The Real Horror of Trick-or-Treating

Although historically All Hallow’s Eve was dedicated to remembering the dead, including saints (hallows),martyrs, and all the faithful departed believers, these days for most kids Halloween is all about the candy.

It is estimated that by the end of the evening, each child’s bag of goodies contains about 4,800 calories and has 3 cups of sugar and 1 ½ cups of fat. The real horror in the Halloween trick-or-treat bag is the contribution it plays to an already scary epidemic of childhood obesity.

“Kids and teens love Halloween. It’s filled with fun parties and costumes, and free candy. Halloween can be a great time as long as parents make sure their child doesn’t go overboard eating all that candy,” said Garry Sigman, MD, director of the pediatric weight management program at Loyola University Health System.

So how can you balance healthy and happy for your kids this Halloween? Here’s some great tips from Dr. Sigmam:

• Focus on fun, not candy. Find fun activities for your kids to do instead of just walking door-to-door getting candy. Plan a party with fun games or have a pumpkin-carving contest. You could watch a scary movie or have a costume parade.
• Set limits. Limit the time your kids are out trick-or-treating. Instead of the pillowcase look for a small bag that they can use to collect candy. When they get home let them pick out two pieces to eat and then put the rest away in a freezer or hidden place to save for another day. All children should eat no more than one or two pieces of candy a day. If a child is obese he or she should not eat more than one or two pieces of candy a week.
• Host a candy trade-in party. When the kids get back from trick-or-treating the candy in each child’s bag is weighed. Kids can exchange their candy for prizes based on the bag’s weight.

Adults can also help by providing healthier alternatives to candy.  For example: Fruit leathers, packs of sugarless gum, boxed dried raisins, 100-calorie packs of cookies or snacks, granola bars, snack-sized bags of popcorn or non-food treats such as play-doh, spider rings, bubbles, temporary tattoos, sidewalk chalk or cookie cutters.

How are you planning on making your Halloween healthier?

School is in Session and So Too Are Germs

While many parents don’t remember much algebra or calculus, most know all too well that school + kids = sick days.

And with more than 200 cold viruses identified,  it’s no wonder parents feel like they are fighting a losing battle when it comes to keeping their kids healthy.

“Kids will be exposed to germs and inevitably get colds, even with the best preventive measures, and that’s OK,” said Jessica McIntyre, MD, family physician at Loyola University Health System and assistant professor in the Department of Family Medicine at Loyola University Chicago Stritch School of Medicine.

According to McIntyre, young children will get between 7 and 8 colds a year and school-age children will average 5-6 colds a year. Kids tend to get more colds during the school year because they are in an enclosed classroom surrounded by other children who are sharing these very common viruses.

“Parents sometimes worry that they have done something wrong to cause frequent colds, or that their child is not healthy. Actually, cold viruses help build a child’s immune system and are an unavoidable part of growing up,” McIntyre said.

Nevertheless, we bring you some tips to help keep your child’s sick days to a minimum

1. You’ve taught your kids their ABCs –  now teach them their CCCs?
   a. Clean – wash your hands and make sure your kids wash their hands frequently
   b. Cover – cover your cough and sneeze, preferably with a tissue, but if one is not available, cough or sneeze into your elbow
   c. Contain – stay at home if you are sick; germs are one thing that aren’t good to share
2. Family flu vaccines. Everyone who is 6 months or older should be vaccinated. Talk to your physician about which type of vaccine is right for your family members.
3. Have your children wash their hands as soon as they get home from school.
4. Change into “home clothes and shoes.”  It helps keep germs, allergens and dirt out of the house making it easier to keep clean. Plus, you won’t be searching the house for shoes that were kicked off under the couch.This is especially beneficial if you have a young infant at home
5. Wash their lunch box daily. Lunch boxes carry more than veggies and fruit to and from school. They also carry A LOT of germs. If they’re dishwasher safe, run them through the sanitizing cycle at the end of each day. If not, spray them down with vinegar and water and wipe them clean before packing a new lunch
6. Backpacks are another huge germ culprit. They make their way onto tables, beds and desks and can transfer nasty germs to all of these surfaces. Wash backpacks once a week to minimize the spread of germs.
7. Reduce consumption of sugary foods before and during school. Consuming just a teaspoon of sugar weakens the immune system for up to 4 hours. To help the body fight germs, make sure to offer a low sugar breakfast and low sugar lunch. Avoid processed foods as much as possible. They are generally loaded with sugars.

And if you’d still like to do more to keep your little darlings safe, there is some evidence that certain  products can be effective in cold prevention if taken regularly:
(i) Probiotics: 1 gram mixed with milk twice daily
(ii) Vitamin C: 1 gram daily
(iii) Zinc sulfate: 15 mg syrup or 10 mg tablet daily

Despite all that, if they do develop a cold, don’t stress about it!  Everyone gets sick sometimes. And while we all hate to see  kids feeling bad, just remember, when they get sick their bodies are building up their ability to fight future infections.

Test Your ER IQ

As many of our regular readers know, I spend most of my spare time working as a volunteer EMT. The long hours and sacrificed sleep are a small price to pay for the camaraderie, sense of community service and the knowledge that you’re helping people during their worst moments.

Not to mention it satisfies the needs of my inner adrenaline-junkie!

Not knowing what the next call is going to be is both exciting and challenging. Not knowing who or what you’re going to find when you arrive on scene keeps things interesting.  From minor toothache to major trauma, you just never know.

It’s not always high drama. Many calls are probably unnecessary and leave us thinking “You called 911 for that?!?”  Sometimes we may even toss in the odd silent expletive or two!

But we never say it out loud. We’re trained to accept that it’s an emergency to the patient / family even if we don’t regard it as such.  And we accept that sometimes people just don’t know better.

New parents especially, seem to find it difficult to decide whether to take their child to the emergency room in the middle of the night or to wait until morning to see their child’s doctor, or even to recognize that something like crying, in a newborn, is perfectly normal.

Not surprising then that children under 4 account for about 10% of the 115 million emergency room visits a year.  Which is why we welcome a recent initiative by ProMedica Toledo Children’s Hospital.

Through a series of interactive videos, doctors and nurses guide parents through several common medical scenarios including ear pain, asthma attack, ankle pain, allergic reaction,  laceration, sore throat, abdominal pain  and mosquito bites.

In each video, you make the decision to go or not to go to the ER. The expert then explains which choice makes the most sense .  Click on the links above to see if you would make the right decisions.

Should this be mandatory viewing for all parents?  Let us know what you think.

Bring on the Bugs?

Think that keeping your children’s hands and mouths clean is helping them stay healthy?  Think again!  New research from Johns Hopkins Children’s Center reveals that exposure to common antibacterials found in soap, toothpaste, mouthwash and other personal-care products may make children more prone to a wide range of food and environmental allergies.

Using existing data from a national health survey of 860 children aged 6-18, the researchers examined the relationship between the children’s urinary levels of antibacterials and preservatives found in many personal-hygiene products and the presence of IgE antibodies in the child’s blood. IgE are markedly elevated in people with allergies.

“We saw a link between level of exposure, measured by the amount of antimicrobial agents in the urine, and allergy risk, indicated by circulating antibodies to specific allergens,” said lead investigator Jessica Savage, M.D., M.H.S., an allergy and immunology fellow at Hopkins.

While antibacterials and preservatives themselves don’t cause allergies, that these agents appear to play a role in immune system development.

“The link between allergy risk and antimicrobial exposure suggests that these agents may disrupt the delicate balance between beneficial and bad bacteria in the body and lead to immune system dysregulation, which in turn raises the risk of allergies,” Savage added.

In the study, those with the highest urine levels of triclosan – an antibacterial agent used in soaps, mouthwash and toothpaste – had the highest levels of IgE antibodies and their risk for food allergy risk was twice that of children with the lowest triclosan levels. Similarly, children with the highest urinary levels of parabens – preservatives with antimicrobial properties used in cosmetics, food and medications – were more likely to have detectable levels of IgE antibodies and twice the risk of environmental allergens such as pollen and pet dander.

These findings are consistent with the so-called hygiene hypothesis, which has recently gained traction as one possible explanation behind the growing rates of food and environmental allergies in the developed world. The hypothesis suggests that early childhood exposure to common pathogens is essential in building healthy immune responses. Lack of such exposure, can lead to an overactive immune system that misfires against harmless substances such as food proteins, pollen or pet dander.

Just  this week, other new research from the University of California, San Francisco has provided some answers to why children who grow up in homes with pets are less likely to develop allergies.

All of which suggests that parents should put away the hand sanitizer and let their kids play in the dirt with a dog!

Treating asthma leads to better diabetic control

At first glance asthma and diabetes would seem to have very little in common, other than they are both diseases that often appear in childhood.

However, a new study published in the journal Pediatrics shows a new link.  Researchers have found that kids with diabetes may have a higher-than-average rate of asthma, and those with both conditions seem to have a tougher time keeping their blood sugar under control.

Among 2,000 3- to 21-year-olds with diabetes, 11% had asthma – higher than the expected 9% rate among children and young adults in the U.S.

The difference was even bigger when the researchers looked at type 2 diabetes, the form associated with obesity, and usually diagnosed in adults. In that group, 16% had asthma.

Researchers also showed that kids with both type 1 diabetes and asthma were more likely to have poor blood sugar control than their peers who were asthma-free.

The reasons for the findings are not completely clear.  However, the higher rate of asthma among young people with type 2 diabetes suggests a role for obesity, according to lead researcher Mary Helen Black, of the department of research and evaluation at Kaiser Permanente Southern California.

Some past research has found that people with poorly controlled diabetes are more likely to show diminished lung function over time than those with well-controlled diabetes. But the reasons for that are also unknown.

Black suggests the reason may simply be that it’s tougher for kids with type 1 diabetes to control their blood sugar when they have another chronic health problem.

The good news is that when kids with both diseases were on asthma medication, their blood sugar control was better. In particular, poor blood sugar control was seen in less than 5% of those taking leukotriene modifiers such as Singulair, Accolate and Zyflo; compared with about 30% of type 1 diabetics who were not on medication for their asthma.

The researchers are not sure if that means there’s an effect of the asthma drugs themselves. It may just be that kids with better-controlled asthma are also more likely to have well-controlled diabetes.

The bottom line for doctors and parents is to be aware that kids with diabetes may have a somewhat higher rate of asthma – and that those with both may have more trouble with blood sugar control.

Do you or your child suffer from both conditions?  Does this research support your experience?  As always we’d love to hear from you.

Watch Out this Memorial Day!

As we observe this Memorial Day and commemorate the men and women who died while serving in the American military let’s also remind ourselves to take care of the living. Holidays aren’t always fun and games. They also present ideal opportunities for our loved ones to get hurt. From burning themselves on the barbecue on Memorial Day to sticking themselves with carving knives on Halloween or ingesting sharp decorations on Christmas, holidays it seems are hazardous for health.

However, parents should be wary of both routine and out-of-the-ordinary activities on a holiday weekend.  According to a new study published in Pediatrics, children are more likely to suffer injuries from everyday activities, such as playing football, than they are to be victims of holiday-specific pitfalls.

Labor Day and Memorial Day are the top two holidays for injuries.  The study authors from the Center for Injury Research and Policy in Columbus, Ohio, and Ohio State University suggest this is because they are often celebrated outdoors and people are more likely to take part in physical activities.

The researchers collected childhood-related injury information from a nationally representative sample of 98 U.S. hospital emergency departments. They looked at records from 1997 through 2006 over eight holidays: New Year’s, Easter, Memorial Day, Fourth of July, Labor Day, Halloween, Thanksgiving and Christmas. They included injuries occurring in a five-day period around each holiday (two days before and two days after, as well as the holiday itself). The thinking was that people don’t always celebrate a holiday on the day itself, or they might hold festivities over multiple days.

An estimated 5,710,999 injuries related to holidays occurred over the nine-year period. After Labor Day and Memorial Day, the runners up for the most injuries were the Fourth of July and Halloween. Christmas had the least number of injuries.

Boys suffered from most of the injuries (62%), followed by children under 5 (29%). The most common injuries were lacerations (29.2%), and the most injured body parts were the face, fingers and hands.

Close to half of the injuries were sports or recreation related. Only a small portion of injuries were from activities that might be considered specific for the holiday. For instance, just 2.9% of injuries occurring around the Fourth of July were related to fireworks while 8.6% were related to riding bicycles!

SRxA’s Word on Health wishes all its readers a SAFE and HAPPY holiday.

Parents want e-communications with their Kid’s Docs.

Health care reform legislation includes promoting electronic health records to improve the efficiency and quality of medical care. Yet, little attention has been paid to understanding whether parents have an interest in interacting with their children’s physicians in this way.

A new nationwide poll asked 1,612 parents about how they communicate with their children’s health care providers.  Results showed that less than 15% can currently access their physician on-line, although almost half would like to do so.

“Electronic communication between parents and their children’s health care providers offers a lot of potential benefits,” says Matthew Davis, M.D., associate professor of pediatrics and communicable diseases in the CHEAR Unit at the U-M Medical School. “For administrative tasks that almost all parents need to complete, electronic communication can reduce wasted time and minimize frustration for both parents and office staff. For clinical services, parents often have questions about whether minor injuries or illnesses require an office visit; electronic communication provides a way to obtain advice without waiting on hold for long periods of time.”

While having access to electronic methods of communicating with physicians may increase efficiency for parents, challenges exist for widespread adoption of online communication by physicians.

“Some health care providers have expressed concerns about reimbursement for electronic services that require staff time. Others worry about medical liability associated with offering clinical advice via e-mail or the Internet, without examining the patient,” says Davis.

What are your thoughts on this?  Word on Health is waiting to hear from you.