Conquering Those Growing Pains
FEVER
Two different painkillers is too much of a cure
When a child has a fever, a parent's top priority is bringing it down-and fast. Maybe that's why so many double up, giving their feverish tots ibuprofen and acetaminophen at the same time. "It's a very common practice," says Mary Hegenbarth, a pediatric emergency specialist at Children's Mercy Hospital in Kansas City, Mo., and a member of the American Academy of Pediatrics committee on drugs.
But not everyone agrees it's such a great idea. It is "a very unsettled issue" in pediatrics these days, says Hegenbarth. Experts say the dual dosing is a result of "fever phobia," a tendency by scared parents to fear fever's extremes, like febrile seizures or brain damage. Both are very unlikely, says Hegenbarth. And febrile seizures, while frightening, are generally harmless. Running a temperature is part of the body's normal immune response to many illnesses.
"The real issue is whether being this aggressive is warranted," says Ian Paul, assistant professor of pediatrics at Penn State College of Medicine and principal investigator in a clinical trial exploring the safety and effectiveness of dual dosing. Until there is conclusive research, Paul advises: "Treat the child, not the number on the thermometer." If a child is lethargic, especially uncomfortable, or dehydrated, a parent should talk with the doctor. Hegenbarth tells parents that using one drug, like Children's Tylenol, in its recommended dose is plenty.
CAR SAFETY
A big boost for booster seats
Quiz: Is it illegal for a 7-year-old child to ride in a car without a car seat? That depends. If you live in Pennsylvania, yes. Not so in neighboring Ohio. All states require children to be in a car seat until the age of 4. About three fourths of them mandate a booster seat past that age, but the standards vary and are becoming more stringent. For example, earlier this year, Kansas upped its booster seat age: Now kids who are under 80 pounds must be strapped in until they turn 8 years of age; before it was 4 years of age.
No matter the state, pediatricians recommend that all children under 4'9" be strapped in a safety seat. Why 4'9"? A seat belt doesn't fit and thus protect until that height, says Marilyn Bull, a neurodevelopmental pediatrician at Indiana University who has published studies on vehicle safety. Make sure the car seat fits the child correctly by checking the weight limit specified by the manufacturer and getting a seat that allows the child's knees to bend over the edge, says Bull. Installing the car seat correctly-including always putting it in the back seat-is just as important as using it. SeatCheck (www.seatcheck.org) can help parents locate a nearby inspection site.
Helmets are worth a bad hair day
It can't be stressed enough. If your child engages in an activity in which he or she is moving quickly, elevated above the ground, or apt to fall on a hard surface, make sure a helmet is worn. It's "the one single thing that will decrease the chances of serious injury or death," says Gary Smith, director of the Center for Injury Research and Policy at Columbus Children's Hospital in Ohio. In 2005, for example, nearly 37,000 children ages 14 and younger visited emergency rooms for bicycle-related head injuries. Studies indicate that helmet use can reduce the risk of head injury by at least 74 percent, preventing concussions as well as more serious brain injuries or even death.
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