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Kids

I’d like to talk about several common activities involving our children, how to ensure safety and to avoid unnecessary injury.

Playground injuries, mostly from falls, account for over 200,000 emergency room visits per year. The highest risk group is five to nine years of age. Young children need close adult supervision.

Make sure that underneath the equipment there is an adequate shock-absorbing material, such as chipped wood or any type of rubber product. Also, one needs to inspect the equipment to ensure that it is in good repair.

Bicycling (300,000 emergency visits a year) and skateboarding (30,000 visits) are the leading cause of head injury accidents in children. Proper safety for these activities includes adult supervision of younger children, routine bicycle maintenance, and mandatory use of head-protective helmets. These helmets must be proper to the activity and they must fit appropriately, but most importantly they must be worn!

Swimming accidents leading to drowning, and are the second leading cause of injury death among children 14 years and younger. All pools must be adequately fenced in and have properly functioning gates. Injury can be avoided by not running around the pool, not jumping onto floating objects, and proper use of a diving board. Again, adult supervision is paramount in preventing swim-related activities.

In 1971, trampoline injuries led to the NCAA eliminating the trampoline from sports competitions. I’m sure it’s also why we don’t see this event in the Olympics.

Trampoline injuries cause 80,000 emergency visits per year, for children age five and younger. If you own a trampoline, do not allow a smaller child to be on a trampoline with a larger child, as the smaller one is 14 times more likely to be injured.

In fact, one should follow the manufacturer’s recommendations and not allow more than one person on a trampoline at a time. Safety netting around the trampoline is essential to protect a child but is not foolproof to prevent injuries.

As with all the above activities, adult supervision is mandatory.

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Last year, my daughter complained to me about back pain. I wasn’t sure what was causing her discomfort until one day when I had to lift her school backpack out of my car. I almost threw my own back out.

I couldn’t believe how heavy it was. It weighed 20 pounds, and my daughter weighed 80 pounds.

Carrying a heavy backpack can be a source of low-level trauma leading to shoulder, neck and back pain in children. This is especially true for those school kids in middle and high school who have neither lockers nor desks to store their books in during the school day.

Experts recommend that children carry backpacks that weigh 10 percent or less of their body weight and no more than 15 percent.

The way a backpack is carried may contribute to the problem. Some kids wear their packs over only one shoulder, often because it’s “cool” or just plain easier. That causes them to walk unbalanced, causing abnormal stresses on their young developing spines.

A heavy backpack may make a bicycle rider top-heavy and less stable on the bike, potentially leading to accidental injuries.

A good backpack should have the following features:

– Lightweight construction

– Two wide, padded shoulder straps

– A padded back, for comfort and injury protection

– A waist belt and multiple compartments to distribute weight more evenly

We as parents need to be aware of this potential problem and be proactive in helping our children make best use of their backpacks.

Children should be taught to pick up their bags properly, by bending at the knees before lifting and using both hands.

Keeping straps tight will help with proper fit.

Remind children to use all of the backpack’s compartments, putting the heaviest items — such as textbooks — near the center of the back. They should not to carry around unnecessary personal items.

Also, take advantage of using available online books that don’t have to be carried around.

If your child continues to have back pain even after making the above adjustments, or has numbness, weakness or tingling in the arms or legs, consult with your doctor.

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Over-the-counter cough and cold medications to alleviate cold symptoms in young children are being largely withdrawn from pharmacy shelves. This is because of unintentional misuse or overdose of these medications causing harm and, rarely, death, especially in children younger than 2.

These medications are frequently used in good faith, even though there is no scientific proof that these drugs are actually effective. This is a case in which the risks outweigh the benefits.

Health care providers are now asked not to advise the use of such drugs for children younger than 6. Some of the most common are PediaCare, Triaminic and Dimetapp.

I know this may sound discouraging when caring for a sick child, but there are useful non-drug treatments for cold and cough symptoms. Try the following, for example:

• Encourage the drinking of fluids to prevent dehydration and to help thin out mucus. Contrary to popular opinion, milk has not been proven to increase mucus formation.

• Control high fever or pain with either acetaminophen (Tylenol) or ibuprofen (Advil), giving doses once every six hours.

• Saline irrigation can be helpful for a congested or drippy nose. For infants, use rubber bulb suction to remove nasal secretions after applying saline nose drops or spray, or try sinus rinsing for older children.

• Use a cool-mist humidifier or vaporizer in the child’s room. To prevent contamination, the water inside should be replaced daily and the machine should be cleansed regularly according to the manufacturer’s recommendations. If possible, maintain indoor relative humidity between 40 percent and 50 percent.

• If a medication such as Tylenol or Advil is given, I do not advise the use of household kitchen spoons to measure doses of medication. Measuring devices that use units of milliliters (mLs,) usually are packaged with the medicine or can be obtained from a pharmacist.

• Honey can relieve coughs by increasing saliva, which coats the throat and relieves irritation. Suggested doses are half a teaspoon for children between 1 and 5 years, one teaspoon for children 6 to 11 years, and two teaspoons for children 12 and older. Do not give honey to a child younger than 1.

Sometimes, a visit to a doctor is called for. See your health care provider immediately for the following cases:

• A child younger than 2 months of age with any fever

• A child younger than 2 years of age with a fever lasting more than two or three days

• A child who complains of an earache or a severe sore throat

• Thick green nasal discharge that continues for more than seven to 10 days

• Mild symptoms that do not improve after 10 to 14 days

• A child who seems very ill to you

By the way, for children who have appropriately been prescribed antibiotics, I am frequently asked whether the drug needs to be refrigerated.

The two most commonly prescribed antibiotics — amoxicillin, which tastes like bubble gum or occasionally is fruit-flavored, and azithromycin (Zithromax), which has a cherry/vanilla/banana taste — can be kept at room temperature for up to 10 days. Refrigeration may improve the taste, but it isn’t needed to maintain potency.

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