Sunday, February 20, 2011

Crib Injuries Land Thousands of Toddlers in ER Each Year

Crib Injuries Land Thousands of Toddlers in ER Each Year
Study shows most involve children trying to climb out and falling on floor
By Steven Reinberg
HealthDay Reporter

THURSDAY, Feb. 17 (HealthDay News) -- Each year in the United States, nearly 10,000 children under the age of 2 arrive in emergency rooms with injuries suffered while in cribs, playpens and bassinets, a new report shows.

Most of these injuries involve cribs and are usually caused by kids climbing out and falling on the floor, said the researchers from Nationwide Children's Hospital in Columbus, Ohio.

"The most surprising thing to me was the number of crib-related injuries we found being treated in hospital emergency departments," said lead researcher Dr. Gary A Smith, a professor of pediatrics and director of the hospital's Center for Injury Research and Policy.

"This is an underestimate," he said. "We know that children are taken to their private physician and urgent care centers."

Smith noted that only about 1 percent of the injuries involved a parent or sibling: "It appears that most of these falls are children climbing out of the crib and falling."

In most cases, the children landed head first, Smith noted, which "really makes this an issue that we should pay attention to." Children at that age are top-heavy, so when they fall they fall head first and don't have the ability to break their fall these injuries can be serious, he explained.

Smith added that as the children became more mobile, the number of injuries increased. "So, parents need to be cautious when a child is in a crib and can start to pull himself up," Smith said.

When that happens, according to the U.S. Consumer Product Safety Commission, you need to lower the height of the mattress in the crib so there is at least 26 inches between the top of the mattress and the top of the rail, Smith said.

And when the child reaches about 35 inches in height he or she should be taken out of the crib and start using a toddler bed, Smith added.

The report is published in the Feb. 17 online edition of Pediatrics.

For the study, Smith's team used data from the National Electronic Injury Surveillance System to identify the number of children injured in cribs, playpens and bassinets from 1990 to 2008.

During that period, the researchers identified almost 182,000 children under 2 who were treated in emergency rooms for injuries associated with these devices. That came to roughly 9,651 such injuries a year.

The researchers found that 83.2 percent of the injuries involved cribs, while playpens accounted for 12.6 percent of the injuries and bassinets accounted for 4.2 percent.

The most common cause of injury was falling from the crib, playpen or bassinet. These falls accounted for two-thirds of the injuries, Smith's group found.

The head and neck were the areas of the body that were most commonly injured, making up 40.3 percent of the injuries. Most injuries were soft tissue injuries (34.1 percent).

Kids with fractures were kept in the hospital 14 percent of the time and were more than five times more likely to be admitted than children with other injuries, Smith's group noted.

Smith believes the findings are a call to action to build better-designed cribs that protect children and make falls less likely.

Right now, parents should only use cribs that meet current standards. That includes cribs with no drop sides, which have been banned by the Consumer Product Safety Commission. So, parents have to be particularly careful with hand-me-down cribs, Smith said.

Smith also advises that when putting the baby in the crib be sure there is no bedding, stuffed toys or bumpers in the crib. "All these products have been associated with suffocation deaths," he said.

"Young infants need to be placed in a crib that's bare, just the child and the crib," he said. "Just dress the child warmly in a sleeper and place him into a bare crib."

"Despite these findings, cribs are still the safest sleeping environment for infants and young babies," Smith added. Having the baby sleep with the parents increases the risk of suffocation, he noted.

Amy Chezem, a spokeswomen for the Juvenile Products Manufacturers Association, said that "each year hundreds of deaths occur when children are placed in a sleep environment that is not specifically designed for children. The safest place for a child is in a fully functional, properly assembled crib."

In addition, the association "reminds parents of how important it is to carefully follow the manufacturer instructions, recommendations and restrictions on all sleep-related products to ensure the safest environment possible."

Wednesday, February 16, 2011

Berhati-hati dengan BONJELA

DOCTORS are calling for mandatory warnings on teething gels after children were hospitalised with potentially life-threatening poisoning.

The authors of a study conducted by two Sydney hospitals and two New Zealand hospitals, published in the Medical Journal of Australia, found that chronic salicylate intoxication could occur in children using over-the-counter teething gels, even at intakes close to the recommended doses.

Symptoms of such poisonings include gastrointestinal problems, hyperventilation, tremor and memory lapses, and the risk of death.

In Britain, the ingredient salicylate was removed from Bonjela teething gel after a 2002 study by the Commission on Human Medicines.

In Australia and New Zealand, several teething gels marketed to infants, including Bonjela, still contain salicylate and do not have warning labels.

Related Coverage

Some products recommend applying as much as a third of a tube every 24 hours, which the study's authors say equates to more than two 15g tubes a week.

The Therapeutic Goods Administration (TGA) considers teething gels to be therapeutic products, so the study's authors, including Sydney Children's Hospital pediatric intensivist Gary Williams and Prince of Wales Hospital consultant pediatrician Caroline Meadows, recommend that they be subject to the requirements of other over-the-counter medication, such as aspirin, and include warnings.

Dr Williams said parents should not assume that just because teething gels were marketed to children and available over the counter, they were perfectly safe.

"Teething can be disruptive and there is no doubting that ... but here is a commonly used solution that is widely thought of as being completely benign and one needs to be aware that that is not necessarily the case and that there is a safety issue here," Dr Williams said.

He said that parents would be better off using teething rings that had been cooled in the fridge as there was no scientific evidence of any beneficial effect of salicylate.

A spokeswoman for the NSW Poisons Information Centre, based at The Children's Hospital at Westmead, said calls to the centre in relation to teething gels were either about children who had accidentally ingested the contents of a tube, or parents who had used the product on children younger than the recommended age.

Two children had been referred to hospitals after calls to the centre's hotline last year, she said.

A TGA spokeswoman said the authority would consider extra warnings on the gels.

"Parents and carers are reminded to always use the product according to product instructions," she said.

In 2009, the TGA investigated links between the use of teething gels containing salicylate and Reye's syndrome, a potentially fatal disease that causes fatty liver and brain damage, after a study was published in the British Medical Journal.

The investigation found the study case was more likely a result of salicylate intoxication than Reye's syndrome.

Info produk Bonjela di Malaysia dari laman web Biro Pengawalan Farmaseutikal Kebangsaan... Ia mengandungi salicylate

Product Detail Information for MAL19910207X
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Monday, February 14, 2011

How do you teach your children?

Yale law Professor and self-described 'tiger mother' Amy Chua provoked international debate when her book 'Battle Hymm of the Tiger Mother' was published recently. The Chinese-American was called nuts, a despot and a monster for her extreme parenting methods, which among others involved calling her daughters 'garbage' and hours of Mathematics and spelling drills. Sonia Ramachandran and Chandra Devi Renganayar find out if tiger parenting is the way to raise cubs that will rule the world

Datuk Farshila Emran, managing director:

One of my daughter's teachers told her that she had better be careful because the discipline teacher was a "tiger".

My daughter replied, "She may be a tiger but my mum is a lion."

I have three children. When my eldest daughter Khalesa was slightly over a year old, I sent her to play school. She cried the first two days and I gave in. When she cried on the third day, I slapped her in front of the teacher.

My action shocked Khalesa and she immediately stopped crying. That was when I realised that the soft approach does not work.

If any one of my children is rude, I will slap them no matter where they are. I don't care if they are embarrassed.

Some parents do not want to take action immediately when their children misbehave. They prefer to do so in private. But if you take action later in the day, the child might have forgotten what she did.

My youngest daughter, Lubna, wanted to accompany me out one day but her brother Mukhlis was not allowed to do so.

She turned to her brother and said, "Na na na na neh! You can't come with us." I immediately slapped her.

When she asked me why, I told her it was because she was rude to her brother. Children are not mature. If you slap, pinch or cane them, they know they have done something wrong.

If you use the soft approach by explaining to them what they did wrong, they might not understand. I once caned my daughter because she did not complete her homework. It is for her own good.

I told her that the moment I receive anything from her school telling me she had not completed her homework, I would slap her in front of the school assembly. I have to put fear in them, otherwise they will not know I'm the boss.

My husband, Dr Mohd Sharif Abu Hassan, is not strict.

If I shout at the children and he comes out of his room, I will look at him and he will immediately return to his room.

I never, however, use harsh words on my children.

Children will forget the pain of a beating but they will not forget the pain caused by harsh words.

For example, if your mother hit or pinched you when you were young, would you still feel the pain now?

Of course not. But if your mum had called you 'garbage' when you were younger, won't you still remember that?

Once, my daughter's piano teacher came to the house to give her lessons. She was sleepy, so she just banged on the piano. I went over and slapped her and she immediately woke up.

Then I told her why I slapped her in front of the teacher.

I explained that the piano teacher had travelled all the way to our home to teach her so that she could earn a living.

I told them I don't care if I beat them in front of their friends because their friends are not going to be there when they're in trouble. I told them they should be proud that their mother cares about them, looks at their homework and hires tuition teachers for them instead of saving that money for make-up, etc.

Nobody can nurture them better than their own mother. We are 'tiger' but we are not "tiger gila". (mad tiger).

My children are allowed to go to the playground in front of the house on Fridays, Saturdays and Sundays.

On other days, they will just look at the other children playing but will not dare to ask if they can go out.

Khalesa always comes first in class.

If she is performing on stage (Khalesa is in the Permata Seni Choir), I send a professional make-up artist to do her make-up and if she goes outstation, I put her, together with her friends, in one of the better hotels.

I make sure Khalesa studies five hours every day. She has a packed schedule every single school day with a maximum of 30 minutes gap between activities.

Besides tuition, there are classes for mengaji (reading of the Quran), Bahasa Malaysia, vocal training, creative writing by a tutor whose mother tongue is English, art, piano, as well as sight reading. She also has English classes at the British Council on Saturdays.

I know Khalesa's capability and I know she can achieve 100 per cent in her examinations. So, if she comes home with 96 per cent, she would be afraid to enter the house to face me. I will evaluate the questions and if the mistake is due to carelessness, I will spank her.

Lubna, who is 5, has a teacher who comes over every day for three hours to teach her living skills, storytelling and to help her with her homework. She also goes to the British Council for English classes during the weekends and to the gym for classes three times a week to lose weight.

People have criticised the way I handle my children but I told them that these are my children and I will do what I like. My husband respects the way I do things. Although he does sometimes think I am too harsh, he understands that I am not doing it for fun.

When I beat, I really beat. I do feel bad about it later and cry in the shower. However, I never show them I am upset.

Dr Leow Mei Ling, housewife:

My only daughter, Emma Ooi, is 13 this year. She is a straight-A student as well as a gymnast who is gearing up for the Commonwealth Games in 2014.

Her Mathematics capabilities are that of a 17-year-old. She can also play the piano and speak Latin. Emma is also a fantastic chess player and has represented her school.

I believe discipline is necessary for a child to have a disciplined outlook in life, whether in sports or education. This is the kind of training I gave her from the time she was a toddler. I insisted she has her own table and chair from the time she could sit. I don't believe in children running around the house.

I quit my job when she was born and I drive her to all her classes and activities.

Emma's schedule is packed, straight from the moment she wakes up to the time she goes to bed, with no time for television, play or anything else.

Her day begins at 6am, with preparations for school. She leaves school at 2pm to go for gymnastics training, where she is in the national team. That ends at 6pm.

Then it's home, dinner, homework and bed. This is her routine seven days a week, with music and Latin classes squeezed in as well.

Emma is also not allowed to sleep late and is up by 8.30am.

She started kindergarten at 4 and was enrolled in the Shichida Right Brain Training Method, developed by Professor Makoto Shichida.

I also monitor her diet strictly. I restrict fatty foods and salt.

My husband (Ooi Khean Min) agrees with me and feels that a rigid and regimented schedule equips a child with the tools for the future as it teaches them to multi-task.

If you don't guide your children, they will not know what to do with their time. I would rather Emma play chess than watch television for hours during her free time.

I think watching television is a waste of time. I would not allow her to go to the playground to indulge in normal play as it is not safe.

I do not believe in harsh words or caning.

I don't feel that I am depriving her of a normal childhood. Play is doing something you enjoy.

I feel she enjoys this. Otherwise, she would not have been able to survive this long.

I don't think I'm a tiger mum but I believe there should be discipline.

Faridah Hamzah, housewife:

I have been labelled a very fierce mother by my family members and friends but I won't change my ways in bringing up my two daughters. I have to be strict to bring out the best in them. It is to ensure that they have a better future.

I cannot start to structure them when they are older, can I?

My 14-year-old daughter, Fatin Zakirah, is a national gymnast and she is training for the Commonwealth Games. Her school teacher introduced her to gymrama when she was 7.

Since she liked it, I decided to push her to excel in the sports. Her 10-year-old sister is interested in singing, so I enrolled her for choir training.

My girls are talented and I want to show them the right path to improve their lives and be successful. I believe you can only achieve results if there is discipline and order at all times.

Their daily routine starts at 6am on weekdays and on weekends, it begins at 7am. Their days are occupied with school, religious classes and training sessions.

Their daily schedule primarily involves studying and training. Yes, there is television time but it's very limited. There is also not much time for computer games or hanging out with friends.

I make sure they are in bed by 11pm after they have done their homework. Fatin has shown her frustrations about not being able to spend time with her friends. However, I have advised her about getting her priorities right. Now, she understands why she needs to focus and work hard.

Since she is with the national gymnastics team, her schedule is much more hectic compared to her sister's. The only time I allow her to play computer games is when I drive her for training daily.

I also control my children's diet, especially Fatin's. As a gymnast, she needs to maintain a lean physique to perform well in the sports. I don't buy or keep any other food in my refrigerator except for fruits and juices. Initially, I had to guide her but now Fatin has disciplined herself to eat the right food. To support and encourage her, I also follow a strict diet rule in the house -- no sweets, chocolates or chips.

My husband supports my approach in bringing up our daughters. Yes, I rule with an iron fist but that does not mean I don't show affection.

My style of parenting is injected with lots of love and words of advice.

I don't believe in using harsh words or degrading my children's efforts to make them better. I show appreciation every step of the way and it has borne fruit.

Read more: Confessions of tiger mothers