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Pediatric News Briefs: 2005 Immunization Schedule, Early Education, Kitchen Dangers, Breastfeeding Ratesby American Academy of Pediatrics
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AAP ISSUES RECOMMENDED 2005 IMMUNIZATION SCHEDULE
The American Academy of Pediatrics (AAP) has issued the recommended 2005 childhood immunization schedule for the United States. The statement represents unified recommendations from the AAP, the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC), and the American Academy of Family Physicians (AAFP).
Compared to the 2004 schedule, no major changes have been made in this year's schedule. However, licensure applications have been submitted to the Food and Drug Administration for a meningococcal (meningitis) vaccine and two new preparations of diphtheria-tetanus-acellular pertussis (DtaP) vaccine. The AAP is considering recommendations for use of these vaccines in adolescents. If new recommendations emerge, all three groups will release a revised midyear schedule.
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In May 2004, the AAP officially expanded its recommendations for annual influenza (flu) immunizations to include children ages six through 23 months, as well as close contacts including household members and caregivers of children under age two and women pregnant during the flu season. Children six through 23 months of age and women pregnant during the flu season remain high-risk groups that should receive the flu vaccine.
HIGH QUALITY EARLY EDUCATION AND CHILD CARE IMPROVES HEALTH AND PROMOTES DEVELOPMENT AND LEARNING
The American Academy of Pediatrics (AAP) recognizes that high-quality early education and child care for young children improves their health and promotes development and learning. The AAP notes in a revised policy statement titled, "Quality Early Education and Child Care From Birth to Kindergarten," that early education includes all of a child's experiences at home, in child care and in other preschool settings. The AAP recommends that pediatricians work in their communities and with their patients' families to improve access to, and quality of early childhood educational experiences.
The AAP recently conducted a national survey that assessed pediatricians' knowledge and experiences with child care issues. The results showed that more pediatricians routinely inquire whether patients younger than 6 years spend time in child care settings. In addition, more pediatricians are confident in their ability to respond to child care questions. The survey also showed that while the majority of pediatricians are interested in receiving more information about child care, lack of time and uncertainty about how to get involved remain the most frequent barriers to providing services or consultation to child care programs.
To address these issues and implement policy statement recommendations, the AAP will offer training to pediatricians and their child care partners at the "Conference for Pediatric Advocates in Early Education and Child Care." Information about the conference and other resources can be found at http://www.healthychildcare.org, including "Telling the Healthy Child Care America Story: Making a Positive Difference in the Health of Children in Child Care." This publication highlights work done through the Healthy Child Care America program to strengthen state licensing regulations, establish networks of child care health consultants, and make access to a medical home for all children a priority.
Although the kitchen is recognized as hazardous for young children, parents seem not to recognize or anticipate the risk for burns and scalds.
The study, "Kitchen Scalds and Thermal Burns in Children Five and Younger," examined emergency room data of thermal burns and scalds associated with non-electric cookware collected by the U.S. Consumer Product and Safety Commission's injury surveillance system from 1997-2002. According to the data, scalds were approximately twice as common as thermal burns and resulted in significantly more hospitalizations. Thermal burns are heat-caused, usually by contact with a hot surface. Scalds are also heat-caused, but the source is usually a hot liquid or steam rather than a hot surface. The two most common ways scald injuries occurred were (1) the child reached up and pulled a pot of hot water off the stove or other elevated surface, and (2) the child grabbed, overturned or spilled a container of hot water onto him- or herself. One-year-olds were at highest risk for scalds and burns and more boys than girls suffered scald and burn injuries. The author asserts that there is an apparent failure on the part of parents to recognize children's ability to gain access to hot items and liquids in the kitchen and a failure to recognize the potential severity of resulting injury.
Breastfeeding Rates - Goals Still Low
Although the rate of breastfeeding initiation in the United States is near the national objective of 75 percent, the gaps remain large in achieving the goals for continuation of breastfeeding. Authors of the study, "Breastfeeding Rates in the United States by Characteristics of the Child, Mother, or Family: The 2002 National Immunization Survey" found that only about 35 percent and 16 percent of US infants are receiving breastmilk at 6 and 12 months, respectively. In addition, rates of exclusive breastfeeding (only breastmilk and water) are low. Because non-Hispanic black children had the lowest breastfeeding rates, the authors conclude that "strenuous" public health efforts are needed to improve breastfeeding behaviors, particularly among non-Hispanic black women and socioeconomically disadvantaged groups.
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