AAP Policy Cites Harm of E-cigarettes

ENDS (electronic nicotine delivery system), including e-cigarettes, are becoming more and more popular. One reason people are starting to use e-cigarettes is because they are touted to help people quit smoking. Note: ENDS have been shown to pose harms for users and non-users and are not approved by the Food and Drug Administration (FDA) as smoking cessation devices. They are considered a less harmful option, in same cases they are considered totally harmless. ENDS are handheld devices that produce an aerosol from a solution typically containing nicotine, flavoring chemicals and propylene glycol and/or glycerin to be inhaled by the user. ENDS include the wide range of products that are known as electronic cigarettes, e-cigs, e-hookah, vaping devices, vape pens and mechanical mods.

The AAP (American Academy of Pediatrics) is publishing a new policy about these systems, addressing pediatricians’ and pediatric health care providers’ questions about these products and the harms to youths. It is available here and will be published in the November issue of Pediatrics.

In 2014, more youths reported using ENDS than any other tobacco product. It has been found that ENDS contain numerous harmful toxicants and carcinogens. Nicotine is one such highly addictive toxicant. Use of nicotine-containing ENDS solution may lead adolescents to start smoking conventional cigarettes and other tobacco products. E-cigs and other devices normalize and make smoking acceptable culturally which can lead to other drug use.

ENDS secondhand vapor has been shown to contain nicotine, toxicants, metal and silicate particles, and carcinogens that can pose harm to non-users. The ENDS solution, or e-liquid, can contain very concentrated nicotine, which can be lethal when ingested even in small quantities. There has been an astronomical increase in calls to poison control centers from ENDS exposures, and one child died after ingesting concentrated nicotine solution.

Below are some FAQ’s about ENDS (source):

Common questions

How many children and adolescents are using electronic nicotine delivery systems (ENDS)?
Surveys of youths show an 890% increase in ENDS use over the past four years. In 2013, as many as 29% of high school students had tried (ever used) e-cigarettes, with use in the past month (current use) of 18%. In contrast, 8.5% of U.S. adults reported having tried an e-cigarette in 2013.

Why am I seeing ENDS commercials on television?
Unlike conventional cigarettes, there are no current regulations on ENDS advertisements on television, print media or point-of-sale (advertisements where ENDS are sold). ENDS are being marketed heavily; in 2013, 80% of U.S. youths ages 12-17 years were exposed to 13 television advertisements for ENDS.

What is in the ENDS solution (also known as e-juice or e-liquid)?
ENDS solutions are advertised to contain concentrated nicotine, flavoring chemicals and propylene glycol and/or glycerin. There are 7,760 flavors of ENDS solutions advertised, many of which are candy and dessert flavored and appealing to children. In addition to what is advertised, however, ENDS solution has been shown to contain numerous toxicants and carcinogens. The ENDS refillable cartridges also allow for addition of other substances to the solution, including marijuana.

What should I say when someone asks if I recommend ENDS?
ENDS have been shown to pose harms for users and non-users and are not approved by the Food and Drug Administration (FDA) as smoking cessation devices. ENDS should not be recommended to youths or their parents/caregivers. Parents and youths who are interested in tobacco dependence treatment should be directed to evidence-based smoking cessation counseling and FDA-approved tobacco dependence treatments (see resources).

After-School Snacks

Do your kids come home from school and immediately reach into the pantry or refrigerator looking for something to eat? It’s not surprising that most kids are hungry after school is over. Many schools have early lunch then an afternoon of classes and sometimes after-school activities before students get a chance to eat again.

When kids are hungry, they are more inclined to eat what’s handy. No wonder the snack food vending machine looks more appealing as the day goes by! While you may not always be able to control what your kids eat in the late afternoon, we can figure out a happy medium. Let’s make sure that your kids can enjoy a snack while still having room for dinner.

Make healthy snacks readily and easily available by packing them in their lunch boxes or backpacks, or by having them visible at home. Leave something healthy up front and center on the kitchen counter or in the refrigerator. For nights when dinner is hours away, a substantial snack like a half-sandwich could be a healthy option for snack time. Some other ideas for easy to grab snacks are fruit (apples, grapes, bananas), low-sugar granola bars, pretzels and hummus.

Most importantly, talk to your kids about which snacks they would like to have at snack time. Come up with a list of healthy options together, or better yet, take your kids along to the grocery store and spend some time teaching your kids about nutrition fact labels. Together, you can choose snacks that are low in sugar, fat, and salt. Involving your kids in the process makes it more likely for them to learn to make healthy food choices in the future.

5 Homework Tips for You and Your Kids

When parents take an active interest in their kids’ homework, they are more successful in school. You can be supportive by demonstrating organization skills or explaining a tricky problem. Sometimes, even encouraging them to take a break.

Here are some tips to help guide you and your kids:

  1. Know the teachers and what they’re looking for. Attend parent-teacher conferences and other school events. Get to know your kids’ teachers and ask about their homework policies.
  2. Help them plan. On nights when your kids have a heavy homework load, encourage them to break up the work into manageable chunks. If necessary, help them create a schedule for the night, and make sure that they take time for breaks every hour.
  3. Keep distractions to a minimum. No TV, loud music, or phone calls.
  4. Motivate them. Ask about their assignments and/or tests. Give encouragement and check their completed homework, but also make yourself available for questions. Praise their work and efforts by posting their aced test or project on the refrigerator.
  5. Set a good example. Kids are more likely to follow their parents’ examples than their advice. Read a book or balance your budget where your kids can see, so they can diligently do the same with their homework.

Finally, if there are continuing problems, talk about it with the teacher and your pediatrician. Some kids may need glasses, and others might need an evaluation for a learning problem or attention disorder.

Tips for Fun in the Sun and Water

This summer, make sure to keep your family safe by following some tips recommended by the American Academy of Pediatrics (AAP).

The best way to protect yourself and your children from harmful ultraviolet radiation (UVR) exposure is to cover up. It is best to limit exposure during hours of intense sun, which are between 10 a.m. to 4 p.m.

Use a sunscreen with an SPF of at least 15 to protect against UVA and UVB rays on both sunny and cloudy days. Reapply sunscreen every two hours or after sweating or any activity in the water, such as swimming.

To prevent heat stress in exercising, children should choose light-colored and lightweight clothing. Dress in one layer of absorbent material to help with the evaporation of sweat. Ensure that your children take a break to drink every 20 minutes while active in the heat.

The best way to prevent drowning in children is to closely supervise your children while near water. Avoid inflatable swimming aids, such as “floaties,” as they can give a false sense of security. Instead, use approved life vests if your children need help in the waters.

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For more tips on sun and water safety, visit healthychildren.org.

Why Does My Teen Have Trouble Sleeping?

Research shows that teens need at least 8.5 hours of sleep a night, which most teens do not reach nightly. During adolescence, the body’s circadian rhythm (like an internal biological clock) is reset, telling teenagers to fall asleep later at night and wake up later in the morning. This change in the circadian rhythm happens because a teen’s brain makes the hormone melatonin later at night than the brains of kids and adults do. However, your teen may also be suffering from insomnia, which is most commonly caused by stress. While everyone has trouble falling asleep from time to time, if your teen regularly cannot fall asleep and stay asleep, they may have chronic insomnia.

Common causes of chronic insomnia could be other medical conditions, mental-health problems, side effects of medicines, or even substance abuse. If you think your teen may be suffering from chronic insomnia, you can get help from a doctor, counselor, or therapist. However, before seeking professional help, you could attempt reducing the stress your teen feels and make sure they have a comfortable sleeping environment, as these are the usual causes of insomnia.

Is Snacking Good?

Good news, snacking is good for you….as long as they are healthy snacks! During adolescence, the body needs more nutrients to grow which is why teenagers feel hungry a lot throughout the day. This is why snacks are a great way to satisfy that hunger and give the body the nutrients it needs to grow. Although it may be tempting for every teen to have a soda and candy bar after school, the temporary sugar boost it gives will slow them down in the long run. In order to keep energy levels going and to avoid weight gain, choose snacks that are full of fiber and protein such as peanut butter, fruits, or yogurts. However, you have to beware of claims that snack manufacturers make on their products. Just because something is “all natural” or “pure” does not mean that it is nutritious, such as fruit juices which can be filled with sugar which makes it extremely high in calories. Similarly, watch out for snacks with “low-fat” claims, because usually the fat is replaced with large amounts of sugar which is just as unhealthy. In order to judge how healthy a product is for you, look at the nutrition information on the food label.

The Difference Between Sadness and Depression

If you have suspicions that your teen may be depressed, this article may help you determine whether it is depression or just sadness. Feeling sad, down, or disheartened are natural human emotions and reactions to the hardships of life, but depression is different. Depression is a strong mood involving sadness, discouragement, despair, or hopelessness that lasts for weeks, months, or even longer. Depression drains the motivation, energy, and concentration of the person it affects, and it can even cause aches and pains in the body. One sign that your child may be depressed is that they are pulling away from friends, family, or activities that they once enjoyed, which will ultimately make them feel more lonely. People with depression may also feel tired and exhausted and it may take them longer to do everyday activities. And depression also has physical symptoms, such as a loss of appetite or weight gain or loss. If you believe your teen may be depressed, schedule a consultation with your pediatrician to discuss your concerns.

What Milestones Should My One-year-old Toddler Be Passing?

Depending on how old your toddler is, she should be passing certain developmental milestones. As you watch your toddler play, you may see her intensely focusing on what she is doing, and that is because everything she does is an opportunity to learn.

At one-year-old, your toddler will be able to gather and recall some information to find answers to problems she may face when playing. One-year-olds are usually attracted to toys with buttons, levers, switches, and knobs, but your toddler may ignore the toy if she is not quite ready to play with it yet. Once your child turns one, she will begin imitating what she sees everyday and will display this in how she plays. For example, she may “drink” from a cup or “knock” on a door, and therefore it is extremely important to monitor your own behavior because she will most likely imitate it. Your child will initially imitate by herself, but as she develops, she will gradually include others in her imitation play.

As she nears two years old, your toddler will begin to shine at hide-and-seek type games, and will remember where hidden items are even after you hide it from her. Your toddler knows she is in control, and she will let you know what role she wants you to play in her games. She will occasionally bring you a toy so you can play with her, but sometimes she will pull her toys away from you so she can play by herself. When she does something she thinks as special, she will pause and wait for your praise. And giving her this affirmation gives her the encouragement and support she needs to continue learning. If your child is not quite at these stages of development, don’t worry, just talk to your doctor to see what steps you can take to get your child on track.

Why Does My Teen Get Acne?

Acne is a problem that many Americans face, approximately 17 million people in the U.S. have acne, so your teen is not the only one. So, why do all these people have acne and where does it come from? Contrary to popular belief, acne is not caused by having dirty skin. Acne is caused by an inflammation of pores due to overactive oil glands and a build-up of oil, dead skin cells, and bacteria. People between the ages of 12 and 24 are more likely to get acne because oil glands become stimulated when hormones become active during puberty. However, having acne can also be genetic, so if people in your family have acne, your teen may be more prone to having acne too.

Even though it is hard to fight genetics, there are ways to help reduce the amount of acne your teen may get!

•Make sure your teen washes their face. Washing your face is extremely important because it helps remove excess oils and dead skin that can clog pores and cause pimples. But be careful, washing the face too much can be harmful by overdrying and irritating existing acne.
•If your teen works out or tends to get pretty sweaty, have them wash their face as soon after sweating as possible, because sweat can clog pores and make acne a lot worse.
•Speaking of clogging pores, it is important to use lotions and makeup that are noncomedogenic or nonacnegenic, which means that the product won’t clog your pores.

AAP Updates Lice Treatment

Lice, it is every parent’s worst nightmare and surprisingly enough most cases are not acquired at school. Head lice is not a disease or sign of poor hygiene and it can be treated. The American Academy of Pediatrics (AAP) recommends that children not be restricted from attending school because of lice. Pediatricians are encouraged to educate communities and schools that children can finish the school day at school, be treated at home and then return to school.

An updated clinical report by the AAP in May 2015 provides safe and effective methods of treating head lice and informs of new medications and products. Pediatricians and parents should consider using over-the-counter medications containing 1 percent permethrin or pyrethrins as a first choice of treatment for active lice infestations unless the community has shown previous resistance. The best way to stop a chronic lice problem is with regular checks by parents and early treatment with a safe, affordable, over-the-counter pediculicide.

Click on this link for more information from the AAP: https://www.aap.org/en-us/about-the-aap/aap-press-room/Pages/AAP-Updates-Treatments-for-Head-Lice.aspx