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Health Information Blog : Double Duty
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I'm a pediatrician by training with an undergrad degree in journalism. I spend my days teaching and mentoring future pediatricians. My wife and I spend our evenings and weekends keeping up with very active twins. This blog will chronicle my thoughts on current children's health care issues and trends, trials and tribulations as a parent and husband mixed in with a lot of life experience.


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photo William Stratbucker, MD
Tuesday, May 31, 2011
Is Indoor Recess Worth Cheering About?
by William Stratbucker, MD at 01:56 PM

"Attention students! Sorry for the interruption but we will have indoor recess today due to the rain," said the voice on the speaker at my children's school one recent rainy morning.

"Yes!" at least four of the six kids sitting within a few feet from me. I was volunteering in my child's classroom.

While I was not surprised by the announcement as it was pouring outside, I was caught completely off guard by the children's mostly unanimous and simultaneous response. So, as a researcher, I asked a question.

"Why are you so happy about indoor recess?"

One first-grade girl said plainly and quickly, "Because, when we have indoor recess we get to play with the toys in the room. If we have to go outside for recess we have to make up games by ourselves to play and just move our body parts around."

I think what she meant was that sometimes it's challenging for kids to think of what to do when given a few minutes on the playground. I hope she didn't mean that she's already decided that sitting inside and not moving is preferable to being able to go outside and run around for a few minutes with friends. I fear that some school age kids would rather not go out for recess as they are either intentionally not included in team activities or games or, worse, are teased or bullied during this time of relatively low close supervision.

One of the other students said the reason he exclaimed "yes" to indoor recess was just that he didn't want to get wet. The girl who responded previously - She said, "Yah, you like outdoor recess because you play soccer."

I worry our schools are not doing enough to provide closely supervised, constructive, fun activities during recess that includes anyone interested. Could this have led to that girl's explanation as to why she'd rather sit inside? With formal physical education time limited in schools, it makes what happens at recess that much more important. There is some medical evidence that kids who are more active tend to do better in school.

The comments from students were from those at the same school which started a running club for kids on Wednesdays during afternoon recess staffed with parent volunteers. We saw a very interesting trend. When we provided a structured, closely supervised activity that was encouraged by the parent volunteers and the school staff, we had all kinds of kids taking advantage. We didn't keep statistics or obtain demographics on the kids who participated and those who didn't but it seemed to be an outlet possibly for that girl who couldn't think of anything to do. The other trend that was noticed is that the boys were able to start up a game of soccer quite easily and play right up until the bell rang again. It didn't seem that way for the girls. But on Wednesday, we had several of them (and non-soccer-playing boys) joining us to run laps for the small incentive of a plastic bracelet charm.

What are your thoughts or your experiences about recess at school for your kids? Do you think we need more structured activities to involve those who are reluctant to move their body parts around? Or do you think it doesn't matter what happens at recess and kids should be allowed to be kids, regardless of whether they are moving around or not?

- Dr. Stratbucker

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Tuesday, May 31, 2011
What's the best form of hydration? Water, not sports or energy drinks.
by William Stratbucker, MD at 09:48 AM

Guest blogger Kyle Morrison is a pediatric exercise physiologist at the Helen DeVos Children's Hospital Healthy Weight Center.

A report released today by the American Academy of Pediatrics (AAP). It says that kids should never consume energy drinks and rarely consume sports drinks-and stresses that parents need to know the difference between the two drinks.

Just so you understand the difference, RockStar and Monster are examples of energy drinks, which are highly caffeinated beverages claiming to boost energy, and Gatorade and PowerAde are examples of sports drinks that supposedly help with hydration and athletic performance.

Professionally, I absolutely agree with this advice from the AAP, and as a future parent, I do, too. I am becoming the father to a six-year-old boy this summer, and can only think of a few situations when I would even consider giving him a sports drink-perhaps if it was one of the hottest days of summer and he seemed dehydrated and no water was available; or if he was very ill and dehydrated, and a sports drink was the only option available to me at that time.

As for energy drinks, I would never give one to a child under any circumstance. Did you know that a Wired x505 energy drink contains a mind-blowing 505 milligrams of caffeine-the equivalent of about 14 cans of soda?

Drinks Designed for Adults, Not Kids

Here's something interesting to consider: The first sports drink, Gatorade, was developed for the Florida "Gators" football team. The players were training in the swelteringly Florida summer heat and were becoming severely dehydrated, sometimes losing 5 to7 pounds after a single training session. A biochemist analyzed their sweat and saw it contained sodium, potassium and amino acids and from this research, developed Gatorade-for adult athletes who train for long durations each day. Children's physiology and sweat are different; kids have fewer sweat glands per square inch of their body and sweat much less than adults. It is therefore more important for children to cool their bodies during extend activity and water is the best means of doing this.

There are so many other reasons why water is a better choice: sports drinks are high in sugar and calories and can contribute to obesity; children can get a "sugar high" and become less effective athletically once they crash; they are also terrible for the health of your child's teeth.

Breaking the Sports Drink Habit with Young Children:

  • If your children are used to drinking sports drinks, they probably will not want to give them up. Stay firm, and know you are doing the right thing for your children.
  • If you can't go "cold turkey," start by diluting your sports drinks, gradually increasing the water. Or consider drinks that have few or no calories, such as Crystal Light. (That said, I believe the goal should always be to drink pure water.)
  • Remember juice is not a good alternative since it contains excess sugar and calories.

Breaking the Energy Drink Habit with Teens:

  • Be aware that your teen may have developed a dependence on the caffeine in these drinks. Your teen may experience headaches, shakiness, fatigue or other symptoms as he or she breaks the habit of drinking them on a daily basis.
  • Elite snowboarders, skateboarders and other young athletes endorse energy drinks, yet it's likely few drink them. Talk to your daughter or son about how these drinks are marketed and how this might be influencing their habits.
  • Instead of trying to force the issue, give your teen the facts, and let him or her know you care about them making healthy decisions.
  • Lead by example-if you are consuming these drinks your child will think it is okay for him or her to also.

- Kyle Morrison

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Tuesday, May 24, 2011
“Smoking Smarties” : Should Parents Be Concerned?
by William Stratbucker, MD at 12:37 PM

Adolescent medicine specialist Eugene Shatz, MD, is this week's guest blogger.Eugene Shatz, MD

For those of you who don't have any idea what I'm talking about (don't worry-I didn't either, until I looked it up online) it's when kids crush Smarties candy in the wrapper until it becomes powdery. They then inhale the powder and blow it out, to mimic cigarette smoking. Kids who are more "talented" apparently even learn how to blow smoke rings.


I'm always surprised at the new ways kids and adolescents come up with to entertain themselves and test boundaries. The latest trend I was surprised to hear about was kids "smoking Smarties."

Should parents be concerned about this latest trend? In my opinion, concerned, no, but aware, yes.

Here are some things to be aware of:

  • Smoking Smarties could cause irritation to the back of throat or bronchial tubes. If you watch YouTube videos of kids smoking Smarties (yes, I did this) you'll notice they don't really inhale, but rather keep the powder in their mouths. Still, particularly if your child has asthma or bronchial problems, smoking Smarties could be dangerous.
  • Some people believe smoking Smarties can be a gateway to smoking cigarettes or using drugs. Again, everyone is entitled to their opinion, but personally, I don't think this is a concern. I put this in the same category as smoking candy cigarettes-probably not something you want your kid doing, but not something that is going to cause serious damage either.

Talk About It-But Not Too Much

I think the more you amplify things or tell a kid not to do something, the more curious they can become. So I say, talk to you kids about smoking Smarties. But take a casual approach-try not to make a big deal out of it. Just tell them that pretending to smoke is not something anyone should be doing.

A Trend I Do Find Concerning

There is one trend that I do find concerning, and one that is worthy of your attention-it's kids spending too much time with electronic media. Here are just some of the negative ways it plays out:

  • Kids aren't getting enough outdoor exercise. Parents should talk to their kids about spending time online versus spending time outdoors. Kids need to get outside and ride their bikes, run, mow the grass, play football, chase butterflies-anything that gets them out and burning calories.
  • Kids aren't getting enough opportunities to build their social skills. Kids need to learn how to interact face to face with people of all ages and backgrounds. Limit all screen time-it is a reasonable thing to do and will help your kids develop these all-important skills.
  • Kids aren't being supervised enough when they are online. Internet time needs to be limited and monitored, just like TV time. Get filtering software so kids can't get to inappropriate sites. Don't let them spend hours alone in their rooms online.

The bottom line is: don't hover over your kids, but be involved in their lives and know what they are being exposed to, whether it's smoking Smarties or something they're finding online.

- Dr. Shatz

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Monday, May 09, 2011
Is Registering a Product Worth the Time?
by William Stratbucker, MD at 09:59 AM

Guest blogger Jennifer Hoekstra is the Safe Kids Program Coordinator at Helen DeVos Children's Hospital and injury prevention specialist. 

When I was pregnant with my first child, I bought a crib that I loved at a garage sale.  I used it for my second child as well.


When I was setting it up for my third child, my sister was helping me. She asked if I had heard about the recalls happening on so many cribs. I said I had, then it hit me-what if a recall was on my crib?  I checked, and unfortunately there was-and it was quite a serious one. I was devastated! Thankfully, we had Pack-and-Play and didn't have to buy a new crib.  


Although safety is my career now, and it is also a top priority in our home, I wasn't tuned into the importance of product registration at that time. Thankfully, nothing happened, but it could have-and I could have prevented it by just registering my crib.


What to Register

Do you register your products and stay informed of recalls? This is one thing every parent should be doing. You probably don't need to register every product you own, but you should register these: your car seat, stroller, crib, high chair, safety gates, swing and bouncy seat.


More Reasons Why

Need some convincing? Here are some good reasons why you should register your car seat (but these reasons apply to other products, too):

  • Registering a car seat is not like registering your toaster. You won't get put on any mailing lists, and it only will take a few minutes of your time.
  • You'll be notified of recalls; if you don't register you may miss the information, unintentionally placing your child in an unsafe situation.
  • If there is a recall, the manufacturer can send you a free repair kit immediately.
  • Manufacturers are always testing their products. If they discover something unsafe, the only way they can contact you is through your registration.

Getting Recall Info

In addition to registering products, I also recommend getting recall information sent to you from these organizations:

  • The Consumer Product Safety Commission at Go to "Get Involved," then click, "Sign Up for Safety News and Recall E-mails."
  • The Highway Safety Research Center at Click on "Safety Information," then "Child Passenger Safety" then "Child Restraint Recalls" and finally "Sign up for automatic email notification of updates to the HSRC recall list" to get car seat recall information sent to you.

Remember that a safe product in itself is important, but it's only safe if a parent uses it properly.

 - Jennifer Hoekstra, CPST-I

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