Category Archives: Child & Youth Health

Teens and Sexual Assault, Part 8: The Media’s Response to the Steubenville Convictions

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Photo by Brainloc

Photo by Brainloc

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This article first appeared on Seattle Children’s Teenology 101 blog.

I thought Part 7 was my last post in the series, but the media response to the sentencing of the two rapists in the Steubenville case has been so outrageous that I’m going to tack on a postscript here.

One of the first news reports to come out after the conviction was from CNN, and it spent much more time sympathizing with the rapists than the victim- in fact, the victim was not mentioned. You can watch the video here.

A concerned Poppy Harlow states, ”It was incredibly emotional, incredibly difficult even for an outsider like me, to watch what happened, as these two young men, that had such promising futures, star football players, very good students, literally watched as they believed their life fell apart…”

She then goes on to describe said emotion in the courtroom, and the offenders’ sadness. Later on, another reporter asked a legal correspondent, “What’s the lasting effect of two young men being found guilty in juvenile court of rape, essentially?”

There is so much wrong there: the concern over the rapists, the “essentially” tacked on to “rape”, the complete and utter absence of any thoughts of the victim. Just as people were beginning to criticize CNN, it turned out that the problem was not just with them.

NBC kept talking about the rapists’ “promising football careers.” I’m not sure why that’s relevant.

ABC News ran a piece on Ma’lik Richmond that talked extensively about his athletic prowess and difficult childhood. And yet, many athletes with difficult childhoods have refrained from raping someone.

Good Morning America mentions that “A juvenile judge will decide the fates of Trent Mays and Ma’lik Richmond, who face incarceration in a detention center until their 21st birthdays and the almost-certain demise of their dreams of playing football.” Perhaps if you dream of playing football, it’s best not to commit a sex crime.

The Associated Press opens a story with “Two members of Steubenville’s celebrated high school football team were found guilty Sunday of raping a drunken 16-year-old girl.” They are celebrated high school football players, the victim is left with the epithet “drunken.”

What none of these major media outlets seem to be addressing is that (ideally) if you rape someone, you pay the consequences for it. None of them are lamenting the long-term effects on a young women of being raped by two young men (and having pictures of it sent to peers). None of them are pointing out that this situation wouldn’t have happened if the two offenders had made the choice not to rape someone. Their promising football careers would be continuing untouched, they might have gone to great universities, and enjoyed all the opportunities and rewards given to people who have chosen not to commit rape.

What are our teens supposed to think when the mainstream media’s treatment of rapists is not full of revulsion, fear, or condemnation, but seems almost… affectionate? At the least, they feel very bad for them.

And they fail to mention concern over the fate of the rape victim. In fact, if she’s mentioned at all, it’s to point out that she was intoxicated. As Henry Rollins (yes, thatHenry Rollins) said in a piece in Raw Story, “It is ironic and sad that the person who is going to do a life sentence is her.”

I spoke earlier in this series about how important it is to talk to your teen about issues regarding sexual consent. It’s also important for you to talk to your teen about rape culture, how they can make sure they’re not a part of it, and what they can do to change it.

About Jen Brown, RN, BSN

Jen Brown, RN, BSN Teens never cease to amaze me with their strength, creativity, and new perspectives! Throughout my career, I’ve enjoyed helping teens and their parents tackle health concerns and navigate social issues. Nursing is my second career; my first degree was in biology from Carleton College, and a few years later I went to the University of Virginia for their Second Degree Nursing Program. Recently I began a graduate program at the University of Washington.

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Teens and Sexual Assault, Part 6: Sexual Assault Within A Relationship

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Photo by Sanja Gjenero

Photo by Sanja Gjenero

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This article first appeared on Seattle Children’s Teenology 101 blog.

When I was about 15, a friend was confiding in me about our friend Sasha’s* fight with her boyfriend James*. Sasha had been dating James for a while, and their relationship included sexual activity. She told me that Sasha had cheated on James, and he had found out and been furious.

“What did he do?” I asked.

“He was really mad. He yelled at her and threw things and made her have sex with him,” she said.

“Like, he made her have sex, when she was saying no?” I said, incredulous.

“Well… I don’t know. I don’t think so. He said she was crying but didn’t fight him or anything.”

Reading this as an adult makes me cringe. But as teens, we were a little confused as to whether James could really rape Sasha, given that they were going out and had had sex before.

When we saw Sasha next, she and James were together and they seemed happy. We concluded that she couldn’t have been sexually assaulted.

When we think of teens being sexually assaulted, we often think of stranger/ acquaintance rape, but teens can and are sexually assaulted by their romantic partners. This can occur even if they have consented to sex in the past, and might again in the future. Consenting to one episode of sexual contact does not mean that there is blanket consent for sexual consent at all times.

This seems like an easy concept for adults to understand, but it’s important to remember that the very idea of date and marital rape wasn’t really addressed by our society until the 1970s. One of my earliest memories of talk radio is listening to (and being confused by) a debate in the early 80s that boiled down to, “Is it really possible to rape your own wife?”

Teens- especially younger teens- can be confused by the concept of sexual assault within the confines of a romantic relationship that has already involved sexual contact. It’s important that teens realize that it’s wrong to make, or coerce, someone into having sex, even if they’ve consented to sex before.

It’s also important that teens know they can say no to someone- with every expectation of an immediate halt to sexual activity- even if they’ve said yes before, no matter what the circumstances. In Sasha’s case, I found out later she felt she’d “deserved it” for having sexual contact with someone else while dating James.

While it’s very important that your teen realize that it’s important to gain consent for sexual contact, they also need to know that consent is important for every sexual contact.

It doesn’t necessarily mean that a teen has to seriously sit down and formally ask for consent every time (although they can if they want to), but they do need to realize that consent is not a one-time process when one is dating someone, or has had sexual contact with them before.

This may not be one of those concepts where you can give a step-by-step guide on how to deal with it, but it’s still important that they’re aware the concept exists.

Once you’ve discussed how important this is with your teen, ask them how they’d go about making sure every sexual contact is consensual. There isn’t one correct answer. Discuss their ideas with them.

Depending on your teen, they may be so embarrassed at the idea of talking to you about this that they stop the conversation, which is fine. Once you’ve asked the question, you can leave their mind to fill in the blanks when it’s time… although bringing it up again when they’re in a romantic/ sexual relationship never hurts.

What conversations have you had with your teen about this? What was their reaction?

*Names changed

Top photo courtesy of Sanja Gienero

About Jen Brown, RN, BSN

Jen Brown, RN, BSN Teens never cease to amaze me with their strength, creativity, and new perspectives! Throughout my career, I’ve enjoyed helping teens and their parents tackle health concerns and navigate social issues. Nursing is my second career; my first degree was in biology from Carleton College, and a few years later I went to the University of Virginia for their Second Degree Nursing Program. Recently I began a graduate program at the University of Washington.

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Federal judge strikes down age limits on ‘morning-after’ pill

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planb-175By Scott Hensley, NPR News

This story comes from KHN partner ‘s Shots blog.

A federal judge in Brooklyn, N.Y., has ruled that the morning-after pill for emergency contraception must be made available over the counter to girls 16 and under.

The ruling could end a more than decade-long battle over how easy or difficult it should be for teenage girls to obtain emergency contraception.

The ruling would also make it easier for older women to obtain the drug because it wouldn’t have to be kept behind drugstore counters anymore.

The judge’s order effectively overturns a controversial 2011 decision by Secretary of Health and Human Services Kathleen Sebelius overruling the Food and Drug Administration. A

fter years of study and internal debate, the FDA had decided that Plan B One Step should be allowed for sale without a prescription — and without age restrictions.

In the ruling dated April 4, Senior Judge Edward R. Korman of the Eastern District of New York held that Sebelius’s decision on Plan B was “arbitrary, capricious, and unreasonable.”

On page 47 of the 59-page decision, Korman skewers Sebelius’s decision, calling it “politically motivated, scientifically unjustified, and contrary to agency precedent ….”

He also slammed the FDA’s rejection of a so-called Citizen’s Petition dating to 2005 that argued for the agency to approve unfettered over-the-counter sale of Plan B. That rejection, he said, was a direct consequence of Sebelius’s ruling.

In the decision, Korman sends the Plan B case back to FDA with orders to make the morning-after pill “available without a prescription and without point-of-sale or age restrictions within 30 days.” If the agency decides the instructions for the drugs need tweaks, that’s OK.

When Sebelius essentially vetoed the FDA’s decision in late 2011, women’s health groups erupted in protest. “As doctors and researchers have repeatedly stated, ample research shows Plan B to be safe for women of all ages and appropriate for over-the-counter access.

It is deeply disappointing that this administration would repeat the mistakes of the previous one,” said Susan Wood, an associate professor at George Washington University’s School of Public Health.

Wood was an assistant commissioner for women’s health at the FDA but quit in 2005 over its continued delay on over-the-counter approval for Plan B.

Advocates for Plan B kept up the pressure on the administration to reverse itself. They argued, in part, that the rules were just too complicated.

“The unique dual-labeling of Plan B One Step has led to confusion among consumers and health care professionals alike, particularly regarding age restrictions and whether men and women can purchase non-prescription emergency contraception,” said a letter signed by more than three dozen women’s health, reproductive rights and individual providers of health care.

“A recent Boston University study of 943 pharmacies in five major cities revealed that, when called posed as 17 year olds seeking EC, one in five were told they could not purchase EC under any circumstances,” the letter said at the time. In fact, those 17 and older are eligible to purchase the product without a prescription; those 16 and younger may purchase it with a health provider’s written order.

This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

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Sun Tanning

Burning issue: Tanning bed laws

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Sun TanningBy Maggie Clark, Staff Writer

Talk of banning teenagers from indoor tanning beds has Maine Governor Paul LePage seeing red.

“This is government run amok,” LePage wrote in vetoing a bill that would have made Maine the latest state to institute a ban on indoor tanning for some teenagers, even if they have permission from their parents. “Maine parents can make the right decisions for their families.”

Teens under 18 are banned from tanning beds in California and Vermont. In New York and now in New Jersey, home of the famously tanned cast of MTV’s Jersey Shore, the minimum age for tanning beds is 17, regardless of what a teen’s parents may say.

For Texas teens under 16.5 years-old and Wisconsin teens under 16, the same rule applies. Four additional states ban teens under age 14 from using tanning beds (see map).

New Jersey Governor Chris Christie, who signed his state’s law earlier this week, said the measure there was inspired by the tabloid-sensation “tanning mom,” Patricia Krentcil, who was accused of putting her five-year-old daughter in a tanning bed. Krentcil, of Nutley, N.J., pleaded not guilty to charges of child endangerment and a grand jury chose not to indict her.

Despite LePage’s refusal to bar teens from tanning booths, the trend seems to be headed in the opposite direction. California, Vermont and New York all enacted their bans in 2012, and in the current legislative session, lawmakers in 29 states have introduced measures that would tighten restrictions on teen tanning.

Some would require parental consent, while others would institute outright bans, according to analysis from the National Conference of State Legislatures.

Legislators are responding to research that directly links indoor tanning to skin cancer. Tanning booths deliver10 to 15 times the UV radiation of natural sunlight, boosting the user’s risk of developing deadly melanoma by at least 75 percent, according to the American Cancer Society.

Teenage girls, the most frequent tanners, are more susceptible to melanoma than other groups, according to the National Cancer Institute. Their research found that melanoma is the most common form of cancer for young adults aged 25 to 29 years.

tanning

In response to that same research, tanning beds are also subject to an additional 10 percent tax under the Affordable Care Act. While the tax was put in place to discourage indoor tanning, it hasn’t made much of a dent in demand for indoor tanning, according to a study from researchers at Northwestern University Feinberg School of Medicine. But according to the Indoor Tanning Association, it’s hurt many small tanning businesses.

“These businesses have paid this unfair tax for the past two years and the results are in: over 3,100 tanning businesses closed; over 35,000 jobs were destroyed,” according to a press release from the Indoor Tanning Association. “Since the tax went into effect, we estimate $145 million has been taken out of the pockets of consumers and main street businesses and remitted to the Federal Government.”

The U.S. Food and Drug Administration, which regulates tanning beds, has not taken a formal position on the issue of teen tanning, but the agency is considering modifying regulations for tanning beds to reduce the amount of UV exposures they emit. The FDA, National Cancer Institute and other health organizations advise avoiding indoor tanning entirely.

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Stateline is a nonpartisan, nonprofit news service of the Pew Center on the States that provides daily reporting and analysis on trends in state policy.

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Teens and Sexual Assault, Part 3: The Age of Consent

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By  This article first appeared on Seattle Children’s Teenology 101 blog.

Calendar

At some point, most teens end up dating someone who is a little older or younger than them. But when that age gap widens, teens can be putting themselves or their partner in danger of legal (and emotional) consequences if the relationship involves sexual contact.

This week we’re going to take a look at the legal implications of the age of consent and statutory rape.

In the United States, the most common age of consent is 16, although in some states, it is 17 or 18. This means that someone under the age of 16 cannot legally give consent to sexual contact with an adult, while once a teen turns 16 they can consent to sex with anyone they choose (with a few exceptions, such as teachers, foster parents, and supervisors.)

An important caveat to this rule occurs when two teens around the same age have sexual contact. A 15-year-old having sex with a 15-year old is not a prosecutable offense.

However, once there is an age gap, it gets a bit confusing; you can access the legal details here. Basically, it is illegal to have sexual contact with: a 12-year-old if the other person is more than 2 years older; a 12-to-14 year old  if the other person is more than 3 years older; a 14-to-16 year old if the other person is more than 4 years older.

These crimes can be labeled as child rape or child molestation, and they are felonies. Anyone found guilty of these crimes will be labeled a sex offender, including minors.

Teens tend to overestimate their maturity and ability to deal with adult situations. To a teen, an older person finding them attractive is not alarming; it may even serve to demonstrate to the teen how mature and desirable they are.

The older person in the relationship may believe that they have found that unusual young teen who is wise beyond their years and can make an equal partner in the relationship.

I can say this from experience, as I dated a 19-year-old when I was 15. I was thrilled with how mature I must be, and he swore that he would normally never date someone so young, but I was much older than my years.

(After we  broke up, his next two girlfriends were also 15; we must have been a particularly mature cohort.)

Can some teens be unusually mature? Sure. Some older teens and young adults can be unusually immature, too. But the fact remains that any sexual relationship that breaks the laws above can end with one partner being labeled a sex offender, possibly for the rest of his or her life.

A good way to broach this subject with your teen is to gauge their views on it. Sit down, tell them about the laws, and ask what they think. If they think the laws are unnecessary, or that they’re too strict, start gauging where their comfort level lies. Is it okay for an 18-year-old to have sex with a 12-year-old? (That should be an obvious question.) Start closing the age gap. Talk about different ages, and see what they would do differently.

Talk about how having sexual contact with someone much younger than them is illegal, it is wrong, and it is sexual assault. Explain how the adolescent brain has different capacity at different ages.

Even when someone much younger may seem like they are able to give full consent, they can’t. It is like someone very drunk agreeing to sexual activity; they are not capable of making that decision.

Explain that “sexual contact” is not just vaginal or anal sex; it includes oral sex and touching as well.

If someone much older wants to have sexual contact with them, that is also wrong and they should seriously question why someone that much older wants a younger partner.

It may be that your teen is unusually mature, or it may be that this older person prefers younger partners. Talk about why that might be. (If your teen is 16 or above, it’s not illegal for them to have sexual contact with a much older person, but feel free to give them your views on that as well.)

Explain to them what it means to be labeled as a sex offender, including publicly available registration, and limited educational, job, and living opportunities. Remind your teen that even if they are in a situation where they think the law shouldn’t apply to them, it still does.

Hopefully this is an issue you and your teen will only have to deal with in the abstract, and you won’t have to deal with the pain of your teen being involved in statutory rape.

But getting it out into the open, and talking about why it’s an issue, may make the different between a hasty decision, and a smarter one.

It’s hard to convince a teen when they are already madly in love with an older/ younger person that it’s a bad idea; if they have the knowledge beforehand, they may  be able to rein in their emotions.

About Jen Brown, RN, BSN

Jen Brown, RN, BSN Teens never cease to amaze me with their strength, creativity, and new perspectives! Throughout my career, I’ve enjoyed helping teens and their parents tackle health concerns and navigate social issues. Nursing is my second career; my first degree was in biology from Carleton College, and a few years later I went to the University of Virginia for their Second Degree Nursing Program. Recently I began a graduate program at the University of Washington.

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Safety begins at home – National Public Health Week article

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Ensuring a Safe, Healthy Home for Your Family

The American Public Health Association is marking National Public Health Week with a series of articles about what you can do to improve your and your family’s health and safety. 

homePublic health is in every corner of our homes. It’s in the safe food in the fridge, the carbon monoxide and smoke detectors affixed to the ceiling, and the child-proof latches that keep dangerous chemicals out of little hands. Home is also where we learn healthy behaviors, such as eating right and exercising. Good prevention starts at home.

Did You Know?

  • The majority of fire-related deaths happen at home. In 2010 in the United States, someone died in a fire every 169 minutes and someone was injured every 30 minutes. About two-thirds of home fire deaths happened in homes without working  smoke alarms.
  • Falls are the leading cause of injury-related deaths among people ages 65 and older. Each year, one out of every three adults ages 65 and older experiences a fall. In 2010, falls resulted in $30 billion in direct medical costs.
  • Nine out of every 10 childhood poison exposures happens at home, with medications being among the top culprits.
  • More than half of all swimming pool drownings among children could have been prevented with appropriate fencing that completely separates the pool from the house and yard.
  • Many more efforts are needed to help all families and households adequately prepare for natural disasters and other emergencies, such as having a three-day supply of water and a written evacuation plan.
  • Fewer than 15 percent of adults and 10 percent of adolescents eat the recommended amounts of fruits and vegetables each day.

What Public Health Teaches Us

Start small…

  • Smoke alarms can double your chance of surviving a fire, so install alarms on every floor of your home and test that they’re working monthly. While you’re at it, install a carbon monoxide alarm on every floor of your home as well.
  • Help prevent fires — as well as serious health problems and chronic diseases — by making your home tobacco- and smoke-free.
  • Keep potentially dangerous household products, such as cleaning products, cosmetics and prescription medications, locked up and out of children’s reach. Also, never store household chemicals in old food containers or in the same place you keep food items. Learn more atwww.upandaway.org.
  • Gather your household for a night of emergency preparedness: Make plans for putting together an emergency stockpile kit, create a crisis communication plan, designate an emergency meeting place and hold household emergency drills.
  • Put this number on your fridge and in your cell phone: 1-800-222-1222. It will automatically connect you to your regional poison control center and often life-saving information.
  • Put up four-sided fencing that’s at least five feet high with self-latching gates around swimming pools to protect children from injury
  • Assess your home, or the home of a loved one, for factors that could contribute to a fall, such as poor lighting, uneven flooring and clutter.
  • Stock your kitchen with plenty of fresh fruits and vegetables and cut down on high-sugar and high-fat items.
  • Learn about proper food handling and cooking techniques to avoid food-borne illness.
  • Learn how to properly dispose of unused medications.
  • Tell your friends and online followers how you and your household are celebrating National Public Health Week. Keep a journal of the changes you’ve made on your blog or other social media accounts or send a letter to the editor to your local newspaper. Let others know how easy — and fun — it can be to make public health and prevention a part of our lives.

Think big…

  • Help organize a yoga or Tai Chi class for older adults to help improve balance and prevent falls.
  • Organize a community fire safety event with the local fire department.
  • Get involved in community efforts addressing the growing epidemic of prescription drug abuse, such as promoting drug take-back events.
  • Spread the word about emergency preparedness at your children’s school, your parents’ retirement community and the other places you spend time. Volunteer to help these places assess their readiness and start planning.
  • Promote awareness of how local public health systems keep communities healthy at home, such as keeping our food and water safe. Encourage residents and leaders to take a moment to imagine how dramatically our lives would change if that system disappeared. Let your key decision-makers know that you support public health and prevention.

There is much more you can do to ensure a safe and healthy home for you and your family. To learn more about putting prevention to work at home, visitwww.cdc.gov/homeandrecreationalsafety.

To learn more about public health visit the American Public Health Association’s website.

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Five

Preventing repeat teen births

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From Vital Signs
A publication of the Centers for Disease Control and Prevention

Although teen birth rates have been falling for the last two decades, more than 365,000 teens, ages 15–19, gave birth in 2010.

Teen pregnancy and childbearing can carry high health, emotional, social, and financial costs for both teen mothers and their children.

1 in 5

FiveNearly 1 in 5 births to teen mothers, ages 15 to 19, is a repeat birth*.

About 1 in 5 sexually active teen mothers use the most effective types of birth control after they have given birth.

Teen mothers want to do their best for their own health and that of their child, but some can become overwhelmed by life as a parent.

Having more than one child as a teen can limit the teen mother’s ability to finish her education or get a job.

Infants born from a repeat teen birth are often born too small or too soon, which can lead to more health problems for the baby.

Repeat teen births can be prevented.

183 About 183 repeat teen births occur each day in the US.

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*A repeat teen birth is the 2nd (or more) pregnancy ending in a live birth before age 20.

Health care providers and communities can:

  • Help sexually active teen mothers gain information about and use of effective types of birth control.
  • Counsel teens that they can avoid additional pregnancies by not having sex.
  • Connect teen mothers with support services that can help prevent repeat pregnancies, such as home visiting programs.

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Problem

Too many teens, ages 15–19, have repeat births.

Nearly 1 in 5 births to teens, ages 15–19, are repeat births.

  • Most (86%) are 2nd births.
  • Some teens are giving birth to a 3rd (13% of repeat births) or 4th up to 6th child (2% of repeat births).
  • American Indian and Alaskan Natives, Hispanics, and black teens are about 1.5 times more likely to have a repeat teen birth, compared to white teens.
  • Infants born from a repeat teen birth are often born too small or too soon, which can lead to more health problems for the baby.

Working together, a sexually active teen and her doctor or other health care professional can decide on the best birth control method.

  • More than 9 in 10 (91%) sexually active teen mothers used some form of birth control, but only about 1 in 5 (22%) used the most effective types of birth control.
  • White (25%) and Hispanic (28%) teen mothers are almost twice as likely as black teen mothers (14%) to use the most effective types of birth control.
  • Long-acting reversible birth control can be a good option for a teen mother because they do not require her to do something on a regular basis – such as take a pill each day.
  • Hormonal implants and IUDs are two types of long-acting reversible birth control. These are some of the most effective forms of birth control.

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What Can Be Done

Federal government is:

  • Funding states and tribes through the Pregnancy Assistance Fund to provide pregnant and parenting teens with a complete network of support services.
  • Promoting home visiting and other programs shown to prevent repeat teen pregnancy and reduce sexual risk behavior.
  • Conducting and evaluating programs that work, as well as innovative approaches to reduce teen pregnancy and births in communities with the highest rates.
  • Helping other groups with information to duplicate teen pregnancy prevention programs that have been shown to be effective through rigorous research. http://www.hhs.gov/ash/oah/oah-initiatives/tpp/tpp-database.html

Doctors, nurses, and other health care professionals can:

  • Discuss with sexually active teens the most effective types of birth control to prevent repeat pregnancies. Refer to CDC guidelines: http://www.cdc.gov/reproductivehealth/unintendedpregnancy/USMEC.htm
  • Counsel parenting teens on how they can avoid additional pregnancies by not having sex.
  • Advise teen mothers that births should be spaced at least 2 years apart to support the health of the baby, and that having more than one child during the teen years can make it difficult for teen parents to reach their educational and work goals.
  • Remind sexually active teens to also use a condom every time to prevent sexually transmitted diseases, including HIV/AIDS.

Parents, guardians, and caregivers can:

  • Talk about how to avoid repeat births with both male and female teens. http://www.cdc.gov/teenpregnancy/parents.htm
  • Check with your insurer about coverage of preventive services. In some cases, preventive services, such as birth control methods and counseling, are available with no out-of-pocket costs.
  • Talk with community leaders, including faith-based organizations, about using effective programs that can help prevent repeat teen pregnancies.

All teens, including teen parents, can:

  • Choose not to have sex.
  • Use birth control correctly every time if they are having sex. Use condoms every time to prevent disease.
  • Discuss sexual health issues with their parents, partner, health care professionals, and other adults and friends they trust.
  • Visit http://www.hhs.gov/opa to find a family planning clinic near them for birth control if they choose to be sexually active.

*A repeat teen birth is the 2nd (or more) pregnancy ending in a live birth before age 20.

Science Behind this Issue

Related Pages

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Teens and Sexual Assault, Part 2: Drinking and Drugs

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By  This article first appeared on Seattle Children’s Teenology 101 blog.

Picture of a table after a party with wine and beer bottlesIn this post, and posts to come, I’m going to talk about safety measures that teens can take to try and lower their risk of sexual assault. However, that comes with two important caveats.

The first is that, unfortunately, there is nothing a teen can do to keep themselves 100% safe from sexual assault.

The second is that if a sexual assault occurs, the blame is 100% on the perpetrator. It does not matter how the victim was acting, or what risks they took, or whether or not they showed good judgment in the situations leading up to the assault; a person who sexually assaults another person is the only one who bears responsibility for that assault.

The tips I am giving in the next few posts are ways to possibly lower risk, but someone who chooses to ignore all of them should never be blamed if they are attacked.

Sometimes I wonder if we spend time teaching our teens to take safety measures and then forget to teach our teens to not sexually assault people.

Like I mentioned in my last post, take the time to discuss with your teen, no matter what their gender, what is and is not acceptable.

Again, I’m not implying your teen is the type of person to victimize someone, but they might be able to speak up to help someone else.

If one teen had chosen to call the police when they saw what was happening during the Steubenville incident, the victim’s assaults- or at least some of them- might never have happened.

Let’s discuss ways to talk to your teen about increasing their safety, and possibly decreasing their risk of being seen as an “easy target” (again, there are unfortunately no guarantees.) And we’ll start by talking about drinking and drugs.

When someone is intoxicated or under the influence of drugs, their judgment and decision-making capacity is lowered and sometimes nonexistent.

This means that they may not be able to assess risk like somebody sober. They may decide to spend time with someone who, were they sober, their gut instinct would warn them away from.

They may be unable to see the danger of a situation that would normally set off alarm bells. If the effects of alcohol or drugs are visible, someone who is seeking a vulnerable person may be drawn to them. Or, if their impulse control is lowered, they may act aggressively towards somebody else.

If your teen decides to drink- hopefully once they are over 21, but the majority of teens do experiment with alcohol before then- they can avoid drinking to the point of severe impairment, especially when in large groups (keeping in mind, however, that most sexual assaults involve someone known to the victim).

When I was in college, we usually had a friend who agreed to be the “lookout” for an evening of parties, someone to avoid intoxication and make sure that nobody was taken advantage of, and that everyone got back to their dorm room safely. Groups of friends can rotate this responsibility among them.

This is obviously not a sure thing- the designated lookout can be drunk him or herself, they can assume one of their charges is having a good time when really they are quite incapacitated… etc.

But it’s never a bad idea for teens to look out for each other in party or group settings, and speak up if they are concerned that someone is being taken advantage of.

Sometimes teens can become incapacitated without having the chance to consider whether or not they want to drink or take drugs. Another important thing for teens to consider is the possibility that someone might slip a drug into their drink to render them less able to respond to or remember incidents.

When possible, teens should get their own drinks, or at least watch them being poured from a previously unopened container, and never leave their drink unattended. You and your teen can find out more about “date-rape drugs”, and ways to avoid them, here.

There are, of course, many other risks to drinking and drugs, many of which are discussed in the “Drug Use Among Teens” post by Dr. Evans.

But encourage your teen to think about drinking and drugs in terms of sexual assault as well. This may help them increase their own safety, or be able to help a friend when they need it most.

About Jen Brown, RN, BSN

Jen Brown, RN, BSN Teens never cease to amaze me with their strength, creativity, and new perspectives! Throughout my career, I’ve enjoyed helping teens and their parents tackle health concerns and navigate social issues. Nursing is my second career; my first degree was in biology from Carleton College, and a few years later I went to the University of Virginia for their Second Degree Nursing Program. Recently I began a graduate program at the University of Washington.

 

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Teens and Sexual Assault, Part 1: The Steubenville Incident

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This article first appeared on Seattle Children’s Teenology 101 blog.

The small town of Steubenville, Ohio, has suddenly become reluctantly but internationally famous, and events there have made headlines around the world.

The story of a teen girl, dragged unconscious from party to party, her repeated assaults known of and even witnessed by peers, is a nightmare.

It chills any parent’s heart, for multiple reasons: the young woman’s vulnerability, the callous nature of the assault, the youth and former promise of the young men who committed it, and the small town politics that many allege obstructed the initial investigation (the mother of one of the accused is the town’s prosecuting attorney).

I want to go over how to talk to your teens about sexual assault and consent. I touch on this in item number three of “10 Tips For Talking to Your Teen About Sex“, but it deserves further discussion.

It’s vital that you have a frank discussion with your teen about sexual assault, and the media coverage of the Steubenville incident gives parents a perfect opportunity to bring it up.

Your teen needs to know the importance of taking “no” for an answer.

First of all, nobody wants to think their child is capable of sexually assaulting someone else. I’m not trying to imply that your child is a budding sexual predator who would perform the acts the young men are accused of in the Steubenville case.

However, bringing up the topic of sexual assault and sexual consent can help your teen with situations that some teens don’t know how to handle, or where others have made the wrong decision.

You can also hear what your teen thinks, both about Steubenville and sexual assault among teenagers.

Rape and sexual assault are terms that apply to a wide variety of circumstances, not just a man forcing sex on a resisting woman. A woman can sexually assault a man, and same-sex sexual assault occurs all too frequently.

Some victims are temporarily incapacitated by drugs or alcohol (or permanently incapacitated by disabilities, which is beyond my scope here), and under these conditions, cannot consent.

Having sex with a partner who is much younger than the other partner is also a form of sexual assault, and can be prosecuted as such.

Your teen needs to know the importance of taking “no” for an answer- you can’t really be too firm on this point- but that also that consent goes deeper than that.

If someone is intoxicated or their thinking is altered by drugs, they do not have the capacity to choose whether or not they want to have sex.

The one extreme of this is the victim of the Steubenville incident, who either was intoxicated to the point of unconsciousness, or was drugged by her aggressors; reports are unclear.

However, people can be awake and still too intoxicated to consent. Someone who is obviously under the influence is not someone that anyone should be physically intimate with.

Encourage your teen to seek consent from their partner, as opposed to just assuming it. Sometimes when a person perceives that a situation is getting out of control, they may “freeze” instead of fighting back.

This happened to someone I knew in college; in the boy’s mind, she was going along and didn’t say “no,” and in the girl’s mind she had frozen on perceiving danger, and he had continued anyway.

Instead of waiting for “no,” talk to your teen about the important of a “yes.” A simple “Is this okay?” shows not only respect for their partner, but helps a teen know that they are with someone who is truly willing, and is enjoying the experience as much as they are.

Make sure your teen knows that sexual activity with someone younger than them, even if that person gives a resounding “yes,” may be illegal. If they have detailed questions, direct them here to see the specifics.

Have you tried to talk to your teen about this? How did it go? Did they say anything that surprised (or impressed) you? Are teens watching the Steubenville incident unfold, and what do they think about it?

About Jen Brown, RN, BSN

Jen Brown, RN, BSN Teens never cease to amaze me with their strength, creativity, and new perspectives! Throughout my career, I’ve enjoyed helping teens and their parents tackle health concerns and navigate social issues. Nursing is my second career; my first degree was in biology from Carleton College, and a few years later I went to the University of Virginia for their Second Degree Nursing Program. Recently I began a graduate program at the University of Washington.

 

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Vilifying food – How fad diets are affecting our children’s health

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Seattle Children's LogoFrom Seattle Children’s blog On the Pulse

Fad diets have taken the U.S. by storm: PaleoMediterranean, the “Fast Diet” – even Gwyneth Paltrow has a new cookbook.  Just as quickly as one diet is “out,” another diet emerges to take its place. With so many options, celebrity endorsements and websites full of misinformation, how can parents know which diets are safe – especially for kids?

Celia Framson, MPH, RD, CD, and Mary Jones Verbovski, MS, RD, CD, clinical pediatric dietitians at Seattle Children’s Hospital encourage parents to keep kids in mind when evaluating a potential diet.

“The alarming prevalence of these diets and trends has created an entirely new entity in the family dynamic,” says Jones Verbovski. “The subject of food and diet can really affect the parent-child relationship. Many parents are constant dieters. Sometimes we overlook how a diet may be affecting a child.”

vegetables

For parents who diet

Parents who adopt certain diets or dietary lifestyles should be aware of the implications on kids. Children are easily influenced by external factors – school, peers, family and celebrities. Also, they are not the ones buying the food that sits in the pantry. A parent’s dietary choice usually falls onto the child.

Children are impressionable and may adopt a diet simply because they want to copy their parents or fit in with their friends. Recently, a 7-year-old girl’s “diyet list” garnered media attention and raised controversy among both dietitians and parents. The girl reportedly learned about dieting from a friend.

Framson and Jones Verbovski say it’s important to develop a positive relationship with food and set a good example for your child.  If your child announces they want to incorporate certain foods or restrict certain foods, make sure you understand what is motivating the change and help them understand they need a wide variety of foods. Have they decided to cut out meat, sweets or carbohydrates because you have?

Many of the most popular diets in the U.S. have a tendency to vilify foods. Framson says that trend isn’t healthy for kids who need a balanced diet for their growing bodies and minds. We have taught children and teens to look at foods as being either “good” or “bad,” she says, instead of promoting a healthy balanced diet, and taking a holistic approach to nutrition.

Framson and Jones Verbovski encourage parents to be aware of how they speak about foods and diets. Saying a cupcake is “bad” or that sweets will make you fat, can give the impression that a child should feel ashamed if they eat them.

Teaching children to feel shame in association with certain foods can lead to unhealthy habits.

According to the Academy of Nutrition and Dietetics’ newly updated position paper, families should focus on moderation, portion size and exercise for balancing food and beverage intakes.

Rather than labeling cupcakes as “bad” and apples as “good,” focus instead on feeling your best, stopping when you’re full and eating a balanced diet. Teaching children to feel shame in association with certain foods can lead to unhealthy habits, say Framson and Jones Verbovski, like binge eating or restrictive eating disorders. It’s easy for a child to go from “this food is bad” to “I am bad” for wanting to eat that food, says Framson.

It’s important to talk to children about nutrition and healthy eating choices. Typically, children only learn the most basic principles of nutrition at school.

Many times these lessons are misconstrued and children take away that they need to cut out sugar all together from their diet, a lesson that Jones Verbovski says isn’t necessarily the right approach.  “Parents should give their children options,” she says. “In our house sugar is okay in moderation.”

Vegetarian and vegan kids

Don’t be surprised if kids around six or seven years old decide to go vegetarian, says the American Academy of Pediatrics. When children first learn where food comes from it’s perfectly normal to have mixed emotions.

The controversial children’s book “Vegan is Love” has ignited a recent debate among parents – is veganism healthy for kids? The book depicts animals crowded behind bars and discusses animal testing. It wasn’t so much the content that stirred the heated debate, however, it was the uncertainty behind the nutritional safety of the vegan diet.

“If a child wishes to be vegetarian or vegan, parents need to look deeper and make sure that is an appropriate choice that works with the family’s food values,” Framson says. “Parents also need to watch for red flags and ensure their child or teen is consuming enough nutrients and calories.”

If families choose to adopt a vegan or vegetarian diet, parents need to be mindful of the dietary implications. Young children need many specific nutrients for their growing minds and bodies. Parents need to incorporate variety into a child’s diet, making sure they get enough vitamin B12, protein, iron, calcium and omega-3 fatty acids.

Tips for dieting parents

Framson and Jones Verbovski suggest parents incorporate diets that fit into their family dynamic and culture. Think about your schedule and lifestyle – cooking is time consuming, organic foods can cost more and there may not be an abundance of fresh fruits or vegetables in your neighborhood. “Your lifestyle needs to fit your food and your food needs to fit your lifestyle,” says Jones Verbovski.

Also, set realistic expectations and don’t focus on losing x amount of weight. “Children shouldn’t be trying to lose significant amounts of weight,” says Jones Verbovski. Parents should allow children to choose what they eat, within reason. For example, offer 2 different veggies at dinnertime, rather “you have to eat this” Incorporate a variety of foods into a child’s diet and give them the responsibility of picking which works best for them. Allow them to engage in choosing what’s on the menu sometimes. “Focus on feeling good about yourself and your lifestyle,” says Framson. Remember, being healthy isn’t about a number on the scale. Fad diets come and go; eating a well balanced diet and feeling healthy can last a lifetime.

Remember to look at the bigger picture. Some days are better than others when it comes to eating well. Look at each week instead of each day, says Framson and Jones Verbovski You should spend some time and energy planning meals and snacks so you make choices you feel good about, but not so much time and energy that it increases stress. Life, after all, is a balance.

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Poison prevention tips from the American Academy of Pediatrics

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From the American Academy of Pediatrics

National Poison Prevention Week, March 18 – 24, 2012

Each year, approximately 2.4 million people – more than half under age 6 – swallow or have contact with a poisonous substance. The American Academy of Pediatrics (AAP) has some important tips to prevent and to treat exposures to poison.

To poison proof your home:

Poison logoMost poisonings occur when parents or caregivers are home but not paying attention. The most dangerous potential poisons are medicines, cleaning products, antifreeze, windshield wiper fluid, pesticides, furniture polish, gasoline, kerosene and lamp oil.

Be especially vigilant when there is a change in routine. Holidays, visits to and from grandparents’ homes, and other special events may bring greater risk of poisoning if the usual safeguards are defeated or not in place.

  • Store medicine, cleaners, paints/varnishes and pesticides in their original packaging in locked cabinets or containers, out of sight and reach of children.
  • Install a safety latch – that locks when you close the door – on child-accessible cabinets containing harmful products.
  • Purchase and keep all medicines in containers with safety caps and keep out of reach of children. Discard unused medication.
  • Never refer to medicine as “candy” or another appealing name.
  • Check the label each time you give a child medicine to ensure proper dosage.
  • Never place poisonous products in food or drink containers.
  • Keep coal, wood or kerosene stoves in safe working order.
  • Maintain working smoke and carbon monoxide detectors.
  • Secure remote controls, key fobs, greeting cards, and musical children’s books. These and other devices may contain small button-cell batteries that can cause injury if ingested.

Treatment

If your child is unconscious, not breathing, or having convulsions or seizures due to poison contact or ingestion, call 911 or your local emergency number immediately.

If your child has come in contact with poison or you suspect that your child may have swallowed a button-cell battery, and has mild or no symptoms, call your poison control center at 1-800-222-1222

Different types and methods of poisoning require different, immediate treatment:

  • Swallowed poison – Remove the item from the child, and have the child spit out any remaining substance. Do not make your child vomit. Do not use syrup of ipecac.
  • Skin poison — Remove the child’s clothes and rinse the skin with lukewarm water for at least 15 minutes.
  • Eye poison — Flush the child’s eye by holding the eyelid open and pouring a steady stream of room temperature water into the inner corner for 15 minutes.
  • Poisonous fumes – Take the child outside or into fresh air immediately. If the child has stopped breathing, start cardiopulmonary resuscitation (CPR) and do not stop until the child breathes on his or her own, or until someone can take over.
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Fewer students smoking and drinking alcohol in Washington state

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Picture of a table after a party with wine and beer bottlesFewer students in Washington state are smoking cigarettes or drinking alcohol, according to the state’s latest Healthy Youth Survey.

The survey is taken every two years by students in grades 6, 8, 10, and 12 in more than 1,000 Washington public schools.

 

Among the findings:

Tobacco:

  • Cigarette smoking is down in all grades. About 10 percent of 10th graders reported smoking a cigarette at least once in the past 30 days —  down from nearly 13 percent in 2010 and from 25 percent in 1999.
  • Nearly as many 10th graders smoked tobacco from a hookah pipe as from a cigarette, and about 7 percent said that they smoked a cigar in the last month.
  • Statewide, about 50,000 youth smoke – and 40 start smoking every day.

Alcohol:

  • Nearly 11,000 fewer students are using alcohol compared to 2010. Still, more than 115,000 youth currently drink.  Twelve percent of 8th graders, 23 percent of 10th graders, and 36 percent of 12th graders used alcohol in the past 30 days.

Marijuana:

  • The  number of secondary school students who believe using marijuana is risky dropped to the lowest level since the state started collecting data and the percentage of Washington 10th and 12th graders who smoke marijuana is nearly double the percentage of cigarette smokers.

Suicide and Depression:

  • About 8 percent of 8th and 10th graders attempted suicide in the past year.
  • Over 100,000 youth, ages 12-17, seriously considered suicide – about one in every six students.
  • More than one in four teens surveyed said they felt so sad or hopeless for two weeks in a row that they stopped doing usual activities: 26 percent in 8th grade, 31 percent in 10th grade, and 30 percent in 12th grade.
  • These numbers haven’t changed much over the past 10 years.

Sex:

  • Nearly one third (32 percent) of 10th graders and more than half (55 percent) of 12th graders reported having ever had sexual intercourse.
  • About 7 percent of 10th graders and 16 percent of 12th graders reported they had four or more sexual partners.
  • About 6 percent of 10th graders and 5 percent of 12th graders reported having sex for the first time at age 12 or younger.

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One in three US drivers texting and checking email while at the wheel

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Cell-Bike-20x30Most U.S. drivers reported talking on their cell phone and about one in three read or sent text or email messages when driving, according to a new study released by the Centers for Disease Control and Prevention.

The study, published in CDC’s Morbidity and Mortality Weekly Report, examined two specific types of self-reported distracted driving behaviors: cell phone use while driving and reading or sending text or e-mail messages while driving, among drivers aged 18-64 years in the United States and in seven European countries (Belgium, France, Germany, the Netherlands, Portugal, Spain, and the United Kingdom).

CDC researchers found that 69 percent of U.S. drivers talked on their cell phone while driving within the 30 days before they were surveyed compared to 21 percent of drivers from the United Kingdom.

The study also found that 31 percent of drivers in the United States reported that they had read or sent text messages or emails while driving, compared  to 15 percent of drivers in Spain.

CDC researchers also looked specifically at U.S. drivers and found that in the 30 days before they were surveyed:

  • There were no significant differences between men and women in terms of cell phone use or reading or sending text or e-mail messages while driving.
  • A higher percentage of 25-44 year-old men and women reported talking on a cell phone while driving than those ages 55–64, and;
  • A higher percentage of 18-34 year-old men and women reported reading or sending text or e-mail messages while driving than those ages 45-64.

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Know the active ingredients in your child’s meds – FDA

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Read the Drug Facts Label: Active ingredients, which make a medicine effective against the illness it is treating, are listed first on the product's Drug Facts label.

Read the Drug Facts Label: Active ingredients, which make a medicine effective against the illness it is treating, are listed first on the product’s Drug Facts label.

FDA Consumer Update

Ah-choo!

If your child is sneezing up a storm, it must be allergy season once more.

And if your child is taking more than one medication at the same time, there could be dangerous health consequences if those medicines have the same active ingredient, according to Hari Cheryl Sachs, M.D., a pediatrician at the Food and Drug Administration (FDA).

A medicine is made of many components. Some are “inactive” and only help it to taste better or dissolve faster, while others are active.

An active ingredient in a medicine is the component that makes it pharmaceutically active—it makes the medicine effective against the illness or condition it is treating.

Active ingredients are listed first on a medicine’s Drug Facts label for over-the-counter (OTC) products. For prescription medicines, they are listed in a patient package insert or consumer information sheet provided by the pharmacist.

Many medicines have just one active ingredient. But combination medicines, such as those for allergy, cough, or fever and congestion, may have more than one.

Take antihistamines taken for allergies. “Too much antihistamine can cause sedation and—paradoxically—agitation. In rare cases, it can cause breathing problems, including decreased oxygen or increased carbon dioxide in the blood, Sachs says.

“We’re just starting allergy season,” says Sachs. “Many parents may be giving their children at least one product with an antihistamine in it.”

Over-the-counter (OTC) antihistamines (with brand name examples) include diphenhydramine (Benadryl), chlorpheniramine (Chlor-Trimeton), clemastine (Tavist), fexofenadine (Allegra), loratadine (Claritin, Alavert), and cetirizine (Zyrtec).

But parents may also be treating their children for a separate ailment, such as a cough or cold. What they need to realize is that more than one combination medicine may be one too many.

“It’s important not to inadvertently give your child a double dose,” Sachs says.

Other Health Complications

The same goes for other active ingredients, often found in combination products for allergies but also used to treat other symptoms, such as fever, headache or nasal congestion:

  • Acetaminophen (in Tylenol and many other products), a pain reliever often used to treat fevers, mild pain or headache. Taking too much can cause liver damage.
  • Ibuprofen (for example, Advil or Motrin), another common medicine for relieving mild to moderate pain from headaches, sinus pressure, muscle aches and flu, as well as to reduce fever. Too much ibuprofen can cause nausea, vomiting, diarrhea, severe stomach pain, even kidney failure.
  • Decongestants such as pseudoephedrine or phenylephrine (found in brand name drugs such as Actifed and Sudafed) taken in large amounts can cause excessive drowsiness in children. They can also cause heart rhythm disturbances, especially if combined with products and foods containing caffeine. In the form of nasal sprays and nose drops, these products, as well as oxymetazoline (the active ingredients in products such as Afrin), can cause “rebound” congestion, in which the nose remains stuffy or gets even worse.

Any of the above symptoms may indicate a need for immediate medical attention. “The bottom line is that neither you, nor your children, should take multiple combination medicines at the same time without checking the active ingredients and consulting your health care professional first,” recommends Sachs.

Furthermore, two different active ingredients may serve the same purpose, Sachs says. For example, both acetaminophen and ibuprofen help reduce pain and fever. So there’s generally no need to give your child both medicines for the same symptoms.

Write It All Down

Whether you’re treating your child’s condition with OTC medicines from the drug store or ones prescribed by your doctor, it’s essential that you keep track of every medicine and the active ingredients each contains, Sachs says.

“It’s easy to forget which medicines you’re giving your child,” Sachs says. “And if you have more than one child, it can get even more complicated.” She recommends making it a habit to write down the name of any medicine you give your child, whether it’s OTC or prescription (download a daily medicine records template).

“It’s really a good idea to carry that list with you when you go to see your pediatrician or even when you go to the pharmacy,” she adds. You should also note whatever vitamins or supplements your child is taking, as these can interact unfavorably with certain medicines, too.

Most importantly, Sachs says parents should always read the Drug Facts label on OTC products, and the patient package insert or consumer information sheet that comes with prescription medicines, every time they’re considering a medication for their child, even if they think they already know the ingredients.

They should know that the ingredients can change without an obvious change in the packaging. And they should contact their health care professional with any questions.

This article appears on FDA’s Consumer Updates page, which features the latest on all FDA-regulated products.

March 12, 2013

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Individual health plan enrollment for children starts March 15

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stethoscope doctor's bag chest x-rayDo you need individual health insurance coverage for your children or would you like to add them to your family plan?

If so, the first open enrollment period of the year is March 15-April 30.

“I urge people looking for coverage for their kids to apply early,” said Insurance Commissioner Mike Kreidler. “If you wait, your coverage could be delayed until May.  If you experience difficulty or have questions, call our Insurance Consumer Hotline at 1-800-562-6900.”

The open enrollment periods apply to all health plans in the individual market, the place where people go to buy health insurance if their employer doesn’t offer coverage.

Federal health reform prevents health insurers from denying coverage to children with pre-existing health conditions.  However, just like employer health plans, individual plans can create open-enrollment periods.

During these times, children under age 19 do not have to complete a health questionnaire and cannot be denied health insurance because of a pre-existing condition.

If you need a health plan outside of open-enrollment, you can apply to the Washington State Health Insurance Pool (WSHIP).

Exceptions where you can apply for individual coverage for your kids anytime include the birth or adoption of a child or if a child:

  • Is no longer eligible for a state program.
  • Loses coverage due to a divorce.
  • Loses employer-sponsored coverage (including COBRA).
  • Moves and their plan is not available where they now live.

Starting next fall, you will have two options for buying a health plan for your child:

  • From Sept. 15 – Oct. 31 you can buy an individual plan that’s offered outside of the new Health Benefit Exchange, called Washington Healthplanfinder from Sept. 15-Oct. 31
  • From Oct. 1, 2013 – March 31, 2014, you can buy an exchange plan within Washington’s Healthplanfinder.

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