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Daily Dose

CPR

1:00 to read

I was seeing a newborn the other day and the parents had a great idea. Their baby had spit up and they were concerned about how to clear his airway.  When we discussed how to hold the baby to clear the airway they had the great idea of having a CPR “teaching party” for a group of their friends who also had young babies!

 

I do encourage new parents (actually all parents and even grandparents) to take a CPR class. I am fortunate that we have yearly CPR class in our office which keeps us all up to date. 

 

It is fairly easy to find local CPR classes either through the YMCA, the American Heart Association and often through the hospital where you deliver your baby.  But, in these cases you have to take the class on “their schedule”. What a great idea to host a party with your friends and hire a certified CPR instructor to come to you!!

 

You know I do like to “isolate” my newborn patients from crowds (for 6-8 weeks), but it is fun to gather with other parents of newborns to get some social interaction. If everyone brought their baby, and a dish for dinner, it could be a mini dinner party followed by CPR training….ending with wine!

 

So…let’s start planning CPR parties, I may even do one for my friends who are becoming grandparents!

 

 

Your Baby

Good News! More Infants Placed in Car Seats Correctly

2:00

More parents and caregivers are getting the message and placing their infants and toddlers in car safety seats correctly, according to new research.

For years, the American Academy of Pediatrics (AAP) has aggressively urged parents and caregivers to put their children in rear-facing car seats until they are at least two years old. The AAP’s education policy seems to be paying off.

The study found that infants placed in rear-facing car seats increased from 84% in 2009 to 91% in 2015. The percentage of toddlers aged 12-17 months being placed in rear-facing car seats also increased dramatically from 12% to 61% during the same time period.

"This study shows that child passenger safety education has been a success in making sure young children are positioned correctly in the car, but there is still room for improvement," Dr. Joseph O'Neil, medical director of the Automotive Safety Program at Riley Hospital for Children, Indiana University Health, said in a press release.

The researchers also found that the use of booster-seat use decreased from 72% to 65% for older kids from 4 to 7 years old during that time.

The study findings suggest educational programs to improve child passenger safety could focus on the gaps identified by the study, including the recommendation to keep children rear-facing in safety seats through age 24 months, to use booster seats through age 8, and the recommendation that children sit in the back seat through age 13.

Safercar.org has a video and step-by-step instructions on how to properly install a rear-facing car seat for baby’s safety.

AAP also offers “Tips for Parents,” in video and written media, for shopping for car seats.

The study will be presented today at the AAP’s National Conference & Exhibition in Chicago.

This research is good news for children! Proper use of rear –facing car seats and booster seats are the first line of defense in keeping children safer when they’re riding in your car.

Story source: Amy Wallace, https://www.upi.com/Health_News/2017/09/14/Study-shows-more-infants-toddlers-placed-in-car-seats-correctly/9381505417976/

Your Toddler

Recall: 1.6 million Unstable Mainstays Chest of Drawers

2:00

Ameriwood Home is recalling about 1.6 million Mainstays chests of drawers sold in the U.S. and Canada because they can easily tip-over if not anchored to the wall, posing serious tip-over and entrapment hazards that can result in death or injuries to children. The chests do not comply with the performance requirements of the U.S. voluntary industry standard.

This recall involves Mainstays four-drawer chests of drawers with plastic drawer glides and a single decorative pull on each drawer. The composite wood chests were sold in six colors: alder, black forest, white, weathered oak, walnut and ruby red. The chests measure 40- 5/16 inches high by 27-11/16 inches wide by 14-11/16 inches deep.

Model numbers included in the recall are 5412012WP, 5412301WP, 5412328WP, 5412015WY, 5412301WY, 5412012PCOM, 5412015PCOM, 5412026PCOM, 5412213PCOM, 5412214PCOM, 5412301PCOM, 5412317PCOM, and 5412328PCOM.

The model number is printed on the instruction manual. 

CPSC has received one report of an injury after a chest of drawers tipped over onto a four-year-old.

The chests of drawers were sold at Walmart stores and other retailers nationwide and online at Walmart.com from April 2009 through May 2016 for about $60.

Consumers should immediately stop using any recalled chest that is not properly anchored to the wall and place it into an area that children cannot access. Contact Ameriwood for a free repair kit that includes a wall anchoring device and feet for the unit. Consumers who require additional installation guidance should contact Ameriwood for further assistance.

Consumers can contact Ameriwood toll-free at 888-222-7460 from 8 a.m. to 5 p.m. CT Monday through Friday, or online at www.Ameriwood.com and click on Support for more information. 

More images of the recalled chests of drawers can be found online at: https://www.cpsc.gov/Recalls/2017/Ameriwood-Home-Recalls-Chests-of-Drawers#

 

Daily Dose

Teen Drivers

1.30 to read

As you know, when teens start to drive, I am a huge advocate for parent - teen driving contracts. I wrote my own contracts for my boys but I recently found a website that all parents who are getting ready to have teen drivers need to be aware of.

Injuries from motor vehicle crashes are the #1 cause of death for teens in the United States.  Studies have shown that having limits and boundaries in place for new drivers reduces the number of motor vehicle accidents that new drivers experience. Although not all states have “graduated driver’s licenses”, all parents can have discussions about the privilege and responsibility of driving and set their own guidelines for their new teen driver.

The website www.youngdriverparenting.org was developed by the National Institute of Child Health and Human Development and is an interactive site for both parent and teen.  The program is entitled “Checkpoints”.  The website includes teen driving statistics to help parents keep their teen drivers safe as well as giving information about state-specific teen driving laws.

The site has a great interactive component to help parents create their own parent-teen driving “contract” that addresses such things as teen driving hours, number of passengers allowed, and boundaries for driving. These parameters can be modified as the teen becomes more experienced and meets the “checkpoints” that were agreed to.  It is a great site as it not only gives you a template for the agreement, but sends emails as the allotted amount of time has passed for each step of the contract.  You don’t have to remember what you and your teen agreed to, they email you and then you and your child can revisit the agreement and expand it over time as your driver becomes more experienced.

Instead of handing out my “dog eared” old driving contracts that I wrote for my boys, I am now going to send my patients to this site (which is also being sustained by the American Academy of Pediatrics).  

Teen drivers whose parents are actively involved in monitoring their driving are not only less risky drivers but know ahead of time what their parent’s expectations are. Having a teen involved proactively with driving rules is far preferable to regretting that limits, boundaries and parental rules were not discussed prior to allowing your new driver on the road.

The website is not only free it is also evidence based, and within 5 - 10 minutes of reviewing the site a family is set to go with their own checkpoint agreement.  Here’s to teen driver safety!

Your Child

263,000 iPhone Cases Recalled Due to Burn and Skin Irritations

1:30

About 263,000 MixBin Electronics iPhone cases are being recalled because liquid and glitter can leak out of the cases, causing skin irritation and burns to consumers.

This recall involves all liquid glitter mobile phone cases for iPhone 6, 6s and 7. The cases contain liquid and glitter that are floating in the plastic case. They were sold in various styles and colors and measure about 5.5 inches by 2.75 inches. The model number and UPC can be found on the product's packaging. To view model numbers, UPC codes and photos, please visit: https://www.cpsc.gov/Recalls/2017/MixBin-Electronics-Recalls-iPhone-Cases/

There have been 24 reports worldwide of skin irritation or chemical burns, including 19 in the U.S. One consumer reported permanent scarring from a chemical burn and another consumer reported chemical burns and swelling to her leg, face, neck, chest, upper body and hands. 

The iPhone cases were sold on Amazon and at Henri Bendel, MixBin, Nordstrom Rack, Tory Burch and Victoria's Secret stores nationwide and online from October 2015 through June 2017 for between $15 and $65.

Consumers should immediately stop using the recalled cases and contact MixBin Electronics for a full refund.

Consumers can contact MixBin Electronics toll-free at 855-215-4935 from 8 a.m. to 5 p.m. ET Monday through Friday, or online at www.getmixbin.com for more information. 

This recall was conducted voluntarily by the company under CPSC's Fast Track Recall process. Fast Track recalls are initiated by firms who commit to work with CPSC to quickly announce the recall and remedy to protect consumers.

Story source: http://www.prnewswire.com/news-releases/mixbin-electronics-recalls-iphone-cases-due-to-risk-of-skin-irritation-and-burns-300497584.html

Parenting

Back to School Road Safety Tips

2:00

Millions of U.S. children are starting a new school year and along with the joy and excitement comes traffic congestion.

It's never more important for drivers to slow down and pay attention than when kids are present – especially before and after school.

The National Safety Council offers these tips to drivers sharing the road with parents and caregivers dropping off or picking up their kids and school busses loading and unloading students.

If you’re dropping off your children, familiarize yourself with the specific drop off rules of your child’s school. More children are hit by cars near schools than at any other location according to the National Safe Routes to School program. These tips can apply to all school zones:

·      No double-parking. It blocks the visibility for other children and drivers.

·      Don’t load or unload kids across the street from the school

·      Carpool to reduce the number of vehicles at the school.

When you’re sharing the road with young pedestrians, remember these safety tips:

  • Don't block the crosswalk when stopped at a red light or waiting to make a turn, forcing pedestrians to go around you; this could put them in the path of moving traffic
  • In a school zone when flashers are blinking, stop and yield to pedestrians crossing the crosswalk or intersection
  • Always stop for a school patrol officer or crossing guard holding up a stop sign
  • Take extra care to look out for children in school zones, near playgrounds and parks, and in all residential areas
  • Don't honk or rev your engine to scare a pedestrian, even if you have the right of way
  • Never pass a vehicle stopped for pedestrians
  • Always use extreme caution to avoid striking pedestrians wherever they may be, no matter who has the right of way

Most likely, you’ll be sharing the road with school busses as well as other cars. A school bus is large, allow a greater following distance than if you were driving behind a car. It will give you more time to stop once the yellow lights start flashing. It is illegal in all 50 states to pass a school bus that is stopped to load or unload children.

  • Never pass a bus from behind – or from either direction if you're on an undivided road – if it is stopped to load or unload children
  • If the yellow or red lights are flashing and the stop arm is extended, traffic must stop
  • The area 10 feet around a school bus is the most dangerous for children; stop far enough back to allow them space to safely enter and exit the bus
  • Be alert; children often are unpredictable, and they tend to ignore hazards and take risks

Cars and busses aren’t the only vehicles on the road around a school; there are also kids on bikes.  On most roads, bicyclists have the same rights and responsibilities as drivers. Bikes can be hard to see though, particularly small ones with little riders. Children riding bikes create special problems for drivers because usually they are not able to properly determine traffic conditions. The most common cause of collision is a driver turning left in front of a bicyclist.

  • When passing a bicyclist, proceed in the same direction slowly, and leave 3 feet between your car and the cyclist
  • When turning left and a bicyclist is approaching in the opposite direction, wait for the rider to pass
  • If you're turning right and a bicyclists is approaching from behind on the right, let the rider go through the intersection first, and always use your turn signals
  • Watch for bike riders turning in front of you without looking or signaling; children especially have a tendency to do this
  • Be extra vigilant in school zones and residential neighborhoods
  • Watch for bikes coming from driveways or behind parked cars
  • Check side mirrors before opening your door

School zone speed lights will soon be or are already flashing, so you’ll have to retrain your eyes to look for them. By exercising a little extra care and caution, drivers and pedestrians can co-exist safely in school zones.

Story source: http://www.nsc.org/learn/safety-knowledge/Pages/back-to-school-safety-ti...

Parenting

Labor Day Safety Tips!

2:30

Traditionally, Labor Day is the fond farewell to summer and a welcomed hello to autumn. Lots of people will be on the roads, having backyard or park reunions, grilling, swimming and basically enjoying family and friends get-togethers.

To make this Labor Day a safe one, here are some tips that can help keep you from having to make a trip to the ER on this special weekend:

Road Safety.

-       Before you start out on a trip, make sure that your vehicle is in good condition, and see that any necessary maintenance is performed.

-       Just as adults and kids should always wear a seat belt, infants should always be properly secured in car seats.  

-       Be sure to follow all traffic laws while on the road, and use extra caution while driving in construction zones.

-       Be vigilant about paying attention to the road, and avoid distractions such as cell phones. Even just a momentary look away from the road can drastically increase your chances of a crash.

-       Be mindful of other vehicles on the road and remember to keep a safe distance between your vehicle and others. Keep in mind that semi-trucks, for example, require more time to come to a stop than cars do, and have large blind spots.

-       Keep an eye out for motorcyclists. Motorcycles are more difficult to see because they are smaller and can swiftly move in and out of traffic.

-       Even though you may have GPS, keep a map in the car and road flares in the trunk.

Food Safety. Picnics, barbeques, and neighborhood potlucks are plentiful and that means so is the chance of food-borne illness. To minimize the chance of cross-contamination:

-       Wash your hands before and after you touch raw meat.

-       Dry your hands on paper towels instead of cloth towels, and discard immediately. Refrigerate meat that’s waiting to hit the grill.

-       Never leave food that requires refrigeration (think potato salad, coleslaw or chicken salad) out in the sun. Instead, set the item the bowl is in on top of a pan filled with ice, and serve from a shaded area.

-       Return the item to the refrigerator as soon as guests have been served.

Boat Safety. Lots of folks will be heading to the lake for a family and/or friends boating adventure over the Labor Day weekend. Make it a safe one with these suggestions:

-       Have your boat in good mechanical condition and have all safety equipment on board such as personal flotation devices, an emergency kit and a first aid kit.

-       Stay away from restricted areas.

-       Make sure someone on land knows when you leave, about what time you’re expecting to return, where you’re headed and who all is on board.

-       Take a fully charged cell phone with you.

-       Everyone should have a life-vest on, including infants.

-       Maintain safe speeds and keep a lookout for hidden objects below the waterline

-       Maintain a 50-foot distance from other boats, swimmers, docks and the shore unless operating at an idle speed.

-       Install a marine-grade CO detector in your boat

-       Keep a flashlight and fresh batteries available.

-       Choose a designated driver before launching. Passengers that drink alcohol should drink in moderation.

-       Have plenty of water on board to avoid dehydration.

Pool and Water Safety. Pools and lakes are another place you’ll find plenty of people this Labor Day. That means lots of children will be in the water as well. It’s always best if someone knows CPR, if you don’t know it now – make a point of the family taking CPR classes together soon.

-       Appoint a “designated watcher” to monitor children during social gatherings at or near pools or water.

-       Have a fully charged cell phone with you. Call 911 immediately if a child is found unconscious in water.

-       Keep rescue equipment poolside or with you at the lake. Don’t wait for the paramedics to arrive because you will lose valuable life-saving seconds. Four to six minutes without oxygen can cause permanent brain damage or death.

-       Have a first-aid kit close by.

-       Maintain constant visual contact with children in a pool or lake or near a pool or lake. If a child is missing, check the water first; seconds count in preventing death or disability.

-       Never use flotation devices as a substitute for supervision. 

-       Don’t assume you’ll hear a child who’s in trouble in the water; child drowning is a silent death, with no splashing to alert anyone that the child is in trouble.

-       At public pools, use one that has a lifeguard. While not a substitute for parental or caretaker supervision, the more eyes available, the better.

Whether you’re splashing in a pool, enjoying the ultimate picnic or enjoying a ride on a boat, we want you to stay safe this Labor Day weekend. Remember: An accident is never planned. But keeping out safety tips in mind may help prevent one.

Story sources: http://www.cooneyconway.com/blog/road-safety-labor-day-weekend

https://www.safewise.com/blog/7-safety-tips-for-an-injury-free-labor-day/

http://www.nationalwatersafetymonth.org/water-safety-tips

Your Child

Is MiraLAX Safe for Young Children?

2:30

Constipation is a common problem in kids. It can become a painful elimination process if not treated quickly. Children will sometimes “hold” their poop to avoid the experience, making the situation worse.

Pediatricians often prescribe MiraLax for treatment. MiraLax contains PEG 3350, which is not habit-forming and is easy to give to kids because it has no taste or odor. You can mix it in their beverages, and they typically won't complain.

MiraLax is not a natural product. It does not completely clean a colon out, like an enema does, but it works well enough to unclog a child. Over time, constipation can cause other serious health consequences, so the condition needs to be treated promptly.

While the majority of children do fine when given MiraLax, a group of parents have reported dramatic changes in their child’s personality after being given the laxative.

For the past few years, the Children's Hospital of Philadelphia (CHOP) has quietly been conducting an FDA-grant funded study into parents' reports of devastating side effects from their kids' use of the over-the-counter constipation relief drug.  

But until that study is completed, the hospital won't comment on the experiences of individual families.

A FaceBook page called, Parents Against MiraLax (PEG 3350) has been created, and more than 3,500 people have joined to organize and voice concerns about PEG 3350.

When the FDA grant was awarded to CHOP in early 2014, the federal agency disclosed that MiraLAX powder contains small amounts of Polyethylene glycol 3350 (PEG 3350), which may under certain conditions degrade into ethylene glycol or diethylene glycol — toxic ingredients found in antifreeze.

"The Food and Drug Administration has received a number of reports of adverse events in children taking PEG products," the FDA said in its grant description. "The Agency has conducted a review that documented a number of reports of neurological and psychiatric events associated with chronic PEG use in children. A number of these pediatric patients received an adult dose of PEG (17 grams) for a duration ranging from a few days to a couple of years."

MiraLAX, manufactured by Bayer, is not recommended for patients under the age of 17, but the FDA concluded that it is often suggested to parents in clinical practice.

Bayer has responded in a statement, referencing existing clinical studies confirming the long and short-term safety of PEG 3350 in pediatric patients, though the company acknowledged the product is not labeled for use in the pediatric population.

An article in the New York Times, published in 2015, reported that the FDA had raised questions about the safety of an “an adult laxative routinely given to constipated children, “ sometimes for years.

The article also mentioned that buried in the FDA’s brief to researchers, it had tested eight batches of MiraLax and found tiny amounts of ethylene glycol (EG) and diethylene glycol (DEG), ingredients in antifreeze, in all of them. The agency said the toxins were impurities resulting from the manufacturing process.

Those tests were conducted in 2008, but the results were not disclosed. Jeff Ventura, an F.D.A. spokesman, said batches were tested because “many of the reported adverse events were classic symptoms of ethylene glycol ingestion.”

Psychiatric illnesses like those reported in children taking the laxatives have also been observed in cases in which a child took substantial amounts of ethylene glycol. Some children taking MiraLax chronically (over long periods of time) also have developed acidic blood, according to F.D.A. records, which can be a consequence of ingesting EG.

MiraLAX primarily is recommended for short-term use up to seven days to relieve constipation. The FDA does not approve chronic use, although many use it regularly or even daily to treat severe issues with digestion.

The North American Society of Pediatric Gastroenterology, Hepatology and Nutrition and the American Academy of Pediatrics said in statement after the study began, that they welcome “an investigation into the safety of treatment through data and research in the prolonged use of PEG 3350.”

A timeline for the CHOP study results is not immediately known.

For many children, MiraLax works well as a short-term laxative. However, parents should discuss the dosage and the pros and cons of giving it to the their child with their pediatrician.

Story sources: Michael Tanenbaum, http://www.phillyvoice.com/chop-leading-fda-study-parents-alarming-claims-about-over-counter-drug-miralax/

Catherine Saint Louis, https://www.nytimes.com/2015/01/06/science/scrutiny-for-a-childhood-remedy.html?_r=1

Steve Hodges, MD, http://www.parents.com/blogs/parents-perspective/2015/01/07/health/is-miralax-safe-for-kids-an-expert-weighs-in/

Your Baby

CDC Warning: Dangerous Germ Found in Powdered Infant Formula

2:00

The Centers for Disease Control and Prevention (CDC) issued a new warning about Cronobacter contamination in powdered infant formulas.

Because powdered infant formula is not sterile, it can sometimes contain Cronobacter — formerly known as Enterobacter sakazakii — a germ found naturally in the environment that can survive in very dry conditions, the CDC reports.

Cronobacter bacteria can cause severe blood infections or meningitis, an inflammation of the membranes that protect the brain and spine. If infected, infants two months of age and younger, are most likely to develop the infection.

Infants born prematurely and those with weakened immune systems are also at increased risk for serious sickness from Cronobacter, the CDC warns.

In infants, the sickness generally starts with fever and usually includes poor feeding, crying or very low energy. Very young infants with these symptoms should be taken to a doctor.

In some outbreak investigations, Cronobacter was found in powdered infant formula that had been contaminated in the factory. In other cases, Cronobacter might have contaminated the powdered infant formula after it was opened at home or elsewhere during preparation, according to the CDC.

Because Cronobacter lives in the general environment, it’s likely there have been other sources of this rare sickness.

Using current methods, manufacturers report that it is not possible to get rid of all germs in powdered infant formula in the factory. Powdered infant formula can also be contaminated after the containers are opened. Very young infants, infants born prematurely, and infants whose bodies have trouble fighting off germs are at highest risk.

The CDC offers these tips on protecting your infant:

·      Breastfeed: Breastfeeding helps prevent many kinds of sicknesses among infants. Almost no cases of Cronobacter sickness have been reported among infants who were being exclusively breastfed.

·      If your baby gets formula, choose infant formula sold in liquid form, especially when your baby is a newborn or very young. Liquid formulations are made to be sterile and therefore should not contain Cronobacter germs.

·      If you use powdered infant formula, follow these steps:

1      Clean up before preparation

Wash your hands with soap and water.

Clean bottles in a dishwasher with hot water and a heated drying cycle, or scrub bottles in hot, soapy water and then sterilize them.

Clean work surfaces, such as countertops and sinks.

2      Prepare safely

Keep powdered formula lids and scoops clean and be careful about what they touch.

Close containers of infant formula or bottled water as soon as possible.

Use hot water (158 degrees F/70 degrees C and above) to make formula.

Carefully shake, rather than stirring, formula in the bottle.

Cool formula to ensure it is not too hot before feeding your baby by running the prepared, capped bottle under cool water or placing it into an ice bath, taking care to keep the cooling water from getting into the bottle or on the nipple.

3      Use up quickly or store safely

Use formula within two hours of preparation. If the baby does not finish the entire bottle of formula, throw away the unused formula.

If you do not plan to use the prepared formula right away, refrigerate it immediately and use it within 24 hours. Refrigeration slows the growth of germs and increases safety.

When in doubt, throw it out. If you can’t remember how long you have kept formula in the refrigerator, it is safer to throw it out than to feed it to your baby.

Story Source: http://www.foodsafetynews.com/2016/04/125714/#.VyJvoat5ylA

 

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