How Can a Sock Monkey Make Commuting with Your Kid Safer?

Rarely do you find yourself getting excited while driving your kid to school. But, much to my teen’s chagrin, that’s just what happened one morning last week.

It’s all because my son was awake and observant that morning. As I was navigating a busy round-about near our neighborhood – he cried out, “What the heck?? Some crazy person has a life-size sock monkey in their front passenger seat!”

Now this intrigued me, but I didn’t manage to see the car since I was trying to keep us safe in traffic. So I asked him for more details, like who was driving. “It was a woman,” he said…..and then the all important clue: “And she had a little kid in a car seat in the back….what a weirdo!”

Now I am both a newly minted public health professional (MPH received last year!) and a child health and safety geek (seven years as Senior Editor at Pediatric Safety will do that to you!), so I immediately had a flash of insight. “Oh,” I said, “I know what she’s doing!!” “Oh that’s so cool!” I was practically bouncing up and down in my seat. Thankfully I had already merged into traffic on the local parkway.

“She’s taking her kid to daycare on her way to work, and the sock monkey is next to her to remind her that the child is in the back seat. When they aren’t using the car seat, the sock monkey sits in it – and when they put the little girl in the car seat, they move the sock monkey doll up front as a visual cue.”

The reason I was SO excited is this was an example of child safety in action. Forgetting a baby or young child in the back seat can happen to any parent when we are on autopilot, trying to get all the morning tasks done and get to work. And even a short time alone in a hot car can be fatal, since children’s bodies heat up faster than those of adults. More details on heatstroke and kids can be found at the links below:

• NHTSA.gov – Tips to Avoid Child Heatstroke
• Healthychildren.org (AAP) – Prevent Child Deaths in Hot Cars

Given the risks of heatstroke, government experts and child advocates recommend memory helpers, like keeping a stuffed animal in the car seat and moving it up front when the child is strapped in (see the links above). Experts also advise parents to keep something critical for their day in the back near their child – like a purse, briefcase or mobile phone.

Now you might think that you don’t need to take measures like this….but research shows that the easiest way to adopt a new habit or remember something is to set up your environment to help you – like ridding your house of fattening foods, keeping your gym clothes handy and visible….or putting a life-sized stuffed animal next to you in the car when your child is in back.

I don’t know who the woman was on the road that morning, but I commend her effort to ensure her child’s safety – and she really made a child safety geek’s day! Oh, and if you’d like to buy a life-size sock monkey, they have them on Amazon.

 

Summer and Animal Bites: A Pediatrician’s Perspective Part II

Childhood Sports Injuries: Avoid Both Common & Serious Problems

The school year will soon be upon us and with the return of homework and uniforms means the return of sports. 60 million children and adolescents participate in organized sports in the United States each year. Still more participate in informal recreational activities. Although sports participation provides numerous physical and social benefits, it also has a downside: the risk of sports-related injuries. In fact, according to Nationwide Children’s Hospital, approximately 3 million youth are seen in hospital emergency rooms for sports-related injuries and another 5 million are seen by their primary care physician or a sports medicine clinic for injuries.

These injuries are by far the most common cause of musculoskeletal injuries in children treated in emergency departments. They are also the single most common cause of injury-related primary care office visits.

I. The Most Common Sports-Related Injuries in Kids

Although sports injuries can range from scrapes and bruises to serious brain and spinal cord injuries, most fall somewhere between the two extremes. Here are some of the more common types of injuries.

Sprains and Strains

A sprain is an injury to a ligament, one of the bands of tough, fibrous tissue that connects two or more bones at a joint and prevents excessive movement of the joint. An ankle sprain is the most common athletic injury.

A strain is an injury to either a muscle or a tendon. A muscle is a tissue composed of bundles of specialized cells that, when stimulated by nerve messages, contract and produce movement. A tendon is a tough, fibrous cord of tissue that connects muscle to bone. Muscles in any part of the body can be injured.

Growth Plate Injuries

In some sports accidents and injuries, the growth plate may be injured. The growth plate is the area of developing tissues at the end of the long bones in growing children and adolescents. When growth is complete, sometime during adolescence, the growth plate is replaced by solid bone. The long bones in the body include:

• the long bones of the hand and fingers (metacarpals and phalanges)
• both bones of the forearm (radius and ulna)
• the bone of the upper leg (femur)
• the lower leg bones (tibia and fibula)
• the foot bones (metatarsals and phalanges).

If any of these areas become injured, it’s important to seek professional help from an orthopaedic surgeon, a doctor who specializes in bone injuries.

Repetitive Motion Injuries

Painful injuries such as stress fractures (a hairline fracture of the bone that has been subjected to repeated stress) and tendinitis (inflammation of a tendon) can occur from overuse of muscles and tendons. Some of these injuries don’t always show up on x rays, but they do cause pain and discomfort. The injured area usually responds to rest, ice, compression, and elevation (RICE). Other treatments can include crutches, cast immobilization, and physical therapy.

Heat-Related Illnesses

Heat-related illnesses include:

• dehydration (deficit in body fluids)
• heat exhaustion (nausea, dizziness, weakness, headache, pale and moist skin, heavy perspiration, normal or low body temperature, weak pulse, dilated pupils, disorientation, and fainting spells)
• heat stroke (headache, dizziness, confusion, and hot dry skin, possibly leading to vascular collapse, coma, and death).

Heat injuries are always dangerous and can be fatal. Heat-related injuries are a particular problem for children because children perspire less than adults and require a higher core body temperature to trigger sweating. Playing rigorous sports in the heat requires close monitoring of both body and weather conditions. Fortunately, heat-related illnesses can be prevented.

II. Preventing and Treating Injuries

Injuries can happen to any child who plays sports, but there are some things that can help prevent and treat injuries.

Prevention Basics

• Enroll your child in organized sports through schools, community clubs, and recreation areas that are properly maintained. Any organized team activity should demonstrate a commitment to injury prevention. Coaches should be trained in first aid and CPR, and should have a plan for responding to emergencies. Coaches should be well versed in the proper use of equipment, and should enforce rules on equipment use.
• Organized sports programs may have adults on staff who are Certified Athletic Trainers. These individuals are trained to prevent, recognize, and provide immediate care for athletic injuries.
• Make sure your child has—and consistently uses—proper gear for a particular sport. This may reduce the chances of being injured.
• Make warm-ups and cool downs part of your child’s routine before and after sports participation. Warm-up exercises, such as stretching and light jogging, can help minimize the chance of muscle strain or other soft tissue injury during sports. Warm-up exercises make the body’s tissues warmer and more flexible. Cool down exercises loosen muscles that have tightened during exercise.
• Make sure your child has access to water or a sports drink while playing. Encourage him or her to drink frequently and stay properly hydrated. Remember to include sunscreen and a hat (when possible) to reduce the chance of sunburn, which is a type of injury to the skin. Sun protection may also decrease the chances of malignant melanoma—a potentially deadly skin cancer—or other skin cancers that can occur later in life.
• Learn and follow safety rules and suggestions for your child’s particular sport. You’ll find some more sport-specific safety suggestions below.

Primary Treatment

Treatment for sports-related injuries will vary by injury. But if your child suffers a soft tissue injury (such as a sprain or strain) or a bone injury, the best immediate treatment is easy to remember: RICE (rest, ice, compression, elevation) the injury (see below). Get professional treatment if any injury is severe. A severe injury means having an obvious fracture or dislocation of a joint, prolonged swelling, or prolonged or severe pain.

Treat Injuries with “RICE”

• Rest: Reduce or stop using the injured area for at least 48 hours. If you have a leg injury, you may need to stay off of it completely.
• Ice: Put an ice pack on the injured area for 20 minutes at a time, four to eight times per day. Use a cold pack, ice bag, or a plastic bag filled with crushed ice that has been wrapped in a towel.
• Compression: Ask your child’s doctor about elastics wraps, air casts, special boots, or splints that can be used to compress an injured ankle, knee, or wrist to reduce swelling.
• Elevation: Keep the injured area elevated above the level of the heart to help decrease swelling. Use a pillow to help elevate an injured limb.

For Basketball…

• Common injuries and locations: sprains; strains; bruises; fractures; scrapes; dislocations; cuts; injuries to teeth, ankles and knees. (Injury rates are higher in girls, especially for the anterior cruciate ligament (ACL), the wide ligament that limits rotation and forward movement of the shin bone.)
• Safest playing with: eye protection, elbow and knee pads, mouth guard, athletic supporters for males, proper shoes, water. If playing outdoors, wear sunscreen and, when possible, a hat.
• Injury prevention: strength training (particularly knees and shoulders), aerobics (exercises that develop the strength and endurance of heart and lungs), warmup exercises, proper coaching, and use of safety equipment.

For Track and Field…

• Common injuries: strains, sprains, scrapes from falls.
• Safest playing with: proper shoes, athletic supporters for males, sunscreen, water.
• Injury prevention: proper conditioning and coaching.

For Football…

• Common injuries and locations: bruises; sprains; strains; pulled muscles; tears to soft tissues such as ligaments; broken bones; internal injures (bruised or damaged organs); concussions; back injuries; sunburn. Knees and ankles are the most common injury sites.
• Safest playing with: helmet; mouth guard; shoulder pads; athletic supporters for males; chest/rib pads; forearm, elbow, and thigh pads; shin guards; proper shoes; sunscreen; water.
• Injury prevention: proper use of safety equipment, warmup exercises, proper coaching techniques and conditioning.

For Baseball and Softball…

• Common injuries: soft tissue strains; impact injuries that include fractures caused by sliding and being hit by a ball; sunburn.
• Safest playing with: batting helmet; shin guards; elbow guards; athletic supporters for males; mouth guard; sunscreen; cleats; hat; detachable,“breakaway bases” rather than traditional, stationary ones.
• Injury prevention: proper conditioning and warmups.

For Soccer…

• Common injuries: bruises, cuts and scrapes, headaches, sunburn.
• Safest playing with: shin guards, athletic supporters for males, cleats, sunscreen, water.
• Injury prevention: aerobic conditioning and warmups, and proper training in “heading” (that is, using the head to strike or make a play with the ball).

For Gymnastics…

• Common injuries: sprains and strains of soft tissues.
• Safest playing with: athletic supporters for males, safety harness, joint supports (such as neoprene wraps), water.
• Injury prevention: proper conditioning and warmups.

III. Safety Tips for ALL Sports

• Be in proper physical condition to play the sport.
• Follow the rules of the sport.
• Wear appropriate protective gear (for example, shin guards for soccer, a hard-shell helmet when facing a baseball or softball pitcher, a helmet and body padding for ice hockey).
• Know how to use athletic equipment.
• Always warm up before playing.
• Avoid playing when very tired or in pain.
• Get a preseason physical examination.
• Make sure adequate water or other liquids are available to maintain proper hydration.

Adapted from Play It Safe, a Guide to Safety for Young Athletes, with permission of the American Academy of Orthopaedic Surgeons.

Play It Safe in the Heat

• Schedule regular fluid breaks during practice and games. Kids need to drink 8 ounces of fluid—preferably water—every 20 minutes, and more after playing.
• Have your child wear light-colored,“breathable” clothing.
• Make player substitutions more frequently in the heat.
• Use misting sprays on the body to keep cool.
• Know the signs of heat-related problems, including confusion; dilated pupils; dizziness; fainting; headache; heavy perspiration; nausea; pale and moist or hot, dry skin; weak pulse; and weakness. If your child experiences any combination of these symptoms or doesn’t seem quite right, seek medical attention immediately.

Adapted with permission from Patient Care magazine, copyrighted by Medical Economics.

Please keep your children active and safe and have a great school year.

Did You Know…Every 2 Weeks a Child Dies From a “Tipover”?

It’s not something we like to think about…and it certainly could never happen to us…but the reality is that every 2 weeks a child dies because an unsecured appliance or piece of furniture has toppled over onto them. In fact between 2000–2008, the CPSC received reports of nearly 200 tipover deaths among children 8 and younger. More than 90% of them involve children under 5!

Typically, injuries and deaths occur when children climb onto, fall against or pull themselves up on television stands, shelves, bookcases, dressers, desks, chests and appliances. Sometimes it’s the out-of-reach item placed on top of furniture, in other cases it’s the furniture or appliance itself that will topple causing serious if not fatal injuries. The CPSC has issued a warning, urging parents to inspect and secure these items. They also offer the following safety tips:

• Furniture should be stable on its own. For added security, anchor chests, dressers, TV stands, bookcases and entertainment units to the floor or attach them to a wall.
• Place TVs on a sturdy, low-rise base. Avoid flimsy shelves.
• Push the TV as far back on its stand as possible.
• Place electrical cords out of a child’s reach and teach kids not to play with them.
• Keep remote controls and other attractive items off the TV stand so kids won’t be tempted to grab for them and risk knocking the TV over.
• Make sure free-standing ranges and stoves are installed with anti-tip brackets.

One thing we often forget is that even when our own home has been thoroughly baby-proofed, our friends and family’s homes will likely not have received the same attention. It’s up to us to be vigilant…wherever we may be.

Code Adam: Because You Don’t Have Eyes in the Back of Your Head

Sometimes, as a parent, you have to give yourself a break. Even mothers have to heed the call of nature. But with a headstrong and mischievous three-year old in tow, a parental potty break in a public building can become an exercise in surprisingly emotional fear and guilt.

I mean, we are supposed to be able to keep our children safe. We aren’t supposed to lose them! But what can any reasonable parent do wedged in a tight bathroom cubicle with a toddler and sitting in a very compromising position when the wiggle worm decides it would be the height of fun to crawl out under the stall door and run out of the bathroom? I can still feel the brush of his jeans across my fingers as I just failed to grab hold….

Thankfully, with Code Adam, a nation-wide program administered by the National Centre for Missing and Exploited Children (NCMEC), my anxiety in our local children’s museum was contained by a very orderly and confident process. Code Adam, created and named in memory of 6-year old Adam Walsh who went missing while shopping with his mother and was later found murdered, is a simple but powerful search process focused on marshaling employees of public buildings, such as stores, libraries and museums, in a systematic search for lost children in the crucial moments immediately following their disappearance.

My Code Adam Experience:

• As soon as I could make myself decent and get out of the bathroom I approached nearby museum staff who were manning the entrance to the exhibit space we had just visited, and learned that my wayward son had not decided to return to the water or sand tables
• The staff then asked me very specific questions to compile a detailed description of my child – including his clothing and shoe color/style (I remember he was wearing those shoes with a light that flashes when he walked)
• A “Code Adam” page including this description was then given within the venue and designated staff immediately began a systematic search
• All potential exits other than the front doors were either closed or closely monitored and a member of the security staff escorted me to the front entrance to ensure my son, Elliott, did not leave the premises. I spent what felt like a wretched eternity desperately scanning the sea of kids, choking back tears, and constantly affirming to my security pal that I’d never lost my kid before…honest!

If my son wasn’t found within 10minutes, the next step would have been for security to call law enforcement. If he had been found in the company of someone other than a parent or legal guardian, the procedure would call for reasonable attempts to delay their departure until the arrival of police, without putting anyone in danger.

Thankfully, I was reunited with my wiggle worm within that timeframe, a staff member having found him obliviously and happily playing on a computer screen in another area of the museum. When he was back within arms’ reach I didn’t know what I wanted to do to him (or what would be considered the politically correct behavior)…wrap him in my arms and say “Thank God”…or berate him for running off from Mommy? So I fudged and did a little of both!

Making Use of the Code Adam Program

Code Adam originated in Walmart stores in 1994 but is now one of the largest child-safety programs in the U.S., used in around a hundred thousand establishments around the country and, since the Code Adam Act was made law in 2003, in all federal public facilities (click here for list of participants). Use of the program in a venue is proclaimed by a Code Adam decal at the building entrances. Thanks to NCMEC and its sponsors, the program is free to participants, who can apply online for a Code Adam kit, including:

• A training video for employees
• A break-room poster explaining the program steps
• Two decals to put on entrances announcing participation in Code Adam

So what can parents and safety advocates do?

• Check building entrances for the Code Adam decal. Know whether Code Adam is used in that venue before you and your children enter.
• Know the Code Adam procedures. I’d like to say my story above is the only example of our use of Code Adam in the past eight years, but my son has triggered 2 other experiences in large retail stores. In one of these venues, the staff I located did not know the Code Adam process. Thankfully I did…and suggested they call security and institute a Code Adam page….missing child quickly found. Lesson: Don’t rely on the quality of any given store’s staff training.
• Make sure caregivers know. Even if you are very familiar with Code Adam and its procedures, what about babysitters or grandparents? How often are they out with your children in a public venue? Be sure that they also know about Code Adam and how to ensure it is appropriately implemented.
• Suggest Code Adam to local venues. If a local store or establishment with a focus on families or children does not display the Code Adam decal, consider finding the manager and suggest that they participate. They can find everything they need at www.missingkids.org (search “code adam”). Additional information can be obtained by calling 1-800-THE-LOST (1-800-843-5678) or emailing codeadam@ncmec.org.

13 Ways to Help Our Kids Prepare for and Deal with Peer Pressure

The school bell has rung and the new school year is in full force. No matter where we live, or where our children go to school, all kids have something in common; they will be faced with peer pressure. As parents, there is much we can do to help our children prepare for, and deal with the pressure that will come from their peers.

1. Believe in our kids, they will believe in us.

Our kids need to know WE believe in them. We know they can make right choices and we know they are strong. Tell them. Point out their good choices and the consequences of right choices. Point out their strengths.

We as parents also need to make right choices. Are we being the best parents we can be? Our children should expect that we would protect them, and do what is best for them. Even if they grumble, or disagree, it is our job to stand our ground and do what is best, not be their BFF.

2. Communicate with our Children: The 3 B’s: (Be Available, Be Present, Be Patient)

As parents, we need to keep the lines of communication open with our children. Especially as they start into their teenage years. How can we do this? Start young, very young, and be available, present and patient.

First, we have to be available. It we are not available, how can our children/teenagers talk to us. We don’t have to announce that we are ready to talk, we have to naturally be there. Be there after school, turn the music off when driving in the car, eat a meal together, be awake when kids come home. Find something that your child likes to do and do it with them. It is the perfect time to not only allow our children to tell us what they are dealing with, but, it is a time for us to talk to them about the pressures that they might be feeling at school and with their friends. We have been there, we know what is going on. Sometimes our kids need us to bring things up because they don’t know how.

Once we have made time and are available, we need to be present. We need to stop thinking about all the other things we need to do, and really be in the conversations. Give our children our undivided attention.

Last, be patient and realize that communication happens over time. It is built on trust and experience. Always be available and present, and our children will start to open up.

3. Express Love

Knowing we are loved gives us confidence and strength. Even if a child does something wrong, NEVER withhold love as a consequence. Our children should know that our love is unconditional.

4. Be Confident Parents: We matter more than peers.

Naturally, children do not want to disappoint their parents, this can single handedly keep children from falling to peer pressure.

5. Role Play

This is a powerful way for us to prepare our children to fight against peer pressure. Be the forceful friend and “act out” different real life situation.

Ask hard questions….

• “What if someone offers you drugs”?
• “What if your friend asks you to steal something”?

Work through what your child could say. It will make it so much easier when it really happens. It is like a memory reflex and the answers will come to your child much easier. They won’t be caught off guard when it happens.

6. Talk about peer pressure.

Tell our children about peer pressure, explain what it feels like, why it happens, and when you have had it happen to you. Give them examples of times when you were faced with peer pressure and how you overcame it. Or, if appropriate, when you fell to peer pressure and the consequences for your decisions. There is strength in our children knowing we understand because we have been there. As parents when you see peer pressure happening, point it out. Our children can have a hard time seeing it.

7. Set rules…AND…Follow through

Set rules, for the every day, and if they fall to peer pressure (ex, drink the beer). Make the consequences VERY CLEAR, and…enforce the consequences. We can talk all we want, but if we don’t follow through, our children will know they can get away with breaking the rules. Make it clear to your children that just because “everyone was doing it”, doesn’t mean that it is okay.

8. Don’t let kids stay the night

Sleeping away from home makes it a lot easier for our children to fall to peer pressure. Why, because they don’t have to come home to their parents. There can be too much freedom away from home for an extended period of time.

9. Wait up for your child

Be awake when your kids come home. Teens will think twice about falling to peer pressure when they have to come home and face you. It is also a really good time for you to be present and talk with your kids about their night.

10 Encourage Opinions

It is okay for our children to have an opinion. In fact we want them to have opinions about what is right and wrong, and how they feel about sex, drugs and alcohol. Help them develop their opinions. Have conversations where you help your children think through the how’s and why’s. Teach them to be critical thinkers. It will give them confidence, and children with opinions are more likely to speak their minds, which is exactly what they need to do to stand up to peer pressure.

11. Teach Conflict Resolution

We deal with conflict our entire lives; at home, at work, at school. Standing up to peer pressure can bring conflict. Teaching our children conflict management skills will not only prepare them for peer pressure, but, prepare them for life. Home is a great place to practice dealing with conflict. As a parent, when there is a problem, we want to jump in and fix it. Don’t. Let children do all they can to work out a resolution on their own. You will be surprised to find that kids can, and will solve their own arguments and conflicts.

12. Teach our kids how to choose good friends.

Our children need to be taught social skills, and how to choose good friends, and be a good friend. Encourage them to choose friends with similar core values and beliefs. Teach them what friendship means, and how good friends treat each other. (A good friend doesn’t pressure you to do anything).

13. There will be mistakes, don’t make them public

When our children do fall to peer pressure, don’t make it public. Spreading the word about your child’s poor choices will not help them make better choices. It will just weaken your relationship. It will hurt the trust that you have tried to build and weaken your children’s resolve. Instead, teach them how to take responsibility for their choices. Help them reflect on what has happened and why.

We owe it to our children to prepare them for the peer pressure they will face. It will not only help them, but help our family relationships as well.

Have your children felt the pressure of their peers?

How do you handle good and bad choices your children make?

Do you ever have a hard time enforcing consequences?

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