10 Kids' Health Issues to Watch in 2010

Earliest Signs of Autism Identified in Babies

With about 1 in every 110 children in the United States being diagnosed with a condition in the "autism spectrum," there's been an upsurge in autism awareness and research. Scientists have long known that poor communication is a hallmark of these developmental disorders, but it was difficult to gauge that ability in preverbal kids — until now.

Researchers now say that the earliest signs of autism in babies include difficulty establishing eye contact, an absence of babbling or joyful expressions, and not responding to one's name.

These new findings will help improve screening efforts for autism, which are recommended at least twice before a child turns 2. Babies who get an earlier diagnosis get the interventions they need sooner.

What This Means to You

The term pervasive developmental disorders (PDDs) refers to a group of developmental conditions that affect children and involve delays or impairments in communication and social skills. Autism is the most well-known of the pervasive developmental disorders, so PDDs also are known as autism spectrum disorders.

Causes of PDDs are not yet well understood. Scientists believe PDDs are complex neurobiological (brain biology) problems that may have a genetic basis like other conditions that stem from abnormalities in the chromosomes a child inherits.

Although there's no cure for PDDs, early intervention and treatment can help kids who have them develop skills and reach their potential. Individually tailored programs can include behavior modification, while educational interventions can help shape a child's behaviors and improve speech and communication.

As with all child development issues, talk with your doctor about any concerns you have and how to find local resources for the services your child needs.

Obesity and Kids: What Parents Should Understand

Why are so many kids today overweight or obese? Many factors are involved, from out-of-control portion sizes and eating on the go to sedentary lifestyles and parental uncertainty about what kids should weigh.

How many kids are overweight? According to the Centers for Disease Control and Prevention (CDC):

• 2-5 years old — about 12.4%
• 6-11 years old — 17%
• adolescents (ages 12-19) — 17.6%

It's important for parents to be good role models for their kids by eating well and exercising often. But beyond that, moms and dads also need to educate themselves regarding where kids should fall on a growth chart.

And that's a problem, because growth charts can be hard to understand. A recent study found that only 56% of parents could correctly identify the meaning of "percentile" from a list of choices (in a growth chart, percentiles measure how a child's height and weight compare with his or her peers').

That confusion likely plays a role in many parents not recognizing that their child is overweight. In fact, a 2008 study found that more than 40% of parents with 6- to 11-year-olds who were obese thought their kids were "about the right weight."

What This Means to You

Carrying around too many pounds isn't just a matter of how kids and teens look. Those who weigh too much are also at risk for a wide range of physical, emotional, and psychological health issues, from diabetes and high blood pressure to depression and eating disorders.

So it's important to seek medical advice if you think your child might be overweight or obese — just as you would if you suspected your child had any other medical condition. If your doctor says your child's weight is an issue, you can help make maintaining a healthy lifestyle a positive experience instead of a stressful, all-consuming race to trim unwanted pounds.

Ask about your child's most recent BMI (a measure of whether a child is at a healthy weight that doctors track at regular checkups from 2 years old on up) and how he or she compares with peers on the growth charts. If you don't understand these numbers and charts, be sure to ask your doctor to explain them.

Many Kids Missing Out on CHIP Benefits

A recent study came to a conclusion that seems obvious — kids who lack regular pediatric care often don't get the medical services they need. In a report published in Pediatrics, researchers found that kids who didn't have a source of regular health care (a "medical home") were more likely to have unmet medical needs such as delayed urgent care and problems getting dental care.

Although it's uncertain how well current health care reform initiatives will help meet kids' needs, there is help available for millions of uninsured children who have no medical or dental care via the Children's Health Insurance Program, or CHIP. Earlier this year, President Obama signed a bill that makes 11 million kids eligible for CHIP — that's 4 million more kids than in 2008.

The extended reach of this benefits program that provides health insurance for poor kids at very low cost is increasingly important as the number of "working poor" families increases during bad economic times. So what's the problem? Most eligible kids still haven't been enrolled.

What This Means to You

If your kids don't have health insurance, they might be eligible for CHIP — even if you work, think your household income is too high to qualify, or have previously applied but been turned down for CHIP.

To find out if your child is eligible, visit Insure Kids Now! (www.insurekidsnow.gov) on the Web.

H1N1 Flu Pandemic Affecting Kids the Hardest

Worry over H1N1 virus has let up a bit in recent weeks and the peak of the outbreak appears to have passed, but experts caution that cases could surge again. So it's important for parents to remain vigilant and do their best to protect their families, especially since kids and teens were especially hard hit by the recent H1N1 pandemic.

While health care officials encouraged parents to make sure that kids got immunized against both seasonal flu and H1N1, many parents found the H1N1 vaccine to be scarce or unavailable at their child's usual place for health care. And there have been several reports of distribution problems. For example, while many doctors' offices and local health clinics went without, some major corporate clinics received supplies of the vaccine, according to USA TODAY.

Indeed, in some cases, early doses went to people not considered most at risk by the Centers for Disease Control and Prevention (CDC). The CDC's at-risk groups include pregnant women, people with chronic health conditions, health care workers, and people ages 6 months to 24 years.

What This Means to You

Many parents became frustrated when, after hearing about the importance of having kids vaccinated against the H1N1 virus, they weren't able to do so because of vaccine shortages or unavailability. One reason for the shortfall was that the H1N1 virus turned out to be a "slow grower" in the lab, which delayed vaccine production. Researchers and public health officials hope to use some of the lessons learned about mass vaccine production and distribution for this pandemic to respond more quickly and effectively to future epidemics.

But it's still important to try to get kids vaccinated against both H1N1 and the seasonal flu viruses, just as it is to have them receive vaccines against other infectious diseases. Immunization works best when there are high rates of acceptance and coverage. Kids who aren't fully immunized not only are at increased risk for a disease or infection, but also can infect others who are too young to be vaccinated, cannot be vaccinated for medical reasons, or were vaccinated but didn't have adequate immunologic response. Each person who isn't immunized gives a highly contagious disease one more chance to spread.

And H1N1 has more severely affected kids and teens than older people. About 90% of seasonal flu deaths occur among the elderly; H1N1 flu deaths, though, have mostly been among people under age 65, with a very large percentage under age 18.

If your kids haven't received full flu immunization, find out where the vaccines are available in your area by checking with your doctor's office or local health department. And remember that kids at risk of severe illness can be treated with drugs to help lessen flu symptoms, which are most effective if taken within 48 hours of the onset of symptoms.

Texting & Driving: Just Say No

Does your teen brag about her mad texting skills without so much as a glance up from her keypad? Does your son live to upload cell-phone pictures and videos to YouTube? As irritating as such proficiencies can be for "old-school" parents, they can be more than just annoying.

On the road, these distractions can be deadly. One report estimates that teens are four times more likely than adult drivers to get into an accident related to cell-phone use. Another found that texting was, by far, the most potentially dangerous and lethal activity related to cell phone use on the road.

Traffic crashes are the leading cause of teen fatalities, accounting for 38% of all teen deaths in the United States. Joining inexperience and drunk driving as top concerns regarding reckless behavior behind the wheel are the numbers of teens with cell phones who, more and more, use them while driving.

What This Means to You

Many lawmakers are trying to curb texting behind the wheel, but parents need to jump in, too: If your state doesn't have laws banning cell phones, ban them yourself in your teen's car. And be a good role model yourself. That means no texting or talking (even hands-free) on the phone while driving, especially when your kids are in the car.

Such tactics work. According to a recent study, when parents set firm rules about driving and car usage in a helpful, supportive way, it lessened by 30% teens' likelihood of talking or texting on a cell phone while driving, and also drastically reduced the odds of other dangerous driving behaviors and boosted good habits (for instance, doubling the odds that teens would wear a seatbelt).

When your teen gets a driver's license, it's important to set some rules of the road beyond the relevant driving laws. By clearly defining your expectations before you hand over the car keys, you'll reduce the risk of frustrating conflicts, costly accidents, and other problems. And most important of all, you'll feel more confident about your teen's safety.

The Importance of Vitamin D

Most of us know that vitamin D is crucial to bone health, but now it's been shown that insufficient levels can cause or increase the risk of developing a number of health problems, such as high blood pressure, diabetes, metabolic syndrome, and low HDL cholesterol (good cholesterol). Recent studies report that about 70% kids in the United States have low vitamin D levels.

It's believed that vitamin D is also crucial for maintaining the body's immune system, and that low levels increase the risk of heart disease and other cardiovascular health problems, as well as some cancers.

The two main forms of vitamin D are D2 (or ergocalciferol, the main form of vitamin D in foods), which is made by plants and fungi, and D3 (cholecalciferol), made by the body when our skin is exposed to ultraviolet light.

A few foods are rich in vitamin D, such as cod liver oil, egg yolks, cheese, and fatty fish (like salmon, mackerel, and tuna or sardines canned in oil). Vitamin D-fortified foods include milk, orange juice, margarine, and some cereals. Traditionally, milk has been the main source of vitamin D for kids, but fewer kids now drink much milk every day.

Another likely risk factor for low vitamin D levels is the 3-4 hours of TV and computer time many kids get each day. Vitamin D is called the "sunshine vitamin" because ultraviolet rays absorbed by the skin help the body make a usable form of vitamin D — so kids who are parked inside day after day aren't getting these natural "doses" of vitamin D the way kids did in the past.

What This Means to You

Low vitamin D levels can be harmful to a child's health, so parents should try to get kids to drink more milk or take a vitamin D supplement — and decrease the hours they spend indoors in front of a screen.

Although the body also makes vitamin D when the skin is exposed to sunlight, it can be hard to gauge just how much sunshine is safe and effective for an individual child. So shoot for giving your kids three servings of low-fat or fat-free fortified milk, which has about 125 IU of vitamin D added.

Supplements are available as vitamin D2 or D3, and while both raise vitamin D blood levels, D3 supplements appear to be more effective and long lasting. Doctors recommend 400 IU of a daily vitamin D supplement for:

• exclusively and partially breastfed babies beginning the first few days after birth
• formula-fed infants and all older kids if they get less than 1 quart of vitamin D-fortified formula or milk daily (that's 32 ounces, or four 8-ounce bottles or cups)
• teens who don't get 400 IU of vitamin D each day through foods

The Toll of Constant Social Networking

Does it seem like your kids are always online? Are their status updates on Facebook seemingly a matter of life and death? If so, you're far from alone. And what was once the domain of older kids and teens is skewing younger and younger.

Facebook and MySpace users are required to be at least 13 years old, but with no real way to verify ages both sites are popular with young users who say they're older when creating their profiles (two recent studies report that 38% of respondents ages 12 to 14 said they had an online profile).

Are kids mature enough to make good decisions about their online privacy? Most experts think that kids are smart enough by their early teens to know what, and who, to avoid. Younger kids, though, need more parental supervision — for instance, parents should make sure that kids' accounts are set to provide as little personal information as possible, and that their activity can be seen only by confirmed friends.

What This Means to You

In today's Internet-connected world, many parents lament the loss of face-to-face family time and worry that their kids are spending too much time online. In 2000, researchers at the Center for the Digital Future reported that 11% of respondents said family members under 18 spent too much time online, a figure that jumped to 28% in 2008.

If you're troubled by all the online activity in your house, consider setting ground rules — for instance, limiting screen time (especially on school nights), keeping the computer in a high-traffic area where you can monitor who's doing what, and shutting down the electronics well before bedtime so kids can wind down and you can spend some time just hanging out together and catching up.

It's also wise to become computer-literate, if you're not already. Learn how to block objectionable material, how to recognize an unsafe website, and check out the sites that are most popular with kids and teens. And, hey, have you heard? Social networking is a hit with adults, too — in fact, the number of adult Internet users with a profile on a social networking site has more than quadrupled in the past few years, with 4 out of 5 using social media at least once a month. So if you've joined the online crowd yourself, make sure networking and surfing isn't crowding out the quality time you could be spending with your kids and family.

The Impact of Concussions

Some sports injuries are obvious — a fracture, a torn ligament, a swollen joint. But concussions — one of the most common and most dangerous injuries — can be harder to detect and care for.

In the wake of head injuries among some of the NFL's most high-profile players, concussions and their treatment have become big news. Indeed, responding to criticism over its handling of head injuries in the past, the NFL just announced important changes to how the league will handle concussions, now stating that athletes must immediately be removed from play if they have amnesia, poor balance, and an abnormal neurological examination, whether or not those symptoms quickly pass.

But the NFL came up short regarding symptoms like dizziness and headache, saying players can return to their sport unless the problems are "persistent."

What This Means to You

Because the treatment of concussions relies heavily on symptom reporting by those who incur them rather than more obvious signs, many athletes have been encouraged to "play through" head injuries. This is especially troubling for younger athletes, in whom repeat concussions can be serious. Rules regarding concussion management can vary, if they exist at all, on the high school, college, and amateur levels.

So it's important to prevent concussions from happening in the first place and, if they do, to know the signs and how to make sure a child recovers completely.

To practice prevention, childproof a house with young kids. And all kids should wear appropriate headgear and safety equipment when biking, blading, skateboarding, snowboarding or skiing, and playing contact sports.

A child with a concussion may lose consciousness, but this doesn't occur in every case. Other signs of a concussion include feeling confused and dazed, temporary amnesia, blurred vision, headache, slurred speech, and difficulty concentrating.

The brain needs time to heal after a concussion, so it's very important for kids to wait until all symptoms have ended before returning to normal activities. They shouldn't participate in sports or other physical activities until a doctor says that it's safe. Even kids who plead that they feel fine or are urged by competitive coaches or teammates should not play until a doctor has given the OK.

Pregnancy, STD Rates Increasing Among U.S. Teens

The Centers for Disease Control and Prevention (CDC) reports that, following declines from 1991 to 2005, birth rates among U.S. teens increased in 2006 and 2007.

Researchers also say that improvements in teens' and young adults' sexual and reproductive health have flattened or even worsened. For instance, in 2008 the CDC reported that more than 25% of 14- to 19-year-old girls have one of four sexually transmitted diseases (chlamydia, genital herpes, human papillomavirus [HPV], or trichomoniasis).

And a new study, which followed 386 urban teenage girls, has found that most had sex at a young age (between 13 and 15), and by age 15, 25% had an STD, most often chlamydia. The average time between becoming sexually active and a first STD infection was 2 years, and reinfections were common. The researchers recommend that young women be screened for STDs within a year of becoming sexually active and retested every 3-4 months if they're diagnosed with an STD.

The CDC also found that about a third of teens hadn't received information on birth control before age 18. And in a new study, the American Academy of Pediatrics (AAP) reports that many parents aren't talking to their kids about sexual development until it's "too late" — more than 40% of kids already had sexual intercourse before any discussion with their parents about STDs, condom use, birth control, or what to do if a partner refuses to use a condom. The AAP recommends that parents educate their kids about sex-related topics beginning early in life.

What This Means to You

Before kids make the very adult decision to have sex they need to understand that it can come with very adult consequences, too. Pregnancy is often the biggest concern, and it should be a major worry, considering that nearly 1 million teenage girls in the United States have babies every year.

But getting pregnant isn't the only risk that sexually active teens should worry about. They should understand that they're also at risk for STDs — some of which (like AIDS, HPV, and genital herpes) could stay with them for life.

That's why it's crucial for parents to talk to kids and teens about not only sex, but STDs, ideally before they become sexually active. The best way to have a healthy dialogue with your kids is to establish lines of communication early on. If parents aren't open to talking about sex or other personal subjects when their children are young, kids will be a lot less likely to seek Mom and Dad out when it counts.

Stumped on how to begin? Ask your pediatrician for advice about what to discuss, when, and how. Also, pediatricians can talk about sexual health issues in one-on-one conversations with teens in their office.

Smoking: Good News and Bad News

The U.S. smoking rate has dropped sharply since the mid-1960s, when it was around 40%, to a little over 20%, according to the Centers for Disease Control and Prevention (CDC). That's the good news. The bad news is that the CDC had hoped to see the rate drop to 12% by 2010. And, according to the American Lung Association, each day 6,300 American kids try their first cigarette and nearly 2,000 of them will become daily smokers.

The bad news continued with a government report stating that more teens and young adults are smoking menthol cigarettes. Experts think that menthol masks the harshness of tobacco, thus making it more appealing to young smokers. The U.S. Food and Drug Administration (FDA) is expected to consider banning menthol (the only flavoring not banned under tobacco laws passed in 2009) in 2010.

But it's not just conventional cigarettes and other tobacco products that parents need to watch out for. Gaining traction are electronic cigarettes (or e-cigarettes), marketed as the "healthier alternative" to regular smoking, with many brands offering free trial kits through online promotions that kids can easily access. While the manufacturers promise "no tar, smoke, or tobacco," e-cigarettes do contain cancer-causing chemicals and other toxins, including a compound used in antifreeze, the FDA warns.

Worse, the cartridges — available in kid-preferred flavors like vanilla, chocolate, and mint — contain nicotine, which is converted into a vapor that's inhaled by the user. While they may indeed be "healthier" than regular cigarettes, e-cigarettes are far from safe — their makers admit they're "not suitable for pregnant or breastfeeding women" and even advise potential customers to consult with a doctor before use.

Trendy now, too, is smoking tobacco with a water pipe (also called a hookah or shisha), especially among young adults. Though widely believed to be safer than cigarettes, a study showed that, on average, participants had higher levels of carbon monoxide after smoking using a water pipe versus a cigarette, with about 48 times more smoke inhaled with a water pipe than with a cigarette.

And, of course, all of these methods of smoking delivered nicotine into the body.

What This Means to You

Urge your child to kick the habit by using these safe, reliable tactics:

• using a nicotine gum or a patch (after talking to a doctor first)
• using substitutes such as sugarless gum, hard candy, carrot sticks, mints, toothpicks, or even lollipops
• getting involved in healthier activities: lifting weights, shooting baskets, going for a swim, etc.

And be sure to add e-cigarettes to the list of no-no's whenever you talk to your kids about the dangers of smoking and using tobacco products. If your child is trying to quit, make sure he or she knows that e-cigarettes are not a safe alternative or even a good way to step down from nicotine addiction.

And remember: You're the most important role model of all for your kids. So if you smoke, it's time to quit.

Reviewed by: Steven Dowshen, MD
Date reviewed: December 2009