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By Lynda Exley (An award-winning column) Each month, Houston Family Magazine contacts experts to respond to readers' questions with helpful suggestions and information. Note: Material contained herein does not necessarily reflect the opinion of Houston Family or its staff. It represents information provided by reputable sources for your consideration. |
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Purchasing over-the-counter cough medication for a child Tips about packing healthy lunches for school When should a child first visit an ophthalmologist Is there any merit to considering herbal remedies for children Q: How do I know what is safe and what isn’t safe when purchasing over-the-counter cough medication for my 5 year old? A: The following is a statement by Linda A. Suydam, D.P.A., president of the Consumer Healthcare Products Association (CHPA), in response to inaccurate and misleading media reports surrounding the U.S. Food and Drug Administration’s upcoming joint meeting of the Nonprescription Drugs Advisory Committee and Pediatric Advisory Committee scheduled for October 18 and 19: CHPA and the makers of pediatric, over-the-counter cough and cold medicines are committed to helping ensure the safe use of cough and cold medicines in children. Our highest priority is the safe use of our medicines. Recent media reports have misstated the FDA’s position on the use of pediatric cough and cold medicines, and these inaccurate reports may unnecessarily alarm and confuse parents who have successfully relied on these medicines to relieve the cough and cold symptoms in their children for generations. FDA has not called for a ban on medicines for children under 6. Rather, the agency has presented a variety of internal and external recommendations for discussion at the upcoming advisory committee meeting. FDA’s press office issued a note to correspondents recently further clarifying that, ‘the Agency has not reached any final decisions as to actions to be taken in response to a citizen petition. After hearing the recommendations of the advisory committee, FDA will determine the course of action.’ Parents can continue to trust over-the-counter cough and cold remedies for their children. The instructions on these medications have always clearly directed parents to ‘Ask a Doctor’ before administering to children under two. We strongly encourage parents to adhere to the recommended dosing instructions for all medicines, recognizing that the vast majority of adverse events associated with their use are due to inadvertent overdosing and misuse. When used as directed, these medicines are safe and effective. Based on our commitment to the health and wellbeing of our nation’s families, and because children under age 2 are most vulnerable to misuse of over-the-counter cough and cold medicines, we are recommending that labeling for children under 2 be strengthened to read, ‘Do Not Use’ versus ‘Ask a Doctor.’ We also are recommending that language be added to the label of OTC antihistamines to read, ‘Do not use to sedate children.’ In the coming months, we’ll be launching a major educational campaign alerting parents and caregivers to use great caution when administering medicines to children. Specifically, we will target parents and caregivers of children under two, as well as pediatricians, to further underscore that over-the-counter medicines should not be given to children under two. As the makers of over-the-counter cough and cold medicines for children, we remain committed to ensuring parents and caregivers have the information they need to use these medicines safely and effectively, and that they have access to the very best possible medicines for their children.” An NDAC meeting took place on October 18 and 19, 2007. FDA has posted some recommendations for parents www.accessdata.fda.gov/scripts/cdrh/cfdocs/psn/transcript.cfm?show=68#8 CHPA is the 126-year-old-trade association representing U.S. manufacturers and distributors of over-the-counter medicines and nutritional supplement products. www.chpa-info.org. Consumer Inquiries: 888-INFO-FDA Q: Anabelle from Katy asks, “Can you give me any tips about packing healthy lunches for school? I have school-age children and am constantly struggling to come up with creative, healthy meals that they will actually eat.” A: Although the National School Lunch program has worked diligently to provide healthy, low-cost or free lunches to 26 million children each school day, many experts say that the best way to ensure that your child is getting a healthy lunch is still to pack it for them. Opinions on this differ, however, and many authorities on nutrition advocate relying on school food services for students. Elvia M. Andarza, M.S., R.D., of the Texas Department of Agriculture, Food and Nutrition Division, explains, “Meals served at schools—both breakfast and lunch—provide all the necessary nutrients, including protein, fiber, vitamins and minerals, that meet students’ dietary requirements. We therefore encourage students and parents to look first to their school food service for healthy, safe, nutritious meals. Cost-effective and convenient, today’s school meals provide healthy choices for breakfast, lunch and in between.” If you do opt to pack lunches “for” your kids, experts unanimously recommend instead packing a lunches “with” your kids. Make a list of acceptable options in a number of healthy categories (whole grains, lean proteins, fruits, vegetables, etc.) and then let kids choose from each category when assembling lunches, say Mary Aragon of Camp Cook, Big Adventures for Little Chefs and Kevin Campbell of Village Table. Involve your children in shopping, preparing and packing their lunches, adds Michelle May, M.D., author of Am I Hungry? What to Do When Diets Don't Work and ‘H’ is for Healthy—Weight Management for Kids. “Use your time together to teach about the nutritious qualities of certain foods by emphasizing colorful, healthful ingredients. May recommends including a snack-size baggie of a less healthful dessert, if your kids so desire, to teach them about reasonable portion sizes and moderation. While a little dessert is fine, Campbell stresses, don't include candy bars, soft drinks or Koolaid-type drinks, though. For dessert, pack homemade cookies made with oatmeal, raisins or other natural ingredients. And use only 100 percent juice products or water. Refined, processed sugars with all of the preservatives will give kids a short-lived sugar rush and can have many other potentially unhealthy effects. As with lunches, kids can help in the kitchen when making desserts to learn some culinary life skills at the same time! Betsy Graham, M.A., of Mealtime Matters emphasizes another important factor: coming up with creative, fun ways to present food for kids. Kids like to feel creative and active, whether helping prepare or eat foods,” says Graham. “Use cookie cutters to make cool shapes, include little containers of dipping sauces and dressings, find new ways to wrap foods.” Kids have short attention spans and like to stay interested. Although you don’t want to include too many choices and overwhelm them, you do want to break lunches down into smaller, interesting portions. Instead of including one giant sandwich and a whole apple,” illustrates Graham, “cut the apple into bite-size slices, include yogurt or a fun dip, and make sandwiches in little shapes. Stores like Costco and Sam's Club sell in packs of hundreds two-ounce disposable containers with lids. These are perfect for dipping sauces, condiments and dressings,” adds Campbell. Try these other ideas from Village Table and other meal-prep experts to create healthy lunches that your kids will enjoy:
Visit www.holistic.com for more ideas for packing healthy lunches. Also look for the Texas Department of Agriculture, Food and Nutrition Division’s upcoming flyer, Nutritious + Quick + Easy = School Meals That Pass the Test, and visit www.squaremeals.org to learn more about healthier snacks or foods for healthy eating. Resources: Am I Hungry?, www.amihungry.com; Camp Cook, www.camp-cook.org; The Holistic Internet Community, www.holistic.com; Village Table, www.villagetable.com; Mealtime Matters; Texas Department of Agriculture; www.agr.state.tx.us and www.squaremeals.org. Q: Grace asks, “When should a child first visit an ophthalmologist? I recently learned from one of my 5-year-old’s teachers that many childhood learning challenges may be due to poor eyesight that develops as early as infancy. Is this true?” A: Experts agree that it is important to recognize and treat poor eyesight to ensure proper childhood vision development. According to Aaron M. Miller, M.D., of Pediatric Ophthalmology and Adult Strabismus with Houston Eye Associates, “I frequently receive questions about vision screening for children with regard to when and how screenings should be performed and who should perform them.” The American Academy of Ophthalmology and the American Academy of Pediatrics both recommend timely screening for the early detection and treatment of eye and vision problems. It may surprise most parents, however, to learn that eye examinations are actually performed on children at many regular visits to the pediatrician or family practice doctor. The first eye examination is typically performed by a physician at birth and is typically repeated within the child’s first 6 months of life. “Another vision screening should be performed around 3 years of age,” Miller advises. Additionally, the Texas Department of State Health Services requires vision screening to be performed by trained and certified personnel for 4-year-old preschoolers at child-care centers and for children in school during kindergarten, first, third, fifth and seventh grades. “Most serious ocular conditions are detected at some point during the numerous vision screening assessments performed in a child’s early life,” Miller explains. “When problems are detected, referral to an ophthalmologist is indicated. As long as vision screenings are being performed, mandatory complete eye examinations with dilation can be considered excessive and unnecessary for most children.” According to Brendan Cassidy, M.D., of ABC Children's Eye Specialists, a child should first “see” an ophthalmologist at a time based on their own and their family's eye history. &“If a child has constantly misaligned, jiggling eyes or significant eye irritation that does not respond to a pediatrician's treatment, he or she should see an ophthalmologist right away, regardless of age. If there is a family history of very strong glasses, crossing/wandering eyes or blindness, the child should be evaluated by 1 year of age.” Both Miller and Cassidy agree that early intervention and preventive care are best. “Early infancy intervention can help tremendously by the time a child is ready to go to school. It is much better to detect serious problems in infancy and get the child off to the right start right away,” Cassidy explains. “Earlier detection of a visual abnormality improves the effectiveness of treatment and improves the overall visual potential of a child,” adds Miller. Good vision is essential for proper physical development and educational progress in growing children. Many serious ocular conditions, which can be found via screening, are treatable if identified in the preschool and early school-age years before children’s visual systems mature. Getting your child’s vision screened at the appropriate times, therefore, is imperative. Thankfully, our health and school systems make screenings quick and easy. Resources: American Academy of Ophthalmology, www.aao.org; American Academy of Pediatrics, www.aap.org; Brendan Cassidy; Houston Eye Associates, www.houstoneye.com; Texas Department of State Health Services, www.dshs.state.tx.us. Q: Melanie asks, “Is there any merit to considering herbal remedies for children? I have heard both recommendations and risks associated with herbal healing, but what is the truth as it applies to children?” A: While experts agree that some supplements may benefit some people in some instances, there is a wide range of opinion as to the degree of use versus potential hazards. First, it is important to explore the actual meaning of “herbal remedy.” “There is a false sense of comfort that accompanies the term ‘herbal’,” states Tara Compare, Pharm D., author of the popular column The Medicine Mom. “Herbal simply refers to the fact that the product in question comes from a plant. Many drugs are actually plant derivatives,” both she and Lynnette J. Mazur, MD, MPH, professor of Pediatrics at the University of Texas Medical School at Houston and chief of Pediatrics at Shriners Hospital for Children—Houston, clarify. This being said, the use of herbal supplements in pediatric healthcare has become more prevalent and they can be beneficial if prescribed and monitored correctly. “Herbs and other natural remedies complement but do not substitute for professional medical care,” explains Mazur. Jennifer Feldman, MD, MPH, assistant professor of Pediatrics, division of adolescent medicine, at the University of Texas Medical School at Houston adds, “Just like antibiotics or anti-hypertensive drugs, herbs are medications with various effects—both desirable and dangerous.” One major concern cited by numerous sources is that nonprescription drugs do not have to meet strict standards proving them to be safe and effective. Both Kompare and Mazur point out, “Under the Food and Drug Administration, drugs must undergo clinical trials to determine safety, efficacy and potential interactions. Herbal supplements have no such regulations.” This means that what is listed on the bottle may not actually be what is in the product itself and that unwanted (possibly dangerous) side effects may occur. Also, numerous experts caution that herbs can interact differently for different populations (adults vs. children), with different medications someone may be taking and for different individuals. Subsequently, it is unanimous among experts that herbal remedies should always be used with caution and the supervision of a trained professional. “A pediatrician or physician can weigh the potential benefits of a given herb against any potential undesirable or dangerous side effects. They can also recommend the correct dosage, which is very important. As with other medications, more is not better! There is a specific ‘healthy’ dosage that your healthcare professional can recommend,” says Feldmann. Parents can also access information provided by a number of third party companies that ensure that herbal products are manufactured ethically. Some credible Web sites for further research include: Consumer Labs (www.consumerlab.com), Office of Dietary Supplements (www.ods.od.nih.gov) and About Herbs Database (www.mskcc.org). Resources: Tara Kompare, www.themedicinemom.com; Shriners Hospital for Children – Houston, 713-797-1616; University of Texas Medical School at Houston, 713-500-4472. |
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