Child Passenger Safety Week

It's Child Passenger Safety Week. Car crashes are a leading cause of death in children. When the right car seat is used and installed correctly, car seats can significantly reduce the risk of injury in children. Unfortunately, many children are not riding in the right seat and when they are, up to half of them are not installed correctly. Let's talk about how you can make sure you child's seat is installed correctly.

Why is this so important?

The U.S. Department of Transportation's National Highway Traffic Safety Administration (NHTSA) just released statistics for 2021. According to the NHSTA, while riding in passenger vehicles in 2021:

• 710 children under 13 were killed.
• More than 100,000 children under 13 were injured.
• More than a third (36%) of the children who died were unrestrained.

Data shows:

• Car seat use reduces the risk for injury in crashes by 71-82% for children, compared to seat belt use alone.
• Booster seat use reduces the risk of serious injury by 45% for children ages 4-8 compared with seat belt use alone.
• Seat belt use reduces the risk for death and serious injury by about half for older children and adults.

How do you choose the correct seat?

The recommended seat for your child depends on their age, weight, and height. All children ages 12 and younger should be buckled properly in the back seat. Here are the stages:

Rear-facing car seat - Use from birth until ages 2-4.

• Infants and toddlers should be buckled in a rear-facing car seat with a harness, in the back seat.
• Check the car seat manual and labels for weight and height limits for the seat. When your child reaches the limits for this seat, they should move to a new seat.
• NEVER place a rear-facing car seat in the front seat of your vehicle. Front passenger air bags can injure or kill young children in a crash!

Forward-facing car seat - Use until at least age 5, depending on your child's size.

• Once children outgrow their rear-facing car seat, they should be buckled in a forward-facing seat with a harness and a top tether, in the back seat. The tether is an adjustable strap with hook used to connect to one of your vehicle's tether anchors.
• Use this car seat until your child reaches the maximum weight or height limit for this seat, which can be found in the manual and labels on the seat.

Booster seat - Use after outgrowing the forward-facing car seat, until the seat belt fits properly.

• Use a belt-positioning booster seat.
• If the booster seat does not position the seat belt properly, your child should still be in a forward-facing car seat.
• A seat belt fits properly when the lap belt is across the upper thighs, not the stomach, and the shoulder belt is across the center of the shoulder and chest. It should not be across the neck or face, and not off the shoulder.
• Seat belt fit can vary by vehicle. Check the fit in each vehicle they may ride in to make sure they don't need a booster seat. Sometimes they need a booster seat in one vehicle but not in a different vehicle.

Seat belt use - When the seat belt fits properly without a booster seat.

• Use a seat belt every time you are in the car.
• Proper seat belt fit usually occurs between ages 9 and 12, depending on size.
• Children 12 years old and younger should ride in the back seat, even after the seat belt fits properly, for the best protection from injury.

How do you know if the car seat is installed properly?

The annual Child Passenger Safety Week will end with National Seat Check Saturday. This year, certified child passenger safety technicians will be offering free car safety seat checks and education nationwide on Saturday, September 23. Use this link to find a car seat inspection station near you:

Car Seat & Booster Seat Safety, Ratings, Guidelines | NHTSA.

Using the same link, if you scroll up from the section on car seat inspection, you will also find a section on car seat installation with an explanation of car seat parts and vehicle parts that are used to install car seats, as well as instructions for installing various kinds of rear and forward-facing car seats, and booster seats.

For more child safety information for parents and caregivers, use this link:

Parents and Caregivers | NHTSA

If you have any questions about child car safety, please log into your account and send us your question. We are here to help.

Dr. Anita Bennett MD - Health Tip Content Editor

Healthy Aging

September is Healthy Aging Awareness Month. It is an opportunity to promote ways that people can stay healthy as they age. There are many factors that influence healthy aging. Let's talk more about what we know about healthy aging.

What is healthy aging?

The Pan American Health Organization defines healthy aging as a continuous process of optimizing opportunities to maintain and improve physical and mental health, independence, and quality of life throughout the life course.

A simple way to think about it is that healthy living equates to healthy aging. The healthy living habits that you develop and maintain throughout your life contribute to the ability to thrive later in life. They contribute to greater resilience relating to illness and hardships in life.

What influences healthy aging? What can we do about these factors?

There are many factors that influence healthy aging, including:

Genetic factors -

• We can't do much about genetic factors, although knowing your family history and sharing that information with your doctor is an important aspect of healthy aging.
• Regular exercise and maintaining an active lifestyle -
• Get at least 150 minutes of moderate aerobic activity per week. Or get at least 75 minutes of vigorous aerobic activity per week. Do this throughout life.
• Do strength training exercises for all major muscle groups at least two times a week, throughout life. One set of each exercise is enough for health and fitness benefits.
• Continue to participate in activities throughout life that maintain flexibility, such as sitting on the floor, squatting, bending, stretching, Yoga, gardening, etc.

Healthy food choices -

• Most of each meal should be vegetables and fruits - They should take up half of your plate.
• Choose whole grains to take up one fourth of your plate.
• Choose healthy proteins for one fourth of your plate, such as fish, poultry, beans, and nuts. Limit red meat and avoid processed meats.
• Limit salt intake.

Healthy sleep habits -

• Get between 7 and 9 hours of sleep per night.
• Sleep quality matters - Follow this link to learn more about how to get better sleep: A Good Night's Sleep | National Institute on Aging (nih.gov)

Regular medical check-ups -

• See your doctor regularly and follow recommended medical screening guidelines, such as cancer screenings.

Take care of your mental health -

• Mental wellness is essential to your overall health and quality of life.
• Stay connected with friends and family and continue to meet new people.
• Find ways to manage stress, such as meditation, physical activity, keeping a journal, etc.
• Exercise your brain regularly by learning new skills, such as learning a new game, a musical instrument, or a new craft or hobby such as quilting, or maybe new computer software.
• Be aware of symptoms that might indicate depression and seek treatment. Follow this link to learn more about depression and its symptoms: Depression and Older Adults | National Institute on Aging (nih.gov)

Quit smoking -

• It doesn't matter how old you are or how long you've been smoking, quitting smoking will improve your health.

Avoid alcohol and other substances -

• Alcohol use is associated with multiple health problems.
• Other substances can be both illicit drugs as well as misuse of prescription drugs.

If you have any questions about healthy aging, please log into your account and send us your question. We are here to help.

Dr. Anita Bennett MD - Health Tip Content Editor

Can Outdoor Play Prevent Nearsightedness? - Part II

Last week, we talked about myopia, or nearsightedness, including the increasing incidence of it around the world. We also talked a little bit about how exposure to outdoor light can help to prevent myopia. Today, we'll continue the conversation.

Why is preventing myopia important?

Nearsightedness is associated with a variety of complications. Last week I talked about the long-term complications associated with high (severe) myopia. Here are some complications of unrecognized or uncorrected myopia:

• Poor school performance - Delays in reading or other academic skills
• Difficulty with social interactions
• Eyestrain
• Headaches
• Impaired safety - Not being able to see hazards adequately

What does the research tell us about the link between outdoor play and myopia?

As we discussed last week, myopia is caused by a mix of genetic factors and environmental factors. We can't change the genetic factors, but we do have some control over the environmental factors.

Researchers from all around the world agree that time spent outdoors reduces the likelihood that a child will become nearsighted. The data supports the idea that the primary reason for this is the bright outdoor light. The strong link between exposure to sunlight and myopia is especially true in families where the parents also had myopia.

How much outdoor time helps to prevent myopia?

• The current recommendation is for 2 hours per day outside. This is based on multiple research studies done around the world.
• There are studies showing benefit from less time outside, just not as much benefit. Even adding one additional hour outside in a week can decrease the risk of myopia to some degree.
• Here's a rhyme to remember: Go outside and play, two hours a day, to keep myopia away!
• This outdoor time is also beneficial for teenagers, to lessen the risk of developing myopia and decrease or maybe eliminate the progression of myopia that is already present.

What about the dangers of sun exposure? Didn't I just tell you a few weeks ago to avoid too much sun exposure due to the associated risks?

There is a fine line we need to walk between healthy sun exposure and damaging our health. I did talk about the dangers of sun exposure in recent Health Tips, including eye damage from UV radiation. So, what should you do so your kids get this benefit from the outdoor light?

• Go outside (or have the kids go outside) without sunglasses for about 20 minutes a day, preferably in the morning. The rest of the day, particularly between 10am and 2pm, wear good sunglasses with UV protection. Even with sunglasses on, there is benefit. The sunglasses are not blocking all of the bright light.
• Use sunscreen for outdoor play time. You still get the eye benefits with sunscreen on.
• You can also have the kids play in the shade on a sunny day, they still get much brighter light in the shade on a clear day than they do indoors.

Can that bright light be recreated indoors?

There are currently some experiments with the idea of glass cube walls to help add light to classrooms. But from the research to date, the amount of light that you need to get the goodness of time outdoors, really has to come from outdoor light.

Light can be measured in different ways, such as lumens, lux, foot candles. Lux is the unit of illuminance, indicating the actual brightness received on the ground. Just for comparison, here are some average illuminance values:

• A bright sunny day - Around 100,000 lux.
• Shade illuminated by an entirely clear sky on a bright sunny day - 20,000 lux
• Indoor classroom light - On average 500 lux

As you can see, there is no real comparison. Outdoor light wins for brightness!

How do you know if your child has myopia?

Make sure they get regular vision screenings, which can be done at their yearly well exam.

• At least once between ages 3 and 5
• Before/during kindergarten, usually age 5-6
• Annually through the end of high school

Also, watch for the symptoms we talked about last week.

If there is a problem on the screening test, or you notice symptoms, they need a complete eye exam with an optometrist or ophthalmologist.

If you have any questions about myopia, please log into your account and send us your question. We are here to help.

Dr. Anita Bennett MD - Health Tip Content Editor

Can Outdoor Play Prevent Nearsightedness?

The prevalence of myopia, otherwise known as nearsightedness, is increasing dramatically in the US and around the world. Also on the rise is the prevalence of severe or high myopia. While simple myopia is correctable with glasses, high myopia increases the risk of multiple serious eye conditions. There is a way to help prevent myopia in our children, which is as simple as having them play outdoors.

What is myopia?

Myopia, or nearsightedness, occurs when the eye grows too long from the front to the back. The lens of the eye functions to focus light onto the retina at the back of the eye. If the back of the eye is too far away from the lens of the eye, as it is in myopia, the images are focused at a point in front of the retina. As a result, people with myopia have blurry vision. Their near vision is ok, but they have very poor distance vision.

How much has the incidence of myopia increased?

In the early 1970s, about 25% of the population in the US had myopia. Today, that number has increased to 42%. This is a trend that is happening in many other parts of the world. The World Health Organization (WHO) estimates that half the world's population may be nearsighted by 2050.

Why is this important?

Being nearsighted, particularly having high myopia, increases the risk of conditions that can cause vision loss and blindness later in life. These conditions include:

• Glaucoma
• Retinal detachment
• Early development of cataracts

What causes myopia?

• Myopia is caused by a mix of genetic or hereditary factors and environmental factors.
• According to several research studies, the amount of time a child spends outside in the daylight plays a significant role in the development of myopia.

What are the signs and symptoms of myopia?

• Blurry distance vision
• Sitting very close to the TV or computer screen
• Holding books very close to the eyes
• Squinting when doing activities that require distance vision

How does outdoor play affect myopia?

Several studies have shown that outdoor time, in sunlight, can prevent or lower the chance of developing myopia, or lower the severity of myopia if it does develop. There are a few things that could contribute to this.

Sunlight -

One of the biggest reasons is exposure to the bright light of the sun. Research has shown that the sun's rays cause a release of dopamine, which impacts the development of the retina and may slow the elongation of the eye as children grow.

Relaxed focus -

Another thing that can provide benefit is allowing the eyes to relax by allowing a child's eyes to change focus from nearby to distant objects randomly, over and over again. Excessive near focus, such as staring at a digital screen could be a significant contributor to the development of myopia.

Vitamin D -

Another possible contributor is that more time spent in the sun allows for greater Vitamin D production. There has been research showing that nearsighted people have lower levels of Vitamin D than people with normal eyesight. We need more research to know how much Vitamin D affects the development of myopia.

Next week, we will talk more about myopia and things you can do to help prevent or lessen the severity of this condition in children.

If you have any questions about myopia, please log into your account and send us your question. We are here to help.

Dr. Anita Bennett MD - Health Tip Content Editor