Today’s tobacco not a safe alternative

By Dr. Ruchi Kaushik
General Pediatrics
The Children’s Hospital of San Antonio

Did you know that nine out of ten smokers start smoking before the age of 18? Consequently, tobacco prevention is a pediatrician’s problem to tackle.  Fortunately, over the past several decades, tobacco use has declined, primarily because of regulations put in place to bar the industry from marketing to children and youth.

Enter vaping – the tobacco industry’s latest attempt to hook your child. Overall, tobacco use among teens has declined since the 1970s; however, a recent study published in Pediatrics revealed that 13.7 percent of 12th grade students in Southern California currently smoke cigarettes or e-cigarettes compared to 9.9 percent in 2004 (before e-cigarettes were available).  E-cigarettes are a type of electronic smoking device available in a variety of colors, sizes, and flavors (eg. vanilla, chocolate) and are advertised to be a “safer” form of tobacco.

Can children thrive on a vegetarian diet?

By Dr. Ruchi Kaushik
General Pediatrics
The Children’s Hospital of San Antonio

Because of the recent increase in obesity incidence and a desire to improve cardiovascular health, many families have developed an interest in vegetarian diets; however, parents often fear that with a diet restriction, they may not be able to meet the nutritional needs of their children. I currently am raising three, young lacto-ovo-vegetarians and assert that, with knowledge and creativity, parents can ensure the normal nourishment and growth of their child. Indeed, studies have shown that with vegetarian diets children may still attain normal weights and heights.

Definitions
Vegetarians do not eat meat, poultry, or fish. Those who do consume eggs and dairy products are lacto-ovo-vegetarians. Lacto-vegetarians eat dairy but not eggs. And vegans only consume plant foods. Although a well-varied diet can be sufficient for all types of vegetarians, without close monitoring of food selection, vegan children may be at risk for a nutritional deficiency.

My child is being bullied. What should I do?

By Elena Mikalsen, Ph.D.
Section Chief, Department of Psychology

There are more and more stories in the media about children being bullied at school. Finding out that your child is being bullied is frightening and you may wonder how much to worry and what to do to help your child. Here are some basic tips on what we know about bullying and ways to handle situations involving your child and bullying.

What is bullying?

• Spreading rumors
• Making threats
• Physical/verbal attacks
• Excluding someone from a group on purpose
• Can happen on-line – cyberbullying

How to keep your baby safe from choking

By Dr. Farooq Mirza
Emergency Department
The Children’s Hospital of San Antonio

Around eight to nine months of age, infants begin exploring their environment by putting almost everything into their mouths. They have to be protected from ingesting dangerous materials. Any hard, smooth food that requires a grinding, chewing motion should not be given to young children.

• Large chunks of foods such as meat, vegetables, etc., are a choking hazard.
• All nuts (peanuts), hard candy, grapes, raisins, hot dogs, sausages, popcorn, and corn should not be given to children under four years of age, since the chewing motion is not well established. Even thick peanut butter poses a choking hazard for infants.
• Small items such as coins, buttons, pins, paper clips, etc., should be kept out of reach of young children
• Un-inflated balloons should not be allowed around children. Balloons and plastic bags or wrap are designed to be airtight. If they are placed over the mouth and nose or are inhaled, they may make a tight seal and smother the child. If an inflated balloon bursts, the pieces should be disposed of immediately.
• While most toys designed for children under three years are safe, the toys of older siblings pose a danger to their younger brothers and sisters. Take care to ensure that young children do not have access to toys designed for older children.

Grant helps provide children with safety helmets

By Dr. Joel S. Blumberg
Director, Pediatric Continuity of Care Clinic
The Children’s Hospital of San Antonio

With the support of the Texas Medical Association and the Texas Pediatric Society, the Pediatric Primary Care Clinic of The Children’s Hospital San Antonio has acquired a limited number of bicycle helmets to distribute to patients. Texas Medical Association’s Hard Hats for Little Heads program promotes exercise and teaches children and their parents about the importance of wearing a helmet when bicycling, in-line skating, skateboarding, and when riding scooters.

Test your flu IQ

By Michelle Barajaz, MD, FAAP
Director, Baylor College of Medicine Residency Program

Most parents would do anything to protect their children from harm. We buckle them into their car seats, make them wear helmets, and teach them to look both ways when they cross the street. However, every year many parents fail to take a simple step that could save them from losing their child to a very real and present, but mostly preventable, danger: influenza. See how much you know about how to protect your child by taking our quick true/false quiz.

Gabriella’s smile lives on through family’s foundation

By Cecilio Torres, Jr.
Founder, Gabriella’s Smile Foundation

Gabriella’s name means “God is my strength” and that is what was exhibited from the moment she was born and was magnified when she was diagnosed with DIPG (diffuse intrinsic pontine glioma), an incurable and inoperable brain tumor, which once diagnosed, only provides children with about nine months of life. She was five years old at her diagnosis.

We were unprepared when Gabriella was diagnosed on March 16, 2015, and verified on March 17 after an MRI confirmed ours and our doctor’s worst fear. We sat in a conference room at The Children’s Hospital of San Antonio surrounded by our oncologist, a nurse and social worker who told us, “Your daughter will not survive beyond 2015. She has DIPG.” These four letters, this diagnosis, sent us into a whirlwind of emotional uncertainty, insecurity and fear of losing our beautiful little Gabriella.

Keeping Your Baby Safe: Infant Car Seat Safety

By Jesse Banales, MD
The Children’s Hospital of San Antonio

Congratulations! Your baby has just finished leaving her comfortable, quiet life in the womb, endured a rude awakening through the birth process, and is finally ready to go home. But are you ready? Many parents think they understand the basics of infant car seats but often overlook important details. Below are some common mistakes parents often make when it comes to infant car seats:

Changing the seat to forward-facing too early. In 2011, the American Academy of Pediatrics started recommending that infants and toddlers be in rear-facing car safety seats until they are two years old or until they reach the highest weight or height allowed by the car seat manufacturer. This is based on studies showing that infants in rear-facing seats were much less likely to have serious injuries following a car crash than those in forward-facing seats. As your baby gets bigger, his feet may touch the seat in front of them and that’s OK! If you worry that your baby is uncomfortable, remember that this is your same child who has the flexibility to put his own feet in his mouth with ease.

There remains no evidence that vaccines cause autism

This blog was prepared by (pictured left to right)
Andrew Martinez, PhD, Co-Director of the Autism Program
Melissa Svoboda, MD, Pediatric Neurology, Director, Autism Program
Jonathan Crews, MD, MS, Pediatric Infectious Diseases
The Children’s Hospital of San Antonio

Although allegations arise from time to time about a link between autism and childhood vaccines, the medical community has spent the last 30 years examining this question numerous times with the same conclusion – there is no link between autism and vaccines. As health care professionals and parents, we want what is best for children – ours and yours. Multiple large studies have been performed by independent researchers from around the world and have included different groups of children. Overwhelmingly, these studies concluded there is no evidence to support an association between vaccines and autism.

These concerns started when Dr. Andrew Wakefield, a gastroenterologist, published a study in 1998 where he associated the onset of autism symptoms with the timing of the MMR (measles, mumps, rubella) combination vaccine. Wakefield was later found to have knowingly falsified data and to have financial interests in the study, including a pending application for an alternative measles-only vaccine. Once his fraud was discovered, the journal redacted the study and Wakefield was stripped of his United Kingdom medical license. Unfortunately, he decided to make a documentary on his journey that has stirred up much of this controversy.

Helping your child cope with anxiety in middle school and high school

By Elena Mikalsen, Ph.D.
Section Chief, Department of Psychology
The Children’s Hospital of San Antonio

Most children will have anxiety about starting middle school or high school. They worry about being good enough for sports or other electives, being smart enough for their pre-advanced placement and advanced placement classes, and fitting in with peers who all seem taller, prettier, smarter, and more socially savvy than they are. Each year brings new anxiety and most children will have some degree of anxiety and worry on their first day of school, even when it’s not their first year of middle or high school or even if they have many friends going with them to the same school. 

How to help your teen feel that she fits in
The most common worry for teens is fitting in with a new, and usually much larger group of peers. Adolescence is the time when teens struggle to find their identity and struggle to figure out which group of peers they wish to fit in with. Schools have multiple groups for teens to try and there will always be a group that will accept your teen. Reassure your child that he will absolutely find peers and acceptance. Encourage him to express his interests but also to try new things. Adolescence is a good time to experiment and try new hobbies. Encourage him to try different extracurricular activities, based on not just abilities but also interests. Especially, encourage children to try something outside of what their group of peers is doing, as often teens get stuck choosing activities based on whether they will grant an automatic acceptance to a clique.