Pediatric HealthSeptember 2009 Your guide to raiSing healthY children

Protect the wellness of your childrenwith Mayo Clinic Health ManagerLearn more at www.mayoclinic.com

pediatric health

2

CONTENTS 2 BeanAdvocateforChildren

4 TheImportanceofVaccines

5 PrepareforFluSeason

5 Germs:FightBack

6 ChildhoodObesity

8 HealthySchools,HealthyKids

8 TimetoSafeguardTheirVision

10 ProtectingAgainstAmblyopia

10 CarSeatSafety

11 PanelofExperts

PEdIATrICHEAlTH

Publisher: Steven Trifon steven.trifon@mediaplanet.com

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TheAmericanAcademyofPediatricsisanorganizationof60,000primarycarepediatricians,pe-diatricmedicalsubspecialistsandpediatricsurgicalspecialistsdedicatedtothehealth,safetyandwellbeingofinfants,children,adolescentsandyoungadults.(aap.org)

RecognizedthroughoutMarylandandbeyondasavaluableresourceforcriticallyandchronicallyinjuredchildren,theUniversityofMarylandHospitalforChildrencombinesstate-of-the-artmedicinewithfamily-centeredcare.Asacenterofexcellence,weareanationalleaderinchildren’shealthcareresearch.

Microsoft®HealthVault™isafreeprivacy-andsecurity-enhancedonlineservicethatputsyouincontrolofyourhealthinformation.HealthVaultletsyoustorehealthinformationfrommanysourcesinasinglelocation,sothatit’salwaysorganizedandavailabletoyouonline.WithHealthVault,youcanaccessarangeofhealthandfitnesswebtools,uploaddatafromhealthandfitnessdevices,andsharehealthinformationwithyourphysiciansandothersyoutrust.

Pediatriciansareavitalpartof

thatteam.WhentheAmerican

Academy of Pediatrics (AAP)

was founded in 1930, the idea that

children are not “miniature adults”

wasbrandnew.Todayweknowthat

childrenhaveuniquedevelopmental

and health needs. At www.aap.org,

you’ll find a wealth of information

about child health, whether you’re

lookingfortreatmentguidelinesfora

specificillness,howtopreventchild-

hoodobesity,oradviceonmonitor-

ing your child’s media use. If you’re

looking for a pediatrician, you can

findoneatwww.aap.org/referral.

Advocateforyourchildrenbytak-

ingstepstoensuretheygetthebest

startinlife:

• Makesuretheygettheirvaccina-

tions on time. Immunizations are

themostimportantthingparents

can do to protect their children

fromdisease.

• Helpthemeatahealthydiet.Limit

sugarydrinksandencouragechil-

dren toeat fruits,vegetablesand

wholegrains.

• Encourageexercise.Childrenneed

atleastanhourofphysicalactivity

daily. Limit “screen time” to two

hoursorless.

• Keep them safe. Have iron-clad

rules forseatbeltsandcarsafety

seatsinvehiclesandhelmetswhen

bike-riding.Removeallgunsfrom

thehome.

• If you smoke, quit. Second-hand

smoke increases children’s risk of

asthma,respiratoryinfectionsand

otherserioushealthproblems.

• Worried about your child’s be-

havior or development? Your

pediatrician can determine if the

behaviorisnormalandhelpguide

yourresponse.Ifyourchildneeds

additionalhelp,earlyintervention

givesthebestchanceofsuccess.

This is a pivotal moment as the

nationworkstowardcomprehensive

healthcarereformforallAmericans.It

isasadfactthatintheU.S.,12million

childrenunderage22lackanykindof

healthinsurance.

But progress is being made. The

newly expanded Children’s Health

InsuranceProgram(CHIP)extendsa

safety net to hard-working families

who don’t have health insurance

throughtheirjobs,orwhocan’tafford

the insurance that is offered.To see

if your kids qualify for CHIP in your

state, call 1-877-KIDS-NOW or visit

www.insurekidsnow.gov.

CHIP is just a first step. The AAP,

withits60,000memberpediatricians,

wantsall children tohaveaccess to

affordable, high-quality health care

provided through a medical home.

We must all advocate for children’s

accesstohealthcare.Visitwww.usa.

gov/Contact/Elected.shtml to learn

howtocontactyourrepresentatives

inCongress.

Weallwantthebestforourchildren.

It’suptoustobetheiradvocates.

Childrenneedadvocates.Ifyouhavechildreninyourlife,youunderstandhowmuchtheyneedateamofcaringadults—parents,familymembers,teachers,medicalprofessionals—toadvocatefortheirhealthandwell-being.

Be an Advocate for Children

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DavidT.Tayloe,Jr,MD,FAAPAAPPresident

Thecontentinthisspecialadvertisingsectionwasnotdevelopedbythe

AmericanAcademyofPediatrics.TheAmericanAcademyofPediatricsdoes

notendorseanyoftheadvertisersappearingwithinthisspecial

advertisingsectionorthecompaniesmentionedintheadvertorialsections.

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Helping you do what you do best:protect the wellness of your children

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pediatric health

4

Today, children are vaccinated

against15infectiousdiseases

bythetimethey’re6yearsold.

Atage11or12,anotherroundofvac-

cinesisrecommended:themeningo-

coccalvaccinethatprotectsagainst

bacterial meningitis; a pertussis

boostertopreventwhoopingcough,

which causes persistent coughing

and can be life-threatening to un-

immunized infants; and for young

women, the HPV vaccine, which

protects against the most common

strainsofcancer-causinghumanpap-

illomavirus.

While medical experts say data

showingthebenefitsofvaccination

are overwhelming, in some com-

munities,misinformationaboutvac-

cinesafetyhasconvincedparentsto

postponeorforegoimmunizationfor

theirchildren.That,saysDr.Bocchini,

putschildrenatrisk.

Hecitestheexampleofmeasles,a

highly contagious, sometimes fatal

disease that causes high fever and

rash and can lead to complications

suchasencephalitis.Thoughwiped

out in the U.S., measles has been

importedhere,causingoutbreaks.In

2008,theCentersforDiseaseControl

andPrevention(CDC)reportedmore

than130cases,thehighestnumber

since 1996. Most of those who got

sickwereschool-agechildrenwhose

parentshadchosennottohavethem

vaccinated.

Such incidents underscore the

importanceoffollowingthevaccine

schedulerecommendedbytheCDC

andtheAmericanAcademyofPedi-

atrics (AAP), says Dr. Bocchini, who

chairstheAAP’sCommitteeonInfec-

tiousDiseases.

Popularalternativevaccinesched-

ules devised by individual doctors

andpromotedinon-linechatrooms

areuntestedandmaybeunsafe,he

says. “Any delay in vaccination pro-

longs the time when a child is sus-

ceptible,”hesays.“Theschedulethat

hasbeenrecommendedisbasedon

scientificdataandstudiesthathave

beenperformedtolookathowsafe

andeffectivethesevaccinesarewhen

givenincombination.”

Dr.NealHalsey,aprofessorofpe-

diatricsatJohnsHopkinsBloomberg

SchoolofPublicHealth,saysthedan-

gerofgamblingonanuntestedvac-

cinescheduleisthatparents“haveno

waytoprojectwhatcouldhappenif

theirchildisnotvaccinated.”

Whentheystrike,vaccine-prevent-

able diseases can range in severity

from mild all the way to deadly, he

says, and at the outset, there’s no

way to predict the outcome. “One

canlookat10childrenandcan’ttell

which twowillbehospitalizedwith

measlesorsevererotavirus,”hesays.

“We need to do a better job of

monitoring the false information”

that is scaring parents, Dr. Halsey

says, and “we need better ways of

providinginformationtoparentsso

theyunderstandthatvaccinesneed

tobetakenseriously.”

The Importance of VaccinesOld-timediseasessuchaspolio,whoopingcoughandtetanusmayseemlikeworriesofthepast,butwithoutwidespreaduseofvaccinestopreventthem,they could come roaring back, says Dr. Joseph Bocchini Jr., chairman of theDepartmentofPediatricsatLouisianaStateUniversityHealthSciencesCenteratShreveport.

When they strike, vaccine-

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nization histories and keep track of

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each child when needed for school

enrollment,daycare,sportsorcamp.

“Ithelpsparentspreparefortheir

children’spediatricianappointments,

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standingofwhattoexpect,”saysDr.

KarenYtterberg,apediatricianatMayo

Clinic in Rochester, Minn. Ytterberg

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5

pediatric health

Shortofplacingyourchildina

bubble,what’saparenttodo?

The American Academy of

Pediatrics(AAP)andCentersforDis-

ease Control and Prevention (CDC)

sayafewsimplestepsmayhelpslow

thespreadofgerms.Frequenthand

washing, or use of alcohol wipes or

gels,istopsonthelist.TheCDCsays

virusescanliveonsurfacesliketables

anddoorknobsforuptotwohours,

making it important to wash hands

throughouttheday.

Othertips:coughandsneezeinto

anelbow,notyourhand;avoidshar-

ingcups,eatingutensils,washcloths

or other items with anyone who

is sick; wash dishes and utensils in

hot, soapy water; and don’t smoke

aroundachild, inthecaroraround

thehouse.

Still, kids will catch colds. When

they do, over-the-counter cold and

cough medications don’t work in

veryyoungchildren,andmayinfact

bedangerous,sopediatriciansno

longerrecommendthem,espe-

cially for children younger than

2years.Torelievesymptoms,the

AAPadvises:

• Forstuffynoses:Useafewdrops

ofsaltwaternosedrops,available

inpharmacies,followedbygentle

bulbsuction.Acool-misthumidi-

fierorvaporizerinthechild’sroom

can add moisture to the air and

helpclearstuffynasalpassages.Be

suretocleanthehumidifieroften.

• For cough: Half a teaspoon of

honeyforchildren2-5years;1tea-

spoonforchildren6-11years,and

2teaspoonsforthose12andolder

isrecommended.Childrenunder1

yearofageshouldnothavehoney.

• Forfever:Giveacetaminophento

ababyage6monthsoryounger;

either acetaminophen or ibupro-

fenifolderthan6months.

Germs: Fight BackAnyparentwhosechildisindaycare,pre-schoolorgroupclassescantellyouthespeedandefficiencyofgermsthatjumpfromonechildtoanotherisanawesomething.

The pandemic flu vaccine is

expected to be available in

October or by mid-Novem-

ber, experts say. If the virus spreads

quickly,immunizationdaysinschools

orotherpublicareasmaybesetup

to allow quick vaccination of large

numbers of children and to avoid

overwhelming private clinics or

health care providers. “A big con-

cern now is the potential impact of

swinefluonpediatricpatients,”espe-

cially thosewhohaveasthma,heart

disease or compromised immune

systems, says Dr. Geoffrey Rosen-

thal, Director of the Pediatric Heart

Program, University of Maryland

HospitalforChildren.

Butbeforethathappens,children

andtheirfamilieswillbeofferedthe

vaccine to protect them from the

regular seasonal flu that circulates

everyyear.

Seasonalflu, thekind thatarrives

everyfallandwinterintheU.S.,poses

a “very substantial threat,” says Dr.

NormanEdelman,chiefmedicaloffi-

ceroftheAmericanLungAssociation.

Each year, 200,000 children and

adults are hospitalized and 36,000

die of flu. The Centers for Disease

ControlandPreventionthisyearrec-

ommendsthatallchildren6months

through19yearsofagereceivethe

fluvaccine,whichisavailablenow.

“It’sgoodprotectionforkidsand

itturnsouttobeagoodwaytoblock

transmission” of the virus to others,

Dr. Edelman says. “When influenza

comesintoatownorneighborhood,

it’susuallypassedaroundbykids.”

This year, there may be a lot of

attention on pandemic flu, which,

unlike seasonal flu, appears to hit

young people hardest, he says, but

“itisasimportantaseverforpeople

to be vaccinated against seasonal

influenza.”

Prepare For Flu Season This fall babies and children will be at the frontof the line when new vaccines to prevent thepandemic strain of flu, known as novel H1N1 or“swineflu,”becomeavailable.

pediatric health

6

At SUBWAY® restaurants, we’re helping kids eat better by offering lower-fat meals. Take our word for it. SubwayKids.com.

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restaurants, we’re helping kids eat better by offering lower-fat meals.

Heavy children often suffer

sociallyandareatrisk fora

lifetime of obesity and the

medicalconditions thataccompany

it, including asthma, diabetes and

heartdisease.TheCentersforDisease

Control and Prevention, which con-

veneditsfirstnationalconferenceon

obesitypreventionandcontrolinlate

July,offersadvicetoparentsonhow

toencouragehealthiereating:

• Offeravarietyofvegetables,fruits

andwholegrains.

• Makeyourfamily’s favoritemeals

healthier by choosing leaner

meats and fish, low-fat dairy and

morevegetables.

• Dishupreasonableportions;more

isnotalwaysbetter.

• Limitsugarydrinksandsnacks.

• Helpkidsstayactive.Childrenand

teensneedatleastanhouraday

ofmoderatelyintenseactivity,and

theylearnfromadults,soparents

needtostayactive,too.

• Turnofftheelectronics.TheAmeri-

canAcademyofPediatricsadvises

nomorethantwohoursperdayof

TV,videogamesorcomputertime

for children, and none at all for

thoseage2oryounger.

Federalandstatetaxesonsugary

drinks, such as sodas, sports drinks

andfruitpunchesarebeingdebated

asawaytoraisefundsforgovernment

whiletrimmingthenationalwaistline.

The Robert Wood Johnson Foun-

dation, which supports research

into obesity prevention, concluded

a researchbriefon thisproposalby

notingsuchtaxescouldbe“apotent

policytool forcurbingobesityrates

by leading people to reduce con-

sumption.’’Theresearcherssaida10

percentincreaseincostcouldcause

adeclineof8percentto11percent

in consumption of the drinks. The

beverage industry says a tax on its

products would burden businesses

andfamiliesandwouldnotaddress

theneed forchildrentohavenutri-

tioneducation.

Childhood Obesity: a call to actionBy now, we’ve all heard the dire statistics: A stag-gering25millionchildrenandteens,nearlyoneinthree,areoverweightorobese.

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58 percent fewer beverage calories in schools. America’s beverage companies committed to cut calories in schools over three years — and we’re already delivering. After two years of implementing the national School Beverage Guidelines, we’ve made significant progress on capping calories, reducing portion sizes and offering a range of nutritious beverage options. And we’re completely removing full-calorie soft drinks by the 2009-2010 school year. It’s all part of a broader effort to teach students the importance of a balanced diet and exercise.

For a progress report on the Guidelines, visit schoolbeverages.com.

The School Beverage Guidelinesoffer balance:

Bottled water

Low-fat and non-fat milk

100% juice with no added sweeteners

Diet sodas, low-calorie teas and reduced-portion sports drinks in high schools only

No full-calorie soft drinks in any schools

schoolbeverages.com

The School Beverage Guidelines were developed with the Alliance for a Healthier Generation, a joint initiative of the American Heart Association and the William J. Clinton Foundation.

pediatric health

8

Insomeschools,healthyhabitsare

apriority.Lastmonth,theAlliance

for a Healthier Generation hon-

ored114schoolsthroughouttheUSA

forexemplaryeffortstopromotebet-

tereatingandmoreactivityamong

theirstudents.

There’satightlinkbetweenhealth

and education, said President Bill

Clinton, who spoke at the alliance’s

Healthy Schools Program Forum.

“Healthystudentsaremorelikelyto

attend class, concentrate on their

schoolwork,andperformbetteraca-

demically,”hesaid.Thealliance isa

jointprojectoftheWilliamJ.Clinton

FoundationandtheAmericanHeart

Association.

Amongschoolscited:

• TheCesarChavezMiddleSchoolin

Lynwood,Calif.,adjusteditsschool

menutoassureallfoodsofferedare

freeoftrans-fats,andnonecontain

more than 30% of calories from

fat.Theschoolinstalledasaladbar

andofferslotsoffreshfruits,too.

• West New York Public School #5,

an elementary school in West

NewYork,N.J.,hasstartedawell-

ness program that meets before

school three mornings a week.

Studentslearnabouttheconnec-

tion between nutrition, activity

and academic achievement; the

components of a fitness regimen

andhowtoreadnutritionlabels.

• NorthFortMyersHighSchool,Fort

Myers,Fla.,startedamobilebreak-

fastprogramthatdelivershealth-

ful breakfast offerings directly to

students as they arrive—hungry

—atschoolinthemorning.

There is no single solution to the

childhoodobesityepidemic,saidDr.

ClydeW.Yancy,ofBaylorHeartand

VascularInstituteatBaylorUniversity

Medical Center in Dallas, who also

spoke at the forum. By promoting

innovativeschool-widechanges,he

said, the Healthy Schools Program

canhelp“maketomorrow’sgenera-

tionhealthier.’’

Healthy Schools,Healthy KidsJustasschoolsplayamajorpartinachild’ssocialandintellectual development, they also are key to de-velopingthehabitsthatleadtobetterphysicalhealth.I was an executive with a

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Sports are fun and good for

growing bodies, but parents

andcoachesshouldmakesure

kidshaveandweartherightgearto

protecttheirvision.

Eyeinjuries,mostofthemrelated

to sports, are the leading cause of

blindness in childhood, says the

National Eye Institute. Baseball, ice

hockey and racquet sports account

formostoftheinjuries.

About 90 percent of the more

than 100,000 sports-related eye in-

juriesthatoccureachyearcouldbe

avoided,saysNEI.

That’swhytheAmericanAcademy

ofPediatricsandotherhealthorgani-

zationsadviseyoungathletestowear

eyeprotection.Thetype“dependson

thesport,”saysDr.GreggT.Lueder,

chairoftheAAPSectiononOphthal-

mology. “For sports like paintball,

racquetball or handball, adults and

children should wear eye goggles,”

he says, while for other sports, pro-

tective gear such as facemasks and

batting helmets with face guards

makemoresense.

Protective polycarbonate glasses,

which can be made with prescrip-

tionorplainlenses,looklikeregular

glasses but are shatterproof. They

shouldberequiredforathleteswho

havevisionlossinoneeye,saysAAP.

“Ifachildhasaneyeproblem,where

one eye doesn’t see well and the

other does, they can have few limi-

tations and live a normal life,” says

Dr.Lueder,aprofessorofpediatrics

and ophthalmology at Washington

University inSt.Louis. “But if some-

thing were to happen to the good

eye, there would be deep trouble,

sothosechildrenshouldwearsafety

glassesatalltimeswhenengagedin

sportsactivities.”

Time to Safeguard Their VisionAutumnmeansthesoundofyoungathletesprac-ticingandcompetingoncourts,playgroundsandballfields.

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pediatric health

10

REAR-FACING SEATS in the back seat frombirth to a minimum of 1 year old and 20pounds. It is safest to keep your baby rear-facing as long as possible up to the upper

weightlimitofyourrear-facingconvertibleseat,whichwillbe around 30-35 pounds. Note: A new study found thatchildren younger than 2 are 75 percent less likely to dieorsustainseriousinjurywhenplacedinarear-facingseat,regardlessofthedirectionofthecrash.

Intoday’shighlymobilesociety,childrentravelmorethanever.Sadly,thismobilitycomesatastaggeringprice—motorvehiclecrashesaretheNo.1killerofchildrenintheU.S.But,researchshowsthatmanyofthesedeathscouldhavebeenprevented.Seatbeltsandsafetyseats,whenproperlyused,arethemosteffectivetoolstopreventdeathsandinjuryinvehiclecrashes.

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SAFETY BELTS at age 8 and older ortallerthan4’9”.Thebackseatisthesafestplaceforallkidsunder13.

That starts on the ride home

from the hospital, with baby

securedinachildsafetyseat.

“Purchasingacarseat,andlearning

howtocorrectly install it,shouldbe

atoppriorityforexpectantparents,”

saidAAAPresidentandCEORobert

L. Darbelnet.“Motor vehicle crashes

are a leading cause of death and

injuryforchildren,andparentsneed

tounderstandthattherightcarseat,

fastenedcorrectly,isthebestwayto

keeptheirchildrensafe.”

There are many models of car

seats.Chooseonethatfitsthechild,

the vehicle and your budget, he

advises, and make sure it’s properly

installed and used according to the

manufacturer’s directions. Children

uptoat leastage8andaheightof

4’9’’shouldbestrappedintoacarseat

orboostereverytimetheyrideinthe

car,Darbelnetsays.

Car Seat SafetyNewparentswanttodoeverythingtheypossiblycantokeeptheirpreciousnewfamilymembersafeateverymoment.

FORWARD-FACING TODDLER SEATS in the back seatfromaminimumofage1and20poundstoaboutage4and40pounds.Itissafesttokeepyourchildinafive-pointharness as long as possible to the upper weight limit oftheseat.

BOOSTER SEATSinthebackseatfromaboutage4toatleastage8,unlessyourchildis4’9”tall.

Conditionssuchasamblyopia,

whichcauses reducedvision

in one eye, can be treated if

caught early, but in the past, most

tools for assessing vision were con-

tingent on the patient cooperating

and possessing certain cognitive

skills. How could an infant read an

eyechart?

“Amblyopia is the most common

causeofdecreasedvisioninchildren

intheU.S.Mostcommonly,itdevel-

opsoverthefirstyearorso,”explains

SeanP.Donahue,M.D.,Ph.D.,profes-

sorandchiefofPediatricOphthalmol-

ogyatVanderbiltChildren’sHospital

and Vanderbilt University Medical

Center. “There’s been an emphasis

on identifying new instrumentation

to allow us to diagnose it earlier so

wecantreatitearlier,”hesays.

Developments such as photo-

screeners, autorefractors and the

Enfant Pediatric VEP Vision Testing

System,whichmeasures thebrain’s

reaction to external stimuli, allow

medical professionals to evaluate

optichealthinpre-verbalchildren,as

nopatientresponseisrequired.

The Enfant has a 97 percent sen-

sitivity in detecting visual deficits

in children as young as 6 months,

features child-friendly graphics and

can be completed in five to seven

minutes. It’s different from other

technologies, “because instead of

lookingatthestructureoftheeyeor

measuringifthereisarefractiveerror,

itlooksatfunction,”saysDonahue.

Amblyopia affects three of every

100children.Theearlierit’sdetected,

the better the chance for success-

ful treatment. AAP advises regular

vision screening of newborns and

preschoolers for risk factors as part

of routine pediatric check-ups. Al-

though many states mandate hear-

ingtestsforinfants,fewrequireoptic

testing, even though more children

are born with visual than auditory

deficits.

Talkwithyourdoctoraboutmak-

ing routine eye exams part of your

child’swellnessplan—earlydiagno-

siscouldbethedifferencebetweena

curableailmentandalifelongvision

deficiency.

Protecting Against Amblyopia: BY:JACqUELINEMCDERMOTT

AccordingtotheAmericanAcademyofPediatrics (AAP),only21percentofpreschoolers are screened for vision problems, and just 14 percent receivecomprehensive exams—an unfortunate trend, as vision disorders are thefourthmostcommondisabilityamongU.S.children.

INSTALLTHESAFETYSEATCORRECTLYApproximately8out10carseatsarenotinstalledprop-erly.Itisimportanttoreadboththevehicleandcarseatmanuals carefully. There are certified child safety seattechnicians who can help you. For additional informa-tion, dial 1-866-SEAT-CHECK, contact your local AAAclub,orvisitAAA.com/SafeSeats4Kids.

Staying on top of the family’s medical

needs—remembering medications, appoint-

ments and which child is due for which vac-

cine—canbeadauntingtaskforanyparent.A

new online tool, Mayo Clinic Health Manager,

canhelpparentstoorganizerecordsforevery

member of the family. It’s free and available

to anyone, not just Mayo Clinic’s patients.

LaunchedinApril,theserviceispoweredbyMi-

crosoftHealthVaultandprovidespersonalized

guidancebasedontheinformationusersenter.

“It’sapersonalhealthrecordforthepatient,”

says Dr. Ytterberg, and it also offers tips and

advicefromMayoexpertsonhealthtopicsand

children’sphysicalandemotionaldevelopment

at different ages.“You can put in information

abouteachchildandreceiveremindersabout

whentodothenextcheckuporwhatimmuni-

zationsaredue,”shesays,soparentscanarrive

atthedoctor’sofficeknowingwhattoexpect.

Havingfamilyhealthinformationstoredon-

linehasadvantagesoverwrittenrecords,which

canbemisplaced.Ifthefamilymoves,changes

doctorsorifsomeonegetssickonvacation“you

havetheinformationrightatyourfingertips,”

shesays.

Most families respectandtrust theirchild’s

primaryhealthcareproviderandarenoteager

totaketheirchildtosomeoneelseforcare.While

thereisnodoubtyourchild’sprimaryphysician

is experienced and knowledgeable, there are

sometimeswhenapediatricspecialistmaybe

needed.Pediatricspecialistshavebeentrained

tohandlethecritical,difficult,unusual,orrare

presentationsofchildhoodillness.Primarycare

providersincludepediatricspecialistsonyour

child’scareteamwhentheyfeelthatthereferral

wouldbenefityourchild.

Pediatricspecialistsbelievethatchildrenare

notjustminiatureadults,andonesizedoesNOT

fitallwhenitcomestohealthcare.Theapproach

todiagnosingandtreatingapediatricpatient

canbeverydifferentfromtheapproachused

foradults.Physicalandemotionalgrowthand

developmentmustbeconsidered.Forexample,

thebodiesofchildrenandadultsoftenhandle

medicationsdifferently,sospecialexpertisemay

beneededtoarriveataproperdoseinchildren.

Sowhenyourchildisreferredtoapediatric

specialist,youshould feelconfidentthatyour

child’s primary care provider and the special-

istwillworktogethertoreachthebesthealth

outcomesforyourbelovedchild.

The American Lung Association’s Faces of

Influenzacampaign,www.facesofinfluenza.org,

whichusuallystartsinNovember,haskickedoff

earlythisyear.Inanannualfluseasonexpected

to be complicated by the presence of a pan-

demicstrain,H1N1or“swineflu,”thecampaign’s

goalofpromotingvaccinationagainstseasonal

flu is more important than ever, Dr. Edelman

says.Theimpactofthenewstrainisuncertain,

but“weknowseasonalfluisathreat,”hesays.

The Faces campaign, which profiles those af-

fectedbyflu,can“makecleartoeverybodythat

ordinarypeoplejustlikethemselvesandtheir

lovedonesareat risk,notonly fromcatching

the flu, but from severe complications of the

flu,”hesays.Eachyear,250millionpeopleare

recommended for vaccination by the Centers

forDiseaseControlandPrevention,Dr.Edelman

says,butfarfewertakethevaccine.Asthmatic

childrenarefivetimesmorelikelythanhealthy

childrentobehospitalizedwithflu-relatedill-

ness,butastaggering70percentofasthmatic

children go unimmunized. Reasons parents

mayskipfluvaccination“mayrangefromnot

wantingtobother,becausetheydon’tthinkit’s

seriousinkids—whichiswrong—tonotwant-

ingtheirkidstohavemomentarypainfroma

shot,”Dr.Edelmansays.Aflushot“won’thurt

morethanamosquitobite,”andis important,

“forindividualhealthaswellasthehealthofthe

familyandofthecommunity.”

Not so long ago, a child diagnosed with

cancer was unlikely to survive very long.

“Pre-1970, virtually every child with cancer

died,”Dr.Buchanansays.Now,theoverallcure

rateis80percent.Improvementsintreatment,

includingcombinationdrugtherapiesandthe

developmentoflesstoxicformsofchemother-

apy,havechangedtheoutlookforbothpedi-

atricandadultpatients.“Thewholeconceptof

givingchemotherapydrugsmorethanone-at-

a-timestartedwithpediatrics,”hesays.“Pedi-

atriccancercarehasaccelerateddiscoveriesin

adultcancers.”

Cooperativeresearchacrossmultiplegroups

and institutions has been important. “Cancer

inchildrenisrareenoughthatanyonecenter

isn’tgoingtohavealargeanddiverseenough

populationtodostudies,”hesays.

Now,manyhospitalshavevibrantsurvivors’

clinicstomonitorchildrenwhohaverecovered

from cancer for long-term effects of chemo-

therapyorradiation,whichcandamageorgans

andleavescars,bothphysicalandpsychologi-

cal.“OurprograminDallasisoneofthefewin

thecountrytohaveanadultcancersurvivors’

clinic,”forpeoplewhohadcanceraschildren

andhavelivedwellintoadulthood.

Still,despitebreakthroughs,cancerremains

theleadingcausedeathduetoillnessinchildren.

“There’sstillalotofworktobedone,”hesays.

Panel of Experts

KARENYTTERBERG,MDAssistantProfessorofPediatrics,MayoClinic

GEOFFREYL.ROSENTHAL,MDDirectorofthePediatricandCongenitalHeartProgram,UniversityofMarylandHospitalforChildren

NORMANHEDELMAN,MDChiefMedicalOfficer,AmericanLungAssociation

GEORGEBUCHANAN,MDMedicalDirectoroftheCenterforCancerandBloodDisordersatChildren’sMedicalCenterinDallas

Protect Your Most Precious Cargo

For more information about car seat safety, visit your local AAA club or AAA.com/carseat.

AAA says use car seats every trip, every time.

This advertisement is distributed as part of the American Lung Association’s Faces of Influenza educational initiative. For more information, please visit www.facesofinfluenza.org.

Are you a Face of Influenza?(More than 4 out of 5 people reading this are — get immunized.)

Influenza is not the common cold. It’s serious. There are many “faces” of influenza.

In fact, annual influenza vaccination is recommended for more than 4 out of every 5 people.

Influenza vaccine is safe and effective and annual vaccination is the best way for people to protect themselves andtheir loved ones against influenza and its complications. Vaccination typically begins in October and can continuethrough March. In most seasons, influenza virus activity peaks in February or March, so vaccination throughoutthe entire influenza season is beneficial and recommended.

To learn more about the American Lung Association Faces of Influenza program, visit our Web site www.facesofinfluenza.org.

Olympic Gold Medalist and mother of two young children, Kristi Yamaguchiwants to do everything she can to protect her children, but as a wife anddaughter, she also knows that influenzaimmunization is a must for everyone in her family.

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