For around four years in a row, starting around 1996, my husband and I rented one of those inflatable bouncy houses for my son’s birthday party every August. We invited a whole bunch of his friends and cousins to bounce in it for a few hours (and let them play in the sprinkler and fed them cake). Nobody got hurt.
Which, in retrospect, was kind of amazing.
In a report just out this week in the journal Pediatrics, researchers report that between 1990 and 2010 about 65,000 children were treated in US emergency rooms for injuries they got in bouncy houses. That’s about 31 kids a day. The number and rate of injuries increased fifteen-fold over that time period.
The vast majority of those injuries were fractures or sprains, usually of the arms and legs. Luckily, only three percent required hospitalization. And while the injuries spanned the age range, more than half were in six- to twelve-year olds, with most of the rest being in younger children.
The injuries happened in all sorts of different ways. Most of them were caused by falls (often by falling out of the bouncy house), but kids are always creative in how they get hurt, and bouncy house injuries are no exception. Pushing and pulling caused a bunch of injuries, and kids crashed into each other and fell on top of one another too.
We did our best to have rules during the birthday parties. We limited the number of kids bouncing at any one time. We didn’t allow flips. We kept a grownup stationed nearby to monitor for roughhousing. We kicked kids out if they were behaving badly. We weren’t perfect at enforcing the rules—there was a limit to the ability of two people to supervise twenty or so kids all over a yard, and the other grownups were not always invested in helping us out—but we did it well enough that there were no trips to the emergency room after any of our parties.
I don’t regret having those parties. My kids have a lot of great memories from them. And bouncy houses are hardly the only or most dangerous activity out there for kids. According to the Centers for Disease Control, every year 500,000 people go to emergency rooms with bike injuries—and we’re not telling kids to stop biking. We can’t put kids in bubbles, and learning to manage risky situations is part of growing up.
But with bikes, we have helmets, and rules of the road for bikers. It’s those safety rules that are missing when it comes to these “inflatable amusement devices.” The authors of the study say that we really need to come up with those rules, given all the bouncy house injuries. They suggest that the safety rules be similar to those we have for trampolines, since the injuries are very similar.
The American Society for Testing and Materials has some guidelines, although they are pretty general and vague. The Consumer Products Safety Commission has recommendations that are more specific, although they are more aimed for people who run fairs, etc, than parents.
While we come up with the safety rules, the best thing you can do is use common sense:
- Always follow the manufacturer's directions and safety guidelines
- Be particularly careful with children under the age of six--might be better to avoid bouncy houses with them entirely
- Keep numbers down (they vary in size, so it's hard to give a specific number). Everyone should be able to have their own personal space.
- Make sure kids keep body parts to themselves (the point of the personal space)
- No flips or other stunts.
- SUPERVISE. Make sure that you have enough grownups to do this (and make sure that they will enforce the rules)
- Have a zero tolerance policy for rough-housing or other dangerous behavior. Consider using a whistle or something like it, the way lifeguards do.
As for me, I think I’m done with renting bouncy houses for birthday parties. I dodged the injury bullet for four years; I may have used up all my luck. Not that my youngest (the only one we'd do it for, at this point) will care; he doesn't like bouncy houses.
The morning-after pill (also known as Plan B): that’s the pill women can take when they’ve had unprotected sex—like when the condom breaks, or they didn’t use contraception for some reason, or, God forbid, they were forced into sex. Taken within 120 hours of intercourse, it can cut down the risk of pregnancy dramatically.
The American Academy of Pediatrics (AAP) would like doctors to give it to their teen patients before they need it. Like at checkups. Like, along with telling them to take vitamins, we should be giving them a prescription for Plan B.
This sounds strange, but it makes abundant sense.
I will never forget a conversation I had with my father when I was about fifteen years old. Out of pure curiosity--I wasn't even vaguely considering having sex at the time--I asked him what we would do if I got pregnant as a teenager. My father, who was one of the most laid-back, mild-mannered people I knew, said very sternly and brusquely, “I don’t ever want to find out what we would do.” End of conversation.
As a teenager, I was taken aback by his reaction; as a mom, I totally get it.
I’m not saying that babies aren’t wonderful. They are incredible and worthy and life-changing. But it’s the life-changing part that is problematic with teen moms, of which I have seen many over the years as a pediatrician. It’s not just that they have to stop cheerleading or going out with friends. Having a baby as a teen throws school, college, graduate school and getting a good job into jeopardy. I’ve watched many girls give up their dreams and quit school and take minimum-wage jobs—or struggle to hold down a job and go to school while parenting a toddler. And then there’s everything it means to the child and the child’s future to have a mom who, frankly, isn’t really ready to handle the stresses of parenthood.
All of us parents want to think that this happens to other people’s kids, not ours. Other people’s kids have sex, other people’s kids don’t use contraception. Ours are smarter and more, um, moral than that. But the statistics don’t back us up. Just under half of 15- to 19-year-old girls report ever having had sex, ranging from 13 percent of 15-year-olds to 70 percent of 19-year-olds. And here’s a frightening fact: ten percent report being forced to have sex. As for birth control, condoms are the most common method, and they break. The second most common method is withdrawal, which leads to pregnancy really often. Oral contraceptives are third—but I’ve had patients forget to take them. These are teenagers, after all.
Enter Plan B.
Plan B is not an abortion. It works the way birth control pills work, by getting in the way of ovulation and messing up the hormones needed for early pregnancy. It stops things from getting started. And if you are already pregnant when you take it, or if it doesn’t work and you get pregnant, it’s not dangerous to the baby (if you use levonorgestrel, the most common kind of Plan B pill).
But the key is getting it early. While it will work within 120 hours of the unprotected sex, it's better to get it within 72 hours--or, even better, 24. That’s why the AAP wants doctors to give it to girls ahead of time. Studies show that having a plan B prescription ahead of time makes teens more likely to use it when they need it (many teens delay getting in touch with the doctor, especially if they might have to tell a parent)—and it doesn’t make them more likely to have sex or less likely to use regular contraception.
I know this will make a lot of parents uncomfortable. In an ideal world, we don’t want to have these conversations with our daughters—in an ideal world we don’t even want to think about them having sex.
But we don’t live in an ideal world. We live in the real world. And what we most want for our daughters is for them to have the best future possible.
So if you are the parent of a teen girl, think about it. Talk to your daughter and your doctor about whether a prescription for Plan B makes sense.
Let's get right to the bottom line: antibiotic resistance has become on of the world's most pressing public health problems. And the cause of the resistance is overuse of antibiotics.
- Don't ask for antibiotics for viral infections. Talk to your doctor about ways to relieve symptoms. Definitely be in touch with your doctor if an illness gets worse or isn't getting better within a few days
- Don't save antibiotics for the next time someone is sick
- Don't take antibiotics prescribed for someone else
- This is key: DO take antibiotics if your doctor says you really need them, and take them EXACTLY as prescribed. Taking too much or too little can lead to resistance.
- Infant cereal (1/4 cup): one serving a day
- Hot cereal (1/4 cup): 1 3/4 servings a week
- Rice-based ready-to-eat cereal (1 cup): 1 1/2 servings a week
- Rice drink (like rice milk): none
- Rice (1/4 cup): 1 1/4 servings a week
- Rice pasta (2 oz): 1 1/2 servings a week
- Rice crackers: 8-9 crackers a day
- Rice cakes (1-3): 1 serving a week