a weblog of pediatric and parenting
news and current events:
Monday, March 24, 2003
We all want our children to get their vitamins and minerals, but having a penny dissolve in their stomach is not a good way to get your child his recommended daily requirements of zinc.
A new article in the March issue of the journal Pediatrics describes a toddler who had an xray done because of a fever and cough, on which his doctors found a coin lodged in his esophagus. The coin was taken out and found to be an eroding and dissolving penny, which had caused irritation in his esosphagus and which could have led to a perforation or rupture.
The fact that pennies are now made mostly from zinc and they can dissolve in a child's stomach because of the reaction between the acid and zinc was first reported in 1998. Although previously made from copper, in 1982, pennies began being minted from mostly zinc with a very thin copper coating. Copper pennies were too expensive to make and the best alternative was thought to be zinc. Aluminum, although also inexpensive, was thought to not be safe, because if children swallowed them, they wouldn't show up on xray.
The case, although it shouldn't alarm any parents or lead them to throw out their pennies, does raise some interesting points.
The first is that young children commonly swallow things. In fact, it is estimated that 5% of children swallow coins. And unless you witness it, you probably aren't going to know that your child swallowed something, which makes looking for symptoms important. One of the biggest is a long term cough that isn't getting better. The child in this case had been coughing for 4 months without improvement. Remember not everything that wheezes is asthma and if a child isn't getting better, further testing is often needed, which in the case of a chronic cough, might be a chest xray.
Another point is that if your child does swallow a coin, even if you witness it, you aren't going to know what type of coin it is. So get an xray and watch for it to pass in your child's stool. If it doesn't quickly pass or if you think it is a newer penny, consider another xray to monitor its passage.
And keep your child's environment safe, removing coins and other small choke hazards from where he can get to them. Although most other US coins are made of nickle, they can still cause problems if swallowed.
Newer Canadian pennies, made after 1997, are also made mostly of zinc.
Sunday, March 16, 2003
The news of a new, deadly form of pneumonia (Severe Acute Respiratory Syndrome) likely has a lot of people scared. It is hard not to be concerned when you hear reports of health agencies issuing a Health Alert Notice and Global Health Warning.
And the vague warnings of looking for symptoms such as fever and 'one or more signs or symptoms of respiratory illness including cough, shortness of breath, difficulty breathing, hypoxia, radiographic findings of pneumonia, or respiratory distress' can also be scary, since these symptoms can accompany many common childhood illnesses, such as a cold or the flu.
Remember though, that part of the warning, in addition to looking for these symptoms, to be at risk for SARS you should also have:
- History of travel to Hong Kong or Guangdong Province in People's Republic of China, or Hanoi, Vietnam, within seven days of symptom onset, or,
- Close contact with persons with respiratory illness having the above travel history. Close contact includes having cared for, having lived with, or having had direct contact with respiratory secretions and body fluids of a person with SARS.
Although there are reports of cases in Canada (Toronto), they are from people who had recently returned from South East Asia. Cases have also been reported in Indonesia, Philippines, Singapore, and Thailand.
Visit the CDC Severe Acute Respiratory Syndrome site for the latest updates.
The CDC does advise that 'persons planning elective or nonessential travel to areas affected by the outbreak may wish to postpone their trips until further notice.'
Saturday, March 15, 2003
Have you been wondering if your children should get the smallpox vaccine once it becomes available to the general public? The American Academy of Pediatrics has actually come out against routine use of the smallpox vaccine. They say that 'the general public, particularly children, should not receive the vaccine prior to an outbreak.'
Instead, the AAP recommends a 'ring vaccination' strategy, in which people exposed to someone infected with smallpox get the vaccine. This creates a 'ring' of vaccinated persons to help control the spread of smallpox to more people.
The AAP has created a helpful section on Children, Terrorism & Disasters that has a lot more information about smallpox and other potential hazards. You can read the full AAP Policy Statement on Smallpox Vaccine there too.
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It was great news that Elizabeth Smart was found safe. A lot of people are questioning why she didn't try to get away, since for a lot of the time, she was actually fairly close to home and at times, she was around other people.
Should we begin teaching our children how to get away if they are in a situation like this? It is hard to say.
What if she had tried to get away while they were camping out in the woods or mountains, and instead of escaping, she got lost and wasn't found until it was too late. What if she had told someone who she was, and the person didn't believe her, and she was further punished or killed by her captives?
For now, we should all likely just continue to teach our kids about Stranger Awareness, keep our kids as safe as we can, and see if any new ideas or guidelines come about because of this case.
Monday, March 10, 2003
As preperations for war continue in the US, you might want to review some of these tips for talking to your children about the news...
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Does your child have a severe allergic reaction to peanuts? If so, hope is on the way. A report in this weeks New England Journal of Medicine will report on a new experimental treatment that decreases the severity of allergic reactions in people allergic to peanuts. This doesn't mean that they will be able to eat nuts regularly though. Instead, they will have to eat more peanuts to cause a severe reaction, which can decrease the risks from accidental peanut ingestion. The injections may provide protection for other food allergies too, but final approval of the drug and its availability to patients is at least 3-4 years away (at best).
Sunday, March 9, 2003
I know that a lot of people buy bottled water, either because of the convenience of drinking from a bottle or the belief that it is safer or tastes better.
For children, this can be a problem, since many brands of bottled water don't have fluoride, which children need for healthy teeth.
One common thing that people do with plastic water bottles is continue to refill them with tap water and then put them in the refrigerator. Is this safe? A recent news report says no. A study of reused water bottles showed that many of them had high levels of bacteria in them, some with levels so high that the water wasn't drinkable anymore. Testing of refilled water bottles at a child's school showed that some even had fecal matter in them. So refilling and reusing water bottles might not be safe.
And it makes sense. You wash a glass each time you use it, don't you? Why would you refill and reuse a water bottle without washing it out?
And is bottled water any safer for you? Bottled water is regulated by the FDA, but tap water is regulated too, by the EPA, which ensures that we have a safe water supply.
Does it at least taste better? Maybe not. A recent episode of the show Penn & Teller Bulls**t demonstrated people in a restaurant taste testing different 'brands' of bottled water that were all filled with a hose on the restaurant's patio. Everyone was sure that they could tell the difference between the 'different types' of water. It wasn't a scientific test, but it does makes you feel silly buying and drinking bottled water, when tap water or filtered tap water is likely just as good.
If you are not convinced, do your own taste test. Let some tap water cool in the refrigerator, and later drink it and then some bottled water and see if you can tell the difference.
So maybe consider buying bottled water if it makes you feel better, but don't feel obligated to buy it for your kids or yourself. If your kids drink bottled water, make sure it is fluoridated (has fluoride added to it) or that your child is getting another source of fluoride.
Saturday, March 8, 2003
A visitor recently asked about vaccine recalls, since her doctor's office had called to tell her that one of the immunizations her child received this year had been recalled.
Why would a vaccine be recalled?
According to the CDC, 'Many types of products, including cars, toys, and food products, are sometimes recalled temporarily or withdrawn permanently from the market because they are found to not work properly or because a safety concern was identified after the product was used widely. Similarly, vaccines or vaccine lots can also be withdrawn or recalled. The vaccine manufacturer may volunteer to recall or withdraw a vaccine or vaccine lot on its own, or the Food and Drug Administration (FDA) can ask the manufacturer to do so.'
However, most of these recalls 'were due to concerns regarding the effectiveness of the vaccine and not because of safety.'
Recently recalled vaccines include:
- Meningococcal Polysaccharide Vaccine, Groups A, C, Y, W-135 Combined, single-dose vials (including single-dose in five dose packaging), Menomune - Aventis Pasteur - 10/18/2002
- Hepatitis A Vaccine, Inactivated (VAQTA) (Packaged in single-dose prefilled syringes for International Distribution) (Merck & Co, Inc.) - 2/7/2002
- Recall of Hepatitis A Vaccine, Inactivated (VAQTA) - (Merck & Co., Inc) - 12/10/2001
See this CDC guide to Vaccine Recalls for more information and specific lot numbers of the recalled vaccines to see if your child has been affected. Hopefully, the manufacturer would already have notified doctors who were using recalled vaccine lots or your doctors would have checked, but you can still check with your doctor if your are worried that your child received a recalled vaccine.
Your child would likely get a vaccine again if it was recalled because of concerns that it wasn't effective in preventing illness. However, in some cases, testing can be done to check your child's titer levels to see if he is protected.
Sunday, March 2, 2003
Although most parents are now worrying about what their kids will be doing over Spring Break, if you are interested, this is also a time to look for a summer camp for your kids.
The New York Times recently posted an interesting article, Parents' Rite of Passage: Shopping for a Camp, which discussed some of the more important things to look for in a summer camp, including your children's safety, what they will be eating and drinking, and if your children have medical problems, how they handle them.
For more information, also see:
Friday, February 28, 2003
A new study reinforces the importance of putting infants to sleep on their backs to reduce the risk of SIDS. This study, which appears in the current issue of the American Journal of Epidemiology, showed that infants sleeping on their side were not as safe as they would be if they were sleeping on their back. In fact, 'infants last placed on their sides for sleep were twice more likely to die of SIDS than infants last placed on their backs' and 'the risk of SIDS was significantly increased if infants turned from their sides to their stomachs during sleep.'
The study also showed that 'if an infant who was usually placed to sleep in the low-risk position — on the back — was then placed to sleep in a high-risk position (the stomach or side), his or her SIDS risk was seven to eight times greater than that of an infant who was always placed to sleep on his or her back.' This makes it especially important to tell all caregivers to place your infant to sleep on their back, even for naps.
See our guide to SIDS for more information.
Thursday, February 27, 2003
The death of Mr. Rogers will likely affect many parents and their children. Although he had not released any new shows in a few years, Mr Rogers Neighborhood is still popular in syndication, and many parents grew up watching his show.
Explaining his death might be difficult for some parents, but it is something that is important to do, and this is a good opportunity to bring up this topic. See our parenting guide to death and loss for more help and information. PBS also offers some helpful tips for parents about discussing the loss of Mr. Rogers.
Monday, February 24, 2003
I know that many parents, especially those in Virginia, were worried about the reports of 5 children dying of unexplained causes. The Virginia Dept. of Health has now stated that two of the children had the flu, one had an 'invasive group A streptococcus' infection, and two were still being investigated. Although still distressing, it is reassuring that 'no link has been found among any of the cases, and no new cases of unexplained and sudden death in children in Virginia are under investigation at this time.'
See the Virginia Department of Health Newsroom for the latest updates on this topic.
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