of drivers aged 16 to 19 involved in fatal crashes fell by 55 percent to 2,568 in 2013, down from 5,724 in 2004, supported by an increase in graduated licenses programs.

The numbers may also be down because some teenagers are waiting till they are 18 to get their driving license, said Eric Teoh, a senior statistician at the Insurance Institute for Highway Safety in Arlington, Virginia.

"An 18-year-old novice is probably more prepared maturity-wise than a 16-year-old novice," said Teoh, who wasn't involved in the study.

Many parents have changed what they look for in a car for their teenager. Newer models have better safety features - such as electronic stability to help keep the car in line if the driver loses control. That one feature alone may also be a contributing factor in fewer crashes.

Across 42 states included in the survey, the proportion of high school students who drive ranged from about 53 percent to about 90 percent, with the highest rates in the mid-western and mountain states, where population density is low. West coast states including California, Washington and Oregon were among eight excluded from the study.

In cities, fewer students drove, which may be related to family income, shorter travel distances and wider use of public transportation or alternatives such as walking or bicycling.

Nationwide in 2013, about three in four high school students 16 and older reported driving in the past month; the proportion was lower among black and Hispanic teens compared to white youth.

The economy may have also played a role in the reduction of teen drivers. Less dispensable money may have forced teens to look for alternative means such as public transportation, bicycles or walking.

"The economic downturn resulted in changes in the way people drive, with people taking fewer elective trips," said Raymond Bingham, a professor at the University of Michigan's Transportation Research Institute in Ann Arbor, who wasn't involved in the study.

Leisure trips, as opposed to driving to work or school, are associated with more crashes, Bingham said.

Whatever the reasons, it’s good to know that more of our teenage drivers are living to grow into adulthood and making it pass the turbulent adolescent years.

Source: Lisa Rapaport, http://www.reuters.com/article/2015/04/08/us-health-teens-drivers-crashes-idUSKBN0MZ21020150408

Daily Dose

Drowning Is Silent!

1:15 to read

Summer is here and many families will spend time at the beach, lake, or pool. The first thing that comes to my mind (when I think of water) is safety!!  

Knowing that over 900 children between the ages of 1–14 die each year from drowning, the discussion of water safety is a necessary part of summer routines. Astoundingly, reports show that 9 out of 10 of those children who drowned were “under supervision”. The American Academy of Pediatrics has endorsed allowing children between the ages of 1-4 to take swimming lessons. It was previously thought that encouraging swimming lessons for children under the age of 4 years might actually contribute to increased drowning.   In fact, recent studies have suggested that children ages 1–4 may be less likely to drown if they have had formal swimming instruction. The AAP has not gone so far as to routinely recommend mandatory swimming lessons for this age group, but does endorse swimming lessons in younger children who are frequently exposed to water and are emotionally and physically able to participate.  

The AAP does not recommend formal “infant survival swimming lessons” for children under the age of 1 year. When I discuss water safety with my patients, I emphasize that drowning continues to be the second leading cause of death for children ages 1–19.  I often have interesting discussions with parents who have a backyard pool who do not believe that it is necessary to have a barrier around the pool. They will say, “we never let our child outside alone” or “he or she is always being supervised by an adult”.

As you might expect, these are usually first time parents who have yet to experience the cunningness of a toddler.  Just as our children watch us and learn how to feed themselves, or drink from a cup or climb out of a bed, they too watch us open a door, or take a stool out to reach something. A toddler is more than capable or figuring out how to reach a door handle even with a lock, or climb out a window to go outside and head straight for the pool. Drowning is SILENT!!  It is not like the movies with screaming and yelling. The child quietly goes beneath the water and sinks.  It only takes minutes and the consequences of drowning are devastating.  Even for a child who is found and resuscitated there may be a life-long brain injury and the worst case scenario, death.

All families with a pool should install a 4 sided fence that is at least 4 feet high to limit pool access. It must be difficult to climb and have a self-latching, self-closing gate. The arguments I hear about “landscape aesthetics” fall on deaf ears.  Every family should also know CPR. Sign your child up for swimming lessons, and have fun practicing flutter kicks and arm strokes. Just do it with an adult within arm’s reach of all new and novice swimmers and a fence around the pool!

That's your daily dose for today.  We'll chat again tomorrow!

Daily Dose

Lead Found in Baby Food

1:30 to read

I know many of the parents of the children I care for are concerned about the latest news from the Environmental Defense Fund which showed that about 20% of baby food samples tested over a 10 year period had detectable levels of lead.

 

This non profit group looked at data that the FDA had collected from 2003-2013 which included 2,164 baby food samples. While none of the baby food samples seemed to exceed the FDA’s “allowable” levels of lead, it is still quite concerning. At the same time the FDA is in the process of reviewing their standards to reflect the latest science surrounding the potential risks to young children who are exposed to lead.  

 

While lead testing is routinely performed in young children (1 and 2 yrs), the CDC currently  considers a blood lead level greater than 5 micrograms/deciliter as elevated, but no lead level is “safe”. 

 

Lead exposure has been shown to have neurocognitive effects - which means IQ, the ability to pay attention and academic achievement…and the effects cannot be corrected.

 

The study did not name baby foods by brand.  Root vegetables (carrots are one) had the highest rate of lead detection (65% of samples), followed by crackers and cookies (47%) and the then fruits and juices (29%). Only 4% of the cereal samples contained lead.

 

This report will cause a lot of parental anxiety, but really doesn’t tell us much about what to do?  Lead based paint is still the number one source of lead exposure, followed by water, which may also have contributed to lead in food…. but there is still lots of be determined.

 

In the meantime, the take home message is “feed your babies and toddlers a wide variety of baby foods” and when possible eat fresh foods. One hypothesis is that baby foods are more processed which may contribute to the higher lead content.  It is easy to cook and “mush” up your own food to feed your baby and it really does not require a fancy food processor.  If you can mush it your baby can eat it!!! The only concern about the introduction of food is basically it has to be soft enough not to be a choking hazard. So no whole nuts, chunks of meat, uncooked hard veggies…you get the idea.

 

Just because your baby doesn’t seem to like certain foods, don’t get stuck feeding them just a few foods…but continue to offer a variety of healthy foods..some of which they may eat more of than others. Every day will be different.

 

So…don’t go throw away all of your baby foods but think if you might be able to substitute fresh foods, don’t offer fruit juices to your babies and toddlers and most importantly eat healthy foods. That’s the best thing for you and your child.  

Your Child

Tips for Preventing Sports Injuries

1:30

The school year is about to wind down and it won’t be long before many kids will be signing up for summer sports programs.

If you’re child loves sports, there’s not a season where he or she can’t find one to participate in. Sports often help children stay in better physical shape, feel good about them selves and with team sports, enjoy social interaction and competition.

However, all sports have a certain amount of risks associated with them - some more than others. The more contact the sport provides, the greater the risk for a traumatic injury. Fortunately, traumatic injuries are rare and most sport injuries to young athletes are due to overuse.

The most common sport-related injuries are sprains (ligament injuries) , stress fractures( bone injuries)  and strains (muscle injuries).Since children’s bodies are still developing, any tenderness over a bone should be evaluated further by a medical provider even if there is minimal swelling or limitation in motion.

The American Academy of Pediatrics offers these tips to help reduce serious injuries in younger athletes:

•       Time off. Plan to have at least 1 day off per week from a particular sport to allow the body to recover. 

•       Wear the right gear.  Players should wear appropriate and properly fit protective equipment such as pads (neck, shoulder, elbow, chest, knee, shin), helmets, mouthpieces, face guards, protective cups, and/or eyewear. Young athletes should not assume that protective gear will always protect them when performing more dangerous or risky activities.

•       Strengthen muscles. Conditioning exercises during practice strengthens muscles used in play. 

•       Increase flexibility. Stretching exercises before and after games or practice can increase flexibility. Stretching should also be incorporated into a daily fitness plan.

•       Use the proper technique. This should be reinforced during the playing season. 

•       Take breaks. Rest periods during practice and games can reduce injuries and prevent heat illness.  

•       Play safe. Strict rules against headfirst sliding (baseball and softball), and spearing (football) should be enforced. 

•       Stop the activity if there is pain.

•       Avoid heat injury by drinking plenty of fluids before, during and after exercise or play; decrease or stop practices or competitions during high heat/humidity periods; wear light clothing. 

While physical injuries are easier to see, sports-related emotional stress can also cause problems for some children. The pressure to win at all costs can add a lot of emotional stress to children who are more interested in playing than always being first.

Not every team is going to win every game, and there will be times when kids involved in more singular sports won’t have a good day. It happens to everyone at some time or another; ask any pro athlete. Young athletes should be judged on effort, sportsmanship and hard work. They should be rewarded for trying hard and for improving their skills rather than punished or criticized for losing a game or competition.  The main goal should be to have fun and learn lifelong physical activity skills.

There are numerous sports that children can engage in and each one offers its own benefits. As parents, it’s important to encourage our children and keep them as healthy as possible.

Source: http://www.healthychildren.org/English/news/Pages/Tips-for-Sports-Injury-Prevention.aspx

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