An Important Message On Gun Safety from Dr. Sunder

Nithya Sunder, MD

The goal of every PHA provider is to help ensure a happy, healthy, and safe childhood for all of our patients. One potential threat to children's safety is the improper storage of firearms. There has been a lot of controversy recently about proposed gun control measures and the best way to protect people in this country from violence committed using firearms. The priority of this blog is on protecting children from gun-related violence.

Aside from the numerous reports of small children, teens and young adults being involved in highly publicized mass shootings including Aurora, Colorado and Newtown, Connecticut, there are many studies detailing how often firearm-related violence affects children and teenagers. In 2008 and 2009, an average of one child or teenager was killedevery three hours. A child or teen suffered gun-related injuries about every 31 minutes during that same time period. The number of preschool-aged children killed by guns was almost double that of law enforcement officers killed in the line of duty. In Illinois in 2009, there were 4.3 children or teens killed or injured by firearms per 100,000. A 1991 study revealed that 8% of accidental shooting deaths were caused by a child under the age of 6 years. The most recent study comparing 23 industrialized nations shows that 87% of children under 15 years who were killed by guns lived in the United States. For teens and young adults between ages 15 and 24 years, the gun homicide rate was 42.7 times higher in the US than in the other countries combined.

One way to protect children from gun violence is to limit their access to unsecured guns at home. Illinois requires locking devices on all handguns sold by retail dealers but not private sellers. Accepted locking devices include both external and integrated options. Despite similar laws in other states, in 2000 out of all American homes containing both children and guns, 55% had one or more unlocked guns and 43% had a gun stored without even a trigger lock in an unlocked location. More than 75% of guns used in youth suicide attempts and unintentional injuries were in the residence of the victim or their relative or friend. The U.S. General Accounting Office estimates that some basic safety additions could reduce 31% of accidental deaths caused by guns. 8% could be prevented by child-proof safety locks and 23% by a loading indicator. Keeping firearms locked while unloaded and keeping the ammunition locked separately has a drastic effect in decreasing the number of youth suicides and unintentional injuries.

Parents should also be aware that while they might have either no firearms in their home or guns that have been stored as recommended, the same cannot necessarily be said of other homes. The homes of your neighbors and your children's friends might contain guns that have not properly been secured.

Regardless of your views on current legislation regarding access to guns, ownership of firearms, and types of guns and ammunition that should be legally available, we at PHA ask that you work with us to protect our kids from gun-related violence starting in the home.

Read more »»  

The flu is hitting hard this year

Here at PHA we have seen a LOTof flu cases!   If your child has not yet received their influenza vaccination, it is not too late to bring them in for one.

According to the Center for Disease Control (CDC), it is too early into the flu season to tell if it has peaked or not.   47 states have reported widespread outbreaks of the flu and there have been 20 children that have succumbed to the illness. 

This year�s flu is the H3N2 virus which historically has been associated with severe symptoms which is causing area hospitals to be inundated with cases.    The H1N1 virus that sent panic across the country back in 2009 is widespread in Europe at the moment but has not been prevalent here in the states.  

The flu vaccine covers 3 different types of influenza:  Influenza A (H3N2), influenza B and H1N1.  This is good news just in case H1N1 should spread from other countries.

Although you may have heard that some areas are experiencing shortages of the vaccine, we believe we have a sufficient quantity on hand for our patients.   You can make an appointment for any of our offices by calling 630-717-2300.

Read more »»  

Deadly Energy: a drink with too many risks

From the desk of Kimberly Gubbins, CPNP:

A popular fad in the United States has been the production and consumption of energy drinks. Americans are drinking these highly caffeinated drinks to keep up with the �hustle and bustle� of our busy daily lives. Although these energy drinks may seem beneficial and helpful, they can pose serious health problems. The drinks have even been linked to multiple deaths and are under extreme scrutiny. The company that makes 5-hour Energy, Living Essentials, has been mentioned in over 90 legal filings and has been blamed in at least 30 life threatening events. These drinks raise heart rates, elevate blood pressure and can affect our central nervous system.

One of our highest risk groups include our teens, especially our athletic teens. What teens do not understand is that caffeine (found in Monsters and 5 hour- Energy) is a diuretic. A diuretic, if used in excess, can cause dehydration which can lead to fatal arrhythmias in our heart. In addition, caffeine can affect a teen�s ability to fall asleep. Without getting proper amounts of sleep, teens have problems with their moods, their grades and their performance.

Other groups who are at higher risk and should avoid these highly caffeinated energy drinks include those individuals with heart, liver or kidney problems, individuals with a history of panic attacks, or history of gastrointestinal problems.

At Pediatric Health we do not condone or encourage the use of any energy products or drinks. We suggest healthy eating, daily exercise and adequate sleep to feel health and energized daily.

Read more »»  

Salt Intake

From the desk of Michelle Maloney, CPNP

It is very likely your child consumes too much salt. Children should not have more than 2300 mg of salt daily, yet the average child takes in approximately 3400 mg daily. This the same amount the average adult consumes. 2300 mg is equivalent to 1 teaspoon of table salt.

What�s the big deal you ask? High Blood Pressure. Yes, hypertension is now a problem in children.  Children who consume the most sodium are 3.5 times as likely to have high or borderline high blood pressure.  This increase blood pressure also coincides with obese or overweight children who tend to eat more of the types of food that have more sodium. 

High sodium foods tend to come from fast foods and processed foods.

Let�s take a typical McDonald�s meal for example. A cheeseburger and small fry equals 880 mg of sodium. Add ketchup and pop in the mix and you�re almost at 1000 mg in 1 meal!

By comparison, if you make a chicken breast at home with fresh fruit or vegetables on the side with a glass of milk you are under 200 mg.

Salt is a preservative that allows food  to be stored for a period of time before the food is eaten.  When foods and meals are made fresh very little salt is consumed. 

There are many things you can do to decrease your families� consumption of salt. Some examples include:

-Limit fast foods, but if eaten don�t add any extra salt.

-Limit convenience foods such as frozen all in one meals, boxed meals, instant or flavored rice/pasta. If you eat these try to get the reduced sodium variety.

-Limit use of salt in cooking, use other spices for flavor. Try a salt free seasoning blend.

-Rinse canned foods to decrease the amount of sodium, or buy the "no salt added" vegetable.

There are many things we can do to ensure our children grow up healthy. Limiting the amount of sodium in their daily diets should be one we can accomplish. Starting healthy habits when they are young translates to healthy adults.

Read more »»  

To Eat or Not to Eat: Organic foods to Avoid Pesticides

The American Academy of Pediatrics (AAP) recently gathered to discuss the hot topic of feeding children organic versus conventionally produced foods. Therefore, the question stands, "is it worth spending the extra 10-40% on food to buy organically?" The AAP agrees that organic foods and non organically produced foods are both nutritionally beneficial; although, it is a fact that organic foods can reduce a child's exposure to pesticides. So again, we beg the questions, "is it worth the extra money?"

If buying organic means that less produce and healthy food choices will be purchased, then regular produce is advised. Secondly, some foods have a higher level of pesticides than others and therefore should make the organic priority list. Those foods with higher pesticide levels include apples, celery, cucumbers, sweet bell peppers, peaches, strawberries, nectarines, grapes, spinach, lettuce, kale, blueberries, potatoes, and green beans. These are all fruits and vegetables that tend to not be peeled or grown in the ground.

Believe it or not, apples are ranked #1 for having the highest amount of pesticide on fruit! The Environmental Working Group (EWG) has a list of the �cleanest and dirtiest� fruits and veggies. You may review this list at http://www.ewg.org/foodnews/summary/.

Although organic produce is grown without the use of pesticides, for the rest of us, washing and scrubbing your fruits and veggies with a brush will greatly reduce the amount of pesticides left. It will not get them all off. We recommend that you remove the peels of fruits like apples and oranges before giving them to your kids since the outer layer is subjected to the heaviest exposure of chemicals. Remove the outer layers of leafy vegetables since those have had the most exposure.

 Yes, it would be wonderful if everything we put into our mouths was pesticide free and without preservatives and chemicals. But even if we could achieve that we are still exposed daily to chemicals and pesticides. Our neighbors have the lawn service spraying fertilizer on their grass. Our cars emit carbon monoxide. We spray DEET on our clothes and body during mosquito season. It�s just part of life. So don�t go overboard worrying about pesticides on food but be aware of it and limit it like all other chemicals as much as possible.

The most important message to remember is, eating a healthy diet is the main priority, the second most important message is all foods need to be eaten in moderation.

For more articles on this topic please visit:

Resources used for this blog:

http://www.eatingwell.com/food_news_origins/organic_natural/dirty_dozen_plus_14_foods_you_should_buy_organic

http://www.familypracticenews.com/single-view/aap-organic-food-not-essential-for-kids-health/52c1722de7d8e804d0103ca300b66e62.html

http://www.webmd.com/food-recipes/news/20110613/apples-top-12-foods-with-most-pesticides

http://www.npr.org/blogs/thesalt/2012/10/22/163407880/docs-say-choose-organic-food-to-reduce-kids-exposure-to-pesticides

Read more »»  

Car Seat Safety Recommendations

? ??

Jerome Gronli, MD

From the desk of Jerome Gronli, MD

One of the most important parts of caring for your child is keeping him or her safe while riding in vehicles. Motor vehicle crashes are the leading cause of death for children older than 4. Counting all children and adolescents through 21 years old, there are over 5,000 deaths per year, and for each death, 18 children are hospitalized, and 400 are injured seriously enough to require medical attention. Many of these children are unrestrained or improperly restrained for their age or size. Understanding the car seat recommendations and how to correctly use and install the proper car seat can truly make a big difference in keeping your child safe. With any car seat you use for any age child, make sure to carefully read the instructions to see if your child is the proper size for the car seat, and to see how to correctly install the seat in your car and secure your child into the seat.

Some of the below guidelines may come as a surprise; in 2011 the American Academy of Pediatrics updated the recommendations for car seat safety for children based on new research, making some of the recommended ages for moving to the next stage higher than the previous guidelines. This was done with the goal of keeping children safe. It is important to recognize that while families often look forward to transitioning from one seat to the next as a kind of milestone, each step upwards gives up some degree of protection of your child in the event of a crash. As a general guideline, each transition should be delayed until it is necessary, when your child fully outgrows the recommendation for his or her current stage.

Infants and toddlers � rear-facing

The American Academy of Pediatrics recommends that all infants should ride in rear-facing car seats starting with their first ride home from the hospital until they reach 2 years old, or reach the highest height or weight allowed by their car seat�s manufacturer. This is a change from the previous guideline of 1 year old, as studies have shown that children under 2 are 75% less likely to suffer severe or fatal injuries in a crash if they are facing the rear of the car. Due to babies� relatively large heads and the immature bones of their neck, these areas are vulnerable to injury in a crash. Facing backwards allows the shell of the car seat to support your baby�s entire body in the event of a crash, while forward facing seats may not adequately protect baby�s head, neck, and spine. One common question about this recommendation is whether it matters if the baby�s legs are touching the back of the vehicle seat. The answer is that babies can easily bend their legs and will still be comfortable and safe facing the rear of the car. Leg injuries are very rare for rear-facing children in car crashes, and the primary objective is to protect their heads and necks.

Toddlers and preschoolers � forward facing

All children 2 years of age or older, or those younger than 2 who have outgrown the height and weight limits set for their rear-facing car seat, should sit in a forward-facing car seat with a harness for as long as possible, through the maximum height or weight recommended by their seat�s manufacturer. It is best for a child to remain in a seat with a harness at least through 4 years of age; if your child outgrows his or her forward facing car seat before this age, you should consider using a car seat with a harness approved for higher heights and weights.

School-aged children � booster seats

Booster seats for children who have outgrown the height or weight limit for their forward facing car seat and harness. Car seatbelts are designed for adults, and not children, and the goal of the booster seat is to raise your child up and him or her so that the vehicle seatbelt fits properly, with the shoulder belt crossing the mid-chest and mid-shoulder rather than the neck or face, and the lap belt crossing the upper thighs, rather than the abdomen. This position allows the belt to fit over strong bones, and helps protect your child from injury in case of a crash. The booster seat should be used until the vehicle seat fits properly over the shoulder and thighs; as a general guideline, this is typically when they have reached 4�9�� in height and are between 8 and 12 years of age. Although this sounds late to many parents, it is important that vehicle seat belts fit correctly, because improperly used or positioned seatbelts are more likely to result in serious injuries in the event of a crash.

Older children � seat belts

Once a child is old enough for the vehicle seat belts to fit properly, they may use the seatbelt alone. Deciding whether the vehicle seatbelt fits properly includes checking that the shoulder belt lies across the middle of the chest and shoulder, and does not cross the neck or throat, and that the lap belt lies snugly across the upper thighs, and does not cross over the child�s belly. As is the case for all passengers, children who are old enough should use the seat belt each and every time they are being driven in a car. Your child should be old enough to sit straight against the vehicle seat back, with knees bent and without slouching. You should also make sure that your child does not tuck the shoulder belt under the arm or behind the back; this is dangerous because it leaves the upper body unprotected, and because it allows extra slack into the seat belt system which can cause serious injury. Keep in mind also that children should never share seat belts; all passengers should have their own car seats or seat belts. Children should remain in the back seat at least through 13 years of age.

One basic fact to keep in mind when looking for the proper car seat is that no one seat is the best or safest seat. This consideration applies as well how you should think about cost � the most expensive car seat may not be the best, safest, or easiest to use car seat. The best seat is the one that fits your child�s size, is correctly installed, and is correctly and consistently used each and every time the child is in the vehicle. Do not use seats that have visible cracks or damage, have been recalled (or does not have a label with the model number and date of manufacture, allowing you to check if it has been recalled), do not come with instructions for how to properly install the seat, are missing parts, or have been involved in a moderate or severe crash. A moderate or severe crash includes any in which the vehicle could not be driven away from the crash, the vehicle door closest to the car seat was visibly damaged, any person in the vehicle was injured, the air bags did not go off, or there is visible damage to the car seat.

We hope that this information helps you to determine the best way to keep your child safe while riding in a vehicle. In addition to understanding these recommendations, always remember to be a good role model. Make sure that in addition to having all children in the car properly secured, you and all adults in the car wear seatbelts correctly as well. Seeing you consistently use your seatbelt helps children build good car safety habits long after they outgrow their car seats. Make sure that the guidelines discussed here are used every time your children are in your vehicle, and also any time they are transported by anyone else or in another vehicle. Consistency between trips, vehicles, and caregivers is safest for your child and will help eliminate fussing and complaints. Good luck and travel safely!

For more information on car safety for children, as recommended by the American Academy of Pediatrics, see:

http://www.healthychildren.org/English/safety-prevention/on-the-go/Pages/Car-Safety-Seats-Information-for-Families.aspx

http://www.aap.org/en-us/about-the-aap/aap-press-room/Pages/AAP-Updates-Recommendation-on-Car-Seats.aspx

Read more »»  

West Nile Virus

Laura Uselding, MD

From the desk of Dr. Uselding:

As we think about the end of summer, we often conjure up images of squeezing in the last summer vacation, barbeques, shorter days, and getting ready for everyone�s favorite time, back to school. This year, however, anyone watching or reading the news should also be thinking about the threat of West Nile Virus. In general, West Nile Virus is a mosquito borne virus that is transmitted through the bite of an infected mosquito. Mosquitoes carry this virus after they bite an infected bird. Once infected, humans cannot spread this virus through person-to-person contact; however, there have been a very small number of cases reported where an infected mother passed the virus to her unborn baby or to a nursing child through breast milk. The incubation period for West Nile Virus ranges from 2-14 days.

The CDC noted that this year, the West Nile Virus is showing earlier and greater activity in the United States than in years past and it is projected that 2012 will have the largest number of West Nile Cases thus far. The majority of the cases are reported in Texas (over 35%), followed by South Dakota, Mississippi, Oklahoma, Louisiana, and Michigan. Just this past week, the CDC reported a steep rise in the number of West Nile Virus cases, and since early to mid-August, the CDC reported an increase of over 40%. Locally, as of August 28, 2012, there were 2,740 cases of mosquitoes infected with West Nile Virus reported in Illinois. The top three counties with infected mosquitoes included Cook (1,953 cases), DuPage (376 cases), and Will (77cases) counties.

Clinical Symptoms

Most people (80%) infected with the virus have no clinical signs or symptoms.

Some people (20%) will experience mild symptoms called West Nile Fever. These symptoms include:

? fever

? headache

? body aches

? fatigue

? red rash on the trunk of the body

? swollen lymph nodes

Less than 1% of those infected will develop severe symptoms, which include:

? severe headache

? high fever

? neck stiffness

? disorientation

? confusion

? seizures

? coma

? muscle weakness

? paralysis

Individuals older than 50 years of age and immune-compromised people are at highest risk for severe disease.

Treatment

The West Nile Virus causes a viral infection and there is no specific treatment. In patients who have milder symptoms, care is mostly supportive, and we recommend rest, fluids, ibuprofen, and acetaminophen. In more severe cases, we hospitalize patients and support them with IV fluids, breathing assistance, pain control, and nursing care.

Ways to Protect Your Family

Despite the fact that everyone is at risk for mosquito bites, which means all of us run the risk of West Nile Virus exposure, there are several things you can do to help minimize your exposure to mosquitoes

1. Minimize your time outdoors during dusk and dawn when mosquitoes are most active.

2. Protect yourself if you have to go outside during these peak times by wearing long pants, long sleeve shirts, socks, and shoes. You can help protect infants by using mosquito netting on strollers and infant carriers.

3. Utilize a mosquito repellent. We recommend a mosquito repellent with 7-10% DEET for children over 1 year of age. It is important to follow directions on the bottle, and to shower after use.  This should only be applied once per day. 

4. Install tight fitting screens in your home and check for repairs. Try to keep doors and windows shut especially at night.

5. Reduce or eliminate standing water around your home. You should always keep children�s wading pools empty and on their sides when they are not being used. Remove water from empty flowerpots and buckets, change water in bird baths every 3-4 days, and keep gutters clear of debris as any container holding water for more than 4 days can become a breeding ground for mosquitoes.

6. If you have a backyard pond utilize aeration, larvae eating fish, or Bacillus thuringiensis israelensis (bacteria that eat mosquito larvae) to minimize mosquito breeding. These tools are available at garden supply stores.

7. Never touch a dead bird with your hands as birds may carry West Nile Virus. Contact your local health department for instructions on reporting and deposing of the body.

References:

American Academy of Pediatrics. (2012, August 27). Possible largest United States West Nile Virus outbreak. Retrieved from http://aapredbook.aappublications.org/site/news/

Centers for Disease Control and Prevention. US Department of Health and Human Services, Centers for Disease Control and Prevention. (2005). CDC West Nile Virus fact sheet. Retrieved from website: http://cdc.gov

http://www.healio.com/infectious-disease/emerging-diseases/news/online/%7B7A770FDA-F669-4535-877B-DF8610A0AA11%7D/CDC-reports-40-increase-in-West-Nile-virus-cases-since-last-week

US Geological Survey. US Department of the Interior, US Geological Survey. (2012). West nile virus mosquito 2012. Retrieved from website: http://diseasemaps.usgs.gov/wnv_il_mosquito.html

Read more »»  

2012 Summer Olympics start this Friday

People around the world will be turning in this Friday for the 2012 Summer Olympics. This is one time we encourage you to let your children watch tv. Let them be inspired by athletes, especially if they participate in summer sports. Swimming, soccer and track are just a few of the sports many of our kids are involved in.

Here are some thoughts on the Olympics from our providers:?? ?

?? ??

We all share the goal that our children will grow up physically fit. Even further, we want them to keep maintaining their healthy lifestyle as adults. As we watch the Olympics, our tendency is to say.."I better get my children in an organized sport" or "is it time to get them a personal trainer?"

?? ????

????Yes, it's true that organized sports at the higher grade levels will help our kids stay in shape--but less than half of the students are actively participating. So how can we build the love of 'activity' in all our children????  ???????

????????

T. Wall, MD

?From a young age, I encourage parents to help their children play 'outside'--it's hard to get good aerobic activity inside, esp. since treadmills are not safe for the 'less than teens'. Any kind of play works, but kids need variety. Lately there is a new twist--our kids don't know how to play spontaneously. Look around your neighborhood during the non-school days? The 'play' activities for most kids is down compared to ten years ago.

?So as parents, grandparents, aunts & uncles, etc.. it's time to help our kids--and that means grabbing the ball and joining them outside. Or invent games they can play that keep them on the go. Consider taking them on regular hikes or bike rides.

??

?? My parents and siblings were the help to me. In my grade school years I was limited to crutches for a time due to a hip disease. I couldn't play organized sports but they encouraged me by joining me outside to play baseball/football. I was the neighborhood quarterback on crutches! Later, I could get in organized sports and played tennis in high school. I am sure it was my family's encouragement to me earlier that helped me learn to enjoy the physical activity.

We can all help our children stay fit for a lifetime by encouraging them in regular play--and joining them in those activities!??? ?

?

K. Gubbins, CPNP

?

*******???

Children's sports are not about who is the best athlete, who is the fastest or who always takes first place; It is about making sure they are having fun and getting fit! Getting their hearts pumping in a fun way! Belonging to a team teaches a child dedication and how to work together with others.

*******??

???

S. Flais, MD

??An exciting aspect of the summer Olympics is the wide range of sports represented in the games. In addition to the usual track and swimming, there are also the less-mentioned yet interesting events such as rowing, badminton, and cycling. The wide range of sports shows our kids there are so many fun ways to stay active and physical. As your child grows it is a great idea to expose him or her to a wide range of activities. If kids connect with a sport that they find fun, staying physically active will happen naturally. Keep in mind that any active movement is a healthy choice compared to sitting on a couch watching TV or playing video games. A rousing game of table tennis (also known as ping pong), while not considered by many to be a "sport", is a much healthier option than sitting down with a handheld gaming device!??

??? ?

Advice for parents of athletes? Ileana Lochte, mother of Ryan Lochte, who is expected to win several swimming medals in London 2012, has mentioned in interviews that she didn't force Ryan to swim growing up, as that approach likely would have caused him to quit. Ryan simply loved the sport and she helped nurture that love along the way without interference. Let your kids "own" their sport, celebrate their successes and encourage them, remembering that the long-term goal is fitness, not trophies.

??

Read more »»  

Safety Reminders for the 4th of July

The 4th of July is America�s time to celebrate our freedom and independence. It�s also the time we need to be vigilant about fireworks safety. Every year fireworks send thousands of people across the country to the emergency room. About half of the injuries happen to children.

Sparklers, bottle rockets and firecrackers are the more common fireworks that children have access to. Sparklers can burn at 1800 degrees Fahrenheit. Burns on the skin happen at 130-140 degrees Fahrenheit and can burn in only 6 seconds. Skin ignites around 480 degrees Fahrenheit. Yet we tend to think of sparklers as safe for our little ones. 57% of children under 5 who suffered a fireworks injury received them from sparklers.

Unfortunately sparklers give off sparks that can cause clothing and hair to catch fire. Children�s clothing is not required to be flame retardant with the exception of pajamas. And although pajamas are flame retardant, they are not fireproof,

The American Academy of Pediatrics (AAP) urge families NOT to buy fireworks and for families to choose professional firework displays to enjoy.

Glow sticks, bracelets and necklaces are also very popular at this time of year. The fluorescent colors are beautiful but remember they happen because of a chemical reaction. Glow sticks contain tiny glass particles as well.

We have heard of some parents pouring the liquid of a glow stick into the bath water. While fun, remember that you are exposing your child�s skin to chemicals which may be harmful to your child. .

Let the 4th be a great time outdoors enjoying nature, family and friends. Let�s make it a safe one!


For more information on firework safety please visit the following sites: http://www.nfpa.org/categoryList.asp?categoryID=297&URL=Research%20&%20Reports/Fact%20sheets/Seasonal%20safety/Fireworks&cookie%5Ftest=1

http://pediatrics.aappublications.org/content/108/1/190.full

http://www.cpsc.gov/info/fireworks/index.html

Read more »»  

Protect Your Family's Skin This Summer!

Linda Hamilton, MD

From the Desk of Dr. Hamilton:
Summer is here and we want to encourage you to get your children outside to play, but to protect them from the ultraviolet radiation of the sun.

Children get most of their lifetime sun exposure during their first 18 years of life, so protecting them from babyhood through adulthood is important. You child does not have to be sunburned in order to sustain photoaging, such as wrinkling and toughening of the skin and skin cancer, over a lifetime.

Ways to protect your children:

The most intense Ultraviolet ray exposure occurs during the hours of 10 am and 4 pm, so try to limit activities during this time period.

Wear tightly woven, loose fitting clothing that covers arms and legs, a wide brimmed hat, and UV protective sunglasses. There is a laundry additive called Sungard, which contains a sunscreen called methoxyphenyltriazene, which adds UV protection to fabric.

Remember that sand, snow, concrete and water reflect UV rays and can intensify sunburn.

Children with very light skin pigmentation are at higher risk for Ultraviolet ray induced sun damage than children with darker skin pigmentation, however, it is recommended that even darker complected people wear sunscreen to protect against photoaging and skin cancer.
 Wear broad spectrum sunscreen which protects against UVA and UVB rays. UVA rays can cause photoaging, such as wrinkling, sagging skin and skin cancer. UVB rays cause most sunburn, and can lead to non melanoma skin cancers.

Sunscreen should have both UVA and UVB protection. An SPF of 50 protects against 97-98 percent of UVB rays, so anything more than that is not necessary. What is necessary is to apply an adequate amount, and to reapply every 2-3 hours after swimming or sweating. Sunscreen should be water resistant, and be hypoallergenic and fragrant free for those with sensitive skin. Sunscreen should be applied even on cloudy days. Water resistant sunscreen just means the sunscreen has effectiveness for 40 minutes while in water, for very water resistant sunscreens, the effective period is about 80 minutes. At present no sunscreen is waterproof.

Most sunscreens that say they are broad-spectrum, i.e., blocking both UVA and UVB rays are not. There is not at present a good way to rate UVA protection, so look for sunscreens that have one of the following ingredients, such as Ecamsule, titanium dioxide, and zinc oxide. These compounds will protect against UVA rays.

Child friendly sunscreens are usually less irritating. For adults and children with sensitive skin, get a sunscreen that is PABA free, and which does not contain benzephenones, such as dioxybenzone, oxybenzone, sulisobenzone, or avobenzone. Sunscreens which contain zinc oxide and titanium dioxide are less likely to irritate skin. If you have dry skin, use a sunscreen with lotion.

Apply sunscreen about 15-30 minutes prior to sun exposure. It can be applied under makeup. For an adult applying two tablespoons to cover the whole body is adequate. Most people do not apply a sufficient amount of sunscreen. Remember to apply sunscreen to your hands especially when riding in the car. In addition, consider lip balm with SPF protection.

Sunscreen loses efficacy over time, so dispose of those past their expiration date.

INFANTS less than 6 months of age should not be in direct sunlight, should wear loose fitting cotton ( long sleeve, and long pants) clothing, and should be in shade or under a stroller umbrella. Infants do not sweat well, so do not over clothe as this can lead to heatstroke.  As infants have the least amount of melanin, they easily sunburn.

Sunburn occurs about 6-12 hours post sun exposure. If the burn is just red and warm, give your child Ibuprofen and apply cool compresses to the area. IF the burn is severe with blistering, fever, chills, headache your child needs to be seen and evaluated for dehydration, and may require hospitalization.

Currently the American Academy of Pediatrics  (AAP) recommends against using tanning beds or sun lamps. While inducing a tan may make one look good now, the effects can be devastating over the long term.
Tanning beds/booths generate ultraviolet radiation, 95 % of which consists of UVA rays. Many adolescents use tanning beds routinely. The FDA does not regulate the amount of UVA or UVB radiation in tanning beds. There are regulations as to the amount of tanning bed exposure however these are not required by law to be adhered to by the tanning salon. Adolescents who use a tanning bed more than ten times per year increase their risk for melanoma. Risks from using tanning beds include corneal burns of the eyes, acute photosensitivity reactions while on medications, melanoma and non melanoma skin cancers and photoaging with thinning of skin, wrinkling, pigmentation.

The AAP does not endorse using tanning sprays or mists. These products were never meant to be used in that quantity and the inhalation of these products during application is of concern. Many tanning salons are not following FDA guidelines for use of the spray.

Counteract against free radicals by eating foods rich in vitamins E and C like wheat germ, apricots and leafy greens such as spinach and kale. Free radicals can hasten the aging process. Eat Internal SPFs, such as chocolate in moderation and tomatoes, which are high in anti-oxidants. Wear SPF rated clothing. These are available through an outfitter such as REI or at Sungrubbies.com or Coolibar.com.
If you have skin which has many moles, see a dermatologist yearly for suspicious areas.

Lastly apply sunscreen first before DEET containing insect repellents. Combined sunscreen repellents decrease the efficacy of the sunscreen and are not recommended. Reapply sunscreen every 2-3 hours.

Enjoy your protected time in the sun!

Read more »»  

Breastfeeding benefits both mom and baby

Time Magazine recently showed a mother nursing her 3 year old son on its front cover generating quite a bit of controversy. Some felt Time was just going for the �shock factor�, others felt it inappropriate for a child that age to still be nursing while others expressed that it was up to the woman as to when she felt it was the right time to stop nursing.

There is no specific time a mom should stop and we support a longer period of nursing -- but we do agree that Time created quite a heated discussion over the depiction.

The American Academy of Pediatrics has revised its policy on breastfeeding as being a public health issue rather than a lifestyle choice. The policy recommends that babies are solely breastfed for their first six months of life. Iron-enriched foods can be introduced into baby�s diet during the next six months.

 Breast milk provides the following advantages for babies:

� It provides antibodies to strengthen a baby�s immune system, giving them a good defense against contracting infections and a number of diseases later in life including juvenile diabetes, multiple sclerosis, heart disease, and cancer before the age of 15.

� It prevents malnutrition caused by over-dilution of infant formula.

� It delays introduction of sugar into their system.

� It is extremely cost effective and convenient.

� Babies receive essential nutrients that are not in formula.

� Diarrheal disease is three to four times less likely to occur.

� Decreases risk of SIDS

� Reduces number of ear infections

� Babies will have less cavities over their lifetime

� Researchers have found evidence that suggests breastfed children develop fewer psychological, behavioral and learning problems as they grow.

� Cognitive development increases

� Breast fed children were on average more secure with themselves, more mature and more assertive.

For moms, breast feeding provides the following advantages:

� More calories are burned during lactation helping moms to lose all the weight they gained during pregnancy.

� The hormone oxytocin is released causing the uterus to return to its normal size quicker.

� Moms reduce their risk of developing osteoporosis later in life

� Moms reduce their risk of breast, uterine and ovarian cancer. For those who nurse for two or more years reduce their risk of developing breast cancer by 24%!

� The bonding between a nursing mom and her child is stronger than ANY other form of contact.

For many moms, it takes about a month for their milk to fully come in causing many moms to give up trying to breast feed. Lactation nurses as well as our own nursing staff can assist you with any concerns you may have during this transitional time. For first time moms, this is an entirely different experience and we understand you may have concerns or questions.

For moms who are returning to work, they can continue to nurse by pumping their milk during their lunch hour. Nursing provides optimal nutrition for your baby so we do strongly recommend that you consider extending the duration that you breast feed. When the time is right for you and baby, we will be happy to assist you with weaning and transitioning them to a bottle or cup.

Read more »»  

"Bully" the movie

There�s quite a bit of talk currently about the movie �Bully�.

Bullying is something nearly everyone has experienced in life. For parents, it is heartbreaking when your child is the one being bullied. It�s difficult to know what to do�.should you intervene or let them work it out for themselves? Should you say something to the bully�s parents, to the school principal, to your child�s friends? Repercussions are always in the back of our minds.

Bullying doesn�t end in childhood�.in fact, it seems that it goes on lifelong for many people. For some, there�s the workplace bully. One the road, there�s the bully who honks and rides your tail. Even in senior housing, bullies will harass, yell or hit other residents.

 Bullying or being bullied can have long term effects. For the bully, effects can be anywhere from living with guilt, having regrets, not learning how to handle things properly, having control issues and for some, acting on their aggression. For the bullied, long term effects can include depression, withdrawal, becoming a bully themselves, anxiety and sleep problems to name a few.

Over the past several years we have seen school shootings caused by those who were bullied coming back for retaliation. In 1999, two young men who were victims of bullying got their revenge in the massacre at Columbine High School. The following year after the incident, the Secret Service determined that two thirds of premeditated school shootings were by victims of bullying.

The 2007 Virginia Tech massacre is another example of a bullied young man who just couldn�t take it anymore. (http://www.msnbc.msn.com/id/18169776/)

The powder keg of hatred, anger and resentment that built up from being bullied caused them to explode. As parents, when we hear this kind of stories, we worry about our children going to school. That�s why is SO important to stop bullying NOW before it�s too late.

Good sources of information on bullying can be found at http://www.bullying.gov/.

http://kidshealth.org/teen/your_mind/problems/bullies.html

http://www.aacap.org/cs/root/facts_for_families/bullying

http://www.healthychildren.org/English/safety-prevention/at-play/Pages/Bullying-Its-Not-Ok.aspx

http://well.blogs.nytimes.com/2012/03/30/why-bully-is-a-family-film/?ref=healthupdate&nl=health&emc=edit_hh_20120403

Read more »»  

Preventing foodborne illness

?

Romina Gieseman, Nurse Practitioner

? As outdoors temperatures suddenly rise, the school lunches we prepare for our children and food storage needs more attention. Foodborne illness rises in the spring because with warmer temperatures the risk of bacterial growth on food rises. Spring is a good time to make sure lunch bags are disinfected and our refrigerators and shelves are purged of expired condiments, oils and foods.

According to the Food and Drug Administration (FDA) and www.foodsafety.gov, stored food and leftovers are increasingly the reason for foodborne illness. Many families store restaurant leftovers in the fridge longer than they should be.

It is also important to be aware that a trip to the grocery store in warmer weather means that food will grow bacteria at a faster rate. It only takes 20 minutes for bacteria to start growing on food so bring those groceries home immediately and store restaurant leftovers in the fridge as soon as possible.

Here are some tips to avoid foodborne illness at home:

� Buy a food thermometer and learn proper cooking temperatures from www.FoodSafety.gov
� Bring a cooler with an ice pack to the grocery store to transport meats in your car.
� Rinse off all fruit and vegetables to remove dirt and pesticides and store them in the fridge when dry, wrapped in paper towels inside Ziploc bags.
� Do not store and heat restaurant leftovers in the same carton from the restaurant. Use airtight containers and heat to 140 degrees.
� Do not keep cooked foods, open packages of meat, soups, salads or leftovers for longer than 3 days.
� Most frozen foods keep safely for up to two months. Get in the habit of labeling your food and writing the date on it.
� Always place a cold pack in lunches to keep food fresh and cold.
� Keep utensils and countertops clean. Use a solution of one tablespoon of bleach to one gallon of water.
� Wash hands and surfaces immediately with hot soapy water after touching raw meat and poultry.
� Remember that food products do not have to smell bad to be expired or rancid.
� Store all food in airtight containers and store oils and nuts in a dark, cool place and away from the stove.
� Infant formula can also spoil rapidly without detection by parents. Do not let formula sit in the sun or warm place.

For more information visit: www.FoodSafety.gov

Read more »»