A Dose of Dr. Gwenntag:drgwenn.kosmix.com,2008://42008-07-07T14:25:11ZMusings and comments on health headlines and news by Gwenn S. O'Keeffe, MD, FAAP, pediatrician, mom and blogger. Movable Type 3.31Summer Safety for Great Outdoor Funtag:drgwenn.kosmix.com,2008://4.1132008-07-07T14:00:00Z2008-07-07T14:25:11ZWith the summer in full swing, and full bloom, kids are actively out and about participating in all sorts of formal and informal recreational activities. Keeping kids safe each summer can be a challenge because you have to consider not...Dr. Gwenn
American Academy of Pediatrics Summer Safety I; used with permission)
FUN IN THE SUN Babies under 6 months:
• Avoiding sun exposure and dressing infants in lightweight long pants, long-sleeved shirts, and brimmed hats that shade the neck are still the top recommendations from the AAP to prevent sunburn. However when adequate clothing and shade are not available, parents can apply a minimal amount of suncreen with at least 15 SPF (sun protection factor) to small areas, such as the infant's face and the back of the hands. If an infant gets sunburn, apply cold compresses to the affected area.
For Young Children:
• Apply sunscreen at least 30 minutes before going outside, and use sunscreen even on cloudy days. The SPF should be at least 15 and protect against UVA and UVB rays.
For Older Children:
• The first, and best, line of defense against the sun is covering up. Wear a hat with a three-inch brim or a bill facing forward, sunglasses (look for sunglasses that block 99-100% of ultraviolet rays), and cotton clothing with a tight weave.
• Stay in the shade whenever possible, and limit sun exposure during the peak intensity hours - between 10 a.m. and 4 p.m.
• Use a sunscreen with an SPF of 15 or greater. Be sure to apply enough sunscreen - about one ounce per sitting for a young adult.
• Reapply sunscreen every two hours, or after swimming or sweating.
• Use extra caution near water, snow, and sand as they reflect UV rays and may result in sunburn more quickly.
HEAT STRESS IN EXERCISING CHILDREN
• The intensity of activities that last 15 minutes or more should be reduced whenever high heat and humidity reach critical levels.
• At the beginning of a strenuous exercise program or after traveling to a warmer climate, the intensity and duration of exercise should be limited initially and then gradually increased during a period of 10 to 14 days to accomplish acclimatization to the heat.
• Before prolonged physical activity, the child should be well-hydrated. During the activity, periodic drinking should be enforced, for example, each 20 minutes, 5 oz of cold tap water or a flavored sports drink for a child weighing 90 lbs, and 9 oz for an adolescent weighing 130 lbs, even if the child does not feel thirsty.
• Clothing should be light-colored and lightweight and limited to one layer of absorbent material to facilitate evaporation of sweat. Sweat-saturated garments should be replaced by dry garments.
• Practices and games played in the heat should be shortened and more frequent water/hydration breaks should be instituted.
POOL SAFETY
(Source)
• Install a fence at least four-feet high around all four sides of the pool. The fence should not have openings or protrusions that a young child could use to get over, under, or through.
• Make sure pool gates open out from the pool, and self-close and self-latch at a height children can't reach.
• Never leave children alone in or near the pool, even for a moment.
• Keep rescue equipment (a shepherd's hook - a long pole with a hook on the end - and life preserver) and a portable telephone near the pool. Choose a shepherd's hook and other rescue equipment made of fiberglass or other materials that do not conduct electricity.
• Avoid inflatable swimming aids such as "floaties." They are not a substitute for approved life vests and can give children a false sense of security.
• Children may not be developmentally ready for swim lessons until after their fourth birthday. Swim programs for children under 4 should not be seen as a way to decrease the risk of drowning.
• Whenever infants or toddlers are in or around water, an adult should be within arm's length, providing "touch supervision."
BUG SAFETY
• Don't use scented soaps, perfumes or hair sprays on your child.
• Avoid areas where insects nest or congregate, such as stagnant pools of water, uncovered foods and gardens where flowers are in bloom.
• Avoid dressing your child in clothing with bright colors or flowery prints.
• To remove a visible stinger from skin, gently scrape it off horizontally with a credit card or your fingernail.
• Combination sunscreen/insect repellent products should be avoided because sunscreen needs to be reapplied every two hours, but the insect repellent should not be reapplied.
• Insect repellents containing DEET are most effective against ticks, which can transmit Lyme Disease, and mosquitoes, which can transmit West Nile Virus and other viruses.
• The concentration of DEET in products may range from less than 10 percent to over 30 percent. The benefits of DEET reach a peak at a concentration of 30 percent, the maximum concentration currently recommended for infants and children. DEET should not be used on children under 2 months of age.
• The concentration of DEET varies significantly from product to product, so read the label of any product you purchase.
For more information on DEET, click here.
PLAYGROUND SAFETY
(Source1; Source 2)
• The playground should have safety-tested mats or loose-fill materials (shredded rubber, sand, wood chips, or bark) maintained to a depth of at least 9 inches. The protective surface should be installed at least 6 feet (more for swings and slides) in all directions from the equipment.
• Equipment should be carefully maintained. Open "s" hooks or protruding bolt ends can be hazardous.
• Swing seats should be made of soft materials such as rubber, plastic or canvas.
• Make sure children cannot reach any moving parts that might pinch or trap any body part.
• Never attach-or allow children to attach-ropes, jump ropes, leashes, or similar items to play equipment; children can strangle on these.
• Make sure metal slides are cool to prevent children's legs from getting burned.
• Parents should never purchase a home trampoline or allow children to use home trampolines.
• Parents should supervise children on play equipment to make sure they are safe.
BICYCLE SAFETY
(Source1; Source 2)
• Do not push your child to ride a 2-wheeled bike until he or she is ready, at about age 5 or 6. Consider the child's coordination and desire to learn to ride. Stick with coaster (foot) brakes until your child is older and more experienced for hand brakes.
• Take your child with you when you shop for the bike, so that he or she can try it out. The value of a properly fitting bike far outweighs the value of surprising your child with a new one. For more information on finding the proper fit, go to http://www.aap.org/family/bicycle.htm
• Buy a bike that is the right size, not one your child has to "grow into." Oversized bikes are especially dangerous.
• Your child needs to wear a helmet on every bike ride, no matter how short or how close to home. Many accidents happen in driveways, on sidewalks, and on bike paths, not just on streets. Children learn best by observing you. Whenever you ride, put on your helmet.
• When purchasing a helmet, look for a label or sticker that says the helmet meets the CPSC safety standard.
• A helmet protects your child from serious injury, and should always be worn. And remember, wearing a helmet at all times helps children develop the helmet habit.
• A helmet should be worn so that it is level on the head, not tipped forwards or backwards. The strap should be securely fastened, and you should not be able to move the helmet in any direction. If needed, the helmet's sizing pads can help improve the fit.
SKATEBOARD, SCOOTER, IN-LINE SKATING AND HEELYS SAFETY
(Source)
• Children should never ride skateboards or scooters in or near traffic.
• All skateboarders and scooter-riders should wear a helmet and other protective gear; wrist guards are particularly important.
• Communities should continue to develop skateboard parks, which are more likely to be monitored for safety than ramps and jumps constructed by children at home.
• While in-line skating or wearing Heelys, be sure to wear appropriate protective equipment and only skate on designated paths or rinks and not on the street.
BOTTOM LINE
Kids want to be spontaneous and to a degree we want to encourage that this summer. However, we have to be sure they don't get into trouble at the same time. So, before they dart outdoors with their 11th hour plans, make sure they take a few extra seconds to lube up, cover with DEET and grab whatever safety gear the activity of the day needs. Those extra few seconds really is the difference between coming home happy and healthy and coming home needing the first aid kit or your pediatrician!
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Summer Long Weekend Fun: Fireworks and Water Safetytag:drgwenn.kosmix.com,2008://4.1122008-07-03T15:14:14Z2008-07-03T15:25:55ZSummer is a wonderful time for outdoor fun with outdoor activities and downtime we don’t get to experience during other times of the year. At the same time, those very features of summer that make it so wonderful, so have...Dr. Gwenn
Fireworks Safety
People seem to have a love/hate relationship with fireworks. Many people love them, while some don't. Despite the warnings from professionals about the extra precautions they need to follow to pull off professional shows, too many people attempt to set off fireworks from their backyards or beaches causes all sorts of injuries to themselves or the people around them.
I have seen more than my share of fireworks injuries over the years! There was the teenager who did a number on his leg after some bottle rockets he had in his pocket exploded as he walked by a campfire. My own toddler nephew suffered a nasty burn to his finger by a sparkler because a relative gave him one to hold not realizing those things burn down – and he was too young to let go! And, I witnessed adults setting off fireworks on a beach in Connecticut a few weeks back where kids were sitting around campfires only feet away. I didn’t stick around long enough to see the result – we scrambled to get our own kids to safety!
Your best course of action is to keep the fireworks to the pros and watch from afar! The American Academy of Pediatrics has these tips for you to keep everyone in your family safe from fireworks harm:
"• Fireworks can result in severe burns, scars and disfigurement that can last a lifetime.
• Fireworks that are often thought to be safe, (i.e. sparklers) can reach temperatures above 1000 degrees Fahrenheit, and can burn users and bystanders.
• Families should attend community fireworks displays run by professionals rather than using fireworks at home.
• The AAP recommends prohibiting public sale of all fireworks, including those by mail or the Internet."
More fireworks safety information can be found here.
BOATING and OPEN WATER SWIMMING SAFETY
How many of you will be on the water this weekend? Very common time of year to explore the ocean and lakes in your area either by boat or by swimming. Any water activity carries an element of risk event for the most experienced of boaters and swimmers. The American Academy of Pediatrics has these tips to keep your family safe with your water activities:
Boating
"• Children should wear life jackets at all times when on boats or near bodies of water.
• Make sure the life jacket is the right size for your child. The jacket should not be loose. It should always be worn as instructed with all straps belted.
• Blow-up water wings, toys, rafts and air mattresses should never be used as life jackets or life preservers.
• Adults should wear life jackets for their own protection, and to set a good example.
• Adolescents and adults should be warned of the dangers of boating when under the influence of alcohol, drugs and even some prescription medications."
Open Water Swimming
"• Never swim alone. Even good swimmers need buddies!
• A lifeguard (or another adult who knows about water rescue) needs to be watching children whenever they are in or near the water. Younger children should be closely supervised while in or near the water - use "touch supervision," keeping no more than an arm's length away.
• Make sure your child knows never to dive into water except when permitted by an adult who knows the depth of the water and who has checked for underwater objects.
• Never let your child swim in canals or any fast moving water.
• Ocean swimming should only be allowed when a lifeguard is on duty."
The Bottom Line
While summer affords us all a wonderful opportunity to relax and participate in recreational activities unavailable to us at other times of the year, we have to remember that relaxation and fun is not an excuse to throw caution to the wind and forget basic safety. In fact, following safety rules will make your adventure more fun because no one will need a first aid kit or emergency room by the end of the day – just a shower!
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Kids and Scary Drug Reactions: What You Need To Knowtag:drgwenn.kosmix.com,2008://4.1102008-06-30T12:41:14Z2008-07-02T12:49:27ZWhen you learn of frightening headlines about medications and children, such as this one run recently on FoxNews.com, your initial reaction may be to panic and not give that medication to your child. Keep in mind that the press loves...Dr. Gwenn
such as this one run recently on FoxNews.com, your initial reaction may be to panic and not give that medication to your child. Keep in mind that the press loves to sensationalize headlines and will over dramaticize a situation to draw you into their website with such stories. Such was the case recently with a very rare and serious drug reaction due to ibuprofen that left a little girl blind.
Ibuprofen, a common pain killer and fever buster, is a common medication for children in many medicine cabinets these days. And, it is safe when used at the proper doses. The problem with any medication, however, is that even at proper doses, there is always the chance of an allergic reaction in any of us – or our children. These reactions range from mild to serious and are due to an over reaction of a person’s immune system from that medication. Prior exposure to a medication is usually needed.
While this child has the most severe of drug reactions a person can have, fortunately most drug reactions are much less severe – typically a rash of some sort.
These reactions are not due to medication error from a physician or negligence on the part of a drug company but bad luck. I’ve had the misfortune of two drug allergic reactions myself and there was no warning and I have diagnosed a range of allergic reactions in children from medications. In all these cases, the one element the reactions shared was the element of surprise.
So, what should you do? Be on the look out for any symptom you don’t expect when any family member is on a medication – whether that medication be over the counter or prescribed. And, call your doctor’s office for advice at the first sign of trouble.
A quick word on Stevens-Johnson Syndrome, the type of reaction the child on the FoxNews.com story had. While often due to a medication, it can also occur from an illness such as a virus. Nonsteroidal antiinflamatory medications are known to be on the list as potential culprits, according to the MayoClinic. It is a type of drug reaction that involves a rash with target-like characteristics and some of the deeper mucous membranes such as the inner lining of the mouth and esophagus and the conjunctivae of the eyes. There’s usually flu-like symptoms such as fever, too. Needless to say, these patients are sick and require very intensive and supportive care to help their body curtain this reaction. This is very rare and occurs in 1 per 7 million cases of drug reactions a year when the target lesions develop.
I want to call your attention to this line on the MayoClinic info page:
“It's difficult to prevent an initial attack of Stevens-Johnson syndrome because you don't know what will trigger it.”
So, what does this mean for medication use in our children? Is ibuprofen safe? First, ibuprofen is safe – go ahead and use it. But, we all have to have a healthy respect for medication - and that is what this story means. We have to learn to use over the counter medications in the right dose and for the right situation so the benefit is worth any potential risk of a reaction. Any time any of us take a medication there is a risk. So, let’s make sure the risk is worth it before we put it into our bodies or our children's mouths.
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Kids and ADHD: Do They Need EKGs?tag:drgwenn.kosmix.com,2008://4.822008-06-03T13:41:14Z2008-06-03T13:47:30ZIt is difficult when experts seem to disagree on how to manage a child health problem. Early May, 2008,the American Heart Associationn(AHA) came out with a statement advising EKGs in kids about to start stimulant medication for ADHD. While this...Dr. Gwenn
a new statement was released by the AHA and AAP that was softer and more consistent with past recommendations to not screen all kids.
There are many issues to consider and it is a bit confusing:
1. There are no studies that actually support the original recommendations by the AHA.
2. The AAP has always advocated a thoughtful approach to heart screening that takes into account family history, review of the patient’s symptoms and physical exam.
3. Widespread screening is costly to all of us in the end and will yield few positive results. It is truly searching for a needle in a haystack.
4. Screening of any kind does place unnecessary anxiety on the majority of families who do not need to go through the procedure with their child and waiting game for the results.
So, how does the this particular screening work? Simple. If a patient has known heart disease, this discussion is moot. Those patients need to get annual screening and their cardiologists will help guide the right tests and the schedule for those tests. The cardiologists will often work with the pediatricians to help arrange these tests in the community near home.
For kids who have no known heart disease, which are the majority of kids being considered for ADHD medication or are already on ADHD medication, a good evaluation of family history, the patient’s history and physical exam are all that is needed. If during any of those evaluations suspicion is raised for heart disease, the option for screening becomes more important and will be discussed based on what information turns up. This isn't a one test fits all. It is a test if needed sort of thing.
So, whenever you are faced with a situation of “to screen or not to screen" with any test, the answer always lies somewhere with the patient and the family. Tests don’t help unless there is a reason for them to help.
If you want to fall back on an “official” statement for the question of "should kids on ADHD medications get EKGs?", fall back on this one:
“Medications that treat ADHD have not been shown to cause heart conditions nor have they been demonstrated to cause sudden cardiac death.”
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Making Your Next Trip To The Pediatrician Go Your Waytag:drgwenn.kosmix.com,2008://4.732008-05-22T17:19:44Z2008-05-22T17:23:53ZTaking a child to the doctor is often stressful. To help make those visits go as smoothly as possible, here are a few tips that my experience has taught me really help make a big difference for everyone. Dr. Gwenn
Taking a child to the doctor is often stressful. To help make those visits go as smoothly as possible, here are a few tips that my experience has taught me really help make a big difference for everyone.
1. Please don’t use your cell phone in the exam room – to make a call or answer a call. It is distracting and delays us from seeing the next patient on time.
2. Please don’t let your child eat in the room. Food in the room is a risk for kids with allergies. It is hard to examine a mouth that has food in it.
3. If a child has been vomiting, don’t give your child anything to drink with out talking to the nursing staff first.
4. If your child has a particular worry, let us know so we can find a way to address it and you’re your child more at ease.
5. Remember your child is the patient, so please don’t interrupt us if we try and get the history from your child. You can fill in the blanks after we are done with that part of the history.
6. Both the history and the physical are important, and we need to do both at every visit.
7. Small children usually have to be restrained gently during parts of the exam. This is for the safety of your child when examining sensitive areas like the ears or mouth. This process goes best if you assist with it by following our cues.
8. If your child has a major medical problem, clue us in even if you think it is in the chart.
9. Be patient if there is a wait. If you have a time crunch, let the staff know to help find solutions if you need to be somewhere.
10. Make sure you have distraction toys to help pass the time. Books. Crayons. Your child’s favorite stuffed animal.
So, give these tips a try. I have a feeling you’ll find they’ll be just what the doctor ordered for making the next visit go better for your child, and for you.
Need more family time? Try unplugging it from the outside world. tag:drgwenn.kosmix.com,2008://4.602008-05-09T02:27:17Z2008-05-09T02:52:32ZMy kids’ spring school vacation this year fell during TV Turn Off Week. I figured this would be a snap with the change in routine and the excitement of exploring new locales. I anticipated happily tired kids falling asleep at...Dr. Gwenn
TV Turn Off Week. I figured this would be a snap with the change in routine and the excitement of exploring new locales. I anticipated happily tired kids falling asleep at the end of each day before they even remembered we had a TV in our hotel room. Even without an “official” no TV week, vacations are low TV times for us – we’re just too much on the go.
However, I quickly faced one huge hurdle I didn’t quite anticipate: we were visiting The Big Apple – the city that never sleeps and that has a screen of some sort on just about everywhere you go: hotel lobbies, elevators, restaurants, bars, museums, Times Square, and even taxi cabs. Talk about TV tube over load complete with an instant failure of our attempt at TV Turn Off Week. My only solace was that none of us actually hit the “on” for those bigger than life screens.
With TVs also now available in refrigerators and cars, we do honestly have to ask ourselves when this will end, especially knowing the plethora of studies citing the risks to our kids and our society for too much tube time. And, that is what we are talking about: too much.
Kids who watch too much tv are at risk for obesity, inattention and even behavioral issues. And, a recent study in Pediatrics actually showed that teens without TVs in their bedrooms were healthier. They moved more, ate healthier foods and spent more time with their families.
But it is not just kids that fare better with less TV and technology. Adults do, too. I recently learned of a very creative day called “Shutdown Day”. Such a brilliant concept: be plugged in less and get outside to interact with the world more.
We all should be doing that a great deal more - unplugging. I often wonder if we emailed less and talked more, would we be better off and I have a feeling the answer would be yes. And, I can say that without citing a study and just by looking a what my life was like pre and post the email craze.
It may take time to niche away at the societal issues of being overly plugged in and with TVs at every turn, but you can do something about your own family's little piece of the world. Since returning from NYC, I've been reciting this to myself:
Spring has sprung; the grass has riz; I wonder where all the family time is??
Family time should be active and outside this time of year and not passive and in front of a tube. So, unplug your family and get everyone out on the same grassy field with some balls and just see what happens. One more thing - leave your cell phones in the car. This is a completely unplugged family experience - I have a feeling the first of many once you see how incredibly bonding with your kids like this can be!]]>
Irritable Bowel Syndrome Happens In Young and Oldtag:drgwenn.kosmix.com,2008://4.552008-04-29T01:02:14Z2008-04-29T01:08:20ZDo your kids ever complain about stomach aches? How often? Do those aches seem to have a pattern to them or interfere with your child’s ability to get through the day and participate in school and social events? If so,...Dr. Gwenn
About IBS
About IBS Kids
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"Play Ball"...but play it safe and for fun!!tag:drgwenn.kosmix.com,2008://4.512008-04-07T18:25:46Z2008-04-29T01:12:32Z It's becoming a tradition. Opening Day for the Boston Red Sox arrives and I find myself posting on youth sports safety. Why? Because of the 40 million kids and counting who are participating in youth sports leagues across our...Dr. Gwenn It's becoming a tradition. Opening Day for the Boston Red Sox arrives and I find myself posting on youth sports safety. Why? Because of the 40 million kids and counting who are participating in youth sports leagues across our country who need us to wake up and pay attention to what they need as kids and developing athletes.
Last year I talked about the youth sports code of conduct and Opening Day for any new season affords a great opportunity to revisit that code and make sure all the adults involved with your kids' sports teams sign on to that code. And, I do mean all adults: parents, coaches, trainers. It's not just our kids who are on the team - we are as parents, too. We may be "just" the carpoolers and cheerleaders but that doesn't diminish our role to the functioning of the team.
Parents are not "just" cheerleaders at all. In fact, parents are really the gatekeepers of their own kids safety but to function in that role, parents need information. This is where Dr. Google can come in very handy!
Information helps not just in preparing our young athletes for each sport, but is your ultimate defense for ensuring your athlete is safe on the field. You don't need to understand each and every rule of the game. But, understand enough so if something looks off on the field, you'll be able to pick it up while on the sidelines cheering. Recent studies have shown that the number of intentional injuries on high school fields is much higher than we all realized. One way to help stop this madness, is for us as parents to know enough about game play to force the coaches and officials to do their jobs better.
There are many great websites for information, but for youth sports, there are only a couple I'd suggest you book mark. First, the American Academy of Pediatrics (AAP) always puts out handy tips each sports season that hit the highlights. In fact, the AAP just released the latest version of their Sports Injury Prevention Tips, reprinted here with permission:
"More American children are competing in sports than ever before. Sports help children and adolescents keep their bodies fit and feel good about themselves. However, there are some important injury prevention tips that can help parents promote a safe, optimal sports experience for their child.
Injury Risks
All sports have a risk of injury. In general, the more contact in a sport, the greater the risk of injury.
Most injuries occur to ligaments (connect bones together), tendons (connect muscles to bones) and muscles. Only about 5 percent of sports injuries involve broken bones. However, the areas where bones grow in children are at more risk of injury during the rapid phases of growth. In a growing child, point tenderness over a bone should be evaluated further by a medical provider even if minimal swelling or limitation in motion is appreciated.
Most frequent sports injuries are sprains (injuries to ligaments) and strains (injuries to muscles), caused when an abnormal stress is placed on tendons, joints, bones and muscle. As always, contact your pediatrician if you have additional questions or concerns.
To reduce injury:
* 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 protect them from performing more dangerous or risky activities.
* Strengthen muscles. Conditioning exercises before games and during practice strengthens muscles used in play.
* Increase flexibility. Stretching exercises before and after games or practice can increase flexibility.
* 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), spearing (football), and body checking (ice hockey) 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.
Sports-Related Emotional Stress
The pressure to win can cause significant emotional stress for a child. Sadly, many coaches and parents consider winning the most important aspect of sports. 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."
These tips are great but only hit the highlights. For more specific information on each sport, including the rules and expert insight, check out www.momsteam.com. MomsTeam is a comprehensive website dedicated to youth sports with the unique goal of "creating a safer, saner, less stressful & more inclusive youth sports experience". You can find a lot of youth sports information on the web, but not in one place and from actual youth sports experts.
There is one final element that you need to make sure is part of any youth sports season your child participates in: fun. Honestly, what's the point in playing if your child is not having fun. Childhood should be about fun, especially with sports. And, I'd argue fun and competition can co-exist on the playing field. In fact, for youth sports, a savvy coach with a developmental background, will be able to do just that.
When day light savings day arrived, I bet you changed all the batteries in your smoke detectors. You likely go through that ritual each fall and spring, right? You have to do a similar ritual with youth sports but with each and every sports season. Youth sports contain a number of burning ambers ready to ignite on many different levels from the leagues on down to the athlete. You are your kids best smoke detector for this fire and it starts with information, awareness and a willingness to speak up when you see something not quite right on the sports field. That is how you fit on your kids' teams - and how your kids need you to be involved.
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Cyberscary: Just The Medicine Our Teens And Tweens May Needtag:drgwenn.kosmix.com,2008://4.502008-03-24T13:10:50Z2008-04-29T01:12:07ZDo your kids spend time on line? Do they instant message (IM), chat, surf websites? If they IM, do you know the people they chat with? Instant messaging is a great way to communicate – it is quick and allows...Dr. Gwenn
“After tossing her books on the sofa, Shannon decided to grab a snack and get on-line. She logged on under her screen name ByAngel213. She checked her Buddy List and saw GoTo123 was on. She sent him an instant message:
ByAngel213:
Hi. I'm glad you are on! I thought someone was following me home today. It was really weird!
GoTo123:
LOL You watch too much TV. Why would someone be following you?
Don't you live in a safe neighborhood?
ByAngel213:
Of course I do. LOL I guess it was my imagination cuz' I didn't see anybody when I looked out.
GoTo123:
Un less you gave your name out on-line. You haven't done that have you?
ByAngel213:
Of course not. I'm not stupid you know.
GoTo123:
Did you have a softball game after school today?
ByAngel213:
Yes and we won!!
GoTo123:
That's great! Who did you play?
ByAngel213:
We played the Hornets. LOL. Their uniforms are so gross! They look like bees. LOL
GoTo123:
What is your team called?
ByAngel213:
We are the Canton Cats. We have tiger paws on our uniforms. They are really cool.
GoTo1 23:
Did you pitch?
ByAngel213:
No. I play second base. I got to go. My homework has to be done before my parents get home. I don't want them mad at me. Bye!
GoTo123:
Catch you later. Bye
Meanwhile....... GoTo123 went to the member menu and began to search for her profile. When it came up, he highlighted it and printed it out. He took out a pen and began to write down what he knew about Angel so far
Her name: Shannon
Birthday: J an. 3, 1985
Age: 13
State where she lived: North Carolina
Hobbies: softball, chorus, skating and going to the mall. Besides this information, he knew she lived in Canton because she had just told him. He knew she stayed by herself until 6:30 p.m. every afternoon until her parents came home from work. He knew she played softball on Thursday afternoons on the school team, and the team was named the Canton Cats. Her favorite number 7 was printed on her jersey. He knew she was in the eighth grade at the Canton Junior High School . She had told him all this in the conversations they had on- line. He had enough information to find her now.
Shannon didn't tell her parents about the incident on the way home from the ballpark that day. She didn't want them to make a scene and stop her from walking home from the softball games. Parents were always overreacting and hers were the worst. It made her wish she was not an only child. Mayb e if she had brothers and sisters, her parents wouldn't be so overprotective.
By Thursday, Shannon had forgotten about the footsteps following her.
Her game was in full swing when suddenly she felt someone staring at her. It was then that the memory came back. She glanced up from her second base position to see a man watching her closely.
He was leaning against the fence behind first base and he smiled when she looked at him. He didn't look scary and she quickly dismissed the sudden fear she had felt.
After the game, he sat on a bleacher while she talked to the coach. She noticed his smile once again as she walked past him. He nodded and she smiled back. He noticed her name on the back of her shirt. He knew he had found her.
Quietly, he walked a safe distance behind her. It was only a few blocks to Shannon's home, and once he saw where she lived he quickly returned to the park to get his car.
Now he had to wait. He decided to get a bit e to eat until the time came to go to Shannon 's house. He drove to a fast food restaurant and sat there until time to make his move.
Shannon was in her room later that evening when she heard voices in the living room.
'Shannon, come here,' her father called. He sounded upset and she couldn't imagine why. She went into the room to see the man from the ballpark sitting on the sofa.
'Sit down,' her father began, 'this man has just told us a most interesting story about you.'
Shannon sat back. How could he tell her parents anything? She had never seen him before today!
'Do y o u know who I am, Shannon ?' the man asked.
'No,' Shannon answered.
'I am a police officer and your online friend, GoTo123.'
Shannon was stunned. 'That's impossible! GoTo is a kid my age! He's 14. And he lives in Michigan !'
The man smiled.
Shannon was stunned. 'You mean you don't live in Michigan ?'
He laughed. 'No, I l iv e in Raleigh . It made you feel safe to think I was so far away, didn't it?'
She nodded.
'I had a friend whose daughter was like you. Only she wasn't as lucky. The guy found her and murdered her while she was home alone. Kids are taught not to tell anyone when they are alone, yet they do it all the time on-line. The wrong people trick you into giving out information a little here and there on-line. Before you know it, you have told them enough for them to find you without even realizing you have done it. I hope you've learned a lesson from this and won't do it again. Tell others about this so they will be safe too?'"
I’ve shown this to a few people and they always have the same reaction – stunned silence. Talk about a wake-up call for all of us. The truth is, the only way we can truly protect our kids is to be active in their lives, on and off line. And, to talk to them honestly about the dangers of internet use if they are old enough to use the internet independently.
This vignette also raises other issues about teen life today. Today’s world is very different than the world we were raised in. Many of us walked to school while in elementary school. We can’t let our kids do that today. Same with middle school. We have to be more careful. The online world has opened a gateway to some dangers we just didn't have as kids. It is not being paranoid or an alarmist to take extra precautions when the dangers are out there. I'd call it being practical and a realist. We have to live in the world we have and today's world, sadly, has some issues that put our kids in harm's way. So, it may be we all have to take a moment or two extra out of our day to drive our child somewhere where even thought it seems silly because of how close to home that place is or our child's age. Perhaps we have to just enforce a better buddy system with our kids. Some parents and I do that with my daughter and her friends whenever they want to walk somewhere in our neighborhood. This gives them some freedom but all of us peace of mind that none of them are alone.
But, back to online safety. This vignette is a great way to help you talk to your kids about the dangers they could face online. This is a very tangible group and they learn better through stories and experiences of other kids their age. Hopefully this story will spark conversation, if not at that moment than over time. Some kids need some time to digest a story as intense as this one.
After reading this vignette with your child, here are some talking points you can use to prompt discussion:
1. Do you ever “chat” with people on line who you don’t know from school or an after school group?
2. What kinds of identifying information have you given out online?
3. What did this make you think about?
4. Has this sort of situation ever happened to anyone you know?
5. If someone every contacted you by IM that you don’t know, what would you do?
You can say something along the lines of: “We have no problems with you IM’ing people you know but we want you to be safe. Let’s make a promise that you’ll only IM people you know, OK? Can you do that? And, if someone you don't know contacts you by IM, can you let us know immediately?” Hopefully, your child will say “yes” after reading this vignette! If not, gently probe about the hesitation.
Another great way to spark conversation is during times your tween or teen is using the computer. Ask questions such as “who were you talking with just now?” or “that was a cool looking site. What was it about?” If nothing else, it will reinforce to your child that you are watching and noticing. Sometimes that is the only way we can show our kids were are there if they need them.
Finally, use the computer to reinforce what we are talking about today. Go on a "internet safety" information hunt and check out these sites with your inquiring teen or tween:
FEMA: online safety rules for kidsGet NetWise Safety Tips for Kids (covers all age groups)A parents guide to online Lingo That Teens Use
Here's to safe surfing and a safe spring!
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Ready For A Sleep Challenge? I Am!!tag:drgwenn.kosmix.com,2008://4.492008-03-13T22:41:20Z2008-04-29T01:11:48ZThere has been a great deal of news recently that we are one big sleep deprived nation! Well, that is not really news. I think we know that. But, what we have to recognize is that lack of sleep doesn't...Dr. Gwenn
just this week we learned that lack of sleep may be tied to heart health. For kids, we are all aware that lack of sleep is connected to poor school performance.
So, time to wake up and take action! How? Great question and the National Sleep Foundation has just the solution: The Great American Sleep Challenge.
Last week, the National Sleep Foundation actually hosted National Sleep Awareness Week ....and most of us missed it. I think I was just to darn sleep deprived to catch the news and Daylight Savings this past Saturday has only made the situation worse. Isn't it amazing how one missed hour of sleep can have such an impact on how we function? It is no wonder that we are all zombies most days! Clearly this is why the java and tea industries are thriving...and why for most major presents my family opts for coffee or coffee gizmos!
The Great American Sleep Challenge is really an awareness campaign and the information on the website is valuable whether you take the full challenge or not. But, if you do sign up for the challenge, there are incentives and prizes along the way to keep you motivated.
According to the National Sleep Foundation, “(b)y taking the Sleep Challenge you can:
• Improve the quality of your life! Sleep problems are far reaching – impacting relationships, health, productivity at work and even driving skills
• Get the most from your sleep – It's as important as diet and exercise (only easier!)
• Understand the causes of sleepiness and fatigue and how they impact your life
• Get help – if you think you may have a sleep problem, take the printable sleep journal to your physician or sleep clinic
• Win a prize! By joining the Sleep Challenge you'll be entered in a raffle with a chance to win!”
I found some interesting information on the site about the link between sleep and performance as well as sleep and health. Click here to learn more. .
So, whether you take the full challenge or just read a bit to get more informed, this site is worth spending some time on and can only benefit you and your kids. We have nothing to loose but gained sleep!
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The Meningitis Scare...What You Need To Knowtag:drgwenn.kosmix.com,2008://4.482008-02-25T15:05:33Z2008-04-29T01:11:26ZIt is a very scary diagnosis for parents and doctors, meningitis. And, this time of year it seems to make headlines somewhere in the country. Last year some hockey players from New Jersey shared water bottles and contracted meningitis, and...Dr. Gwenn
Last year some hockey players from New Jersey shared water bottles and contracted meningitis, and this week two Bentley College students in Massachusetts have been hospitalized with meningitis.
Parents often wonder when their children complain of symptoms if those symptoms are "meningitis". Viruses and bacteria can cause meningitis, which is irritation of the lining around the brain. Like all illnesses, there is variation and there can be mild to severe degrees of illness. But, bacterial meningitis, the type that is making news this week, makes people very, very sick and very quickly. This isn't the type of situation where you wonder if your child is sick - you know it. These kids look and act sick. They have fever, often very high. They feel lousy. They are tired and often very sleepy. Some may feel very sick to their stomachs . Some may seem confused to those around them. They have severe headache and their neck becomes so stiff they truly can't bend it without their heads hurting more.
Antibiotics help when begun early but it is a serious illness and, sadly, can claim lives and leave survivors with horrible problems once they recover. For this reason, close contacts are also treated, and a vaccine has been developed for preteens and close contacts. But, what is important to remember is that only close contacts need to be treated because bacterial meningitis can only be spread by sharing saliva - kissing, sharing food utensils or cups. This isn't the type of illness that spreads by casual contact which is actually reassuring. Your kids won't get bacterial meningitis by being in the same room as a person with the illness - there has to be that direct contact with saliva. Breathing air or touching isn't a risk factor.
So, what should you do next time your child has fever, headache and complaints of a sore or stiff neck? Don't play doctor, call your doctor for advice. Keep in mind that true, serious illness like the type bacterial meningitis causes doesn't hide for long so if your child looks well and is acting well that is always reassuring. But, if your child is becoming sick before your eyes, your child needs medical attention right away. In fact, if that is going on, call your doctor on the way to the ER or call 911 if your child is horribly ill to you.
Here are some links for more information:
CHOP Meningitis InformationCDC Meningitis Information]]>
Lessons From TV Are often A Stone’s Throw Awaytag:drgwenn.kosmix.com,2008://4.472008-02-13T21:56:08Z2008-04-29T01:11:05ZDid you catch the recent Eli Stone controversy? Regardless of where you fell on the issues of immunization and autism, there’s no denying that TV greatly impacts our ideas and how we think. The problem with shows that have medical...Dr. Gwenn
the recent Eli Stone controversy? Regardless of where you fell on the issues of immunization and autism, there’s no denying that TV greatly impacts our ideas and how we think. The problem with shows that have medical content, however, is that if those shows become misguided, so too can their audiences. And, recent events should cause us all to pause and at the very least wonder about the thoroughness of medical review for TV dramas.
Why is this so important? Simple. It's essential to have solid background information on all TV dramas because of how real and believable the events portrayed can seem. The same is true for what you see, hear and read on the internet. Keep in mind that celebrities are actors but are not experts. They just play experts on TV or online.
If it hadn’t been for the medical community shedding light on the Eli Stone episode before it aired, many parents may have not known the facts and could have been too easily convinced that immunizations are harming their children. They may have been all too swayed by the power of the drama and their own emotional hot buttons and could have been misguided to not immunize their own children. The interesting irony with this episode is that even before it aired, a new study demonstrated that thimerosal, the element always cited as the culprit of vaccine harm, is innocent as charged.
Thanks to the outcry of medical experts, the producers of Eli Stone did post a disclaimer at the start of the show and some links at the show's conclusion. Those are often tried and true ways of alerting you to important medical information. In fact, question shows you see with questionable medical information that does not take those extra steps. A responsible show with a good message will include some sort of informational message at the end, if not question the reliability of the show and hold fast to your current health beliefs.
If you ever watch a show that raises medical questions about someone in your family, your family's pediatrician or internist are two wonderful resources available to you. Start there before you go too far online. The last thing any of us want is for a TV show to confuse you and if you are confused, others in the practice likely are, too. So, let someone know.
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What's in your medicine chest?tag:drgwenn.kosmix.com,2008://4.462008-01-26T15:03:59Z2008-04-29T01:10:41Z It used to be so simple – get an over the counter medication and fix a symptoms, in ourselves and our kids. Nowadays, however, there is concern in over the counter medication use in children under 6 years of...Dr. Gwenn It used to be so simple – get an over the counter medication and fix a symptoms, in ourselves and our kids. Nowadays, however, there is concern in over the counter medication use in children under 6 years of age and many of the products we were given as children and may have used in our teens and tweens as infants and toddlers with colds have now been pulled from the shelves.
Knowing what over the counter medications to have on hand and when to use them can come in very handy for those unexpected illnesses, when on vacation and for those middle of the night ails!! If you have any doubt at all about whether a medication is appropriate for your child, consult your pediatrician.
Here are some rules of thumb to help you decide what to stock in your medicine chest at home:
1. Other than ibuprofen (Advil and Motrin) and acetaminophen (Tylenol), most over the counter medications do not work well in children under the age of 2 and are thought to be unsafe in this age group. With this in mind:
a. Most over the counter (OTC) cold medications for kids under 2 years of age have been pulled from the shelves for this reason.
b. If you notice a product on a store shelf, do not purchase it.
c. If you have an OTC product at home that was once on a shelf, toss it.
2. Medications are dosed by age until approximately 12 years of age and 95 pounds at which point “adult” dosing kicks in.
a. Medication dosing for kids under 12 years of age are typically given in a range on over the counter packaging but this range is not very accurate on the extremes.
b. For an accurate dose for your child, consult your pediatrician for a weight-related dose.
3. Never give over any counter medication if your child appears very ill to you. Consult your doctor first or call 911 if your child appears
a. distressed in any way
b. has labored breathing
c. has altered mental status (inability to recognize you or act normally)
4. Fever is an elevation in body temperature and the cut off for what is considered fever varies by age. The younger the child, the lower the cut off for what we consider fever.
a. 100.4 rectally is considered a fever in infants. Infants under 1 month of age should be seen very quickly for a fever but older infants may not need to be seen right away. Consult your pediatrician right away in this age group for advice.
b. Fever in older infants, toddlers and school age children is generally considered 101.5 or higher taken any way – orally, by ear, rectally, under the arm. For older infants, consult your doctor’s on call group if a fever develops and it is after hours
c. For older children with fever, fever may be the only measurable sign of illness and it can last for a few days. You can usually wait for 1-2 days before seeing your doctor unless your child has any specific complaints (such as ear pain or abdominal pain).
5. I would not recommend using anti-diarrheal medication without consulting your doctor first.
In addition to over the counter medications, there are a number of other items that are useful to stock and have on hand:
1. First Aid Kit: band-aids of all sizes, wound cleaner, antibacterial ointment (Bacitracin or Neomycin), ace wraps, ice packs, tweezers for splinter removaA
2. bug spray and antiitch lotions such as aveeno, calamine or the first aid antiitch sprays
3. Benadryl for hives and allergic reactions (consult your pediatrician for a dose)
4. Fever reducer: acetaminophen and ibuprofen. Acetaminophen also comes in a rectal suppository – Feverall is the brand
5. Humidifier – cool works for most coughs and congestion
6. Pain reducer: Tylenol and Motrin/Advil as well as over the counter ear pain drops for middle of the night ear pain
7. For girls: Uristat is worth having for pain with urination to buy time while waiting to see your doctor. Hydrocortisome cream and antifungal creams are useful (such as Lotrimin)
8. Potty issues: stool softeners, Dulcolax suppositories, swipes
9. Rashes: mild soaps, hydrocortisone cream, lotrimin, lotions – Aveeno, Eucerin, Lubriderm are my favorites
10. Saline nose spray – great for kids of all ages, and bulb syringe for infants
You may end up needing other medications at home depending on your child’s symptoms. Your pediatrician’s office will guide you to these as your child’s symptoms evolve.
Image
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Staying Safe in the Coldtag:drgwenn.kosmix.com,2008://4.452008-01-12T13:23:50Z2008-05-09T02:26:59ZFor those of us in New England, we live for season changes, especially winter. However, the last few years have been quite disappointing with very mild temperatures and modest snowfalls creating rather unimpressive ski conditions. We honestly didn’t know what to do when the snow started falling just days into December and the deep freeze came shortly thereafter.Dr. Gwenn(image) For those of us in New England, we live for season changes, especially winter. However, the last few years have been quite disappointing with very mild temperatures and modest snowfalls creating rather unimpressive ski conditions. We honestly didn’t know what to do when the snow started falling just days into December and the deep freeze came shortly thereafter. Out came all the winter gear, hardly used for the last few years, and high hopes were set for a season filled with much anticipated winter fun: sledding, snow shoeing, skiing, and just basic outdoor snow fun!
But, where cold and snow are concerned, “fun” takes on new challenges if we are not adequately prepared and it is all too easy to get injured from the elements and the activities so unique and special to a snowy winter. Anything can happen in snow from concussions due to sledding accidents to sprained ankles or broken arms from falling on icy sidewalks or getting checked during a hockey game. Even building a snow village can be treacherous with frostbite and frostnip risks and lacerations and contusions occurring from snowballs containing hidden objects such as pieces of trees or ice.
According to SafeKids USA more than a quarter million kids are injured in winter sports each year. They report that more than 49,000 children ages 5 to 14 were taken to emergency rooms in 2005 for winter sports juries. Of these, 29,000 were from skiing and snowboarding, 20,000 from sledding, and 660 from snowmobile accidents. If you add to these numbers the amount of kids injured that were treated at home or by their pediatricians, these numbers go much higher.
Proper equipment is essential in minimizing risk for all sports but especially important for winter sports with the added elements of snow, cold and ice. Make sure the equipment is the proper size for your child and consult and outdoor store if you have any doubt as to the integrity of used equipment. For all winter sports, including sledding, a ski helmet is mandatory for kids and adults and can cut down the risk of traumatic brain injury by over 50%.
Kids often have trouble understanding how dangerous the cold can be because we dress them like Eskimos but fail to explain to them why. It is crucial they understand starting very young that without all those thermal layers, they would be at risk for hypothermia, frostnip and frostbite – even while just walking to and from school or while waiting in line for a ski lift. How do you decide how cold is “too cold”? In general, the further below zero the wind-chill falls, the shorter the time it will take for any of these cold-related injuries to occur. Massachusetts schools all follow very strict guidelines for outdoor recess. Children must have snow suits and boots to play in the snow. And, children are kept indoors during cold weather advisories and when the temperature drops below zero. Encourage your family to follow these same guidelines for home and recreational activities. So, if it's too cold for outdoor recess, than it's too cold to build a snowman or hit the slopes.
(Image)
Cold-related injuries can be very serious and early identification and treatment is essential. Hypothermia develops when the body's core temperature drops below normal. The body essentially freezes and major systems stop functioning normally. Symptoms result from the body's attempt to warm up and conserve energy. Early symptoms include shivering, clumsiness, and slurred speech. If you become concerned your child may be developing hypothermia, get your child in a warm environment and seek medical attention right away.
Frostnip and frostbite are two extremes of the same problem and result from direct cooling and freezing of the skin and underlying structures. Early on the skin turns white and becomes numb and is referred to as frostnip. Frostbite is an actual freezing of the skin and outer tissues. Fingers, toes, ears and nose are the most susceptible. They may appear pale, gray or blistered and the child may complain that the skin burns or feels numb. Frostbitten areas need to be warmed up with warm water. Wrap your child in a warm blanket and give hot cocoa to warm up the inside temperature. If the symptoms do not resolve in a few minutes, call your doctor.
I know my family is looking forward to finally having a winter worthy of schlepping all the ski stuff north for! At the same time, I know as a parent I have no hope in getting my kids to dress like an Eskimo if I don’t do the same. So, “all for one, one for all” will be our motto for winter dressing and should be your family’s motto, too. And, that includes on the slopes. Believe it or not, ski helmets do come in adult sizes!!
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Nuts and Bolts for a Healthy Flu Seasontag:drgwenn.kosmix.com,2007://4.422007-12-18T17:06:16Z2008-04-29T01:10:15ZWith all the talk of the flu shot this time of year and how “best” to combat the flu, it can be confusing to figure out who in your family should get the flu shot each year. The bottom line boils down to this: if you are a household with kids under 5, every grown up and child over 6 months of age should get the flu shot annually....Dr. Gwenn
the official CDC recommendations for who should get the flu shot each year:
1. People at high risk for complications from the flu, including:
o Children aged 6 months until their 5th birthday,
o Pregnant women
o People 50 years of age and older
o People of any age with certain chronic medical conditions (primarily chronic heart and lung conditions such as congenital heart disease, respiratory conditions, and those people on immunosuppressive treatment)
o People who live in nursing homes and other long term care facilities
2. People who live with or care for those at high risk for complications from flu, including:
o Household contacts of persons at high risk for complications from the flu (see above) – i.e. parents of kids under 5!!
o Household contacts and out of home caregivers of children less than 6 months of age (these children are too young to be vaccinated)
o Healthcare workers
Your pediatrician can help you figure out if your child would benefit from the flu shot and help answer any other questions you might have. For more information, the CDC website is a great resources, and I post frequent updates on Pediatrics Now as the flu season progresses.
Finally, talk to your kids about some simple flu-avoidance measures that can keep all of you as healthy as possible this winter:
1. Wash hands frequently
2. Stay away from sick people – cancel playdates if you have to, don’t go to school, work or activities if feeling sick. This self-exclusion is very important to control the spread of illness.
3. If you have to cough or sneeze, use the crook of your arm – and wash your hands if you cough/sneeze in your hands.
So, be wise, immunize…and when in doubt, wash your hands!
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It's becoming a tradition. Opening Day for the Boston Red Sox arrives and I find myself posting on youth sports safety. Why? Because of the 40 million kids and counting who are participating in youth sports leagues across our country who need us to wake up and pay attention to what they need as kids and developing athletes.
Last year I talked about the youth sports code of conduct and Opening Day for any new season affords a great opportunity to revisit that code and make sure all the adults involved with your kids' sports teams sign on to that code. And, I do mean all adults: parents, coaches, trainers. It's not just our kids who are on the team - we are as parents, too. We may be "just" the carpoolers and cheerleaders but that doesn't diminish our role to the functioning of the team.
Parents are not "just" cheerleaders at all. In fact, parents are really the gatekeepers of their own kids safety but to function in that role, parents need information. This is where Dr. Google can come in very handy!
Information helps not just in preparing our young athletes for each sport, but is your ultimate defense for ensuring your athlete is safe on the field. You don't need to understand each and every rule of the game. But, understand enough so if something looks off on the field, you'll be able to pick it up while on the sidelines cheering. Recent studies have shown that the number of intentional injuries on high school fields is much higher than we all realized. One way to help stop this madness, is for us as parents to know enough about game play to force the coaches and officials to do their jobs better.
There are many great websites for information, but for youth sports, there are only a couple I'd suggest you book mark. First, the American Academy of Pediatrics (AAP) always puts out handy tips each sports season that hit the highlights. In fact, the AAP just released the latest version of their Sports Injury Prevention Tips, reprinted here with permission:
"More American children are competing in sports than ever before. Sports help children and adolescents keep their bodies fit and feel good about themselves. However, there are some important injury prevention tips that can help parents promote a safe, optimal sports experience for their child.
Injury Risks
All sports have a risk of injury. In general, the more contact in a sport, the greater the risk of injury.
Most injuries occur to ligaments (connect bones together), tendons (connect muscles to bones) and muscles. Only about 5 percent of sports injuries involve broken bones. However, the areas where bones grow in children are at more risk of injury during the rapid phases of growth. In a growing child, point tenderness over a bone should be evaluated further by a medical provider even if minimal swelling or limitation in motion is appreciated.
Most frequent sports injuries are sprains (injuries to ligaments) and strains (injuries to muscles), caused when an abnormal stress is placed on tendons, joints, bones and muscle. As always, contact your pediatrician if you have additional questions or concerns.
To reduce injury:
* 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 protect them from performing more dangerous or risky activities.
* Strengthen muscles. Conditioning exercises before games and during practice strengthens muscles used in play.
* Increase flexibility. Stretching exercises before and after games or practice can increase flexibility.
* 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), spearing (football), and body checking (ice hockey) 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.
Sports-Related Emotional Stress
The pressure to win can cause significant emotional stress for a child. Sadly, many coaches and parents consider winning the most important aspect of sports. 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."
These tips are great but only hit the highlights. For more specific information on each sport, including the rules and expert insight, check out www.momsteam.com. MomsTeam is a comprehensive website dedicated to youth sports with the unique goal of "creating a safer, saner, less stressful & more inclusive youth sports experience". You can find a lot of youth sports information on the web, but not in one place and from actual youth sports experts.
There is one final element that you need to make sure is part of any youth sports season your child participates in: fun. Honestly, what's the point in playing if your child is not having fun. Childhood should be about fun, especially with sports. And, I'd argue fun and competition can co-exist on the playing field. In fact, for youth sports, a savvy coach with a developmental background, will be able to do just that.
When day light savings day arrived, I bet you changed all the batteries in your smoke detectors. You likely go through that ritual each fall and spring, right? You have to do a similar ritual with youth sports but with each and every sports season. Youth sports contain a number of burning ambers ready to ignite on many different levels from the leagues on down to the athlete. You are your kids best smoke detector for this fire and it starts with information, awareness and a willingness to speak up when you see something not quite right on the sports field. That is how you fit on your kids' teams - and how your kids need you to be involved.
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It used to be so simple – get an over the counter medication and fix a symptoms, in ourselves and our kids. Nowadays, however, there is concern in over the counter medication use in children under 6 years of age and many of the products we were given as children and may have used in our teens and tweens as infants and toddlers with colds have now been pulled from the shelves.
Knowing what over the counter medications to have on hand and when to use them can come in very handy for those unexpected illnesses, when on vacation and for those middle of the night ails!! If you have any doubt at all about whether a medication is appropriate for your child, consult your pediatrician.
Here are some rules of thumb to help you decide what to stock in your medicine chest at home:
1. Other than ibuprofen (Advil and Motrin) and acetaminophen (Tylenol), most over the counter medications do not work well in children under the age of 2 and are thought to be unsafe in this age group. With this in mind:
a. Most over the counter (OTC) cold medications for kids under 2 years of age have been pulled from the shelves for this reason.
b. If you notice a product on a store shelf, do not purchase it.
c. If you have an OTC product at home that was once on a shelf, toss it.
2. Medications are dosed by age until approximately 12 years of age and 95 pounds at which point “adult” dosing kicks in.
a. Medication dosing for kids under 12 years of age are typically given in a range on over the counter packaging but this range is not very accurate on the extremes.
b. For an accurate dose for your child, consult your pediatrician for a weight-related dose.
3. Never give over any counter medication if your child appears very ill to you. Consult your doctor first or call 911 if your child appears
a. distressed in any way
b. has labored breathing
c. has altered mental status (inability to recognize you or act normally)
4. Fever is an elevation in body temperature and the cut off for what is considered fever varies by age. The younger the child, the lower the cut off for what we consider fever.
a. 100.4 rectally is considered a fever in infants. Infants under 1 month of age should be seen very quickly for a fever but older infants may not need to be seen right away. Consult your pediatrician right away in this age group for advice.
b. Fever in older infants, toddlers and school age children is generally considered 101.5 or higher taken any way – orally, by ear, rectally, under the arm. For older infants, consult your doctor’s on call group if a fever develops and it is after hours
c. For older children with fever, fever may be the only measurable sign of illness and it can last for a few days. You can usually wait for 1-2 days before seeing your doctor unless your child has any specific complaints (such as ear pain or abdominal pain).
5. I would not recommend using anti-diarrheal medication without consulting your doctor first.
In addition to over the counter medications, there are a number of other items that are useful to stock and have on hand:
1. First Aid Kit: band-aids of all sizes, wound cleaner, antibacterial ointment (Bacitracin or Neomycin), ace wraps, ice packs, tweezers for splinter removaA
2. bug spray and antiitch lotions such as aveeno, calamine or the first aid antiitch sprays
3. Benadryl for hives and allergic reactions (consult your pediatrician for a dose)
4. Fever reducer: acetaminophen and ibuprofen. Acetaminophen also comes in a rectal suppository – Feverall is the brand
5. Humidifier – cool works for most coughs and congestion
6. Pain reducer: Tylenol and Motrin/Advil as well as over the counter ear pain drops for middle of the night ear pain
7. For girls: Uristat is worth having for pain with urination to buy time while waiting to see your doctor. Hydrocortisome cream and antifungal creams are useful (such as Lotrimin)
8. Potty issues: stool softeners, Dulcolax suppositories, swipes
9. Rashes: mild soaps, hydrocortisone cream, lotrimin, lotions – Aveeno, Eucerin, Lubriderm are my favorites
10. Saline nose spray – great for kids of all ages, and bulb syringe for infants
You may end up needing other medications at home depending on your child’s symptoms. Your pediatrician’s office will guide you to these as your child’s symptoms evolve.
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(image) For those of us in New England, we live for season changes, especially winter. However, the last few years have been quite disappointing with very mild temperatures and modest snowfalls creating rather unimpressive ski conditions. We honestly didn’t know what to do when the snow started falling just days into December and the deep freeze came shortly thereafter. Out came all the winter gear, hardly used for the last few years, and high hopes were set for a season filled with much anticipated winter fun: sledding, snow shoeing, skiing, and just basic outdoor snow fun!
But, where cold and snow are concerned, “fun” takes on new challenges if we are not adequately prepared and it is all too easy to get injured from the elements and the activities so unique and special to a snowy winter. Anything can happen in snow from concussions due to sledding accidents to sprained ankles or broken arms from falling on icy sidewalks or getting checked during a hockey game. Even building a snow village can be treacherous with frostbite and frostnip risks and lacerations and contusions occurring from snowballs containing hidden objects such as pieces of trees or ice.
According to SafeKids USA more than a quarter million kids are injured in winter sports each year. They report that more than 49,000 children ages 5 to 14 were taken to emergency rooms in 2005 for winter sports juries. Of these, 29,000 were from skiing and snowboarding, 20,000 from sledding, and 660 from snowmobile accidents. If you add to these numbers the amount of kids injured that were treated at home or by their pediatricians, these numbers go much higher.
Proper equipment is essential in minimizing risk for all sports but especially important for winter sports with the added elements of snow, cold and ice. Make sure the equipment is the proper size for your child and consult and outdoor store if you have any doubt as to the integrity of used equipment. For all winter sports, including sledding, a ski helmet is mandatory for kids and adults and can cut down the risk of traumatic brain injury by over 50%.
Kids often have trouble understanding how dangerous the cold can be because we dress them like Eskimos but fail to explain to them why. It is crucial they understand starting very young that without all those thermal layers, they would be at risk for hypothermia, frostnip and frostbite – even while just walking to and from school or while waiting in line for a ski lift. How do you decide how cold is “too cold”? In general, the further below zero the wind-chill falls, the shorter the time it will take for any of these cold-related injuries to occur. Massachusetts schools all follow very strict guidelines for outdoor recess. Children must have snow suits and boots to play in the snow. And, children are kept indoors during cold weather advisories and when the temperature drops below zero. Encourage your family to follow these same guidelines for home and recreational activities. So, if it's too cold for outdoor recess, than it's too cold to build a snowman or hit the slopes.
