May 24th, 2013
A new survey shows that 24 percent of U.S. teens have abused prescription medications that were not prescribed to them and this number represents more than 5 million teenagers. These numbers are very scary. This is a 33% increase from 2008. Many teens may take ADHD drugs which have not been prescribed for them but were prescribed for their siblings or friends. In fact, 13 percent of teens said they took either Adderall or Ritalin (both ADHD medications) at least once when it was not prescribed for them.
The prescription drug use may begin before teens are 14 years of age. Research shows 20% of the teens who admit to abusing prescription drugs said they first abused prescription drugs that were not prescribed for them before they were 14 years old. Teens that start abusing drugs when they are young are much more likely to have an addiction problem as adults. Unfortunately, 27% of these same teens mistakenly believe the abuse of prescription drugs is safer than the use of ecstasy or cocaine. Almost 33% of parents surveyed believed Adderall or Ritalin can boost a teen’s school performance safely even if they haven’t been diagnosed with Attention Deficit Hyperactivity Disorder.
Inappropriate doses of ADHD medications can cause hallucinations, seizures, psychosis, hypertension, mania or aggressive behavior and many other untoward reactions. Use of narcotics like OxyContin can result in addiction, respiratory arrest, severe hypotension and shock. Teens and adults may have the misconception that these prescription medications are safe and are safer than “street drugs”.
This same study indicates about 80% of parents talk to their teens about marijuana and alcohol, almost 33% talk about crack and cocaine, but only 15% of parents said they ever discussed abuse of prescription medications.
The take home message is clear. Parents need to talk to their kids about the abuse of all these drugs and not neglect discussing the abuse of prescription medications. These conversations should begin in grade school and should be reinforced as kids enter middle school and high school. Secondly, prescription medications should be locked up so they are not accessible and unused, old and expired prescription medications should be discarded safely. We all need to wake up to the reality of this crisis for our young people.
Submitted by David Roos, M.D.
Posted in General Information, News and Updates, Prescription Medications, Teens | No Comments »
May 7th, 2013
If you have been to a well baby appointment recently, you may have filled out the Ages and Stages Questionnaire. This is a routine component of our well child visits that helps us evaluate how your child is developing. It is given at every check-up from 4 months of age until 5 years old.
One goal of a preventative health care visit is to ensure that a child is developing normally. The American Academy of Pediatrics recommends that all young children have a formal developmental screening at each check-up. This screening helps identify subtle delays that may not otherwise be apparent. Early identification of problems allows for immediate intervention and greatly improves the child’s chance of reaching his or her full potential.
If any concern is raised using this standardized screening tool, your child will be referred for further evaluation through the early intervention services in our community.
As parents, you play an important role in the detection of your child’s developmental problems. It is important to bring up any concerns you may have regarding your child’s development with the doctor. The Ages and Stages Questionnaire is simply another tool to help us give your child the best care possible.
Posted in Babies, General Information, News and Updates, Well Care | No Comments »
April 29th, 2013
During the infancy period, infants are obligate nose breathers which means they only breathe through their nose and not through their mouth. If an infant has any amount of nasal congestion present, they will have an increased amount of difficulty breathing, especially when feeding.
I’ve just learned about a product available to help with the aspiration of the nasal congestion to help infants have an easier time of breathing. ”The NoseFrida The Snotsucker” is a nasal aspirator that actually works! It is distributed by fridababy.com. It’s doctor invented and recommended. It’s 100% hygenic due to the included filters. It’s been reviewed by Rachel Ray and Parenting Magazine! It’s the number 3 selling baby product on Amazon.com. It’s easy to clean and top-rack safe in the dishwasher. You can purchase it on fridababy.com, amazon.com or at Babies R Us. It sells for $15.00 on fridababy.com, $12.75 or $19.20 with 20 additional filters, on amazon.com and $16.99 at Babies R Us.
Submitted by Vona M. Lantz, CPNP
Posted in Babies, General Information, News and Updates | No Comments »
April 22nd, 2013
National Infant Immunization Week (NIIW) is April 20-27. NIIW is an annual observance to highlight the importance of protecting infants from vaccine-preventable diseases and celebrate the achievements of immunization programs and their partners in promoting healthy communities. Since 1994, NIIW has served as a call to action for parents, caregivers, and healthcare providers to ensure that infants are fully immunized against 14 vaccine-preventable diseases.
Colorado Children’s Immunization Coalition (CCIC) is a statewide non-profit organization that promotes improved access, delivery, and demand for children’s vaccinations to keep Colorado healthy. CCIC announces “TEAM VACCINE”, a blog created to improve access and delivery and demand for children’s immunizations to keep Colorado kids healthy. Team Vaccine features physicians, nurses, parents, researchers, advocates, and community members who are passionate about immunizations and protecting kids from vaccine-preventable diseases. I encorage parents visit this blog site to learn more about immunizations and read other parental accounts of their experiences with immunizations.
Submitted by Vona M. Lantz, CPNP
Posted in News and Updates | No Comments »
April 16th, 2013
A recent study published in the Journal of Pediatrics March 2013 shows that children who receive the regular schedule of childhood vaccines are at no increased risk of autism compared with children who are unvaccinated or who are on an alternate/delayed schedule of the vaccines. This demonstrates there is no connection with any particular vaccine or the number of vaccines children receive in 1 day or the total number of vaccines children receive and autism.
There have been more than 20 studies showing no connection between autism and vaccines. Approximately 10% of parents today are choosing to skip or delay vaccinating their children and this has resulted in a sharp increase world-wide in vaccine preventable diseases. We are currently experiencing a nationwide epidemic of whooping cough (pertussis) with more cases seen last year in 2012 than we have seen since 1962. There were more than 1400 cases in Colorado last year of pertussis and 1 infant died from the disease. Deaths from pertussis last year were also seen in 16 other states. We have also seen increases in measles and rubella. Pregnant moms who develop rubella (German measles) during their pregnancy may have a baby with rubella syndrome which can result in heart defects, hearing loss or deafness, cataracts, mental retardation or death. At least 3 infants in 2012 were born with congenital rubella in 2012 Increased rates of these infections are directly tied to the increased numbers of parents not vaccinating their children.
In third world countries with poor vaccination rates for their children there is an even higher incidence of vaccine preventable infections. The U.S. will see more epidemics of these infections as more third world children visit this country and expose our unvaccinated children. Some communities have more unvaccinated children than other communities and these poorly vaccinated communities are ripe for epidemics with infections like whooping cough, measles and rubella or meningitis from bacteria like Haemophilus or Meningococcus.
A 2010 study in Pediatrics also confirmed the safety of the current regular vaccine schedule when it compared babies receiving all the standard vaccines on time during their first year of life with infants skipping or delaying vaccines. The researchers found no neurological or psychological differences between these groups of infants. That is there were no increased problems with items like stuttering, facial tics or lower IQ’s.
The take home message is simple: WHEN PARENTS SKIP OR DELAY VACCINATING THEIR CHILDREN THIS PUTS THEIR CHILDREN AND OTHER CHILDREN IN THE COMMUNITY AT RISK FOR DEVELOPING DANGEROUS INFECTIONS. Ask a provider at Crown Point Pediatrics if you have any questions about vaccines for your kids.
USA Today (3/29)
Submitted by David Roos, M.D.
Posted in News and Updates | No Comments »
April 8th, 2013
A quarter of children’s calories come from snacks so it is important to offer healthy food choices at snack time. If your child’s snack usually includes chips, cookies, candy or soda, then it’s time to make a change. Starting healthy eating habits early in life is critical in the prevention of obesity. Remember that small changes make a big difference!
First, have your child drink water and eliminate soda, juice boxes and other sugary drinks. 100% fruit juice is okay but should be limited to one cup a day. Low-fat milk can accompany meals.
Next, try to offer fresh produce, complex carbohydrates and lean proteins as snacks. The following list may give you some ideas.
- Fresh fruit (when in season)
- Vegetables with low-fat dressing or hummus
- o Carrot and celery sticks
- o Red or yellow peppers
- o Cherry tomatoes
- Raisins and dried fruit
- Canned fruit in natural juices
- Yogurt
- Popcorn
- Pita bread
- Low-fat string cheese
- Hard-boiled eggs
- Natural peanut butter
- Lean turkey slices
- Ice pops
- Fruit smoothie
- Low-fat frozen yogurt
- Low-fat granola bar
- Trail Mix
- Seeds and nuts
Reduce the temptation to grab a bag of chips by preparing snacks ahead of time so they are ready-to-eat when the kids are hungry. Don’t keep unhealthy snacks in the house. It is best to have one set snack time between meals or after school in order to avoid continual snacking and grazing. Avoid snacking due to boredom – children will often complain of hunger or ask for snacks when they are bored instead of hungry. Last, but not least, parents should remember to set a good example by reaching for those healthy snacks too.
Submitted by Jaime Fell, MS, PA-C
Posted in News and Updates | No Comments »
March 28th, 2013
A study by the CDC (Centers for Disease Control) finds that “despite warnings from pediatricians about feeding newborns anything other than breast milk or formula, many mothers appear to be introducing solid foods well before their babies’ bodies can handle it.” A CDC survey of mothers found that “40 percent said they gave their baby solid food before they were 4 months old.” “According to the American Academy of Pediatrics (AAP), the head and neck control and overall coordination that infants need to safely eat solids doesn’t develop until around 4 months old. In addition, the early introduction of solids may increase the risks of some chronic disorders, such as diabetes, obesity, eczema, and celiac disease.” Additionally, exclusive breast feeding is recommended the first 6 months of life because of numerous health benefits for infants, including reduced risk of respiratory and ear infections, diarrhea, diabetes, obesity, and SIDS (Sudden Infant Death Syndrome).
We will discuss your infant’s growth and development and our feeding recommendtions at your infant’s well baby exam.
Submitted by Vona M. Lantz, CPNP
Posted in Babies, General Information | No Comments »
March 19th, 2013
Parents, have you ever found yourself wondering which car safety seat is appropriate for your child? Do you have a child that has recently gone through a growth spurt and you are now questioning if the car seat you own is still adequate? Have you placed your child in the car seat and then into the car to find that he or she must contort themselves into different positions to remain in the car seat?
If you answered yes to any of the above questions, there is help through a new resource. The American Academy of Pediatrics has come up with an app called Car Seat Check. This app allows parents to determine which car seat is best for their child. On the app, parents enter the height, weight and age of the child and are provided with proper car seat recommendations, installation instructions, prices, videos, local car seat instillation technicians and any product recall information.
The app is available for iPhone and iPad. Parents can download the $1.99 app from iTunes at https://itunes.apple.com/us/app/car-seat-check/id584790382?mt=8.
The above information was obtained from the February 2013 AAP News magazine.
Elizabeth S. Wilson, M.D.
Posted in Babies, General Information, News and Updates, Safety Guidelines | No Comments »
March 11th, 2013
Common departing instructions a medical provider at Crown Point Pediatrics will give to parents is that they should ensure their sick child is drinking plenty of fluids. I can guarantee that Dr. Roos, Vona Lantz, Jaime Fell and I have all instructed parents to push fluids to ensure the child is staying hydrated. Parents might have wondered why hydration is important, especially when their child is sick. Hopefully this blog will answer some frequently asked questions by parents concerning hydration and fluid intake by infants, children and adolescents.
The European Hydration Institute (http://www.europeanhydrationinstitute.org) does an amazing job of explaining the importance of hydration stating “Appropriate hydration of the body is an absolute requirement for health and is essential for life itself. Water sustains the body’s many vital chemical reactions and maintains correct body functions. The importance of hydration: Water plays many important roles within the body. Water is the major part of most of the body’s cells (except for fat cells) and it also cushions and lubricates the brain and the joints. It transports nutrients and carries waste away from the body cells. It also helps regulate body temperature by redistributing heat from active tissues to the skin and cooling the body through perspiration. Benefits: Good hydration is essential for health and wellness. Every cell in the human body requires water. Hydration is central to the most basic physiological functions such as regulating blood pressure and body temperature, hydration and digestion”.
A common question the medical providers at Crown Point Pediatrics get asked is what is considered proper hydration and fluid intake for my child on a daily basis? Below is a table outlining how much fluid an infant, child and adolescent needs to meet daily hydration needs. This table was obtained from an article entitled “Water & Wellness: Get the FACTS about Hydration & Health” by Brooke Horn, MPH, RD.
Proper Hydration: Total Daily Adequate Intake:
| Age |
Daily Amount in Liters (1 Liter = ~ 4 cups) |
| Infants (0-6 months) |
0.7 L (3 cups) from human milk/ infant formula |
| Infants (7-12 months) |
0.8 L (3.5 cups) from human milk/ infant formula & complementary foods & beverages |
| Children (1-3 years of age) |
1.3 L (5.5 cups) |
| Children (4-8 years of age) |
1.4 L (6 cups) |
| Males |
|
| 9-13 years of age |
2.4 L (10 cups) |
| 14-18 years of age |
3.3 L (13 cups) |
| Older than 19 years of age |
3.7 L (15 cups) |
| Females |
|
| 9-13 years of age |
2.1 L (8.5 cups) |
| 14-18 years of age |
2.3 L (9 cups) |
| Older than 19 years of age |
2.7 L (11 cups) |
When a child is sick with a temperature, vomiting, diarrhea, respiratory distress and/or increased work of breathing or a urinary tract infection they will need an increased amount of fluids to make up for the loss of fluid. Vomiting, diarrhea, temperature with sweating, frequent urination from a urinary tract infection and loss of water vapor through respiratory effort can increase the total amount of fluid a child loses in a day. Not only does the child need to meet an adequate daily fluid intake, but they will need to make up for additional losses of fluid while they are sick. Therefore, the medical providers at Crown Point Pediatrics will encourage parents to PUSH FLUIDS to ensure a child stays hydrated to prevent dehydration.
The European Hydration Institute does a nice job providing signs and symptoms for parents to look for when a child maybe dehydrated. A sick child can feel even worse when their illness is compounded by being dehydrated. Often, a child will need to go to the ER or be admitted into the hospital for IV fluids because they are sick and also dehydrated. PUSHING FLUIDS can prevent dehydration and ensure a speedier recovery of your sick child.
“What are the signs and symptoms of dehydration in children?
We should be concerned if children have an excessive loss of water by vomiting or diarrhea, or if the child refuses to eat or drink. Presence of the following symptoms may be a sign of dehydration, but many of these are not specific and cannot be used as definitive signs:
- the urine will become concentrated and darker yellow in color;
- decreased frequency of urination or dry diapers;
- sunken eyes;
- sunken soft spot on the top of the head in babies;
- no tears when the child cries;
- dry or sticky mucous membranes (the lining of the mouth or tongue);
- lethargy (less than normal activity);
- Irritability (more crying).
How can children be encouraged to drink more?
Several studies show that children consume about 45 to 50 percent more liquid when it’s flavored than when they are given just plain water. This is useful when trying to encourage a child to stay hydrated. Other tips for increasing a child’s fluid intake include:
- Allow older children to suck on ice or home-made popsicles made with low-calorie beverages.
- Have your child pick out a fun drinking water bottle and keep it filled with water or other low-calorie beverages.
- Offer more fluid-rich foods like fruits and vegetables and soups as meals or snacks.
- Let children create their own flavorful beverages by adding fresh fruit.
- Offer beverages that are neither very hot nor very cold. Beverages slightly cooler than room temperature tend to be consumed in greater volumes than fluids at either temperature extreme.
- Make sure that a variety of different drinks is available.”
If parents have any questions concerning hydration or fluids for your child, never hesitate to ask a medical provider at Crown Point Pediatrics. As we head into spring and summer with increasing temperatures and increased activity level for all kids, it is really important to remember to hydrate and drink lots of water. PUSH THOSE FLUIDS!! Staying hydrated will allow all families to enjoy their spring and summer adventures.
Elizabeth S. Wilson, M.D.
Posted in General Information, Illness | No Comments »
February 25th, 2013
The CDC has reported an alarming finding that 16 cases of acute kidney injury occurred last year in the United States in young adults following the use of synthetic marijuana. These patients included 15 males aged 15-33 years and 1 female aged 15. All of these patients had symptoms severe enough to require emergency room visits and hospitalization. These patients had initial symptoms including nausea and vomiting and pain in their abdomen, flank or back. Biopsies in 8 patients included findings of acute tubular injury or acute interstitial nephritis. Hemodialysis was required in 5 of the patients and 4 of the patients were placed on corticosteroids. All 16 patients eventually showed improvement in their kidney function but recent studies suggest that any patient experiencing any acute kidney injury is at increased risk for chronic and end-stage renal disease.
Synthetic marijuana may have street names like “spice”, “blaze”, “Red X Dawn” or “K2” and can be packaged to appeal to teens and young adults in colorful wrappers. Unfortunately, studies show the use of synthetic marijuana is increasing among adolescents and the medical side-effects of this drug are more worrisome than those of natural marijuana. Synthetic marijuana can cause seizures and is up to three times more likely to produce rapid heart rate and hypertension and five times more likely to cause hallucinations or paranoia compared with natural marijuana. Other side-effects of synthetic marijuana include anxiety, vomiting and non-responsiveness.
Our office does not recommend the recreational use of natural or synthetic marijuana. Under Amendment 64, marijuana remains illegal for those under the age of 21. There are 41 states including Colorado that have banned “spice” and “K2”. In June of 2012 Congress passed a bill to add 26 synthetic drugs, including “K2” and “Spice”, to the Controlled Substances Act. Presumably the ban on synthetic marijuana will continue despite the passage of Amendment 64 which legalizes the use of small amounts of marijuana for those over the age of 21 in the state of Colorado.
David B. Roos, M.D.
http://www.familypracticenews.com/news/child-adolescent-medicine/single-article/cdc-multiple-cases-link-synthetic-cannabinoid-kidney-injury/1e351d77fded7bbe7c81c34c362c21bd.html
Posted in Safety Guidelines, Teens | No Comments »
A new survey shows that 24 percent of U.S. teens have abused prescription medications that were not prescribed to them and this number represents more than 5 million teenagers. These numbers are very scary. This is a 33% increase from 2008. Many teens may take ADHD drugs which have not been prescribed for them but were prescribed for their siblings or friends. In fact, 13 percent of teens said they took either Adderall or Ritalin (both ADHD medications) at least once when it was not prescribed for them.
