Want to know the key to bravery? What we can learn from injured children.

via Want to know the key to bravery? What we can learn from injured children.

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Want to know the key to bravery? What we can learn from injured children.

You jumped from the bunk bed… fearless. I watch you notably in pain. Your right arm is twisted in ways it anatomically shouldn’t be. After you receive some anti-inflammatory pain medication you start dancing around the room and jumping up and down with energy abound, and yes both bones in your forearm are broken. You do not know me or the bone doctor but you trust we will “fix your boo-boo” for you. You trust your parents to take care of you, and trust you will use your arm again. Right now all you are concerned about is what is a necessity- food and drink. You are hungry and tired, but must be patient to eat and drink until after we fix your broken arm. You are fourth in line for the bone doctor, but you are oblivious, content, and continue to jump. When you get tired you fight the urge to sleep as hard as you can. Mom and Dad are teary-eyed, but you have your eyes fixated on The Little Mermaid. You have now succumbed to the sleep monster. We give you additional comfort with pain and sedative medication, so after your arm is put back together again you will not remember anything that happened.

Wow, you are so brave!

Children illustrate bravery by illustrating fearlessness

  • 2nd Timothy 1:7 God has not given us the spirit of fear, but of power, love and a sound mind
  • Psalm 118:6 The LORD is on my side; I will not fear. What can man do to me?
    Who is man that I should fear him

 

Children illustrate bravery by trusting that everything will be alright

  • Proverbs 3:5-6 Trust in the LORD with all your heart and lean not on your own understanding; in all your ways submit to him, and he will make your paths straight.
  • Psalm 37:3 Trust in the LORD and do good; dwell in the land and enjoy safe pasture

 

Children illustrate bravery by only seeking what is necessary at the time of injury (food, shelter, and loving support)

  • Matthew 11:28-30 Come to me all you who are weary and heavy burdened and I will give you rest.
  • Matthew 6:25-27  Therefore I tell you, do not worry about your life, what you will eat or drink; or about your body, what you will wear. Is not life more than food, and the body more than clothes? 26 Look at the birds of the air; they do not sow or reap or store away in barns, and yet your heavenly Father feeds them. Are you not much more valuable than they? 27 Can any one of you by worrying add a single hour to your life?

Children illustrate bravery by showing courage

  • Deuteronomy 3:16 Be strong and courageous. Do not be afraid or terrified because of them, for the Lord your God goes with you; he will never leave you nor forsake you.”

 

Mark 10:14 – Jesus said “Let the little children come to me, and do not hinder them, for the kingdom of God belongs to such as these…”

pED advocate at your service

For more information related to children’s health tips,  please check HealthyChildren.org, Sylvia Owusu-Ansah MD

Psalm 127:3 Behold children are gift from God

Beaten and Defenseless: Is Foster Care the Better Option?

 

I stood admiring your perseverance as you continued to suck on your pacifier with bruises all over your face and a collar around your neck to support your spine as a precaution to your injuries. You have only been on earth for 2 months but have endured so much.  There is bleeding in the back of your eye (retinal hemorrhage) from the shear force upon your head. The culprit the boyfriend of the babysitter. The odds seem against you with a drug addict mother and a sex offender father.  You are not alone, the following day I was witness to a toddler who was covered in welts and bruises after being dropped of at a babysitter’s, and a 2 month old with an erratic mother and unexplained bleeding from the mouth admitted for a child abuse work up. Is foster care the better option?  Initially it seems that way…

Over 7.2 million children in America  are abused, and during FFY 2015 and that number continues to be on the rise.  The major abuse type is neglect, followed by physical, then sexual and psychological.  FFY 2015 saw nearly 1,700 children die from child maltreatment and over three- quarters were under the age of 3 years of age. (https://americanspcc.org/child-abuse-statistics/), (https://www.acf.hhs.gov/cb/research-data-technology/statistics-research/child-maltreatment). Having a toddler myself those numbers send chills down my spine.  The next step for a good portion of those who are reported is usually foster care.

“Each day 438,000 children in foster care in the United States. This equates to about 6% of all United States children every placed in foster care from birth to 18. In 2016, over 687,000 children spent time in U.S. foster care. On average, children remain in state care for nearly two years and six percent of children in foster care have languished there for five or more years.” (www.childrensrights.org/newsroom/fact-sheets/foster-care/).

Foster care placement can be one of the most tragic events a child can experience. Disproportionately Native American and African American children are at higher risk for placement. Children in foster care are more likely to have depression, bipolar disorder, attention deficit and hyperactivity disorder (ADHD) and suicidal ideation compared to other children. They often live lives of chaos and instability  and have increased rates mortality and disease processes such as asthma. (Widerman et al, Cumulative Risks of Foster Care Placement by Age 18 for U.S. Children, 2000–2011,PLOS Online, Mar 2014; 9(3): e92785)

Foster Care Advantages:

  • Be a temporary residence for children to provide care
  • Parents may not be well enough to take care of their children and are seeking assistance to get better
  • Provide financial support for a child’s needs
  • May provide a means of adoption into a loving and providing home

Foster Care Disadvantages:

  • Most children, no matter how bad the situation would like to stay with their birth parents
  • Temporary residence may move the child from house to house creating instability
  • The Foster home may not be able to cater the the child’s emotional needs and may be overcrowded

As noted above, foster care is not always the best option for any particular child, and is usually a temporary solution.  As a physician and a parent it is heart wrenching to be exposed to these cases day in and day out. But I realize there are always things we can do to advocate for our children.

  • Advocate- Speak to your local, regional and federal congress members. Look and or push for legislation regarding child health issues such as child maltreatment. As a constituent you have that right.
  • Volunteer- You can volunteer with your local child health protective services or organizations such as American Society of Positive Care of Children (SPCC)
  • Speak Up- Use your social media outlets to speak up about child maltreatment. If you see say something, say something to your local child protective services, do not turn a blind eye.
  • Help– The perpetrators themselves need help, a majority of them have been abused as a child, we need to break the cycle

If you want to know more regarding pediatric health care tips. Please check out HealthyChildren.Org and search Sylvia Owusu-Ansah MD

Psalm 127:3 Children are a gift from the Lord;
    they are a reward from Him.

pEDadvocate at your service

 

 

 

 

 

 

Is convenience harming our children?

Is convenience harming our children?

I recently took care of a young infant who was found to have taken a SUDS ( single use detergent sacs), otherwise known as laundry pods. This little boy was fighting for his life all in the name of convenience. The child’s mom called 911 because of vomiting, by the time the paramedics brought the patient to the emergency department the patient was barely conscious, breathing hard and fast, intermittently gasping for air. At one point we considered inserting a breathing tube and connecting him to a ventilator to help him breath. Lucky for this infant the situation turned around and worked out for the better. I could not help but wonder, is the convenience worth it?  Laundry pods were designed to make doing laundry easier, less messy, and more portable. Each pod is more highly concentrated then regular detergent and covered with a chemical called polyvinyl alcohol, it easily dissolves in water of any temperature and thus can easily dissolve in an infant’s mouth. No teeth required. The detergent can cause burns down a child’s esophagus and stomach, and can end up in a child’s lung and make it difficult to breath.  There has already been one suspected death from these laundry pods and multiple morbidities

During May 17–June 17, 2012, poison centers reported 1,008 laundry detergent exposures to the National Poison Data System (NPDS), of which almost half of the exposures ( 48%) involved laundry detergent pods. Age was recorded for 481 exposures, of which 454 (94%) exposures involved children aged ≤5 years. Among children aged ≤5 years, a significantly greater proportion of those exposed to laundry detergent from pods had gastrointestinal and respiratory adverse health effects and mental status changes compared with those with non-pod laundry detergent exposures.  A lot of these children present with choking, trouble breathing, and vomiting.

Parents and caregivers should keep laundry detergent pods, as well as other household cleaning products, out of reach and out of sight of children. Health-care providers should be aware that exposure to laundry detergent from pods might be associated with adverse health effects more often than exposure to non-pod laundry detergents. Compared with non-pod laundry detergent exposed persons, pod-exposed persons were significantly more likely to have a minor, moderate, or major medical outcome compared with no effect.

If you suspect your child has swallowed or taken a laundry pod call 911 for time is of the essence.  Then call poison control at 1-800-222-1222, they will guide you on next steps. Do not force your child to vomit this may worsen symptoms as the child may accidentally choke and take contents into the lungs.

Another set of products that can be detrimental to children are prepackaged noodle soups.  From experience I have witnessed several severe scald burns for infants and toddlers with noodle soup.  Last week I saw a young toddler whose entire diaper area was burned from noodle soup which was accidentally spilled, she was admitted to the hospital for burn care. Noodle soup is particularly dangerous for a couple of reasons, one the hot noodles tend to stick and stay on the skin longer creating a severe scald burn and they take longer to cool.

Studies have shown the average length of stay for patients with noodle soup burns was significantly longer than for those with other types of soup burns.  Also, the cooling curve for noodle soup is much slower than for normal tap water. Noodle soup causes a significantly longer hospital stay than other types of soup. Because the boiling temperature of water and noodle soup is about the same, but the cooling curve of noodle soup is much slower, noodle soup may present a greater danger to children than other types of soup.

If your child has any scald burns from hot water or food, immediately remove their clothing and cover with loose clothing. Do not place any lotions or concoctions on the burn and call 911 immediately, especially if the burn is to the chest , face, groin areas or extensive.

We have to be better advocates for our children as parents, health care workers, aunts, uncles, cousins, grandparents. We can only be better advocates by realizing and addressing the problems that face our children on a daily basis. These problems we can easily help to prevent as a community and as commercial industries.

Psalms 127:3 Children are a gift from the Lord; they are a reward from Him

pED advocate at your service

Gun legislationand our children- a perspective

As the white house looks to readdress gun legislation to prevent gun violence, we cannot forget the tragedies that got us to this point. As a pediatrician and a mother myself, my heart goes out to the families in Newtown, Conn., Colorado, Blacksburg Virginia, City of Chicago and all those who have lost loved ones  gun violence. The most basic, instinctive need of parents is to protect their children. As pediatricians, so much of what we do is meant to help parents and caregivers do this.  As a mother I can’t imagine losing own my child to an incident caused by gun violence that could have been prevented. Also as a pediatrician working in the emergency department I see firsthand the effects of gun violence in our communities.  I witness the physical, emotional, psychological damage it has on our children their families and surrounding communities.

Firearms are one of the top three causes of death among youth, causing twice as many deaths as cancer, five times as many as heart disease and 15 times as many as infections.

I recently saw a teenage patient who was a victim of gun violence a year prior. He presented to the emergency with stomach pain, the patient ended up having severe blockage of his bowels and needed emergent abdominal surgery for the third time. Why the severe blockage and surgery? This was a consequence of his multiple gunshot wounds which included injury to the heart and liver. But he was one of the lucky ones, because he survived. Gun violence must become a reality to us.

There are many children I see in the emergency department who suffer from mental illness with problems such as depression, mood disorder, and bipolar disease. Many of them contemplate suicide or even attempt to kill themselves, others of them are homicidal and attempt to hurt or kill loved ones. Many of these children cannot get the help they need because mental health resources simply are not available to them. Inadequate insurance coverage and high out-of-pocket costs prevent children from accessing needed mental health services. Treatment of many mental disorders has been deemed highly effective, but without intervention, child and adolescent psychiatric disorders frequently continue into adulthood. Child mental illness must become a reality to us.

As a mother every night I put my child to sleep I thank God for her life. I pray for her health and her safety. Our children’s safety must become a reality to us. We need to become a more proactive and less reactive society. We cannot accept a national culture that tolerates tragedies like Sandy Hook.

The American Academy of Pediatrics has long advocated for changes that will give our country a better chance at protecting our most innocent and vulnerable. As a nation, we must:

Ban the sale of assault weapons and high-capacity ammunition magazines to the public

Advocate for strict firearms safety laws

Improve support for mental health services

Push for changes in how the media report on acts of mass terror, and the perpetrators

Rethink a culture that sees violence as entertainment

Limit children’s exposure to media violence (eg, violent movies and video games)

Invest in our youngest, most vulnerable members to foster their healthy, lifelong development

Federal agencies should be able to conduct gun safety research, without any funding restrictions, to determine which programs and interventions are most effective.

Pediatricians, parents, teachers and all who care for children nationwide will continue to look for ways to comfort, support, nurture and protect them. We must remember our children cannot advocate for themselves. It is our duty as parents, relatives, teachers, and physicians to be their strongest advocate. I hope that our elected leaders can see the real stories within the tradegies as they work on passing legislation to prevent gun violence. We look to our nation’s leaders to help prevent further atrocities like Sandy Hook.