Caffeine Powder Packs More Than an Energy Punch

Caffeine PowderAn Ohio teen mysteriously dies just days away from his high school graduation. One month later, the coroner finds the cause of death: caffeine overdose. He had more than 70 micrograms of caffeine per milliliter of blood in his system, 23 times the amount of a typical coffee or soda drinker. In his room, the teen’s mom found bags of white powder later identified as caffeine powder. This caffeine powder was bought online and is totally legal.

Caffeine is one of the most commonly used stimulants in the United States. Caffeine is found in tea, coffee, chocolate, many soft drinks and energy drinks, and over-the-counter medications. Known for giving the user a burst of energy and increasing alertness, people often use it for a pre-workout boost or to stay awake and study (like Jessie Spano from 90’s sitcom Saved by the Bell….you can find a clip of her character’s dramatic caffeine-induced breakdown on youtube). Partygoers take it to combat the downer effects of alcohol and marijuana. Caffeine powder is marketed as an alternative to coffee or soft drinks and much cheaper than buying the expensive energy drinks – one could mix it in shakes, drinks, or even food.

Like other drugs, caffeine has a number of side effects. Small amounts of caffeine can cause headaches, jitteriness, and sleep disturbances. Higher amounts can cause very high heart rates or an abnormal heart rhythms, agitation, and seizures. Regular caffeine consumption leads to physical dependence, which manifests as withdrawal symptoms when the user abruptly stops using caffeine.

Caffeine powder, like the kind found in the Ohio teen’s room, is much more potent than most caffeinated products (see table below). Its small serving size of 1/16 of a teaspoon requires mini-measuring spoons and a scale to measure. This 1/16 of a teaspoon can contain about 200 milligrams of caffeine, roughly the equivalent found in two large cups of coffee. Experts agree that you should avoid having more than 600 milligrams of caffeine in one day; 5,000-10,000 milligrams (5-10 grams) of caffeine is considered the lethal amount in an adult. Even less could be lethal in a caffeine-naïve teen. That looks like a large number, but just one teaspoon of caffeine powder may contain as much as 3,200 milligrams of caffeine (equal to 25 cups of coffee). Simply mixing two regular spoonfuls of the powder into a drink is the same as drinking more than 70 Red Bulls at once, which could kill you.

This is not the first time in recent history that caffeine has been in the news for negative effects. In 2013, the United States Food and Drug Administration (FDA) investigated 13 deaths and 33 hospitalizations related to 5-hour Energy products. In 2010, the FDA forced manufacturers of alcoholic caffeinated beverages (like Four Loko) to cease production of those drinks due to concern that caffeine masked signs of intoxication in users leading to increased binge drinking (and more serious health consequences).

Caffeine powder is sold as a dietary supplement, so it’s not subject to the same federal regulations as certain caffeinated foods, beverages, or medications. The FDA said it is collecting additional information about the powered products and will consider taking regulatory action as appropriate.

In the meantime, my advice is to avoid caffeine powder. It’s nearly impossible to accurately measure the appropriate serving size and it extremely easy to overdose. If you believe you are having an adverse event related to caffeine, stop using it and seek immediate medical care or advice. For questions regarding caffeine or any other substance, contact your local Poison Center at 1-800-222-1222.

Caffeine content in common products

Product Serving Size Caffeine Content
Starbucks coffee 16 oz
(Grande)
330 mg
Starbucks coffee 20 oz (Venti) 415 mg
Coffee 8 oz 135 mg
Diet Coke 12 oz 45 mg
Mountain Dew 12 oz 54 mg
Lipton Tea 8 oz 35-40 mg
Excedrin 1 tab 65 mg
Red Bull 8.4 oz 80 mg
5-hour Energy 1.9 oz 208 mg
No Doz 1 capsule 200 mg
Zantrex-3
(weight loss supplement)
2 caps 300 mg
Caffeine powder 1/16 tsp 200 mg

 

Caffeine Powder Packs More Than an Energy Punch
About Paula Cody, MD, MPH
Dr. Paula Cody is fellowship trained in adolescent medicine and is a pediatrician at the UW Health John Stephenson Teenage and Young Adult Clinic.

View all posts by Paula Cody, MD, MPH
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High School Athletes: Staying Safe in the Heat (Giveaway)

Teen Playing TennisMany high school athletes have already returned to sports camps in preparation for the fall season. The challenge is that during July, August and even September, we can experience some of the hottest days of the year. With the high temps, athletes need to be aware of how environmental factors like heat and humidity can affect their health and athletic performance.

How Heat Affects the Body

As heat and humidity rise our body has to work harder to cool off. Our bodies cool primarily through the evaporation of sweat. When temperatures rise, we produce more sweat to cool the body. As the humidity rises, it becomes more difficult for the sweat to evaporate hampering the ability of the body to cool off. It is one reason why it is important for athletes to drink fluids during the day and at practice to stay adequately hydrated, and to modify practice routines based on weather conditions.

Recommendations for Exercise in the Summer

Even before the temperatures start to soar, there are ways you can help get your body ready for practicing in the heat and staying safe when you do.

Acclimatization (Getting Used to the Temps)

Acclimating the body to exercising in the heat is important for staying safe. Hopefully by now youth athletes have been actively playing outside even before camps began. If jobs or activities have prevented it, try to start at least two weeks before camp. Begin by doing a small amount of exercise outdoors in the heat and humidity and gradually increase the amount and intensity of the exercise over the two weeks until reaching the level of activity that will be taking place during camp.

Remember, even when we are used to working out in the heat, we still require an increased level of water to stay hydrated but our bodies will be better able to tolerate the heat.

Pay Attention to the Heat Index

Heat index is a measure of combined heat and humidity or heat and dew point. This helps provide a sense of how hot it will feel to athletes, and their risk for heat-related illnesses.

The risk of heat-related illnesses varies based on the level of heat and humidity in the air. On sunny days, 5 to 15 degrees should be added to the heat index.

To learn more about heat index charts and how the heat index is calculated, these sites can be helpful resources:
National Weather Service Heat Index Calculator 
National Oceanic and Atmospheric Administration Heat Index Chart
OSHA Heat Safety Tool App

If you don’t have access to a heat index chart use the following as a loose guideline:

Humidity:

  • Look at the weather forecast for both expected temperature and humidity
  • Humidity is considered “high” when it is above 45-50 percent
  • If the humidity level is above 50 percent, the practice plan for the day should be modified particularly with temperatures above 85 degrees

Dew Point:

  • When the dew point exceeds 55 degrees the amount of moisture in the air is becoming high
  • When the dew point exceeds 65 degrees the air has very high levels of moisture, will be very uncomfortable, and is a high risk condition for a heat illness. The practice plan for the day should be modified in response to the extreme conditions.

Modify Activity

When heat and humidity are high all activities should be modified to maintain a healthy level of hydration and a safe core temperature. A few things to consider:

  • Take additional and longer water breaks
  • Include rest times and use shady, cool areas for these breaks
  • Move practice times to the early morning (before 10am) or evening (after 4pm)
  • Wear lightweight, light-colored clothing
  • Athletes in sports that require wearing protective equipment should alter practices and remove equipment during times of high heat and high humidity

As the season progresses, the heat and humidity will become less of an issue. But, with proper planning athletes can stay healthy and safe when on the practice field and during those early fall games.

Smiling Sun

Enter this week’s giveaway

Leave a comment below with how you exercise in the summer heat and humidity.

Prize: 1 - $10 Dick’s Sporting Goods gift card.
Rules: Giveaway closes on Sunday, August 3, 2014 at 11pm CST. Open to Wisconsin, Iowa and Illinois residents only. One entry per email address is permitted. The winner will be selected using random.org and announced on the following Monday as an update to this post. Winner will be notified via email and asked to provide a mailing address to receive the prize; if the winner does not respond within 7 days, the winner forfeits the prize and another winner will be selected. Subscribe to the blog and you’ll get new posts delivered to your inbox as soon as they’re posted.

Posted in Activity, Safety

Summer Safety for Infants and Toddlers

Toddler in lifejacket on boatThe sun is shining, the corn is knee-high, and everyone wants be out in the sun before winter rolls back in. As people are planning their summer vacations, many pediatricians are asked about how and when infants or toddlers can participate in their parents’ or siblings’ favorite summer activities, such as biking, swimming, and boating. Being outdoors and active is great for the whole family, but safety – as always – comes first when you’re thinking about having your little one along.

Biking

Bicycling is a wonderful way to be active and get around in the summer, but many parents are unsure when their infant or toddler can join them for the ride. Most importantly, infants need to able to sit well in an infant bicycle seat or bike trailer for a long period of time and strong enough to control their head while wearing a bicycle helmet that is appropriate for their age. For these reasons, children less than 12 months of age should not be transported by bicycle.

Safety should be fun! Celebrate your child’s birthday with a bicycle helmet and a ride in their bike seat or trailer!

The two primary options available for supporting a toddler for bike travel are mounted seats and bike trailers. Children, including infants, should never be transported in infant carriers or backpacks, as these are not secure, generally do not allow for helmet wear, and can lead to serious injury if an adult or older child lands on an infant during a crash. Bike trailers are generally thought to be the safest option, as they are low to the ground, allow for a child to be securely harnessed while wearing a helmet, and provide structure that can be protective in minor crashes. Mounted bicycle seats for toddlers also allow for secure harnessing with a helmet in place and can be less bulky than trailers, though their height can add to the momentum of falls. Front-mounted bicycle seats have entered the scene more recently and their safety compared to rear-mounted seats is unclear; front-mounted seats are more limited in their weight requirements, so be sure that the seat is appropriately sized for your child. If you are considering a mounted seat, ensure that the seat is securely and appropriately attached to your bike frame, that the seat has a sturdy harness and high back that can support a sleeping child, and that spoke guards are in place to prevent injury to a child’s feet or hands.

No matter the mode that you choose for including your child in biking, you can make your trip safer by:

  • Taking less-traveled roads and roads with clearly marked bike lanes
  • Using hand signals to let drivers know when you’ll be turning
  • Making sure that your bike is highly visible, with bike lights and visibility flags for trailers
  • Double-check child seat and trailer attachments before every ride
  • Taking into account that adding an infant seat or trailer to your bike may add to your brake time and bike instability
  • Making sure that you and your child always wear a helmet when on a bicycle!

Swimming

Nothing says summer like a day at the beach, and many children love the sand and the water. Sometimes, however, crowded areas and unfamiliar undertows can make it difficult to keep your young child safe, and drowning is a leading cause of death for 1-4 year olds. Knowing your surroundings and committing to appropriate supervision can keep children safe and lead to great play that involves the whole family. For infants and toddlers, “touch supervision” – where an adult is within reach of the child at all times – is recommended whenever a child is in or near the water.

Safety should be fun! Sing songs and play games in the water with your child while practicing touch supervision.

To ensure that the supervising adult is able to devote full attention, it’s also important to make sure that smart phones or other distractions are put away and to clarify which adults are supervising particular children. Designate one adult as a “water watcher” so that the role is clear. Choosing beaches and pools that have life guards on duty also help to ensure that an individual trained in CPR and rescue is available in case of emergency. For young children, wearing a personal flotation device (PFD, or life jacket) helps to ensure safety when they are playing in or near the water (see Boating section below for more information).

Many parents wonder whether their infant or toddler should take swimming lessons so that they are more comfortable in the water. Swimming lessons can be a fun way to get outside with your child at this age, and should always involve a parent or guardian for children under three. This makes for a great activity that families can share, but does not change the importance of close supervision in water. While a few small studies have suggested that swimming lessons may decrease risk for drowning in this age group, no lesson or intervention can promise to prevent a child from drowning.

Summer safety and drowning prevention is also critical at home, as infants and toddlers can drown in even small amounts of water. Home pools should be appropriately covered and fenced on 4 sides by a fence that is at least 4 feet high. This is true of “inflatable” pools as well. Pop-up pools are popular with families because they’re larger than a kiddie pool, but don’t have the expense of an installed pool. This is a concern not just for the children living in the home, but for other children in the neighborhood. Often, these pools are not fenced, making it possible for young ones to climb in unsupervised. If you have a pop-up pool, put a fence around it. And, if you have a kiddie pool, be sure the empty the pool after use and supervise children closely around yard ponds and other bodies of water.

Boating

Children can be brought along as passengers on a boat when they are big enough to wear a personal flotation device (PFD, or life jacket) that is appropriate for their weight, approved by the U.S. Coast Guard, and fits well. PFDs for infants and young children should have flotation collars, straps that go between their legs, and handles to ensure that the PFD will stay on and cause an infant to face up and be easily removed from the water if needed. The fit of a PFD can be assessed by having your child raise their arms up over their head in the “touchdown” sign: if the PFD bumps into the child’s ears or chin, it is too loose. Water wings do not provide appropriate flotation, do not cause the wearer to float on their back, and should never be used to replace a PFD.

Safety should be fun! Let your child get used to their PFD by wearing it on land and pretending to boat! Older children can be designated “safety captains” and can be in charge of verifying that every passenger has a PFD before the boat leaves the dock.

Boats, like homes, should be childproofed and have limits and rules for safety. Consider what your child can access from their position in the boat and set limits around unsafe activities, such as running or putting hands or feet outside of the boat. Adults operating a boat should have the appropriate license and should never operate a boat after consuming alcohol or other drugs.

When out on the water, it’s also important to consider the risks from exposure that can occur. Small children are at higher risk for hypothermia than adults; plan ahead with extra changes of dry clothes, layers, and towels to help dry a wet child off. Lightweight clothing can also be good protection against the sun, but don’t forget to bring sunscreen (at least SPF30) and reapply frequently when you are out on the water.

Getting outside and being active is fun and an important part of your family’s health! Use these tips to help you safely include your infant or toddler in biking, swimming and boating so that the whole family can have fun in the sun!

Additional Resources:

Your state or local Department of Natural resources also will have information on boating legislation in your area.

Summer Safety for Infants and Toddlers
About Brittany Allen, MD
Dr. Allen is a pediatrician at UW Health University Station. Her special interests include preventive pediatric care, adolescent health and care of LGBT and transgender youth.

View all posts by Brittany Allen, MD
Posted in Activity, Parenting, Safety | Tagged , , , , , , , , , , ,

Get Fit Together Family Activity Guide (Giveaway)

This giveaway is no longer accepting entries. Congratulations to our winner Shelly

We know that children are little mimics – they will copy behaviors that they observe and repeat words that they hear (nearly every parent can attest to this with stories of awkward situations involving particular word choices not appropriate for 5-year-olds to utter). So if mom and dad relax in front of the TV after dinner, chances are that’s going to be the preference for the kids as well. But, if mom and dad instead say it’s time to do something fun together after dinner, that helps create an environment where activity is normal and encouraged.

Family Hiking in the Woods

While it can be hard with busy lifestyle – whether it’s work, or scheduled activities like music lessons or sports – you really have to make the time, otherwise it’s too easy to put things off until the next day. Block time on the weekend – whether it’s an hour or half the day – and do something fun as a family. Go for a hike, go for a bike ride on a trail, go geocaching, discover a new park – just go. Do something. You can even let the kids decide – chose between a hike or bike ride. Go for a walk after dinner. Just get out together.

Keep in mind, this isn’t your time to get your daily exercise in. You’ll get too frustrated if you’re focused on “miles” and the kids are wanting to look at the pretty flowers by the side of the road. It’s about them. It’s about spending time together as a family. Let them discover their world and enjoy re-discovering the world through their eyes. And, if you’re hearing them complain, “It’s too long to walk! Are we there yet? Why can’t we play our video games!” that’s actually a sign they’re bored. So think about how you can keep it fun. Play a game of I Spy. Make up stories. Do some research and find out the history of the place before you go.

That said, remember kids do need breaks. Kids younger than 5 usually need a break every 15 minutes. So if you’re planning an hour hike, that could easily turn into a two hour venture. For elementary age kids that usually turns into a break every half hour. You know your child best, but aim for under-doing rather than over-doing. Trying to do too much can make it a frustrating experience for kids, and one they’ll not want to repeat.

When you’re thinking about what to do, remember they may not like everything you try so expose them to a lot of different things – biking, hiking, ice skating, roller skating – you never know what might click. And help them remember it’s not about doing things right. It’s about having fun and laughing. It may be challenging the first time the family tries things, but that can also help create fond family memories (“Do you remember that time dad tried roller skating?). And, it’s also a good way for kids to see even adults have to practice and work at an activity.

And, you’ve heard it before, but it’s always a good reminder to use sunscreen and sun protection, and any safety equipment like helmets you may need.

So, what are some ideas you can try? Check out Wisconsin’s State Parks, find out what’s going on around Wisconsin, learn some simple things to do around home or explore our Exercise for Kids Pinterest board.

They’re only young for a fleeting time so enjoy every moment of it while you can. When you make a family habit of doing things together when they’re young, they’ll continue to enjoy doing family activities as they grow. And, there is a special bonding that takes place when you’re active together. A simple walk with the dog can turn into an hour spent laughing and learning more about what’s going on in your child’s life. It’s a gift for the whole family.

Smiling Sun

Enter this week’s giveaway

Leave a comment below with your favorite place for a family hike or bike ride.

Prize: 1 - Picnic package including a picnic blanket, water bottle and sunscreen.
Rules: Giveaway closes on Sunday, July 27, 2014 at 11pm CST. Open to Wisconsin, Iowa and Illinois residents only. One entry per email address is permitted. The winner will be selected using random.org and announced on the following Monday as an update to this post. Winner will be notified via email and asked to provide a mailing address to receive the prize; if the winner does not respond within 7 days, the winner forfeits the prize and another winner will be selected. Subscribe to the blog and you’ll get new posts delivered to your inbox as soon as they’re posted.

About Judy Hilgers, RN, BSN and Ellen Heiser, MS
Judy is a clinic nurse with the UW Health Pediatric Fitness Clinic. Ellen is Clinical Exercise Physiologist at the the UW Health Pediatric Fitness Clinic.

View all posts by Judy Hilgers, RN, BSN and Ellen Heiser, MS
Posted in Activity, Parenting | Tagged , , , , , , ,

Campfire Safety Guide

Campfire SafetySummer nights are perfect for having a campfire with your family. You can sing songs, tell stories and roast marshmallows to make s’mores. Keep your campfire experience fun and safe with these tips from the UW Health Burn Center:

  • Always have an adult around. Children should never build a fire alone
  • Keep the campfire small so that you can manage it
  • Choose one person to be in charge of adding wood to the fire
  • Do not throw or use flammable liquids on a fire
  • Never throw trash on a fire
  • Keep a safety zone of at least 3 feet when standing around the fire. You can use long sticks to roast marshmallows.
  • Make sure everyone knows how to stop, drop and roll. Explain to your kids that if their clothes accidentally start on fire they should stop, cover their face, drop to the ground and roll around to put out the flame.
  •  Have plenty of water and a shovel nearby in case the fire starts burning outside of the fire area. If you don’t have water, you can use dirt!
  •  Never leave a campfire unattended.

When you are ready to leave, pour water on the fire until the hissing sound stops and make sure everything is wet and cold to the touch. Remember what Smokey the Bear says: “If it’s too hot to touch, it’s too hot to leave!”

What is your family’s favorite campfire activity?

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