School Age

All Articles in the Category ‘School Age’

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. ~

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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 »

School Is Out, Head Lice May Still Be Around

Head LiceThey’re a little gross, somewhat annoying and for most parents, inevitable. It also seems to me that for most of us they show up at the most inconvenient times. I’m talking about lice. With school coming to an end this month, you may think your child’s chances of picking up the little bugs will diminish. Unfortunately, according to the American Academy of Pediatrics (AAP) most cases of lice occur outside school. Between summer camp, sports and play dates there are still plenty of opportunities for lice to take shelter on the head of at least one family member. They’re certainly no picnic to deal with and they can also be unwittingly contagious during the school years. Clearly there’s nothing to be ashamed of when discovering lice but it doesn’t always feel that way. New guidelines from the AAP out last month offer some tips for getting your family lice-free as quickly as possible. Acting fast with a plan often diminishes all sorts of anxiety and discomfort for all. Read full post »

What To Do If Your Child Is Drowning: School-Age & Teens

6-2 boy swimmingThis is part two of the “What To Do If Your Child Is Drowning” series. Read about infants/toddlers here.

The purpose of these posts is to find out what you should do if you realize your child is actually drowning or struggling in the water rather than repeat the warnings of how to prevent it. I want to put a couple thoughts and tools in your hands to know WHAT to do if faced with an emergency.

Dr. Linda Quan, an emergency attending physician and drowning expert at Seattle Children’s shares information on what to do if you come upon a school-age child or teenager who is drowning. Preparing for this can help boost awareness and response if ever you support or discover a child in need for rescue. Read full post »

Allergies Run In The Family

It’s a gorgeous time of year when things are abloom. Many of us suffer from irritation and allergies to these months as pollens and particles float around and trigger allergic response.  Not so beautiful when our families (over)react to pollen. Thing is, there’s also the fact that cold season isn’t quite over and the exact cause of that runny nose your child is dealing with may be hard to decipher. One hint that it’s allergies and not a cold: do you, your spouse or any of your other children suffer from seasonal allergies? Unfortunately if so, there’s a 25% chance your child will too. That said, the likelihood more than doubles when both parents deal with allergies on a seasonal basis. Watch the video above for tips on telling the difference between hay fever & the common cold and when to be on the lookout for the former. Read full post »

Power Of A Kiss And Family Oral Health

Image courtesy: American Dental Association

Image courtesy: American Dental Association

Oral health doesn’t start and end with the dentist. Times are changing as the Washington Dental Service Foundation has trained 1,600 pediatricians and family physicians throughout the state on the importance of oral hygiene in young children. Pediatricians are now applying fluoride during well-child check-ups and counseling families more comprehensively on how to prevent dental decay while also referring to dentists for prevention and acute dental problems. Just last month I attended the 1-1/2 hour oral health training with a pediatric dentist. That learning coupled with a new policy statement from The American Academy of Pediatrics highlighting the importance of oral health inspired me to get the word out. I suspect we can all do a bit better protecting our children’s mouths. Recommendations for fluoridated toothpaste have recently changed (use it with the very first baby tooth!) as has knowledge and reminders about how we share our bacteria with our children. What we do for our mouth may have direct effects on our children’s.

The Most Common Chronic Childhood Disease

  • The facts about oral health in children are a little surprising. By their first birthday 8% of toddlers have cavities in their mouth and the Pediatrics policy detailed 24% 2-4 year-olds, 53% 6-8 year-olds and 56% 15 year-olds also have dental disease. Since oral health (even in babies and toddlers) is an integral part of overall health of children this is problematic. Dental disease has strong links between diabetes, respiratory infections and heart disease. The numbers for children with dental disease are high (!!) which makes dental disease the most common infection of childhood.
  • Good news is much of this disease can be prevented (or corrected) and because infants and young children see the pediatrician more frequently than the dentist, it’s becoming clear that pediatricians need to hone skills on oral health, the disease process, prevention and dentist interventions when necessary.

4 Things I Learned About Oral Health

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