Is Your Child Consuming Too Much Sodium

sodium

 The September 2014 edition of the Centers for Disease Control (CDC) Vital Signs focuses on the amount of sodium in children’s diets.

Reducing Sodium in Children’s Diets

Nearly 9 in 10 US children eat more sodium than recommended, and about 1 in 6 children has raised blood pressure, which is a major risk factor for heart disease and stroke. Lowering sodium in children’s diets today can help prevent heart disease tomorrow. Small changes make a big impact on your child’s daily sodium intake. Learn more in the current CDC Vital Signs.

Sources of Sodium

Americans get most of their daily sodium—more than 75%—from processed and restaurant foods.2 What is processed food?

Sodium is already in processed and restaurant foods when you purchase them, which makes it difficult to reduce daily sodium intake on your own. Although it is wise to limit your use of added table salt while cooking and at the table, only a small amount of the sodium we consume each day comes from the salt shaker.

Dietary Guidelines for Sodium and Potassium

The Dietary Guidelines for Americans, 2010[PDF-2.9M] recommend that everyone age 2 and up should consume less than 2,300 milligrams (mg) of sodium each day. Some groups of people should further limit sodium intake to 1,500 mg per day, including:

  • Adults age 51 or older.
  • All African Americans.
  • Anyone who has high blood pressure, diabetes, or chronic kidney disease.

Those groups add up to about half of the U.S. population and the majority of adults.

The Dietary Guidelines for Americans also recommend meeting the potassium recommendation (4,700 mg per day). Higher potassium intake can help lower blood pressure. Foods that are high in potassium and low in sodium include bananas, potatoes, yogurt, and dry beans, among others. The U.S. Department of Agriculture’s Sodium and Potassium fact sheet[PDF-153K] has more information about the role of potassium in a healthy diet and a list of foods rich in potassium.

Nearly everyone benefits from lower sodium intake. Learn more about sodium in your diet in Where’s the Sodium?, a February 2012 report from CDC Vital Signs.

 

Keeping Foodborne Illness Out of the Lunchbox

lunchboxTo help prevent what the USDA calls a serious public health threat…foodborne illness in the lunchbox; follow these six top tips for keeping foods safe.

  1. If you’re packing meats, eggs, yogurt or other perishable food, use at least two freezer packs. Harmful bacteria grow rapidly between 40 and 140 degrees Fahrenheit.
  2. Juice boxes can provide another option: freeze some juice boxes overnight to use with at least one freezer pack. The frozen juice boxes will thaw by lunchtime.
  3. If there’s a refrigerator at school or work, find a space for your lunch. Remove the lid or open the bag so the cold air can circulate better.
  4. Use an insulated, soft-sided lunchbox or bag instead of a paper bag. Perishable food can spoil more quickly in a paper bag.
  5. For a hot lunch like soup, use an insulated container. Make sure the container remains tightly closed until lunchtime.
  6. And finally, throw out all leftover food, used packaging and paper bags.

Medline Plus, a service of the National Institutes of Health, reminds us that not all illness comes from the food. It can come from a lunchbox that is not properly cleaned, or from the area where the lunch was prepared. They ask that we please remember that:

  • A dirty lunchbox may contain bacteria that can make a youngster  sick.
  • A lunchbox picks up a lot of grime in a day.
  • Kids don’t always wash their hands before handling their lunchboxes and food.
  • It’s a good idea to put a small bottle of antibacterial gel with a tight-fitting lid in your child’s lunchbox. Your child can use the gel when there isn’t a chance to wash with soap and water before eating lunch.
  • Kids should avoid setting down their food on the table. Include a paper towel, a piece of wax paper, or even a small fabric place mat in your child’s lunchbox that can be washed at home to help keep food off surfaces that may have been used by a number of youth and adults.

When packing a lunchbox:

  • Start with clean hands, a clean work surface and a clean lunchbox.
  • Disinfect kitchen surfaces, such as kitchen equipment and refrigerator handles, regularly.
  • Also clean cutting boards, knives, dish-drying towels and sponges or dish cloths daily.
  • Wash fruits and vegetables before packing them

 

Labeling for Pediatric Medications

pediatricThe Food and Drug Administration (FDA) has made it easier for parents and health care professionals to find information on pediatric medications. The FDA created a database that covers medical products studied in children under recent pediatric legislation.

The C4 is a one-stop resource. You can search for information by the product’s commercial or chemical name, or by the condition for which it was studied. FDA’s Office of Pediatric Therapeutics (OPT), which focuses on safety, scientific, and ethical issues that arise in pediatric clinical trials or after products are approved for use in children, developed the tool in collaboration with another branch of the agency, the Center for Drug Evaluation and Research.

OPT also maintains a Safety Reporting page5 with information on products that have been tied to safety problems that specifically relate to children. This page lists products that have been the subject of an adverse event report presented to FDA’s Pediatric Advisory Committee, a group of outside experts that advises the agency on pediatric treatments, research and labeling. (An adverse event is any undesirable experience associated with a medical product.)  The committee’s recommendation is also given if further actions were necessary to ensure safe use of the product in children.

“We are excited to share this goldmine of information with parents,” says Debbie Avant, R.Ph., the health communications specialist in OPT who helped develop and maintain the database. “We want parents to know they can rely on FDA for accurate, timely information about the medications their children take.”

Pediatric Medication Labels

Parents should always read medicine labeling carefully. For prescription medications and vaccines, there is a Pediatric Use section in the labeling that says if the medication has been studied for its effects on children. The labeling will also tell you what ages have been studied. (This labeling is the package insert with details about a prescription medication.)

Congress’ efforts to increase the number of studies of prescription drugs used in children have allowed FDA to build a foundation for pediatric research and discover new things. For example, researchers have found that certain drugs produce more side effects for the nervous system in children than adults, says Dianne Murphy, M.D., OPT’s director.

FDA is able to use information gathered from pediatric studies to make labeling changes specific to kids, and to share that news with the public. The database, which is updated regularly, currently contains more than 440 entries of pediatric information from the studies submitted in response to pediatric legislative initiatives. The labeling changes include:

  • 84 drugs with new or enhanced pediatric safety data that hadn’t been known before;
  • 36 drugs with new dosing or dosing changes;
  • 80 drugs with information stating that they were not found to be effective in children; and
  • 339 drugs for which the approved use has been expanded to cover a new age group based on studies.

The easiest way for parents to use the database is to search by their child’s condition to find all mentions of that condition in all of the labeling information within the database. If you know the name of the drug you want to find, sort the database’s information by trade name.

Avant says parents should note that the database contains the version of the label at the time of the labeling change. It may not be updated with later changes if they don’t affect children.

OPT has also evaluated the amount of progress in the inclusion of pediatric information in drug labeling and has published a research letter in the Journal of the American Medical Association67on May 9, 2012. They found that in 2009, more than 60% percent of the drugs used for both adults and children that were in the Physician’s Desk Reference—a drug information resource for physicians and other health professionals—had specific information on pediatric use, compared to only 22 percent in 1975.

Critical information in the pediatric section of the labeling tells you if the product was studied in children but could not be shown to work. When a product has been studied in adults and cannot be shown to be effective, that information is not put in the label. However, Congress told FDA to put this information in labeling when a product had been studied in children and was not effective.

“There is still much work to be done, as we have only studied two thirds of the products that are already on the market,” says Murphy. “And there is a steady stream of new products approved every year for children and adults.”

Source : FDA Consumer Updates page

Back to School Health and Safety Tips

School

It’s that time again; it’s back to school time with all the prep and practical planning needed to launch the school year for your child(ren). The American Academy of Pediatrics shares about health and safety tips at the start of the school year in the following release. Hopefully it will make your work a little easier.


MAKING THE FIRST DAY of SCHOOL EASIER

  • Remind your child that there are probably a lot of students who are uneasy about the first day of school. This may be at any age. Teachers know that students are nervous and will make an extra effort to make sure everyone feels as comfortable as possible.
  • Point out the positive aspects of starting school.  She’ll see old friends and meet new ones. Refresh her positive memories about previous years, when she may have returned home after the first day with high spirits because she had a good time.
  • Find another child in the neighborhood with whom your student can walk to school or ride on the bus.
  • If it is a new school for your child, attend any available orientations and take an opportunity to tour the school before the first day.
  • If you feel it is needed, drive your child (or walk with her) to school and pick her up on the first day.

BACKPACK SAFETY

  • Choose a backpack with wide, padded shoulder straps and a padded back.
  • Pack light. Organize the backpack to use all of its compartments. Pack heavier items closest to the center of the back. The backpack should never weigh more than 10 to 20 percent of your child’s body weight.
  • Always use both shoulder straps. Slinging a backpack over one shoulder can strain muscles.
  • If your school allows, consider a rolling backpack. This type of backpack may be a good choice for students who must tote a heavy load. Remember that rolling backpacks still must be carried up stairs, they may be difficult to roll in snow, and they may not fit in some lockers.

TRAVELING TO AND FROM SCHOOL

Review the basic rules with your student:

SCHOOL BUS

  • Children should always board and exit the bus at locations that provide safe access to the bus or to the school building.
  • Remind your child to wait for the bus to stop before approaching it from the curb.
  • Make sure your child walks where she can see the bus driver (which means the driver will be able to see her, too).
  • Remind your student to look both ways to see that no other traffic is coming before crossing the street, just in case traffic does not stop as required.
  • Your child should not move around on the bus.
  • If your child’s school bus has lap/shoulder seat belts, make sure your child uses one at all times when in the bus. (If your child’s school bus does not have lap/shoulder belts, encourage the school system to buy or lease buses with lap/shoulder belts.}

CAR

  • All passengers should wear a seat belt and/or an age- and size-appropriate car safety seat or booster seat.
  • Your child should ride in a car safety seat with a harness as long as possible and then ride in a belt-positioning booster seat. Your child is ready for a booster seat when she has reached the top weight or height allowed for her seat, her shoulders are above the top harness slots, or her ears have reached the top of the seat.
  • Your child should ride in a belt-positioning booster seat until the vehicle’s seat belt fits properly (usually when the child reaches about 4′ 9″ in height and is between 8 to 12 years of age). This means that the child is tall enough to sit against the vehicle seat back with her legs bent at the knees and feet hanging down and the shoulder belt lies across the middle of the chest and shoulder, not the neck or throat; the lap belt is low and snug across the thighs, and not the stomach.
  • All children younger than 13 years of age should ride in the rear seat of vehicles. If you must drive more children than can fit in the rear seat (when carpooling, for example), move the front-seat passenger’s seat as far back as possible and have the child ride in a booster seat if the seat belts do not fit properly without it.
  • Remember that many crashes occur while novice teen drivers are going to and from school. You should require seat belt use, limit the number of teen passengers, and do not allow eating, drinking, cell phone conversations,  texting or other mobile device use to prevent driver distraction. Limit nighttime driving and driving in inclement weather. Familiarize yourself with your state’s graduated driver’s license law and consider the use of a parent-teen driver agreement to facilitate the early driving learning process. For a sample parent-teen driver agreement, see www.healthychildren.org/teendriver

BIKE

  • Always wear a bicycle helmet, no matter how short or long the ride.
  • Ride on the right, in the same direction as auto traffic.
  • Use appropriate hand signals.
  • Respect traffic lights and stop signs.
  • Wear bright-colored clothing to increase visibility. White or light-colored clothing and reflective gear is especially important after dark.
  • Know the “rules of the road.”

WALKING TO SCHOOL

  • Make sure your child’s walk to school is a safe route with well-trained adult crossing guards at every intersection.
  • Identify other children in the neighborhood with whom your child can walk to school.  In neighborhoods with higher levels of traffic, consider organizing a “walking school bus,” in which an adult accompanies a group of neighborhood children walking to school.
  • Be realistic about your child’s pedestrian skills. Because small children are impulsive and less cautious around traffic, carefully consider whether or not your child is ready to walk to school without adult supervision.
  • If your children are young or are walking to a new school, walk with them the first week or until you are sure they know the route and can do it safely.
  • Bright-colored clothing will make your child more visible to drivers.

EATING DURING THE SCHOOL DAY

  • Most schools regularly send schedules of cafeteria menus home and/or have them posted on the school’s website. With this advance information, you can plan on packing lunch on the days when the main course is one your child prefers not to eat.
  • Look into what is offered in school vending machines. Vending machines should stock healthy choices such as fresh fruit, low-fat dairy products, water and 100 percent fruit juice.  Learn about your child’s school wellness policy and get involved in school groups to put it into effect.
  • Each 12-ounce soft drink contains approximately 10 teaspoons of sugar and 150 calories. Drinking just one can of soda a day increases a child’s risk of obesity by 60%. Choose healthier options to send in your child’s lunch.


BULLYING

Bullying or cyberbullying is when one child picks on another child repeatedly. Bullying can be physical, verbal, or social. It can happen at school, on the playground, on the school bus, in the neighborhood, over the Internet, or through mobile devices like cell phones.

When Your Child Is Bullied

  • Help your child learn how to respond by teaching your child how to:
    1. Look the bully in the eye.
    2. Stand tall and stay calm in a difficult situation.
    3. Walk away.
  • Teach your child how to say in a firm voice.
    1. “I don’t like what you are doing.”
    2. “Please do NOT talk to me like that.”
    3. “Why would you say that?”
  • Teach your child when and how to ask a trusted adult for help.
  • Encourage your child to make friends with other children.
  • Support activities that interest your child.
  • Alert school officials to the problems and work with them on solutions.
  • Make sure an adult who knows about the bullying can watch out for your child’s safety and well-being when you cannot be there.
  • Monitor your child’s social media or texting interactions so you can identify problems before they get out of hand.

When Your Child Is the Bully

  • Be sure your child knows that bullying is never OK.
  • Set firm and consistent limits on your child’s aggressive behavior.
  • Be a positive role model. Show children they can get what they want without teasing, threatening or hurting someone.
  • Use effective, non-physical discipline, such as loss of privileges.
  • Develop practical solutions with the school principal, teachers, counselors, and parents of the children your child has bullied.

When Your Child Is a Bystander

  • Tell your child not to cheer on or even quietly watch bullying.
  • Encourage your child to tell a trusted adult about the bullying.
  • Help your child support other children who may be bullied.
  • Encourage your child to include children being bullied in activities.
  • Encourage your child to join with others in telling bullies to stop.


BEFORE AND AFTER SCHOOL CHILD CARE

  • During early and middle childhood, youngsters need supervision. A responsible adult should be available to get them ready and off to school in the morning and supervise them after school until you return home from work.
  • If a family member will care for your child, communicate the need to follow consistent rules set by the parent regarding discipline and homework.
  • Children approaching adolescence (11- and 12-year-olds) should not come home to an empty house in the afternoon unless they show unusual maturity for their age.
  • If alternate adult supervision is not available, parents should make special efforts to supervise their children from a distance. Children should have a set time when they are expected to arrive at home and should check in with a neighbor or with a parent by telephone.
  • If you choose a commercial after-school program, inquire about the training of the staff. There should be a high staff-to-child ratio, and the rooms and the playground should be safe.

DEVELOPING GOOD HOMEWORK AND STUDY HABITS

  • Create an environment that is conducive to doing homework. Children need a consistent work space in their bedroom or another part of the home that is quiet, without distractions, and promotes study.
  • Schedule ample time for homework.
  • Establish a household rule that the TV and other electronic distractions stay off during homework time.
  • Supervise computer and Internet use.
  • Be available to answer questions and offer assistance, but never do a child’s homework for her.
  • Take steps to help alleviate eye fatigue, neck fatigue and brain fatigue while studying. It may be helpful to close the books for a few minutes, stretch, and take a break periodically when it will not be too disruptive.
  • If your child is struggling with a particular subject, and you aren’t able to help her yourself, a tutor can be a good solution. Talk it over with your child’s teacher first.
  • Some children need help organizing their homework.  Checklists, timers, and parental supervision can help overcome homework problems.
  • If your child is having difficulty focusing on or completing homework, discuss this with your child’s teacher, school counselor, or health care provider.

© 2014 – American Academy of Pediatrics

 

E-cigarettes…What Do We Know About Their Safety ?

e-cigerettes

In an effort to quit,many people who smoke, are turning to e-cigarettes to help ease the process of giving up cigarettes entirely. Adolescents are experimenting with e-cigarettes. Yet little is known about the long term effects of using e-cigarettes.

What follows is a press release that speaks to the concerns of The  American Association for Cancer Research (AACR) and the American Society of Clinical Oncology (ASCO) with regard to e-cigarettes.

 Press release... The American Association for Cancer Research (AACR) and the American Society of Clinical Oncology (ASCO), in a joint letter responding to a proposal by the U.S. Food and Drug Administration (FDA) to extend its regulatory authority over tobacco products, today urged the agency to regulate electronic cigarettes (e-cigarettes), cigars, and all other tobacco products and to strengthen the proposed regulations for newly deemed products.

“There is no safe form of tobacco use,” said Margaret Foti, PhD, MD (hc), chief executive officer of the AACR. “Tobacco is the leading cause of preventable deaths in the United States, and among its dire health consequences are 18 different types of cancer. It is imperative that the FDA takes action to regulate all tobacco products. The future health of the American people, in particular our nation’s children, depends on it.”

The AACR and ASCO applauded the FDA’s proposal to regulate e-cigarettes. “We believe it is vitally important for the FDA to begin regulating these products,especially because we don’t know much about the health effects of e-cigarette use. We are also quite concerned that e-cigarettes may increase the likelihood that nonsmokers or former smokers will use combustible tobacco products or that they will discourage smokers from quitting,” said Peter P. Yu, MD, FASCO, president of ASCO.

“There are insufficient data on the long-term health consequences of e-cigarettes, their value as tobacco cessation aids, or their effects on the use of conventional cigarettes. Any benefits of e-cigarettes are most likely to be realized in a regulated environment in which appropriate safeguards can be implemented,” said Roy S. Herbst, MD, PhD, chair of the AACR Tobacco and Cancer Subcommittee and chief of medical oncology at Yale Comprehensive Cancer Center.

The AACR and ASCO support many of the FDA’s proposals for regulating e-cigarettes and other products, but urge the agency to do more. Specifically, preventing children from using tobacco products is crucial and can be achieved by efforts such as banning youth-oriented advertising and marketing, self -service product displays, and tobacco company sponsorship of youth-oriented events, in addition to restricting sales to minors and implementing age-verification procedures for internet sales.

Expressing grave concern about the proliferation of flavored e-cigarettes, the AACR and ASCO encouraged the agency to ban e-cigarette flavors or flavor names that are brand names of candy, cookies, soda, and other such products, and to prohibit e-cigarettes containing candy and other youth-friendly flavors, unless there is evidence demonstrating that they do not encourage young people to use these products.

The AACR and ASCO strongly discouraged the FDA from exempting “premium” cigars from regulation, an option the agency is considering. “All cigars pose serious health risks,” said Graham Warren, MD, PhD, chair of ASCO’s Tobacco Cessation and Control Subcommittee. “As the FDA itself noted in the proposed rule, even cigar smokers who do not inhale have a seven to 10 times higher overall risk of mouth and throat cancer compared with individuals who have never smoked.Exempting these dangerous products from FDA regulation is clearly not in the best interest of public health.”

Noting that both large and small cigars are of increasing interest to youth and adult users, the AACR and ASCO underscored that the continued availability of premium cigars in an unregulated market, compounded with the ability of the tobacco industry to strategically market its products to youths and young adults, could reverse the progress made in reducing youth tobacco use.

Finally, the AACR and ASCO urged the FDA to drop the “consumer surplus” discount used to assess the net impact of the proposed deeming rule. This discount allows the FDA to only consider 30 percent of the benefits achieved via tobacco cessation due to the costs associated with this proposed regulation, including the “lost pleasure” of smoking. The AACR and ASCO stressed that addiction is an unwelcome burden for many tobacco users and that many consumers are not making rational and fully informed choices when initiating and continuing their use of tobacco products.