What parents should know about HPV and cervical cancer

Ruchi Kaushik, MD, MPH, FAAP
Assistant Professor, Pediatrics, Baylor College of Medicine
Medical Director, ComP-CaN (Comprehensive Peds for Complex Needs)
Medical Director, The Children’s Hospital of San Antonio Blog

January is Cervical Health Awareness Month

All right ladies (and parents of young ladies), this month is dedicated to the health of your cervix.  But you hardly know each other, so before diving into an intimate discussion, how about we start with some introductions?  Meet your cervix, the lower, narrow part of your uterus.  The cervix forms a canal that opens into the vagina and the vagina leads to the outside of the body.

HPV and Cancer
Now with the introductions out of the way, let’s get “down” to your “business.” Cervical Health Awareness Month is an opportunity to share information about HPV and cervical cancer.  HPV is the name for a group of over 150 viruses, some that cause warts and some that cause cancer.  HPV is transmitted either by skin-to-skin or sexual contact.

According to the CDC, HPV is one of the most common sexually transmitted infections–almost 80 million Americans currently have it, 14 million more become infected each year, and many people do not even know they are infected.

Most of the time, the infection goes away by itself, but sometimes it can lead to:

  • cancer of the cervix, vagina, or vulva in women;
  • cancer of the penis in men; and
  • cancer of the anus and back of the throat in both genders.

Cervical Cancer Screening (Pap tests)
Over the past 40 years, the rate of cervical cancer and cervical cancer deaths have decreased because of women getting regular Pap test screenings.  Pap tests are recommended every three years for women 21-29 years of age and every three to five years for women 30-65 years of age. Check with your primary care physicians or gynecologist if you have questions.

HPV Vaccine
The HPV vaccine protects against nine types of HPV that most commonly cause cancer.  It is approved for both boys and girls over the age of nine and is typically given as a two-dose series starting at the 11-year-old physical (because there are often other vaccines given at this visit).  Below are some myths about the vaccine debunked:

MYTH: “It’s hasn’t been studied long enough to check out side effects.”
FACT: The vaccine does cause side effects such as pain, redness, swelling at the vaccine site, fever, headache, nausea, and muscle pain, just as most other vaccines do.  The only difference is that your preteen is able to tell you he is feeling this way and couldn’t tell you when he was two months old. Additionally, because your preteen is free to get up and walk away after a medical procedure (in comparison to when he was two months old and lying flat), he will also be asked to stay in the clinic for 15 minutes to make sure he doesn’t get “woozy.” The first HPV vaccine was licensed in 2006 and since then all three available HPV vaccines have been studied in almost 75,000 men and women.  The vaccine is safe.

MYTH: “Why should my son have to get a vaccine to prevent cancer in a girl?”
FACT: HPV can cause anal, penis, and throat cancer and genital warts in males.  It is just as important for your son to receive the vaccine as your daughter.  And it isn’t any different from any other vaccine.  Your son also received the whooping cough vaccine not only to protect himself from the whooping cough, but to also keep a community whooping cough-free.

MYTH: “It’s going to make my kid want to have sex.”
FACT: A recent study of almost 300,000 girls ages 12-18 years in British Columbia, Canada, revealed that receiving the vaccine did not increase engagement in sexual intercourse or risky sexual behaviors. While researchers could not conclude that the vaccine was a direct correlation, they did find that girls surveyed in 2013 after starting the school-based vaccination program were less likely to engage in sexual intercourse, less likely to have sex before 14, and less likely to become pregnant, compared to the girls surveyed in 2003 before the program started.

For more information about the HPV vaccine, talk to your child’s pediatrician. If you need to identify a physician for your child, please visit www.chofsa.org/findadoc.

What parents need to know about drug and alcohol abuse

By Ruchi Kaushik, MD, MPH, FAAP
Assistant Professor, Pediatrics, Baylor College of Medicine
Medical Director, ComP-CaN (Comprehensive Peds for Complex Needs)
Medical Director, The Children’s Hospital of San Antonio Blog

January 22-29 is National Drug and Alcohol Facts Week

Today’s youth face a completely different landscape of peer pressure and drug groups from what we remember as children. Gone are the days of the television ads using eggs in a frying pan as an analogy for our brains on drugs. In fact, gone are the days of watching ads on TV!  Our public service announcements will need to move from the family room to social media platforms, such as this blog itself.

Our children face not only pressures to partake in underage drinking, but also new tobacco delivery devices, a world that is incrementally legalizing marijuana, and prescription pain medications that may serve as a gateway to illicit opioids. The following tips will catch you up to speed on what your kids are up against.

That drinking under the age of 21 is illegal is common knowledge. Further, it is illegal to supply alcohol to your child’s minor friends in your home. When you talk to your kids about the dangers of alcohol, be sure to engage in a conversation about binge drinking.

  • Binge drinking is a pattern of drinking that brings the blood alcohol concentration to the legal limit (0.08 g%).
  • This typically happens when men consume five or more drinks or women consume four or more drinks in approximately two hours.
  • Binge drinking is most common among young adults.
  • Most people under age 21 who drink report binge drinking.
  • Binge drinking is associated with many health problems including
    • unintentional injuries (eg. car crashes),
    • violence (eg. homicide, suicide, intimate partner violence, sexual assault),
    • sexually transmitted infections and unintended pregnancies,
    • chronic problems (eg. high blood pressure, liver disease, stroke, heart disease), and
    • cancer.

E-cigarettes are electronic devices used to heat a liquid and produce an aerosol that can be inhaled.  They can look like cigarettes, cigars, or pipes, or they can be found in shapes more attractive to teens such as USB flash drives, pens, or even lipstick containers.

  • Most e-cigarettes contain nicotine, but they can also deliver marijuana.
  • Nicotine can harm the developing adolescent brain, and the brain continues to develop until the age of 25.
  • Using nicotine as a teenager increases the risk of addiction to other drugs.
  • We are still learning the long-term health effects of e-cigarettes.
  • Children and adults have been poisoned by swallowing, breathing, or absorbing e-cigarette liquid through their skin or eyes.

Pain Medications
It is an all too common story. A teen breaks her leg during a soccer game and is appropriately given opioids for pain management. How does a parent know when to give the pain medication, for how long, and which teen is likely to develop an addiction?

  • When taken as prescribed, under the supervision of a physician, and for a short time, opioids are a safe and effective method to control pain.
  • Be sure to ask your physician if your teen’s prescription is a long-acting type of opioid (eg. oxycontin) as they tend to be more addictive.
  • Always check in on your teen’s mental health. If you are worried about depression, seek medical assistance.
  • Tell your child to never use a friend or family member’s opioid prescription.
  • Do not mix opioids with alcohol or other drugs.
  • Ask your physician about other coping methods to help relieve pain that do not require the use of medications. Deep breathing, meditation, mindfulness, and yoga are actively being studied as alternatives to medication for pain control, particularly in chronic pain.

If you suspect your child may be addicted to any drug, including opioids, seek medical help immediately.

For more information, visit www.cdc.gov.  To find a pediatrician, visit www.chofsa.org/findadoc

Follow these ABCs of dental health

By Allison Wells Morales, MD, PGY-3
Baylor College of Medicine Residency Program
The Children’s Hospital of San Antonio

All parents want to make sure their children are the healthiest they can be. One aspect of health that often gets overlooked is dental health. Dental health is very important to your child’s overall health. Below are five steps that you can take to help your child achieve their healthiest smile.

A: Accept a household routine
The first step of helping your child maintain good dental health is to make sure they are brushing their teeth twice a day. As children get older, it is often a challenge to get them to brush their teeth at night when they are tired; however, this is a very important step to preventing cavities. When we skip brushing our teeth, food and bacteria are able to sit on our teeth and cause decay which will ultimately lead to cavities.

Continue reading “Follow these ABCs of dental health”

Folic acid can prevent birth defects

By Rebecca Okashah Littlejohn, MS, CGC
Certified Genetic Counselor
The Children’s Hospital of San Antonio

January is National Birth Defects Prevention Month and the week of January 7-12 is Folic Acid Awareness Week.

According to the Centers for Disease Control and Prevention (CDC),¹ one in every 33 babies in the United States is born with a major birth defect, which is about 120,000 babies each year. Birth defects affect different parts of the body, such as the heart, brain, kidneys, eyes, arms or legs and change how that body part typically looks, works, or both. Some babies may only have one birth defect, while others may have many birth defects. Sometimes we know exactly why these birth defects happen, but often the cause is a mystery. Most occur in the first three months of pregnancy, when these body parts or organs are forming. The March of Dimes has excellent resources about birth defects and birth defects prevention.

One serious birth defect that can happen during pregnancy is called a neural tube defect, which can affect the spinal cord or brain of the developing baby. To help prevent neural tubes defects, the American College of Obstetricians and Gynecologists (ACOG) recommends that all women take a prenatal vitamin that contains 400 micrograms of folic acid beginning at least one month prior to getting pregnant and all throughout the pregnancy.² A woman who is not sure when she plans to get pregnant should take a vitamin with 400 micrograms of folic acid every day.

A woman can increase her chances of having a healthy baby by:

  • Visiting with her health care provider as soon as she realizes she is pregnant
  • Talking to her health care provider about any medications she is taking
  • Talking to her health care provider about any current medical condition
  • Not drinking alcohol, smoking cigarettes, chewing tobacco, or using street drugs
  • Talking to her health care provider about any illnesses or infections
  • Taking prenatal vitamins prior to getting pregnant and during pregnancy
  • Talking to her health care provider about diet and exercise during pregnancy

One common medical condition that is linked to birth defects is diabetes. In 2014, approximately 15 percent, or one in seven adults, in San Antonio were diagnosed with type 1 or type 2 diabetes.5 Babies born to women who have diabetes have an increased chance of having a baby with birth defects of the skeleton, kidneys, heart, gastrointestinal system, and genitalia.³  Women with diabetes should seek medical care prior to getting pregnant and immediately after they think they might be pregnant.4   

There are many other reasons why a baby might be born with one or more birth defects. Genetics professionals specialize in figuring out these reasons and helping families understand what happened, what might happen in the future, and what we can do to make the future as bright as possible. Genetic specialists also can help families understand if birth defects might happen again in another pregnancy.

If your baby has a major birth defect, if you have a family history of birth defects, or if you are currently pregnant and concerned about your risk for a birth defect, consider getting an appointment with a Genetics Specialist in Pediatric Genetics or Maternal Fetal Medicine.

We, the genetics professionals at The Children’s Hospital of San Antonio, encourage you to ask your health care providers about birth defects, folic acid and other vitamins, and diabetes – questions that will help you discover what is best for you and your children. We are ready to support you on your current or future pregnancy journey.

Talk to your doctor or your child’s pediatrician if you need a referral to consult with the Genetics team at The Children’s Hospital of San Antonio. Referrals can be made by calling 210.704.4708.


Parenting resolutions for the new year

By Ruchi Kaushik, MD, MPH, FAAP
Assistant Professor, Pediatrics, Baylor College of Medicine
Medical Director, ComP-CaN (Comprehensive Peds for Complex Needs)
Medical Director, The Children’s Hospital of San Antonio Blog
The Children’s Hospital of San Antonio

Welcome 2019! The beginning of a new year reminds us to celebrate achievements of the past and reset goals for the future. Whether it be weight loss, quitting tobacco use, or saving money, while you narrow down your list of objectives, consider making a few New Year’s Parenting Resolutions that will help build stronger relationships with your children.

Limit screen time
If you want more time with your kids, everyone in the house will need to spend less time on their screens. It seems that children, from toddlers to teens, are on their phones or tablets all the time, so what is a parent to do? Set rules.

  • Place a bin near chargers and ask everyone (including yourself) to drop devices by a specific time that works for your home – such as after school, before dinner, 7 p.m., etc.
  • Do not allow screens at the dinner table.
  • For younger children, implement a rule of co-viewing and watch all content with your child. This allows you to limit time (because what parent has time to sit around and watch YouTube videos all day?), ensure that content is truly educational, and point out actions you do and do not agree with (“Was that nice of him to take her kitty?  No, it was not.  I’m so glad he returned it and apologized.”)
  • Remember the American Academy of Pediatrics recommends that children two years and older spend two hours or less per day on screens.

Be active
Almost half of Americans say they would like to lose weight in the new year. If you, too, made such a resolution in the past and have found it to be challenging, consider doing it as a family. Of course, we would all like to be healthy, but, more than anything, parents want a better life for their child. Creating a habit of exercise for them now will last into adulthood and prevent many health problems that you may be experiencing. Exercise is linked to improved mental health. The key to staying on track is choosing an activity that works for your family. Join the YMCA and take classes together. Start training in a martial art as a family. Run or bike on the weekends. Race up and down the stairs in your home (being careful not to fall!). Or turn up the music and have a dance party in your living room. The American Academy of Pediatrics recommends that all children be active for at least 60 minutes per day.

Role model self control
Our world is quickly and constantly changing, and we are facing a host of #FirstWorldProblems: we can respond to a post on social media, order a pizza, download a video game, and shop for shoes all in a span of 10 minutes and a few clicks. But are we taking a moment to discuss the difference between “wants” and “needs” with our children? Whether your resolution is to save money, lose weight, stop yelling at your children, or spend less time on Instagram, you are making an effort to exercise self control. You are your child’s best teacher and when you take a few moments to breathe before reacting, they are watching and learning from you.

Learn something new
Have you always wanted to learn to play an instrument or speak a new language? Why not take it up together? Learning something new with your child holds you accountable (it is really hard to say you don’t feel like practicing to your 10-year-old when she pulls out her guitar), demonstrates to your child that it is never too late, and teaches your child that failure is part of success. Your first crochet project may look like a preschooler’s and your child needs to see that success is a series of steps that takes hard work and, often, many mistakes.

Serve together
In our desire to give our children the childhood we feel we never had, we are often passing up life lessons our parents instilled. We forget that empathy, compassion, generosity, and kindness must be taught. This year choose a charitable organization and serve. Volunteer at the Food Bank. Make baskets for the Salvation Army. Collect children’s books for Goodwill. Or just hand out free lemonade in your neighborhood. There are so many opportunities to give that your children can only see when you show them.

Cherish every moment
Yes, it is cliché, but they grow up so fast! So live in every present moment. Their every antic does not need to be recorded or posted. Put your phone down, watch the craziness, and create a memory in your mind. Better yet, join the craziness, and you will never forget what it felt like to swing them, floss with them, or build (and destroy!) trains with them.

But give yourself a break
We all want to be the perfect parent. If you could see yourself through your child’s eyes, you would realize they already think we are. So give yourself a break. You are doing the best you can to create a memorable childhood for them. Some days you will feel like you rocked it and others you will wish you could forget. But it is all part of your family’s story. So, give yourself a pat on your back and have a prosperous, safe, and healthy new year!

To locate a doctor for your child, visit www.chofsa.org/find-a-doctor.