Christmas Safety, Grandma’s Purse & Everyday Dangers

christmas-dangersAt this time of the year, we think of the holiday dangers rather than the same dangers that fill emergency rooms around the country each day.  Mistletoe and dangerous toys should certainly be on our list of concerns but do not forget about the most common types of injuries that occur year round  -— poisonings, chokings, falls and burns.

The single most dangerous item during the holidays may be grandma’s purse, where her medications may be left in places accessible to children. They may even be set out for her to remember to take them.  When our older relatives and friends travel, they may not think to place their pills out of the reach of children.  They pill case is placed on the night stand or bathroom counter rather than up high and away from little hands looking for candy.

Parents should be on the lookout for potential for mishaps in visits to homes that haven’t been “child-proofed.” Be vigilant and inspect homes for unblocked stairways and other hazards non-parents may have missed.

There are two common seasonal injuries — that’s when a child pulls over a Christmas tree or sees the candle burning and decides to play with fire. Trees should be securely fastened to the wall and toddlers should not be permitted close enough to a tree to tug on it. Candles should also be placed on fireproof plates and away from any low areas or counters that are easily climbed.

Other dangers to watch for include easy access to alcohol at holiday gatherings. During a large party, guests may leave half-imbibed cups around the house. Small children may wander the house sampling the drinks. Children often show up at ERs showing symptoms of alcohol poisoning.


“Eco-Friendly” (Mercury) Fluorescent Bulbs – How to Dispose of Safely

570A patient recently called after finding one of those curly, new fluorescent  “environmentally friendly” bulbs that had broken in her house.  She was concerned as she had heard that they are toxic when exposed to air.

Indeed they are!

The EPA has an excellent website for just this situation and what to do in case of breakage of a compact fluorescent light bulb or CFLs.

After reading all of the pertinent information, I feel as though there must be a good joke here somewhere…

How many decon-haz-mat suits do you need to change a light bulb?

Mercury is a known neurotoxin and a potential carcinogen.  Although the mercury contained in the new bulbs is only about 1% of that found in the old-fashioned thermometers, I feel more comfortable in a house full of tiny people with the good old incandescent bulbs.   Yes, they are not nearly as energy-efficient, but they do make your skin much prettier in the evening!

In case you have a breakage, here are the basics:

1. Remove all people and pets from the vicinity for at least 10 minutes.

2. Turn off your central air conditioning and open windows for several hours.

3. Without touching, carefully place broken parts in an airtight jar/plastic bag.

4. Use duct tape to get up those really tiny bits.

5. Wipe down area with wet paper towels & then place all refuse in the jar/bag.

6. Place the jar/bag outside & then later to the recycling center. (The recycling center – like you need something else to do but this is a hazardous material and must be disposed of properly.)

7.  Avoid vacuuming as this aerosolizes the toxic particles, but if you must then throw out the bag filters with your bulb and clean machine up the wazoo.

8.  Wash your hands.

9.  Go shopping for nicer bulbs.

In the end, light bulb jokes are not all that funny.

Tylenol Linked to Developmental Delay (Yes) / Autism (Maybe)

tylenol-acetaminophen-dangers“Our findings suggest that Tylenol/acetaminophen/paracetamol might not be as harmless as we think,” said the lead doctor on a study in the International Journal of Epidemiology.

Frequent use may be linked to poorer language skills and behavior problems among their children, according to the study. “Long-term use of (acetaminophen) increased the risk of behavior problems by 70 percent at age three,” the researcher said. “That is considerable.”

The developmental problems seen in this study align with symptoms of autism spectrum disorder, though the children had not been diagnosed at age three.

As the most popular over-the-counter drug in the U.S., Tylenol has been extensively studied in relation to premature birth and miscarriage, with no connections found.

But its maker Johnson & Johnson periodically comes under fire for the drug’s small therapeutic index – that is, the difference between an effective dose and a dangerous dose is quite small. So interest in investigating the drug persists.

The new study is the first to look at young children whose mothers took Tylenol while pregnant. Close to four percent of women took Tylenol for at least 28 days total during pregnancy. Their children seemed to have poorer motor skills than kids whose mothers had taken the drug fewer times or not at all. Tylenol-exposed kids also tended to start walking later, have poorer communication and language skills and more behavior problems.

It’s difficult to define risks for pregnant women and their children, since rigorous tests and controlled studies of drug exposure aren’t ethical. All researchers can do is closely observe women in the real world. But this study involved a large number of women.

Researchers also looked for any link to ibuprofen/Motrin. They found no development problems tied to ibuprofen.

10 Things Your Nanny Won’t Tell You

nanny safetyI saw this article in the Wall Street Journal on October 13, 2013 and the title made me smile. What does my (your) nanny know that I (you) don’t? From a pediatrician’s perspective, this is a great opportunity to raise a few thought-proviking questions.

1. “Your kid loves me more than you.”

Wow – this means the parent is never around or the nanny is over stepping boundaries. TIme to change your lifestyle or nanny.

2. “You’re the worst part of my job.”

This is a natural yet unfortunate and avoidable situation. When you have two people caring for a child, they both want to be the ‘gatekeepers’ of health and wellness.  This creates a tension as the two people may have different value systems and thus caring styles. I see this all a lot with mothers and mother-in-laws. The solution is to make clear boundaries and know the child is yours. Always be open to advice and guidance but do not be afraid to hold your line and your family’s boundaries.

3. “I can’t save your kid’s life (or treat his injuries).”

Enroll all caregivers, is parents, grandparents, older children, nannies, etc, in a CPR course.

4. “I’m sleeping with your spouse.”

Umm, no comment.

5. “You’re not paying me enough.”

Salary is always a debate and fairness depends on the level of responsibility and availability of the nanny. $16 an hour is the median. I suggest thinking about the nanny’s  family needs as well. Your nanny is part of your community and if you do not take care of your community then points #1-4 are more likely to occur. Enough said.

6. “I’ll sue you.”

Be professional and respectful and this should not happen. If I were writing this for the nanny, I would make sure they created their own boundaries and would have them express these at the start of their employment to avoid unnecessary problems. Clear communication and respect are the key to to any healthy relationship. Karma, karma, karma.

7. “I’m smarter than you are.”

This may be true and often is true. However smarts do not determine who runs the house or how the children are cared for. Many times the employee is smarter than the boss but again let professionalism and respect rule the day.

8. “Your secret’s not safe with me.”

Having someone live in your house makes one vulnerable since they get to see you with your guard down. Again if you are respectful and professional then there should not be a problem but I suggest having the nanny sign a confidentiality and nondisclosure agreement.

9. “I know about that nanny cam.”

Technology allows 24 a day surveillance. Use it especially if your child is less then 6 years old. Every job should have markers of performance and when working with toddlers who cannot provide an adequate history then a camera (or several of them) are fine.  I would let the nanny know they are there too.

10. “You better do a thorough background check on me.”

This goes without saying. I have had parents run background checks on me as their pediatrician. This is not only smart to do but necessary. I work on the child protection team and never want to see your child in my office for a suspected abuse.

The bottom line is treat your nanny with respect, be clear about your boundaries, do not worry about disagreements as long as both sides are professional, and treat them like family. Working with a co-gatekeeper will force you to acknowledge your own strengths and weaknesses, will demonstra
te to your children how to work with others and give you time to contribute to your larger community. After all, our lives are about service.