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Many High School Pitchers Suffer Pain as Pitch Counts Mount

baseball pitcher

MONDAY, June 4, 2018 (HealthDay News) -- The new baseball season could bring pain to lots of America's younger players. By 

New research shows that more than half of all high school pitchers are likely to suffer discomfort in their throwing arm during the season.

"We found that the number of injuries peaked early -- only about four weeks in -- and then slowly declined until the end of the season," said James Onate. He's associate professor of health and rehabilitation sciences at the Jameson Crane Sports Medicine Institute in Columbus, Ohio, part of Ohio State University.

"We see a lot of kids who didn't prepare in the offseason, and when their workload goes through the roof they're not prepared for the demand of throwing," Onate said in a university news release.

For the study, Onate and his colleagues at the university's Wexner Medical Center asked 97 players to submit a weekly questionnaire by text message.

"Most of the pain reported was mild or moderate and players were actually continuing to play through it," Mike McNally, a researcher at Ohio State University's School of Health and Rehabilitation, said in the news release. "Part of the reason we think we're seeing a decline is because players start to get used to playing through the pain as the season goes on. So they likely still have that pain, it just doesn't affect them like it used to."

Onate and McNally are exploring the biomechanics of overuse injuries. They have developed a high-tech pitching mound that measures the amount of force driven by the legs, trunk and arms when throwing. In addition, they have a preseason program that helps pitchers avoid injuries.

"We're starting to pinpoint what's going to be the personalized approach to an individual to be able to throw, and then tweak it from there," Onate said. "The whole goal is to keep the kids safe to be able to do what they want to do."

One idea: extend the high school baseball season so that games aren't played in close succession, the researchers said. That could ease up on repetitive pitches, lowering the injury rate.

"Spreading out games is important in that it allows players to get some recovery time. Rainouts and postponements force kids to go from playing a few games a week to five or six games per week," McNally said. "When that happens, you have a high school kid that's essentially playing a major league schedule, which can accumulate and cause more pain and injuries."

More information

Baseball Strength Training & Injury Prevention Video from the AAP

Little League Elbow

SOURCES: Ohio State University Wexner Medical Center, news release, June 1, 2018

By contactus@priority-pediatrics.com
June 10, 2018
Category: Healthy Kids
Tags: Hydration   Dehydration   Sport   Fluids   Pedialyte   Enfalyte   Equalyte   Speedlyte   Water  

 

 

 

 

This is a Good article:

Is your kid getting enough to drink?  Here’s what you need to know about hydration.


(iStock)

Adequate hydration is essential for growing babies, toddlers and kids. As with adults, water is necessary for their body’s daily activities. Because of their smaller size, though, children are more vulnerable than adults to losing water through their skin. Kids also often forget to drink and don’t always recognize when they are thirsty, so parents need to be vigilant about making sure they stay hydrated.

Children should aim to have six to eight beverages — ideally water or milk — per day (total ounces needed vary with a child’s age). Kids playing sports, spending a lot of time outdoors during the summer, or who are sick with a fever often need more. Here are some age-specific guidelines for making sure your infant or child is getting enough fluids.

Infants under 6 months: Breast milk provides fluid and all the nutrition a baby needs at this age for proper growth and development. No extra water is necessary (unless recommended by your pediatrician). If you are formula-feeding, double check to make sure you correctly mix formula with the right amount of water (usually 1 powder scoop per 2 ounces of water). The amount of liquid nutrition your baby needs slowly increases as he grows, and depends on his weight. In the first month of life, he may only need 12 to 24 ounces a day, increasing to 20 to 36 ounces a day by the time he is 4 to 6 months old. 

Infants 6-12 months: The liquid nutrition your baby consumes will slowly decrease as solid food nutrition increases. That said, she still needs liquid for hydration. Rely on plain water, which is good for hydration and gets an older infant used to the taste of plain water — a healthy habit for life. It’s best to avoid sweet beverages and juice as that will just get your little one used to sweet-tasting drinks. How much water does she need? Initially your infant will just take sips. But work up to a few ounces a few times a day by her first birthday. (City tap water in most Metropolitan areas provides just the right amount of daily fluoride to grow healthy teeth enamel to prevent tooth decay. Bottled commercial water generally is fluoride free and does not protect from tooth decay.) 

Toddlers and preschoolers: Young children need about 16 ounces of milk a day. After that, plain water should be your beverage of choice. Around 2 to 5 cups of water a day (16 to 40 ounces) should suffice, depending on the child’s size and what else they are eating. On hot summer days when they are running around outside (try to get your kids active outside for at least an hour a day), they need even more water. Don’t forget that fruit and vegetables also contain water (along with tons of important nutrients), so encourage them to eat those as well.

Instead of fixating on exactly how much water your kids are drinking, try to make plain (city) water available throughout the day, have them carry a water bottle to school and activities, and model good habits by drinking lots of plain water yourself.

School-age children and adolescents: Water (public city water) should continue to be the drink of choice. The amount of water needed varies with a child’s age and activity level, and with the climate. So while your 5-year-old probably only needs about 5 cups (40 ounces) of water each day, by the time he reaches 13, he should be drinking as much as an adult (8 cups, or 64 ounces, per day). In addition, older children, particularly adolescents, should drink about 2 to 3 cups (16 to 24 ounces) of low-fat or skim milk daily as part of a calcium-rich diet to support their rapidly growing bones. If your teen is vegan, lactose intolerant or doesn’t like dairy, ask your pediatrician for some healthful alternatives. Juice should be limited to 4 to 6 ounces per day. Look for 100 percent fruit juices or simply encourage whole fruits, which are much more satisfying and nutritious than juice. Try to keep sodas, sports drinks, energy drinks and vitamin water out of your home. They are loaded with sugar and unnecessary calories, and are a big reason so many kids are overweight.

Children who play sports: The majority of child and teen athletes do not require anything more than city water for adequate hydration before, during and after exercise. Athletes should be sure to hydrate an hour or two before activity, as well as during and immediately after, to ensure they do not become dehydrated. Water should be readily available during sports, for kids to drink every 15-20 minutes while they are active.

What about sports drinks?

The most popular sports drink available was developed by a kidney doctor and specifically created for college football players who were practicing several hours a day in intense Florida heat. This drink was not intended for the casual athlete, despite the fact that it is often marketed that way. Sports drinks should be reserved for serious athletes in the setting of prolonged, strenuous exercise (more than an hour). These drinks should be discouraged outside of that setting, because they are high in sugar and have been linked to obesity.

When should you call your pediatrician?

When your child is sick, they will likely need extra fluids to stay properly hydrated. Fevers, rapid breathing, vomiting and diarrhea can all increase your body’s water losses. Yet when kids are sick, they generally eat and drink less. Infants are particularly vulnerable to serious dehydration during illness. For babies younger than 1 year, continue to feed them breast milk or formula even if they have vomited. Keep in mind you may have to give smaller amounts more frequently. If your baby isn’t tolerating milk, your pediatrician may recommend an electrolyte solution (Pedialyte, Enfalyte, Equalyte, Speedlyte). Older children should be encouraged to sip water frequently when they are sick.  Keeping track of the number of wet diapers or number of times your child has urinated is a good way to make sure they are staying hydrated. If a child goes more than 8 hours without urinating, it’s a sign of dehydration and warrants a call to your pediatrician. Other warning signs that merit consulting a doctor include dryness inside the mouth, crying with no tears, and increasing sleepiness, weakness or fatigue.

Tanya Altmann is a practicing pediatrician who founded Calabasas Pediatrics, an assistant clinical professor at Mattel Children’s Hospital at UCLA and a mom of three.  She is an American Academy of Pediatrics spokeswoman, and is the author of several books, including the newly released “Baby and Toddler Basics: Expert Answers to Parents’ Top 150 Questions.” 

Tiffany Fischman is a pediatrician for the Brigham and Women’s Hospital in Boston, a clinical instructor of pediatrics for Harvard Medical School and a mom of two.

More reading:

Want a safe nursery? Here are the latest recommendations

You can now use a 529 to pay for K-12 education — so should you?

 

By contactus@priority-pediatrics.com
May 27, 2018
Category: Healthy Kids

Electronic Nicotine Delivery Systems

 

From the Academy of Pediatrics:

Electronic Nicotine Delivery Systems (ENDS), also called e-cigarettes, personal vaporizers, vape pens, e-cigars, e-hookah, or vaping devices, are products that produce an aerosolized mixture containing flavored liquids and nicotine that is inhaled by the user. ENDS can resemble traditional tobacco products like cigarettes, cigars, pipes, or common gadgets like flashlights, flash drives, or pens.

These products have grown rapidly, particularly among youth and young adults. Youth use of ENDS products​​​ is a significant public health concern.

 

Quick Facts about ENDS

  • ENDS are the most commonly-used tobacco products among youth. In 2016, 11% of high schoolers and 4% of middle schoolers reported using e-cigarettes in the last 30 days.1
     
  • Youth who use ENDS products are more likely to use cigarettes or other tobacco products.​2,6
     
  • ENDS contain a liquid solution that is usually flavored. Flavors, which are appealing to children, can include fruit flavors, candy, coffee, piña colada, peppermint, bubble gum, or chocolate. You can read more about the ways the Tobacco Industry uses flavors to lure kids into using tobacco products in “The Flavor Trap​,” a report issued by AAP and four partner organizations.

  • ENDS solution has chemicals (ie, anti-freeze, diethylene glycol, and carcinogens like nitrosamines).3​​

  • ENDS devices mimic conventional cigarette use and help re-normalize smoking behaviors.

  • ENDS are not approved for smoking cessation, and the long-term health effects to users and bystanders are st​ill unknown. The chemical compounds in an ENDS device can vary between brands.3

  • E-liquid from ENDS devices and refill packs can contaminate skin, leading to nicotine poisoning. Symptoms of nicotine poisoning include vomiting, sweating, dizziness, increased heart rate, lethargy, seizures, and difficulty breathing.3

  • In 2014, poison centers in the US reported 3,783 exposures to e-cigarette devices and nicotine liquid, compared to only 1,543 exposures in 2013. In 2015, 3,073 exposures were reported.4

  • Some states have enacted legislation to require child-resistant packaging for ENDS devices and liquids, and a bill to do this at the national level was signed into law by President Obama in early 2016.

  • ENDS users should always keep e-cigarettes and liquid nicotine locked up and out of the reach of children and follow the specific disposal instructions on the label.5

  • In 2016, US Surgeon General Vivek Murthy, MD MBA released a report, "E-Cigarette Use Among Youth and Young Adults: A Report of the Surgeon General." The report concluded that youth should not use e-cigarettes due to the health effects on users and on others exposed to secondhand e-cigarette aerosol.6​

AAP Resources about ENDS

Sources

1) Centers for Disease Control and Prevention. Tobacco Use Among Middle and High School Students—United States, 2011–2016. Morbidity and Mortality Weekly Report, 2017;66(23):597-603. Accessed July 28, 2017

2) Dutra LM, Glantz SA. Electronic cigarettes and conventional cigarette use among U.S. adolescents: a cross-sectional study. JAMA Pediatr. 2014;168(7):610–617pmid:24604023​

3) American Academy of Pediatrics Section on Tobacco Control. Policy statement: Electronic Nicotine Delivery Systems. Pediatrics. 2015; 136(5):1018—1026.

4) American Association of Poison Control Centers. January 31, 2016. Electronic Cigarettes and Liquid Nicotine Data. Accessed February 10, 2016.

5) American Association of Poison Control Centers. E-Cigarette Devices and Liquid Nicotine. Accessed October 16, 2015.

6) US Department of Health and Human Services (2016). E-Cigarette Use Among Youth and Young Adults: A Report of the Surgeon General. Atlanta, GA. US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health

By contactus@priority-pediatrics.com
May 02, 2018
Category: Healthy Kids
Tags: School   health   Success   Free   BOKS   Activity  

Build Our Kids' Success [BOKS]

This looks very interesting: 

BOKS is a FREE physical activity program that improves our children physically, mentally and socially by strengthening their minds and bodies through movement. BOKS hopes to empower school communities to improve our children mentally, physically and socially by strengthening their minds and bodies through movement in order to reverse the worldwide pandemic of physical inactivity and its crippling effects.

The New York Times (2/14, Subscription Publication) reports a “supervised exercise program that gets young children running and playing for an hour before school could make them happier and healthier, while also jibing with the needs and schedules of parents and school officials, according to a new study involving two dozen elementary and middle schools.” The program has “gained a formal curriculum, a name and acronym, Build Our Kids’ Success (BOKS).” The findings were published online in the American Journal of Preventive Medicine.

 
By contactus@priority-pediatrics.com
February 28, 2018
Category: Healthy Kids

8 Simple Rules for Raising a Healthy Kid

A doctor mom reveals the easiest ways to keep your little ones as healthy as possible. 

 

1. Offer lots of fruits and vegetables. Eating five servings every day is good for your heart and helps protect against cancer and prevent obesity. Unfortunately, kids facing, say, broccoli won't be particularly persuaded by a reference to the scientific literature. They often need to be taught to like fruits and veggies. When kids reject a food, it's often due to unfamiliarity, not true dislike. So offer the same food many times. While babies eagerly try new foods, older kids may need as many as 15 tries before they'll like or tolerate them.

 

2. Teach hand-washing. When I became a pediatrician, I was always sick. I assumed that exposure to kids' illnesses was part of the job. Although I washed my hands frequently, I eventually realized that I was inadvertently transferring germs from my computer keyboard to my mouth when I snacked between seeing patients. I stopped eating at my computer and I haven't had a stomach virus since! A group of researchers in London called the International Scientific Forum on Home Hygiene (IFH) tracked germ transmission through homes and found that people's hands are the number-one source for spreading infection. We may blame our pets, sneezing kids, and dirty shoes, but they're not the real cause. We transfer germs from our hands into our body when we touch our eyes, mouth, or nose. And young kids touch their face a lot: One study found that it's as often as 50 times an hour. The goal, then, is to reduce the number of germs on their hands. Certainly, door handles and toys are germ reservoirs, so wipe those down frequently. Other hot spots are the bathroom and the kitchen, which the IFH found to contain some of the most contaminated surfaces in the home.

3. Vaccinate on time. Children get up to 24 shots by age 2. With that number, it's no wonder some parents may be tempted to delay certain vaccines. I actually postponed my daughter's HPV (human papillomavirus) vaccine because we were too busy to schedule visits for all three shots, and protecting her from an adult disease when she was in 7th grade just didn't seem that critical. But after researching my decision, I was reminded that the vaccine schedule is meticulously designed to give immunizations when they are most effective. Babies and toddlers need to get their vaccines in the critical window that begins when their immune system is developed enough to respond but before they are at highest risk from the most dangerous diseases. Deviating from the schedule won't guarantee effectiveness, and delays may also contribute to more side effects. For example, measles-containing vaccines are twice as likely to cause a febrile seizure when given late, shows research from University of Washington in Seattle. Needless to say, we got my daughter back on schedule, and she finished her HPV series before she turned 13.

4. Brush teeth with fluoride. Even mild tooth decay can affect kids' health by causing pain, poor eating, and interrupted sleep. In one extreme case, I had an 11-year-old patient who spent a week in the hospital for a dental infection. Fortunately, simply brushing protects teeth—if you use f luoride. That's what builds and maintains the protective enamel on teeth. They need to "bathe" in fluoride for its magic to work. So as soon as your child has teeth, brush them with fluoride toothpaste at least twice a day. So-called "training" toothpaste doesn't contain fluoride. 

5. Enforce a regular bedtime (starting in toddlerhood). I have to confess, I've often delayed my kids' bedtime just to spend a little more time with them. But I'm not doing them any favors. Children who don't get enough sleep can become hyperactive, and their school performance suffers, according to a Pediatrics study. Sleep deprivation in kids may also impact the hormone leptin, which signals us to stop eating, and kids who don't get enough zzz's may be more likely to be overweight or obese than those who do. Make sure your child is going to bed early enough too. Research found that kids who regularly turned in after 9 p.m. also displayed more behavior problems. The good news is that the behavioral consequences of poor sleep are reversible once a kid switches to a regular, appropriate bedtime, no matter how old he is. Kids need far more sleep than many parents realize. Toddlers need 11 to 14 hours (including naps), preschoolers need ten to 13 hours, and after kindergarten, kids need nine to 11 hours. So set a regular bedtime routine and stick to it. If you read a book, cuddle, and tuck them in at roughly the same time each night (before 9 p.m.!), kids will find their natural rhythm and sleep the right number of hours. 

 

6. Insist on a helmet. We keep a dented helmet on a shelf in our pediatric E.R. with a note from a 13-year-old bike rider that reads, "This helmet saved my life when my head dented the hood of a car." It's a reminder that wearing a helmet can prevent serious injuries—yet less than half of kids wear one, and more than a third wear them incorrectly, according to Safe Kids Worldwide. Your attitude has the greatest influence on your kids' helmet use. So insist that your children wear helmets when they ride anything with wheels—and always wear one yourself. Kids often complain that a helmet is uncomfortable. Here's how to know it fits properly: It should rest two-fingers' width above the eyebrows and not slide around. Tighten the chin strap until it's snug; no more than one finger should fit under the strap. When your child opens her mouth wide, the helmet should pull down on her head. Adjust it so that the left and right straps form a Y below her ears.

7. Apply sunscreen, all year long. While sun exposure wreaks havoc on skin at any age, sunburn during childhood is particularly risky. The earlier in a child's life that skin cells become damaged, the greater his chance of developing skin cancer over his lifetime. Kids are especially sensitive to the harmful effects of ultraviolet radiationbecause their skin has a thinner outer protective layer than an adult's does. For kids over 6 months, apply sunscreen any time they're exposed to the sun. (Keep younger babies out of direct sunlight altogether.) In addition to sunscreen, protect kids with clothes that minimize exposure, a wide-brimmed hat, UV-protective sunglasses, and by keeping them in the shade as much as possible.

 

8. Use safety straps. The National Highway Traffic Safety Administration reports that three out of four kids aren't restrained properly in vehicles. Make sure you carefully follow the instructions on your child's car seat, booster seat, or seat belt so he is safe.