I’M ABSOLUTELY SURE THAT YOUR TEENAGERS ARE AWARE OF THESE SAFETY ASPECTS. NEVERTHELESS, REMIND THEM ONE MORE TIME.

From Federal Trade Commission (FTP) website:

http://www.ftc.gov/bcp/edu/pubs/consumer/tech/tec14.shtm

Your Safety’s at Stake

The FTC suggests these tips for socializing safely online:

• Think about how different sites work before deciding to join a site. Some sites will allow only a defined community of users to access posted content; others allow anyone and everyone to view postings.
• Think about keeping some control over the information you post. Consider restricting access to your page to a select group of people, for example, your friends from school, your club, your team, your community groups, or your family.
• Keep your information to yourself. Don’t post your full name, Social Security number, address, phone number, or bank and credit card account numbers — and don’t post other people’s information, either. Be cautious about posting information that could be used to identify you or locate you offline. This could include the name of your school, sports team, clubs, and where you work or hang out.
• Make sure your screen name doesn’t say too much about you. Don’t use your name, your age, or your hometown. Even if you think your screen name makes you anonymous, it doesn’t take a genius to combine clues to figure out who you are and where you can be found.
• Post only information that you are comfortable with others seeing — and knowing — about you. Many people can see your page, including your parents, your teachers, the police, the college you might want to apply to next year, or the job you might want to apply for in five years.
• Remember that once you post information online, you can’t take it back. Even if you delete the information from a site, older versions exist on other people’s computers.
• Consider not posting your photo. It can be altered and broadcast in ways you may not be happy about. If you do post one, ask yourself whether it’s one your mom would display in the living room.
• Flirting with strangers online could have serious consequences. Because some people lie about who they really are, you never really know who you’re dealing with.
• Be wary if a new online friend wants to meet you in person. Before you decide to meet someone, do your research: Ask whether any of your friends know the person, and see what background you can dig up through online search engines. If you decide to meet them, be smart about it: Meet in a public place, during the day, with friends you trust. Tell an adult or a responsible sibling where you’re going, and when you expect to be back.
• Trust your gut if you have suspicions. If you feel threatened by someone or uncomfortable because of something online, tell an adult you trust and report it to the police and the social networking site. You could end up preventing someone else from becoming a victim.

News Author: Emma Hitt, PhD

February 16, 2011 — A lack of research and regulation associated with energy drinks, combined with reports of toxicity and high consumption, may result in potentially dangerous health consequences in children, adolescents, and young adults, according to a review of scientific literature and Internet sources.

Sara M. Seifert, BS, and colleagues from the Department of Pediatrics and the Pediatric Integrative Medicine Program at the University of Miami, Leonard M. Miller School of Medicine in Florida, reported their findings in a report published online February 14 and in the March print issue of Pediatrics.

According to the review, self-report surveys indicate that energy drinks are regularly consumed by 30% to 50% of children, adolescents, and young adults. The current trial questions the use of energy drinks in these young populations, as they provide no therapeutic benefit and are associated with risks for serious adverse health effects.

The authors note that because energy drinks are categorized as nutritional supplements, they avoid the limit of 71 mg caffeine per 12 fluid ounces that the US Food and Drug Administration has set for soda, as well as the safety testing and labeling that is required of pharmaceuticals. As a consequence, energy drinks can contain as much as 75 to 400 mg caffeine per container, with additional caffeine not included in the listed total often coming from additives such as guarana, kola nut, yerba mate, and cocoa.

“Of the 5448 US caffeine overdoses reported in 2007, 46% occurred in those younger than 19 years,” the authors note.

The recommended maximum caffeine intake of 2.5 mg/kg per day for children and 100 mg/day for adolescents, although safe levels of consumption of other energy drink ingredients have not been established.

Although US poison centers have only recently begun tracking toxicity of energy drinks, Germany, Australia, and New Zealand have reported numerous adverse outcomes associated with energy drink consumption. These include liver damage, kidney failure, respiratory disorders, agitation, confusion, seizures, psychotic conditions, nausea, vomiting, abdominal pain, rhabdomyolysis, tachycardia, cardiac dysrhythmias, hypertension, myocardial infarction, heart failure, and death.

The researchers also note that the caffeine in energy drinks may interfere with bone mineralization during a critical period of skeletal development.

“The marketing of energy beverages is targeting towards males in the preadolescent, adolescent, and young adult ages,” Dr. Higgins told Medscape Medical News. “The fact that a child can walk into a grocery store or supermarket and buy these and consume [them] is frightening.”

Clinical Context

Caffeine has wide and far-reaching effects on human physiology. It causes coronary and cerebral vessel vasoconstriction, reduces insulin sensitivity, and stimulates skeletal muscle. It is also a ventilatory stimulant with bronchoprotective effects. Regular consumption of low to moderate amounts of caffeine among adults can improve exercise tolerance and cognition as well as reduce the risks for Parkinson’s disease and age-related cognitive decline.

However, caffeine can also have many unhealthy effects, particularly at high doses. Children are at greater risk for harm related to caffeine, yet the popularity of energy drinks that combine caffeine with other activating substances is soaring. The current review examines the use of energy drinks and the health consequences of this trend among children and adolescents.

Study Highlights

• Energy drinks are consumed by 30% to 50% of adolescents and young adults. A study of college students found that more than half of them mixed energy drinks with alcohol, a practice that might promote risky behaviors such as drinking and driving.
• Energy drinks contain 70 to 80 mg of caffeine per 8-ounce serving, which is approximately 3 times the amount of caffeine as cola drinks. The caffeine content of “energy shots” may be up to 5 times that encountered in 8 ounces of cola drinks.
• Energy drinks combine caffeine with substances such as guarana, which itself contains 40 to 80 mg of caffeine per gram. Moreover, guarana may have a longer half-life than caffeine.
• Caffeine consumption should not exceed 100 mg/day or 2.5 mg/kg/day among children and adolescents. In a study, consumption of 1 retail unit of energy drinks was associated with caffeine exposure that was considered excessive among 70% of children and 40% of teenagers.
• Consumption of 4 to 12 mg/kg of caffeine can promote anxiety and jitteriness. Headache and fatigue are common withdrawal symptoms after short-term, high-dose use of caffeine.
• Some countries have tracked cases of caffeine intoxication, but most reports are sporadic, and the prevalence of caffeine overdose is poorly understood. Caffeine intoxication is characterized by tremor, tachycardia, and insomnia. Other symptoms may include vomiting, abdominal pain, hypokalemia, hallucinations, seizures, arrhythmias, and death.
• Children and adolescents who may be at particularly high risk for complications related to the use of caffeine include those receiving stimulants for attention-deficit/hyperactivity disorder, children with known heart defects and arrhythmias, and those with eating disorders. Energy drinks can also add to total caloric intake and may reduce peak bone mineral density.
• The authors of the current recommendations conclude that energy drinks have no therapeutic benefit but may promote serious adverse events. They call for greater regulation of these drinks, which have thus far escaped existing regulations for soft drinks because producers have labeled them as “natural dietary supplements.”

Toxicity surveillance of energy drinks should be improved. Clinicians should screen for the use of energy drinks, particularly among athletes, and advise their young patients and parents regarding the potential negative health consequences associated with energy drinks.

Clinical Implications

• Caffeine causes coronary and cerebral vessel vasoconstriction, reduces insulin sensitivity, and stimulates skeletal muscle. It is also a ventilatory stimulant with bronchoprotective effects.
• Caffeine consumption should not exceed 100 mg/day or 2.5 mg/kg/day among children and adolescents, meaning that consumption of 2 energy drinks per day is inappropriate.

Click here for full article

                                                                                           Alfred Hitchcock

Have you ever heard of “second-hand TV viewing”? You probably haven’t because I made it up.

We have all heard about the “second hand smoking”. We all know its harmful applications: it affects the lungs, causes asthma, etc. Now I will tell you about ”second hand TV watching”.

I’ve been in pediatrics for a lo-o-ong time. I’ve seen lots of kids (including my own) biting their nails. We all know that this is a sign of nervousness and anxiety. There is little we can do with it as parent. All we can do is to reduce stress for our kids or change their attitude to the stressful situations. One thing that I have never seen before is 1.5 year old child biting his nails.  A couple of weeks ago I saw 2 of these toddlers in my office. These were children from very loving and caring families. Tell me, what kind of stress do they face? I started digging. I thoroughly examined them. I figured that out!

For both families, the parents were at work while the toddlers were watched by the family members who had TV on all the time. Furthermore, they were watching horror movies! “No!” the parents exclaimed,” He doesn’t watch, he plays nearby!” I know. He doesn’t watch it directly. Rather, he does it indirectly. Some scary visual and auditory stimuli come to his brain causing anxiety, bad dreams, and waking up at night. Have you heard about night terrors?

 In our society we have become very concerned about what cigarette smoke can do to our kids or other non-smokers’ lungs. But what about the health of our kids’ minds, souls, and brains?

Our bodies, our kids’ bodies- tell us what is going on within us. We just need to learn to see, hear, and decode the signs. If you have a hard time with it, I will try to help.

                                                                                Unknown

It was many years ago. I didn’t have my own practice yet and worked for another doctor.   One day I entered the room to see a teenage boy who came for his regular check up. I have never seen this family before. The boy was sitting on a high stool, the mom on a regular chair. Nothing unusual. I started asking the mom about her concerns while looking through the boy’s chart. All she mentioned was his height.

“What about his height?”, I asked. Automatically, I opened his growth chart. Then, the boy stepped down from his high stool… I held my breath: he was very short. Barely 5 feet tall. He was 16 or 17. Even without thorough examination, which later on confirmed my suspicion, I could say that he completed his sexual development. For me, it meant that the growth plates of his long bones closed and he would not grow any more.

The sad part is that it could have been fixed.  Of course, it happens; some people are tall and some are short. A man that is 5 feet tall is a little less than what we would expect.

Let’s go back to his record. He was seen 3 years earlier, was already short for his age, and already started his sexual development. The following 3 years were critical in managing his problem. He was an excellent candidate for the growth hormone treatment. It could give him extra several inches of height.

It was too late by the time I saw him. The mom was devastated and so was I. Was it her fault she wasn’t bringing him for the annual check ups?  Was it a medical office’s fault that they didn’t remind her about it?

No, I don’t accuse her of being a bad parent. She was used to see him that way and didn’t expect him to stop growing earlier than other boys his age.

Dear parents of my patients!

Don’t be annoyed that my staff is reminding you about your child’s check up! It’s not them. It’s me bugging them. I don’t want to find myself in similar situation again. I want you to know that you do everything to keep your children healthy and happy. I want to be able to uncover and fix something that may go unnoticeable to you.

I started studying multivitamin composition, absorption in the body, recommendations, and daily requirements. The more I learned, the more confused I was getting:

• Some of the recommended dosages have not been renewed in more than 10 years;
• What brand of vitamins to buy?
• How can I be sure that the pharmaceutical company that makes them is reliable?
• Do they contain any preservatives or additives that could be harmful long term?

I spent a long time in different drug stores, including what they call “natural” ones, looking at the labels, trying to figure out who made them, whether they were made in U.S. and looking for any evidence of certifications, etc. Unfortunately, I was not lucky enough to find supplements for myself and my family that would satisfy me. To be specific, I could not find the vitamins manufactured (not distributed!) in the U.S.A. and certified by the independent non-profit organizations.

I found out that VITAMINS AND OTHER DIETARY SUPPLEMENTS DO NOT GO THROUGH THE FDA APPROVAL!!! So, anybody can sell them!

We can’t always eat a perfect diet, and each of us has unique health needs. Vitamins and other dietary supplements are something we use on a daily basis. You do not see the immediate effect of vitamins. So, we really need to know what we introduce into our bodies every single day.

As it was such an eye-opening experience for me, being in the medical field for a long time, I felt obligated to share this information with you. Now when shopping for supplements for your family, you will have a better idea of what to look at.

At the same time, many of us are concerned about whether more costly brands, such as those offered at doctors’ offices or on-line, are worth the extra money?

At some point we realized that the best way to maintain our high standards would be for us to develop our own line of vitamins and supplements. We have learned a great deal about supplement purity and quality. We found, in fact, that one way we can ensure delivery of quality is by working exclusively with labs that are externally validated by the NSF International, a non-profit, non-governmental organization that develops manufacturing standards that meet or exceed the FDA’s GMP guidelines

We view the NSF’s GMP program as an essentially in quality assurance. This makes sense for three simple reasons:

• We want to be true to what we say.
• If you are going to pay for it, you need to know that you are getting your money’s worth.
• If a supplement contains the right ingredients, you can be assured that what you are using it for is going to work.

What originally led us to choose NSF GMP Certified lab as our manufacturing partner was our own need to be sure that every one of our bottles contains what we want it to – nothing more and nothing less. The bottom line is, you can be confident of its authenticity, potency, quality and purity. We feel, that you’re worth it.

Our vitamins:

• Doctor-formulated, based on the latest nutritional and medical science for you, and your child’s health.
• Contain essential nutrients, including patented compounds to ensure maximum bioavailability, in conservative dosages.
• Manufactured in a facility validated by the NSF (The Public Health and Safety Company), to meet or exceed all governmental requirements for good manufacturing practices (the FDA’s GMP’s).
• Made from the most natural ingredients available. All ingredients are food based and contain no preservatives, sugar, artificial flavoring, filler, dyes or coloring of any kind.

At this point in time we have the following products available:

Chewable Kids’ Multivitamins

Adult Food-Based Multivitamins

Multi Mineral Comprehensive Formula

A three-year-old child is a being who gets almost as much fun out of a fifty-six dollar set of swings as it does out of finding a small green worm.

- Bill Vaughan

Last week I met with a new family in my office. It was a couple that adopted an eighteen month-old boy from a Russian orphanage, where the boy had spent most of his life.

I always admire and greatly appreciate people who have the courage and big heart to adopt children. It must be so difficult: sudden transition of becoming a parent, lack of knowledge of the health history of the child in most cases, cultural background and conditions the child used to live in that affect him physically and emotionally

I salute these families, but my thoughts today concern the boy.

This was an absolutely adorable, happy, pleasant boy. More than that: he was very patient. One can imagine that given the situation, I spent a long time talking with the new parents. At the same time, I was watching the boy. He kept himself busy all the time. Most of the time he played with the table paper, crawling under it, covering his head with it, tearing it into peaces, and playing with them. It was amazing how creative this child was.

In his misfortunate past he probably wasn’t exposed to a great deal of attention and expensive, sophisticated toys, but he learned how to entertain himself.

Is it something our more fortunate children miss? Really, how can you be creative with some electronic toys when some very creative engineers already invested their time and knowledge into them?

Of course, we want the best for our children. Does it mean they need the toys the other kids have? The newest toys on the market?

Or do we need to teach them to be creative and happy as then they will not depend on circumstances, companies and other people entertaining them?

Just a thought…

TV

TV.  If kids are entertained by two letters imagine the fun they’ll have with twenty-six.  Open your child’s imagination.  Open a book. 

~Author Unknown

It’s been for a while now that I seriously doubt the existence of coincidence.

A couple of weeks ago I received a letter with a very attractive promotion for our office: they would come to install TV at NO cost for us, provide service at NO cost, etc…..

As I was planning a new topic for my Blog, this promotion came in handy. No!!!  I will not have TV in my waiting room (as I have never had it before). It gave me an idea that I want to share with you.

We never had and never will have a TV in our office. It is not because we can’t afford it. The reason is deeper: I never promote it. Furthermore, I always try to convince the parents to use it as little as possible.

For busy, working families, TV becomes a lifesaver at the times: it keeps kids busy while we fix the dinner, when we need some time on the phone, and finally… when we need to take a shower!

Unfortunately, kids get used to TV very quickly and, after a while, we have a hard time limiting it.

There are so many reasons why TV is harmful (computer and video games are included) that I will not be able to cover them all at once, but I am committed to share my thoughts with you in full.

The children who watch TV a lot do not read, do not interact with their parents and siblings, and have a hard time entertaining themselves because they are used to “ be entertained”.

Later on, the problem of overeating comes to play because they see various commercials, and crave unhealthy foods.

They spend too much time sitting in front of TV and don’t play outdoors.

As our kids get older, many of them get computers. They spend most of the time in their rooms (sometimes doors closed). It takes time away from homework and their sleep schedule suffers. In the morning, they are already tired. In school, friends talk about the TV show they watched the night before and our children think: “why am I not involved?”.

These are the facts, coming from multiple studies, not just my observations. Although it is difficult to change our kid’s TV habits,  it requires the change in our own behavior, I’m always open to share my experience with you as a professional as well as a parent.

Together we can achieve a lot!

Open & Find Out

Before I got married I had six theories about bringing up children;now I have six children, and no theories.

John Wilmot

This is the first of the series of Blog posts I will be sending to you, parents of my patients. You may sign up to receive them on-line. You may discontinue your subscription anytime. You may share them with your friends and relatives.

Why did I start doing it?

1. Some of my patients’ parents encouraged me to do so.
2. This is a great way to share my thoughts and ideas with those of you who I don’t see very often in my office.
3. There will be no specific recommendations for certain situations. There will be just general thoughts that may help you uncover some tiny or a little bigger problems in your child that skips from your glance.
4. We have access to an enormous amount of information now. I want to help you to sort it out (we’ll limit it to yours and your child’s health issues, of course!).
5. I’ve collected enough of interesting cases and thoughts that I will gladly share with you.

I will try to focus on the issues that may be interesting to most of you. If the topic applies to your family and carries useful information I ask you to share it with your spouse and other family members. And, what may be even more important, with your child (if his/her age allows you to do so).

You may know by now that, unfortunately, you are not always a great authority for your child. This has absolutely nothing to do with you, the way you approach your child, level of your education, etc.  No. It is just the way IT IS.

Here I need to tell you a story from my life as a parent and a practicing pediatrician.

It was a while ago when my older daughter was about 14. She started having allergies and I brought some medications and explained how to use them.

In several days my daughter said that they were not working. In a week, she claimed that she was getting worse because of my treatment. At one point, she refused to use anything. The message was clear: You don’t know what you are doing.

But her symptoms required treatment. I asked my colleague at that time Dr.K. to see her. Before coming to the room  Dr.K. asked me:” What does she need?” I said, ”Some Claritin and steroid  nasal spray”.

In a couple of minutes my daughter was done. She came out of the room happy, confidently carrying prescription for Claritin and steroid nasal spray. “Look, mom”, she said” I have a prescription now. Dr. K. is a real doctor”. ‘’Great”, I said, ”That’s why we are here.”

Our dear children are all different and all alike. Sharing my thoughts (that apply) with them could be a good tool to manage different situations at home.

We will see how it works!

All the best to you and your families!

Photo credit: Flickr Hu2Desigh

To snore

A healthy mind has an easy breath.

~Author Unknown

It was several years ago. We just moved to our new office and our patients were showing up to say “hi” and see our new place. Among them was my patient “E” with his mom. They stopped by with a bouquet of flowers to chat for a couple minutes – perhaps a while longer. “E” got used to it and was always very patient. To acknowledge his presence, proper demeanor, and good manners I approached him and tried to involve him in our conversation. But profession is profession.

“Is he sick?” I asked the mom.

“No, he is fine,” she replied.

“Are you sure?” I insisted.

She was sure. At this point, I feel the need to mention that, usually conversation in my office goes the other way around: anxious parents ask the questions and I answer them trying to comfort and reassure them. It seemed like the direction of this conversation puzzled the mom as well. “Why do you ask? Does he sound different than usual?”

In a way she was right.  He always sounded pretty much the same to me. Being an overall healthy boy he would be brought to me only with bad colds or an occasional sore throat. Then he would sound congested, not breathing through his nose with his mouth open. It was normal. He was sick. This time something wasn’t right. He sounded congested… but he wasn’t sick.

I decided to push further, “Does he snore?”

The response was, “Oh, big time!”

Two weeks later he had a surgery: his adenoids were removed, treatment of the nose initiated.  His parents couldn’t believe that there was no more snoring, his speech sounded different, and his mouth was open only for eating and talking!

Trust me: these were very good parents. They loved their child dearly (and still do) and they wanted the best for him. They were used to seeing and hearing him that way every day and they didn’t know that a healthy child shouldn’t snore. It is OK (I guess) for some adults, but definitely not OK for kids – take my word for it.

When the child doesn’t breathe through the nose, which is designed mostly for breathing, certain physiologic processes do not go right. Among them – inadequate aeration of the brain during the sleep, low energy level, fatigue and poor attention in school. Also, teeth get affected with excessive oxygen coming though the mouth; tonsils get bigger when the mouth is open most of the time. Even the structure of the skull and the face features change.  Did I convince you?

Dear parents!

If something of what you just read sounds familiar, please bring it to my attention. There are so many things we can fix to make our children happier! Let’s do it.