A record 31 seats have been designated Best Bets, meaning they correctly position a vehicle safety belt on a typical 4 to 8 year-old in almost any car, minivan, or SUV. Prices for these top-rated seats range from less than $15 to several hundred dollars.

In addition to the 31 Best Bets, another 5 seats are Good Bets, meaning they provide acceptable belt fit in most vehicles. Six boosters are not recommended because they don’t provide proper belt fit, and consumers are advised to avoid them.

Booster seats are for children who have outgrown forward-facing child restraints. A booster should elevate a child and route the lap and shoulder belts, which are designed for adults, in the correct position to restrain a child during a crash. Some boosters do this better than others.

The problem is that consumers can’t tell a good booster from a bad one just by comparing features or prices. The Institute’s booster seat ratings, initiated in 2008, are the only evaluations to tell parents which boosters do the best job of improving belt fit for children in the widest range of vehicles.

“A Best Bet means any of these top-rated boosters should work well in the family SUV or the babysitter’s sedan,” said Anne McCartt, the Institute’s senior vice president for research, in a news release.

Engineers evaluated 62 booster models in the latest round. Twenty-one of them show up twice in the lists. These are dual-use seats, which can work as highback or backless boosters. In the ratings, each dual-use model is considered to be 2 separate boosters for a total of 83 seats evaluated, 11 more than last year.

The biggest group of boosters falls into a middle category, designated “check fit.” These 41 seats may provide good fit for some children in some vehicles, but not as many as Good Bets or Best Bets. Parents are advised to make sure the lap belt lies flat across a child’s upper thighs and the shoulder belt crosses snugly over the middle of the shoulder. If not, a different seat is needed.

The focus of the Institute’s ratings is belt fit, not crash performance, and no crash tests are conducted as part of the evaluation. To assess belt fit, engineers use a test dummy representing an average-size 6 year-old. They measure how lap and shoulder belts fit the dummy in each booster under 4 conditions representing the range of belt configurations in real-world vehicles.

Boosters have improved a lot in recent years. In 2008 there were 10 Best Bets. That fell to 9 in 2009 but soared to 21 last year after manufacturers began using the Institute’s test protocols as they designed and updated their seats.

“Just 4 years into our ratings program, parents have a wide variety of top-rated seats to choose from,” McCartt says. “Still, boosters that don’t consistently provide good belt fit outnumber the ones that do, so consumers need to keep paying attention to this issue.”

One thing consumers need to be aware of is that most dual-use boosters have different ratings for each mode. For example, 14 dual-use boosters are Best Bets or Good Bets in highback mode but are designated check fit in backless mode. For one seat, the Evenflo Big Kid Sport, the opposite is true: It’s a Best Bet in backless mode and a check fit in highback mode.

The Harmony Dreamtime remains the only dual-use booster that’s a Best Bet in both modes, while the Combi Kobuk Air Thru is a Good Bet in both modes.

A notable newcomer to the Best Bet list is the BubbleBum, an inflatable seat that’s marketed for vacations, car pools, and taxis, as well as everyday use. When needed, it can be quickly inflated by blowing into a valve at the back of the seat.

Among booster manufacturers, Harmony Juvenile Products continues to be a standout. All 5 seats the Canadian company currently makes, counting the Dreamtime in both modes, are Best Bets. The company is discontinuing the dual-use Baby Armor, which was a Best Bet in highback mode but not recommended in backless mode.

Diono, which recently changed its name from Sunshine Kids, bumped an existing seat, the Monterey, from check fit to Best Bet by changing the shoulder belt guide. The new ranking applies when the dual-use seat is used in highback mode. The booster remains a “check fit” in backless mode. Consumers should look for Montereys manufactured after July 2011 to ensure they are getting the newer version.

Meanwhile, the Evenflo Symphony 65, which has been a Good Bet since 2009, now has a sister seat, the Symphony 65 e3. It has a slightly different shoulder belt guide, and that makes enough of a difference to make it a Best Bet.

“Booster manufacturers often use similar names for different seats or, in the case of the redesigned Monterey, even the same names,” McCartt says. “It’s important for consumers to look at model numbers and manufacture dates when consulting our ratings.”

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

Drowning is the leading cause of unintentional death among children ages 1 to 4. And while much attention is paid to water safety during the warm months, parents and caregivers need to know that drowning risks inside the house are ever present.

In fact, bathtubs are the second leading location, after pools, where young children drown. Buckets, other containers, and even landscaping features, also can present a danger of drowning.

A new report from the Consumer Product Safety Commission related to non-pool and non-spa products indicates that from 2005 to 2009, there were 660 submersion incidents involving children younger than five years old. There were 431 fatalities, 212 injuries and 17 incidents with unknown injuries.

The majority of the victims were younger than the age of two and most of the incidents involved bath or bath related products. CPSC’s analysis of the fatalities found that 92 percent occurred in residential settings.

“Young children can drown in just a few inches of water,” said CPSC Chairman Inez Tenenbaum in a news release.  “I urge parents and caregivers to constantly supervise young children around bathtubs, bath seats and buckets. There are simple steps that every family can take to prevent drownings in the home.”

Many of the reported incidents involved a lapse in supervision, such as a parent or caregiver leaving the bathroom while the child was in the bathtub to answer the phone or door, or to retrieve a towel. In other incidents, an older sibling was left to watch a younger sibling.

CPSC’s drowning prevention safety tips include:

• Never leave young children alone near any water or tub or basin with fluid. Young children can drown in even small amounts of water.
• Always keep a young child within arm’s reach in a bathtub. If you must leave, take the child with you.
• Don’t leave a baby or young child in a bathtub under the care of another young child.
• Never leave a bucket containing even a small amount of liquid unattended. Toddlers are top heavy and they can fall headfirst into buckets and drown. After using a bucket, always empty and store it where young children cannot reach it. Don’t leave buckets outside where they can collect rainwater.
• Consider placing locks on toilet seat covers in case a young child wanders into the bathroom.
• Learn CPR (cardiopulmonary resuscitation). It can be a lifesaver when seconds count.

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

Gastroenterologists from the Pediatric Inflammatory Bowel Disease Center at Johns Hopkins Children’s in Baltimore say that many of the hundreds of children they see were referred to them only after months of repeated visits to their primary-care physicians for symptoms mistakenly attributed to common GI ailments like viral gastritis.

“Inflammatory bowel disease is still considered an adult condition and is rarely on pediatricians’ radars,” says Dr. Maria Oliva-Hemker, chief of the Gastroenterology & Nutrition division at Hopkins Children’s and director of the comprehensive IBD center there, in a press release. “Fifty years ago, IBD was almost exclusively diagnosed in adults. These days, treating children with IBD is business as usual in our clinics.”

More than 100,000 children in the United States have IBD, according to the Crohn’s & Colitis Foundation of America. A 2003 study published in The Journal of Pediatrics reported a surprisingly high rate of IBD among children in Wisconsin — the highest in the world at that point — 7.5 cases per 100 000, with a CD rate of 4.56 and a UC rate of 2.14.

Scientists believe that IBD is triggered by an overactive immune system that mistakenly attacks the colon and small intestine. The reasons driving the rise of childhood IBD remain unclear, but genetic and environmental factors are clearly at play, experts say.

Because genetic makeup does not change drastically in populations over short periods of time, it is more likely that changing environmental factors are triggering new cases in genetically predisposed children, the researchers say.

The two main forms of IBD are Crohn’s disease (CD) and ulcerative colitis (UC). For unknown reasons, Crohn’s disease seems to be rising more rapidly in children than ulcerative colitis, Oliva-Hemker says.

Children with CD also tend to be diagnosed later than those with ulcerative colitis because the most common symptom is vague abdominal pain rather than the more suggestive bloody stools seen in ulcerative colitis, she notes.

Delays in treatment can make IBD worse and lead to severe anemia from gastrointestinal bleeding, poor food absorption, malnutrition and stunted growth. In advanced cases, IBD can cause serious damage to the colon and small intestine that requires surgery.
To prevent dangerous delays in diagnosis and treatment,  Oliva-Hemker says the following symptoms — especially if they keep coming back or never fully go away — should prompt a visit to a specialist:

• abdominal pain
• bloody stools
• diarrhea
• nausea and/or vomiting
• poor appetite and weight loss
• poor growth, especially in younger children
• pale skin, rapid heartbeat, fatigue and dizziness, all of which could indicate chronic anemia from GI bleeding
• a family history of IBD —  up to 30 percent of childhood cases have genetic roots

Oliva-Hemker advises pediatricians who suspect IBD to obtain routine blood tests to check for anemia and inflammation markers like elevated sedimentation rate and C-reactive protein. The diagnosis can usually be confirmed with an endoscopy and colonoscopy.

IBD is most commonly diagnosed in school-age children and teens, but gastroenterologists say that they have seen the disease in a growing number of children younger than 5 years of age.

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

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.

Think it could never happen to you? Think of these possible scenarios, courtesy of the Mayo Clinic.

■You’re in a hurry. You might unwittingly give your child too much acetaminophen if you don’t take the time to carefully measure the medication — or if you don’t realize that another caregiver has already given your child a dose of medication.
■You combine medications. If your child has various cold symptoms, you might combine acetaminophen with a cold remedy. But this can be dangerous because many cold medications already contain acetaminophen.
■You use the wrong formulation. You might cause an overdose if you give your child adult acetaminophen tablets instead of the children’s formulation. Even the children’s versions of acetaminophen come in many different formulations, and the dosage varies for each one.
■You decide that more is better. If you’re not satisfied with the performance of the recommended dosage, you might increase the dosage and cause an accidental overdose.
■Your child mistakes the medication for candy or juice. Overdoses
often occur when a child mistakes acetaminophen for something safe to
eat or drink.

If your child ingests more than the recommended amount of acetaminophen but not enough to cause a toxic reaction, medical care may not be necessary.

Be cautious, however. If you’re concerned about a possible acetaminophen overdose or notice early signs or symptoms of an
overdose — nausea, vomiting, lethargy and abdominal pain within 24 hours — call your local poison control center at 800-222-1222 or seek emergency care.

Left untreated, a serious acetaminophen overdose may be fatal within a few days, according to the Mayo Clinic. Careful use of acetaminophen and prompt treatment in case of an overdose can help prevent a tragedy.

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

Most American children with middle-ear infections are treated with antibiotics. But for children with mild symptoms, US clinical practice guidelines generally recommend watchful waiting, reserving antibiotics for children whose symptoms do not improve with time, according to researchers at the Children’s Hospital of Pittsburgh of the University
of Pittsburgh Medical Center  In contrast, responding to concerns about the overuse of antibiotics, doctors in many European countries follow a strategy of watchful waiting for
nearly all cases of middle-ear infections in children

Previous trials comparing the two strategies yielded conflicting results, chiefly, say the authors of the current study, because of differences among the trials in the definition of middle-ear infections.

In the NEJM study reported in the Jan. 13th issue of the New England Journal of Medicine, the investigators randomly assigned 291 children between 6 and 23 months of age with acute middle ear infections, diagnosed by stringent criteria, to receive either
amoxicillin-clavulanate or a placebo for 10 days.

They found that those children in the treatment group had a significant reduction in both the severity and duration of their symptoms compared with those in the placebo group. The study authors caution that these results must be weighed against concerns about the
side effects of antibiotics and the potential emergence of antimicrobial resistance.

The study was funded by the National Institute of Allergy and Infectious Diseases, part of the National Institutes of Health.

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

Staying off busy roads is not enough. More than half the 135 children who die in bike-related car accidents are killed on minor roads or in residential areas. They don’t have to – bike helmets reduce the risk of severe brain injury by 88 percent.

Make sure you set a good example for your child. You are a role model whether you like it or not. Your approach cannot be “do as I say, not as I do.” Children are always watching you for what is acceptable behavior.

Use hand signals in traffic and always ride responsibly. Ride on the right side of the road with traffic. Don’t let your child be one of the 75 to 85 percent of children who ride bikes without helmets. Show them that using a helmet is the only way to bicycle.

Even though you may be riding responsibly, sometimes injuries occur due to the fault of others. Helmets significantly reduce your risk of needing a Daytona Beach personal injury lawyer.

Stocking hangers have become popular as a way to hang those well-loved holiday stockings without drilling holes or using other hardware in you home. These heavily weighted ornaments come in all shapes and sizes: stars, penguins, reindeer, you name it.

However, the stockings that hang from them are very attractive to children, with their bright colors, bells and bows. Within one hour of a Florida mother hanging a stocking on a star shaped hanger, her 18-month-old son pulled on the stocking causing the heavy hanger to fall off the mantel and strike him right between the eyes. Luckily his father was a plastic surgeon with some surgical supplies at home. He patched the boy up on the spot.

Not every child has been so lucky. Another suffered a deep puncture wound to the forehead and another child’s toe was crushed from these heavy stocking hangers. No deaths have been reported yet, but one child began vomiting (a symptom of brain trauma) after a stocking hanger fell on his head. He suffered no permanent injury.

Most of the injuries children suffer from falling stocking hangers probably hurt the parents more than the children. The vomiting boy’s mother said she was sick to her stomach with worry as she rushed her boy to the emergency room. For that reason alone, I’d keep my hangers packed and save them for later years.

Dads have to be careful too during the holidays. The Consumer Product Safety Commission reports that 13,000 Americans suffer holiday decoration related injuries that require emergency room treatment. Whether it’s falling from a ladder or a staple gun accident, the holidays are not a time to throw caution to the wind.

When you’re cutting through packaging, slow down. Also Make sure your candles are in safe places. Both these situations have caused injuries in holidays past. Make your holiday a merry one. Play it safe.

Experts also reassure us that we should not worry – that stealing things as a child does not indicate a future propensity for theft or other crime. Perri Klass recently wrote a wonderful blog in the New York Times about her experience with this phenomenon and reports that a prominent pediatrician says “most children with take something sometime” and that it is just as much a part of growing up as sleep problems, toilet training, the terrible twos, ad infinitum.

Parents must realize that because stealing is just as much a part of maturing as all the other things mentioned, we should not blame ourselves or our child for such behavior. But that does not mean that parents should ignore it. Children of different ages steal for different reasons and should be dealt with differently.

Toddlers who take things cannot even be considered to be thieves because they just can’t understand rules at that point. Klass recommends setting limits is the best way to care for a child that age. They should begin learning that not everything they touch becomes theirs and that they need to share.

How you set those limits is up to you. Renowned author Stephen Covey tells a story of teaching his daughter to share in which he concludes that young children cannot share until they feel like they have owned an object. At the daughter’s birthday party, she received many toys. Covey allowed his daughter to possess her toys for enough time for her to develop a sense of ownership before asking her to share the toy.

Now what about the 5- or 6- or 7-year-old child who steals? They are old enough to know the rules. What if you find them stealing from you, a friend or even a store? Again, do not worry. This type of behavior is extremely common. Though parents don’t always catch them, it is likely unusual for a child to go through childhood without ever stealing anything

Older children steal for different reasons than younger ones though. We, as parents, must understand what is going on there so we can best address the issue. Older children most often steal as part of a testing phase. They’re testing the boundaries of behavior. They’re looking to see what, if anything, happens as a result of different behaviors.

We should use these teachable moments when we catch children stealing to fully explain and demonstrate the ramifications of their actions. That doesn’t mean reading them the riot act or touring them around the county jail in a scared straight attempt.

It means telling your children that stealing is wrong and why it’s wrong. It’s important to make those ideas concrete to them by doing things like eliciting an apology and requiring that they have to either give the item back or pay for it.

Unfortunately, some children do exhibit troubling patterns of theft that should sound alarm bells for parents. So-called symbolic theft should be addressed differently. An example of symbolic theft is stealing someone’s valuables and destroying them. In addition, repeated theft should be dealt with professionally right away.

Other than those two situations, we shouldn’t worry ourselves about childhood stealing. The key in dealing with it is being evenhanded. Demonstrate consequences, discuss ethics and morals, but don’t treat your child like a criminal.

If you give birth in America, chances are good your doctor will use a fetal monitoring device during delivery. In fact, doctors use fetal monitoring devices in more than 85 percent of births in this country. They do this despite any evidence the devices are beneficial in any way.

“Honestly, the technology got rolled out before we knew if it worked or not,” said one St. Louis obstetrician.

In use since the early 1970s, fetal monitors have failed to reduce the risk of either cerebral palsy or newborn deaths. In addition, fetal monitors have significantly increased the incidence of both Cesarean surgeries and forceps deliveries.

Cesarean surgeries are much more costly than traditional births and extend the new mother’s recovery time.

Fetal monitoring technology was supposed to reduce the risk of either cerebral palsy or newborn death by giving doctors early warning signs of when a baby was not receiving enough oxygen to its brain during child birth. The thinking was that the early warning would give doctors more time to take corrective action and save the baby from injury or death.

The flaw in that reasoning is that 70 percent of cerebral palsy cases are caused before labor begins. Only 4 percent of cerebral palsy is caused solely from a mistake during childbirth. The remaining 26 percent of cases are caused by a combination of factors that can occur before, during or after childbirth.

In summary, fetal monitoring has the potential to prevent only 4 percent of cerebral palsy children and it has failed to do even that. Physicians’ new understanding of the technology is not expected to result in a lower incidence of cerebral palsy, but hopefully it will result in a lower incidence of unnecessary, costly Cesarean surgeries.

The reason for such hope is that the new guidelines refine what once were two categories of fetal monitor data into three categories. Previously, data was categorized as “reassuring” and “nonreassuring” so doctors would err on the side of caution and often intervene in the “nonreassuring” cases when in fact the babies would have been perfectly healthy without intervention.

Now the categories are “normal,” “nonreassuring” and “abnormal.” The “normal” babies clearly do not require intervention like Cesarean surgery or forceps delivery. The new guidelines go as far as to say that “abnormal” babies do not require immediate intervention but should instead be quickly evaluated for other means of providing the baby with oxygen such as giving the mother oxygen, changing her position, treating her low blood pressure or ceasing the artificial induction of labor.

The “nonreassuring” category now calls for much more thorough evaluation of additional factors before doctors are encouraged to intervene. Previously, where a doctor was apt to intervene in “nonreassuring” cases based solely on the fetal monitoring data, the guidelines now call for doctors to “look at the entire clinical picture, not just the [fetal monitor data].”

The entire clinical picture includes things like the mother’s blood pressure, heart rate and temperature, what medicines she might have been given, the frequency of contractions and how fast labor is progressing.

Immediate delivery is discouraged by the guidelines so hopefully that will save future mothers from the pain and costs of unnecessary Cesarean surgery. Further refinements of the guidelines are expected to be released next year.