Talking to Children about Tragedy


Tips for speaking to your children about tragedies such as shootings, mass disasters, natural disasters.

US National Archives kids

Photo courtesy of National Archives

Unfortunately there have been shootings and other tragedies in many communities, large and small, in America. Children and teenagers are affected by disasters and tragedies just as are adults.

The most important thing that a parent can do is ask the child or teen his or her understanding of the tragic event, so that the child feels comfortable expressing emotion. Silence suggests to the teen that the subject is too awful to even discuss, even though of course, the teen is thinking and worrying about the event. Start by gently correcting any misconceptions. You don’t have to describe the event in detail, but allowing the child or teen to discuss her feelings is important.

Parents think toddlers don’t understand what they see on television, but toddlers recognize the emotions their parents are feeling. Preschool children may regress in their behavior and become more clingy. They may start sucking their thumbs, or wetting the bed. Other toddlers may act out. Strong emotions bring out strong behavior. When toddlers, preschool, and school age children see the disaster or tragic event on television, they think the event is occurring again and again. Keeping the television off to prevent retraumatization is helpful. Recording television programs and reviewing the broadcasts before the children see it can be helpful. Watching the television with your child so he can ask questions is also helpful.

School age children may also either act out or regress in their behavior. Sleeping in parents bed or skipping chores for a day or two is okay! It allows the child to feel more secure and safe. Security is a huge concern for children. Make sure they know that measures have been taken by law enforcement or the community, or that your family has a safety plan.

With teens, they may feel that life is meaningless and may take more risks than normal. Watch for this type of behavior because risky behavior can affect the adolescent in a significant way. Discussing positive actions carried out by heroes or bystanders can also be helpful. The teen may want to be closer to their parent for a period of time, to feel safe, and that is fine. Trouble sleeping and a decline in grades (transiently) can also occur. Some teenagers may try to avoid the people and situations that occurred at the time of the tragedy because these triggers cause

If your child or teen continues to have negative feelings and depression after 2 weeks, professional consultation with a physician, psychologist, or counselor will be helpful.

Last updated by Dr. Vee on October 22, 2015.

Tips to Make Your Halloween Safe!


Take your kids to fun and safe trick-or-treating event in Myrtle Beach, S.C.

Pumpkin carving safety

Only Adults Should Carve Pumpkins

  • Never let children carve pumpkins. Kids can help by drawing a pattern on the pumpkin and removing the pulp and seeds once the pumpkin is cut.
  • A sharp knife can become wedged in the thicker part of the pumpkin, requiring force to remove it, causing hand injury when the knife finally dislodges from the thick skin of the pumpkin. Injuries are also sustained when the knife slips and comes out the other side of the pumpkin where your hand may be holding it steady.

Use a Pumpkin Carving Kit

  • Special kits are available in stores and include small, serrated pumpkin saws that work better because they are less likely to get stuck in the thick pumpkin tissue.
  • When cutting, adults should cut away from themselves in small, controlled strokes.

Help for An Injury

  • If you cut your finger or hand, apply direct pressure to the wound with a clean cloth. If pressure does not slow or stop the bleeding within15 minutes, be evaluated in the Emergency Room

Halloween Safety Tips

Costume Safety

  • Be sure your kids are wearing flame-resistant costumes.
  • Never walk near lit candles or luminaries.
  • Keep candle-lit Jack O’Lanterns and luminaries away from steps, walkways, sidewalks, landings, and curtains.
  • Place Jack O’ Lanterns on sturdy tables, keep them out of the reach of pets and small children, and never leave them unattended.
  • For greater visibility attach to costumes reflective tape that will glow in the beam of a car’s headlights. Halloween bags should also be light colored or decorated with reflective tape. Reflective tape is usually available in hardware and sporting goods stores.
  • Children should carry flashlights while trick or treating to see where they are walking and so that cars can see them as they walk
  • Costumes should be short enough to prevent children from tripping and falling.
  • Children should wear well-fitting, sturdy shoes to prevent trips.
  • Apply a natural mask of cosmetics (avoiding the eye area) rather than a loose-fitting mask that might restrict breathing or obscure vision. If wearing a mask make sure keyholes are large enough to allow good vision
  • If wearing a mask, use a well-fitting masks to avoid blocked vision
  • Swords, knives, and similar costume accessories should be soft and flexible to avoid injury.
  • Test makeup on a small patch of skin before applying to face or body.
  • Don’t decorate your face with things that are not intended for skin
  • Do not use face paint near the eyes, even if the label has a picture of people wearing it near the eyes.

Diagram showing ways to prevent accidents on halloween costumesPhoto:Consumerist|CC

Trick or Treating Safety

  • Young children should always be accompanied by an adult or an older, responsible child.
  • All children should walk, not run from house to house and use the sidewalk if available, rather than walk in the street.
  • Children should be cautioned against running out from between parked cars, or across lawns and yards where ornaments, furniture, or clotheslines present dangers.
  • Glow sticks contain a liquid that produces a temporary burning sensation and bad taste in the mouth when tasted. Small amounts that are swallowed are generally not harmful.

Choosing Safe Houses:

  • Children should go only to homes where the residents are known and have outside lights on as a sign of welcome.
  • Children should not enter homes or apartments unless they are accompanied by an adult.

halloween-safety.jpg

Halloween Candy Safety

  • Before kids go trick-or-treating, serve a healthy meal so they’re not hungry when they collect candy.
  • To prevent temptation, know how much candy your child has collected and don’t store it in his or her bedroom.
  • Consider being somewhat lenient about candy eating on Halloween, within reason, and talk about how the rest of the candy will be handled. Candy and snacks shouldn’t get in the way of kids eating healthy meals.
  • If a child is overweight — or you’d just like to reduce the Halloween stash — consider buying back some or all of the remaining Halloween candy. This method acknowledges the candy belongs to the child and provides a treat in the form of a little spending money.
  • Be a role model by eating Halloween candy in moderation yourself. To help avoid temptation, buy your candy at the last minute and get rid of any leftovers.
  • Encourage your kids to be mindful of the amount of candy and snacks eaten — and to stop before they feel full or sick.

Alternatives to Candy

You also can offer some alternatives to candy to the trick-or-treaters who come to your door. Here are some treats you might give out:

  • Non-food treats, like stickers, toys, temporary tattoos, false teeth, little bottles of bubbles and small games, like tiny decks of cards (party-supply stores can be great sources for these)
  • Snacks such as small bags of pretzels, sugar-free gum (for older kids), trail mix, small boxes of raisins, and popcorn
  • Sugar-free candy
  • Small boxes of cereal
  • Avoid toys that could pose choking hazards to very young children.

Children Trick-or-treating

Children Trick-or-treating — Image by © Royalty-Free/Corbis

Candy Safety

  • Parents should instruct their children not to open their candy until they return home.
  • Inspect all candy for tampering before allowing them to start eating.
  • Accept only wrapped and packaged candy.
  • Do not eat candy that has been unwrapped or opened.
  • Never eat fruit or other unwrapped items.
  • Prevent a stomach ache by limiting 2- 3 small pieces of candy at a time.
  • Throw away any candy or food that is not wrapped tightly by the candy company.
  • Accept and give out candy that isn’t easily unwrapped. Candies such as Tootsie Rolls, hard candies and certain bubble gums with twist-type wrappings can be tampered with more easily than those that are sealed.
  • When in doubt, throw it out
  • Keep small hard candies, gum, peanuts, from children under the age of five because it is a choking hazard.
  • Keep chocolate candy, raisins, and macadamia nuts away from dogs. It is toxic to them, even in small amounts.

References:

Kids Health.org

American Society for the Surgery of the Hand

CDC. gov

American Academy of Pediatrics

AAA

PismoBeach.org

Red Cross

MyrtleBeach.com

Halloween Safety - AAA

Last Updated by Dr. Vee on October 14, 2015

How to Please a Picky Eater (Toddler or Teenager)


Top 5 Mistakes Parents Make with a Picky Eater

  1. Forcing a child to eat everything put on the table for a meal
  2. Bargaining with a child to eat healthy items in a meal in order to get a dessert or treat
  3. Not re-introducing a food item if the child doesn’t like it the first time
  4. Parents don’t eat healthy food themselves but expect their children to eat healthy food
  5. Stocking the refrigerator and pantry with junk food but expecting a child to choose healthy items over the non-nutritious snacks

1. Forcing a child to eat everything put on the table for a meal

  • A child doesn’t have to eat everything on the table, but should try at least one bite. If after the bite he says, “No, thanks” at least you’ve exposed the child to the new food.
  • Don’t force a child to eat an entire serving of something she doesn’t like, but don’t make a separate meal for the child
  • Remember, kids will not starve! They will learn to be more flexible with food choices rather than go hungry.
  • If a child skips a meal because he doesn’t like anything, the child will be hungry enough at the next meal to be more willing to eat what is served
  • Try to include at least one item the child likes at every meal, but don’t avoid all items the child does not like.
  • Don’t threaten or punish—this only results in power struggles with your child!

2. Bargaining with a child to eat healthy items in a meal in order to get a dessert or treat

  • Bargaining does not work long term to help the child learn to eat and enjoy healthy food such as vegetables.
  • It also promotes the false belief that a cookie or cupcake or other dessert item has more value than the healthy food item

3. Not re-introducing a food item if the child doesn’t like it the first time

  • The 10-15 Rule: Studies show that it can take up to 10-15 tastes of one kind of food before a child accepts or likes the food. Repetition is important!

4. Parents don’t eat healthy food themselves but expect their children to eat healthy food

  • Parents are the best role model for their kids. It helps if they eat the kind of food they want their children to eat. If parents don’t eat vegetables or fruits, chances are, their kids won’t either. 
  • If kids see their parents ENJOYING vegetables and fruits, they are more likely to choose to eat them as well.

5. Stocking the refrigerator and pantry with junk food but expecting a child to choose healthy items over the non-nutritious snacks

  • Don’t stock unhealthy items like candy. If a child is hungry, give her the choice of two healthy snacks to eat instead of giving in to the candy that she requested
  • Put healthy foods like cut up fruit where your toddler or teenager can quickly find them when they are hungry.
  • Avoid giving milk or juice before a meal to pacify hunger. This prevents kids from eating the rest of the meal
Home made macaroni and cheese, with some dried...

Home made macaroni and cheese, with cauliflower. (Photo credit: Wikipedia)

Some ideas to encourage your kids to eat a healthier, wider variety of food:

  • It is normal for kids to eat less as they turn one year of age because of slowing of their growth at this age. At age two toddlers want to make their own food choices. Many toddlers appear to be picky eaters to parents because they don’t like to try new foods and prefer to snack.
  • It’s normal for kids to like one thing one day and not like it the next, or want the same food three days in a row and then say they are sick of it. In general, try to avoid preparing only the things a child eats—say prepared chicken nuggets, hot dogs and macaroni and cheese, to the exclusion of other food.
  • Involve your child in food shopping so that she can choose the vegetables and fruits she wants to try. Kids are more likely to eat a food they picked out. Remember not to bring your kids to the grocery store when they are hungry. Set ground rules in advance of shopping: no candy, no soda, no sugary snacks or cereal. They can choose any fruits and vegetables as long as they are willing to try them when brought home.
  • Involve your kids in making meals. They are more likely to eat the food “masterpiece” they made. Making cooking a fun experience will encourage kids to eat the food they cooked.
  • Kids are also more likely to eat food they have helped grow, so a having your child involved in a home garden or going to the farmer’s market will encourage them to eat more vegetables.
  • Avoid “grazing” all day long, because prevents a child from learning when he is hungry or full. Kids learn to manage their appetites by knowing when meals and snacks will be available.
  • Don’t encourage filling up on snacks, especially junk food or sugary snacks, because kids will learn to skip meals and eat only the unhealthy snacks.
  • Breastfed or formula fed babies should eat on demand because this is a period of high growth. Toddlers also need three meals and up to three snacks a day, so they should be encouraged to have a healthy snack before meals.
  • Let kids as young as 9 months of age feed themselves. Children should be able to use utensils by age 15-18 months. Having this control will help kids learn how much food it takes to fill them up and not overeat.
Healthy Berries are Good Food for Health

Photograph used with permission from epoSo.de

It is ok to disguise healthy foods in your kids’ favorite dishes:

  • Kids generally love pizza. Kids will eat vegetables like broccoli or spinach if it is on a pizza
  • Add a healthy vegetable like cauliflower to a kid pleaser like macaroni and cheese.
  • Add fruits or even vegetables to “milk shakes” Adding pre-frozen fruit to smoothies gives them a creamier texture similar to a milkshake.
  • Combine dried fruits, unsalted nuts and unsweetened cereal for a healthy snack mix
  • Make yogurt parfaits with fruit and granola. Even kids who won’t eat yogurt, fruit or granola separately tend to like them when they are served up as an appealing parfait.
  • Kids love peanut butter and jelly. Add peanut butter to celery sticks or apples for a healthy snack.
  • Add pureed vegetables like spinach to homemade hamburgers or turkey burgers
  • Add vegetables like squash or zucchini to spaghetti sauce. Kids tend to like pasta, so adding any vegetable to a pasta dish makes it more palatable to kids.
  • Add pureed cauliflower to mashed potatoes
  • Substitute sweet potatoes for French fries, and bake in the oven instead of deep frying.
  • Make baked vegetable “fries” or “fingers” by coating zucchini, eggplant or squash with egg substitute and bread crumbs
  • Make homemade baked chicken fingers coated with parmesan cheese and breadcrumbs instead of the fast food variety.
  • Légumes

    Photo credit: Wikipedia

    Carrots and corn are vegetables with high natural sugar content, so these are good vegetables to make in a pinch for picky eaters

Pay attention to the texture of foods or the way it is prepared. For example, some kids love applesauce but not raw apples.

Some kids will only eat vegetables if it is with a sauce, and others will eat only if there isn’t any sauce

Kids often prefer stir fried veggies (use a small amount of canola or olive oil) to steamed

  • Add vegetables like broccoli to a baked potato
  • Sometimes kids don’t like “mushy” foods. Cooking vegetables so they are tender-crisp may be more appealing to these children.
  • Yes, it is ok to add a small amount of ketchup or barbecue sauce to any food item including broccoli if it will encourage your child to eat the food item.
  • Make healthy whole grain waffle “sandwiches” (no syrup) containing lunch meat or vegetables inside. Use hummus or salad dressing as a spread inside the waffle.

Last Updated by Dr. Vee on October 22, 2012

  • English: vegetables

    (Photo credit: Wikipedia)

Healthy Chicken and Mushrooms Fricassee


To help busy people and families shop for, prepare, and serve healthy meals, the National Heart, Lung, and Blood Institute (NHLBI) of NIH created and published Keep the Beat Recipes: Deliciously Healthy Dinners. The new cookbook features 75 simple and delicious recipes influenced by Asian, Latino, Mediterranean, and American cuisine that are good for your heart and taste great, too.

Chicken and Mushroom FricasseePhoto: Keep the Beat Recipes

Chicken and Mushroom Fricassee

Serves 4

Ingredients:

1 Tbsp olive oil
1 carton (10 oz) white button mushrooms, rinsed and quartered
1 Cup leeks, split into quarters, then sliced into small squares and rinsed well
1 Cup potatoes, peeled and diced
1 Cup celery, rinsed and diced
1 Cup pearl onions, raw or frozen
3 Cup low-sodium chicken broth
1 lb skinless chicken legs or thighs (4 whole legs, split, or 8 thighs)
2 Tbsp each fresh herbs (such as parsley and chives), rinsed, dried, and minced (or 2 tsp dried)
1 Tbsp lemon juice
1 Tbsp cornstarch
2 Tbsp fat-free sour cream
½ tsp salt
¼ tsp ground black pepper

Instructions:

  1. Preheat oven to 350º F.
  2. Heat olive oil in a medium-sized, heavy-bottom roasting or braising pan (a large sauté pan with a metal handle will work as well).
  3. Add mushrooms to pan, and cook until golden brown, about 3–5 minutes. Add leeks, potatoes, celery, and pearl onions, and continue to cook until the vegetables become soft, about 3–5 additional minutes.
  4. Add chicken broth to the pan, and bring to a boil. Add chicken legs to the pan, cover, and place in the heated oven for about 20 minutes or until the chicken legs are tender when pierced with a fork (to a minimum internal temperature of 165° F).
  5. When chicken legs are tender, remove legs from the pan, return the pan to the stovetop, and bring the liquid to a boil. Add herbs and lemon juice.
  6. In a bowl, mix the cornstarch with the sour cream, and add to the pan. Bring back to a boil and then remove from the heat.
  7. Season with salt and pepper, and pour 1 cup of vegetables and sauce over chicken.

Nutrition Information Per Serving: Calories 242, Total Fat 9 g, Saturated Fat 2 g, Cholesterol 42 mg, Sodium 430 mg, Fiber 3 g, Protein 20 g, Carbohydrates 24 g , Potassium 807 mg
* Recipe taken from Keep the Beat Recipes: Deliciously Healthy Dinners, from the National Heart, Lung, and Blood Institute

Last Updated January 16, 2012 by Dr. Vee

Restriction Elimination Diet Helps ADHD Without Medication


Photographs courtesy of epSos.de

The INCA study was a placebo controlled study carried out in the Netherlands that showed a hypoallergenic diet helps treat hyperactivity, inattentiveness and oppositional defiant behavior (such as temper tantrums!) in children not on stimulant medication.

The restriction elimination diet included turkey, lamb, rice, water, salt and pepper, and many vegetables, including cauliflower and cabbage. Children were then challenged with foods, added back one by one, to see which foods caused worsening attention and behavior symptoms. Surprisingly, foods that worsened symptoms in an individual child did not correlate to high IgG immunoglobulin levels as would be expected in food allergy/intolerance. IgE allergy to food was not tested. The authors recommend that food allergy testing not be used to guide food therapy in children with ADHD, instead eliminating food that clinically caused problems in a particular child.

The details of the restriction elimination (RED) diet and the Food Journals used by families enrolled in the study are included n the appendix of the journal The Lancet.

An important detail of this study is that all children were screened to determine if they actually met criteria for ADHD, were of school age and did not take any stimulant medication.

Remember that many kids with ADHD have been found to have zinc deficiency, so it is a good idea to supplement with a multivitamin/mineral. High doses of zinc are not recommended.

Here is my WJXT Morning Show interview discussing a hypoallergenic diet and ADHD.

Reference:

Dr Lidy M Pelsser MSc, Klaas Frankena PhD, Jan Toorman MD, Prof Huub F Savelkoul PhD, Prof Anthony E Dubois MD, Rob Rodrigues Pereira MD, Ton A Haagen MD, Nanda N Rommelse PhD, Prof Jan K Buitelaar MD. Effects of a restricted elimination diet on the behaviour of children with attention-deficit hyperactivity disorder (INCA study): a randomised controlled trial. The Lancet, Volume 377, 5 February 2011 doi:10.1016/S0140-6736(10)62227-1.

Last updated by Dr. Vee on October 22, 2012

Super Foods for Kids


Photograph of Pumpkin Soup Courtesy of Egal


Superfoods are foods packed with higher than average nutrients and antioxidants to fight cancer and heart disease

1. Berries. Blackberries, blueberries, strawberries, raspberries and cranberries—rich in antioxidants.

• Chokeberries and elderberries (difficult to find) are berries with the greatest antioxidant content

2. Pumpkin—use canned pumpkin (not pumpkin pie mix).

• Has antioxidants vitamin A, E and beta carotene.
• Use in pumpkin pancakes, soup, pumpkin ravioli (fun to make with the kids).

3. Dark Chocolate

• Avoid chocolate with refined sugar, milk fats and hydrogenated oils.
• Want high purity cocoa powder that is high in antioxidants. Avoid cocoa that has been alkalinized by the Dutching process (boils away nutrients). Label should state cocoa/dark chocolate has not been alkalized, has been dried and cold pressed rather than roasted.
• Should consist of at least 70% cocoa
• use cocoa butter instead of milk fats or hydrogenated oils
• contain natural, low glycemic sweeteners such as raw sugar cane rather than refined sugars

4. Nuts have omega 3 Fatty acids.

• Almonds and walnuts are the healthiest source. Almond butter.
• Child’s handful daily.

5. Popcorn—lots of fiber.

• Use unsalted and unbuttered.
• No more than three cup serving (not the huge bag at the theater!).
• It is better to pop popcorn yourself (and more fun with the kids!) than to eat pre-packaged microwave kind. Microwave containers have perfluorooctanoic acid (PFOA), a fluorotelmer in the lining of the bag. Can leak into popcorn during microwave cooking. to infertility, liver, testicular, and pancreatic cancer. Popcorn manufacturers have promised to voluntarily phase out PFOA by 2015 under a voluntary EPA plan. Accumulates in the body and stays there for years.
• Wait until age one to serve corn and age four for popcorn to avoid choking hazard

6. Antioxidant Lycopene in tomatoes (and tomato ketchup—does that make it a health food????).

•prevention of cancers of the prostate, pancreas, stomach, breast, cervix and lung
•prevention of heart disease
•Better available when tomatoes are cooked, packed in oil or in tomato juice (but these forms have high levels of sodium or dietary salt)
Whole wheat pasta with marinara sauce is a good source of lycopene

7.Cruciferous (like a cross) vegetables (cauliflower, broccoli, Brussel Sprouts)—steam lightly–nutrients remain even after cooking. (Nutritious value of broccoli INCREASES when cooked).

Vitamin C and K, beta carotene (powerful antioxidant converted to vitamin A in the body), iron, folic acid and potassium.

Contains phytochemicals which prevent cancer by preventing damage to cell DNA. Sulphorophanes prevent damage from carcinogens.

Broccoli sprouts have more sulphorophanes than bean sprouts.
Healthiest cruciferous plant is kale, which is a superfood because it is a great source of antioxidant vitamin C, vitamin A, vitamin K, and micronutrients that help eye health (lutein and zeaxanthin). Mix a little in a fruit smoothie or mix in cooked dishes.

8. Beans/lentils-Black beans have the highest concentration of the antioxidant anthocyanin phytonutrients. Other beans with high levels of antioxidants include soybeans, navy beans, split peas, lentils, pinto beans and garbanzo beans.

•Can make soups and hummus.
•Packed with protein, complex carbohydrates (low glycemic index) and fiber.
•Good source of iron, magnesium, folate, calcium, potassium, and zinc. Use in hummus, soups.

9. Sweet potatoes
•twice the recommended daily allowance of vitamin A
•42 percent of the recommendation for vitamin C
•four times the RDA for beta carotene,
•When eaten with the skin, sweet potatoes have more fiber than oatmeal.
•130 to 160 calories for small to medium sweet potato
•Cinnamon added to sweet potato helps stabilize blood sugar.
•Sweet potato digests more slowly than white potatoes so they are lower glycemic load.

10.Whole grain breads instead of wheat or white bread. Whole grains are rich in fiber and vitamin E

•very low in fat
•The germ and outer coating in wheat and other grains has most nutritional value. Avoid refined grain foods such as white bread and certain breakfast cereals.
•Whole grains typically fortified with folic acid, B vitamins, iron, and zinc.me whole grain breakfast cereals contain added calcium and vitamin D, too.
•Give kids whole grain breakfast cereals instead of highly processed, sugary cereals. Use whole grain breads for toast and sandwiches, whole grain crackers for snacks, oat bran muffins.
•brown rice instead of white
•quinoa, buckwheat, barley
•whole wheat pasta.
•Add roiled oats to meat loaf

11. Red grape juice—has resveratrol (a flavenoid antioxidant that protects agains blood clots and heart disease) like in red red wine.

• Be careful of sugar—dilute with water and limit intake, especially in toddlers.
•Cranberries and pomegranate juice provides antioxidants, but be careful of the concentrated sugar in juices.

Fatty Cold Water Fish– heart healthy omega-3 fatty acids.

• Choose wild-caught Alaska salmon over farmed salmon. Farmed salmon has been shown to contain 10 times more toxins, including Polychlorinated biphenyls (PCB) and dioxin, than wild salmon. Farmed salmon are fatter, and the PCBs are stored in this fat. In addition, salmon farms can harbor parasites. Some salmon farms use artificial colorings, which may be harmful to health.
• No more than two or three ounces fish/week for children between the ages of two and six years old.
• Canned tuna is composed of smaller tuna types such as skipjack and albacore (more mercury in albacore than white tuna). In general, the smaller the fish, the less potential for mercury.
• Stick with one tuna fish sandwich weekly in children
• Careful with tuna steaks (made from larger, older tuna which have accumulated mercury).
• Avoid fish such as grouper, tilefish, shark due to high mercury content

Last Updated by Dr. Vee on February 14, 2011

Mirror Mirror On the Wall, Which Friday is Blackest of Them All?


Photograph Courtesy of Gina Smith

I’m in a panic because it is November and I have already missed the “first” Black Friday and now am about to miss the “second” Black Friday of the holiday season. I am fascinated by the marketing phenomenon of this year’s “early” Black Friday. “Traditional” Black Friday (I am waiting for the greeting card industry to get in on this one so I have yet another card to send during the year) is, of course as every smart American shopper knows, the day after Thanksgiving. (Another requirement for a greeting card, I rest my case.)

Last year, a few “genius” manufacturers decided to advertise an “early” Black Friday and they scored a home run in sales. In response, this year, many retailers, desperate for business in difficult economic times, started “early” Black Friday advertising (AKA “sales” and “deep discounts”) as early as July.

No wonder parents feel like a pawn in the endless sea of toy and electronic gadget advertising, aimlessly trying to determine which toys will be “the IT toy” of the holiday season. (Hint: Cabbage patch dolls are NOT hot this year!). Not necessarily the most fun toy, but the item that one “must have.” Kids are still determining which toys they “must have” from Santa this year while manufacturers jockey for position to be the “ultimate number one” toy to have in 2010. (Ta Da!)

I am embarrassed to say that as a pediatrician and a parent, I too have succumbed to the pressure of finding the “IT” toy before the item “runs out” and I have to buy it online for ten times the suggested retail price. Of course, suggested retail price is a relative term, determined primarily by the phenomenon of the “sale” price. I’d rather spend $30 on a toy that is “slashed” from the suggested retail price of $60 than actually buy an item that costs the suggested retail price of $30. And if I can find a coupon for $5 off, well, I am in parents’ retail heaven.

Whew, I am sweating at the mere thought of not being able to get the “right toy” so that my child is not an outcast at school for getting that “educational” holiday present (AKA books or “reading material”). Parents (AKA “consumers”) are now used to the annual ritual of fighting for a small supply of the most popular toys (which will surely be determined by a multitude of manufacturing experts writing online articles now that the first two “early” Black Fridays are over so that one may prepare for the “original” Black Friday, followed by the “late” Black Fridays of the holiday season.) Parents are forced by manufacturers to believe that a toy can’t be valuable unless it is in short supply. The aura of a holiday present is not quite the same unless your Santa gets it when other kids’ Santas were unable to find it in time for the holidays! (Of course finding a coupon and a “drastic reduction” in price helps. None of us wants to admit going overboard on holiday presents!).

Of course the unknown deciding factors this year are the holiday movies geared toward children and teenagers. Can one really accurately determine the “best toys of 2010” until after the movies have come out? (Surely they will be released on what will be known as the third and fourth “early” Black Fridays of this year.) That’s a lot for parents to think about (along with internet safety, bullying and underage drinking)!

How is a parent to deal with all of this? Well go on the internet of course! Right after each Black Friday, there will be plenty of retail “experts” writing internet articles telling us which items are the “official” “must have” items for 2010. I have already read ten “Top Ten Toys of 2010” lists online in the time it took me to write this blog post!

For a second there, I toyed with the idea of dawdling enough to get presents at the “the last and final early Black Friday” of 2010, also known as the “Day after Christmas sale,” which I now believe will be called “the first earliest Black Friday of 2011.” Nah…

Last Updated by Dr. Vee on November 26, 2010

The Tylenol Recall–What a Headache!


This week I went to my sample closet looking for recalled versions of McNeil children’s products. Yes, even some samples were recalled! Fortunately, I found out that I don’t have samples of any of the items. I used to be upset that I rarely received samples of Tylenol or Motrin brands, because it is nice to be able to give some to a parent when their child has a fever (or after immunizations) so that the parent does not have to stop at the store on their way home.

I guess I should be glad that I do not have to track down any patients to whom I have given samples. Since I have received a lot of telephone calls from anxious parents, I thought I better research the recalled items further.

McNeil Consumer Healthcare is initiating this voluntary recall because some of these products may not meet required quality standards. This recall is not being undertaken on the basis of adverse medical events…Consumers can contact the company at 1-888-222-6036 and also at www.mcneilproductrecall.com.”

McNeil products websites go on to say, “Some of the products included in the recall may contain a higher concentration of active ingredient than is specified; others may contain inactive ingredients that may not meet internal testing requirements; and others may contain tiny particles.”

McNeil has also recalled certain forms of Motrin Infant Drops (berry flavored) and Children’s Motrin ® berry flavored, dye free suspension. Remember that the infants’ version of any pain reliever is typically more concentrated than the children’s version, and so should not be used in children over the age of one year.

Even certain hospital versions of Children’s Motrin have been recalled, as well as doctors’ samples. Children’s Motrin Cold Formulas have been recalled as well. Remember, over the counter cold medicines are not safe (and also not found to be effective) in children under the age of nine. I wrote about the 2008 recall of over the counter cold medicines on the American Academy of Pediatrics website.

Other products recalled include Children’s Zyrtec Sugar Free Dye Free Bubble Gum flavor and Zyrtec grape flavored syrup in several size bottles.

To find out if you have the formulation that is recalled, enter the NDC (identification) number from your bottle body=/zyrtec/pages/ndc_finder.jsp here.

Children’s Benadryl and Infants’ Benadryl drops were also recalled.

You can get a refund or coupon for future purchase by filling out the McNeil form here.

Answers to frequently asked questions about the recalled medications, including how to dispose of unused medicine and what to do if you have given these agents to your child, are also available.

The recall brings up some really important points for doctors and parents. First, any medication ingested potentially could have side effects or cause problems. So you should only take a medicine or give it to your child if you absolutely need it. That goes double for medications like antibiotics, which are often prescribed without thought to sick patients.

Second, in some cases, there are generic versions which can be used instead of the brand name Motrin (ibuprofen), Benadryl (diphenhydramine) and Tylenol (acetaminophen). Other non-sedating antihistamines (except brand name Benadryl) such as loratadine can be used instead of Zyrtec (certirizine).

Last Updated May 9, 2010 by Dr. Vee

The Children’s Television Act 1990-2010


Picture of children watching television courtesy of Heartfelt

Photograph of Mr. Rogers Courtesy of Thoth

The Children’s Television Act (CTA) was passed by Congress in 1990 with the goal of providing educational programming to children that “furthers the positive development of the child in any respect, including the child’s cognitive/intellectual or emotional/social needs 1.”  

In return for providing such educational programming, broadcast stations were given free access to public airwaves.  The Act also required that commercials be limited to 10 minutes an hour on weekends and 12.5 minutes an hour on weekdays. It was hoped that major networks would promote educational/academic shows similar to Sesame Street and Mr. Roger’s Neighborhood.  

However, broadcasters reported shows of questionable educational value as their E/I choices.  For example,  The Jetsons was a show promoted as educational because it dealt with the futue and The Flintstones because it dealt with history.  Although the show GI Joe had violent content, it was hearalded by broadcasters as having pro-social themes.  Leave it to Beaver  was also descibed as educational by networks because it had pro-social messages.

In 1991, the Federal Communications Commission (FCC) required the clear separation of commercials  and television show host sales from children’s programming, since children have a difficult time distinguishing commercial content from the educational content of a show.

In 1996, broadcasters were required to provide a minimum of three hours per week of educational and informational shows targeted to children under the age of 16 during their prime viewing hours of 7 AM to 10 PM.  Since that time, most major broadcasters, other than PBS and Nickelodean have limited their educational children’s programming to just three hours per week. Most shows have pro-social themes that promote self-esteem and altruism rather than academic/educational themes.

In 2004, the FCC delineated educational programming requirements as television transitioned from analog to digital.  Broadcasters, who can have up to six channels of programming in digital instead of one channel in analog, were required to provide the commensurate  amount of children’s educational/informational programming on each of the channels.

In 2005, the FCC required that educational/informational children’s shows had to show the “E/I” label on the television screen the entire length of the show.

The Commission, in 2006, restricted the display of internet websites that contain commercial matter during children’s programming.

In 2007, the FCC entered into a consent decree with Univision to resolve petitions by children’s and media organizations to deny the broadcaster’s license renewal applications.  It was alleged that Univision’s children’s programming did not comply with the educational requirements of the Children’s Television Act.   Univision voluntarily paid $24 million and developed a children’s educational programming initiative.

Children Now, a non-partisan children’s media research and advocacy organization, evaluated educational shows broadcast by the four major networks from 1997-2008 (2).  Findings included a significant decrease in the number of shows found to be “high quality” and an increase in “moderate quality” shows during this time period. 

In 2007-2008, only 13 % of programming described by networks as educational and informational were determined to have high quality measure.   Health and nutrition messages, especially those that addressed childhood obesity prevention, were “extremely rare.”

The report concluded that current television programming does not meet the original intentions of the Children’s Television Act.  Eight shows were found to contain highly educational content by Children Now:

Sesame Street (PBS)

Beakman’s World (Commercial)

Between the Lions (PBS)

3-2-1 Penguins (Commercial)

Cyberchase (PBS)

The Suite Life of Zack and Cody (Commercial)

Fetch! with Ruff Ruffman (PBS)

Teen Kids News (Commercial)

On July 22, 2009, Senate Commerce, Science and Transportation  Committee Chairman Jay Rockefeller, D-W.Va., convened a hearing called “Rethinking the Children’s Television Act for a Digital Media Age.”   The Senator said he planned to introduce legislation to regulate children’s media content, citing his “grave concerns about violence and indecency in the media.”

Since 1990, there has developed an array of new screen media available to children–multichannel television such as cable and satellite TV, video games, video programming on mobile phones, interactive video, videos viewed on internet sites such as YouTube and Hulu, texting with pictures attached, digital multicasting of four to five streams of programming, and the potential for interactive programming made possible by the conversion of broadcasters from analog to digital.

At the Senate Commerce Committee hearing in July of 2009, FCC Chairman Julius Genachowski spoke about the new landscape of video broadcasting and television.  He recommended empowering parents with tools and information to determine the appropriate video content for their children and teenagers rather than government regulation of video content. 

At the same hearing, James P. Steyer, CEO and founder of Common Sense Media, a non-partisan, not-for profit organization that advocates for educational children’s media content, said there were ways to regulate children’s media content without limiting broadcasters rights to free speech. 

A full report from the committee is expected to be released at the end of August 2009.

1. “Policies and Rules Concerning Children’s Television Programming Memorandum Opinion and Order,” Federal Communications Commission Record 6,(1991): p.2114.

2.  Executive Summary: Educationally/Insufficient?  An Analysis of the Availability & Educational Quality of Children’s E/I Programming.  Children Now.

Last Updated May 10, 2010 by Dr. Vee

Lavender and Tea Tree Oil May Cause Breast Development in Young Boys


Lavender and Tea Tree Oils May Mimic Estrogen Effects in Boys

A study published in  the New England Journal of Medicine suggested that the use of topical agents containing lavender oil and/or tea tree oil may cause breast tissue (called gynecomastia) to develop in young boys. This finding was reported by Clifford Bloch, M.D., a pediatric endocrinologist at the University of Colorado at Denver and Health Science Center’s School of Medicine. 

This doctor found that three of his young male patients with unexplained breast development (gynecomastia) had all used lotions, creams, shampoos, styling products or soap with lavender or tea tree oil in them.  Once these products were stopped, the gynecomastia also resolved.

Researchers who conducted laboratory studies at t he National Institute of Environmental Health Sciences (NIEHS), part of the National Institutes of Health (NIH), confirmed that there may be an association between the use of products containing these oils and prepubertal breast development in boys, but cautioned more research is needed.  Large scale epidemiologic studies are needed to determine the association of lavender and tea tree oils and gynecomastia.

Ken Korach, Ph.D., chief, Laboratory Reproductive and Developmental Toxicology at NIEHS confirmed that his laboratory studies confirmed that pure lavender and tea tree oils can indeed mimic the effects of the female hormone estrogen and inhibit the effects of androgens (male hormones).

Interestingly enough, the male and female hormone levels in the three boys with gynecomastia were not changed by their exposure to lavender or tea tree oil. Therefore, Derek Henley, Ph.D., the lead NIEHS author on the study hypothesized that lavender and tea tree oils may be  “endocrine disruptors.”    Endocrine disruptors are agents that interfere with the activity of hormones but not affect the levels of the hormones themselves.  They may alter signaling of the hormones, resulting in abnormal endocrine effects.

Studies are need to decide whether lavender and tea tree oils have the same effects in females or adults.

The National Institute of Environmental Health Sciences (NIEHS),  a part of the National Institutes of Health, supports research to understand the effects of the environment on human health. 

Reference:

Henley DV, Lipson N, Korach KS, Bloch CA 2007 Prebubertal gynecomastia linked to lavender and tea tree oils. New England Journal of Medicine 365(5): 479-485  

 Photograph of Australian Tea Tree courtesy of J. Brew.

Last updated April 18, 2010 by Dr. Vee

           

Homeopathy, Supplements, Omega 3 Fatty Acids and Probiotics in Children


I discussed homeopathy, supplements (including vitamin D and iron), omega 3 fatty acids and probiotics in kids on Melanie Cole’s Healthradio show.
Last Updated January 30, 2010

My Interview about Rear Facing Car Seats being Safer Until Age Two


The Parents Journal

My interview on The Parents’ Journal with Bobbi Conner about “Rear-facing Car Seats being safer until Age Two” is being featured on public radio stations nationwide this week. 

Next week (one week following the Public radio broadcast) the interview will be featured on The Parents Journal Podcast, which can be accessed through The Parents Journal website, so that everyone (world-wide) can listen!

http://www.parentsjournal.com/radioshow

Last edited by Dr.Vee on July 27, 2009