School Age

All Articles in the Category ‘School Age’

Read The Label And Know What Is In OTC Medicines

Quick reminders as we tidy our lives at the beginning of the school year. With little ones and children all heading back to school, we know it’s time to buckle down and get ready for the shift in schedules and in illness that comes with onslaught of viruses that come with preschoolers and elementary-aged kids back in the classroom. Before the fall is upon us, it’s a great time to really learn how to read the drug label and learn the ingredients, why or if it’s safe for a child the ages of your kids, why the inactive ingredients matter, and organize the cupboard! In some ways it’s combination medicines that make me worry the most — so this is a quick review on what you can do to feel confident when dosing and using OTC medications at home with your family.

Reading Over The Counter Labels & Dosing Liquid And Children’s Medicine:

1. Read the label.  Plain and simple get in the habit of always reading it as we don’t want to forget to make sure we really know what ingredients we’re giving and why. No question that sometimes we use medicines to “cure” children of illnesses, infections, or deficits (prescription antibiotics, anti-infectives, chemotherapy) but most OTC medicines only treat symptoms our children experience from infections or injuries. That makes them less necessary, although sometimes wildly helpful and soothing. Treating pain and discomfort is of course a priority for all parents when our children are uncomfortable! Consequently, we want to use OTC when they earnestly help and match the correct medicine with the symptom we’re targeting…the label can help.

reading labels 2

2. Know the ingredients — watch out for double dosing! So many products out there have combination medications. Many medicines for cough and cold will combine medicines for fever with medicines for mucus with medicines for cough. Some medicines combine medicines for allergy symptoms with medicine for fever. You might inadvertently be giving your child a second dose of acetaminophen (AKA “Tylenol”) when using a combination medicine without knowing it. Expert toxicology and pediatric emergency room friend, Dr. Suzan Mazor reminds, “that sneaky acetaminophen shows up in all sorts of combination medicines” so watch out! If you’re dosing acetaminophen for fever make sure you’re not double dosing if you’re also treating other symptoms with medicine.

3. The syringe or dosing cup -KEEP IT! Keep the dosing devices that comes with the OTC medicine you buy (use a rubber band as needed to attach it to the bottle)! No question that it is confusing to dose medicines based on weight. In the past, data finds that 98% of liquid OTC medications for children have inconsistencies, excess information, or confusing dosing instructions — thankfully this is changing and there is national push to have pediatricians write and explain doses only in milliliters or milligrams as opposed to dosing and explaining in “teaspoons” and “ounces.” As we work to standardize this there will still be some confusion. Read full post »

Take Me Out To The (Peanut-Controlled) Ball Game!

ThinkstockPhotos-508446509Having food allergies (specifically to peanuts) might prevent you and your family from attending certain events, but baseball in Seattle hopefully won’t be one of them. The Seattle Mariners are offering 5 “peanut-controlled” games this season at Safeco Field. No peanuts will be allowed in sections 313, 314 and 315 in the view box level during these games. And although fans should note that peanut-controlled does not mean the game will be entirely peanut-free, this does offer a new way to improve safety for children with serious allergies. The Mariners certainly deserve an “Atta Boy!” for this one. (More game information below).

While peanut allergies have doubled in the past decades and are reported to have tripled between 1997 and 2008, they are just one food allergy of the nearly 400,000 school-aged children who suffer from mild to severe reactions if exposed to an allergen. Some food allergies are serious and life-threatening.

One in every 13 children has a food allergy so this isn’t a rare experience for children or their families. How we support our own children and children in the environment, at school, in sports, and at our homes is also changing. We really are perhaps becoming more compassionate and sophisticated (peanut-free tables, thoughtful policies for birthday treats, more open discussions about how best to include children with dietary restrictions). The Mariners games are just a lovely example of how to do things better at scale.

When To Introduce Peanuts To Babies?

Data is still evolving for recommendations for all babies, but about a year ago (March, 2015), new recommendations (comprehensive blog post) were given regarding introducing certain foods to babies. The New England Journal of Medicine found if allergy-prone infants were introduced to peanuts early in life (between 4 and 11 months of age) their risk of peanut allergy at age 5 years significantly decreased. The current American Academy of Pediatrics policy on food allergy introduction (revised in 2008) states there is insufficient evidence to support delayed introduction of potential food allergens to reduce the risk of developing allergies. This means holding back on foods during infancy isn’t recommended! Try introducing things like wheat, egg, soy & fish before 12 months. We’re moving towards not waiting on any foods in late infancy and this data on peanuts is the beginning of understanding creating recommendations to start foods early. More data will help make these recommendations for all babies. Check in with your baby’s doctor with any questions or concerns, especially if food allergies run in the family. Read full post »

7 Quick Tips For Healthy Mouths

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Valentine’s Day this weekend….Even if you think it’s a card-store holiday chances are your children LOVE it. So power on Super Mama & Super Papa and learn something that makes it worth it. The American Dental Association declared February National Children’s Dental Health Month (I’m thinking because of the holiday and all those sugar hearts). This may have to do with candy…..but please read on even if you DON’T have a sweet tooth. Setting a good example and teaching children from an early age how to take care of their teeth is worth all of our time. It’s something I’m STILL working on as a parent. This matters because tooth decay is the most common chronic disease in kids age 6-11 and adolescents age 12-19. Additionally, at least 20% of children ages 5-11 have at least one untreated decayed tooth. Flossing and brushing 2 times a day changes the odds. Boom.

7 Tips For Healthy Teeth:

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Calming Down And Talking To Our Children About School Violence

Gun Safety family on hillSchool violence and threats of violence are scary and seem to be happening more and more frequently, but the fortunate reality is that they remain rare.  I’m almost telling myself this like a chant — trying to keep myself centered. Because like many other parents I’ve talked to, instead of worrying about my son getting lice at school I kiss him good-bye and say a blessing for safety. Happened today again.

2015 has been hard for all of us in this respect. The increased media discussions about violence are shaking us up and focusing light on violence, especially from guns and mass shootings, in ways no one ever wanted or could imagine.

Although mass shootings are dreadfully more common now than in the past, the rate of crime at U.S. schools that involve physical harm has been declining since the early 1990s. According to the Centers for Disease Control and Prevention (CDC), fewer than 1% of all homicides among school-age children happen on school grounds or on the way to and from school. The vast majority of students will never experience violence at school or in college.

Still, it’s natural for kids and teens (and those who adore them, feverishly) to worry about whether something may happen to them. To help them deal with these fears, it’s important to talk to children who are in the know when these tragedies happen, and to know what your kids watch or hear about them. This helps put frightening information into context. This helps build trust.

Children should be informed about a disaster as soon as information becomes available. Children can sense when critical information is being withheld and when trusted adults are not being genuine; this, in turn, undermines their trust and sense of safety and compromises the ability of these adults to be later viewed as a source of support and assistance. Even very young children or those with developmental disabilities can sense the distress of trusted adults. Children also often overhear or otherwise learn information about the events, such as through the Internet or social media or from conversations with other children. We probably need to shift the conversation sometimes away from talking our children out of having legitimate concerns to how do you deal with your concerns.” ~Dr. David Schonfeld

8 Tips To Support Your Children’s Understanding Of School Violence

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U.S. Soccer Bans Headers For Kids Under 10

Soccer HeaderOur kids don’t have to play like the pros, even if we they think they’re ready. I mean really, what’s the rush?? I report this as a pediatrician & as a bona fide soccer mom to 2 boys under age 10:

The U.S. Soccer Federation yesterday announced a ban on “headers” for children under 10 years. There has been no new expert consensus (the new rule rose out of a lawsuit, not new pediatric expert opinion) that heading the ball causes changes/damage to the brain. Although headers have been found to cause concussions, more often children are concussed when hit by a falling ball or after a collision. Research published this fall in JAMA Pediatrics found about 30% of boys’ concussions and 25% of girls’ concussions in high school soccer are a result of heading. Regardless, more research is needed to determine the safety of heading the ball throughout young and late childhood. In the meantime there are 3 things we can all know (and advocate for)  as research teases out early head injury and the influence heading may have over an athlete’s lifetime:

  1. Headers require essential technique to reduce injury: If heading the ball, young players need to learn proper technique (head positioning, neck position, have appropriate muscular strength etc) so using their forehead they reduce likelihood for injury. Most pediatric sports experts opine that this is unlikely to be easy for little players to reliably learn this technique under age 10 years. It’s unclear what degree heading causes concussion and long-standing injury. “Collision,” pediatric experts wrote in 2010 for Pediatrics, “rather than purposeful heading, was found to be the most likely cause for acute head injuries in soccer players treated in emergency departments.” 
  2. Appropriate Balls: We need to reduce risk of injury by ensuring balls are appropriate size for players, that balls are NOT hyper-inflated and thus more firm, and that balls are water-resistant (so as to not take on water and be heavier). Smarter play, smart equipment. 
  3. Smarter Timelines For Rules: Graduated rules like this (no headers under 10, limited headers for young teens, and then routine headers thereafter) make sense. Not all 8 year-olds need to play by the rules of the pros. Why the rush?

Heading among pre-adolescents is usually a random act. Eyes shut. Head scrunched into neck. Shoulders clenched. ~ Slate.com

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What You Can Do: Children And Safe Gun Storage

Gun Safety family on hillGun violence is a tricky topic to write about. It’s emotionally laden, there are political overtones that bring out passion and I find quicksand when I never expect it.

No matter where you fall on issues related to firearm safety, there is no doubt that we all want the same thing: healthy communities, healthy families, and safe environments to raise our children.

Unfortunately, we continue to have countless reminders about the curiosity of children in the presence of a loaded firearm. No question children and guns are a dangerous combination.

According to the Behavior Risk Factor Surveillance Survey that is administered nationally by CDC, in 2013, there were an estimated 73,000 Washington state children that resided in homes where guns were loaded and unlocked. Nationally, 1.7 million children and teens in the U.S. live in a home with a loaded, unlocked gun.

Kids don’t always know what to do when they find one, but curiosity leads. In a research study entitled, “Seeing Is Believing,” researchers put boys in a room where there were water guns and pistols and watched behind a mirror while they played. The 8 to 12 year-old boys who stumbled upon a gun had a hard time figuring out it if was a toy or a real gun. When they did find it, almost half pulled the trigger. Half pulled the trigger! CURIOSITY is that innocent, protectable right of children that drives this dangerous act.

I don’t need to detail deaths, but quick mentions of gun-related injuries and tragic losses in America can bring fresh energy for necessary safety measures we are all responsible for, gun owners or not. A 3-year-old in New Mexico shot his parents when he grabbed a gun out of his mother’s purse and not the iPod or phone he was searching for. The mother was pregnant and there was also a 2-year-old girl in the room at the time. In the past month we’ve heard about the horrific tragedies with three shootings on college campuses and the unthinkable tragedy of an 11-year-old who shot an 8-year-old this past month over wanting to see a puppy.

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Head Lice, School, And OTC Treatment

Raise your hand if you never had head lice before going to college. Your hand isn’t in the air, is it? Turns out, lice is common. And no question, it’s wildly unsettling for us all. It’s a new world when it comes to prevention and treatment though — more choice, less stigma and less school disruption. Twentieth-century lice care is no more.

Back in 2010 the American Academy of Pediatrics (AAP) updated its recommendations on lice. Basically, schools are no longer encouraged to send children home with lice or keep them away from school. Lice spreads from child to child but it’s certainly nothing like measles. Sending children home from school for a “non-health issue” doesn’t make sense. Further, lice can be living on your child’s head for up to 30 days without hatching (horrifying I know) and can be around for weeks before causing itching the first time around so an urgent send-the-lice-infested-kid-home policy just doesn’t make a lot of sense. Thing is, this changes the game. We all want to get rid of lice on our child’s head immediately, but we’re dependent on all the other families in school doing the same so we don’t get it AGAIN…

In the midst of a lice “crisis,” don’t beat yourself up. This has nothing to do with hygiene. It has more to do with bad luck.

“Head lice are not a health hazard or a sign of poor hygiene and, in contrast to body lice, are not responsible for the spread of any disease.” American Academy of Pediatrics

KYOTC Lice 1New 2015 guidelines from the AAP offer some tips for getting your family lice-free as quickly as possible. Lots of over-the-counter (OTC) ways to deal with it. OTC treatments are safe and effective. However, lice are tricky and have been found to have resistance patterns that aren’t entirely understood at this point (the prevalence is unknown)– so rarely a parent needs to switch treatments. That means sometimes we do all the right things and even with the BEST routine and adherence and lice possibly remain. If you suspect you’re not getting rid of lice at home despite great treatment routines, involve your pediatrician. Often ongoing lice is simply that your child is getting re-infested at school or sports. Or they weren’t gone in the first place.

Follow instructions on the bottle — many treatments need to be repeated about 7-10 days after first application.

Sometimes it may be that you need to swap treatments. It’s RARE that you need a prescription treatment. Your child’s clinician can help recommend a transition to prescription medications. The prescription meds are expensive and often unnecessary but one does have the benefit of requiring only a one-time treatment and no combing.

If the thought of chemicals of any kind on your family’s skin is unappealing, manual removal by “wet-combing” or suffocation through hair is acceptable and can sometimes be effective (things like mayonnaise, butter, oils) yet there is no real hard data about effectiveness. It’s important to note that wet-combing should be repeated once a week for at least three weeks if you do this to ensure all lice and nits are removed as you must comb through entire scalp and hair fastidiously.

Discovering lice is clearly in the no-fun parenting category, but it’s also NO BIG DEAL. From experience (x 2) I can say best thing we can do is calm down, head to the drug store, comb away, wash the linens and move on.

What Parents Need To Know

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How To Read OTC Medication Labels

reading labels 1Reading and familiarizing yourself with the drug facts label is perhaps more important than it seems before you administer an over-the-counter (OTC) medicine to your children. I think we may get more hands-off at times than is ideal. And I think caregivers who casually help us with our children (grandparents, babysitters, nannies, neighbors) can too. Although it’s inconvenient to fill out forms for medicine administration in daycare, preschool and school, these locations seem to be the environments with the most safety around OTC medicine delivery. Those forms help remind us how important this stuff can be.

With little ones and children all heading back to school, as parents we know it’s time to buckle down and get ready for the shift in schedules and in illness that comes with onslaught of viruses that come with preschoolers and elementary-aged kids back in the classroom. Before the inevitable fall, wintery illnesses resume, it’s a great time to set aside some time to really learn how to read the drug label and learn the ingredients, why or if it’s safe for a child the ages of your kids, why the inactive ingredients matter, etc. In some ways it’s combination medicines that make me worry the most.  Read full post »

It’s Gotta Be Screen Time Somewhere

Illustration by David Rosenman

Illustration by David Rosenman

My boys always want it to be screen time. I don’t think that is changing anytime soon. These apps, shows, games, and devices are only getting smarter at capturing their attention.

It feels like there isn’t a giant list of new advice to share regarding “screen time.” But because of the recent media focus and deluge of content on “screen addiction,” coupled with recommendations for dealing with screens while parenting this summer, I’m here with a few responses and observations. It seems to me, parents (all of us) are looking for a couple of things in the content we read about parenting with screens: permission and hacks for simplicity. This post will perhaps offer neither. Until the end.

Most of us acknowledge that not all screens are the same, nor is all programming, nor are the stages of life where apps and screens are enjoyed (infants versus an 8 year-old). “Screen time” is an issue layered with complexity. Parenting during this explosive device development era demands simple rules and dictums for limiting their use help, but the rules by themselves limit the development of full-on zealots. No one follows the rules like religion. Parents, grandparents and caregivers aren’t devout to recommendations because we claim the rules just don’t fit into the context of our lives. Most of us figure out a way to make justifiable exceptions. It’s simply too easy to pull out your phone, especially when it delights your child the way it does, and entertain. But no question that with the rules out there stressing non-use and limits, we’re left feeling a little guilty anytime we left our children indulge. Imagine knowing that screens before bed interfere with the “sleep hormone” melatonin (the light emitted from the screen limits secretion) but even so still choosing to let your children “chill out” with a video for a 1/2 hour before bed each night. Or imagine following the no-screen-time-before-age 2 religiously for your first child but then breaking this rule routinely when you have a second one! This just happens all the time. Read Why No TV Before Bed Is Better. Read full post »

Hot Days: Why Children Are At Particular Risk

Hiking on a hot dayEven here in the cool Pacific Northwest the summer months can send temperatures soaring into the 80’s, 90’s and 100’s. Hot for any average adult, but potentially even more dangerous for young children. Our country is currently experiencing rolling heat waves. Thing is, children heat up faster than adults (five times faster) because they have fewer sweat glands, their body-to-surface ratio is different (their sweating would never do as much good) and this combination makes it more difficult for children to regulate internal temperatures. Couple this physiology with children’s inability to tell us they’re HOT (infants/toddlers) or the instincts of a child or teen athlete (who may not know limits or want to regulate activity) and it can sometimes lead to overheating.

Heat is different for children than adults. They are at particular risk for two reasons: their dependency and their judgment.

Frankly, I worry most about children being left or trapped in hot cars this time of year. Ten children have already died this year in the U.S. after being trapped in a car that can heat up like a cooking oven. Yesterday, with millions of Americans on heat advisories, NBC national news showed footage of bystanders this week breaking glass to save a child left in a hot car. Even though everyone seems to believe it won’t happen to them, about 3 dozen children die each year (primarily during the summer) after getting forgotten or trapped in a car that heats up. If you think you’re too smart for it to happen to you or your family read this — a piece I’ve called the most devastating article around. Read full post »