Buy safe toys this holiday season

With the holidays approaching, it’s so easy to buy that special child in your life the coolest toy you can find. Like a 280-piece dump truck model kit you know your 3-year-old nephew will just love. But if you don’t check the toy’s intended age range, one or all of those 280 pieces might end up in his mouth instead, and put him at risk of injury or even death.

I might have bought that dump truck when my wife and I went shopping for our nephew this weekend, had it not been for a toy safety demonstration I recently sat in on here at Children’s.

Jesus Alderete, a coordinator with our Injury Prevention Program, recently shared with media how to keep the holidays accident-free by choosing safe and age-appropriate toys for youngsters. He said if a toy or its parts can fit through a toilet paper roll, it poses a choking risk for kids 4 and younger. Other tips included:

Check the toy’s intended age range listed on the packaging, and follow the manufacturer’s guidelines.

• Keep toys meant for older kids away from infants and younger kids.


• Buy dolls or stuffed animals with eyes that are sewn on, rather than plastic. Plastic eyes tend to fall off and are a choking hazard for younger children.


• For older kids, be sure to buy a helmet that they can wear with their new bike or other riding toys.

The information is a great reminder considering that since 2000, an average of 20 children a year have died in the U.S. after being injured or involved in accidents with toys, according to Safe Kids USA, a non-profit organization that works to prevent unintentional childhood injuries.

Thanks to Jesus’s guidance, my nephew won’t be getting that dump truck model for a few years. Instead, we went with an age-appropriate sea turtle night light.

You can read more about toy safety and the recommendations of our Injury Prevention Program here.

Bringing Home Allie Was Too Much for Momo

Editor’s note: This week is American Veterinary Medical Association’s National Dog Bite Prevention Week. Children’s is also focusing this month on injury prevention. To highlight both efforts, Melanie Medina weighs in with her family’s experience with dog bites, and shares tips from the veterinary behavioral therapist she worked with to treat her dog’s aggression.
The instant it happened, I knew we had to get rid of him. I loved this dog more than life itself. He was like my child — until I had a child and he tried to bite her.
That’s when it hit me: Momo is a dog. He is going to do what his DNA tells him to do, no matter how much I loved him and how much I tried to change him.
Growing aggression
It happened more than three years ago, but it still hurts to think about the day we surrendered Momo, our pug. My daughter was only about 10 days old. I had laid my daughter on the couch and was standing over her, about to swaddle her into a little burrito. Momo was standing there, right under my feet, with his eyes on Allie.


Momo lunged under my arm, up onto the couch and tried to bite Allie. He had the toe seam of her pajama pants in his mouth.
I screamed for my husband. We unsnapped my daughter’s pajamas and realized she was OK. If he had reached just a millimeter or two further, I’m confident he would have taken off her toe, or maybe her foot. Within 30 minutes, we were on the phone with DFW Pug Rescue, talking to the manager about surrendering Momo. My husband had the horrible task of driving Momo up to a vet’s office, where he left him for a Pug Rescue representative to pick him up.
Behavior therapy for dogs
But we had to do it. We’d had Momo for seven years, and his aggression slowly built up until it was out of control. A year before our daughter was born, we hired a behavioral therapist who specializes in aggression in dogs. Her opinion was that in most cases, a family’s new baby and old baby (the dog) can develop a loving relationship right from the start — unless the dog has serious pre-existing issues.
We hired her to help us sort out Momo’s issues, and his aggression definitely improved. But bringing a new baby into the home was too much for him. (The therapist we hired, Lecreca Taliaferro, DVM, has guidance on how your family can get your human baby and canine baby to bond.)
Pug wins graham cracker
Fast forward three years later. With Momo living happily ever after (I hope) in a new family’s home, I thought we were past worrying about dog bites.

But just a few weeks ago, Allie, who, thankfully, has both of her feet, was munching on a graham cracker. Our other pug, Spanky Mae, swiped it out of Allie’s hand. Allie swiped it back, but Spanky Mae wasn’t having it. Spanky jumped toward Allie to get it back, and in the process, bit Allie’s face. Spanky’s teeth barely grazed Allie’s skin, but it scared us, especially Allie.
My husband and I considered calling DFW Pug Rescue again but decided to keep Spanky Mae. After all, she didn’t have a history of biting or being the least bit aggressive. She just wanted that darn graham cracker.
Instead, we used the experience as a teaching moment for Allie. We told her, “When you’re fighting with a dog over food, the dog always wins. Mommy and Daddy can always get you another graham cracker.”
Nationally and locally dog bites on the rise
If my personal story hasn’t left an impression, maybe some statistics will. Here at Children’s, our Trauma department has seen a rise in patients being treated for dog bites. In 2001, we saw 15 kids for dog bites. By December 2010, that number rose to 36.
Our statistics mirror national ones. Since 2008, the number of Americans hospitalized for dog bites increased from 5,100 in 1993 to 9,500 in 2008, according to a government study. Children younger than 5 and adults older than 65 are most likely to be hospitalized for dog bites, to the tune of $18,200 on average for treatment.
Thankfully, my family didn’t fall into those statistics.
Shopping for cats?
DFW Pug Rescue later told us that Momo was adopted by a family who also owned a boxer. Momo tried to be aggressive in his new family’s home, but the boxer, who probably had a good 30 pounds on Momo, asserted his dominance. I think that’s what Momo needed.
And today, Allie insists that she wants a kitty cat, not a puppy dog. We’ll see about that.

Marathons may be for kids, too

It sounds crazy, but children may be able to run marathons as early on as first or second grade.

Several weeks ago, The New York Times ran this blog on their website. The author, Gretchen Reynolds, reported on two different studies: one about running injuries in children and the other about how early children can run the hallowed 26.2 miles involved in marathons.

The first study indicated that as many as 12 million children ran for exercise in 2007 and that the number is increasing. Along with the increase in child runners, though, there has been an increase of running injuries in children. But those injuries aren’t typical overuse injuries like stress fractures or tendonitis. Instead, the commonly reported injuries seemed to be caused by a lack of coordination and falling, things like twisted ankles, scraped wrists and bruised knees.

The second study analyzed data on the 310 children between the ages of 7 and 17 who ran and finished the Twin Cities Marathon in Minnesota between 1982 and 2007. What it revealed was that only 4 of the 310 (a whopping 1.3 percent) ever visited the race’s medical tent and that none of them required anything beyond a brief test. The author of the study concluded that running long distances like marathons isn’t inherently unsafe for certain children as long as they have proper supervision and training.

That sounded a little wacky to me. I was always told that children aren’t supposed to lift weights before puberty (although thoughts on that have changed in the past several years, too). I assumed the same principal applied to distance running.

Moreover, my vet told me not to run my golden retriever before she was 18 months old. I figured human bones would be much more sensitive and fragile than dog bones.

So, in my confusion, I sent an email with those thoughts to the pediatric sports medicine expert at Children’s, Dr. Shane Miller. This was his response:

Foster,
The reason your vet recommends not running with a golden retriever at that age is because as a breed goldens are at increased risk for hip dysplasia. The theory is that around 18-24 months of age, the growth plates in the dog's hips are closing and are at less risk of damage (which is why they can do X rays at 2 years of age to eval for hip dysplasia). A golden retriever is very obedient and will continue to run through pain to keep up with its master, but will limit itself if playing with other dogs. Growth plates in kids close in the teens (boys usually later by about 2 years than girls).
The answer really should be individualized to the athlete. For example, it is generally accepted that an 8-10 year old could do a 5k race, but I ran my first 10k (6.2 miles) race at age 6 without any difficulty. It really should be more dependent on the athlete, their maturity, etc. This also assumes a gradual increase in training intensity and duration. A rule of thumb is one should not increase by more than 10% per week.
As with all kids that age, we have to be cautious with heat illness and dehydration as their surface area to volume ratio is less than adults, and they are not as good at thermoregulation. Falls, sprains, strains, overuse injuries, heat illness, and dehydration are all potential injuries in running at all ages.
Running can be safe for kids when supervised and the emphasis is on having fun. Just like with your golden retriever, allowing the kid to set the pace will give them the best chance of staying free of injuries and should not cause any long-term damage to growth plates or otherwise.
One recommendation for younger kids that want to do a "marathon" is to have them complete 26.2 miles over multiple sessions. At the end, they can have the pride of saying they completed a "marathon" with the added benefits of learning the importance of physical fitness. One example is marathonKids (www.marathonkids.org).

A Real-life Ralphie

If you have ever seen “A Christmas Story,” you know the line “You’ll shoot your eye out.” Nearly every authority figure in the movie says it over and over again to the main character, a fourth-grade boy named Ralphie who wants a BB gun for Christmas. Ralphie ends up getting his wish and actually does shoot himself in the eye when a BB ricochets off of a metal target.

Since the movie is a comedy, it would be easy to dismiss the incident as contrived. But 9-year-old Lane Foreman of Eustace, Texas, knows better.

“I know it really happens,” he said. “Because it nearly happened to me.”

Lane was playing with a BB gun over the holidays when one of his shots ricocheted off of a tree stump and hit him in the right eye. His family rushed him to a nearby emergency room, but his injury looked so bad that the staff decided he needed to be seen by pediatric trauma specialists. So, they referred him to Children’s.

“I thought he was going to lose his eye,” Lane’s mother, Tammy Foreman, said. “I thought he was going to be blind.”

Treat BB guns like ‘real’ gunsStories like Lane’s fortunately don't happen every day at Children’s. In 2010, there were 15 patients admitted to our Trauma service for gun-related incidents. Out of those 15, six involved BB guns.

However, Claudia Romo, the program manager for Injury Prevention at Children’s, still thinks parents should be especially cautious with allowing their children to use BB guns.

“All BB guns aren’t the same,” Romo said. “Some are more powerful than others. And young children lack the developmental and coordination skills to assess danger and handle some of these powerful guns.”

Romo said that she advises parents not to buy BB guns for children younger than 14 but also understands that some parents will anyway.

"If parents are still going to buy them, then they should make sure their children wear protective gear like goggles and a vest,” she said. “They should also store the BB guns in gun safes or lockboxes if they have children of different age ranges. Treat them like real guns.”

No permanent damage for Lane
Lucky for Lane, his eyelid caught most of the BB that hit him and prevented permanent damage to his eyeball. He may need future surgery but is expected to completely recover.

The biggest worry he has now is that he misses being at Children’s.

“He told me the other day that he missed the room service and nurses,” Tammy said. “He took a picture with his nurses to show off to his buddies once he got back home.”

Lane is also informally educating other children about gun safety. He’s even using “A Christmas Story” as a teaching tool.

“When we went to a doctor’s office recently, he went up to a little kid and told him that movie is a great example of why you don’t need to be playing with BB guns,” Tammy said.