Category Archives: Health and Nutrition

Warning for Parents Giving Codeine to Young Children!

Posted by Marianne Frederick

The U.S. Food and Drug Administration (FDA) has issued an urgent warning to parents whose children have been prescribed codeine, an opioid pain reliever, for pain following surgery, saying parents should look for obvious and serious side effects.

Three young children between the ages of two and five years old recently died after having operations for tonsils and adenoid removal (T&A) and then receiving codeine for pain.

According to the FDA, some children “may be at risk of developing serious side effects, or even dying, after being given codeine in amounts that are within the recommended dose range.”

These children are known as “ultra rapid metabolizers” and have livers that are able to convert codeine to morphine in unusually high proportions. High levels of morphine in a child’s bloodstream can result in difficulty breathing which could cause death.

Physicians can order genetic tests to be performed to learn whether children are ultra rapid metabolizers prior to surgery. Also, parents can check with their pediatricians and request medication other than codeine for pain for their children.

Parents should look for the following warning signs if their children have been prescribed and are being given codeine following surgery:

  • Unusual sleepiness, difficulty in waking them up;
  • Disorientation or confusion;
  • Labored or noisy breathing;
  • Blue coloration of the lips or around the mouth.

If any of these symptoms are observed, call 911 immediately (and tell the 911 operator that the child has been given codeine) or take your child to the closest emergency room as soon as possible!

Watch Out for Poisonous Berries!

By Marianne Frederick

Summer is not quite over and young children are still spending a lot of time out of doors with family, caregivers and friends. Whether going on picnics, for walks in the woods, parks and preserves or just playing in the backyard, there is something parents need to watch for, besides bugs and snakes, says the National Capital Poison Center. They would like to remind us about berries. Yes, berries.

It’s berry-picking season. While the strawberries are through being picked in many places, there are still blue berries, raspberries and other berries, both wild and domesticated (and soon there will be grapes) loading bushes on farms, at roadsides, in the woods and fields.

This is the time of year when the Poison Center receives a lot of calls saying, “My child just picked and ate some purple berries. I don’t know what they are, what should I do?”

The first thing you can do–if you don’t know what the berries are–is call the National Capital Poison Center’s toll-free number at 1-800-222-1222. It’s a good idea to keep that number by your phone. You also will want to make a mental note of what is growing in your environment, in the areas you visit with your children, and in your yard! I was amazed to learn that many of the shrubs around our home were actually hazardous to one’s health if consumed (and that includes yew bushes (the berries) and rhododendrons (the leaves)!

To children, the berries of the Pokeweed plant, called pokeberries, look like grapes! They hang down in purple clusters from thick green stalks of the poke plant and its red branch-like stems. Poke grows wherever a seed has been planted (by birds, animals or the wind)–and the berries can hang at a child’s face level, so they are easy for children to pick. The plant’s white spring flowers become deep purple berries that ripen in August and September. The National Capital Poison Center says children who may eat one or two berries may not develop symptoms, but children who consume more than that may have stomach distress, pain, nausea, vomiting and diarrhea. Fortunately, pokeweed dies back after the first frost. It’s hard to keep it from growing because it may have a large, deep root in the ground. If it grows in your yard, you may want to think about cutting it down. In rural areas of the country, young (or early) poke leaves are often cooked as “poke salad”, but if you don’t know your garden greens, it’s better, we think, to stick to spinach and kale and those you know are safe!

With gratitude to the National Capital Poison Center!

How Parents Can Help Prevent Food Poisoning in Children

Posted by Marianne Frederick

Children are among those who are affected in the most serious ways by food poisoning. Young children are small, growing, and usually active. Anything that can dehydrate them or rob their bodies of the nutrients that promote growth and health is not good. One out of six people is affected by food-borne illnesses annually in the U.S. Many people are hospitalized  each year and some actually die from food-borne illnesses. There are a variety of disease-causing microbes, or pathogens, which can contaminate foods, the Centers for Disease Control and Prevention (CDC) tells us, so there are many different food-borne infections.

When people say they have had the “stomach flu” or the “24-hour flu,” it frequently turns out to have been a food-borne illness. Common symptoms in many food-borne illnesses occur in children (and adults), such as nausea, vomiting, abdominal cramps and diarrhea. The microbes causing food-borne illnesses, such as e.coli, for instance, can be transmitted in different ways–through contaminated food or contaminated drinking water, through contaminated swimming water, even from toddler-to-toddler in a daycare facility. There are different kinds of control efforts — from chlorinating a swimming pool to boiling drinking water, to sanitizing and even closing facilities temporarily where children gather — that can help curb the effects of food-borne pathogens.

Salmonella is one of the top five pathogens that transmit food-borne illnesses domescially, sending people to the hospital and even causing death. In the past two months, cantaloupes contaminated by Salmonella that were grown in Indiana have made the news. announced the cantaloupe recall from markets throughout the U.S. Salmonella can also spread to humans in different foods of animal origin. The illness it causes,salmonellosis, can involve fever, diarrhea and abdominal cramps and can last from 4 to 7 days. Since children are the most likely to get salmonellosis and the rate of diagnosed infections in children under five years old is higher than the rate in all other persons, what can parents do to prevent salmonellosis’ severe infections in young children?

  • Cook poultry, meat and eggs thoroughly;
  • Do not eat (or drink) or give your child raw eggs or unpasteurized milk to drink;
  • Wash hands, kitchen work surfaces and utensils after any contact with raw meat, poultry or eggs;
  • Be especially careful when preparing food for infants and young children;
  • Wash hands immediately after contact with pets, pet feces, or “zoo” animals (reptiles, snakes, birds, chicks, etc.);
  • This last one may surprise you (it did me): Do not work with an infant and raw food at the same time! This means especially do not change the diaper of a child while you are working with food! (According to the CDC website, this can and does happen. So please put the food down, wash your hands, tend to your baby, then wash your hands again before you work with food again.
  • Wash your hands and your baby’s hands frequently.

Children’s Vitamins: Why is NBTY Offering Refunds?

by Marianne Frederick

Yesterday, a news sound-byte piqued my curiosity: Was it Children’s meds recalled? No, children’s vitamins were being…refunded! “The marketer of popular children’s vitamins is refunding nearly $2.1 million to customers after acknowledging its pills contained only a fraction of a nutritional substance the packaging claimed,” according to News 22

At the root of the refund, is DHA (Omega-3 fatty acid, touted in fish oil), and the fact that the vitamins may not have contained as much DHA as promised on the packaging (or near the suggested or minimum daily requirement). The amount of DHA in the Disney and Marvel Complete vitamins apparently only “equaled only one-thousandth of what the marketers claimed per serving for children age 4 and older.” A similar situation occurred with NBTY’s DHA-containing vitamins marketed for use in children ages 2 to 4.

The colorful packaging sporting Disney Princesses, Winnie the Pooh, Nemo and Spider-Man lured parents and children to the product and promised “100% of a child’s daily requirement.” Yet, in some cases, the products merely contained minute amounts of DHA, according to the Federal Trade Commission (FTC). The packaging also claimed that the DHA in the vitamins “would help vision and brain development in children,” but the FTC begged to differ and suggests these claims are “unsupported.” The basis of the refund is the Federal Trade Commission’s settlement in 2010 requiring children’s vitamins marketers NBTY, Inc. and two of its subsidiaries to stop making false, unproven claims their multivitamins promote healthy brain and eye development in children.

The refunded products were sold as “Marvel Heroes,” “Disney Gummies” and “Disney Complete” by CVS Pharmacy, Wal-Mart, Target, Walgreen’s, Kroger, Kmart, Meijer, Rite Aid, and online, for between $4 and $8 each. The manufacturer, NBTY, is also the manufacturer of Osteo-BI-Flex, Nature’s Bounty®, Rexall Sundown®, Vitamin World®, and Puritan’s Pride® brand vitamins, and, according to its website, markets approximately 22,000 products including vitamins and other dietary supplements and has company locations in 9 states in the U.S.

Parents who may have purchased these vitamins (as far back as May 2008 until September 2010) have until October 12, 2012, to file a claim for a refund by accessing the FTC’s website: Complaints may be filed in English or Spanish, by visiting the FTC’s online Complaint Assistant or calling tollfree, 1-877-FTC-HELP (1-877-382-4357).

Whooping Cough Update: Cause for Concern!

Posted by Marianne Frederick

Recent news reports indicate that outbreaks of Pertussis, also known as whooping cough, are occurring more frequently than in past years. Pertussis is an extremely contagious disease spread by the Bordetella bacterium. Characterized by bouts of uncontrollable coughing, a “whooping” sound is made when a child or adult tries to inhale. Initial symptoms can be similar to those of a cold, runny nose, congestion, fever and a mild cough, but the cough can become serious without treatment with antibiotics. Complications from the disease according to the Centers for Disease Control and Prevention (CDC) vary from pneumonia to permanent lung damage.

Parents need to know that whooping cough can be fatal to infants and young children–and, according to an Associated Press report, the disease has increased 72 percent in babies under 4 months of age since the 1990s. Outbreaks of pertussis have been reported in New Hampshire, Vermont, Ohio, Pennsylvania, Minnesota, Arizona, Wisconsin, Washington state and recently, in south Florida.

Pediatricians generally recommended children receive pertussis immunizations at 2, 4 and 6 months of age, but statistics compiled by the CDC show that during 2002-2003 only 83 percent of infants were vaccinated against pertussis, which may indicate that pre-school vaccination policies are not always followed, according to an ABC News article of July 14, 2012.

The CDC estimates that last year there were approximately 11,000 pertussis cases in the United States, representing an increase of 2,000 cases over the previous year. This year, 18,000 cases have been reported so far, according to a report by The Wall Street Journal, and there is concern that the disease may reach epidemic proportions–not seen since an estimated 40,000 cases in 1959.

Because “Pertussis is the only vaccine-preventable disease that has not been completely controlled by routine childhood immunization,” physicians think that increased health and safety measures may need to be taken in order to control the disease. Health officials in some states are currently calling on adults, especially parents, pregnant women and others who spend a lot of time around children, to get a booster shot as soon as possible.

Why Vaccinate?

Posted by Marianne Frederick

It’s summer, and schools are out. While young children are ready to play, parents are thinking how to get kids ready for the coming school year. Here’s an item you may want to add to your summer to-do list: It’s never too early to think about vaccinations. Summer is a good time to prepare to have young children vaccinated to protect them from the bugs that circulate when kids go back to school.

Parents and caregivers may wonder why we vaccinate children. The U.S. Centers for Disease Control and Prevention tell us that many diseases which used to routinely harm and even kill infants and children in the U.S. in the recent past, have been reduced or eliminated due to the development and use of vaccines. The administration of vaccines has reduced the incidence and spread of many childhood diseases. But the viruses and bacteria responsible for vaccine-preventable diseases still “live” in the world and can be passed on to infants, children and adults who may be unprotected unless they are vaccinated. A vaccine-preventable illness can be serious for children and parents. When children are sick, they are unable to attend school and must be seen by a physician, involving doctor’s appointments and even trips to the hospital emergency room.

Before the polio vaccine was developed, 13,000 to 20,000 cases of paralytic polio were documented annually in the United States. The debilitating effects of polio are long lasting. Because we vaccinated children for polio for more than 50 years–we don’t see polio very often in the U.S. But polio still exists in the Middle East and in Africa where the disease still causes misery to families with young children. Now that world travel is more possible than ever before, we must continue to protect children and families against polio by vaccinating.  Childhood diseases, such as measles, mumps and diphtheria, also caused serious illness and death in American children before there were vaccines against them. Mumps caused deafness in 1 out of 20,000 children. Vaccines are now available to stave off chicken pox, rubella, pneumonia and other childhood diseases, as well as tetanus (lock jaw) which is only preventable by vaccine. How fortunate that our children today do not to have to experience these nasty bugs if they are vaccinated.

When your school’s representative or primary care physician contacts you about your community’s vaccination programs, please remember that vaccinating a child prevents the spread of diseases that can have very negative outcomes, not just for your family, but for other children and adults in your community.

Ticks Are Serious Stuff!

Posted by Marianne Frederick

Any season these fellows are out in abundance is tick season. Unfortunately, some areas of the country didn’t have a hard freeze this past winter, so there may be more of these biters than usual. Ticks are mite-like arachnids and are parasitic to mammals. They live in bushes, woodlands and in tall grass, but can also be found in low-lying moist, damp areas. They exist in several sizes, from practically microscopic to the size of a pinky fingernail–and their bites can transmit diseases including Lyme Disease, Babesiosis, Rocky Mountain Spotted Fever, Colorado Tick Fever and Tularemia. If you are bitten, you may get nothing–or you may get what the tick was carrying!

If you enjoy hiking and camping and you take your young children along–or any family member with a compromised immune system–it’s important to do a tick check after walking or spending time in the woods or tall grass. Ticks attach themselves as you walk through leaves, by bushes or through grass. Once attached, ticks crawl to warm, moist places on the body and then proceed to draw blood.

To help children avoid ticks when walking in woods or fields, dress them in long-sleeves and long pants, tuck their shirts in their pants and pull their sock-tops above the bottoms of their pant legs, so the ticks can’t reach the skin around their ankles. Dressing children in light-colored clothing will help you see the dark-colored tick if it gets on their clothing.

If your child has been bitten by a tick, you will need to remove it if it is embedded in the skin, wash the bite site and dab it with some rubbing alcohol. Tick bites are usually painless, so it’s difficult for a child to know that a tick is there unless you check for and see it. In the past, people used to burn ticks and that is NOT advised, as it’s a burn hazard! The best way to remove a tick is to take a tweezers (not your fingers), grip the tick as close to his embedded head as possible and slowly, steadily pull straight out from the site. Store the tick in a jar…and over the next few weeks you should watch for symptoms of any tick-borne disease. If the tick isn’t removed completely, you will need to take your child to the doctor or emergency room so a health professional can remove it. If symptoms do materialize, you will want to take that tick in the jar with you to the doc, so they can determine what the tick was carrying.

Symptoms of a tick-borne disease can include swelling at the bite site (though not all tick bites do this), severe pain at the bite site, red rash, muscle-joint aches, stiff neck, swelling of lymph nodes, flu-like symptoms, difficulty breathing or apnea (cessation of breathing), weakness and uncoordinated movement. A tick bite can cause paralysis in humans, so you need to pay attention to the symptoms. If any of these symptoms develop,take your child to an emergency room as soon as possible. You can also call the National Poison Control Center 1-800-222-1222 whose staff will provide more information about what you need to be doing immediately following a tick bite or further symptoms. Remember to do a tick check if you walk in the woods, and in the meantime, wishes you a safe and tick bite-free summer!

Moms Oblivious to Overweight Toddlers

Recently, MedPage Today’s Crystal Phend highlighted the results of a study that mothers frequently turn a blind eye to their toddlers who are overweight. In the article of May 7, 2012, Phend said instead of being apprehensive about their babies’ pudgy cheeks and chubby bodies, mothers seemed to approve of these as signs their babies were on track and normal.

The study and its results, performed by the University of Maryland School of Medicine, in Baltimore, were published in the Archives of Pediatrics and Adolescent Medicine. The study also noted that mothers of children whose weights were “healthy” were less satisfied with their babies’ body size. Those moms regarded heavier toddlers as the norm.

In the past, heavier babies have been symbols of health and successful parenting; and, therefore, have been perceived to be less at risk for a variety of childhood illnesses. Seventy percent of the mothers in this study did not correctly perceive their baby’s body size–possibly indicating that love is truly blind. How often have I heard a mom say when referring to her toddler’s weight, “Oh, she’s not fat, she’s just pleasantly plump, just right!”

But, it is not difficult to recognize, especially with recent publicity, that there is a looming safety and health problem in our country. It is a problem that has become very costly to our society in many ways. It is obesity. And sometimes it begins, sadly, in childhood with parents frequently over-feeding their children or allowing them to eat too many foods which are not healthful–and, certainly, too much fast food. This often sets up a dangerous pattern that is difficult to reverse or conquer as an older child or adult, and can even be the precursor of Type II diabetes, atherosclerosis, high blood pressure, elevated cholesterol levels and a host of weight-related bone structure and tissue problems. hopes that to keep your baby healthy, you will be sure to go to all your pediatrician appointments regularly and check your baby’s weight-to-length ratio with your pediatrician to make sure your baby’s weight and growth are where they should be. Feeding toddlers healthful foods, making sure they have adequate play, exercise, and rest, are just a few ways to help keep your babies happy and healthy, and ultimately reduce their risk of becoming an obese child or adult.

Study Shows Kids Don’t Play Outside Enough!

A review of a study in an article by Todd Neale in MedPage Today of April 2, 2012, shows that only about half of children preschool age or below are taken outside at least once a day to play! This surprising revelation was also reported in the Archives of Pediatrics and Adolescent Medicine.

Examination of the study’s results by Seattle (Washington) Children’s Research Institute, by Poojah Tandon, MD, MPH, dealt with a large survey group consisting of 8,950 children aged four, or children who were one year away from attending kindergarten-level school. The study data supplied by the Early Childhood Longitudinal Study-Birth Cohort tracking children born from 2001 showed “girls, non-white children and children in some types of daycare were less likely to have a parent take them outside every day.”[1] Most of the children in the study (80%) spent almost 30 hours/week in non-parental daycare. Sixty percent of the mothers of the almost 9,000 children worked outside the home, but only 44% of the parents–mothers or fathers–reported taking their kids outside to play once a day.

In the study, there was no association to the probability of children playing out of doors regularly vis à vis the amount of time children time spent watching TV or playing video games. Nor were there indicators of the family’s household income or the parents’ perception of the safety of the neighborhoods in which they lived. The researchers noted that the study’s survey was limited in detail and believed that “future studies that better quantify outdoor time” and its benefits to children would be important.[2]

One thing many children’s health and safety experts agree about is that outdoor play for children is generally very good and parents as role models for young children can encourage this practice safely. Some simple guidelines for parents of young children for their safe outdoor play are:

  • Very young children playing outside need to be closely supervised by a parent, caregiver or family member.
  • Play area surfaces should be thick and soft if you have an option! If it’s a playground, make sure there is no broken glass or uneven pavement where a little one could trip, fall and hurt themselves.
  • Play toys and equipment should be in good condition–no rusty swing sets, no sharp edges, no loose or broken parts, please!
  • When riding tricycles or other wheeled toys, put a helmet on their head.
  • As with any play, make sure toys and equipment used are age appropriate–young children should not be using the same equipment older children use.
  • Watch the weather–if it’s too cold or very hot, use caution–young children get can get too chilled or overheated fast. Make sure children are dressed appropriately for the weather outside. Don’t forget to use sunscreen on their nose, ears, hands, etc.
  • If little shoes get wet during play, make sure to remove their shoes and thoroughly dry their feet (and put on dry socks) when they come indoors; and
  • Have fun with your children and at the same time remember to play safely!

What Baby Eats–How Safe Is Establishing Preferences for Salt or Sweet?

A recent study published in the American Journal of Clinical Nutrition, supported by the National Institutes of Health (NIH) of the U.S. Department of Health and Human Services (DHHS), points to the fact that eating patterns favoring salt may begin in children as early as infancy and that this may have a serious effect in later life.

According to the HHS HealthBeat of February 27, 2012, Leslie Stein of the Monell Chemical Senses Center in Philadelphia, PA, examined the “taste preferences” of babies fed starchy table foods which frequently contain additional salt.[1] The infants who received the starchy foods appeared to like “saltier water” and the salt preference continued as the babies aged.

Children introduced to starchy table foods by six months of age had a tendency to like the taste of salt when they were in preschool.” This is significant because “eating patterns which favor lots of salt are associated with high blood pressure and heart disease in adults.” So, parents and caregivers, we are again cautioned to watch our child’s intake of salt–even in infancy. So, if you haven’t been reading the labels, be sure to check the sodium content, especially of processed baby foods. And, if your children are being fed “starchy” table foods, ensure that they are also eating vegetables, fruit, and the right amount of dairy and protein too.

An article in MedPage Today, February 7, 2012, entitled, “Baby’s First Foods Should Be Finger Foods”[2] pointed to the fact that baby-led weaning has had a positive impact on a child’s liking for carbohydrates–foods that form the building blocks of healthy nutrition (those found at the bottom of the food pyramid). The author of the article, Nancy Walsh, noted that there has been a lot of interest and support “for baby-led weaning, which encourages a less controlling parental style and can help ease maternal worries about appropriate feeding.”

Baby-led weaning emphasizes infant self-feeding with solid finger foods from the outset, rather than parental spoon-feeding, but using the self-feeding method exclusively, worries me–parents need to make sure that not too much, nor too little, food finds its way into baby’s mouth. Meanwhile, if parents and caregivers are encouraging baby to feed himself, babies still need to be closely supervised while they eat. A very young child does not know how much they can safely put in their mouth and swallow.

Walsh notes that the study performed by research scientists, Ellen Townsend, PhD, and Nicola J. Pitchford, DPhil, of the University of Nottingham in England, concluded spoon-fed babies preferred sweets. One might say that in health-conscious America of the 21st Century, establishing this sort of pattern for a child will no longer do! This pattern of eating may contain another cause for childhood obesity–or adult Type II diabetes–by establishing a child’s preference for sweets in early life by spoon feeding. So, as parents and caregivers, we are cautioned on both accounts–the salt and sugar content of our babies’ foods. Perhaps, after all the science, it comes back to a wise grandmother’s good advice, “Moderation in everything is best!”

[1] “Kids on Salt”, HHS HealthBeat, February 27, 2012,

[2] “Baby’s First Foods Should Be Finger Foods”, Walsh, Nancy, MedPage Today, February 07, 2012,