Category Archives: Family health

How to talk to your pre-teen about the HPV vaccine

The American Academy of Pediatrics now recommends that boys ages 11 or 12 receive the HPV vaccine in a three-dose series, which can be started as early as 9 years old.

Courtesy MCN Healthcare

How do you explain what the HPV vaccine is to a nine-year-old boy?

Well, that’s up to parents to decide.

So you will have your facts straight, however, we asked  Michelle Huddleston, M.D.  a member of the Arizona Chapter of the American Academy of Pediatrics, to explain why the HPV vaccine is on the schedule for pre-teen girls, and now boys, too.

Vaccines are designed to prevent diseases, says Dr. Huddleston, who practices at Phoenix Children’s Hospital. This vaccine is no different.

The HPV vaccine provides protection from certain subtypes of the HPV virus long before boys and young men (and young women) become engaged in any type of sexual activity. 

HPV transmission can happen with any kind of genital contact and intercourse isn’t necessary, adds Dr. Huddleston, who says that many people who have HPV infection are without signs or symptoms and unknowingly pass the virus to their partner.

The HPV vaccine is most effective in the pre-teen age group producing higher antibody levels than in older patients. So, that’s why the vaccine is on the schedule for pre-teen boys and girls.

Talking about the purpose of the vaccine might be a conversation starter for a talk about sex. Dr. Huddleston says that although feeling nervous about broaching the subject with kids is fairly common, she suggests  that as parents,  we should try to consider sexuality a normal topic of conversation.

“Certainly by the time your child starts to exhibit the physical changes of puberty, questions will start to arise,” says Dr. Huddleston. “Be certain to listen, answer honestly and by approachable. You may start the conversation by asking, ‘What do you know about sexuality?’ and see where the conversation leads.

Dr. Huddleston recommends as a good resource for parents as they prepare to talk to kids about sex.

Another update on the vaccine schedule is the age at which the meningococcal vaccine can be given.

Children as young as 9 months can get the vaccine if they are residents or travelers to countries with epidemic disease or at increased risk of developing meningococcal disease, says the AAP.

Routine immunization with the meningococcal vaccine should begin at 11 through 12 years with a booster dose administered at 16 years of age.

So who is at greatest risk for developing meningococcal disease? And what is it, exactly?

Children who do not have a spleen, have an abnormally functioning spleen or certain immune disorders are at increased risk of developing meningococcal disease, says Dr. Huddleston.

Teenagers are at increased risk of developing meningococcal disease by being in crowded places, living in close quarters, sharing drinking and or eating utensils or having a run-down immune system.

Meningococcal meningitis and septicemia can present with flu-like symptoms and patients can die within 24 hours. 

And, speaking of flu, there’s one more update on the vaccine schedule. 

For children aged 6 months through 8 years, the influenza vaccine should be administered in two doses for those who did not receive at least one dose of the vaccine in 2010-11, says the AAP.

Children who received one dose last season require one dose for the 2011-12 influenza season.

Questions about vaccines or this most recent schedule revision? We list resources below, but any parent who is unsure of what a vaccine is for or when it should be given to a child should check with the child’s health care provider.

More resources on vaccines:

Centers for Disease Control and Prevention 

Center for Young Women’s Health

The Arizona Partnership for Immunizations 

American Academy of Pediatrics Healthy Children website




Rates of hospitalization for drowning decline

In the U.S., drowning accounts for nearly 1,100 deaths of children aged 1 to 19 years each year.

That makes it the second leading cause of unintentional injury death in this age group.

But not every drowning results in fatality. Some children survive a drowning…but doesn’t always mean a full recovery for the victim.

Lesia Crawford, of Phoenix, tells the story of how her younger brother, Andrew Hill, survived after falling in to a swimming pool- and what his life is like now, many years later.

For every pediatric drowning death, another two children are hospitalized after nonfatal drowning injuries.

And in Arizona, warm weather, long summers, and thousands of residential swimming pools that do not need to be drained in winter contribute to tragic water-related accidents among young children.

But there is good news.

Research results that will be released in the February 2012 issue of Pediatrics (published online Jan. 16), found rates of pediatric hospitalizations associated with drowning actually declined 49 percent during the study period, from 4.7 hospitalizations per 100,000, to 2.4 per 100,000.

The hospitalization rate for boys remained consistently higher than the rate for girls, though rates declined for all age groups and for both males and females.

Hospitalization rates decreased across all geographic regions of the U.S., with the greatest decline occurring in southern states.

The American Association of Pediatrics (check out their re-designed website) says that the study offers benchmarks that can be used to judge future efforts in drowning prevention and to target interventions to high-risk areas.

Top kids’ health issues to watch in 2012

Nemours, an  internationally recognized children’s health system that owns and operates the Alfred I. duPont Hospital for Children in Wilmington, Delaware, along with major pediatric specialty clinics, manages the  website.

Physicians and editors at sifted through health issues affecting children and families to choose a few important trends to keep tabs on in 2012.

Here are a few areas that made the list:

The Risks of Postponing or Avoiding Vaccinations 

When it comes to immunizing children, increasing numbers of parents aren’t just consulting their pediatricians for advice — they’re also paying heed to rumors and advice spread online.

Even when the science or sources behind anti-immunization stances are proved unreliable or even completely discredited, it can be difficult for some parents to accept that vaccines are safe.

As a result, health officials are seeing alarming rises in preventable diseases, mostly among people who are not immunized.

Helping Teens Take Charge of Their Health Care

Preparing kids for independence and adulthood brings many challenges for parents. Among them is helping teens start managing their own health care.

But it’s important to guide teens toward taking on this responsibility. After all, parents won’t always be around to manage their children’s health care — and in most cases, once their kids become adults, legally they won’t be allowed to.

The Rise of Eating Issues and Disorders

Seeing the rail-thin models who strut down catwalks at fashion shows, you might think that eating disorders like bulimia or anorexia mostly affect women whose livelihoods are based on being thin.

But more and more, these problems are affecting people from all walks of life — and, unfortunately, many of them are kids. Of the almost 24 million Americans who suffer from an eating disorder, 95% are between 12 and 25 years old — and many of them are male.

Prenatal Surgery: Helping Babies Before Birth

Operating on a baby before birth may seem like science fiction, but prenatal surgery is becoming more and more common in special pediatric programs throughout the United States.

Since prenatal surgery was first pioneered in the 1980s, it’s become an important way to correct certain birth defects that could be severe (and in some cases fatal).

Choose mobile apps wisely

Many parents no longer just call their pediatrician for help and advice. Many also look for health information online. And, more and more, their sleuthing is done via smartphones and tablets, which has given rise to health-specific apps.

Read more on each topic

Food for kids: what’s healthy, and what’s not

Pity the folks who work hard every day planning, cooking, and serving school lunches.

They do it on tight budgets and under rigid guidelines to meet nutritional requirements. It’s not easy. Everyone has a story about their own school cafeteria experience, likely involving “mystery meat” or watery spaghetti sauce that topped over-cooked pasta.

Things became even worse when over time, schools stopped doing any real “cooking” at all.

Instead, they used pre-packaged foods that merely required re-heating or defrosting, leaving them now with mostly ovens just to heat-and-serve with, says Michelle Dudash, local registered dietician and chef consultant.

Salad bars are becoming more common in schools.

But these days, schools are making an effort to do more scratch cooking, as they used to do way back when the idea of serving children a hot lunch at school began.

“This is a gradual process,” says Dudash, “because it takes more labor and a little more variety of equipment.”

Valley school cafeteria managers are challenged to meet the new USDA guidelines. Parents are challenged, too, as they try to provide good nutrition to their children in a world where sugary drinks, snacks and cereals, as well as fast foods, are heavily marketed to kids.

Dudash says that many people, including parents, tend to get caught up in focusing on one single nutrient in a food, but forget to take in account the total nutrient-richness.

For example, she says that though flavored milk has added sugar, it contributes just 3% of added sugars to kids’ diets while delivering 9 essential nutrients. Soda and many fruity drinks deliver little, if any beneficial nutrients, which makes them “empty-calorie drinks.”

Pairing a soda with a meal has become commonplace, says Dudash, but it should not be this way.

Soda can be enjoyed as a treat, but not offered on the everyday menu. “Kids should be drinking milk (lowfat dairy or fortified non-dairy alternative if needed) first, water throughout the day, and up to 4 to 8 ounces (for younger and older children, respectively) 100% fruit juice per day if they choose.”

The single-focus approach on one ingredient that many people take, says Dudash, can cause people to overlook particular foods like nuts or avocados. Parents say, “Oh, it’s high in fat!”

The truth is, says Dudash, that these types of foods that contain fats that are healthy. They contain other nutrients that are essential towards a child’s development.

Portion size is key, says Dudash, for parents and kids alike.

Carb and calorie contents are now posted with selections

Dudash encourages families to take a look at the simplicity of the guidelines that school cafeterias are trying to implement, and try following them at home. Parents who are confused, or have questions, should delve a little deeper in to what the recommendations are, and why they have been established.

“Go beyond simply asking your kids what they had for lunch,” says Dudash. “Take a closer look at the menu. Make an appointment to tour the cafeteria to see what really goes on — have a friendly, respectful chat with the cafeteria manager. And, maybe have lunch with your child at school.”

Subtle, healthy changes in school lunches around the Valley

What makes a good school lunch?

Serving a mid-day meal to school children dates back to the turn of the century, when young students, post Industrial Revolution, became the focus of social scientists, nutrition experts, government researchers and welfare groups, according to the Food Timeline.

Community leaders began to understand the connection between good nutrition and learning, and an awareness of the dietary needs of children grew.

The sandwich, according to food historian and reference librarian Lynn Olver, who assembles information on the site, was a mainstay. It was a convenient way to “carry foods that are to be eaten with bread,”  as referenced by a 1915 cookbook.

Sandwich ideas from a cookbook published in 1940 included meat loaf, egg and

Courtesy Smithsonian Institute

olive, cheese and onion, salami, or peanut butter. A baked apple, carrot “straws” and celery were recommended to go alongside, followed by a homemade dessert such as cookies, puddings, or tarts.  An insulated container of soup was often included. Beverages were always milk or  juice, cocoa or lemonade.

Hot lunches were served to children in the public schools of large cities from the time of World War I.

The National School Lunch Act, passed in 1946, was intended to meet the needs of students and families as well. “The educational features of a properly chosen diet served at school should not be under-emphasized,” reads a House report on the measure passed by Congress. “Not only is the child taught what a good diet consists of, but his parents and family likewise are indirectly instructed.”

USDA recommendations for what makes a healthy school lunch, and how to teach parents and kids about what a healthy diet includes, have morphed over the years. In the Valley, school districts recently began following the guidelines.

The changes are subtle. Mac-n-cheese, pizza, and chicken nuggets may still make the menu- but the ingredients used for these old favorites have changed.

Michelle Dudash, local registered dietitian and author of Clean Eating for Busy Families, to be published in fall, 2012, says that districts are eager to spread the word to parents on what kids are being served.

The Mesa School District, says Dudash, has really ramped up their marketing program to communicate to parents the positive things they are doing, and what is new. Changes in Mesa Schools include:

– Chicken nuggets are baked instead of fried. There are no fryers in the school.

– Some pizzas are made with whole grain crusts and reduced-fat cheese.

– Flavored milk  selections are fat-free and contain only 31 calories more than unflavored non-fat milk.

– At least one entrée per week is made from scratch. New recipes are being tested and sampled by students. Mesa Schools plans to add more from-scratch entrees to menus next year.

Washington Elementary School District, in northwest Phoenix, has also instituted the changes, says Dudash, which includes a tweaking of ingredients as well:

-Cheese sticks are made with whole grain breading and reduced fat cheese.

From the Washington Elementary School District

– “Fruit or Vegetable of the Month” is served once per week for a month in elementary schools. Foods in the spotlight include gala apples, bell peppers, and watermelon. Kids love it, says Dudash.

– Dark green lettuces and sweet potatoes are served more often.

-Stir fry dishes are accompanied by brown, instead of white rice.

Next up: Dudash offers tips on how to cut through the confusion on what is healthy…and what is not.


Eat this way, everyday

This week, we’ll take a look at some of the ways school lunches are changing in response to the new MyPlate Guidelines, the Federal government’s response to the obesity epidemic among today’s children.

The United States Department of Agriculture first published recommendations on good nutrition for Americans at the turn of the century.

The first graphic guide, “Eat this way, every day,” established food groups and recommended amounts within each group. Proper nutrition was seen as a the great protector of good health.

The most recent guide, dubbed “MyPlate,” uses a a simple image of a plate with a circle to the side for a dairy product. It’s fairly simple. If you fill your plate halfway up with fruits and veggies, then add a whole grain item plus some lean protein to the other half, you’re within the guidelines. 

Another major message of MyPlate, says registered dietitian Michelle Dudash, is to make half of the grains on your plate whole grains, such as whole wheat bread or brown rice.

MyPlate also emphasizes drinking more water, and fewer sugary drinks, says Dudash, who is president-elect of the Arizona Dietetic Association.  Arizona already imposes limits on the amount of sugar a beverage may contain for students in kindergarten through eighth grade, she adds.

Schools that participate in the National School Lunch Program (NSLP)– schools that offer free or reduced-price meals – including public schools, some independent non-profit private or charter schools, must serve meals that meet the new MyPlate guidelines.

No doubt parents have seen some changes in school lunch menus as schools strive to meet the requirements, and, says Dudash, some are puzzled.

“Just by reading menus, says Dudash, “parents many times assume (the new recommendations) are unhealthy. Even though parents see pizza on the menu, they don’t realize that it’s on a whole grain crust and with reduced fat cheese. When they see “French fries” they assume they are fried, when in fact only 11% of all schools in the country even have deep fryers anymore.”

Although school lunches must meet the Federal nutrition requirements, decisions about what specific foods to serve, and how they are prepared, are made by local school authorities, says the NSLP.

Next up: Chicken nuggets? Mac-n-cheese? Dudash shares what some local school districts are serving up that might surprise parents.

My family’s heart attack story and why you need to learn CPR

On the Wednesday before Christmas, Rob was out in the backyard, chopping wood for the fire pit, and neatly stacking it up.

Rob is married to my husband’s sister, Aimee. They live in Florida.

Rob is known in our family as the guy who builds things like decks and outdoor cabanas and sunrooms. With no plans or drawings. The ideas pour from his imagination, and are implemented purely from the calculations in his head.

His tools hang on the wall of his garage in perfect order. There’s a box for clean rags…and a second box for dirty rags. I’ve seen this. Rob is a perfectionist. He’s an electrician, a carpenter, a plumber. He can program remotes and trouble shoot any TV/home theatre system.

And he thrives on creating and then constructing something new for his family and friends to enjoy.

Rob's fire pit

Aimee is used to Rob’s penchant for puttering around, working on projects. She’d returned from a morning of Christmas shopping that Wednesday, and sat down to take a break. As she was channel surfing, she looked up to see Rob come in from outside.

“Will you sit with me,” Rob asked her. “I’m going to lie down. I’m not feeling very good.” Continue reading