My Blog

Posts for tag: car seats

By contactus@priority-pediatrics.com
February 19, 2019
Category: Safety
Tags: teens   car seats   texting   distractions   booster seats  

Grand Rounds at Children's Healthcare of Atlanta at Egleston Hospital was very interesting today. Dr. Mark Zonfrillo of Alpert Medical School of Brown University and Hasbro Children's Hospital spoke on Child and Adolescent Road Traffic Safety_a topic dear to the heart of most pediatrician and 21st Century parents and grandparents. 

He made some key points, among them were:

1] car restraint systems for children should be used all the time, even short neighborhood trips.

2] apparently fathers are less diligent than mother's in proper and regular use of children car restraint systems/car seats.

3] a car seat should be used until the child exceeds either the height OR weight standards of the individual car seat.

4] car seats that require a TETHER for proper use must use the tether for safety or the child may suffer avoidable injury or fatality otherwide.

5] booster seat use age range can go from 4 years through 10 years of age.

6] children are safest in the back seat of a vehicle and should not ride in the front passenger seat until 13 years of age.

7] car seats with five-point strap restraints are the safest restraint seat, especially facing the rear of the vehicle according to seat specifications.

8] Teen drivers' greatest driving risk is their LACK OF EXPERIENCE, which makes the first 6 months of their driving the period of greatest risk of fatality or injury.

9] the second greatest risk factor for teen drivers are other teen passengers in the vehicle. The risk and the number of crashes increase with increasing numbers of teen passengers in the vehicle with a teen driver. Apparently GA law allows no teen passengers in a vehicle with a teen driver in the first year of driving. In South Carolina, one teen passenger is allowed in the vehicle with a teen driver.

10] GA has a midnight teen curfew for teen drivers.

11] To correct inexperience, teen drivers need a minimum of 30 to 50 hours of SUPERVISED driving by an experienced adult driver.

12] Teens because of their inexperience driving are poor at hazard detection and anticipating or scanning for hazards when driving.

13] Teens have poor insight into the SIGNIFICANCE of their inexperience driving.

14] 16 years is the minimum age in GA for unsupervised teen driving.

15] It takes about 5 sec to do a cell phone text; at 55 MPH, in those 5 seconds, the vehicle will travel the length of a football field. There is increased risk of accident if one's eyes are off the road for greater than two seconds. https://www.itcanwait.com/

It was quite a presentation and very sobering. It reminds me when my daughters were teens, my wife and I had them take a performace driving course at the Atlanta Motor Speedway, https://atlantamotorsportspark.com/teen-driving/.  We do what we can! But I really like the idea of 30-50 hours of supervised teen driving by a parent or other experienced adult from the initial point of teen licensing.

Dr. T

By contactus@priority-pediatrics.com
September 01, 2018
Category: Safety
Tags: guidelines   car seats   update   car safety   toddler   rear facing   2018  

Key takeaways for parents in preparation for Child Passenger Safety Week is 

Sept. 23-29, 2018

  • Children should ride properly restrained on every trip, in every type of transportation, beginning from birth.
     
  • Rear-facing is the safest way to ride. Parents should keep children rear-facing as long as possible until they fit within the weight and height limits set by the manufacturer of their car safety seat.
  • While parents look forward to children moving from one milestone to another, car seats are one area where delayed transitions are best. Each transition – from rear-facing to forward-facing, forward-facing to booster – lowers the child’s protection in the event of a crash.
     
  • When a child rides rear-facing, the head, neck, and spine are all supported by the hard shell of the car safety seat and all move together, with little relative movement between body parts. When children ride forward-facing, their bodies are restrained by the harness straps, but their heads – which for toddlers are disproportionately large and heavy – are thrown forward, possibly resulting in spine and head injuries.

 

What is the change in recommendations?

  • Previously, the AAP recommended children should remain rear-facing at least to age 2; the new recommendation removes the specific age milestone.
  • The prior recommendation to keep children rear-facing to age 2 was based in part on a study that found lower risks of injury among children ages 1 to 2 years who were rear-facing. That data was supported by biometric research, crash simulation data and experience in Europe where children ride rear facing for longer periods. However, in 2017, questions arose about the original study, and it was retracted by the journal Injury Prevention. A re-analysis of the data found that while rear-facing still appeared to be safer than forward-facing for children younger than 2, the injury numbers were too low to reach statistical significance.
  • This means we don’t have a large enough set of data to determine with certainty at what age it is safest to turn children to be forward-facing. If you have a choice, keeping your child rear-facing as long as possible is the best way to keep them safe.
  • The AAP decided to update its recommendations to reflect how the science has evolved.
  • Fortunately, car seat manufacturers have created car seats that allow children to remain rear-facing until they weigh 40 pounds or more, which means most children can remain rear-facing past their second birthday.

 

Facts about car seats and motor vehicle injuries:

  • Motor vehicle injuries are the leading cause of death among children in the United States. (CDC)
     
  • In the United States, 633 children ages 12 years and younger died as occupants in motor vehicle crashes during 2015 and more than 132,000 were injured. (CDC)
     
  • Of children ages 12 years and younger who died in a crash in 2015, 35 percent were not buckled up. (CDC)

 

  • Child safety seats are often used incorrectly. Approximately 59 percent of car seats and 20 percent of booster seats are installed or used incorrectly. (CDC)

 

  • Car seats reduce the risk of death in car crashes by 71 percent for infants and 54 percent for toddlers ages 1 to 4.  Booster seats reduce the risk for serious injury by 45 percent for children ages 4 to 8 years.  (CDC)

 

Child Passenger Safety Week culminates with National Seat Check Saturday Sept. 29. Certified child passenger safety technicians will be available at car seat events nationwide to provide safety tips and car seat installation instructions to parents and caregivers.

 

Car Seats: Product Listing for 2018

 

My bottom line and practical advice is to let your toddler ride in an appropriate rear facing car seat until he/she doesn't fit any more (knees are almost in your child's face).

 

Dr. T

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.