Youth Tackle Football

OK, I may make some enemies in our community with what I am about to say, but here goes.  There is a growing consensus among health professionals who care for children–including pediatricians like me, neurologists, radiologists, and others–that organized tackle football should be avoided in younger players.  Children have larger heads and weaker neck muscles compared to adults, making collisions riskier.  Moreover, younger, less experienced players more often utilize poorer tackling technique which also raises the risk threshold.  While hard shell helmets do limit skull fractures, the evidence regarding concussion prevention is actually quite poor.

Of course, at these younger ages the brain is still developing.  Researchers at Wake Forest Medical School recently followed children 8-13 yrs during football season with MRI scans.  None of the boys had developed concussion symptoms during the study period, yet their scans showed subtle but clear disruptions of normal brain metabolism from pre to post season.  Related studies done at Boston University Medical School looked at former NFL players and found that those who had started in the sport <12 years old had a significantly higher incidence of “white matter” brain changes and more frequent difficulties with depression, cognitive impairment and behavioral problems in later life.  There are additional studies reporting similar patterns in people playing other contact sports from an early age compared to those who did not.

So where does that leave us?  Well, I am certainly NOT “anti-football”(well, maybe anti-NE Patriots, but anyway…).  > 1 million boys play high school football.  As I spend a good part of my time begging/yelling at my teen patients to get off their darn phones and to be more active, I strongly support this and all high school sports.  Presently there are approximately 1.2 million US 9-12 year olds playing youth football (numbers have decreased in the last few years because of these concerns) and those kids sustain approximately 240-585 head hits each season.  Note that youth football is a relatively recent phenomenon–when I was growing up in the 1960’s-70’s it hardly existed.  Back then, tackle football was something we played on weekends in the park if we could collect enough guys to make 2 teams.  There were no non-HS football “leagues”–tackle or otherwise– to speak of.

We need a new paradigm, and I believe this is where flag football comes in.  The nonpartisan Aspen Institute recently issued a White Paper advocating for flag only <14 years.  Here in NJ, Assemblywoman Valerie Vainieri-Huttle (D-Bergen) has introduced a bill (A-3760) that would allow flag football but ban tackle statewide <12 yrs.  Given the above, the arguments against–that teaching younger boys proper tackling technique improves safety–are, at best, unconvincing.  I believe this bill deserves serious consideration; personally (and professionally) I support it.

Don’t all yell at me at once– but send along questions and comments, and thanks for following.

Advertisements

Flu Shots 2018

Our flu shots are in, so it’s time to get in and get vaccinated. I have discussed this before here, here and here.

The flu is not just a bad cold. Last year, 179 U.S. children died of influenza, which is the second most annual deaths ever (2009 was the worst). 80% of those deaths occurred in unimmunized children, and 49% of those deaths were in children who were previously healthy. The American Academy of Pediatrics recommends that everyone over age 6 months be immunized against the flu.

  • All healthcare and law enforcement personnel, and all who work with children should be immunized.
  • Pregnant women should be immunized. The immunity can pass across the placenta to the unborn baby and provide useful immunity in the first 6 months of life.
  • Children with egg allergy can safely receive flu shots. No special precautions are required.
  • Vaccination is safe for breastfeeding mothers and infants.
  • Children under age 3 should receive 2 doses of 0.25 cc vaccine at least 1 month apart in their first month immunized. In subsequent years, only one 0.25 cc dose is required less than 3 years.
  • Children 3-9 years should receive two doses of 0.5 cc at least 1 month apart the first year immunized. In subsequent years, they only need one 0.5 cc dose.
  • Above age 9, people required one dose 0.5 cc each year.
  • Injected, inactivated vaccine (“IIV4”) is the vaccine of choice. Note that since this is inactivated, there is no risk of infection from this shot.
  • Live, attenuated “quadrivalent” vaccine (“LA4”)–nasal spray–can be used in selected situations (greater than 2 years of age, no health problems). As this vaccine is less effective against H1N1, I have chosen to not stock this form.

As flu season is very unpredictable, AAP recommendations stress that the earlier the better to be immunized. If possible, by the end of October.

So give us a call.

Thanks for following.