Children’s Health

Nancy Ferrari

Protecting your children against Enterovirus D68

Enterovirus D68 is a respiratory infection that has been spreading across the country and making some children quite ill. It is especially problematic for kids with asthma or other respiratory issues. Enterovirus D68 can start out looking like a garden variety cold but lead to serious trouble breathing. What’s a parent to do? The same things he or she would normally do during cold and flu season: hand washing, staying away from people who are sick, regularly cleaning common surfaces like doorknobs, not sharing cups and utensils, and coughing or sneezing into the elbow, not the hands. Those who have children with asthma need to be extra vigilant about their child’s asthma care routine. Most upper respiratory infections are the simple cold. Still, it’s important to stay alert for signs of breathing difficulties.

Howard LeWine, M.D.

Study: no connection between drinking alcohol early in pregnancy and birth problems

In a new study sure to raise hackles and controversy, an international team of researchers is reporting that pregnant women who drink alcohol during the first trimester of pregnancy and possibly beyond aren’t putting their babies at risk for premature birth or low birth weight, or themselves at risk for high blood pressure complications during pregnancy. This goes against recommendations for women to avoid drinking alcohol during pregnancy. The main reason for this is that heavy use of alcohol during pregnancy has been linked to a long-term and irreversible condition known as fetal alcohol syndrome that can cause long-lasting physical and developmental problems. The medical evidence supporting strict abstinence from alcohol during pregnancy is not very strong. Will there be consensus about whether it’s safe for a pregnant woman to have a glass of wine or a beer once or twice a week? I don’t think we will see that any time soon.

12 ways to help a child make the transition to kindergarten

For some children, beginning kindergarten represents a scary transition. They wonder about making new friends and getting used to a new teacher—will they be able to find the bathroom, where will they eat snack, how will they fit in? There are several ways to help make the transition a smooth one. These include acknowledging the child’s fear as real and appropriate while offering reassurance, talking about the transition in a positive way, doing play therapy at home, visiting the school beforehand if possible, and reading to the child about starting kindergarten.

Patrick J. Skerrett

Falling TVs injure 17,000 kids a year

More than 17,000 American youths end up in emergency departments each year with injuries from a falling television set. Two-thirds of them are under age 5, according to a report published online today in the journal Pediatrics. From 1996 to 2011, nearly 400,000 children under 18 years old were treated in emergency departments for TV-related injuries. In 1996, most of the injuries occurred when kids ran into television sets. By 2011, injuries from falling TVs dominated. The rate of TVs falling from dressers, bureaus, chests of drawers, and armoires nearly quadrupled. The authors of the study suggest that adding TVs to the list of furniture types that come with anti-tip devices “would be an important step in decreasing the number of injuries resulting from falling TVs.”

Heidi Godman

Think fast when kids want fast food

An army of nutrition experts is constantly reminding us that most fast food is bad for health. But they’re not around to back you up when your children or grandchildren unleash powerful weapons of cuteness to convince you to stop at a fast-food chain. It’s hard not to give in when the ones you adore put on the pressure, even when they’re older. One new study links several weekly fast-food meals with increased risks of asthma, rhinitis, and eczema. Another shows that when kids eat out they take in up to 300 more calories than when eating at home. Stacey Nelson, a registered dietitian who is a clinical nutrition manager at Harvard-affiliated Massachusetts General Hospital, offers some advice for when fast food is the only option.

Dennis Rosen, M.D.

Why “sleeping in” on weekends isn’t good for teens

After getting too little sleep Monday through Friday, many teens try to catch up on weekends, sometimes straggling out of bed after noon. While they may feel like they are doing their bodies a favor, they actually aren’t. Sleeping late on Saturday and Sunday may fill a teen’s sleep deficit, but it creates a bigger problem. It allows his or her inner clock to further drift away from the external clock, worsening the shift begun by delaying bedtime on school nights. The result: the circadian sleep is thrown out of whack, which makes it much more difficult to get up at the usual wake time. In effect, by sleeping late on Saturday and Sunday, your teen is suffering from the equivalent of a five-hour jet lag when it’s time to get up on Monday morning. The alarm clock may be saying 6:00 am, but his or her inner clock is reading 1:00 am. This will make it much harder for your teen to concentrate and take in anything at school.

Patrick J. Skerrett

Studies explore global burden of disease and heart disease in the United States

If you like numbers and statistics, especially those about health, two reports released this week should keep you occupied for days: the massive Global Burden of Disease study was published in The Lancet, and the American Heart Association released its annual “Heart and stroke statistics” report. The Global Burden of Disease project found that average life expectancy continues to rise in most countries. It also found that infection and other communicable causes of disease no longer dominate deaths and disability. Today, so-called non-communicable causes like traffic accidents, violence and war, heart disease, cancer, and other chronic conditions account for two-thirds of world deaths and the majority of years lost to disability and death. According to the American Heart Association’s annual report, the percentage of deaths due to heart attack, stroke, and other cardiovascular diseases has fallen by nearly one-third since 1999, but don’t expect that to continue. Increases in high blood pressure, high cholesterol, diabetes, overweight, and inactivity threaten to reverse these gains.

Patrick J. Skerrett

New treatment for head lice effective with one dose and no combing

As a parent who has dutifully combed nits from my children’s hair, the promise of a no-comb treatment for head lice sounds mighty appealing. An article in today’s New England Journal of Medicine looks like a slam dunk for such a treatment, a medication called ivermectin (Sklice). In two trials, one dose of ivermectin and no nit-combing did vastly better than a placebo treatment. Side effects were also minimal. Keep in mind that the trials didn’t test ivermectin against the current standard treatment using lotions made with permethrin or pyrethrins. And they included under 800 people in carefully controlled situations. That means we don’t really know the true effectiveness, side effects, safety profile, and interactions with other drugs. Until more is known about side effects and how ivermectin stacks up against other treatments, it seems wise to follow the current guidelines from the American Academy of Pediatrics. They call for the use of an over-the-counter product containing permethrin or pyrethrins as a first salvo against head lice, along with combing wet hair with a fine-toothed comb to remove nits.

Patrick J. Skerrett

Puberty starts earlier in many American boys

Two years ago, new research showed that American girls were hitting puberty at younger ages than ever. The same thing is happening with boys: they are starting puberty almost two years earlier than they did 30 to 40 years ago. Why this is happening isn’t clear, but it could affect social and sexual behaviors. A new study shows that the average age of puberty is now 10 years for white boys (about one-and-a-half years earlier than what has long been considered “normal”), 9 years for African-American boys (about two years earlier than expected), and 10 years for Hispanic boys, which is unchanged from before. Although early puberty is increasingly common, it can be a signal of a tumor in the brain, pituitary glands, or elsewhere; an underactive thyroid gland; or other medical problems.

Michael Craig Miller, M.D.

The angry adolescent — a phase or depression?

A friend once asked me about his son, who was about to turn 20. As a teenager, the boy had a quick temper. But now, on the brink of adulthood, the young man seemed to be getting worse. When a teen gets angrier as time goes by, it is a cause for concern. A 19-year-old is no longer a child, but neither is he or she a fully-fledged adult. This in-between state can extend well into the twenties. Some human development researchers have begun to call it “emerging adulthood.” No matter this stage is called, it presents a tricky time for parents and their children. Emerging adults must decide how much help they want or are willing to accept from their parents or anyone else. At the same time, parents must decide how much help it is reasonable to give.