A tradition common during the holidays is the giving of gifts to loved ones, particularly children. But it’s important that the presents are appropriate for children’s ages, skills and abilities, and that any toys given are well-made and safe.

Those are the key messages of National Safe Toys and Gifts Month, observed each December.

The Consumer Product Safety Commission (CPSC) has developed a strict set of toy standards. The CPSC closely monitors and regulates toys made in or imported into the United States to be sure they meet those standards. The commission issues recalls of toys that don’t meet the standards and are deemed unsafe.

Toys are recalled for various reasons, including unsafe levels of lead, the presence of choking or fire hazards or any other issues that can make them dangerous.

Click for a list of product recalls for 2022 from Safe Kids Worldwide.

Even with these standards, about 200,000 toy-related injuries in children 14 and younger are treated in American emergency rooms each year. The majority of these injuries are not serious; the children are treated and released. Still, a handful die each year of toy-related causes. There’s good news, though. The number of injuries and deaths has been steadily decreasing over the past 10 years.

Many times, injuries occur when parents give their children toys that are meant for older children. Before giving a toy, read the label to make sure it is age appropriate. Even if the child seems advanced compared with others the same age, the youngster still shouldn’t play with toys labeled for older children. Age levels for toys are determined by safety factors, not intelligence or maturity.

The best way to avoid a toy-related injury is to be proactive when selecting toys and other gifts for children. Here are some tips to follow before purchasing:

• Read all instructions and warnings listed on the packaging.
• Avoid buying toys with sharp edges, rigid points or spikes.
• Buy toys that can withstand impact and will not break into pieces that can be a choking hazard or cause other injuries.
• Look for the letters “ASTM” on the toy or packaging. That means the toy has met the safety standards set by the American Society for Testing and Materials.
• Avoid toys that shoot, such as BB guns, or include parts that fly off.

Here are some additional tips to keep in mind during National Safe Toys and Gifts Month:

• Learn how to properly use the toy first, then teach the child how to use it.
• Buy quality toys. They might be more expensive, but high-quality materials are less likely to break into pieces and lead to injury.
• Inspect gifts as the child opens them to be sure they are safe before allowing the youngster to play with the toys.
• If you give sports equipment, also give the appropriate protective gear for the sport, such as helmets for bicycles or riding toys. Make sure the gear is sized to fit the child.
• A gift that includes art supplies should be labeled “nontoxic.”
• Keep small toys, “button” batteries and other potential choking hazards away from children younger than 3.
• Keep deflated balloons away from children under 8. Immediately throw away balloons that won’t inflate or have popped.
• Discard plastic wrapping and other toy packaging before they become dangerous playthings for young children.

According to World Against Toys Causing Harm (WATCH), online shoppers are at a disadvantage because they cannot physically inspect the toys before purchasing them. Unfortunately, there are some disreputable online retailers that may omit warnings and provide incomplete or misleading information regarding toy safety. Further, unsafe and recalled toys can resurface on online websites.

If shopping for toys online, be sure to carefully inspect the toy and its packaging for obvious hazards before giving it to the child.

“Don’t let your child unwrap a potential safety hazard this holiday season,” states Joan Lawrence of The Toy Association, a site for toy safety information. “By shopping smart, you can ensure safe play.”

Patti DiPanfilo

September marks National Muscular Dystrophy Awareness Month.

The term “muscular dystrophy” refers to a group of more than 30 genetic diseases characterized by progressive muscle weakness and the degeneration of the skeletal muscles that control movement. The focus of this blog, Duchenne Muscular Dystrophy ( DMD), is the most common and most severe form.

On Wednesday (September 7), people around the world will raise awareness through World Duchenne Awareness Day (WDAD).

For the past six years, Jett Foundation has hosted an annual event in recognition of this day.  This year, the foundation is hosting a virtual event to bring together patients and families, experts and industry partners to celebrate advances made in Duchenne research, acknowledge challenges still to come, and show they are Stronger Than Duchenne. You can participate to learn more about Duchenne throughout the day!

Duchenne affects approximately one out of every 5,000 live male births. About 20,000 children are diagnosed with Duchenne globally each year.

Parent Project Muscular Dystrophy

While DMD primarily affects males, females can also be affected, which is one of the reasons the World Duchenne Organization has deemed this year’s theme as Women in Duchenne.

Signs and symptoms of DMD may vary from person to person and can range from mild to severe. The average age of diagnosis is 4 years. Early signs may include delayed sitting, standing or walking, and trouble learning to talk.

DMD is a progressive disease, so symptoms generally worsen as a child ages.

Other signs and symptoms include weak legs, especially in the thighs and hips; difficulty running or jumping; waddling gait; walking on the toes or balls of the feet; trouble getting up from a sitting or lying position; enlarged calves; difficulty walking stairs; frequent falls; and weakness in the arms or neck.

As a child gets older, he or she may lose the ability to walk and require a wheelchair. The child may experience difficulty breathing and swallowing, and may develop a sideways curve of the spine (scoliosis). About one in three individuals with DMD also exhibit some cognitive impairment or learning disability.

As DMD progresses, it can weaken the heart and respiratory muscles as well. DMD is associated with a heart condition called cardiomyopathy and impaired lung function. People with DMD often die as a result of heart and breathing complications.

DMD is caused by a defect on the gene responsible for producing dystrophin, a protein that keeps muscles strong and protects them from injury as they contract and relax. Without dystrophin, muscle cells are fragile and easily damaged, resulting in a loss of muscle strength and function. The dystrophin gene is located on the X chromosome, one of two sex chromosomes in humans. The other is the Y chromosome.

Females rarely get DMD because they inherit two X chromosomes from their parents. If one has the gene with the defect, the other X chromosome can typically produce enough dystrophin to compensate. Females with a mutation on one X chromosome are considered carriers. Some female carriers are considered manifesting carriers and display a range of physical symptoms. If their X chromosome has the defective gene, they develop DMD. Females with the mutation are carriers and can pass the defect on to their children. However, in some cases, both X chromosomes have a defective dystrophin gene, where a female would be diagnosed with Duchenne.

A doctor may suspect DMD based on family history, symptoms or a thorough physical exam. The doctor will likely use certain tests to assist in making a diagnosis. One is a creatine kinase (CK) blood test. CK is an enzyme inside muscle cells. When these cells are damaged by DMD, they release high levels of CK into the blood.

Another test is a muscle biopsy, in which the doctor removes a tiny sample of muscle tissue and studies it under a microscope to check the level of dystrophin. Absent levels indicate DMD. Doctors can also use genetic tests to look for the defect on the gene that produces dystrophin.

There’s no cure for DMD, but there are treatments that can ease symptoms and improve quality of life. Treatment typically begins with anti-inflammatory medications called corticosteroids. These medications, which include prednisone and deflazacort (EMFLAZA®), have been found to slow the progression of DMD.

Since 2016, the FDA has approved five new treatments for DMD, including EMFLAZA. The other drugs are “exon-skippers,” which bypass the mutation on the dystrophin gene and allow for the continuation of the process for producing a functioning dystrophin protein. 

Medications that improve heart and respiratory function may also be prescribed, and many of these are being researched in clinical trials.

Physical therapy helps the child maintain motion in the joints and prevent joint deformity and scoliosis. Occupational therapy can help the child manage activities of day-to-day life, such as dressing or using a computer.

In the past, people with DMD often did not live beyond their teens. However, improvements in diagnosis and treatment have increased life expectancy. Today, many people with DMD reach their 30s, and some live into their 40s and 50s. Ongoing research on new treatments is making that possible.

Patti DiPanfilo and Alexa Tinsley

Your baby’s vision at birth is limited but develops progressively during the growth process. While developing, your child’s vision is vulnerable to eye diseases. Untreated, vision disorders can interfere with your child’s ability to learn and play, and can lead to headaches, eyestrain and fatigue.

August is Children’s Eye Health and Safety Month, a time to concentrate on the well-being of our children’s eyes as they head back to school.

There are many conditions and diseases that can affect a child’s vision.

Refractive errors are among them. The most common are:

• Myopia, or nearsightedness, when closer objects are clear but faraway objects are not.
• Hyperopia, or farsightedness, which is difficulty seeing close-up objects but faraway objects are clear.
• Astigmatism, blurry vision due to an irregular shape of the cornea, the clear, outer layer at the front of the eye.

Eyeglasses are typically prescribed to treat these refractive errors and provide clear vision.

Amblyopia and strabismus are other common eye disorders in children.

• Amblyopia, or lazy eye, is characterized by reduced vision from lack of use in one otherwise healthy eye. Treatment typically consists of patching the stronger eye or blurring the vision in the stronger eye with eyedrops. These techniques make the weaker eye work harder and become stronger.

• Strabismus, or crossed eyes, is when the eyes are misaligned. One or both eyes may turn inward, outward, up or down. It can be caused by problems with the eye muscles, the nerves that transmit information to the muscles or the control center in the brain responsible for eye movement. Treatment includes glasses, eye patching, muscle surgery to straighten the eyes and eye exercises.

Other nonrefractive conditions include:

• Glaucoma, a condition associated with a higher-than-normal fluid pressure inside the eyes.
• Cataracts, a clouding of the lens.
• Retinoblastoma, a rare cancer of the retina, the light-sensitive layer of nerve tissue lining the back wall of the eye.

Catching and treating eye disorders early will help a child develop healthy vision and avoid learning difficulties at home and in school. Eye care for children begins at birth. A pediatrician will perform a screening eye exam on a baby after birth. This exam can detect abnormalities in the light reflex from the pupil and eye alignment, as well as in external features of the eye.

The pediatrician will continue to check the eyes and vision during routine well-baby visits. There’s disagreement among eye specialists as to when a child should begin seeing an eye doctor for eye exams and how often a child should be examined. Follow doctor’s recommendations, which are based on your child’s specific circumstances.

Here are some things a parent can do to help protect a child’s eyes and developing vision:

• Encourage healthy eating. Healthy vision is influenced by the food we eat. Try to incorporate many fruits and vegetables into the child’s diet. Fruits and vegetables contain many of the vitamins and minerals necessary for maintaining healthy eyes and vision.
• Spend time outdoors. Playing outside for at least an hour a day, or even just taking a walk outdoors, will help eye muscles relax. It can also help lower the risk of certain eye conditions, including myopia.
• Wear sunglasses outdoors. Wearing sunglasses protects eyes from the sun’s harmful ultraviolet rays. Excessive exposure to UV radiation over time has been linked to serious eye diseases later in life.
• Wear protective eyewear while playing sports. Avoid serious eye injuries by wearing protective eyewear with shatterproof plastic. Different sports have different eyewear recommendations.
• Limit screen time. Prolonged time staring at computer and television screens may cause blurry vision, focusing problems and possibly even increase your the risk for developing myopia. Limit the amount of time on digital devices each day and ensure the child takes frequent breaks to the eyes a rest.

Set a good example for your child. Incorporate these tips into your own life as well.

If you suspect a problem with your child’s eyes or vision, contact a qualified eye doctor who can diagnose and treat the problem.

Patti DiPanfilo

Each year, more than 10,000 people, about 1,000 of them children, lose their lives on America’s roadways due to drunk driving. That’s about 1/3 of all traffic-related deaths. According to the US Centers for Disease Control and Prevention, drinking and driving kills nearly 30 people every day in the US or about one person every 50 minutes.

Car accidents involving intoxicated drivers happen even more often during the holidays, when social binge-drinking is more accepted and prevalent. Increased drinking at holiday parties and gatherings leads to an uptick in impaired drivers on the road and a higher risk for alcohol-related accidents. So, even if you drive sober, there’s a greater chance you’ll be sharing the road with other drivers who are not.

During the winter holiday season, from Thanksgiving to New Year’s Day, 40 percent of highway deaths are alcohol related. During the same period, there’s an estimated 25,000 injuries from alcohol-related accidents. Curiously, a quarter of the profits for the $49 billion alcohol industry are made during this same time span.

While the risk for encountering a drunk driver is higher throughout the holiday season, New Year’s Day is the most dangerous holiday to be on the road, with 58 percent of car accidents being alcohol related. During the month of December, 28 percent of fatal car accidents involve intoxicated drivers. An average of 300 people are killed in drunk-driving accidents during the week between Christmas and New Year’s Day.

Alcohol impairs by affecting key skills needed for driving. It slows your reflexes, which can decrease your ability to quickly react to changing situations. It can alter your visual perception and even cause blurry vision. It can impact your ability to judge your car’s position on the road. Alcohol can affect your concentration, coordination and decision-making capability as well.

Blood alcohol concentration (BAC), also called blood alcohol content or blood alcohol limit, is the percentage of alcohol in your blood after you’ve been drinking. In 49 of 50 states and Washington DC, you are considered legally drunk if you have a BAC of 0.08 percent or above. But in Utah, the BAC limit is 0.05 percent. Any detectable blood alcohol concentration is a violation in people under 21.

Many factors contribute to how fast you reach a BAC of 0.08 percent. Your weight, body fat percentage, hydration, digestion and the way alcohol affects you, as well as the length of time you’ve been drinking, all affect how quickly you become impaired.

But generally speaking, a 180-pound man can reach a BAC of 0.08 percent after four drinks and a 120-pound woman can reach it after just two drinks. A standard “drink” is defined as one shot of liquor, a five-ounce glass of wine or one 12-ounce beer.

Even if you don’t kill anyone, driving while intoxicated will impact your life in many ways and cost you big time. If you’re arrested for a DUI or DWI, you could face the suspension of your driver’s license, jail time – up to a year for a first offense in some states – and thousands of dollars in fines and court costs. When all is said and done, alcohol-impaired drivers cost the US about $132 billion each year.

The fact of the matter is 100 percent of alcohol-related fatalities and injuries are preventable. The bottom line: there are no excuses. If you drink, don’t drive!

Try these common-sense tips for a safe holiday season:

• If you plan to drink at a holiday gathering, line up a sober driver.
• If you don’t have a designated driver, call a cab, ride-sharing service or friend to take you home at the end of the event.
• Consider spending the night at a nearby hotel or motel that you can walk to if you have more than a few drinks.
• Eat food and drink water while you’re consuming alcoholic beverages. Don’t drink on an empty stomach.
• Even if you only feel a little buzzed, you’re impaired. Get a ride with a sober driver or call a cab.

If you’re hosting a holiday gathering, follow these recommendations:

• Serve a variety of food and non-alcoholic beverages, as well as coffee.
• Avoid providing salty snacks. They make your guests drink more.
• Don’t make alcohol the main attraction at the party.
• Stop serving alcohol one to two hours before the event ends.
• Keep an eye on your guests. If someone is visibly intoxicated, don’t serve them any more alcohol.
• Don’t let drinking guests drive. Take their keys and be sure a sober driver, cab or ride-sharing service takes them home.

December is a month of multiple religious and cultural celebrations. A tradition common to these celebrations is the giving of gifts to our loved ones, particularly our children. We all want to make our kids happy this holiday season. But before you give them that toy they’ve been asking for, make sure it’s safe. That’s the message of National Safe Toys and Gifts Month.

The US Consumer Products Safety Commission (CPSC) has established strict toy safety guidelines that include rigorous testing by independent, third-party laboratories, enforcing rigid lead and phthalate limits for toys, and imposing stringent standards to stop dangerous toys from reaching the marketplace and getting into children’s hands.

In spite of these efforts, thousands of children are injured every year as a result of playing with unsafe toys. A report released by the CPSC revealed that in 2020, there were nine deaths and nearly 150,000 emergency room visits for toy-related injuries in children ages 14 and younger.

Actually, those figures represent an ongoing decline in toy-related incidents compared to the past two years. In 2019, there were 14 toy-related deaths and 224,200 injuries. In 2018, there were 17 deaths and 226,100 injuries treated in US emergency rooms. Fortunately, more than 90 percent of the injured children were treated and released.

The most common toy-related injuries treated in emergency rooms included lacerations, contusions and abrasions, strains and sprains, fractures, internal injuries, ingestion of toys or toy parts, concussions, dislocations and puncture injuries. Nonmotorized scooters were associated with several of the reported deaths each year.

The best way to avoid a toy-related injury is to be proactive when selecting toys and gifts for your children. Before you buy, consult a watchdog website, such as toysafety.org, the website of World Against Toys Causing Harm (W.A.T.C.H.), for a list of recent toy recalls. But not all unsafe toys are recalled, so follow these tips before you purchase a toy:

• Read all instructions and warnings listed on the packaging.
• Ask yourself if the toy is appropriate for your child’s age and developmental abilities.
• Avoid buying toys with sharp edges, rigid points or spikes.
• Buy toys that can withstand impact and will not break into pieces that can be a choking hazard or cause other injuries,
• Look for the letters “ASTM” on the toy or packaging. That means the toy has met the safety standards set by the American Society for Testing and Materials (ASTM).
• Avoid toys that shoot, such as BB guns, or include parts that fly off.

Here are some additional tips to keep in mind this National Safe Toys and Gifts Month:

• Be sure the gifts you give are age appropriate. Playing with toys above a child’s age and level of maturity can lead to misuse and potential injury. Toy manufacturers list the age the toy is appropriate for on the packaging.
• Learn how to properly use the toy first, then teach your children how to use it.
• Buy quality toys. They might be more expensive, but high-quality materials are less likely to break into pieces and lead to injury.
• Inspect your children’s gifts as they open them to be sure they are safe before allowing them to play with the toys.
• If you give your children sports equipment, give them the appropriate protective gear for the sport as well, such as helmets for riding toys. Make sure the gear is sized to fit your child.
• A gift that includes art supplies should be labeled “non-toxic.”
• Keep small toys, “button” batteries and other potential choking hazards away from children under 3 years old.
• Keep deflated balloons away from children under 8. Immediately throw away balloons that won’t inflate or have popped.
• Discard plastic wrapping and other toy packaging right away before they become dangerous playthings for young children.

According to WATCH., online shoppers are at a disadvantage because they cannot physically inspect the toys before purchasing them. Unfortunately, there are some disreputable online retailers that may omit warnings and cautions and provide incomplete or misleading information regarding a toy’s safety. Further, unsafe and recalled toys can resurface on online websites.

If you shop for toys online, be sure to carefully inspect the toy and its packaging for obvious hazards before giving it to your child. “Don’t let your child unwrap a potential safety hazard this holiday season,” states Joan Lawrence of The Toy Association, a site for toy safety information. “By shopping smart, you can ensure safe play.”

October is Sudden Infant Death Syndrome (SIDS) Awareness Month. Want to learn more about SIDS? Read on.

First of all, SIDS is the name given to the sudden, unexpected and unexplained death of a seemingly healthy baby less than 1 year old. SIDS is sometimes called crib death because it usually occurs when babies are asleep in their cribs. SIDS is a silent killer.

About 2,300 babies die of SIDS each year in the US. It is the most common cause of death in babies between the ages of 2 weeks to 1 year. It most often occurs in babies between 2 months and 4 months old. It occurs more often in African-American and Native American babies than in Caucasian babies and is slightly more common in boys than in girls.

SIDS doesn’t have any recognizable symptoms. It happens suddenly and unexpectantly to babies that appear healthy. A diagnosis of SIDS is one of exclusion. The diagnosis is generally made if no clear cause of death can be determined after a thorough investigation that includes an autopsy.

There are certain factors that increase your baby’s risk of dying from SIDS. The most important risk factor is laying your baby down to sleep on his or her stomach or side rather than their back. Other factors that increase your baby’s risk include:

• Having a family history of SIDS
• Being overheated with blankets or a high room temperature
• Co-sleeping (sharing a bed with a parent or caretaker)
• Having a mattress that’s too soft and having soft objects in the crib, such as stuffed toys, bumper pads, quilts and pillows
• Being born prematurely or having a low birth weight
• Having a mother younger than 20 years old
• Having a mother who received inadequate or no prenatal care
• Having a mother who smoked, drank alcohol or took drugs during pregnancy
• Being exposed to secondhand smoke

The cause of SIDS is unknown but researchers are studying certain theories. Many researchers believe that SIDS is related to your baby’s inability to arouse from sleep when not getting sufficient oxygen from breathing. As a result, carbon dioxide builds up in the baby’s bloodstream. A high level of carbon dioxide can lead to death. Some researchers believe this occurs because the center in your baby’s brain that controls arousal is not fully developed.

The proposed “Triple-Risk Model” suggests that three factors combine to cause SIDS. This theory holds that SIDS occurs when an underlying brain abnormality and a triggering event, such as a poor sleep position (sleeping on the stomach), occur during a vulnerable stage in your baby’s development, essentially the first six months of his or her life.

It may be frightening to know that there’re no symptoms to be alert for and no clear cause of SIDS, so there’s no way to prevent it from happening to your baby. But there are some tips for reducing your baby’s risk for SIDS. These include:

• Lay your baby on his or her back when putting him or her down for a nap and at night.
• Avoid overheating your baby. Don’t tightly swaddle your baby in a blanket and keep the room temperature at a level that’s comfortable for a lightly clothed adult.
• Don’t co-sleep with your baby or let your baby sleep with other children or adults.
• Choose a firm, safety-approved mattress for your baby’s crib and place a fitted sheet over it.
• Keep toys, bumper pads, fluffy blankets, quilts and pillows out of your baby’s crib when he or she is sleeping.
• Don’t smoke, drink or take drugs while you are pregnant and if you are breastfeeding.
• Get proper prenatal care during pregnancy.
• Don’t let anyone smoke around your baby.
• Set up your baby’s sleep area close to you but separate from your bedroom or those of your baby’s siblings.

In addition, make sure everyone who cares for your baby – including grandparents and other relatives, babysitters and friends – knows these recommendations. And consider sharing these tips with other parents and caregivers of young babies during Sudden Infant Death Syndrome Awareness Month and all year long.

Newborns can see colors and objects up to 12 inches away, and their vision gets progressively sharper as they get older. By the time they reach school age, children should possess clear, comfortable vision at all distances. But problems can develop as your child’s vision matures. Most childhood vision problems emerge between 18 months and 4 years old.

The most common vision problems affecting children are refractive errors, amblyopia and strabismus.

Refractive errors occur when the eye can’t focus light entering the eye onto the retina, the thin layer of nerve tissue lining the back of the eye. The retina organizes the light into nerve signals, which it sends to the brain to create visual images. When light isn’t focused on the retina properly, the images appear blurry. There are three main refractive errors: myopia, hyperopia and astigmatism.

With myopia, the eyeball is longer than normal or the cornea, the clear front part of the eye, is curved too steeply. This causes the light to focus in front of the retina instead of directly on it. As a result, your child sees near objects more clearly than objects far away. Myopia is also called nearsightedness.

With hyperopia, or farsightedness, the situation is reversed. Your child can see objects in the distance clearly but near object6s are blurry. In cases of hyperopia, the eyeball is shorter than normal or the cornea isn’t curved sufficiently, and the point of focus falls behind the retina.

Astigmatism is an imperfection in the shape of the cornea or lens of the eye. Instead of being round like a ball, the cornea with astigmatism is shaped more like a football, which distorts the light focusing on the retina. With astigmatism, vision is blurry at all distances.

Refractive errors are typically corrected with glasses or contact lenses. Your child’s eye doctor can prescribe the lenses that will give your child the clearest vision.

Sometimes, there’s a breakdown in the way the brain and eyes work together, and the brain doesn’t accept the visual images coming from one eye. The brain relies on the stronger eye, and the vision in the weaker eye gets worse. This condition is called amblyopia, or lazy eye, and it is the most common cause of vision loss in children.

Amblyopia can be caused by crossed eyes (strabismus) or a difference in the refractive error between the two eyes. If that’s the case, your child’s eye doctor will likely correct those conditions first. Treatments for amblyopia include patching the stronger eye, which forces the weaker eye to work harder, and putting special eye drops in the stronger eye, which temporarily blurs the vision in that eye, forcing the weaker eye to work harder.

Strabismus, or crossed eyes, is a condition in which the eyes are misaligned; they don’t point in the same direction. One eye may point inward, outward, upward or downward. To prevent double vision, the brain may ignore the images from the misaligned eye, and that eye may not develop properly as a result. Strabismus occurs in about four out of 100 children or 4 percent.

Strabismus is caused by problems with the eye muscles, the nerves that transmit signals to the muscles or the control center in the brain that directs eye movement. It has been associated with uncorrected refractive errors, poor vision in one eye and certain medical conditions, such as cerebral palsy and hydrocephalus. Strabismus is often inherited. About 30 percent of children with strabismus have a family member with a similar problem.

Strabismus in children can result in amblyopia and can lead to permanent vision loss if not treated. Potential treatments include prescription glasses, special prism glasses, eye patching, BOTOX® injections and surgery to strengthen the weakened eye muscles.

Most vision problems, such as refractive errors, cannot be prevented. But there are steps you can take to safeguard the health of your child’s vision. Start by scheduling routine eye exams. This will enable the eye doctor to follow your child’s visual development at every stage and be there if there are any changes along the way.

Encourage healthy eating habits with a diet rich in fruits and vegetables. Fruits and vegetables contain many vitamins and nutrients that are necessary for maintaining healthy bodies, including healthy eyes.

Spend at least an hour outside every day. Playing outdoors, or even just taking a walk, helps the muscles in your child’s eyes to relax. This goes hand-in-hand with limiting screen time. Prolonger time staring at screens can cause blurry vision, focusing problems and may even increase your child’s risk for developing myopia.

Have your child wear sunglasses outdoors to protect their eyes from the harmful effects of the sun’s UV rays. They should also wear protective eyewear during sports and activities to prevent serious eye injuries. Eye injuries account for more than 1.5 million visits to the emergency room in the United States.

These are easy ways to protect your child’s vision. But if you notice that your child constantly rubs their eyes, has excessively watery eyes, is extremely sensitive to light, has trouble focusing on moving objects or has chronically red eyes, see an eye doctor. These are common signs of vision problems that may need correction.

According to the American Academy of Otolayrngology’s Division of Head and Neck Surgery, ear, nose, and throat disorders are one of the main reasons children see a physician, and ear infections rank as the number one reason. February is Kids ENT Health Month, so this blog reviews a few of the more common ENT disorders that affect children.

Just about every child will experience an ear infection at some point. My child was no exception; he had his share. Acute otitis media is a painful ear infection that occurs when the middle ear, which lies between the eardrum and the inner ear, where the cochlea and vestibular system are located, becomes inflamed and infected.

With acute otitis media, your child’s Eustachian tube becomes swollen or blocked, and fluid gets trapped in the middle ear. That fluid can become infected and cause symptoms. Symptoms of otitis media include unusual irritability, difficulty sleeping or staying asleep, tugging at one or both ears, fever, fluid draining from the ear, loss of balance, difficulty hearing, and ear pain.

Treatment begins with home care, which includes applying warm, moist compresses over the ear and using over-the-counter eardrops and pain relievers to ease pain. If over-the-counter products don’t do the trick, your child’s doctor may prescribe stronger eardrops and pain relievers. If your child’s symptoms persist after that, the doctor may recommend antibiotics to treat the infection.

Enlarged tonsils and adenoids are also common in children. Tonsils and adenoids are collections of lymphoid tissue that help the body fight infection, but they can become enlarged if they become infected or irritated.

Enlarged tonsils and adenoids are actually normal in some children. But in other children, the enlargement is due to a bacterial or viral infection, allergies, exposure to irritants, or possibly even to gastroesophageal reflux disease.

Usually, there are no obvious symptoms when the tonsils and adenoids are enlarged. But the condition can cause difficulty breathing or swallowing, and can cause your child to sound like they have a stuffy nose when they talk. Enlarged tonsils and adenoids can also cause nosebleeds, bad breath, and cough.

In some cases, enlarged tonsils and adenoids can cause recurring ear or sinus infections, or sleep apnea, a sleep disorder in which the upper airway becomes blocked, causing the child’s breathing to stop and star during the night.

Treatment for enlarged tonsils and adenoids begins by treating the underlying cause, such as the allergies or infection. If this treatment fails to achieve results, your child’s doctor may suggest removing the tonsils and adenoids. Surgery may be recommended if your child has sleep apnea or extreme difficulty when talking and breathing, or if they experience multiple throat infections.

Another common ENT issue in children is sinusitis. The sinuses are air-filled cavities in the skull behind the face that are lined with mucus membranes. Sinusitis is an infection of the sinuses near the nose.

Sinus infections often develop after a cold or upper respiratory infection. These infections cause inflammation of the nasal passages that can block the opening of the sinuses into the nose. Allergies can also cause sinusitis due to the swelling of the nasal tissue and increased mucus production.

Treatment for sinusitis may include a course of antibiotics, acetaminophen for pain, a decongestant and/or mucus thinner, and a nasal spray to reduce inflammation. Your child’s doctor may recommend that you run a cool humidifier in your child’s room to keep the air moist.
In extreme cases, surgery on the sinuses may be needed.

Allergic rhinitis, also known as hay fever, is another ENT problem that is common in children. Allergic rhinitis, which is a reaction that happens in the eyes, nose and throat, can be seasonal or year-round. The most common causes of allergic rhinitis in children include pollen from trees, grass or weeds; dust mites; mold; cockroach waste; and animal dander. These substances are called allergens because they trigger an allergic reaction.

Symptoms of allergic rhinitis include sneezing, nasal congestion, nasal discharge, fatigue, and skin rashes. Treatment generally involves giving your child antihistamines, decongestants, and nasal sprays. If your child also has asthma, their doctor will treat those symptoms as well.

Consider allergy shots if your child has severe allergic rhinitis. The shots are a type of immunotherapy that helps your child’s body get used to the allergens so that they do not react when exposed to them.

Children have 20 baby, or primary, teeth – 10 on the top and 10 on the bottom. The primary teeth begin to come in at around 6 months of age, and by the time your child is 2 to 3 years old, all of the primary teeth should have come in. On the flip side, most adults have 32 permanent teeth, including four wisdom teeth, which are often removed for lack of space in the mouth.

Primary teeth are technically called deciduous teeth because they eventually fall out just like leaves fall from deciduous trees in autumn. Generally, the primary incisors, the middle front teeth, begin to loosen and fall out by around age 6. The molars in the back of the mouth are typically lost between ages 10 and 12, and are replaced with permanent teeth by about age 13.

Primary teeth may be in the mouth for just a short time, but they play a vital role when they are there. They reserve space for the permanent teeth, give the face a natural appearance, assist in the development of clear speech, and help the children get good nutrition by enabling them to chew foods effectively.

The primary teeth act as place-holders for the permanent teeth. But if they become infected or decay and fall out too soon, the permanent teeth can come in early and be crooked due to limited space, which often makes braces necessary. Orthodontists report that 30 percent of their cases are the result of the premature loss of primary teeth.

Further, healthy primary teeth give the permanent teeth a healthy start. Decay or infection in the primary teeth can cause damage to the permanent teeth developing beneath them. That means how we care for our children’s primary teeth affects the health of their permanent teeth, as well as their overall oral health.

Unfortunately, 40 percent of children in the United States have tooth decay by the time they reach kindergarten. Tooth decay is the result of poor oral health, which can lead to gum disease and cavities. Cavities are caused by the breakdown of the tooth by acids produced by bacteria. Cavities are one of the most common chronic diseases of childhood in the US.

But cavities in children can be prevented by teaching them good dental health habits right from the start then modeling those behaviors to show our children the importance of a good daily routine. It’s essential to establish a proper oral hygiene routine early in life to help ensure the development of strong and healthy teeth later in life.

The foundation for healthy permanent teeth is formed during the first years of life, and caring for your baby’s teeth begins before the teeth even show up.

The US Centers for Disease Control and Prevention recommend that you wipe your baby’s gums twice a day with a soft, clean cloth in the morning after the first feeding and right before bed. Doing this eliminates any bacteria and sugars that can cause cavities in the teeth that are sitting just under the surface.

Once your child’s teeth begin to come in, start brushing twice a day with a soft, small-bristled toothbrush and plain water. When there are two or more teeth next to one another, begin to gently floss between the teeth. The American Dental Association recommends that children see a dentist by their first birthday. Consider a dentist who specializes in children. Pediatric dentists are trained to handle the unique issues associated with children’s dental health.

At around age 2, as your child gets more teeth, you can begin using a small amount of fluoride toothpaste, about the size of a grain of rice. Children ages 3 and older should use only a pea-sized amount of fluoride toothpaste.

These limits are necessary to keep your child from swallowing the fluoride toothpaste when they brush. Many cities around the US fluoridate their water, and ingesting too much fluoride can lead to dental fluorosis or skeletal fluorosis, which can damage bones and joints.

Continue to brush your child’s teeth until they insist on brushing themselves, but supervise closely to ensure that they don’t swallow a lot of toothpaste. At around 6 years old, children are generally able to brush their teeth using the appropriate technique. Still, supervise your child’s daily toothbrushing task until the eruption of the second molar at around the age of 13.

For long-term dental health, your child should follow the ADA’s recommendations for home oral care: brush twice a day with fluoride toothpaste, clean between the teeth daily (floss), eat a healthy diet that limits sugary drinks and snacks, and see a dentist regularly for prevention and treatment of oral disease.

Improve your child’s chances for keeping their teeth for life. Start them off strong with good oral care.

According to the Centers for Disease Control and Prevention, birth defects affect one in every 33 babies born in the US, which is about 3 percent of all babies. The CDC also reports that birth defects are the leading cause of infant death in the US, accounting for 20 percent of all infant deaths. This blog takes a closer look at birth defects and offers a few strategies to prevent them.

A birth defect is a problem that forms when a baby is developing in the womb, so it is present at birth. Every 4½ minutes, a baby is born with a birth defect in the US. A birth defect can affect how the baby’s body looks, works, or both. Some birth defects are relatively harmless and require little or no treatment. Others require immediate surgery and a lifetime of care.

The March of Dimes notes that birth defects can occur at any time during a woman’s pregnancy, but most happen during the first three months, or the first trimester. During that time, the baby’s organs are developing. But birth defects can occur later in pregnancy as well as the organs continue to grow and develop.

In many cases, birth defects are the result of genetics, as mutated genes get passed from the parents to the baby. The mother’s behavior during pregnancy, such as smoking, using illicit drugs, or drinking alcohol; exposure to certain medications or toxic chemicals; having certain types of infections during pregnancy, including sexually transmitted infections; or a combination of these factors, can also lead to birth defects. The cause of some birth defects is unknown.

Being 34 years old or older may put you at an increased risk for having a baby with a birth defect, as can having certain health conditions such as diabetes, high blood pressure and seizure disorders.

Birth defects can be structural or developmental. Structural defects include conditions involving body parts that are missing or malformed. Common structural birth defects include:

• Heart defects – The walls, valves, or blood vessels of the heart form abnormally. This affects how well the heart can pump blood through the body.
• Cleft lip and cleft palate – If the tissues of the roof of the mouth or lip don’t merge properly during development, an opening or split can result.
• Spina bifida – This is a neural tube defect, which involves the brain and spine. With spina bifida, the spine does not form and close properly, affecting the spinal cord and nerves.
• Clubfoot – A shortened Achilles tendon causes the foot to point inward and under instead of forward.
• Sickle cell disease – The normally round red blood cells are shaped like sickles or crescent moons. These sticky cells get stuck in the small blood vessels, which blocks blood flow and oxygen delivery to organs and tissues.

Down syndrome is a common developmental birth defect. Down syndrome, in which an extra chromosome 21 is present, causes delays in physical and mental development. Another developmental birth defect is cerebral palsy. This condition is most often caused by abnormal brain development before birth. It affects movement, balance, and posture.

Some birth defects can be detected during pregnancy using prenatal ultrasound. Your doctor may employ a more sensitive test such as amniocentesis or chorionic villus sampling (CVS) to look for birth defects before your baby is born. Most birth defects can be positively diagnosed through a physical exam and newborn screening test after birth, but some defects are not detectable until the child is older.

If something is detected on your baby’s newborn screening test, more in-depth testing, called diagnostic testing, will be needed to determine if there’s a problem. If the diagnostic testing is positive for a defect, your doctor will guide you through the next steps. When a birth defect, such a heart defect, is found early, it can often be treated and more serious problems can be prevented.

Not all birth defects can be prevented, but there are steps you can take before and during pregnancy to reduce the risk. The CDC suggests that women Commit to Healthy Choices to Help Prevent Birth Defects. Here are some of the CDC’s tips:

• Manage health conditions, such as diabetes and high blood pressure, and adopt healthy behaviors, including quitting smoking and stopping alcohol, before becoming pregnant. Continue these behaviors during pregnancy.
• Strive to reach and maintain a healthy weight. Women who are obese before pregnancy are at a higher risk for complications during pregnancy. Obesity also increases the risk of several serious birth defects.
• Take 400 micrograms of folic acid every day one month before and during pregnancy. Folic acid can help prevent major birth defects of the developing brain and spine.
• See your health care provider regularly when planning a pregnancy and begin prenatal care as soon as you suspect that you are pregnant. Be sure to tell your provider about any medications that you are taking.
• See your provider regularly throughout your pregnancy. Talk to your provider about any vaccinations you may need. The flu vaccine and the Tdap (tetanus, diphtheria and pertussis) vaccine are specifically recommended during pregnancy to protect women against infections that can cause birth defects.