Many parents have concerns about the choices their child is making when it comes to underage drinking. This is an issue that requires a real commitment from both of the parents. Alcohol can be dangerous, and teens and young adults aren’t always aware of its consequences. We talked to Dr. Katie Alvord, a local pediatrician, about some signs of alcohol use parents should watch for. Here’s what she had to say:

“Parents should start talking to their kids about drugs and alcohol around the age of 12  -- and keep talking about it. There’s no limit to how often you can discuss the risks, dangers and consequences of alcohol. Parents should make the point that alcohol is often associated with making poor choices. In this day in time, especially with social media, making bad choices can have very long-term affects. Try not to sound close-minded when you have your discussions; kids should feel comfortable talking about it with you. An open relationship and a good comfort level is key when it comes to parenting. When you can get your child to be open and honest, you’re doing the right things.”

There are some specifics signs that should cause concern. Here’s a watch list from www.antidrug.com.
 
•  Changes in friends
•  Negative changes in schoolwork, missing school or declining grades
•  Increased secrecy about possessions or activities
•  Use of incense, room deodorant or perfume to hide smoke or chemical odors
•  Subtle changes in conversations with friends, (e.g. more secretive, using “coded” language)
•  Change in clothing choices; new fascination with clothes that highlight drug use
•  Increase in borrowing money
•  Evidence of drug paraphernalia, such as pipes, rolling papers, etc.
•  Evidence of use of inhalant products (such as hairspray, nail polish, correction fluid, common household products); Rags and paper bags are sometimes used as accessories
•  Bottles of eye drops, which may be used to mask bloodshot eyes or dilated pupils
•  New use of mouthwash or breath mints to cover up the smell of alcohol
 

We thought our readers might enjoy this segment that aired recently on WHBQ Fox13. Reporter Sarah Bleau takes a look inside Le Bonheur's Pet Therapy Program, which helps patients cope with being at the hospital. Learn why it works!

Recommendations for this year’s flu season urge parents to get all children ages 6 months and older vaccinated against the flu. Updated guidelines were published Sept. 10 in Pediatrics, the journal of the American Academy of Pediatrics (AAP).

Those who regularly care for a young child are especially encouraged to be immunized, the guidelines state. Children ages 2 years and younger are considered at high-risk for influenza-associated hospitalization. Other high risk groups include:

• Children who have medical issues like asthma, diabetes, suppressed immune systems or neurologic disorders
• Women who are pregnant, have just delivered or are breastfeeding

Here’s what you need to know about the flu vaccine this year, as outlined by the AAP:

• For children 6 months or older, the vaccine can still be delivered via an injection.
• Kids 2 years old or older can receive the nasal spray version.
• If your child is between the ages of 6 months and 8 years and has received at least two does of the fly vaccine since July 1, 2010, he or she only needs done dose of the vaccine this season.
• Children in that age group (6 months-8 years) who have not received two or more doses in that time frame need two doses of this year’s vaccine.

For more information about the flu vaccine, visit the AAP’s website or consult your child's pediatrician.

This week is Child Passenger Safety Week. Check out the information below from Safe Kids USA for information on how to ensure your children are safe in the car.

Parents are making five critical, but fixable, mistakes when using child safety seats, according to new data announced recently.

“Correctly used child safety seats can reduce the risk of death by as much as 71 percent,” said Susan Helms, director of injury prevention and Safe Kids at Le Bonheur Children’s Hospital. “Engineers are working hard to ensure cars and child safety seats are designed to keep kids as safe as possible. But it’s up to every parent to take full advantage of these innovations by making sure child safety seats are used and installed correctly.”

Motor vehicle crashes are a leading cause of death to children ages 1 to 14. In a nationwide effort to educate parents about the importance of child safety seats, Safe Kids and the General Motors Foundation are asking every parent to take 15 minutes for an at-home car seat checkup using the Safe Kids downloadable checklist.

Car Seat Checkup Checklist

• Right Seat. This is an easy one. Check the label on your child safety seat to make sure it’s appropriate for your child’s age, weight and height. Like milk, your child safety seat has an expiration date. Just double check the label to make sure it is still safe. 
• Right Place. Kids are VIPs, just ask them. We know all VIPs ride in the back seat, so keep all children in the back seat until they are 13. 
• Right Direction. You want to keep your child in a rear-facing child safety seat for as long as possible, usually until around age 2. When he or she outgrows the seat, move your child to a forward-facing child safety seat. Make sure to attach the top tether after you tighten and lock the seat belt or lower anchors. Continue to use a booster seat until your child properly fits in the seat belt, usually when they are between the ages of 8 and 12.
• Inch Test. Once your child safety seat is installed, give it a good shake at the base. Can you move it more than an inch side to side or front to back? A properly installed seat will not move more than an inch.
• Pinch Test. Make sure the harness is tightly buckled and coming from the correct slots (check child safety seat manual). Now, with the chest clip placed at armpit level, pinch the strap at your child’s shoulder. If you are unable to pinch any excess webbing, you’re good to go.  

The at-home checklist is meant to be a first step. Parents are encouraged to read the vehicle and child safety seats instruction manuals to help with the checklist. Certified child passenger safety technicians are also available to provide one-on-one “hands-on” help with installation. You may call the coalition at (901) 287-6730 to make an appointment.

Last week, Pediatrics, the official journal of the American Academy of Pediatrics, published a research article investigating the positives and negatives of behavioral infant sleep intervention for infants who cry when put to bed. Thomas Hobson, director of Child Life at Le Bonheur, weighs in on this topic below.

It is not uncommon for infants between the ages of 6 – 12 months to develop parent-reported sleep problems. These are well, healthy children who all of the sudden cry, get upset, etc., when put down to sleep. The study found there are two best practices – called controlled comforting and camping out – that effectively address the behavior and have no long-term impact on the child.

Dealing with behavioral sleep issues with your child is a common experience for many parents – and it can be exhausting. So, I thought I would share some tips and tricks, applying the two practices mentioned in the Pediatrics article.

My 6 – 12-month-old infant starts crying when put to bed.
Controlled comforting: When an infant is put in bed and starts to cry, the parent responds but gradually, over time, increases the length of time between responses. This helps the child more learn to self-soothe. This is a great technique, but if you have a hard time letting your child cry, you have to commit yourself to following it.

Camping out: When the infant is put to bed, the parent stays in the room. The parent sits in the room, letting then child learn to fall asleep on his or her own. As the child learns to fall asleep on his own, the parent slowly removes himself/herself from the room.

My toddler/pre-schooler won’t stay in bed.
In situations like this, I recommend a modified camping out method. Go through your normal bedtime routine, put your child to bed, and then either sit outside of the room or in the room. When your child gets out of bed, pick him up and put him back into bed. The most important part of this interaction is that you don’t give any kind of reinforcement, positive or negative. This means that you don’t talk, make eye contact, play, scold, or anything else. This can be hard to do, but the lack of interaction shows that this will continue to happen. Also, you may have to do this for several days, but in a short period of time, your child will stay in bed.

My child keeps getting into my bed in the middle of the night.
This is a common situation, and it’s tough on the parents. I would treat this situation just like the child who won’t stay in bed. As soon as your child gets into your bed, pick him up and put him back in his own bed. Remember to be consistent.

When one of your children is having a behavioral-based sleep issue, it’s exhausting for both you and your child. Unfortunately, when you’re tired, you’re more likely to cave in or let this behavior become the “new normal.” The truth is there are great approaches that you can use that will help both you and your child. Yes, they will take some effort on the front end, but not nearly as much as you think.

If you have a child in school, you may have gotten the dreaded letter about head lice in the class. Lice can be common in children, but there are things parents can do to prevent their child from getting them. We talked to Dr. Kip Frizzell, local pediatrician and director of the Coordination of Care for Le Bonheur Children’s Hospital. Here’s what he had to say.

“Head lice are ectoparasites, meaning that they live on or within the skin rather than inside the body. They are mostly common among preschool and school age-children and they are very contagious. Having head lice has nothing to do with a child’s hygiene or the cleanliness of their household. Despite these being the facts, in many instances the parent and the child feel embarrassed for having it.

An adult head louse is tan or grayish white and about the size of a sesame seed. The eggs are located at the base of the hair strand and are colored to match the color of the hair. This is why lice are so hard to see. The hatched eggs are much easier to see because they become white in color. Usually, it’s easier to see the eggs at the nape of the neck or behind the ears.

Lice can’t live away from a host for more than 24 hours and cannot jump from one person’s head to another. Transmission is usually from direct head to head contact or from kids sharing things such as hats, coats, pillows or clothing.

The best prevention is to be informed about any outbreaks of lice. If your child has been exposed, check them daily looking closely around the neck, ears and individual hairs. If you notice that lice are there, it’s best to call the pediatrician for treatment options.

It is important to understand that lice aren’t caused by bad hygiene. Many of the parents I see are embarrassed about having it. Don’t be; lice are just a pesky, really contagious problem that many, many people have to deal with.”

The U.S. Consumer Product Safety Commission (CPSC) announced a recall of more than 450,000 horizontal and vertical window blinds made by Blind Xpress, a Michigan-based company. The recall was made after a 2-year-old was reportedly strangled in the blind’s cord in 2009.

The recall includes all Blind Xpress custom-made vertical blinds (sold throughout Michigan, Ohio and Indiana) without a cord-tensioning device that attaches to a wall or floor. It also involves Blind Xpress horizontal blinds without inner cord stop devices.

This recall serves a good reminder for parents to be mindful of the danger of exposed cords – such as those of window blinds – that are a strangulation hazard.

For more information about the recall, visit the CSPC website. The Window Covering Safety Council will give free repair kids to consumers to own the recalled blinds.

Labor Day marks the unofficial end of summer, but there will likely be many more sunshine-filled days to enjoy traveling and social gatherings with friends and family. You will probably be on the road or near water so Safe Kids Mid-South, led by Le Bonheur Children’s Hospita,l wants you to keep the following safety tips in mind to keep your family safe.

Inside the Vehicle
• Children should not be left in a car without an adult, not even for a second.
• Always lock car doors and the trunk.
• Keep keys and remote entry devices out of reach of children.
• Don’t be a distracted driver.
• Always choose a designated driver before the festivities begin.
• Never use the cell to talk or text while driving.
• Always look twice when turning and crossing streets.

Child Safety Seat Basics
• Children should ride in the back seat until age 13. 
• Children and adults should be buckled up on every ride, no matter how short the trip.  
• Children should use child safety seats or booster seats that are right for their age, height and weight.  
• Always follow all the instructions on using and installing a child safety seat.  
• Never use a child safety seat found at a flea market or yard sale. The recall and coding updates may not be up to date.
• Make sure you are using the best child safety seat for your child -- if you are not sure, ask us. Safe Kids Mid-South is here to help!

In or Near Water
• Always watch children when they are in or near water -- never leave them alone.
• Inexperienced swimmers should be within an adult’s reach in the water.
• Have “designated water watchers” who are responsible adults with a focus on actively supervising children.
• If a child is missing, check the water first.
• Have a phone handy in case there is an emergency.
• Teach children water safety skills. Enroll them in swimming lessons.
• Use life jackets. Swimming noodles and water wings are not safety devices.
• Know how to perform CPR and use rescue equipment.

Hormones. We all have them, but what are they and how do they affect our behavior or moods? At what age should parents expect to see hormonal or physical changes in their children? We asked Dr. Robert Ferry, a Le Bonheur pediatric endocrinologist, to answer some of parents' most common questions about hormones. 

What are hormones?
Several glands in the body produce hormones, special chemicals that travel through the blood to control growth, puberty and metabolism.  

How do they affect girls/boys?
Several hormones are essential for normal growth, overall health and metabolism in both girls and boys. For example, the pituitary gland in the brain produces growth hormone, which is essential for most of the normal growth during infancy, childhood and adolescence.  LH and FSH are two pituitary hormones that control puberty. The thyroid gland in the neck produces thyroid hormone, which is essential for normal brain development in infants as well as normal growth and metabolism throughout life. 

What age should I expect changes?
The first sign of true puberty in boys is enlargement of the testes, as these organs began to produce testosterone, typically between ages 9.5 to 13.5 years.  The first sign of true puberty in girls is breast development, which happens after estrogen release from an ovary, typically between ages 9 to 13 years.  Pubic hair, body odor and moodiness are unreliable as indicators of puberty and often represent normal variations of maturation and development.  However, many children and parents become concerned by such changes.  When in doubt, ask your doctor.  Your doctor can assess the issue and, if necessary, refer to a pediatric endocrinologist for further evaluation.  That said, any boy lacking pubic hair by age 14 and any girl who has not menstruated by age 14.5 years should be formally evaluated by a physician.

Do hormones change their behavior?
Hormones cannot be blamed for most of the unpleasant behaviors typically associated with childhood and adolescence (e.g., toddlers' tantrums, teenagers' sulky moodiness and risky behaviors). Still, a significant change in behavior for your child, or a substantial difficulty in academic performance, can be a symptom of an endocrine disorder. Talk with your health care provider about your concerns. He or she can determine whether referral is needed for further counseling or evaluation by a psychologist, pediatric endocrinologist or other specialist.

Reassure your child about normal changes associated with puberty. Answer your child's questions directly but at a level appropriate to the question. Most children do not require detailed answers so much as they want reassurance that you will be candid and, as a parent, care about her/his concerns.

Are there tips for how to handle a pre-teen child who seems to be especially emotional?
Listening to your child's concerns, setting clear limits and providing unconditional love are the most supportive actions that a parent or guardian can take. Encourage your child to keep a diary, and try to respect your child's privacy whenever possible. For instance, when visiting your child’s pediatrician, take some time to step outside the exam room in order to allow your child to discuss her/his concerns privately with the doctor.

I've noticed my daughter had strong body odor and was extremely irritable with her family.  Now she seems to be calmer and her body odor has improved.  Does that involve hormone changes?
Puberty typically lasts 3.5–five years and is associated with dramatic changes in physical growth and development, hormone actions, societal expectations, and your child's self-esteem and self-perception. It's normal for a child to have body odor and need deoderant as early as age 4, without true puberty. Discuss your concerns with your child’s pediatrician, who can best perform a comprehensive assessment of your child's health, including a physical examination.  Your child’s doctor can determine whether referral is needed for further counseling or evaluation by a psychologist, pediatric endocrinologist or other specialist.