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."

http://www.businessweek.com/lifestyle/content/healthday/649997.html

Duty of all to stop child abuse

2010/11/28
Hans Olsen

EARLIER this year, the life of a small child was cut short. She died from injuries to her brain, stomach and kidneys inflicted by an adult who was taking care of her, a person she should have been able to trust and depend on.
An autopsy conducted found cuts and bruises all over her body, believed to have resulted from previous instances of abuse. Her case was, and is, not an isolated incident.

According to 2008 statistics from the Welfare Department, the number of abuse cases is increasing and now, an average of seven children are abused in different ways every day in Malaysia.

But these figures are only based on reported incidents. Many more children are hidden behind these numbers and if they eventually get recorded, it may already be too late.

Can we prevent these abuses from happening at all? Yes, I believe we can. But to achieve this, everyone must regard child abuse as unacceptable and be prepared to take action and intervene.

In the case of this child, there were witnesses who saw her being abused close to her home. No one interfered. I can't believe that this was because they condoned what they saw. I think there is a widespread uncertainty about how to interpret what you see and how to act. Had these witnesses known how to act and be prepared to do it, the small Malaysian child may still be alive today.


There are mechanisms in place to support such action. Police and government agencies are trained to handle this kind of cases. An immediate report would have mobilised a team of law enforcers to save the child from further abuse and, in this case, death. Intervention depends on family members, neighbours and bystanders who have the knowledge and spirit to intervene and put a stop to the abuse before it is too late.

In line with the Convention on the Rights of the Child, Malaysia has introduced the Child Act 2001 to guarantee the protection for children. With this legislation, not only can abusers be held accountable for their actions, informers are guaranteed anonymity and protection by law.

Furthermore, Childline Malaysia, a civil society initiative, has collaborated with the government to set up the dedicated hotline, 15999, where the public, as well as children themselves, can call for advice or report abuse. It is crucial that people know and utilise these services, and that they feel they can make a difference.


We need to empower ourselves with knowledge about child abuse and what we can do as individuals or in groups to stop it. To provide an opportunity for this, Unicef has set up a dedicated website, www.uniteagainstabuse.my, where people can learn more about the issue and what to do to protect a child from abuse.

This website is part of the larger Get on Board campaign by Unicef to encourage people to break their silence and take responsibility for the children around them -- be it in their home and families or in their communities. We each have an important role to play.

The Get on Board campaign clearly recognises the challenges parents go through in raising children, and provides a link to special services provided by the government to help cope with the stresses of parenting.

Unicef also urges communities to provide support activities for parents to manage the stress they face. By focusing on efforts to stabilise families and provide support for healthy child development, we are collectively creating an environment around us that reduces the likelihood of child abuse.

Every child has the right to grow up in a safe environment and to be sheltered from all forms of abuse, be it physical, emotional, sexual or neglect. This environment is only possible when society unites around children's basic rights, openly confronting violence and defending their right to protection.

While the government is primarily accountable for translating the Convention on the Rights of the Child into reality, parents and other caregivers, like teachers, health workers, youth leaders as well as children themselves, have a crucial role to play every day to protect the rights of children.

Very young children who lack the capacity to report abuse, or older children who fear reprisals by perpetrators should be able to rely on the people around them to take action.

What we see in statistics of reported cases only tells us a small part of the truth about child abuse in Malaysia. We need to know more. Thorough research is needed to help the government establish benchmarks for measurement of child abuse.

Data from this research would also make it possible to monitor future trends in abusive behaviour towards children and society's attitude towards it. This kind of evidence-based intervention is equally important for individual interventions by family members and the community.

We cannot wait for more children to die or be scarred for life. Everyone must be ready to take action. The silence must be broken. I invite the people of Malaysia to get on board and unite against child abuse.

The writer is Unicef representative to Malaysia

http://www.nst.com.my/nst/articles/27hansomea/Article/

Read more: Duty of all to stop child abuse http://www.nst.com.my/nst/articles/27hansomea/Article/#ixzz16YpBkPi5

Sarawakian woman rescues lost child on bus

NOBLE DEED: Nur Asyikin receiving a letter of commendation from Abdul Rahim for rescuing the lost toddler

KUALA LUMPUR: If it was not for a mother-of-two, three-year-old Mohd Amin Rozi may have disappeared forever after boarding a bus alone on Wednesday morning with a milk bottle in hand.

Nur Asyikin Rufi became concerned when she noticed the boy looking lost and restless as he was constantly changing seats.

The Sarawakian, in her 40s, was sitting at the back of the bus and became suspicious when she saw a foreigner speaking to the boy.

"I did what any mother would have done," she said, walking forward to rescue the child. "The boy was unresponsive when I asked him questions. So, I called 999."

Nur Asyikin then got off at Jalan Tun Hussein and carried the boy to the police station, as advised over the phone. She also lodged a report after handing the child to police officers.

"I hope this is a serious lesson learnt by every parent as such young children are naive and vulnerable."

Expressing disappointment that no one aboard the bus tried to help Amin, she said: "We should also look out for other children around us."

The police took photographs of the boy before handing him over to the Welfare Department in Jalan Pahang. Copies of his photo were distributed at the Sri Sabah flats area, where the boy was seen waiting before boarding the bus.

At 5.30pm on Wednesday, a couple arrived at the Cheras district police station, claiming their grandchild had gone missing. The boy, whom they called Amin, had apparently been sleeping while the grandfather was washing his car.

Neither of them realised the boy had woken up and wandered off. Amin's mother also arrived at the police station later to retrieve her child, but police refused to release him until a DNA test was conducted.

When the test results confirmed the grandparents and mother were indeed related to the boy and the necessary documentation were produced, Cheras acting police chief Supt Abdul Rahim Hamzah Othman allowed the child to be reunited with his family yesterday.

"What happened here is typical curiosity of children at such an age. As adults, we should be more aware of their tendencies and look out for them," said Abdul Rahman, who gave a letter of commendation to Nur Asyikin yesterday.

It was learnt the bus driver was not aware of the boy's presence as Mohd Amin was hidden among the passengers when he boarded the bus. The bus had travelled 10km before he was noticed by Nur Asyikin.

Meanwhile, Bernama reported the boy was suffering from a hyperactive disorder. His mother, Norhaslinda Hashim, 23, said she was working when informed by her mother about her missing child at about 1pm.

Norhaslinda said she would try to keep a close watch on her son from now.

http://www.mmail.com.my/content/54869-sarawakian-woman-rescues-lost-child-bus
THASHA JAYAMANOGARAN
Friday, November 12th, 2010 04:51:00

Am I ready for another baby?

Non-daily contraceptive options available include the levonorgestrel intrauterine system, copper intrauterine device, progestogen implants, and sterilisation.

JULIE, 33, is a senior manager at an accounting firm. She has been married for five years and recently gave birth to her second child, Jayden, 10 months ago. Her first child, Caitlin, is two years old.

Although Julie and her husband are very happy to have a son, they did not plan on adding to the family so soon as they are both still focused on building their careers. Julie’s unplanned pregnancy happened when she forgot to take her oral contraceptive pills, and she does not want to run the risk of being surprised with another child in the next few years.

For couples such as Julie and her husband, deciding whether to expand your family by one more – whether this would be your second child or your fourth – is one of the most significant decisions you will make in your lifetime. Assuming that you have struck a happy balance with your present family size, it is understandable that mothers can be pulled between the joys of having another child and a reluctance to upset the balance that currently exists.

While you and your husband are still deciding on whether you wish to have more children, it is essential to have effective and reversible contraception.

Non-daily contraceptive options available today include the levonorgestrel intrauterine system, copper intrauterine device, progestogen implants, and sterilisation.

The advantages of these methods are that they require less action by the user, and for levonorgestrel and progestogen implants, create steady blood hormone levels due to continuous release of a low dose of hormones.

A ‘fit and forget contraception’

The levonorgestrel intrauterine system or LNG-IUS is one of the most effective contraceptive options available when compared with other methods such as condoms, oral contraceptive pills, and hormone injections. Most importantly, this method does not require daily patient compliance as it provides continuous and effective contraception for up to five years.

The LNG-IUS is a small, T-shaped device made of impregnated plastic that is placed inside the uterus (womb) to provide continuous contraceptive protection. The LNG-IUS releases a progestogen called levonorgestrel (LNG), which acts directly on the lining of the uterus to make it thin and unreceptive to implantation of a fertilised egg, and changes the lining of the fallopian tubes and the mucous produced by the cervix to make it difficult for sperm to swim.

In some women, it also stops ovulation from occurring.

The insertion of LNG-IUS can be carried out in your doctor’s clinic within minutes. Once inserted, you should not be aware of the system. The device is removed by your doctor after five years, or earlier if contraception is no longer required. If further contraception is needed, a new system is inserted at the same time as removal of the previous system.

The most common side effect of the LNG-IUS is a change in the pattern of your periods. This can include an increased time between periods or longer periods, but the longer the LNG-IUS is in place, the more likely that periods will become fewer (further apart) or, for some women, absent altogether.

The LNG-IUS is useful for women who need effective long-term contraception, have just had a baby, who need a reversible alternative to sterilisation, and those who are dissatisfied with other methods of contraception. Compliance is good as it is a “fit and forget” method, which makes it convenient to use. The LNG-IUS is also becoming an increasingly preferred alternative to the irreversibility of sterilisation among women in developed nations.

An advantage of the LNG-IUS is that it can provide effective contraception for a mother who is breastfeeding as the hormone effect is contained within the womb and will not affect the composition or volume of breast milk produced. Other benefits of the LNG-IUS include reduced menstrual flow and pain, a shorter duration of menstrual bleeding, as well as increased haemoglobin and serum ferritin (iron) levels.

Normal menstruation generally returns within 30 days after removal of the LNG-IUS, and a woman’s usual level of fertility returns quickly after removal, with conception rates becoming equal to before IUS use (90% within the first year). Pregnancies progress as normal with no increased risk of foetal abnormalities.

The Copper IUD (Cu-IUD)

A Cu-IUD is also inserted into the uterus and may be left in the uterus for up to 10 years. However, it is different from the LNG-IUS in that it does not release hormones, but copper, into the uterus. Copper is toxic to sperm. The presence of an IUD interferes with the movement of sperm, fertilisation of eggs, and implantation. Cu-IUDs may sometimes cause increased menstrual flow, cramps, or backaches.

A Cu-IUD is a small plastic device that has a stem wound with fine copper wire. It looks like a small anchor with two side branches. Attached to the base of the stem is a nylon string. The string hangs out from the uterus through the cervix and can be felt with the fingers high in the vagina.

The insertion procedure for the copper IUD is similar to the LNG-IUS. Fertility will also return with the removal of the copper IUD.

The implant

The contraceptive hormonal implant is inserted under the skin of the inner, upper arm to provide three years of contraceptive protection. The implant is made of plastic containing a progestogen, and is 2mm wide and 4cm long – similar in shape and size to a match stick.

Your doctor will remove the implant after it has been in place for three years, or at any time prior to this if the contraceptive effect is no longer required. Normal fertility returns soon after removal of the implant. To continue contraception, a new implant must be inserted at the time of removal of the previous one.

The contraceptive hormonal implant will continuously release a progestogen hormone called etonogestrel, which prevents ovulation from occurring each month. This means that no egg is available for fertilisation, so pregnancy is avoided. The contraceptive hormonal implant also changes the mucous produced by the cervix, which makes it difficult for sperm to enter the uterus.

Even though the contraceptive hormonal implant is inserted and removed with just a local anaesthetic, you need to be comfortable with the idea of having an implant placed under your skin if you plan to use this contraceptive option. Prolonged, irregular or absent periods, acne, weight gain, headache, and breast tenderness are among the side-effects that have been reported in some women using the contraceptive hormonal implant.

Sterilisation

This is an irreversible method of contraception which can be performed on either the male or female. In tubal ligation for the female, the Fallopian tubes are cut and stitched to prevent the ovum (egg) from reaching the uterus. It is a surgical procedure requiring a general anaesthetic.

In the male, a vasectomy is a minor surgical procedure that interrupts the vas deferens (tube that connects the testes to the urinary tract), preventing the sperm from entering the urinary tract, so that semen is ejaculated without sperm. A vasectomy is usually done under local anaesthetic. Sterilisation results in permanent infertility in the female or male in which the procedure is done and cannot be reversed.

Deciding on whether your family is complete or not is a personal decision and one that needs to be discussed thoroughly with your partner and other family members. Family members bond through the process of being considered in the decision making process. Discussing and gathering input will help you and your children prepare for the challenges and the joys of adding a new member to the family.

Nevertheless, until you and your husband decide that the family is ready, effective contraception is a vital consideration in avoiding an unplanned pregnancy.

By Dr S.Y. CHONG
http://thestar.com.my/health/story.asp?file=/2010/11/7/health/7348379&sec=health

> This article is contributed by Dr S.Y. Chong, medical advisor with Bayer Schering Pharma. This information is provided for educational purposes only and should not be taken in place of a consultation with your doctor. Bayer Schering Pharma disclaims any and all liability for injury or other damages that could result from use of the information obtained from this article.

Reports over bosses mistreating pregnant staff on the rise

KUALA LUMPUR: There has been an increase in the number of reports from women workers who claim their employers discriminate against those who are pregnant.

Among complaints normally given by employers is that pregnant women under-perform in their duties.

MCA public services and complaints bureau head Datuk Michael Chong said he has received six complaints from women who alleged their bosses gave them a hard time, leading them to resign from their jobs.

Citing an example, Chong said one woman complained that her employer always nagged her for going to the toilet so often.

“She had to explain that she could not avoid it as she was pregnant,” he said, adding that the complainant also alleged she was put in “cold storage” by not being assigned the tasks she usually did before her pregnancy.

“Unable to take it any more, she resigned from her job,” Chong told a press conference here yesterday.

He said it was traumatic for pregnant women, who had worked to support their husband or family, to eventually lose their source of income.

“The department is contemplating legal action against employers who harass pregnant women under their payroll,” he said, adding that among those who had lodged complaints with his department were women who were still under probation at the work place.

Others had worked for two or more years with their employers.

Chong said he was worried that with the extension of maternity leave to 90 days for working mothers, there would be an increase of such victimisation.

http://www.thestar.com.my/news/story.asp?file=/2010/10/21/nation/7259530&sec=nation

Jangan ganggu emak memasak ya (English)

I wished it were a matter of simply watching Mom while she cooked. Mom is a fantastic chef, but she did not like interlopers in her kitchen. She preferred to be left alone, and we girls knew better than to bother her while she was cooking up her culinary achievements. Even Dad steered clear when she was at work. My plan to sit in the kitchen and carefully document each step as she prepared her sauce meant that I would be entering uncharted and dangerous waters.

Thursday arrived accompanied by rising anticipation. I rushed home from work, quickly changed my clothes, and sat at the kitchen table with pad and pen. "Don't worry, Mom. I'll stay out of your way. You won't even know I'm here."

Mom gave me a look that said, "I already know you're here." She set an empty pot on the stove and began chopping an onion. I watched her and asked my first question. "How big is that onion?"

"What do you mean, ‘How big?' It's an onion."

Her back was to me, but I was sure she rolled her eyes.

"I know it's an onion, but is it a small, medium, or large onion?"

She sighed. "Let's just say it's a medium one."

I wrote that down: one medium onion, finely diced.

Then she reached for the garlic, broke off a couple of cloves, and crushed them.

"How many cloves was that?"

"Two... unless of course they're large, then you only need one."

I wrote that down as well.

Mom poured some olive oil into the pot, and then added the onion and garlic.

"Wait! How much oil did you use?"

"I don't know. Enough for the pot."

I ignored the growing annoyance in her voice. "Well, how much is that?"

"It depends on the size of the pot. Just enough to coat the bottom. Use your judgment."

I didn't want to use my judgment. I wanted a recipe.

Mom emptied a can of pureed tomatoes into the blender. Then she added the blended mixture to the onions.

I grabbed the empty can and noted the size. "But why did you bother to blend tomatoes that are already pureed?"

"Because this is the way I make it. Are you here to tell me how to prepare my sauce, or to learn?"

Next, she poured one can each of tomato soup, tomato sauce, and tomato paste into the blender. I wrote down the size of each empty can when she finished.

While I wrote, Mom took a bunch of parsley and began chopping. Scooping up a handful of the chopped parsley, she moved toward the blender.

"Wait!" I jumped up and reached for her wrist. "How much parsley is that before you add it to the tomatoes?"

"A handful."

"But, Mom, how much is a handful? Your hands are smaller than mine!"

I grabbed a large measuring cup and had her empty the parsley into it, noting the amount. After blending the parsley and tomatoes, she added the mixture to the pot. I could see she was beginning to get a little rattled, but thankfully we seemed to be near the end.

"Mom, I forgot to ask. How long were the onions cooking before you added the other things?"

"Once the oil begins to bubble, simmer for about five minutes."

Then she sprinkled some oregano into the palm of her hand and walked over to the stove, only to be intercepted by me once again. I carefully emptied the contents of her hand into a measuring spoon. "Aha. Just about one teaspoon." I dashed back to my pad and wrote it down.

"That's it. Simmer the whole thing for about an hour."

"Uh... Mom? That's the second time you said ‘simmer.' Exactly what does that mean?"

She counted to ten before she answered. "It means cook over a low flame."

The sauce was simmering, and so was Mom.

I waited a few moments before venturing to ask my final question. "Are we done?"

"Yes, we're done. Now it just cooks — simmers — for an hour. There's nothing more for you to write down, so please get out of my kitchen before you drive me completely crazy!"

An hour later, we all sat down to dinner. My sister was the first to speak up. "Mom? This sauce doesn't taste like you usually make. Did you do something different?"

"Of course not. It has the same ingredients I always... wait a minute." Mom grimaced and shot me one of her patented looks. "I forgot the sugar... and the salt and pepper."

The rest of the family laughed as I shrunk down in my seat.

I learned an important lesson that day. We've now been married more than thirty years, and my very special husband has always been served a very special spaghetti sauce.

Ragu.

http://www.chickensoup.com/bulletin.asp?newsid=newsletter-101016-2