According to the Archives of Pediatrics & Adolescent Medicine, parents can do several things to help a child with pain from a procedure:

Stay with your child during the pain. This is important for children as young as babies and as old as teenagers. Having a loved one near is very comforting to children.

Hold or touch your child. If you can hold your child in your arms during the procedure or without causing pain, this can greatly lessen your child’s pain.

• Kangaroo care: This is when a mother or father holds the baby against her or his bare chest, like a kangaroo holds their young, with the baby wearing only a diaper.  It has been used all over the world, and research suggests that it can increase babies’ breastfeeding, bonding with parents, and growth and development. A recent study found that babies who had kangaroo care during a painful procedure had less pain, even compared with babies who were given other pain management techniques.

• Holding hands: If you are not able to hold your child during a procedure, even a gentle touch or holding a hand can be helpful to your child.

Be honest. It is not a good idea to lie to your child and say that a painful procedure will not cause pain; this may hurt the trust your child has in you.

Distract your child during the procedure. There are many ways to help your child focus on things he or she enjoys, even during a procedure. If a child has other things to think about, the procedure may not affect him or her as much. Some ways to distract your child include playing music or singing with your child, showing a favorite video, reading a book, or just telling your child a favorite story.

Include time for play. If a visit to the doctor’s office or hospital included a painful procedure, make some time for fun afterward. Consider a trip to a favorite toy store, the zoo, or the library or spending time at a friend’s house.

Ask for help from experts. Many hospitals include staff with special training in ways to help children cope with being in the hospital, including ways to help children cope with procedures. Pediatric psychologists can also be helpful in working with children who are struggling with chronic illnesses or numerous painful procedures. Expressive therapists can help children find ways to express their anger or frustration from having procedures in a beneficial way.

For more on child medical issues, see the library of articles by Daytona Beach child injury attorney.

The new mandatory crib standards, approved unanimously on Dec. 15, 2010, are the most stringent crib safety standards in the world. As of  June 28, 2011, all importers, distributors, manufacturers, and retailers must offer only cribs that meet the CPSC’s new and improved full-size and non-full-size crib standards.

Federal mandatory crib standards had not been updated in nearly 30 years and the new rule will usher in a safer generation of cribs, which will mean a safer sleep for babies across the country. These mandatory standards will:

• Stop the manufacture and sale of dangerous, traditional drop-side cribs
• Make mattress supports stronger
• Improve slat strength
• Make crib hardware more durable
• Make safety testing more rigorous

“A safe crib is the safest place for a baby to sleep. It is for this reason that I am so pleased that parents, grandparents and caregivers now can shop with confidence and purchase cribs that meet the most stringent crib standards in the world,” said CPSC Chairman Inez Tenenbaum in a news releasea. “From the start, our goal has been to prevent deaths and injuries to babies in cribs, and now the day has come where only stronger and safer cribs are available for consumers to purchase.”

CPSC has recalled more than 11 million dangerous cribs since 2007. Drop-side cribs with detaching side rails were associated with at least 32 infant suffocation and strangulation deaths since 2000. Additional deaths have occurred due to faulty or defective crib hardware. The new standards aim to prevent these tragedies and keep children safer in their cribs.

Starting on December 28, 2012, child care facilities, including family child care homes and infant Head Start centers, as well as places of public accommodation, such as hotels and motels, and rental companies must use only cribs that comply with the new crib standards.

To learn more about crib safety, visit CPSC’s crib information center at: www.cpsc.gov/cribs

For more on child safety issues, see the library of articles by Daytona Beach child injury attorney.

The study, involving 257 students, highlights that a higher degree of pain was experienced with the use of gaming devices compared to mobile phones. Pain reported by children using Xbox and Gameboy was statistically higher than pain reported for the iPhone.

Importantly, the length of time spent on the devices heightened the pain suffered, as the data demonstrated that length of time was independently associated with the pain reported, with the odds of reporting pain increasing by two for every one hour of play.

“Our study has shown the negative impact that playing computer games and using mobile phones can have on the joints of young children, raising concerns about the health impact of modern technology later in life,” said Professor Yusuf Yazici, Rheumatology, NYU Hospital for Joint Diseases, New York. “We hope that further research in this area will shed light on what could be a serious health concern for today’s gaming children, in later life.”

The study also investigated pain attributed to mobile phone usage for the sending of text messages, the number of texts sent, the use of abbreviations, and the type of keyboard used, according to age and gender.

The results indicated that female students reported twice as much pain as male students respectively, measured using the 10cm Visual Analogue Scale (VAS, a pain measurement scale) and gender was the only independent variable associated with pain.

The study involved 257, nine to 15 year old students from two schools in St Louis. They were administered with a questionnaire to aid researchers in determining the possible association device type, age of children and hours played may have on wrist and finger pain.

A multivariable generalised linear model examined whether reported pain was associated with game device usage adjusting for age, gender, school and duration of game play per game device.

The study results were presented last week during the European League Against Rheumatism 2011 Annual Congress.

For more on medical issues, see the library of articles by Daytona Beach child injury attorney.

Only one of the 29 infants who received human milk developed the dangerous intestinal condition necrotizing enterocolitis (NEC) and recovered without surgery, compared with five out of the 24 babies on formula, four of whom required surgery. The findings, say the researchers at Johns Hopkins Chidren’s Center, justify a move toward a “human milk only” diet in extremely premature babies — those born weighing less than 1,500 grams, or 3.3 pounds.

“The stark differences in the risk of NEC, its complications and the need for surgery between babies who receive human donor milk and those who get formula signal the need for a change in feeding practices across neonatal intensive care units,” said lead investigator Dr. Elizabeth Cristofalo, a neonatologist at Hopkins Children’s, in a press release.

Moreover, babies who got human milk tolerated feeding better, allowing them to be taken off supplemental IV nutrition much sooner — after 27 days on average — than the group who received cow’s milk formula.

Those babies spent an average of 36 days on IV nutrition, largely because their intestinal tracts were not adapting to food as well, the researchers say. IV nutrition, used temporarily in all premature babies to supplement feeding, carries risks, the most serious of which is liver damage.

“Although we didn’t look specifically at liver function, we know from experience and from previous research that prolonged IV nutrition can harm a premature baby’s liver,” Cristofalo said. “Using human milk cuts that risk by allowing us to wean babies off IV nutrition sooner.”

Necrotizing enterocolitis is marked by tissue damage to the baby’s bowel. Because up to 40 percent of babies who develop NEC die, the condition is considered an emergency. Some cases of NEC can be treated with antibiotics and by temporarily withholding of food, but some babies require surgery to remove the dead portions of the intestines. The remaining intestine, however, can develop scarring that leads to poor absorption of nutrients, growth problems and the need for more surgery down the road.

The health advantages of mother’s milk have been well established, but some concerns about donor milk have lingered, including how it compares to mother’s milk and whether it is, indeed, superior to cow milk formula. The new findings should resolve any residual doubts about the risks and clarify the benefits of human donor milk, the investigators said.

The multi-center study is the first trial of its kind to compare the risk for NEC and NEC surgery between premature infants fed human donor milk and those fed preterm baby formula. An earlier study by the same team showed that babies who get their own mother’s milk fortified with the standard cow milk protein are more prone to NEC than babies given a combination of their mothers’ milk fortified with human donor milk.

Other hospitals participating in the study included Cohen Children’s Medical Center of New York, University of Texas, University of Florida-Gainesville, Innsbruck Medical University in Austria, Baylor College of Medicine and Children’s Hospital and Research Center, Oakland, Ca.

For more on child medical issues, see the library of articles by Daytona Beach child injury attorney.

Since the Toxic Substance Control Act (TSCA) was passed in 1976, tens of thousands of new chemicals have been developed for widespread use with little oversight or testing and the law itself has never been really updated, the pediatricians claim in a new position paper for the AAP.

“It is widely recognized to have been ineffective in protecting children, pregnant women, and the general population from hazardous chemicals in the marketplace. It does not take into account the special vulnerabilities of children in attempting to protect the population from chemical hazards,” write the authors.

It is because of the inadequacies of the TSCA that parents and pediatricians have been subjected to multiple high-profile media blitzes about specific chemicals, such as phthalates in toys and bisphenol A in infant bottles, that create anxiety without solving the problems of risky chemical exposures

Under the TSCA, companies must disclose any known hazards of chemicals used to make consumer products, but unlike drug companies, they are not required to perform pre-market testing, or even post-market followup. Pediatricians say the system works as a disincentive for companies to learn more about the chemicals because any problems found would need to be remedied at a company’s expense.

Among the changes called for by the AAP:

• Manufacturers should be responsible for developing information about chemicals before marketing.
• The U.S. Environmental Protection Agency (EPA) should have the authority to demand additional safety data about a chemical and to limit or stop its marketing when a high degree of suspicion about safety exists.
• The federal government should provide funding to evaluate the effects of chemicals on children’s health. Research should include effects on reproduction and development.

The EPA has implemented several voluntary programs in attempts to compensate for inadequacies of the TSCA. These programs include the Endocrine Disruptor Screening Program, the Voluntary Children’s Chemical Evaluation Program, and the Chemical Assessment and Management Program.

Because these programs are voluntary, the EPA cannot require companies to produce information about the health and safety risks of these chemicals. Each of these programs has produced few data over long periods of time, and none has led to any significant regulatory changes.

Under the EPA Inventory Update Reporting program, the chemical-manufacturing industry estimated that approximately 27 trillion pounds of chemicals were produced in or imported into the United States per year in the early part of this decade, which is the equivalent of approximately 74 billion pounds a day (nearly 250 pounds per person) and does not include fuels, pesticides, pharmaceuticals, or food products. Yet, in the past 35 years, the TSCA has been used to regulate only five chemicals.

“The current policy really is virtually useless,” said Dr. Jerome Paulson, the paper’s author and medical director of the Child Health Advocacy Institute at Children’s National Medical Center in Washington, D.C., in a press release. “In the last couple of years we’ve had a ‘toxicant of the month’ situation. Why aren’t these chemicals tested before they’re in the market so we . . . can know if they’re unlikely to do harm to the environment or to human beings?”

For more on medical safety issues, see the library of articles by Daytona Beach medical malpractice attorney.

The number of pediatric emergency department visits that included a computerized tomography or CT examination increased from roughly 330,000 in 1995 to 1.65 million in 2008, with a compound annual growth rate of 14.3 percent. The leading complaints among those receiving CT included head injury, abdominal pain and headache. The rate of imaging for abdominal pain increased the most, owing to improvements in the technology.

“We need to think creatively about how to partner with each other, with ordering clinicians and with CT manufacturers to ensure that all children are scanned only when it is appropriate and with appropriate techniques,” said the study’s lead author, Dr. David B. Larson, director of quality improvement in the Department of Radiology at Cincinnati Children’s Hospital Medical Center in Ohio, in a press release.

Advancements in CT technology like helical scanning have made it a vital tool for rapid diagnostic evaluation of children in the emergency department. Decreased scan times are especially helpful in eliminating the need for sedation in many pediatric cases.

However, the relatively higher radiation doses associated with CT, compared to most other imaging exams, have raised concerns over an increase in risks associated with ionizing radiation.

A child’s organs are more sensitive to the effects of radiation than those of an adult, and they have a longer remaining life expectancy in which cancer may potentially form. In addition, the current prevalence of CT makes it more likely that children will receive a higher cumulative lifetime dose of medically related radiation than those who are currently adults.

To study CT utilization trends in children, Dr. Larson and colleagues analyzed National Hospital Ambulatory Medical Care Survey data from 1995 to 2008.

“We found that abdominal CT imaging went from almost never being used in 1995 to being used in 15 percent to 21 percent of visits in the last four years of the study,”  Dr. Larson said. “In 1995, abdominal CT took much longer, the resolution was not as good and the research hadn’t been done to support it. By 2008, helical scanning had helped make CT very useful for abdominal imaging. It’s widely available, it’s fast and there are a lot of great reasons to do it, but it does carry a higher radiation dose.”

Dr. Larson pointed out that abdominal CT’s effective dose of radiation is up to seven times that of a head CT, suggesting that the radiation dose to children in emergency departments increased at an even higher rate from 1995 to 2008 than the rate of increase in the percentage of visits in which CT was performed.

Non-pediatric focused emergency departments made up 89.4 percent of emergency department visits associated with CT in children and increased from 316,133 examinations to 1,438,413 over the study period. Dr. Larson noted that most of the radiologists who oversaw and interpreted these studies likely were not subspecialty-trained in pediatric radiology.

“The performance of CT in children requires special oversight, especially in regards to the selection of size-based CT scan parameters and sedation techniques,” he said. “It is important to consistently tailor CT technique to the body size of the pediatric patient.”

The results of this study were published online and in the June print edition of Radiology.

For more on children’s health issues, see the library of articles by Daytona Beach child injury attorney.

These findings raise safety concerns, note the researchers. They point out the paucity of evidence supporting the efficacy of these medications to treat young children, their known adverse metabolic effects, and unknown long-term effects on the developing brain.

The rate of antipsychotic drug treatment among privately insured children, aged 2-5 years, rose from 0.78 to 1.59 per 1,000 children during the study period, and increased more for girls (148 percent) than for boys (94 percent).

Treatment with antipsychotic drugs rose significantly for children diagnosed with pervasive developmental delay/mental retardation (57 percent), disruptive behavior disorders (54 percent), and attention deficit/hyperactivity disorder (70 percent).

Antipsychotic drug treatment for children without a diagnosed mental disorder increased by 65 percent, although the rate per 1,000 children remained low. Over the same time period, the rate of nondrug interventions decreased or remained unchanged. The rate of mental health assessments for children treated with antipsychotic drugs remained essentially unchanged from 1999-2001 (40 percent) to 2007 (almost 41 percent).

While 50 percent of children treated with antipsychotic drugs in 1999-2001 had at least one psychotherapy session during a treatment year, this rate fell to slightly more than 41 percent by 2007.

These findings were based on analysis of service and pharmacy claims from the MarketScan Research Databases on privately insured individuals and their families from 150 United States employers. The study was funded in part by the Agency for Healthcare Research and Quality (AHRQ) to the Center for Education and Research on Mental Health Therapeutics at Rutgers University.

Despite increasing rates of antipsychotic use by very young children, provision of formal mental health services remains sparse, the authors note. These service patterns highlight a critical need to improve the availability of specialized and well integrated mental health care for very young children with serious mental health problems.

For more on child heath issues, see the library of articles by Daytona Beach child injury lawyer.

In a new policy published in the April 2011 issue of Pediatrics (published online March 21), the American Academy of Pediatrics (AAP) advises parents to keep their toddlers in rear-facing car seats until age 2, or until they reach the maximum height and weight for their seat. It also advises that most children will need to ride in a belt-positioning booster seat until they have reached 4 feet 9 inches tall and are between 8 and 12 years of age.

The previous policy, from 2002, advised that it is safest for infants and toddlers to ride rear-facing up to the limits of the car seat, but it also cited age 12 months and 20 pounds as a minimum. As a result, many parents turned the seat to face the front of the car when their child celebrated his or her first birthday.

“Parents often look forward to transitioning from one stage to the next, but these transitions should generally be delayed until they’re necessary, when the child fully outgrows the limits for his or her current stage,” said Dr. Dennis Durbin, lead author of the policy statement and accompanying technical report, in a press release.

The updated policy is based on new research that shows children are safer in rear-facing car seats. A 2007 study in the journal Injury Prevention showed that children under age 2 are 75 percent less likely to die or be severely injured in a crash if they are riding rear-facing.

“The ‘age 2’ recommendation is not a deadline, but rather a guideline to help parents decide when to make the transition,” Dr. Durbin said. “Smaller children will benefit from remaining rear-facing longer, while other children may reach the maximum height or weight before 2 years of age.

“A rear-facing child safety seat does a better job of supporting the head, neck and spine of infants and toddlers in a crash, because it distributes the force of the collision over the entire body,” Dr. Durbin said. “For larger children, a forward-facing seat with a harness is safer than a booster, and a belt-positioning booster seat provides better protection than a seat belt alone until the seat belt fits correctly.”

While the rate of deaths in motor vehicle crashes in children under age 16 has decreased substantially – dropping 45 percent between 1997 and 2009 – it is still the leading cause of death for children ages 4 and older. Counting children and teens up to age 21, there are more than 5,000 deaths each year. Fatalities are just the tip of the iceberg; for every fatality, roughly 18 children are hospitalized and more than 400 are injured seriously enough to require medical treatment.

Children should transition from a rear-facing seat to a forward-facing seat with a harness, until they reach the maximum weight or height for that seat. Then a booster will make sure the vehicle’s lap-and-shoulder belt fit properly. The shoulder belt should lie across the middle of the chest and shoulder, not near the neck or face. The lap belt should fit low and snug on the hips and upper thighs, not across the belly. Most children will need a booster seat until they have reached 4 feet 9 inches tall and are between 8 and 12 years old.

Children should ride in the rear of a vehicle until they are 13 years old.

Although the Federal Aviation Administration permits children under age 2 to ride on an adult’s lap on an airplane, they are best protected by riding in an age- and size-appropriate restraint.

“Children should ride properly restrained on every trip in every type of transportation, on the road or in the air,” Dr. Durbin said.

For more on child safety issues, see the library of articles by Daytona Beach child injury lawyer.

But for 250,100 children in 2009, play time stopped being fun as they were treated for toy related injuries at hospitals, according to the Consumer Product Safety Commission. That same year, 12 children died from toy-related injuries.

Most (46 percent) of the estimated emergency department treated injuries are classified as lacerations, contusions, or abrasions. Forty-five percent of the estimated injuries were to the head and face area, the most common affected area of the body.

The U.S. Home Safety Council says parents should check all toys to make sure they’re safe and age-appropriate for children.

The Council offers the following guidelines for toy safety:

• Use a toilet paper roll to gauge safe toy size. (Toys should be too big to fit into the child’s mouth.) If any of your young one’s toys fit inside the toilet paper roll, they probably are a choking hazard.

• Inspect toys to ensure there are no broken parts.

• Search your home for any tiny toys or parts that could pose a choking hazard.

• Store toys and games designed for older children out of reach of younger ones.

• Avoid toys with cords or strings that could become wrapped around a child.

• Keep latex balloons away from children.

• Make sure all toys have been safety-tested.

• Don’t let young children play with motorized or electric toys.

• Throw away packaging from new toys as soon as possible

For more on child safety issues, see the library or articles by Daytona Beach child injury lawyer.

The study is consistent with what doctors have long suspected, and why women of childbearing age are always asked about the possibility of pregnancy before being x- rayed.

A UK-US collaborative study found small increases in risk of cancer for children who had x-rays at ages less than three months and in children whose mothers had undergone an x-ray while pregnant. These increases were not statistically significant. The researchers report no increased risk from ultrasound scans.

Researchers studied the childhood cancer risk associated with exposure to radiation and ultrasound scans during gestation and in early infancy.

Previous studies of children born between the 1940s and the 1970s, when radiation doses were likely to be higher, found in utero x-ray exposure to be associated with an increased risk of childhood cancer, particularly leukemia. The effect of medical radiation on young children has been less clear.

Although diagnostic x-rays and other radiological imaging procedures to the abdomen and pelvis of pregnant women are rare, there are concerns about the growing use of computed tomography (CT) scans and other types of higher-dose imaging procedures on younger children.

Researchers compiled data on 2,690 children with cancer and 4,858 healthy children from the UK Childhood Cancer Study (UKCCS). All children were born between 1976 and 1996. Data on exposure to radiographic and ultrasound examinations were collected from medical records.

A total of 305 children received 319 radiographic and related examinations while in utero and 170 children received 247 diagnostic x-ray examinations in early infancy. A total of 13,723 in utero and 138 early infant ultrasound scans were carried out.

Researchers measured the risk of childhood cancer overall, and leukemia, lymphoma, and central nervous system tumors specifically.  Results showed a heightened risk following in utero exposure to x-rays for all cancers and for leukemia, though neither was statistically significant.

Exposure to diagnostic x-rays in early infancy was found to be associated with a small, non-significant extra risk for all cancers and leukemia, as well as increased risk of lymphoma, but this finding was based on small numbers (only seven cases).

The researchers conclude: “Our results, which indicate possible risks of cancer from radiation at doses lower than those associated with CT scans, suggest a need for cautious use of diagnostic radiation imaging procedures to the abdomen/pelvis of the mother during pregnancy and in children at very young ages.”

For more on health safety issues, see the library of articles by Daytona Beach personal injury lawyer.