This is a position post where I take a stand that represents no one other than myself as a mom and a pediatrician. The reason I clarify this, is that my position is a strong one. No one wants to go up against someone like the NFL, it seems. But let me say this very clearly: It if it were my child, I’d never let them play football. No way. For my boys, the risks are too large, the sentiments too cruel, and the gains simply not worth it. There are plenty of other sports teams out there to grow, exercise, form friendships, and excel. I never want my children to be a part of any institution that houses intent to harm another human being. Although direct harm may not be a tenet in pee wee football, we all know that young sports teams are built to emulate the pros. If the NFL is the inspiration, for now, count my boys out. This isn’t just about the risk of concussion…
On my way into clinic on Saturday morning, I heard the alleged tape of Gregg Williams directing players to seriously harm opposing teammates. In the tape Mr Williams, the previous defensive coordinator for the New Orleans Saints, employed his players to inflict harm on multiple players–for example, attempt to tear the ACL of Michael Crabtree and work to re-concuss another player, Kyle Williams. Let me point out, some data finds the harms of concussions (particularly in adolescents) may be longstanding, and the risk of a second concussion may rarely be deadly.
In the tape you hear Gregg Williams repeatedly say, “Kill the head, the body will die” followed by, “We want his head sideways.” The tape goes on to capture more directives for harming additional players. It’s nauseating and provoking–got my fingers shaking during my drive. And really more than anything else, it was wholeheartedly disappointing. Particularly for me as a pediatrician. When parents now ask me about football, instead of talking about concussions as a significant risk, I’ll also be talking about ethics, sportsmanship, and integrity.
The great thing is that as parents we have lots of choices. Read full post »
This morning as I was getting ready for the day, my 2 1/2 year old was watching Sesame Street. In the show, the segments change every few minutes or so and seem to weave old-school 1970′s content (familiar to me) with newly created vignettes that have a modern feel and construction. I like it nearly as much as the boys. One of the stories this morning was about tooth fairies. An animated group of fairies were detailing how they got to the tooth under a child’s pillow (lifting up the child) to replace it with a golden coin. Mind you, I was coming and going from the room and didn’t view the whole story. However at one point, the fairies accidentally turn on the child’s TV and worry it might wake the child, ultimately uncovering their work and secret magic.
A TV in the child’s bedroom? No way, Sesame. Read full post »
A joint statement published in 2009 by the American Academy of Pediatrics Committee on Pediatric Emergency Medicine, American College of Emergency Physicians Pediatric Committee, and Emergency Nurses Association Pediatric Committee spelled out the need for reform in emergency care when it comes to caring for children.
The bottom line is this: if your child has an emergency and you have the luxury of time and choice of where to go, go to an ER at a Children’s Hospital or a pediatrician-staffed emergency room. Collect $200 and pass go. Learn from my mistakes.
Driving the joint statement was concern from both pediatricians and ER physicians about inconsistent care for children in Emergency Departments (EDs) that do not normally specialize in the care of children. The statement outlines strategies to prepare EDs around the country to care for children based on some sobering statistics… Read full post »
Warning: this is a rant. Recently I was on my way to meet a physician for coffee to talk about my work in social media and health. While driving in front of Children’s Hospital, I saw a car going more slowly than I’d expect, changing the traffic patterns. We stopped at the light, it turned green, and she didn’t move. I looked over and saw her punching away at her phone, composing a text message. I laid on the horn. I pointed to her phone. I screamed! She looked surprised and confused that she’d done anything dangerous. I think she wondered why I was fanatical. You’re 23 times more likely to have a crash while texting and driving compared to someone who is simply driving. I wish I could have mentioned that, too.
No one was hurt, no one was injured that morning. Yet it appeared the last thing this driver was thinking about was the road, the traffic light, the children and their parents crossing at the walk while entering and leaving the hospital. Imagine.
Texting while driving was responsible for 16,000 deaths in a 6 year period. Over 5,000 lives were lost in 2009 alone and almost 1/2 million were injured in accidents related to distracted driving. Read full post »
After I saw reports of the 5-fold increase in CT scans in children, I asked for “The Husband’s” take. I worry about a rise in the use of pediatric CT scans in the US because when a child gets scanned, they are being exposed to radiation. A CT scan is a series of x-rays taken in quick succession that form a more composite view of the body. Although x-rays and CT scans save lives and improve diagnosis, the radiation given to children when obtaining these studies must be minimized. Children are more sensitive to radiation than adults; their bodies are still developing. And as the Society for Pediatric Radiology reminds, “What we do now lasts their lifetimes.” Here’s a post about why it may matter where your child gets a CT scan by Dr. Jonathan Swanson:
Pardon the interruption…I’m chiming in again on a similar topic as my last guest post (I am kind of a one trick pony) – radiation exposure in children. SMD has asked me to talk about a recent radiology-based study and what it might mean for how we take care of our children. My take:
If it were my child, and F or O needed to go to an emergency room, I would go to the nearest children’s hospital…to spare my children unnecessarily high radiation exposure. Bias alert, I am a pediatric radiologist working at a children’s hospital. However, I think the literature supports my position. Read full post »
I was forwarded a case series that captured a bit of data about injuries in bouncy houses and inflatables. It’s not a large study (only 21 families injured in a bouncy house were interviewed) but it sheds light on 2 things. One, orthopedists worried enough about bouncy houses that they set out to determine the risk, and two, bouncy houses do pose a real risk for fractures. Their suspicion alone doesn’t confer a problem, of course. But, validate my worry? Maybe. Change my decision? I don’t know…
The post I wrote last week about hating the bouncy house was more about negotiating my experience of parenthood than it was about the bouncer itself. What I mean is, I was writing about the internal wrestle I have with wanting to do things one way but feeling compelled (in my gut) to go in the opposite direction. You know what I mean, the parenting dynamic in which we set out to do one thing, then being tugged by instinct, we find ourselves in yet another spot. It feels typical, maybe expected, and entirely normal. For example, I set out not to use the pacifier with my first son. At hour 2 of crying, on about day of life 6, we grabbed onto that pacifier and gave it to F. Parents in my clinic will state that they meant to wait until 6 months to introduce solid foods, but once their darling 4 month-old started staring at their spoon with each bite, they gave in and grabbed the carrots. I set out not to use any television in our home. But after the second baby arrived, showing Sesame Street to the 2 year-old allowed me to take a shower. The list goes on and on and on. The ideas of how we’re going to parent and how we implement our choice are not always aligned much less overlapping. Like I said, this is normal. Being a parent helped me “get this.” Read full post »
Last week news of a study evaluating the timing of solid food introduction for infants emerged. It got a ton of press because the study evaluated the timing of solids on the likelihood of obesity at 3 years of age. Researchers divided babies into 2 groups, those that received partial or full breast milk until 4 months, and those that were weaned from breast milk and received formula exclusively before 4 months of age. Researchers then determined when babies were given solid food (rice cereal, biscuit, pureed “baby” food, etc) of any kind.
The results proved notable. Babies who received exclusive formula and solid foods before 4 months of age were 6 times more likely to be obese as a 3 year-old (defined as BMI over 95%, sum of triceps and subscapular skinfolds). This however, was not true for the babies that were receiving breast milk of any kind. So this study may not be applicable to many babies; in the US for example, 25% of infants are never breastfed and approximately half are breastfed for less than 4 months. Yet still, this sheds light on what we can do to help. Use this data when Grandma Trudy is urging you to feed your infant cereal at 3 months. Or why it’s best to wait until 4 months when you get excited about starting solids. Those of you who didn’t wait? Before you spin your wheels with worry about that bite of rice cereal you gave your baby at 3 1/2 months, read on. Because although, if it were my child, I wouldn’t give baby food before 4 months, there may be more to consider when it comes to timing. Read full post »
On Saturday, the FDA released a recall of Hyland’s teething tablets. The recall stems from concerns for increased and varying amounts of belladonna, a toxic substance that could cause serious systemic effects to babies. It’s unclear how much belladonna is found in these tablets normally although it is well known it’s in them. Recently, infants have developed symptoms consistent with belladonna toxicity after using the tablets (change in consciousness, constipation, skin flushing, dry mouth). Homeopathic supplements and medications are unregulated and therefore it’s hard to know what is in them, how consistent one bottle is from the next, and how different brands of the same products compare. Local and national poison control previously deemed teething tablets safe even though it is known that they have trace amounts of belladonna (and possible caffeine). The FDA states it is “unaware of any proven clinical benefit from the product.” Because of safety concerns and no known benefit, I’ve always recommended against using teething tablets. If it were my child, I didn’t, and would not use teething tablets. If you have these at home, throw them out. Here’s some FDA tips of safe disposal of unwanted medications. If your child has had these tablets in the past, there is no reason to worry. Ill effects would have been seen soon after using them.
Some Teething Truths:
“If it were my child: No kids feeding the dog.” Don’t allow kids to play, handle, or touch the dog bowls, dog treats, or supplements, either. You have to be vigilant and organized. I’m not always both, or either, for that matter. I have found my boys basically bathing in dog water, and dipping their hands/face/sippy cup into our dog food bin many times. News today informed me to change the rules around here.
Pet owners, be aware. Not, “beware.” I’m not trying to scare. A study published yesterday in Pediatrics found that a large number of salmonella infections between 2006-2008 were linked to contaminated dry dog/cat food. Salmonella infections cause abdominal cramping, bloody stools, and in some (often the very young), more severe infections. I read about dog food as a possible cause of infection back in 2007 when my son (4 months at the time) came down with Salmonella gastroenteritis. Yes, it’s a real story. Bloody diarrhea, cramping pain, lots and lots of crying–poor little guy. I felt it was all my fault. He was an infant and I was controlling everything he ate, after all.
But F didn’t get Salmonella from dog food, he got it from a more predictable route. Read full post »
Earlier this year there was a massive Tylenol recall. The recall included Infant Tylenol drops, Children’s Tylenol, as well as many other children’s medications. I’m not exaggerating when I say massive, but generic medications (liquid acetaminophen made by Walgreens or CVS, for example) were not included. The recall was a great reminder that generics are just as good as brand-name medications.
The recall also serves as a great reminder that giving medications to children is never risk-free. Recalls like this remind us to use medications only when absolutely necessary. There is always risk when you intervene.
Tylenol (acetaminophen) is a great medication. It has a place in our medicine cabinets and in keeping children comfortable in the face of fever or pain. Teething, viral infections, ear infections, and minor injuries are great times to use Tylenol. But prior to shots is not. Or afterward, as it turns out. After shots, Tylenol will help prevent fever, but may also prevent the desired immune response. There is new data to support this that has changed the way I think and counsel families about Tylenol. Now when parents ask, I say,“If it were my child, no Tylenol before shots.”
Fever is a “normal” immune response to a trigger (medical school and residency taught me this). But being a mom has certainly shown me that fevers in my babies don’t feel “normal.” When we pediatricians say it’s “normal,”we neglect to connect with the experience of parenting a feverish child. I understand why so many parents reach for the Tylenol. I did; after F’s 2 month shots, he developed a low-grade fever and cried his little face off. I gave him Tylenol twice that night. I wouldn’t have, had I known this: Read full post »