Evidence continues to mount that parents should think hard about the use of media in their homes. Recent study findings include:

• • Increased media use (TVs and computers) in a home significantly decreases the amount of time parents talk to their child and read with their child. Talking and reading with your child are critical to their language development.
• • Young children playing in a room with a TV on look up at the screen on average 3 times every minute. Their attention to the screen interrupts the creative hands-on play that is best for brain development.
• • TV use before bedtime is associated with decreased quantity and quality of infant and child sleep. By age 3 years, about a third of all American children have a TV in their bedroom…..this is clearly a bad idea!
• • Youths who watch TV with violent or rude behavior and foul language are much more likely to behave violently, rudely, and use foul language. They also are more likely to believe that such behavior is acceptable and “normal” than teens whose family forbids that type of TV viewing in their home.
• • College-bound high schoolers beware: over 350 top universities in the US routinely search the internet for information about applicants. For 12% of last year’s college applicants, the presence of negative information on Facebook and other internet sites (including reported alcohol and drug use, plagiarism, profane language, and revealing photographs) resulted in colleges refusing admission to those students. Talk to your teens….they may not anticipate that their social media use can have a direct impact on their college career.

Acetaminophen (sold as Tylenol, Pediacare and a variety of other brand names) is currently under investigation for a potential link with asthma. Several pediatric studies have shown that children who used acetaminophen were twice as likely to have a diagnosis of asthma or suffer from chronic or recurrent wheezing.

Epidemiologists have been hesitant to conclude that acetaminophen causes asthma because of the possibility of confounding factors. For example, children who are asthmatic may become sick more easily, and then receive acetaminophen. Also, children who are frequently sick can develop viral-induced asthma, and those children are often given Tylenol. So, does acetaminophen really cause asthma, or is acetaminophen use just a marker for kids who have asthma?

While further studies are done to determine the nature of the link between acetaminophen and childhood asthma, some pediatric pulmonologists (and Dr. B) are recommending that ibuprofen (known by brand names Advil and Motrin) be the preferred medication for fever or pain in children who have wheezed or have a diagnosis of asthma in a parent or sibling. Note that ibuprofen is currently FDA approved for use in children 6 months of age or older. In young babies or in children who have no personal or family history of asthma/wheezing, acetaminophen is an excellent first choice for fever or pain.

The AAP recently published a policy statement that significantly strengthens its recommendations for a safe infant sleeping environment.  Among its recommendations:

• •  Always place your baby on her back on a firm sleep surface, particularly a crib or playpen that conforms to current safety standards.  Adult’s mattresses, couches, and recliners are not recommended.
• •  SIDS may be decreased by as much as 50% by having infants sleep in the same room as their parents, but NOT in the same bed with parents.  The AAP policy states that infants may be brought into bed for feeding but should be returned to their bassinet or crib as soon as feeding is done.  This arrangement markedly decreases the chance that baby will be accidentally harmed during sleep.  Particularly risky for cosleeping are infants whose parents are smokers, excessively tired, or medicated with alcohol, street drugs, or prescription drugs that cause fatigue.
• •  The crib should be bare.  No bumpers, blankets, sheets or stuffed animals should be in an infant’s crib during sleep.
• •  Commercial devices to position a baby (including wedges, nursing pillows, sleep nests) should not be used.
• •  Carseats should not be used for sleeping due to the possibility of the baby’s head falling forward and obstructing the airway.
• •  Tummy time of 30-60 minutes per day with an adult supervising is recommended to facilitate development and minimize positional flattening of the skull.
  •  Home heart and breathing monitors to prevent SIDS are not effective and should not be used.

Dr B has long taken a relaxed stance on cosleeping, as she coslept with her babies when they were young.  However, given the mounting evidence that infant safety can be greatly enhanced by increased vigilance about returning babies to their own beds after nighttime feeding, Dr B agrees with the newer recommendations to help keep babies safer.

These directives are not yet law in Oregon, but they will be soon. And, most importantly, if all parents follow these suggestions, the risk of death and serious injury for children in car crashes will drop by an amazing 75%!

The new recommendations affect children of almost every age:

• Babies should be rear-facing until age 2 years.
• Toddlers should be in a five-point safety seat until they outgrow the height and weight limits of that particular seat (in other words, don’t switch to a booster seat until you have to).
• Children should be in a belt-positioning booster seat until they are 4 feet 9 inches tall.
• Teenagers should sit in the back seat until age 13 years.

Dr. B’s comments on these new recommendations:

• The data is very strong to suggest that following these rules will prevent many deaths and injuries in kids. We should all follow these rules.
• Our kids may not like the changes, but it’s our job as parents to insist that they stay safe. Dr. B’s kids were the last ones out of booster seats in their class…and her kids hated it!!
• Other kids and parents may not adopt these rules…but that should not determine what you decide is best for your child. Be a leader at your child’s school -- follow the new recommendations yourself, talk to other parents, and speak to your child’s teacher or school principal to encourage others to follow the new guidelines.
• Be sure when you drive other school-age children in your car that you insist their parents provide a booster seat for them.
• The front passenger seat is the most dangerous seat in any vehicle…keep your kids in the back seat, even after they turn 13, as much of the time as possible.

Car accidents are a leading cause of death in the USA, so slow down, get off your cell phone, and buckle your kids up following the new AAP guidelines.

Energy drinks and supplements containing caffeine and other stimulants are popular in the U.S., even among children. Recent studies show that as many as 1 in 3 children age 12 years and older regularly consume energy drinks. But these products are not regulated by the FDA, nor are the effects on young bodies and brains. The American Academy of Pediatrics just released its conclusion that energy drinks have no therapeutic benefit and need further research and regulation.

Thousands of people are treated every year in emergency rooms for acute caffeine overdose, and about half of all cases are children. Side effects of energy drinks and supplements include high blood pressure, heart arrhythmias, mood disturbances, seizures, stroke, paralysis and death. Although caffeine and similar chemicals can improve attention, its effect can cause the brain’s reward/addiction center to become dependent on caffeine. After becoming “hooked” on caffeine, stopping it can lead to withdrawal symptoms like headaches, fatigue and irritability.

Read labels when you buy drinks for your kids. In addition to caffeine, be on the lookout for “taurine”, “guarana”, “ginseng”, “yohimbine”, and “L-carnitine.” Talk to your kids about the dangers of energy drinks and supplements, and set a good parent example by avoiding these products yourself.

It’s cold and cough season, but be careful when you reach for over-the-counter medications to treat your young child’s symptoms. Most orally administered cold and cough medications are not especially helpful in relieving symptoms. Worse yet, some of them can inadvertently cause very serious reactions in young children.

In January 2008, the FDA recommended against using cold and cough medication in children under 2 years due to “serious and potentially life-threatening side effects.” These effects included neurologic or behavioral changes (including extreme lethargy, unsteady gait, irritability, hyperactivity), allergic reactions, or even death.

Despite these dangers, a recent study in the Journal of the American Academy of Pediatrics noted that nearly 10,000 children were treated in emergency departments for side effects from ingesting cold and cough remedies in the 14 months following the 2008 warning. Many of these emergency room visits related to incidents where young children accidentally got into medications and took them when caregivers weren’t watching. Others were excess doses of medications given by the adult to the young child due to confusion about dosing instructions or other adult error.

So, to keep your children safe, Dr. Bradshaw recommends that you:

• Go through all your cabinets, drawers, baby bags, purses and other hiding places and take out all over-the-counter medications. Throw away outdated bottles. Put them away again all in ONE spot that is up and out of reach of young children.
• Do NOT carry medications in your purse or baby bag. Children love to tear apart the contents of your bags, and may find medications stored there.
• Review with your young children that all medications are not to be touched. Please don’t let your babies play with bottles of medicine (I see this often in my exam room, as a parent lets their babies entertain themselves by chewing on the top of a dropper-bottle of medication from the baby bag!).
• Use non-medication techniques to ease your child’s cough and cold symptoms (see the purple box for suggestions).
• Do NOT give over the counter cold and cough medications to your child under age 2 years!
• If you give over the counter cold or cough remedies to your child over age 2 years, read the label very carefully. Medications are usually dosed on weight, so know your child’s weight before you pick the dose. Don’t mistake “tsp” (teaspoon) for “tbsp” (tablespoon). When in doubt, check the purple box or call Eugene Pediatrics to talk to us.
• If you believe your child has accidentally ingested a medication, always call Oregon Poison Control at (800)222-1222.