Dr. Deb

Is it OK for the State to take a child into custody for being obese? Medical neglect is the stated cause but with obesity rates having tripled in the last 30 years, is it fair to single one family out? 44% of kids are overweight or obese by the time they are 8 to 10 yrs old so where are we going to put all these kids? A 10 yr old in Cleveland was taken from his family for weighing 220 or a BMI of 60 and many are questioning if the state has overstepped its boundary. I think the real question is what is the solution for the 44%? Foster care does not seem to be it.

Did the child have a medical condition that caused the State to take him?

The boy had been monitored for 20 months after being hospitalized with sleep apnea. He needed a CPAP machine to help him sleep at night. Obesity does cause hypertension, high cholesterol, diabetes, joint pain, liver disease, and psychological stress in children but he was only known to have sleep apnea. His family did attend a free nutrition class and tried to make lifestyle changes.  While he initially lost weight, he gained it back within the year.  The State intervened because they felt that it was a last resort and the boy was at high risk of death before the age of 18 from his obesity. There is a court hearing on December 10^th that may return him to his home. He has lost 10 lbs since he was placed in foster care in October but neighbors argue the weight loss may be from the stress of separation from his family.

Does removing children from the home for obesity have a proven track record?

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November is Child Safety & Protection month. Many parents use safety gates and car seats but forget that a cell phone may pose one of the biggest safety threats.  Cell phones are no longer primarily for making calls but your child may be targeted for sexting, stalking, identity theft and bullying all through this portable device that is supposed to make parents feels safer. My poor 13 year olds are the “only kids in their class” without a cell phone but we are not ready for the risk or the expense when I know they are always under adult supervision.

Dr. Deb’s Cell Phone Safety Tips

1. Password Protect:

Place a password on all phones so another child won’t steal, take photos or send texts on their phone.  Many phones contain contact information, passwords and other critical information that you would not want to share. Most carriers will allow you to remotely block information so contact them as soon as a phone is missing. Remember to back up your phone on a home computer.

2. Turn Off Time:

Facts (from BeSmartWireless):

Boys typically send and receive 30 texts a day; girls typically send and receive 80 messages per day

26 percent have been bullied or harassed through text messages and phone calls.

25 percent of text messages sent by teens are sent during class

Teen’s who are considered “hyper-texters” (defined as texting 120 or more messages in a school day), are:

40% more likely to have tried cigarettes

43% more likely to be binge drinkers;

41% more likely to have used illicit drugs;

55% more likely to have been in a physical fight;

Nearly 3.5 times more likely to have had sex; and

90% more likely have four or more sexual partners.

Hold onto the phone until homework is finished and chores are completed. Phones are a privilege, not a right.

Collect phones at bedtime so kids can get a break from the constant texting.

When parent’s limit their child’s text messaging capabilities, they are less likely to be involved in “sexting”;  be a passenger in cars where the driver texted behind the wheel or used the phone in a dangerous manner while driving.

Data released today from American Public Health Association show 13% of high school students say they’ve received “sext” messages and one in 10 has either forwarded, sent or posted sexually suggestive, explicit or nude photos or videos of people they know by cellphone or online.

New controversial advice is to delete sexting messages and not to tell. Teachers are obligated to report to the police and sexting is still considered a felony in many areas under child pornography laws. Automatically deleting it does end it and prevent your child from being implicated but I personally I would consider contacting the parent of the child that sexted.

Children that sext reported twice the number of depressive symptoms, compared to teens who did not. 13% of teen involved in sexting reported a suicide attempt during that period compared with 3 percent of non-sexting teens, according to the researchers at the Education Development Center in Newton, MA.

3. Disable Geotagging & Use Parental Controls

2/3’s of teen frequently use a mobile device’s camera to take pictures “love it” and would “die without it.”

When Photos are posted online from a phone most of the time they are geotagged giving the exact longitude and latitude of where that photo was taken. This can give specific home address locations and show patterns of locations giving stalkers an exact map with timetable of your child whereabouts

Learn how to disable geotagging via IcanStalkU.

More than 37% of teens in the U.S. access the Web through their phones.

Parental controls can block content as well as limit accessibility during certain times of the day.  Contact your phone carrier for parental control options

Learn about Parental Block Options of popular phone carriers.

4. Don’t Download Apps

54% of text-using teens have received spam or other unwanted texts.

Children’s identities are being targeted more than ever and one of the easiest ways for scammers to access personal information is through malware on apps.  Children should never download an app without showing their parent but even reputable apps have been targeted with malware. Generally speaking limiting apps, limit hackers’ access.

Apps that pull information are also common on social networks sites and you should regular check what apps have access to your personal information.

Teach kids not to put their phone number on social networking sites. Don’t click on ads, contests, or texts for free prizes.

Learn how to delete an app from Facebook via Consumer Reports.

5. Pause before you Post

Anything you share on a social network, text or phone may become public knowledge so teach them never to post anything that would hurt or embarrass someone. Recently public comments made on Facebook have become accessible under Google searches.

Start talking about etiquette when they are first learning to use a computer. Constantly reinforce Pause before you Post.

Many parents are overwhelmed with technology just as they were learning to use a car seat. They must also learn the technology so they can keep their children safe.

Dr. Deb

I always wanted twins until I actually HAD them. It took about 18 months before I actually LOVED mothering twins, which I do now with a passion. The early months were all about survival and I savored the exersaucer time in front of the TV. 20 minutes of Smart Baby gave me the least bit of sanity and I was making them smart, right? Turns out those videos don’t really make your baby smart and television, especially for young children, may lead to several health risks.

SpongeBob SquarePants is the most-watched TV show among kids between the ages of 2 to 11 but a recent study showed that 4 year olds who watched only 9 minutes of the show were significantly impaired on tests of executive function or the ability to focus and not get distracted compared to kids that watched a PBS show Caillou or drew with crayons.

Sponge Bob is considered a fast-paced show with complete scene changes every 11 seconds compared with 34 seconds for the slower-paced program. These fast paced shows may over stimulate the brain and lead to deficits.

This is not the first study to show problems with television. Television watching is associated with higher blood pressure and obesity, because not only is it sedentary and noninteractive, but there are an estimated 10,000 unhealthy food commercials per year being viewed each year.

Watching too much television is unhealthy for even active people. A recent study of the National Cancer Institute showed adults age 50-71 who watched more than 5 hours of TV a day were twice as likely to die sooner. Even those who exercised at high levels but also watched a lot of TV were still at risk for early death.

What is a sleep deprived mother to do?

Dr. Deb’s Television Watching Recommendations

1. Limit Screens to less than 2 hours a Day

The American Academy of Pediatrics discourages TV altogether for children under the age of 2 so forget Smart Baby like programs. It is important to be active and interactive and television does neither. When you do have the TV, keep closed caption on. This had been shown to be a far better reading aid than any video or smart program.

2. No Television in the Bedroom

32% of 2-7 year olds and 65% of 8-18 year olds have a television set in their bedroom. Television creates sleep problems for both children and adults. Even watching TV too close too bedtime caused sleeping problems in 28% of preschoolers who watch TV or played video game at least 30 minutes after seven.

Children need a quiet soothing winding down ritual time before bed and reading a book is a great habit to get children into at an early age.

3. Aim for Educational & Nonviolent Television

Children have trouble discriminating fantasy from reality. 37% of children who were exposed to one hour or more of violent media had sleep problems compared to those who watched less than an hour or none at all. Not only does more media violence promote real life violence but teens that watch sexualized shows tend have earlier and more frequent sexual experiences.  Make sure they are watching quality and diverse television. The FCC has V chip guidelines for every show with age recommendations.

4. Watch TV with your kids to Find Teaching Moments

I don’t think you should ban every violent or sexual show but make sure you are watching these shows together to have teaching moments about the choices the characters have made. You can help clarify the fantasy versus the reality of real life.

5.  Turn TV off during Meals

Mealtime should be sacred. Families that eat together and share their day are more successful in school and in life. It is too easy to have television as the background noise so make all television viewing with a purpose.  Those that eat while watching TV consume far more calories than those sitting at a table together.

Do my kids enjoy Sponge Bob? Absolutely! Keep him in his target audience of 6-11 year olds and out of the younger kids eyes. You don’t have to ban TV but don’t make it your babysitter either.  Think about what kind of modeling you are doing for your kids too.

Have a great week and don’t forget, the new fall season starts soon!

Dr. Deb

Preventing Annoying Back to School Infections

There’s peace in my house as all the kids are back to school but the return to school also means the return of annoying school infections such as pink eye and lice. I want to share my tips to keep those infections out of your house this year.

1. ABCs: Allergies, Bacteria and Colds

These three account for the most common infections in children and can all be prevented with hand washing, covering mouths while coughing and not sharing drinks and utensils.

Just one lesson on hand hygiene where students ages 5-15 learned to clean hands 3xs during the school day decreased 4 or more sick days by 66 percent according to the American Journal of Infection Control.

Most importantly have kids wash their hands when they come home from school to keep germs out of the house. They should also wash their noses with normal saline spray to prevent allergy outbreaks. If they do become ill then wash their toothbrush in the dishwasher or replace it to prevent reinfection.

2. Pink Eye

Pink eye is conjunctivitis or inflammation (swelling) of the conjunctiva—the thin layer that lines the inside of the eyelid and covers the white part of the eye.

The most common causes of conjunctivitis are viruses, bacteria, and allergens.

Symptoms include red eyes, crusty eyelids in the morning, itchy eyes, tearing and blurred vision.

Is typically mild, with symptoms being the worst on days 3–5 of infection. The condition usually clears up in 7-14 days without treatment but may take 2-3 weeks.

Many cases improve without treatment but topical antibiotics are often prescribed.

Prevention:

Wash your hands often with soap and warm water or an alcohol-based hand gel, especially after applying eye ointment.

Avoid touching or rubbing your eyes.

Wash any discharge from around the eyes several times a day but use different cloths on each eye.

Wash pillowcases, sheets, washcloths, and towels in hot water and detergent.

Don’t share tissues, towels, washcloths, eye makeup or eye drops with other people.

When treating allergic conjunctivitis dust and vacuum often to reduce allergens in your home and close windows when the pollen count is high.

3. Head Lice

6 to 12 million cases of head lice infestation occur each year in the United States in children ages, 3 to 11 years, according to the Centers for Disease Control and Prevention. They are tiny parasitic bugs that don’t spread disease and spread mainly by direct head-to-head contact with a person who already has head lice. Lice don’t fly or jump; they move by crawling.

Every parent should check regularly for lice by parting the hair in several spots. Lice can move fast so use a magnifying glass and a bright light. Nits can look like dandruff, but stay firmly attached to the hair if you pull your fingernail across the hair while dandruff will come off easily.

Most important for lice treatment is to use a fine-toothed comb or special “nit comb” to remove dead lice and nits that can be used with or without chemical treatment.

Prevention:

Don’t share hairbrushes, combs, hair ornaments, scarves, bandanas, towels, or helmets.  Girls with long hair should keep their hair braided and pulled back. Avoid head-to-head contact during play or slumber parties

When your child returns from a sleep over put everything in the dryer on high heat for 10 minutes. This treatment will also kill bedbugs.

Treatment:

Machine wash and dry clothing, bed linens, and other items using hot water (130°F) and dry on high heat. Clothing and items that are not washable can be dry-cleaned or sealed in a plastic bag and stored for two weeks. Head lice survive less than one or two days if they fall off the scalp and cannot feed.

Vacuum the floor and furniture, particularly where the person with lice sat or lay.

Disinfest combs and brushes used by a person with head lice by soaking them in hot water (at least 130°F) for 5–10 minutes. After finishing treatment with lice medication, check everyone in your family for lice after one week.

4. Molluscum Contagiosum

MC are pink, white or flesh-colored bumps caused by a type of poxvirus. It is common in kids ages 1 to 10 but many parents have never heard of it. Molluscum contagiosum is very contagious, mainly through skin-to-skin contact or contact with contaminated objects, such as clothing, towels or toys.

Once someone has the virus, the bumps can spread to other parts of their body by touching or scratching a bump and then touching another part of the body. Molluscum can also be spread by sexual contact. There has been a relationship of catching molluscum by shared swimming pools, baths, saunas, or other wet and warm environments, this has not been proven. Most likely sharing towels and other items around a pool or sauna than through the water spread the virus.

Prevention: Hand hygiene and not sharing personal items, including towels are the best ways to avoid this skin infection, which typically clears up without treatment in 6 to 12 months. Do not shave or have electrolysis on areas with bumps. If you have bumps in the genital area, avoid sexual activities until you see a health care provider.

To prevent the spread of molluscum to other areas of your body or to other people, it is important to keep every blister or bump covered either with clothing or with a watertight bandage

Treatment

There are many treatment options including Cryotherapy (freezing), Curettage (removes the fluid inside the bumps), Lasers and Creams that include certain chemicals (i.e., salicylic acid, podophyllin, tretinoin, and cantharidin). There is also a newer cream (imiquimod) that helps strengthen the skin’s immune system.

Mollusscum is tough to treat when it spreads and I have used imiquimod on my own children with great success.  It needs to be used every night, is expensive, may cause irritation but is safe.

A home remedy that may be worth trying is apple cider vinegar or ACV. There are several options but one is to soak a cotton ball with ACV and tape it to the MC overnight. There can be some irritation and stinging. Some have reported just soaking in a bath nightly with ½ cup of ACV will work too. Others advocate popping the MC with a sterilized needle then applying the ACV that is very similar to the curettage that we do in the office. I do not recommend popping at home as you may spread the infection or cause a bacterial infection but I would try the ACV nightly bandage option.

Being a parent is never easy. Here is hoping for a Happy Healthy School Year!

Dr. Deb

Kids are headed for college this week and while my last blog discussed the nuts and bolts health tips for BACK TO SCHOOL like vaccines and hygiene, this week I want to talk about what parents are really worried about: How will my child handle the smorgasbord of temptations without rules or limitations?

Here are Dr. Deb’s 5 College Health Tips.

1. Avoid the Freshman 15

Students often gain weight the first 2 years of college and most of it occurs during the first trimester of freshman year, but weight gain is not inevitable. It only takes an extra 150-175 calories a day to gain that weight so making a small change like cutting the midnight snack or drinking water instead of pop can mean the difference between weight gain or staying the same.

Critical to avoiding the weight gain, as well as stress relief, is REGULAR EXERCISE!

Don’t skip meals and be aware that everyone has a different metabolism. Avoid the mob mentality. Just because your skinny friend is chowing down on French fries and fast food after a night of drinking doesn’t mean you won’t gain weight if you do too. She may have a hidden eating disorder that is quite common on college campuses. Click her for more information on Eating disorders.

2. GET SOME ZZSs

Sleep is critical for all but especially dealing with the stress of college.  Try to get on a regular sleep schedule and avoid all nighters. You need at least 4 hours of sleep to perform well on a test but 7-9 regular hours is best for your health as well as your grades. Lack of sleep also contributes to that freshman 15 as hunger chemicals are released in times of low sleep. Stay away from energy drinks and avoid caffeine in the evening as it can take 8 hours to wear off.

3. Stress Relief

Depression and other mental illness usually start between ages 15 though the 20s. The stress of school and being away from home can trigger depression in children especially with a family history. Talk to your kids about warning signs and make sure they know where to get help. Regular sleep, a healthy diet and exercise are critical to keep all children feeling their best. Encourage joining a club to build social support, as college life can be very overwhelming.

Talk about warning signs and have them see a professional if the have:

Extreme mood swings

Feelings of sadness or hopelessness

A loss of interest in things they once loved

Loss of appetite or binging

Significant changes in sleep patterns.

4. Sex and Safety

College is different because they have not grown up with these kids or know their families so a healthy amount of caution is necessary. Don’t allow boys you just met to “walk you home” because predators come in all shapes. Almost every campus has a college escort service so make sure your kids know about it.

Sexual expectations may also be different in college and make sure they do not put themselves in situations they may not be used to. Have them discuss at the beginning of a date, what if any sexual expectations either of them have. Talk to them about keeping themselves safe as they are in a high-risk group for sexually transmitted diseases and what they would do if something they had not planned for were to happen like emergency contraception.

Take this Sexual Assertiveness Quiz and read about date rape prevention.

Avoiding or limiting alcohol is critical for college health and safety. 1/3 of college students abuse alcohol, which contributes to the 3 most common causes of death in teenagers, accidental injury, homicides and suicides. Alcohol also plays a role in most sexual transgressions and sexual assaults.

5. Set them Free

Don’t be a helicopter parent and try to micromanage every grade or class. College is the time for kids to learn to be an adult and if you don’t want them back at home after graduation then have fight their own battles. Set limits on texts or phone calls to what is reasonable for you both.

Kick Ball games may be replaced by beer pong but arming your kids with the information and confidence is the best way to keep them healthy and safe at college.

Happy New School Year!

Dr. Deb