Parenting Archive

The Incredible (little?) Plasticman!

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If you know me, you know one of my peeves is when people try to swing my kids around by their arms or lift them up by their hands. I’m always the bad guy to ruin the fun for all. But here’s why:

Kids, especially the under 5 set, are pretty much just running around connected by rubber bands. It sounds crude to say, but it’s true. The ligaments holding their joints together are still fresh, and aren’t as strong as they will be later in childhood. One of the most common minor injuries of childhood is known as the “nursemaid elbow”. It occurs when a child is pulled hard by the arm, falls on it wrong, or is picked up or swung by their arms/hands. The weight is too much for the immature ligaments to handle, and the joint of the elbow partially or completely dislocates. It’s pretty painful for the child, and you’ll know right away if it happens. Kids will cry and refuse to use their arm.

elbow2

It’s pretty scary but fortunately it’s benign and a simple fix. Your pediatrician or the doctor at urgent care or the emergency room can quickly pop it back into place by doing a maneuver known as a reduction. It hurts for a split second but there’s immediate relief. The downside is if this happens to your child once, the odds of it happening again are pretty high, so you may be making multiple trips before your child’s ligaments firm up a bit after the age of 5 or 6.

I swear sometimes my 2 year old does look like this.

I swear sometimes my 2 year old does look like this.

You can prevent this from happening altogether by always leading your child gently by the arm (I know this is hard when you’re holding their hand and they are doing spaghetti legs and flailing around!), only lifting them by their armpits, and avoiding rough play that involves swinging them around by their hands or wrists. Sometimes it just happens regardless, but following those basic tips greatly reduces the chances that your toddler will have to go through the pain.

But if it does happen, don’t fret. It’s very common and sometimes it’s just another bump in the roller coaster of childhood.

How to toss your cookies but not your sanity.

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Let’s talk about one of our absolutely favorite things about being a parent. Something that makes childless people totally jealous, makes you cry tears of joy, inspires the angels to sing, and brings that rhetorical unicorn to continue defecating glorious sparkling rainbows all over your home.

Your child comes to you. They have that look in their eyes- the look of true love and need for you. You open your arms to accept them and “GAHHHHGKSJHDJHERUIGTGSJGJAJSHJFDH*#$^&#^$@%#@^#&@”!!!!!!!!!!!!!!”

The stomach runneth over. You look down at the coating on your shirt. The puddle collecting in your lap. The smell invading your brain.

No? Not your favorite?  Well that’s a bummer because ‘tis the season!

toystory puke

Anyway, a common misconception is that this is a “stomach flu”. Actually it’s not the flu at all. Influenza is characterized by sudden onset fever, chills and body aches, runny nose, cough, etc. Gastroenteritis is the inflammation of the stomach and intestine, causing nausea, vomiting, cramps, diarrhea, low grade fevers, aches, and general ickiness. It’s definitely no fun.

So what can you do when you or your little one is lucky enough to contract this? Honestly, the less you do, the better. The first thing people worry about it dehydration, which is a valid concern, but it really only becomes a danger when the vomiting or diarrhea becomes excessive (think more than once per hour and continuing this way for a long period of time). The stomach is purging because it is irritated, so you want to give it a rest. Resist the urge to give your child fluid after they vomit. It will continue the cycle and prolong the misery. Let them rest and once they’ve been vomit free for more than an hour or two, allow a few SIPS of water or electrolyte drink. No drinking full glasses no matter how hard they beg! Once they’ve been vomit free for longer than that, they can nibble on crackers or something bland. If they throw up again, start back at square one with nothing by mouth again. Sometimes this lasts for just the day, sometimes a few.  Avoid giving sugary drinks like Gatorade and juice since it can irritate the stomach more. You don’t need to follow the BRAT diet- typically once kids aren’t throwing up anymore they can resume normal eating patterns but do avoid fatty, fried, or spicy foods. Avoid dairy as much as possible during this time, most irritated stomachs cannot tolerate lactose.  Breastfeeding is always ok! If you are nursing, encourage them to breastfeed as much as they want. Resist the urge to give medications. Ibuprofen can irritate the stomach and any kind of anti-emetic and anti-diarrheal is preventing the purging of the virus from the system. Just let it ride- the best medicine is rest and love.

Typically a stomach virus doesn’t require a visit to the pediatrician. Viruses are not treated with antibiotics. However, if your child is showing signs of dehydration (dry skin, dark urine or not urinating, crying without tears, sunken soft spot in infants, listlessness, or high fever) then they should be seen. Rotavirus and norovirus can cause severe dehydration, so if your child shows any of these symptoms or is vomiting/having diarrhea uncontrollably then swift action is needed.  Also if you notice red blood or dark coffee ground-looking stuff in their vomit or diarrhea, get them seen right away.

Remember to wash wash wash! Hand sanitizer is not effective in killing stomach viruses. Good ol’ soap and water is your best bet. Make your child wash their hands constantly and remember to wash yours too even if you aren’t sick! Also remember that even if they stop vomiting or having diarrhea, their stools will still be contagious for several weeks, so be vigilant with those diapers and disinfecting the bathroom/house.

quarantine-sign

Even if this isn’t your magic parenting moment, you will make it through. I have faith in you. Although may I suggest investing in a good carpet/upholstery cleaner?

Magnet Ingestions – when attractions go bad

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The term “opposites attract” is usually reserved  for dating websites or corny Hallmark cards, but right now I’m going to apply it to something you probably don’t think about on a regular basis:

Magnets.

More specifically, neodymium magnets, or rare earth magnets.

buckyball-magnets

Sometimes these are sold in toys (think Magnatiles, etc) but were more often sold as desk toys or stress relievers for adults. While the magnets within children’s blocks are safely encased and tightly regulated by the CPSC, the magnets marketed for adults only are easily ingested by children. They are small, pretty, and apparently very tasty looking. When a child (or pet!) ingests 2 or more, they attract each other within the digestive tract. This can result in an obstruction, a perforated bowel, and necrosis of the tissue which can lead to sepsis and death. Picture two magnets being in opposite ends of the intestine. They come together with the intestine pinched in between. Either the intestine tears (a perforation) and the contents seep into the abdominal cavity, or the pinched tissue is deprived of blood flow and becomes necrotic (dies). Either can result in sepsis, which is an infection within the blood stream that can lead to multiple organ failure and death.

The scary thing about these magnets is if your child doesn’t tell you they ate them, you won’t know until they start showing symptoms. The initial symptoms are abdominal pain and vomiting and basically mimic a common stomach virus. Parents and pediatricians just give symptom support and assume it will subside in a few days. When the symptoms instead intensify , warranting an x-ray, the damage is already done.

Most of the desk toys marketed for adults have since been recalled and removed from the market, such as BuckyBalls. However millions still lurk in desk drawers and offices. Make sure to remove them immediately and place them out of reach (or better yet, get rid of them!) if you do have them in your house. Magnetic toys are becoming more prevalent on store shelves with the trendy rising of STEM education aspects. Tegu blocks, Magna-Tiles, Magformers, etc are all toys that have magnets safely encased in plastic or wood. Remember to check the integrity of these toys regularly, and supervise when your children are playing with them. Wood is easily chewed by family pets, so keep them out of reach and immediately search the area for magnets if a block is damaged. These toys are amazingly fun, just make sure to play safely!

If you think your child may have ingested a magnet, alert your pediatrician immediately or go to the ER. Also note that on an x-ray, multiple magnets can appear as only one when they’ve attached to each other. The damage caused can be irreversible and as evidenced by several recent stories I’ve read on parenting message boards- life changing.

F1.large

Kids are crazy and seem to be able to hurt themselves with almost anything. This is truth, and with all these blog posts about the things that can pick off your kid, it seems overwhelming and that you may as well put your kid in a bubble. I get this, my own kids are 5 and 2. And if it makes you feel any better, I’m currently watching them beat each other with sticks through the kitchen window. Someone may lose an eye. But so far, no one has recalled sticks so I’m gonna let it slide. However, knowledge is power. Even as a nurse myself, I never would have thought of magnets as anything other than a choking hazard. Buckyballs are small enough to pass, so that’s what I would be waiting for. Arming yourself with knowledge and being proactive is the best thing you can do. I will be forever grateful that I wasn’t one of the parents that was given this knowledge by a doctor while my child was critically ill. I wish every parent could be spared that.

Government Calls for Lap/Shoulder Seat Belts on School Buses

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NHTSA Pushes Lawmakers and School Districts to Enhance Safety for Children on School Buses

School BusAccording to recent remarks made by NHTSA Administrator Dr. Mark Rosekind for the National Association for Pupil Transportation, the National Highway Traffic Safety Administration will shift its position to endorse 3-point lap/shoulder seatbelts on school buses.

As NHTSA’s administrator, my primary role is as the leader of our agency. NHTSA has not always spoken with a clear voice on the issue of seat belts on school buses. So let me clear up any ambiguity now: The position of the National Highway Traffic Safety Administration is that seat belts save lives. That is true whether in a passenger car or in a big yellow bus. And saving lives is what we are about. So NHTSA’s policy is that every child on every school bus should have a three-point seat belt. NHTSA will seek to use all the tools at our disposal to help achieve that goal, and today I want to launch a nationwide effort to get us there.

Is this a change in position? Yes. But it is consistent with NHTSA’s role as the guardian of safety on America’s roads. It is consistent with decades of progress in raising seat belts in the minds of the public from novelty to nuisance to “the car doesn’t move until I hear that click.” Seat belts are icons of safety. And that makes them the single most effective thing we can provide to improve the confidence of parents, policymakers and children. Without seat belts on buses, there is a gaping, obvious hole in our safety measures that sparks questions all of us have to answer. With seat belts, we can build momentum for student pedestrian safety, enhanced enforcement, and more.

Photo Credit: Safeguard4kids

Photo Credit: Safeguard4kids

While school buses are among the safest methods of transportation due to size, mass, visibility, driver experience and other factors, seatbelts would make them even safer. Seatbelts would also make large buses compatible with child safety seats for younger kids. Smaller school buses are already being transitioned to lap and shoulder belt systems. Concerns include cost and passenger capacity, which could reduce the number of children served by buses, possibly forcing some to other means of transportation. Currently, states determine if large school buses require seatbelts. Six states currently require either lap or lap/shoulder belts, but some of these mandates remain unfunded.

According to NHTSA, approximately 4 school age children (5-18 years old) who are occupants of large school buses are killed annually. Assuming 100% seat belt use, a Federal mandate for lap/shoulder belts could save 2 lives annually. Passenger car fatality rates are over 7 times higher overall.

It is still worth noting that most published comparisons between cars and buses use overall car fatality rates where fatal injuries are dominated by unrestrained occupants and crashes where the car driver is a teen or is under the influence of alcohol or other drugs. Overall rates also don’t take into account that many car fatalities happen with greater frequency during overnight hours, evening rush hours and during summer months when school buses may not be operating. So, the rates for a grade school child transported by a parent or adult caregiver in an appropriate restraint system in the back seat of a family vehicle would presumably be closer to the rates observed in school buses.

Even so, CarseatBlog applauds NHTSA’s new goal that could cut school bus fatalities nearly in half, and significantly reduce many more preventable injuries, making large school buses safer than any alternative. The consistency of message for a child to buckle-up anytime they are in a vehicle is also extremely important. The American Academy of Pediatrics also endorses such a policy.

The AAP recommends that all children travel in age-appropriate, properly secured child-restraint systems when transported in all motor vehicles, including school buses, to ensure the safest ride possible. The AAP further recommends that all newly manufactured school buses be equipped with lap/shoulder restraint systems that can also accommodate car safety seats, booster seats, and harness systems. The AAP recognizes the added benefit of improved student behavior and consistent habits of restraint use when traveling in motor vehicles. Policies on seat belt use have been found to improve student behavior and reduce driver distraction.