Fractures

Our kids can be very active, and, unfortunately, accidents do happen. One of the most common injuries in school-age children is fractures. Broken bones in children are generally not too serious (bones in young children are more flexible and have a thicker covering than bones in adults), and they generally heal quickly with proper diagnosis and treatment.

It can be difficult to tell whether or not your child has a broken bone. As a general rule of thumb, if the bone is broken, your child will experience pain and will be unable/unwilling to move the affected limb. However, some children are too young to tell you they are in pain, and just because a child is able to move the limb, doesn't always mean the bone isn't fractured. If you suspect the bone is broken, it never hurts to take your child to the doctor to have it examined.

The first thing the doctor will do if a fracture is suspected is order x-rays in order to see the extent of the injury. Most of the time a simple cast that immobilizes the area is all that is needed for the fracture to heal. If the fracture is more serious, bones that are displaced may need to be realigned by an orthopedic surgeon.

Here are a few tips if your child does appear to have a fracture injury:
1) Try to immobilize the area with use of a sling or splint.
2) If your child is older, place an ice pack on the area to reduce swelling and relieve pain. Never use ice with babies or toddlers because their skin is delicate and the extreme cold can cause injury.
3) Don't give your child anything by mouth; no food, drink, or medication for pain.
4) If your child has a broken leg, don't try to move him/her yourself. You may cause further injury. Instead call for medical help.
5) If bone is protruding through the skin, use firm pressure on the wound to control the bleeding, and then cover the area with clean gauze to help prevent infection.

Ask a Nurse

Today's ask-a-nurse question is a follow-up on last week's vaccine question:

How do I know my baby isn't getting too large of a dose of a vaccine?

Vaccine doses for infants are different from the doses for children and the doses for adults. It is important to note that it requires at least 10 years of FDA testing before a vaccine can even be licensed. Before they are even in use, vaccines are thoroughly tested for proper dosing, safety, and effectiveness, so you can be certain that the right amount is being given to your child to provide immunity to the disease without causing serious adverse effects.

Once a vaccines is licensed, the Centers for Disease Control and the FDA continue to monitor for safety and effectiveness of the vaccine. Any hint of a problem will lead to an in-depth investigation and appropriate actions will be taken including even revoking the vaccine's license if necessary.

If you have a question you would like Nurse Brittany to answer, e-mail it to healthyhappychildren@gmail.com.

In the News: Bath Toys

Recently I was watching The Today Show, and there was a segment on children's bathtub toys that I knew I had to share on the blog. As I watched the segment, I was appalled. The topic was something I had never thought about before, but it makes perfect sense—the combination of stagnant water, warmth, darkness, and an already-prone-to-bacteria bathroom setting is the perfect breeding ground for bacteria growth on and in your child's bath toys.

Watch the video here or read the news story here.

Scoliosis

You may remember getting a scoliosis health screening in junior high school—the one in which you bend over and touch your toes while the examiner looks at your back. Scoliosis is a common condition that develops during adolescence. One in 25 teenage girls and one in 200 boys are affected. It is called scoliosis because the person’s spine, which runs in a fairly straight line down the back in a normal individual, instead curves in an s-shape.


Most cases of scoliosis are idiopathic, meaning there is no known cause for the curvature. Researchers have found, however, that there does seem to be some familial tendency associated with the condition, which suggests there may be a genetic component. They have also found that scoliosis is more common in tall, thin women and tends to develop during rapid periods of growth.

Symptoms of scoliosis you should look for in your children/adolescents are:

uneven or rounded shoulders
curving of the upper body
leaning to one side
complaints of back pain


Scoliosis screenings are usually done in school, but your pediatrician can also do it during your child's yearly visit. A curvature greater than 10 degrees is considered scoliosis and is often referred for evaluation.

Six out of seven people with diagnosed scoliosis never receive treatment. In fact, it is only when the curvature gets severe (around 25 degrees) that the doctor will suggest either bracing or surgery. The purpose of bracing is not to fix the curvature of the spine but to prevent it from getting worse, so the brace is usually worn full-time until growth is complete. The only way to actually correct scoliosis is through spinal surgery.

Ask a Nurse

Today's ask-a-nurse question is from Angie in Michigan:

Is there still mercury in vaccines?

In the 1930s thimerosal, an organic compound containing mercury, started being widely used in vaccines and other drug products as a preservative. Although there was never evidence that the small doses of mercury in the preservative caused any harm to patients, in July of 1999 the American Academy of Pediatrics, along with several other public health organizations, began working with vaccine manufacturers to reduce or eliminate the use of thimerosal in vaccines simply as a precautionary measure.

To date, thimerosal has been removed or reduced to trace amounts in all vaccines recommended for children under the age of six. For older children and adults, there are now many vaccines that are available in thimerosal-free formulas.

If you have a question you would like Nurse Brittany to answer, e-mail it to healthyhappychildren@gmail.com.

Vision Problems in Children

Middle childhood (ages 6 to right before adolescence) is the time when many children begin to develop problems with their vision. The most common visual problems are myopia, hyperopia and astigmatism.


Myopia is also called nearsightedness. This condition occurs because the eyeball is too long, which causes light that enters the eye through the lens to focus in front of the retina. As a result, these children can see close objects clearly, but distant objects appear blurry.


Hyperopia is farsightedness. In this condition, the eyeball is shortened, so light is focused behind the retina, causing close objects to be out of focus. These children can see street signs a mile away but may have difficulty reading or seeing clearly close objects.


Astigmatism is another condition that affects vision. This happens because the front surface of the eye has an irregular shape—it is shaped is more like a football than a basketball. This leads to distorted vision, both near and far.

All three of these conditions can be inherited, so children of parents that wear glasses are at greater risk for developing visual problems.

The good news is that all three of these visual problems can usually be corrected with eyeglasses. If your child complains of having difficulty seeing the board in school or reading the words in a book or if you notice your child squinting or sitting close to the TV, you should make an appointment with an eye doctor to get your child's vision tested.

Choking Prevention

Choking is a common form of injury and death among children. The risk of choking is high among children under the age of five, with children under one being at the greatest risk. Here are several things parents can do to help prevent choking accidents from happening:

* Food is responsible for most choking accidents, so supervise your children during mealtime. Encourage your child to chew completely before swallowing, and never allow your child to run and play while eating.
* Cut food, especially hard or round food, into small, bite-size pieces no more than 1/2 inch in size. Hot dogs are the number-one choking culprit among children.
* Don't give your young child hard, smooth foods like raw vegetables. These foods must be chewed with a grinding motion, and children don't develop that skill until around the age of 4. As a result, young children will often attempt to swallow these foods whole, therefore increasing the risk of choking.
* Keep your home clean. Remember that young children will put anything they find in their mouth. Small objects found around the house are often responsible for choking accidents.
* Beware of items associated with choking accidents: balloons, safety pins, coins, marbles, pen/marker caps, buttons, hard or sticky candy, chewing gum.
* Look at manufacturers' guidelines when selecting toys for your children, but also use your own judgment. If there are small parts associated with a play item, it could be a choking hazard. Select toys with parts larger than 1 3/4 inches, which is about the diameter of a toilet paper roll.

And because accidents can happen to anyone at anytime, I recommend that all parents take an infant/child CPR class, which includes instructions on what to do if a choking accident does occur.