Driveway Disasters (Article)

The combination of driveways and your children can be a deadly one. Accidents can happen in the blink of an eye while a parent is performing a mundane task like backing their car out of the driveway; disaster can sadly be just feet away. We all know how much kids love playing outside in the driveway. This puts them squarely in a dangerous zone where they can be injured by a moving car. It’s an alarmingly easy mistake to make that happens frequently. So many families have been devastated when their children are injured or killed by the family car.

In the U.S., fifty children are backed over every week. Of these fifty, two are fatally injured, and most victims are between only twelve and twenty three months old; they are just little innocent toddlers who have no awareness of the danger a moving car poses. They just innocently toddle out into the driveway following their parents, right in the way of the moving vehicle. Most accidents occur when drivers cannot see children in their car’s blind spot, the space behind the car that is not visible from the driver’s seat. Since trucks, vans, and SUVS have the largest blind spots, the majority of accidents are attributed to these vehicles. Fortunately, with more awareness, most of these accidents are preventable.

Here are a few easy tips to ensure that your children are kept safe in your driveway.

  • Always walk all the way around your car before backing out of the driveway. These few seconds could save your child’s life.
  • When young children get in or out of the car, hold their hands and guide them to a safe area where the driver can easily see them.
  • When you’re behind the wheel, remember to back up slowly and always pay attention to your mirrors.
  • Consider purchasing a car that is equipped with a back-up camera and alarm, especially when your children are very young.

Hopefully, all these measures will reduce the number of children who are injured where they should be the safest…their own homes. The prevention of such accidents is possible and in our hands. This is a problem that we can fix!

Your comments are welcome at my blog, Until next time.

Smo Notes:


Written collaboratively by Keri Register and Paul Smolen M.D.

Children and Pools (Article)

​Summer is a season when parents need to be especially vigilant about their children’s safety. One of the biggest summer risks starts when the pools open for business. What summer vacation signifies for youth is cooling off from the summertime heat by jumping and playing in a pool. For children, the neighborhood pool means freedom, friends, and fun. For parents however, their immediate concern needs to be, “safety first!” As beautiful and harmless as backyard appears, parents must remember it can be dangerous and even lethal for their children. A 2013 report found that children younger than 15 represented 78% of deaths from pool-related injuries. These data certainly cast a dark shadow over the image of fun in the sun. ​Since when did swimming at the pool become dangerous? The report “Pool and Spa Submersions: Estimated Injuries and Reported Fatalities” discusses findings related to this class of injuries. This 2013 report found that the majority of these pool-related fatalities involved children “15 years or younger” at neighborhood pools. Interestingly enough, the report also found interesting demographic information related to these incidents. The Centers for Disease Control and Prevention found African American and Hispanic children at higher risk of drowning. Particularly, African American children, between ages 5 and 19, were “six times more likely to drown in pools [versus] white and Hispanic children.” They also found that 70% and 62% of African American and Hispanic children, respectively, could not swim adequately. The report did not identify the exact origins behind these figures but point out a serious health hazard threatening a large group of children. ​How do we solve the problem of childhood drownings? Should we outlaw community and backyard pools? No, we need to increase our efforts to make sure every child learns to swim and know how to safely be around water. Thanks to organizations like the American Red Cross, the YMCA, and most public swim facilities, families can teach their children how to swim and remain safe during this and all future summer seasons. Proper swimming is a vital life skill that all beachgoers, children and parents should know. It may seem obvious but the solution to childhood drownings is really simple, professionally taught swim lessons along with good adult supervision around water. Smo Notes: Written collaboratively by Norman Spencer an Paul Smolen M.D.

White Noise Machines Can Be Noisy! (Article)



I am an old enough pediatrician to have seen a number of sleep fads come and go in my career. I recall a device that gently shook the crib and made the noise similar to a car ride that was very popular back in the 80’s.  I also recall, a set of springs that were fitted to the bottom of the crib so as to create a rocking motion each time the baby moved.  Who could forget the stuffed animal that had placenta noises or heart beat sounds emanating to help the infant replicate the womb-like environment in their crib. The current trends in infant sleep aides seem to be  swaddle devices and white noise machines, to a large degree popularized by Dr. Harvey Karp, a pediatrician in California.


It was with great interest to me when I recently read a study that has questioned the safety of the white noise machines that are currently sold in the US. The authors recorded the decibel level of a variety of these machines and found that, at close distances, the amount of noise they produce could potentially cause hearing loss in an infant, especially if they were run all night. Currently, experts recommend that noise in hospital nurseries not exceed 50 decibels but many of these machines tested reached 85 decibels sound levels, far above what is considered safe. Exposure to noise of that level over an extended period of time can potentially cause permanent hearing loss.


Parents need to use caution when they introduce any external device into an infant’s sleep ritual as we have recently been reminded with revelations about swaddle devices and now sound machines.  Yes, there might be some short-term advantages from these devices but those unintended consequences often come back to haunt us.  In the case of white noise machines, exposure to a lot of noise is clearly a limiting factor. Although difficult for many infants, maybe learning to settle oneself down and control one’s own environment by creating their own “Comfortable sleep environment” is an important learning step for infants.


Smo Notes:

Swaddling Harmful? (Article)

What is old is new and what is new is old as they saying goes. Nothing could be more true when it comes to swaddling infants, that ancient practice that has enjoyed a resurgence of popularity among todays parents.  Just go into a baby store and you will know what I am talking about; baby blankets for swaddling, swaddle wraps (a blanket with pockets for the infant’s arms and legs along with Velcro), wearable blankets (a blanket with holes for the arms and head zippered up the front), and sleep sacks (a sack with an opening for the infant’s head), along with other variations.  Most parents will agree that these swaddling devices sooth babies and create a warm environment for the infant but are they safe?


The dangers of swaddling have been known about for decades; over bundling and heat illness, suffocation if the wrap gets loose and gets near an infants face, an infant who rolls over while wrapped and smothers, being wrapped too tightly restricting breathing, pieces of the swaddle coming loose or damaging an infant’s mouth. In a recent retrospective study published in the Journal of Pediatrics, the authors reviewed deaths and injuries from swaddles between 2004 to 2011 in the US.   In all, they found 22 infant deaths in part or totally attributable to swaddling.  Here was the breakdown:

 5 cases involving wearable blankets (1 death, 2 injuries, 2 potential injuries);

 18 cases involving swaddle wraps (8 deaths and 10 potential injuries);

 1 death involving an unspecified product (either swaddle wrap or wearable blanket); and

 12 deaths involving swaddling in ordinary blankets.


Swaddling remains a useful tool for parents to soothe a fussy baby but this new study reminds us of its limitations and dangers.  Parents need to be vigilant not to overwrap their infants and get them too hot, wrap them too tightly and restrict their breathing or leg movements, ever leave a child swaddled who can flip onto their stomachs and smother face down, or have a wrap that can get anywhere near a child’s face.  22 deaths out of approximately 21 million babies born during the study period isn’t exactly an epidemic but maybe if the limits of swaddling are better understood, we can make the next number collected be ZERO!  Let’s hope.  Until next time.


Your comments are welcome at my blog,

Smo Notes:


2. J Pediatr. 2014 Jan 30. pii: S0022-   3476(13)01591-6. doi: 10.1016/j.jpeds.2013.12.045.

Infant Deaths and Injuries Associated with Wearable Blankets, Swaddle Wraps, and Swaddling, McDonnell E1Moon RY2.