The sports drinks and energy drinks that up to 62 percent of teens drink regularly deliver more than calories and caffeine. A new study shows that high acid levels can permanently damage the glossy enamel of their teeth.

"Young adults consume these drinks assuming that they will improve their sports performance and energy levels and that they are 'better' for them than soda," says Poonam Jain, B.D.S., M.S., M.P.H., lead author of the study and director of The Community and Preventive Dentistry Program at Southern Illinois University. "Most of these patients are shocked to learn that these drinks are essentially bathing their teeth with acid."

Jain and her team swished samples of human tooth enamel in 13 different drinks for 15 minutes four times a day, then stored the enamel chips in artificial saliva the rest of the time. After just five days, the enamel showed signs of wear.

When reality television personality Bethany Frankel announced on the cover of a popular parenting magazine that she was raising her toddler as a vegetarian, she was criticized by both the media and parents around the country.  People called her, “crazy” and called her decision  “child abuse.”  I wasn’t worried. 

My colleague’s three-year-old son became a vegetarian by preference. Though her husband was in a panic, she wasn’t worried either.

So it raises the question that I hear over and over ... is it safe for your child to be vegetarian? 

by Gary Emmett, M.D.

Five years ago, a one-year-old boy named Connor was brought into my office for a second opinion. He had gone to a fine pediatrician on the Main Line who knew that something was very wrong, but did not know exactly what. As a baby, Connor had seemed healthy and normal until about 4 months when instead of growing new skills, he started losing old ones. He had rolled over by 4 months, but then he stopped turning over. He no longer paid attention to people or smiled for his mother. Connor had seen a developmental specialist who took a sample of his chromosomes and performed an imaging study of his brain, but couldn’t make a diagnosis.

Connor’s mother was determined to find out what was wrong. She is a very bright woman who knows that names give us power. We might find a treatment if we knew the name of Connor’s condition. We might find the origin of his developmental delay if we had a name. We would know if it could happen again in his family. (Fortunately, it did not. Connor has a younger, perfectly healthy sister and an older, equally healthy brother.)

Classic fitness advice says kids need an hour of vigorous activity every  day. In theory, that makes sense. In real life, it can be tough figuring out whether your child’s gotten 5, 10 or 200 minutes of activity in a day. When they’re in school, you’re not there to see what they’re doing. And even when they’re at home playing in the backyard or jumping around in the basement, they’re not actually in constant motion – kids’ play and even most kids’ games (from kickball to freeze tag to soccer) involve lots of starts and stops.

But a cheap piece of technology could help. Plenty of kids will wear a pedometer. And a new study of 1,613 kids ages 6 to 19 says that by checking the number on the screen, you can estimate their activity level. Researchers from Canada’s Children’s Hospital of Eastern Ontario Research Institute determined that kids who get 12,000 steps a day are hitting the 60-minute goal. “Step counts are something that children and teens can easily monitor themselves and use to work toward personal health goals,” says lead author Rachel Colley, Ph.D.

You could spend $25 to $99 (no, that’s not a mis-print!) for a special kid’s pedometer. But don’t do it. Pedometers get dropped, lost, left in pants pockets and run through the washer and dryer. A cheaper model makes more sense; you’ll find pedometers that cost as little as $5 in local discount stores.

Pollen season came early this year, bringing with it an early start to the sneezing, sniffling, itchy-eyes season for many kids. If your child’s discomfort lasts for weeks or months on end or is so severe that it interferes with school, other activities or sleep, you may wonder if allergy shots are the answer. 

At Nemours, only a small proportion of our allergy patients receive allergy shots. In fact, allergy shots were more common 30-40 years ago than they are today for a variety of reasons. Now medication does the trick for most kids.

There are basically three treatments for allergies:

• Avoid the allergen. Environmental controls such as keeping windows shut on high-pollen days and keeping pets out of a child’s bedroom; if he or she is allergic to pet dander.
• Medication to relieve symptoms.  These include antihistamines and decongestants (ask your doctor about the best types and dosage for your child) and prescription drugs such as inhaled nasal steroids and leukotriene antagonists.
• Allergy shots. To treat allergies that are not effectively relieved by medications, allergy shots are a viable option for children.  For some kids, allergy shots may temporarily alter their immune systems and allow them to develop tolerance to allergens. Shots don’t work for everyone or every allergen; for example they haven’t been effectively studied in the treatment of mold and certain animal allergies (horses, rabbits, etc). However, they do work well for dust mite, some common household pet allergies (dog and cat), grass and other pollen allergies.

by Gary A. Emmett, M.D.

My last blog was about Stefon, a teenager who did not really understand when he was in trouble with his asthma or how asthma medicines could help him. This blog is about those medications – and how to use them.

First, some basics. There are two kinds of asthma medicines: Rescue medicines (in the U.S. primarily albuterol and sometimes levalbuterol) and preventive medicines (inhaled corticosteroids such as fluticasone and many others). Stefon, who wheezed with every cold he caught, skipped preventive medicines and relied on his rescue medicine much too frequently. As a result, he ended up in the hospital several times. He would have probably stayed out of the hospital if he had used his medications the smart way: Preventive medicines everyday, rescue medicine only on rare occasions.

By Hazel Guinto-Ocampo, M.D.

The CDC recently released data showing that unintentional injuries remain the number one killer of kids, claiming the lives of 9,000 children in the U.S. in 2009 alone. Car crashes, suffocation, drowning, poisoning, fires, and falls are the most common ways children are hurt or killed.

According to the director of the CDC’s National Center for Injury Prevention and Control, “Every 4 seconds, a child is treated for an injury in the emergency department, and every hour, a child dies as a result of an injury.”

Sudden infant death syndrome has been cut in half since a 1994 safety campaign urged parents to put babies to sleep on their backs. But there’s still danger. SIDS is still the top cause of death in young babies – and rates are holding steady. In addition, suffocation deaths in babies less than a year old have risen 54 percent in recent years, according to a new CDC report on injuries in kids.

Big causes of both are risky sleeping arrangements. A new study that looked at 568 SIDS deaths in California between 1991 and 2008 found that deaths in infants put to sleep on their side rose from 7 to 17 percent. And deaths in which babies were sharing a bed with an adult increased from 19 to 38 percent. Meanwhile, suffocation deaths have risen four-fold in the past 20 years – due to soft bedding in a baby’s crib or bassinet, an adult rolling over or up against an infant while sleeping, or a baby becoming trapped such as between the mattress and a wall or between the bars of a crib.

What can parents and caregivers do to protect babies when they go to sleep? I asked Adam P. Richards, M.D., director of Pediatric Emergency Services at Kennedy University Hospital in Washington Township, N.J.  Here’s his advice:

By Gary A. Emmett, M.D.

Stefon is 15 and has asthma. More importantly, his asthma is often out of control – and as a result he’s been admitted to the hospital once in the last year and spent the night in the ER twice. He has a preventive steroid inhaler, but stops using it once he feels “better.”  So Stefon’s asthma gets worse again. It happens so often that coughing, wheezing, chest tightness and night-time wake-ups have become his new normal –he doesn’t even notice these warning signs of trouble.

It doesn’t have to happen. Asthma is what’s called a “reversible airway disease.”  We can reverse asthma symptoms so that kids can live full, fun lives – but only if we know whether their daily treatment plan is working and when their asthma’s getting worse. The challenge with teen-agers is that, as one recent study found, they dramatically overestimate their ability to control this breathing problem. Parents can help, by asking themselves and their teen-ager with asthma the right questions.