http://www.planforyourhealth.com/ Latest Healthy Living News from Aetna en http://www.planforyourhealth.com/ http://www.planforyourhealth.com/ Latest Healthy Living News from Aetna TYPO3 - get.content.right http://blogs.law.harvard.edu/tech/rss Wed, 22 Feb 2012 13:47:00 -0500 http://www.planforyourhealth.com/living-healthy/health-news/healthy-living/healthy-living-details/newsarticle/more-kids-treated-for-gender-issues/ More children are seeking support and treatment for gender identity disorder, new research finds.... What Is the Doctor's Reaction? Newborn baby girls are dressed in pink. Baby boys are dressed in blue. Young girls get Barbie dolls and tea sets for birthday presents. Young boys receive toy trucks and sports equipment. What if your daughter would rather play football with the boys than dress up with the girls? Or your son would rather wear dresses than jeans? When we think of ourselves as being male or female, that is our gender identity. Everyone has a gender identity. For most people, their gender identity matches the sex (boy or girl) they look like on the outside. Sometimes people do not match. A child who is born as a boy may feel that he should be female. Or a child born as a girl may feel that she should be male. These children often say that they feel like they are "trapped in someone else's body." This is what doctors call gender identity disorder (GID). The journal Pediatrics published 2 articles and a commentary this week about gender identity disorder. Researchers looked at children and teens with GID who were referred to a children's medical center. They collected data from 97 patients who had come to a special GID program between January 1998 and February 2010. The average age for evaluation was about 15. The number of males and females was about equal. Most teens were far along into puberty. Among these children, many had a history of psychological problems.

• Almost half had been diagnosed with a psychiatric disorder.
• More than one-third were taking medicine for a psychiatric disorder.
• About 20% had a history of hurting themselves, such as cutting.
• About 9% had attempted suicide.

These findings suggest that children with GID may be at a high risk for psychological problems. The authors recommend that these children and their families receive counseling. This can help them to cope with the difficulties of being (or raising) a child with GID. What Changes Can I Make Now? Parents often worry when their daughter chooses to play with cars and trucks instead of dolls. Or if their son is interested in playing house instead of soccer. They often have questions, such as: Is my child's behavior normal? Should I be trying to change him or her? Does he or she need profes¬sional help? It is important to remember that GID is a real condition. Some boys do identify more with females. Some girls do identify more with males. Remember, gender identity is not a choice. Trying to force a child to change his or her gender identity is not helpful and can lead to problems. Boys who may have GID may say they want to be girls. They may have a preference for:

• Female clothing and underwear
• Always sitting when using the bathroom
• Playing with girls' toys
• Having long hair

Girls who may have GID may have a preference for:

• Male underwear
• Breast binding
• Refusing to wear female swimsuits

These girls may say they want to be boys. They may break down psychologically when menstruation starts. Talk with your child if you believe that he or she might be confused about gender. It can be shocking to hear that your son believes himself to be a girl (or your daughter believes herself to be a boy). You may find gender identity confusion hard to understand. But it is important that you show your love and support. Children with GID also are more likely to be bullied at school. Tell your child to tell a teacher or other adult if such bullying occurs. These children need to know that they do not deserve to be hurt. Keep an eye out for signs that they may be having problems at school. They may refuse to go to school, complain of pains, or cry terribly. Your family may benefit from speaking with a mental health professional, such as a psychologist or psychiatrist. This is especially helpful if the child:

• Refuses to accept his or her biological sex
• Plays only with children of the opposite sex
• Is socially isolated at school and/or is teased or ridiculed by other children

Early professional help can make a difference for these children. Treatment may include:

• Counseling
• Blocking the development of puberty with medicine
• Giving opposite-sex hormone therapy

What Can I Expect Looking to the Future? Researchers will continue to study GID. I hope this will help us to understand it better. For example, what psychological changes occur when people's physical looks match the gender they prefer? We also need to figure out why more children do not come to medical attention sooner, since early treatment can help. The more we learn about GID, the better we will be able to help children who feel gender confusion. Expect pediatricians to ask your child if he or she is going through "gender-related" issues. The American Academy of Pediatrics offers more information about GID on its website, www.healthychildren.org. ]]> Mon, 20 Feb 2012 13:33:00 -0500 http://www.planforyourhealth.com/living-healthy/health-news/healthy-living/healthy-living-details/newsarticle/100-years-of-worry-about-kids-and-sleep/ Parents worry that the distractions of modern life are keeping their kids from getting enough... What Is the Doctor's Reaction? "This is a sleepless age and more and more … we are turning night into day." Sounds like something you might hear or read these days, right? Well, it's something that British psychiatrist Sir James Crichton-Browne said in -- get this -- 1905. Worrying about children getting enough sleep is hardly new. Researchers at the University of South Australia decided to look at historical trends in sleep advice. They also looked at the rationale behind that advice. The journal Pediatrics published the article online. Here's what the researchers found:

• There were 32 different sets of sleep recommendations for children and teens between 1897 and 2009.
• The amount of nightly sleep recommended for different age groups has declined, on average, about 0.71 minutes a year since 1897.
• The actual amount of sleep kids get went down about 0.73 minutes a year. ("No matter how much sleep kids are getting," the authors say, "it has always been assumed that they need more.")
• Only one set of recommendations, from 1926, gave an actual reason. The authors looked at how much sleep 500 "healthy" kids were getting. Then they figured that's how much all kids should get.
• In general, there isn't much scientific evidence to support sleep advice. Over the years, we've mostly just guessed.

What Changes Can I Make Now? We may not know exactly how much sleep kids should get, but we do know that not getting enough can lead to health and behavioral problems. So what is a parent to do? Since we know that not getting enough is bad, it's a good idea to minimize things that interfere with sleep.

• Get the TV out of the bedroom (computer, too, if your child tends to go on it at night).
• If your child has a cell phone, get that out of the bedroom at night.
• Have a consistent bedtime, with calming routines leading up to it.

When choosing that bedtime, a reasonable ballpark amount of sleep for school-age kids is 9 to 10 hours. But understand that some kids may need more and some less. Remember that it's not just the quantity of sleep that matters, but the quality of it.

• If your child snores, it could be a sign of an obstruction that is interfering with sleep. Talk to your doctor.
• Try to reduce things that could wake a child from sleep during the night, such as noise or interference from siblings and others.

How do you know if your child is getting enough sleep? Well, is he healthy and happy? Does he have energy during the day? Is he doing well in school? If so, chances are he's getting enough. However, these can be signs that your child might need more sleep:

• Feeling sleepy during the day
• Not having a lot of energy
• Seeming moody
• Having trouble in school

Other things can cause these problems, too. So definitely talk to your doctor if they are happening. But you should take a good look at the quantity and quality of your child's sleep. What Can I Expect Looking to the Future? We are learning more and more about sleep all the time. New science and new technologies are helping us understand sleep better. I hope this will help us be sure everyone, including children, gets enough sleep. ]]> Mon, 13 Feb 2012 13:53:00 -0500 http://www.planforyourhealth.com/living-healthy/health-news/healthy-living/healthy-living-details/newsarticle/study-tallies-serious-child-abuse-injuries/ Nearly 4,600 children had to stay in a U.S. hospital in 2006 because of child abuse, a new study... What Is the Doctor's Reaction? It is hard to imagine an adult would ever purposely hurt a child. Parents want to protect their children. Adults want to keep children safe. Sadly, that does not always happen. Almost 3 million cases of child abuse are reported each year in the United States. It is likely that even more cases of abuse are not reported. The American Academy of Pediatrics lists five types of child abuse:

• Physical abuse
• Physical neglect
• Verbal abuse
• Emotional abuse
• Sexual abuse

A study just published in the medical journal Pediatrics focuses on physical abuse. Researchers studied data from the 2006 Kids' Inpatient Database. This includes information from about 4,000 hospitals in almost 40 states. The authors confirmed many cases of physical abuse in children in the United States. In 2006, about 4,500 children were hospitalized due to physical abuse. Three hundred of these children (7%) died from their injuries. Which children were more likely to have a hospital stay for serious physical abuse?

• Boys more than girls
• White children, followed by African-American children
• Children who were poor -- About 3 out of 4 abused children had Medicaid.

Children less than 1 year of age died most often from physical abuse. School-aged children had the lowest rates of death. Children who were abused had longer hospital stays (about 7.5 days) than children in the hospital for other reasons (about 4 days). They also had higher hospital costs (roughly twice as much for each hospital stay). This new information can allow experts to study trends in physical abuse in children over time. It also can show how well programs created to prevent child abuse are working. What Changes Can I Make Now? Abuse often happens right in the child's home. The child may even know his abuser. It can be a parent, relative, babysitter or neighbor. This makes it very hard for children to tell someone that they are being hurt. Abuse may cause a major lifelong problem for its victims. Parents, pediatricians and all adults must be on guard. We must all watch out for signs of child abuse. We all must know what abuse is and when and how to respond to it. Look for these types of injuries:

• Black eyes
• Bite marks
• Burns in the shape of cigarette butts or of having been put in scalding hot water
• Repeated injuries (especially if the child cannot explain how she got them)
• Injuries that the parent does not want to talk about

Watch out for these kinds of behavior in a child:

• Cries a lot (more than usual)
• Is very aggressive and disruptive
• Seems afraid of a parent or caretaker
• Is unusually tired or tired too often
• Tries to run away from home
• Has sudden changes in how she feels about herself (self-esteem)
• Has too many fears
• Has too many nightmares
• Is failing in school

If you ever think that a child is being abused, you must say something! Contact your local child protective services agency, police, hospital or emergency hotline. If necessary, you can do so anonymously (without giving your name). In many states, teachers, doctors, dentists and other professionals are required (by law) to report suspected cases of abuse. Keep your children safe from physical abuse outside the home. Teach them to:

• Say "no" when someone asks them to do something they do not want to do
• Always tell an adult if someone hurts them or makes them feel bad
• Stay away from places they don't know or don't usually go by themselves
• Keep their distance from people they do not know

What Can I Expect Looking to the Future? We must continue to do what we can to help all children feel safe and loved, especially in their homes. Abuse is a major public health problem. I hope that we can decrease the number of children who are abused each year. Expect much more public education about child abuse for parents and communities. If all adults know the signs of child abuse, they will be better able to protect all children. Researchers also will continue to learn more about the specific causes, findings and clinical outcomes in children who suffer abuse. ]]> Mon, 06 Feb 2012 12:24:00 -0500 http://www.planforyourhealth.com/living-healthy/health-news/healthy-living/healthy-living-details/newsarticle/booster-seat-use-lower-in-carpools/ Even parents who use booster seats for their children don't always insist on using the seats for... What Is the Doctor's Reaction? Families spend lots of time in cars. We drive our kids to school, the library, sports activities and friends' houses. We travel in our cars on family vacations and to visit relatives. We are in our cars so often it can sometimes feel like we are practically living in them! One of the best ways to protect your children is to see that they always are using a car seat when it's recommended for their age or weight. Car seats are not just for infants and very young children. A child who outgrows the toddler car seat (at about age 4) should begin to use a booster seat. A booster seat should be used until the child is 4 feet, 9 inches tall (57 inches). This usually happens between ages 8 and 12. Booster seats have been shown to greatly reduce the risk of severe injury in motor vehicle accidents. But many parents do not use booster seats for their older children. A study just published online by the journal Pediatrics looked at why this happens. Researchers focused on whether carpooling affects parents' use of car safety seats for their children. The researchers surveyed parents who had children between the ages of 4 and 8.

• About 3 out of 4 said their child used a safety seat when riding in the family car.
• Of the children who used seat belts instead, 3 out of 4 did so in agreement with their state laws.
• Younger children were more likely to be placed in safety seats. So were those living in states with booster seat laws.

Researchers also asked parents whether they take part in a carpool and drive other families' children. About 64% of parents did report carpooling. Among this group, the use of safety seats varied widely.

• About 1 out of 5 parents do not always ask other drivers to use a booster seat for their own child.
• Only about half always have their child use a booster seat when riding with friends who do not have booster seats.

Half of the parents admitted not knowing to what age their state requires that children use booster seats. When asked, 1 in 5 parents guessed the wrong age. Even though it is safer to use booster seats after age 8, only 2 states require it. This clearly shows a need for better public education about car safety and booster seat use. What Changes Can I Make Now? Motor vehicle injuries are the leading cause of death among children in the United States. You can take important steps to help keep your child safe when riding in a car.

• Buckle up! You are a role model to your children. By using a seat belt on every trip, you are setting a great example.
• Make sure your child is properly buckled up in a car seat, booster seat or seat belt.
  
  • Rear-facing car seats -- These are used for infants. Infants should remain in these seats until at least 2 years of age or as long as possible until they reach the upper weight and height limit for that seat.
  • Front-facing car seats -- Next children should move into front-facing car seats. They should remain in these seats at least until age 4. It is safest for children to stay in front-facing car seats until they have reached the upper weight and height limits for that seat.
  • Booster seats -- Children who outgrow car seats should use booster seats. until the seat belts in the car will fit them properly. A seat belt fits properly when the lap belt lies across the upper thighs and the shoulder belt fits across the middle of the shoulder and chest. This is typically when the child has reached 4 feet, 9 inches tall and is 8 to 12 years old.
  • Seat belts -- When children are old enough and large enough, they can use the seat belt alone. They should always use both the lap and shoulder belts.
• Children should sit in the middle of the back seat when possible. This is the safest spot.
• All children under age 13 should sit in the back seat, no matter how much they beg to sit up front! It is safer for them.
• Never seat a child in front of an air bag.

Ask your child's doctor if you want to know any more about whether or not your child should be using a car seat. What Can I Expect Looking to the Future? It would be ideal to increase the number of children passengers who are buckled in, according to car safety guidelines. More public education is necessary. Many parents still do not even know that older children need booster seats. Doctors who care for children will increase their efforts to get the word out about car seats. Sadly, too many children still die from motor vehicle injuries each year. I hope that if more parents use car seats (such as with carpooling), the number of children injured or killed in car accidents will go down. ]]> Mon, 30 Jan 2012 06:30:00 -0500 http://www.planforyourhealth.com/living-healthy/health-news/healthy-living/healthy-living-details/newsarticle/parents-role-in-weight-control-assessed/ A new report calls for more research to find the best ways for parents and other caregivers to... What Is the Doctor's Reaction? As a pediatrician and a parent, it seems plain old obvious to me that anything we do to fight the childhood obesity epidemic needs to involve parents and other adult caregivers. After all, they are the ones who:

• Shop
• Pack lunches
• Cook meals
• Take kids to McDonald's
• Sign them up for soccer
• Buy video games and televisions
• Make decisions about how much time kids spend in front of them

Basically, there is nothing I can do as a pediatrician that doesn't involve a parent or caregiver. So I was pretty excited about a new scientific statement from the American Heart Association (AHA). It's called "Evaluating Parents and Adult Caregivers as Agents of Change for Treating Obese Children." The first part of the statement goes through the core behavior change strategies for obese youth. The AHA says these strategies are "grounded in strong theoretical models." They include:

• Choosing specific habits or behaviors that should change
• Writing down or keeping track of a target behavior such as what children eat or how much they exercise
• Setting goals
• Limiting temptations
• Offering support for good behavior (such as rewarding kids for making good food choices)
• Using self-efficacy and self-management skills (learning willpower!)

The authors talk about ways that parents and adult caregivers can implement these strategies. Again, it seemed somewhat obvious to me that involving all caregivers is necessary for any of these strategies to work. But in the second section, when they reviewed studies on the effect of parent and other caregiver involvement, do you know what they found? It wasn't at all clear that caregivers made a difference in treating child obesity. To be fair, some studies did show that it made a difference. Also, most of the studies only kept track of kids and families for a few months. This may not have been long enough to show real results. But nevertheless, it was discouraging. So what is going on? Maybe parents and caregivers really don't make a difference -- but that's hard to believe. Maybe that's not the explanation. Maybe parents need more education and support to be effective. Or -- and this is the most likely explanation -- maybe our overall efforts to treat childhood obesity just aren't effective. The last section of the statement discussed possible areas of research. For example, what is the role of family relationships when it comes to childhood obesity? What is the role of genetics, or culture? What are the best changes to make in the home environment? What are the best parenting practices if we want to keep kids at a healthy weight? The parent, the child and the environment each play an important role in childhood obesity, the authors say. We need to understand each one separately before we can understand how they work together. That's the central problem here. There's no obvious solution for the treatment of childhood obesity. If there were, we'd have had it fixed by now. It may be obvious that parents and caregivers need to be involved. But the best way to involve them is far from obvious -- and they aren't the only solution. What Changes Can I Make Now? If you are a parent or caregiver of a child, you should:

• Know your child's body mass index, or BMI, and know if it's healthy. Your doctor is your best resource. The U.S. Centers for Disease Control and Prevention (CDC) website has a great BMI calculator for kids. It also includes lots of useful information about healthy eating and exercise.
• Know your own BMI. Overweight parents are more likely to have overweight kids. The reasons involve genes and also family lifestyle habits. Which leads me to…
• Take a long, hard, honest look at your family's lifestyle. Do you exercise? How much is the TV on? Is there soda in the fridge? Are your habits as healthy as they could be?

What Can I Expect Looking to the Future? As I have said many times in news reviews related to childhood obesity, unless we make some real changes what we can expect is more overweight kids. And those kids are far more likely to grow into overweight adults. This will bring a future load of medical, emotional, social and financial problems. This scientific statement helps us understand how parents and caregivers might be able to help fight child obesity. And it also points out what we need to study if we are going to make them really helpful. That's just the kind of information we need if we are going to save our children's future. ]]> Tue, 24 Jan 2012 13:05:00 -0500 http://www.planforyourhealth.com/living-healthy/health-news/healthy-living/healthy-living-details/newsarticle/two-strep-bacteria-implicated-in-tooth-decay/ INTELIHEALTH - The one-two punch of two bacterial strains may put children at higher risk for... Wed, 18 Jan 2012 13:07:00 -0500 http://www.planforyourhealth.com/living-healthy/health-news/healthy-living/healthy-living-details/newsarticle/hospital-visits-for-drowning-cut-in-half/ The number of children treated in hospitals for drowning injuries has dropped by half since 1993,... What Is the Doctor's Reaction? There is nothing more fun for children than playing in water, especially on a hot day. Some kids enjoy swimming in pools. Others splash around in the bathtub. Sadly, a new study reminds us that these activities can be dangerous. The journal Pediatrics published the study. Researchers looked at data on children who visited a hospital because of drowning. They used a large database of inpatient care information. It included an average of 8 million hospital trips each year in the United States. Drowning is being unable to breathe because water has filled the airways. People can survive drowning if rescued soon enough. However, they may have lasting injuries. The study focused on children under age 20. It covered the years 1993 through 2008. Overall, the study found that hospital visits related to drowning went down by more than half (51%) for both boys and girls.

• There were 40% fewer bathtub-related drownings for kids younger than age 4.
• Half as many older kids drowned in swimming pools.

Drowning remains the second leading cause of death from an accidental injury among children 1 to 19 years old. Nearly 1,100 children die from drowning each year. Some survive, but end up with serious, long-term health problems. Lifetime costs linked with drowning are in the billions of dollars range. Certain children are at a higher risk of drowning based on:

• Gender -- Boys are 4 to 6 times more likely to drown than girls.
  
  • Boys tend to think they can swim better than they can.
  • Male teens may use alcohol more often.
• Where they live -- Rates of drowning are highest in the Southern and Western states. This may be because warmer weather creates more chances to swim.
• Age -- Drowning incidents differ by the ages of children.
  
  • Children under 4 years are more likely to drown in a bathtub or by falling into water.
  • Older children are more likely to drown while swimming.

What Changes Can I Make Now? Keep an eye on your child at all times. The best way to keep your child safe is close supervision. Remember swim lessons do not "drown proof" your child. Even children who know how to swim can drown. If you have older children, be sure to speak with them about the dangers of swimming alone or after drinking alcohol. Caution them not to take chances related to how far they think they can swim (for example, across a lake or river). The American Academy of Pediatrics (AAP) recommends taking these steps to protect your children from drowning:

• Watch your children at all times. Drownings can happen in a bathtub, toilet, swimming pool, bucket of water or any body of water.
• Allow children to swim only in supervised areas.
  
  • Younger children always need an adult who knows how to swim in the area.
  • Older children should swim only in pools and beaches with lifeguards around.
• If you have a private swimming pool, install a four-sided fence. The fence should be separated completely from the house. It should be at least 4 feet high and have a self-closing or self-latching gate.
• If you own a pool or have children, learn CPR.
• Always keep a telephone and CPR equipment by the pool.
• Use life jackets (not inflatable flotation devices) on children while swimming.
• Enroll your children in formal swimming lessons.

What Can I Expect Looking to the Future? You can expect increased public education about how best to keep your children safe around water. We can hope that drownings will continue to decline. Public health groups need to better translate these research findings into practical water safety tips for all of us. We also need to find better ways of collecting more detailed data about drowning. This will help experts learn about factors that increase the risk of drowning and the best ways to protect our children. ]]> Tue, 17 Jan 2012 13:16:00 -0500 http://www.planforyourhealth.com/living-healthy/health-news/healthy-living/healthy-living-details/newsarticle/many-factors-limit-play-in-child-care/ Why do kids get little physical activity in child care and preschool? Researchers asked providers... What Is the Doctor's Reaction? We are turning our preschoolers into couch potatoes. Three-quarters of the kids aged 3 through 5 are in child care. Studies have shown that for the vast majority of their time in child care they are not physically active. In fact, only 2% to 3% of that time is spent in vigorous activity. Researchers from Cincinnati Children's Hospital wanted to find out why. So they put together focus groups of various child care providers, and asked them why the kids weren't more active. Here’s what they found out:

• For some, the issue was financial. They didn't have much space for play outside or inside. They also couldn't afford outside play equipment (or at least the kinds that really encouraged activity).



• Even when there was enough space and money, concern for injury was a big factor. Providers have to follow licensing rules. The rules restrict the equipment allowed for play by preschoolers. Beyond that, providers said they often stopped kids from active play for fear of injury. Often they did this at the request of parents.



• Child care providers felt a lot of pressure to get as much academics into the day as possible. Parents were much more interested in what their child learned that day than how much they played.

These are all understandable concerns. But daily physical activity is really important for kids. That's why the American Academy of Pediatrics recommends at least an hour of it every day. With one-third of U.S. kids overweight or obese, physical activity is crucial. When kids sit around, they are far more likely to be overweight. And it's in childhood that we develop lifelong habits. If children don't learn to enjoy physical activity when they are young, it's harder to get them to move when they are older. More and more studies show that overweight kids grow into overweight adults. Too little activity is a big part of the reason. But play isn't just important for weight. Play is important for learning. It's a big part of how kids learn what we call "executive function," the organizing principles of behavior. Executive function has to do with the ability to concentrate, take turns, problem-solve, negotiate and wait for things that you want. Kids try this stuff out and practice it during play. If they play less, they are more likely to have behavioral problems. It can affect them in the classroom as well. What Changes Can I Make Now? If you are picking a preschool or child care setting, choose one with lots of chances for play -- especially active play. Look for access to big outdoor places and equipment that encourages kids to really get moving. Of course, you want your child to learn. But at preschool age, much of how they learn is play. So find a place with lots of books on the bookshelf. But also look for dress-up gear and finger paints and blocks and a pretend kitchen and other things that encourage creativity and fun. Policy makers should pay attention to the findings of this study. So should school personnel and everyone involved in early childhood education. They need to help make active play (and other kinds of play) a bigger part of every child's day. What Can I Expect Looking to the Future? As I've said in many news reviews related to childhood obesity, if we don't start making real changes, we can expect an increase in the number of obese kids. This will lead to an increase in the number of obese adults, with all the terrible health, emotional and financial consequences that brings. And if we don't give kids more chances to play, we are going to see more children -- and later, more adults -- with poor executive function and all the behavioral and learning problems that brings. This can't be what we want for our children and our future. It's time to do something. Our children are depending on us. ]]> Wed, 04 Jan 2012 12:42:00 -0500