The American Academy of Pediatrics recommends shared dinnertimes as often as possible as a way to strengthen families and support children’s development. Many national studies, conducted by Harvard University, the YMCA and others, have concluded that these dinnertimes can forge better family relationships and enhance personal growth – not just in terms of nutrition but in terms of feeling a sense of belonging, stability and family connection.

Make it a priority to share meals.
Why not challenge the whole family to eat at least one meal together each day for four days a week for the next two weeks? You might be surprised how easy it is to establish that routine.

Declare these meal times as sacred.
Set a start time and end time. Don’t watch television. Don’t answer cell phones or reply to text messages. Sit at the table and have uninterrupted conversation while enjoying healthy food together.

Be flexible about when.
These meals don’t have to be formal or at the same time each day. They can be take-out or eaten in a restaurant, as long as the focus is on talking and sharing time, not just rushing through the meal. If someone can’t make it for dinner, reschedule for breakfast. Be flexible but stick to it.

Susan A. Helms, R.N., M.A.L.S., director of injury prevention and Safe Kids at Le Bonheur, says she is frequently asked by parents what they can do to be sure their teenagers are safe drivers.

First, it is important to know that according to the Centers for Disease Control and Prevention, motor vehicle crashes are the leading cause of death for U.S. teens.  Traffic accident rates for 16- to 19- year old drivers are higher than those of any other age group. Between 2004 and 2008, 3,100 youth ages 10 and older were treated at Le Bonheur Children’s because of a motor vehicle accident; seven died.

What causes teenage drivers to be such risky drivers?
There are many reasons, but talking and texting on a cell phone while driving ranks very high on the list. When texting and driving, it forces you to look down at your phone causing you to swerve, miss stop signs, red lights, or even pedestrians.  According to the National Highway Traffic Safety Administration, drivers who are texting can be more than 20 times more likely to crash than non-distracted drivers.

Most teens engage in distracted driving even though almost all are aware that it’s dangerous, according to a survey of nearly 2,000 male and female teen drivers ages 16 to 19 conducted in May 2010 by the American Automobile Association and Seventeen magazine. Almost nine in 10 teenage drivers (86 percent) have driven while distracted, even though 84 percent say they know they shouldn’t, the survey found. More than one-third of the respondents said they nearly crashed because of their own or someone else's distracted driving.

The survey also found that teens who text while driving sent an average of 23 text messages monthly while driving. A quarter of all teens admit to texting behind the wheel. “Teen drivers are some of the most vulnerable drivers on the road due to inexperience, and adding cell phones to the mix only compounds the dangers, “said Helms.

The Department of Transportation, Seventeen magazine and AAA are trying to convince teens to change their habits by launching a contest that will run from today until Sept. 10 to raise awareness among teens about the dangers of talking and texting while driving. The contest challenges teens to develop a catchy, creative anti-distracted driving video to promote safe driving, which they can upload and share with other teens.  The best video will win a $2,000 prize and be featured on Seventeen.com, AAAExchange.com, Distraction.gov and at the Department of Transportation's Distracted Driving Summit on Sept.21.  More information about the contest can be found here: seventeen.com/twosecond.

Rear-facing, forward-facing, booster seats? Child safety seat rules are among the top of the list of parent's concerns. Often, parents don't know when to transition their infant from rear-facing to forward-facing or when to graduate their child from a child safety seat to a booster seat.

We asked Susan A. Helms, R.N., M.A.L.S., director of Safe Kids Mid-South, what are the guidelines that parents and caregivers need to follow.
 
"There are four stages of child passenger safety as children grow, from infant seats to the time they are ready for an adult safety belt alone. Always follow the child safety seat manufacturer's instructions for the exact weight and height limits. Check your vehicle owner's manual, too. Here are the rules and how they apply:

REAR-FACING SEATS go in the back seat. Infants should ride rear-facing from birth to as long as possible according to the upper weight and height limits of the child safety seat, but should never ride forward-facing before reaching their first birthday and 20 pounds.

FORWARD-FACING SEATS go in the back seat. Children should ride forward-facing in a five-point harness until reaching the upper limits of the harness, which is usually 40- 65 pounds, and when they are approximately 4 years old. Allow toddlers plenty of time to grow and gain weight and height before moving them to a booster seat.

BOOSTER SEATS go in the back seat. Children from approximately age 4 to at least age 9, unless 4 feet 9 inches tall, should ride in a Booster Seat. 

ADULT SAFETY SEAT BELTS are for children age 9 and older or for those children who taller than 4 feet 9 inches. All children age 12 and younger should ride in the back seat.

Child safety seats save lives when they are installed properly. Unfortunately, at least nine out of 10 children in a child safety seat are not buckled in properly. Learn to correctly use the child safety seat by reviewing the instructions from the child safety seat manufacturer as well as the vehicle owner's manual. If you need assistance, a child passenger safety technician can help.

Safe Kids Mid-South schedules on-going child safety seat check ups at Safe Kids-sponsored events. Dates and times are posted on this BLOG or you can schedule a personal appointment by calling (901) 287-6730."

A probiotic supplement may be an option for parents trying to soothe a colicky baby, according to a new study.

Researchers from the University of Turin, Italy, found that a few daily drops of Lactobacillus reuteri, a bacterium that can help improve digestion, significantly reduced crying among infants with colic.

The findings were published online in Pediatrics.

Colic occurs during the first three months of an infant's life in which an otherwise healthy child cries and cannot be comforted for three hours or more every day. Colic affects up to 28% of infants and has no known cause or cure.

However, recent research suggests colic may be linked to an immature immune system struggling with bacterial imbalances in the gastrointestinal tract, and that high levels of E. coli bacteria in particular may contribute to colic symptoms. Some researchers question whether symptoms could be alleviated using probiotic therapy, or "healthy" bacteria to restore bacterial balance in the gut.

To test this theory, the Italian researchers compared 25 healthy infants who were randomly assigned to receive drops of Lactobacillus reuteri to 21 healthy infants randomly assigned to receive placebo drops. All the infants were diagnosed with colic, born full-term at a healthy gestational weight, had no history of gastrointestinal disorders, were breastfed, not formula fed, and did not receive any other probiotic supplements during the week prior to the study. The infants' mothers were also advised to avoid cow's milk in their own diets during the study period.

Reduction in Crying
Crying was measured in minutes per day. At the beginning of the study, the crying times between the Lactobacillus reuteri group and placebo group were about the same.

Over a three-week period, the infants received either placebo drops or five drops of Lactobacillus reuteri mixed with sunflower oil once a day 30 minutes prior to their morning feeding. Researchers also collected stool samples from the infants to measure bacteria levels.

After three weeks, crying was reduced in both groups, but the Lactobacillus reuteri infants showed the greater reduction -- from a mean of 370 minutes of crying per day at the start of the study to 35 minutes. The placebo group's mean crying time dropped from a mean of 300 minutes per day to 90 minutes. Stool analysis also showed a significant reduction in the presence of E. coli among infants who received the Lactobacillus reuteri drops.

Researchers speculate infants in the placebo group may have experienced an improvement because of reduced cow's milk in the mother's diet.

Overall, the findings support the belief that Lactobacillus reuteri may help reduce colic symptoms by improving gut motility and function, which could reduce gas in the gastrointestinal tract and abdominal pain and cramping. At the same time, Lactobacillus reuteri appears to reduce levels of harmful E. coli.

About 3,700 Zooper strollers have been recalled for a frame latch failure that can result in the high-end stroller unexpectedly collapsing, federal safety official announced Thursday.

The Zooper Tango double strollers were sold in 2007 and 2008 at retailers including Babies “R” Us. Lan Enterprises, the manufacturer of the stroller, has received 185 reports of the problem, according to the U.S. Consumer Product Safety Commission. In one incident, a 13-month-old boy and a 3-year-old boy received scrapes and bruises when their stroller hit a sidewalk curb and then collapsed. The CPSC said owners of the SL808B and SL808F models should stop using the strollers and contact Zooper USA or visit its website, zooper.com, for a repair kit.

Danielle Keeton, M.A. CCC-SLP is the Director of Le Bonheur Early Intervention and Development and Therapy Outreach at Le Bonheur Children’s Hospital. Danielle has been an integral facilitator of the inclusive environment concept, which as she states in her own words below, is beneficial for all children – those with special needs and those who are developing typically.

Now that school has started, it’s a good time for parents to talk to kids about the importance of accepting all of their peers. Kids should be taught that it’s o.k. to be different, and being different provides good learning experiences. Danielle shares her personal thoughts and expertise on the benefits and learning opportunities that come from an inclusive environment.  

"Parents of children with special needs have long sought to have their children included with peers who are developing typically.  Research shows that children with special needs make greater developmental gains when provided with peer modeling in an inclusive environment.  In an effort to make the best choices possible for their kids, many parents of children who are typically developing question the benefits of an inclusive environment for their own children.  I would love to share those benefits with you, as a professional and most importantly, as a mom.

As a Speech Language Pathologist, specializing in early intervention, I have coached students, parents and other caregivers on ways to include all children to maximize the learning for everyone in early childhood environments.  Children who are typically developing learn so much by serving as peer models for their friends with special needs.  Children modeling sign-language or picture symbols to aid in communication, for example, develop a broader vocabulary and combine words at an earlier age than children who are not exposed to alternative communication methods.  Children who are typically developing continue to learn at their natural pace and are not "held back" by sharing a classroom with children who have special needs. 

As the mother of two boys, now entering first grade and kindergarten, I have personally experienced the social and emotional benefits of an inclusive environment for kids with typical abilities. My sons attended an inclusive early childhood center (the LEAD program at Le Bonheur) from age two until they were ready to leave for kindergarten.  They shared daily life with children who ate, breathed, moved, slept, played, and spoke differently from them, and at the end of each day, what they noticed most was that they were all just kids.  My boys learned to help when a friend needed it, to wait when someone took a little longer, and to find what's the same about us all.  I'm not saying that they didn't notice the differences.  They did.  They asked questions about why someone got their food through a tube in their tummy instead of their mouth. Then they pretended to feed their stuffed animals that way!  They asked about why a friend still crawled around the classroom while everyone else walked.  They asked why one child colored with his feet and why he didn't have arms.  I was able to use these daily observations as teachable moments.  Reinforcing that everyone in the world is different, and there's nothing to make fun of or be afraid of.  It's ok to focus on the things we all CAN do.

I'll finish with a story from my younger son's classroom when he was just 4.  Their class was studying Black History Month and listening to a portion of Dr. Martin Luther King Jr's "I Have A Dream" speech.  Their teacher asked them all to draw a picture of something they dreamed about.  My son had a friend in his class who was diagnosed with Cerebral Palsy and used a walker or wheelchair to move around the room.  A little girl in the room drew a picture of her and this child under a rainbow.  She was standing up, holding his hand, and he was standing up too.  Beside the two of them was a scribbled out, empty wheelchair.  Above the rainbow was a blue cloud, and in the middle of the cloud, the words read "I dreamed he was walking."

As I stood outside the classroom admiring this drawing hanging on the bulletin board, my eyes filled with tears, and my heart filled with pride.  That's what an inclusive environment is all about - little people learning to wish for the best, for everyone."

Every family has natural concerns when their child is about to have surgery or a procedure under anesthesia.  For those of you researching this subject, we talked to Dr. Joel Saltzman, Chief of Anesthesia at Le Bonheur Children’s Hospital. He provides excellent insight and solid expertise. Here’s what he had to say.

While there are risks associated with anesthesia, the odds of something going wrong are low. Even traveling in a car is riskier than undergoing anesthesia. Advances in monitoring and specialized training and experience have greatly reduced the risk to children. Many parents ask, “what can I do to reduce the risks to my child?” 

Ways to Reduce Risk (www.pedsanesthesia.org)
• Sharing all information about your child’s health (including all medications your child is taking, even those that can be obtained without a doctor’s prescription) with the anesthesiologist prior to the procedure.  This will allow the anesthesiologist to make a decision as to which type of anesthesia and drugs are safest for the patient.
• Adhering to the guidelines you are given regarding limiting eating and drinking before the operation.
• Continuing usual medications unless the anesthesiologist or surgeon recommends against it.
• Ensuring that any other chronic illnesses are being optimally treated; some require pre-operative clearance.
• Having an anesthesiologist who is experienced in the care of children.

All of the Le Bonheur and Le Bonheur East staff members have specialty training and experience with pediatric anesthesia and sedation.  The Pediatric Anesthesia team is experienced in caring for patients from extreme prematurity through adolescence, as well as adult transition patients.  The team recognizes that the child is the patient, but the entire family is going through a stressful experience.  We work to address the anxiety of the patient and the family.  You will likely hear members of the team say; “We treat every child like he or she is our own,” and we truly mean it.

Most children require a general anesthetic for their surgery or procedure.  Prior to surgery the patient and family will be interviewed by members of the anesthesia care team.  During the interview, the patient is offered a list of pleasant smells to choose from: bubble gum, strawberry and other child friendly flavors.  The interview is very important to allow the team to deliver individualized care and maximize safety.

On arrival to the operating room, monitors are placed by the anesthesia care team.  Standard monitors include a pulse oximeter to measure oxygen content, an EKG to monitor the heart, and a blood pressure cuff.  Some children go to sleep more calmly with only the pulse oximeter, which looks like a Band-Aid with a light on their finger; the other monitors are placed as soon as they are asleep.

The flavored mask is given to the child, and the anesthetic gas is added as the child goes to sleep.  After the child is asleep, an IV is started, and additional medications are administered based on the patient’s needs and weight.  The patient’s airway is secured with a breathing tube, LMA, or mask.  Additional gases the patient inhales and exhales are monitored throughout the procedure.  Following surgery, medications either wear off or are reversed.  The patient continues to be monitored throughout the wake-up process and is then transported to the recovery room.

In the recovery room, the anesthesia team and the recovery room nurse reapply monitors and reassess the patient.  While airway and vital signs are continuously monitored, post-operative pain management is also addressed.  Some children awaken agitated, and this needs to be distinguished from post-op pain.  The surgeon and anesthesia team provide for post-op pain prior to leaving the operating room; however, some children require additional medication in recovery.  In all cases, patient safety is paramount.  Parents are invited into the recovery room with their child.

 Families can find more information at:
1. www.pedsanesthesia.org
Click on: “Parents and Families.”
2. www.asahq.org/clinical/PediatricAnesthesia.pdf
3. Le Bonheur Children’s Hospital
www.lebonheur.org click on: “services” “clinical specialties” “Anesthesiology”
Department of Anesthesiology
(901) 287-6060

From Practical Parenting Blog photos

With summer ending and the start of school just around the corner, drivers need to do their part to keep kids safe as they walk and bike to school. Whether you are taking your kids to school or just driving through a school zone, you can do your part to keep kids safe. August is designated as Back-to-School Safety Month, and we want to remind motorists to be extra careful at all times.
Follow the tips below to make sure you keep your children safe while walking and biking to school

Here are some simple reminders for drivers:
• Slow down and be especially alert in the residential neighborhoods and school zones.
• Take extra time to look for kids at intersections, on medians and on curbs.
• Enter and exit driveways and alleys slowly and carefully.
• Watch for children on and near the road in the morning and after school hours.
• Reduce any distractions inside your car so you can concentrate on the road and your surroundings.
• Put down your phone and don’t talk or text while driving.

Here are some reminders for your kids:
• They should cross the street with an adult until the age of 10.
• Cross the street at corners, using traffic signals and crosswalks.
• Never run out into the streets or cross in between parked cars.
• Make sure they always walk in front of the bus where the driver can see them.

As last year proved beyond a doubt, influenza can be unpredictable. Consequences of the 2009 H1N1 pandemic factored into CDC's Advisory Committee on Immunization Practices' (ACIP) vote earlier this year to recommend universal influenza vaccination for all persons 6 months of age and older.

How does this affect you? Because all people age 6 months and older are now recommended to receive annual influenza vaccination. Vaccination efforts should begin as soon as vaccine is available and continue throughout the influenza season.  This year's vaccine will include the 2009 H1N1 strain as part of the regular seasonal vaccine. Communication science research conducted this summer has shown us that consumers may have safety concerns about the 2009 H1N1 strain being included in the vaccine, which can be a barrier to seeking vaccination. This year's flu vaccine is made in the same way as past flu vaccines. An average of 100 million doses of influenza vaccine have been used in the United States each year and flu vaccines have an excellent safety record.

While everyone is now recommended to receive influenza vaccine, your high-risk patients—pregnant women, those with asthma, diabetes, or other chronic conditions—remain at risk for serious complications from influenza. CDC, and state and local public health agencies, will continue to reinforce efforts to emphasize the crucial importance of vaccine for these groups while simultaneously promoting annual influenza vaccination for everyone in the community.

Parents are encouraged to make sure they vaccinate themselves and their family members too, perhaps utilizing options that might be available through pharmacies, schools, workplaces or other local partners. Information on the flu vaccine is available at www.cdc.gov/flu and www.flu.gov. 

Vaccination continues to be the best protection against influenza and your efforts will be reflected in a healthier community—yours.

With kids back in school and flu season approaching us, Le Bonheur offers some good information for parents. We talked to Dr. Keith English, head of infectious disease at Le Bonheur Children's Hospital. Here are some important points he had to offer.

Flu season usually runs from late fall through mid-winter, though last year was different as the novel H1N1 influenza A pandemic began in early spring.

Flu vaccine is the single most important way to reduce your child’s risk of developing influenza, and this year's vaccine will protect against the novel H1N1 flu virus that was recognized last year as well as two other flu strains.  UNIVERSAL IMMUNIZATION of all children (and adults) 6 months of age and older is recommended.

Note that it is very important for everyone in the family to be immunized, particularly in homes with infants less than 6 months of age and/or with children or adults at higher risk of complications of influenza.

Symptoms of the flu include fever, headache, muscle aches, dry cough and sore throat.  Once symptoms of the flu occur, they typically last anywhere from three to seven days. To relieve your child’s pain and symptoms, first, administer fluids and make sure your child is getting plenty of rest. Acetaminophen helps with the aches, pains and fever reduction.  Do not use aspirin or aspirin-containing products. There are several antivirals that can be prescribed by your doctor if your child has influenza, and these are most effective if given early in the course of the illness.

There are other very important ways to reduce the spread of the flu:

Keep your children away from those with cold or flu symptoms.
Teach your child how to cover his or her mouth and nose with a tissue when sneezing or coughing.
Remind children to wash their hands with soap and water regularly to avoid transmitting the virus.
Keep children home from school, etc., when they are sick. (http://www.flu.gov/plan/school/schoolguidance.html)

If you have questions regarding the flu vaccine or the flu, contact your pediatrician or local health department.

Infant Death Prompts Recall of Nap Nanny® Recliners Due to Entrapment, Suffocation and Fall Hazards

On July 26, the Consumer Product Safety Commission announced the recall of 30,000 Nap Nanny® baby recliners due to entrapment, suffocation and fall hazards. The agency is investigating a report of a 4-month-old girl from Royal Oak, Mich. who died in a Nap Nanny® that was being used in a crib. For more information, read the CPSC recall notice.

http://sk.convio.net/site/R?i=7S4fiHV9Vp5BWrEx72DOSg.

A Le Bonheur specialist’s guide to sun safety all summer long

Fun in the sun is what kids and summer is all about. But trying to decide what sunscreen is best for your child as you sift through the countless brands and forms is no easy task. No need to worry. Mid-South dermatologist Robert Skinner, M.D., has some advice to make those choices easier. Skinner, who works with the UT Medical Group, is board certified by the American Board of Dermatology.

For starters, Skinner recommends that parents use what’s called a physical sunscreen that contains titanium oxide and zinc oxide. Lotions with those ingredients tend to be thicker and look white when first applied. Skinner also cautions parents to stay away from sprays, even though they may seem more convenient for busy children. “You also have to be sure you have a UVA protector, not just UVB,” Skinner said, adding that there has been a bigger emphasis on UVA protection in recent years.

According to the American Academy of Dermatology, UVB rays are the sun’s burning rays and the primary cause of sunburn and skin cancer. UVA rays penetrate deeper into the dermis, or basic layer of skin and can also contribute to sunburns and skin cancer.

Armed with physical sunscreen and UVA and UVB blockers, it’s also important to check the sun protection factor level. An SPF number measures how long you can stay out without getting red, and doesn’t necessarily mean that one bottle of lotion is stronger than another, Skinner said. When parents look for a good level for their children, SPF 30 should be enough. Skinner recommends that parents also reapply sun block every couple of hours, especially when children are in the water or sweating a lot. It’s also important to apply the sunscreen before going outside, he said. Not only is it difficult to get children to stand still once they are at the pool, there also a chance you might forget to apply once you are outside. Speaking of outside, Skinner recommends that parents be smart when considering when to apply the lotion. If you are going to the beach, an amusement park or the zoo, for example, put it on. “I think anytime you’re out for a prolonged period of time, it’s best to err on the side of caution,” he said. But if you do forget, and your child does burn, there’s no real quick fix. Baths and emollient creams can help some, though. He recommends the over-the-counter lotion for burns. Skinner’s best advice for that: “just don’t forget the sunscreen.”

As the temperature continues to rise, so do the numbers of children dying in hot vehicles. Through the end of July there has been a record number of children - 28 - who have died due to vehicular heat stroke, making 2010 the worst year ever for children dying in hot cars.

The NBC TODAY Show aired a segment to help raise awareness about these dangers and let people know that technology does exists to prevent these tragedies. Spread the word and share our safety tips to help prevent any more children from dying in this manner. Log on to http://today.msnbc.msn.com/ to view the segment and read more about the technology and safety tips to prevent this from happening.

Safe Kids Mid-South says to keep peeking in car windows in parking lots. And to call 9-1-1 if you see a child in a car - you could save the life of an innocent child.