New 2014 recommendations are out for improving our prevention efforts for children. Parents can help ensure children get what they deserve at check ups. The updates to recommendations for wellness check-up are written to guide physicians but parents are a key voice in ensuring it all happens!
Updated 2014 Recommendations For Check-Ups
Some relevant changes to prevention/screening for children:
- Infants: All infants need a pulse oximetry screen at or after 1 day of life to screen for heart defects. The test is non-invasive (just requires a technician, nurse, or doctor put an oxygen probe on their arms and legs). More information on the test here. Ideal time for testing is between 24 and 48 hours of life. If your baby is born at home or outside the hospital, go in to see pediatrician for the screen on day 1 or 2! Toddlers should be screened for iron deficiency risk at 15 and 30 months of age.
- Children: All children should be screened for depression every single year starting at age 11 years. Don’t ever shy away from discussions about mood with your pediatrician. In addition, all children are recommended to have cholesterol screening at age 9-11. I reviewed ways to prevent heart disease and cholesterol screening policy statement here.
- Teens: All teens need an annual check-up (a complete check-up will provide some time alone with doctor and nurse; mom or dad will be asked to leave for at least part of the visit). All teens need HIV screening test at age 16-18 (or sooner) and girls get their first pap smear at age 21.
5 Things Parents Need To Know About Check-Ups
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I was up helping my son for the majority of the night. He’s got a stomach bug (which he got from his brother) therefore I was up dealing with the enormous mess that comes with vomiting in the middle of the night. I know you know my woe. This is the second round of this bug at our house so I was clearly exhausted when 6 am rolled around.
First thing I reached for was my cup of coffee. Pretty typical for a working mom just trying to get by. As I write about caffeine, from my perch in this dear coffee town, I’m in no way suggesting we parents should ditch the latte! In fact the health benefits of moderate coffee intake during adulthood continue to unfold amidst ongoing small concerns. The pendulum seems to swing back and forth on the health benefits lurking in coffee. Moderation, like always, is key.
Yet when it comes to children, we may be more lax about caffeine intake than ideal. Caffeine consumption is pretty high in the US with more than 70% of children having caffeine on a daily basis. New research out today evaluating trends in caffeine intake from 1999 to 2010 illuminates the shifts in our children’s consumption. The researchers summed it up best here:
Mean caffeine intake has not increased among children and adolescents in recent years. However, coffee and energy drinks represent a greater proportion of caffeine intake as soda intake has declined, and generally have higher concentrations and amounts of caffeine than soda.
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Tanning beds are a known carcinogen. Word on the street (or in the hallway) may not reflect true knowledge of the dangers. I know plenty of cancer survivors who use tanning beds. Therefore it’s obvious to me that there is a clear disconnect between the science of tanning risks and our insight.
Although you may think tanning beds are a thing of the 1990s, widespread use continues. In fact, new research published today in JAMA Dermatology finds that 35% of adults in Western countries have used a tanning bed during their life while 14% have used a tanning bed within the last year. Tanning beds deliver ultraviolet (UV) radiation that damages skin cells or cells in our eyes. The Center for Disease Control explains it this way, “Indoor tanning exposes users to both UV-A and UV-B rays, which damage the skin and can lead to cancer. Using a tanning bed is particularly dangerous for younger users; people who begin tanning younger than age 35 have a 59% higher risk of melanoma. Using tanning beds also increases the risk of wrinkles and eye damage, and changes skin texture. Indoor tanning is a known and preventable cause of skin cancer, skin aging, and wrinkling.”
In my opinion it’s worth your time to figure out ways to ban indoor tanning for those in your home.
Education and tanning have an unfortunate relationship. Going to college actually increases your exposure to the carcinogen. In the JAMA study, researchers found that 55% of university students have used a tanning bed and 43% have used a tanning bed within the last year. Indoor tanning is a known real threat to human health, on par with the risks incurred from things like cigarettes. It’s predicted the rate skin cancer due to indoor tanning will continue to surpass the number of lung cancer cases caused by smoking. Smoking causes other health problems (elevated BP, heart disease) so the comparison is imperfect. That being said, researchers explain that indoor tanning is a relatively new behavior that has grown in popularity, whereas smoking rates are declining in the US and other Western countries.
Teens And Tanning:
- The JAMA study found 19.3% of adolescents (< 19 years) in Western countries have used a tanning bed. Read full post »
Miami-Dade County Corrections Department Photo from the nydailynews.com
Justin Bieber was arrested early this morning in Florida for a DUI. The smirk on his face is a bit misplaced. While it’s no longer a surprise when we hear about a celebrity’s challenge with drugs and alcohol, Bieber serves up a perfect moment for education. I mean this kid (he’s 19 years old) really could have killed himself last night. Thank goodness he’s only in jail. You got Bieber Fever in your house? Now’s the moment to step in. The number one thing parents must remember is that data and research consistently show that a parent’s opinion and guidance on avoiding alcohol remains the most powerful influence over a teen’s decision to drink alcohol underage.
Check out this powerful infographic on girls and alcohol. One in five high school girls binge-drink. 1 in 5!
Alcohol-related injuries kill over 5,000 teens every year. Bieber’s decision-making presents a huge opportunity to protect our own children. I’m reposting this data because we just can’t forget how powerful we are, as parents, when protecting our children as they grow. Our job today is simply to remember our super power–that we have influence. Don’t brush this story off as “Bieber’s a mess and an outlier.” Lamborghini or not, every teen is at risk for making this kind of choice.
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Our children are growing up with mixed messages about alcohol and drugs, at least that’s how it feels to me here in Washington. It seems to me we’re grappling with using pot and what to do with alcohol as a community. As our state legalized marijuana use this past year, we sent a big flare into the sky. It’s possible we really do one thing and then say another in front of our children and teens, particularly at times of celebration. No question they are watching. Can you seriously imagine a pro football game without beer ads or a holiday party without booze? I can’t. The great luck is that we have profound influence over our children (tah dah!); we have a huge opportunity to help them survive.
One of the biggest mistakes parents to teens make is to believe that they no longer have influence on their kids — Lara Okoloko, LICSW
I read a tweet about a month ago suggesting that perhaps we should never drink alcohol in front of our children. At first glance it seemed somewhat absurd — that we’d ban a legal adult substance from our lives as parents to young (or teen) children that we can enjoy and drink (even in moderation) all because of the risk that our children may abuse it if they saw us drink while children. However when I read the statistics on teens and alcohol it got me thinking that perhaps I needed to be more thoughtful, not only how I talk about this but how I live with my children these next 15 years. At first glance, avoiding alcohol just seems like an inconvenient annoyance. Yet I started to read the data I recognized the incredible opportunity we all have to speak clearly and repeatedly about alcohol and risk with our children, early on.
Parents are the #1 influence on whether teens choose to drink (or smoke weed). Experts really stress we need to share data and opinions with our teens before they start drinking. The hope is that when we explain how we feel, when we share facts, when we clearly articulate that alcohol could kill a teen or their friends, that we can help our children understand their actions can greatly affect their happiness and their survival. I really don’t think I’m over-framing this in terms of survival. Teens are 3 times as likely to be in a fatal crash than older, more experienced drivers and the 3 main causes of fatal crashes among teens are drunk driving, speeding, and distracted driving (think cell phone). Alcohol-related car accidents are the leading cause of death for teens and young adults.
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PG-13 movies now have more gun violence than R-rated ones.
I was in fourth grade when Red Dawn debuted as the first PG-13 rated movie back in 1985. At the time Red Dawn was released, it was considered one of the most violent films by The National Coalition on Television Violence, with a rate of 134 acts of violence per hour, or 2.23 per minute. And although not every PG-13 movie has had significant violence (think Pretty in Pink) it turns out PG-13 and gun violence have become close bedfellows over the last 28 years.
New research out today in Pediatrics finds that gun violence is becoming a more common thread in the movies. Researchers sampled 945 films (all from the top 30 grossing films annually) since 1950, coding and evaluating 5-minute violent sequences in those films. The results proved unsurprising but unsettling: overall gun-violent sequences more than doubled in the sixty years from 1950 to 2012. When looking specifically at PG-13 movies researchers saw a tripling in gun violence since the rating was created in 1985. The trend for violence in these PG-13 movies has grown so rapidly it’s created a new reality. Over the past 30 years, R-rated movies have shown no change in the amount of gun violence sequences while PG-13 have soared making gun violence more prominent in PG-13 movies than in R-rated movies. Stunning when you think of it — gun imagery densely populating the movies targeting our teens. Yes, violence sells.
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Fortunately, teens can control this by opting out of public sharing. The default setting at this point for teens when joining Facebook will not automatically allow for public sharing. Teens can opt-in after clicking through a pop-up notice. This step could of course change.
Visit the privacy setting page on Facebook with your teen.
In my opinion this is not in the best interest of our children. As we evolve and adapt to using social tools, we’re all still getting our footing. So are our teens as they begin to create a digital footprint of thoughts and photos online. Further, concerns about this shift include public access to teen sharing that will likely be data-mined and scoured by advertisers and companies hoping to target teens with goods and services.
Read this blog post from pediatrician and social media expert, Dr Megan Moreno, on the new changes for teens. Information and links on how to talk to teens about changes along with resources for learning more are included. A recent Q&A she completed online about parents and teens is linked. She says it best when she says:
This situation presents an enormous opportunity for parents to have conversations with their teens about privacy settings online. For parents who have already had these conversations in the past, it’s time to sit down and discuss Facebook’s decision, review your family’s rules about online safety, and review your teen’s current privacy settings on Facebook – both their overall “privacy settings” and the “audience” for their posts.
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The research published about texting and driving never seem to add up to my in-real-life experience. In a typical day driving in Seattle I see countless people with their phones out, many with it wedged at the steering wheel, stuck between their right hand and the right turn signal post. Like all of us have come to observe, it’s the unusual or unexpected driving patterns that alert me to look into their car window and confirm my suspicion.
I hate feeling like an old lady, angry at those few reckless decision-makers who compromise my family’s safety on the road. I also hate feeling powerless amidst the problem. After a few feeble and failed attempts to influence others’ decisions on the road (waving my hands, pointing my finger or honking my horn and screaming in my fury), it’s clear to me that we citizens can’t police the issue. Further, trying to change others’ behavior from our own driver seat is an entirely imperfect solution – yet another distraction. I can’t help but ranting that I remain angry about this significant human frailty–the inability to follow the law and put down the devices and drive. Read full post »
Ever Electronic Cigarette Use ~ National Use Tobacco Survey, 2011-2012
Grim news out today. E-cigarette use in teens has doubled in a year. The CDC reports that 1 in 10 high school students admitted to ever using an e-cigarette in 2012. The rate of use doubled for middle school students as well. Although I’m not surprised, I remember just weeks ago tweeting about my dismay with Jenny McCarthy’s new job– advertising e-cigarettes. I took flak. Some advocates for e-cigs felt I was shortsighted and not valuing the potential benefits of these electronic nicotine-laden vapor tubes. All I could think of was her image, the lure she may create for teens, and the likelihood that teens would peek in on e-cigs with greater fervor.
Just a month ago we learned that smokeless tobacco use is steady with teens (5%) and many teens are now turning to novel sources of nicotine (dissolvable tobacco, snuff, snus) in addition to tobacco cigarettes. I consider myself fairly up to date, and until the AAP report came out in August I’d never once heard of snus. You?
Some people are wed to the concept that e-cigs may reduce the burden of illness and smoking-related morbidity from tobacco cigarettes. Even if you believe in harm-reduction for adults (switching from tobacco cigarettes to e-cigs to reduce use or quit) this is an entirely different issue for our middle and high-school students. A nice summary of the data for e-cigs from pediatrician, Dr Aaron E Carroll, with numerous associated comments helps frame the issue.
I wish I could remain agnostic about these devices, but I can’t. This is pretty easy to say:
I don’t recommend e-cigarettes for a teen.
Compare two stats: One in five adults who smoke has used an e-cig with one in ten of ALL high school students have tried an e-cig. Teens aren’t wired to conceptualize the power of nicotine addiction.
The e-cig really does feel like the gateway to the gateway drug.
There is still a lot of unknowns about e-cigarettes. More research will come out and the FDA is likely to regulate e-cig use shortly.
In the meantime, check in with your teens, look around, and I urge your to support regulation of e-cigs and advertising of e-cigs to teens. This just can’t be good.
As we approach the 4th of July, a quick reminder about injuries and ways to protect your children. Each year, preventable injuries occur in young children and teens from fireworks. Children between the age of 5 and 14 are the highest risk for firework injuries—over double the risk of the rest of us. Serious injuries occur including devastating injuries to the eyes and face. Not surprisingly, the most common injuries are burns. Even sparklers can cause serious burns; sparklers burn at up to 2000 degrees, as hot as a blow torch and hot enough to melt some metals.
As you prepare for the long weekend and take time with your family and friends to celebrate the incredible freedom we enjoy here in the United States, make sure your family is safe if you choose to use fireworks. Remind teens about safe driving, avoiding alcohol on the road, and distractions. A crummy fact: the 4th of July ranks as the deadliest day of the year for teen drivers.
Tips And Facts For Preventing Family Firework Injuries:
- The most important (and likely most obvious) reminder is to never allow children to light or set-off fireworks. Injuries often occur when fireworks malfunction or are not set-off properly.
- Don’t use or ignite homemade fireworks. All 6 firework-related deaths in 2012 in the United States occurred secondary to use of illegal or homemade fireworks.
- If you think you’re too smart for injuries on the Fourth of July, hold on a second. Recent research found that higher levels of education do not protect against firework-related injuries.
- If you have fireworks in your backyard, make sure you have a garden hose and bucket of water ready and full while enjoying fireworks in case of any emergency or fire.
- Light fireworks one at a time, and move back quickly! Don’t ever allow your family members or friends to re-light a firework that didn’t go off properly or perform as expected.
- All ages considered (children and adults), 3/4 of firework burns and injuries occur in boys and men. Males are most injured from firecrackers, sparklers, bottle rockets, roman candles, and re-loadable shells.
- Here’s a complete, updated infographic from the Consumer Product Safety Commission about firework injuries and source of the drawing included here!