Child Passenger Safety – PediaCast 560

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  • Drs David Kling and Morgan Wurtz visit the studio as we explore child passenger safety. Motor vehicle accidents are a leading cause of death for children 4 years of age and older. We review best practices for keeping kids safe using car seats and booster seats. We hope you can join us!

Topics

  • Child Passenger Safety
  • Car Seats
  • Booster Seats

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Episode Transcript

Dr Mike Patrick:     This episode of PediaCast is brought to you by the Division of Emergency Medicine at Nationwide Children's Hospital. Hello everyone, and welcome once again to PediaCast. It is a pediatric podcast for moms and dads. This is Dr. Mike coming to you from the campus of Nationwide Children's Hospital.

Dr Mike Patrick:     We are in Columbus, Ohio. It's episode 560. We're calling this 1 Child Passenger Safety. I want to welcome all of you to the program. So we all want to keep our kids safe, right?

Dr Mike Patrick:     I mean, that's a really important goal for parents everywhere. However, there is a dangerous activity that most of us do with our kids very frequently, sometimes every day, And that is driving them around in the family vehicle. Turns out that motor vehicle accidents are a leading cause of death for children 4 years of age and older, but it also turns out we can greatly reduce their risk of death with the proper selection, positioning, use, and maintenance of car seats and booster seats. Now, this isn't always as easy as it sounds. And from the lens of many parents, car seats and booster seats, seat recommendations may feel a little bit confusing and a bit of a moving target.

Dr Mike Patrick:     Literally. No pun intended there. It is a moving target and that is because things have changed over the course of the last 10, 15 years or so. Certainly 15 to 20 years ago. So this is going to be the time when grandparents had their kids.

Dr Mike Patrick:     The recommendations were quite different back then, and so you may have a family member who is giving you 1 piece of advice, but the advice now is not the advice that it was then. Things are much safer now, and that is because of the changes in these recommendations which we are going to talk about. So our goal today is to explore CAR-C and booster seat recommendations along with a discussion of why the current best practices are in place and what we can all do as parents to keep our kids safe while traveling. We have a couple of great guests joining us today. Dr.

Dr Mike Patrick:     David Kling and Dr. Morgan Wurtz, both of them with Pediatric Emergency Medicine at Nationwide Children's Hospital. Before we get to them, I want to remind you the information presented in our podcast is for general educational purposes only. We do not diagnose medical conditions or formulate treatment plans for specific individuals. If you are concerned about your child's health, be sure to call your health care provider.

Dr Mike Patrick:     Also, Your use of this audio program is subject to the Pediacast Terms of Use Agreement, which you can find at pediacast.org. So let's take a quick break. We'll get Dr. David Kling and Dr. Morgan Wurtz settled into the studio, and then we will be back to talk about child passenger safety.

Dr Mike Patrick:     It's coming up right after this. Dr. David Kling is a pediatric emergency medicine fellow at Nationwide Children's Hospital, and Dr. Morgan Wurtz is a pediatric emergency medicine attending at Nationwide Children's and an assistant professor of pediatrics at The Ohio State University College of Medicine. Both have a passion for keeping kids safe, including when they travel in motorized vehicles.

Dr Mike Patrick:     That is what they're here to talk about today, child passenger safety. But before we dig into that, let's offer a warm PDA cast welcome to our guests, Dr. David Kling and Dr. Morgan Wurtz. Thank you both so much for stopping by today.

Dr David Kling:     Hi, thank you for having us.

Dr Morgan Wurtz:     Hello, nice to be here.

Dr Mike Patrick:     Yeah, really excited to talk about child passenger safety because we all know that it's important, but sometimes it can be a little bit confusing in terms of what the rules are for parents. And I know everybody wants to keep their kids safe. So, David, let's start with you. Why is it important for children to use car seats?

Dr David Kling:     Well, car seats are actually crucial in protecting children and minimizing the risk of injury or death in car accidents. Car seats are actually designed to provide protection for children in the event of a car crash, and they are actually built to absorb and distribute the force of the impact to reduce the risk of injury. Additionally, properly secured children are less likely to distract the driver. And lastly, state laws, of course, mandate the use of appropriate child restraints based on the child's age.

Dr Mike Patrick:     Yeah, so all really important reasons. And can you share some statistics that kind of highlight the effectiveness of car seats?

Dr David Kling:     Definitely. So proper use of car seats can actually reduce the risk of death by as much as 71% in infants and 54% in toddlers. Booster seats can actually reduce the risk by 45%. And recent numbers actually show that 325 children under the age of 5 are actually saved by car seats in a single year.

Dr Mike Patrick:     Yeah, so really important. And there are many times when a family is involved in an accident and If their child had not been appropriately secured in a child passenger seat Whether that be a car seat a booster seat, whatever it is that they're supposed to be in at that time, you know, a lot of those kids are saved because of those seats and we can say without them your child may have passed away in that accident. And so it's really, really is an important thing. Morgan, what common mistakes do parents make when using car seats?

Dr Morgan Wurtz:     Sure. There's a couple of things that can kind of go wrong when using car seats. The first 1 I would say would be choosing the incorrect size or type of seat for the size of child or the age of the child. Other things can be an incorrect installation, not securing the seat itself tightly or not following the manufacturer's instructions for the car seat. Also when putting the child into the car seat, things like loose harness straps or incorrect position of the harness, and also wearing a winter coat inside the car seat, it can make the car seat less effective.

Dr Morgan Wurtz:     So other things that sometimes can go awry is that using expired or recalled seats, and also not replacing car seats after a crash. Even a mild fender bender, a car seat should be replaced after that. Also, things that we see often are our parents turning children forward facing too early. So those are kind of some of the mistakes that we see with car seats.

Dr Mike Patrick:     A couple of those I want to highlight because maybe this is the first time that people have heard this. 1 is the winter coat thing. So you don't get as snug of a fit of the harness in the car seat if you have a big bulky coat on, is that correct?

Dr Morgan Wurtz:     That's correct, yes. The harness is meant to be against the child's body and big winter coats, especially here in places like Ohio, can really impact the fit of those and impact the safety of the seat for the child.

Dr Mike Patrick:     So that's important. So in the winter months, layers are gonna be more important than 1 big bulky coat, correct?

Dr Morgan Wurtz:     That's correct, yes.

Dr Mike Patrick:     And then the other thing that you had mentioned that people may not be aware of is replacing the car seat even if it's just a mild accident. And I guess the reason for that is you never know what kind of forces travel through the car And it might not be something that you felt, but just as an example, someone may come up behind you at a stoplight, and they're not going crazy fast, 25, 30 miles an hour, and they run into the back of you, your airbags may not go off, you get a little bit of a jar, but you don't know for sure what those forces did to the car seat and how that may impact its ability to keep your kids safe the next time an accident and maybe even a worse accident comes along. And so that's the reason why it's so important to replace those. Now, not everyone is having accidents right and left, but you know that does make you maybe not want to buy 1 with all the bells and whistles that's at the top of the price point, thinking about you know just a little fender bender you may have to replace it.

Dr Mike Patrick:     So but you still want it to be a good car seat and safe, but you know, maybe also practical in terms of cost. So Morgan, what resources are available to help parents select a car seat and how do they choose the right 1?

Dr Morgan Wurtz:     Sure. And that this can be a really daunting decision for a lot of new parents, especially. You go into any of these baby stores and you just see whole walls of different options for car seats. It can be really overwhelming and, and many different price points as well. So There's a lot of choices on the market, but thank goodness there's a lot of resources that can help parents make good decisions about their car seat.

Dr Morgan Wurtz:     The first decision would be to select a car seat based on your child's age and size, and then choose a seat that fits into your vehicle and use it every time. That's the important part. Yes. So always refer to the specific car seat manufacturer's instructions. Check the height and weight limits for the seat, and read the vehicle owner manual as well on how to install the car seat using the seatbelt or lower anchors or tether.

Dr Morgan Wurtz:     So those can be helpful for how to choose the right car seat. Those are kind of some things that can help kind of get you started. There are also some options in terms of resources. 1 is the National Highway Traffic Safety Administration does give a lot of resources for how parents can choose the right car seat for their child and You can also put in your child's height your child's weight and it will help you determine Which car seat to choose for your child in many communities? There are car seat safety technicians that work at formal inspection stations and there are a few resources to help you find these inspection stations that can help ensure that your child's car seat is installed properly.

Dr Morgan Wurtz:     You can look at a couple of different websites. 1 is www.seatcheck.org to find a technician in your area. And also the National Highway Traffic Safety Administration, like I mentioned before, does have a search tool to help find areas in your community where you can have your car seat assessed. There also a lot of times you can actually Google your county just put it in to the your search engine a your county and car seat check and that actually will will help you come up with some resources for where you can have your child's seat assessed.

Dr Mike Patrick:     Great, great tips. We, so we're going to have a lot of links in the show notes for folks, so they can head over to pediacast.org and this is episode 560 and you'll be able to find some great links there. We actually have links from the National Highway Traffic Safety Administration, from Nationwide Children's, from the American Academy of Pediatrics. There's a great resource that's available in some cities. Columbus is 1 of them called CAP for Kids and they have a section on car seat safety as well.

Dr Mike Patrick:     And then the Ohio Department of Health, for those in Ohio, we have a link to them too. So there's gonna be a lot of resources that folks can check out over at pediacast.org in the show notes for episode 560. So David, what then are the key steps to installing the car seat correctly? So you've purchased 1 that is recommended, that maybe isn't like at the high end of the price range, but is going to do the job. How do you go about installing it the right way?

Dr David Kling:     Yes, you've already done the most important step, which is step 1, buying and purchasing the correct-sized car seat, and that is approved by the National Highway Traffic Safety Administration. Next step, like Morgan already mentioned, is reading the manual, not only for the car seat itself, but the car, and then making sure that too, that you install it in the back seat of the car appropriately, whether that be a rear-facing car seat or a front-facing car seat, they should not be interchanged. And then of course, you want to make sure that you secure it within your vehicle before you put your child into the car seat, whether that be with the vehicle's seat belt or anchoring system. And again, the manuals for the car seat itself and your car can help guide you through that process. I'm also sure there's YouTube videos as well for if you're more of a visual learner.

Dr David Kling:     And then you want to also kind of another key step is make sure that it's installed at the appropriate angle. A lot of car seats actually have an angle indicator on the side of the car seat to ensure that you have it properly fitted into the car.

Dr Mike Patrick:     That's really important. And you know, a lot of times when we get new things, the instruction manual is something you sort of just toss aside. Like, I know how to do this, but it's going to be really important. I mean, your child's safety is at stake to really look through those, the handbook that comes with it and follow all the instructions to the letter and making sure again that that car seat is certified for your child's age and weight and length and all of those things. Really, really, really important.

Dr Mike Patrick:     How Often then should parents check and adjust the car seat once it's in place?

Dr David Kling:     Great question. I think a good habit is actually check before every trip. You know, you wanna make sure that that car seat is still secure in the back seat of your vehicle and it hasn't become loose for some reason. Another child potentially unbuckled the seatbelt itself that was securing it, for example. So I think it's a good habit to always make sure that that car seat is nice and secure before putting a child in it.

Dr David Kling:     Of course, another good point is whenever your child is growing, maybe a good habit would be after each of your well child checks, you have a new height and weight for your child, ensure that that car seat is still appropriate for your current child's height and weight. Another 1 to emphasize is after washing the car seat itself, again, things might gotten loose or changed or adjusted. So again, you wanna make sure that it's nice and secure in the backseat. And then of course, if you change vehicles, same process, you want to go through all those different steps to ensure that the car seat is nice and secure in that new vehicle. And then just to again, emphasize that point again, make sure that you replace that car seat after any car crashes, even if they're minor.

Dr Mike Patrick:     And then, so those are great tips for the car seat itself, and you should be checking that regularly to make sure that it's in there the proper way. Then what are some tips for ensuring that your child is buckled in safely every single time?

Dr David Kling:     Yes, so we've kind of already hit on some of the points already. Of course, we want to make sure that that harness is correctly positioned. You want to ensure that the straps are actually lying flat on the child's shoulder. They're not really loose. You should only be able to fit maybe a finger between the strap and your child's shoulder.

Dr David Kling:     So make sure you're adjusting those harnesses so that way it is sitting appropriately on your child's shoulder. You also wanna make sure that that chest clip is right at your child's armpit level. So again, making sure that it's laying flat against your child's chest. It should be nice and snug. You shouldn't be able to fit a bunch of fingers or space in between that chest clip and your child's body.

Dr David Kling:     So again, you want to make sure after you have it in the appropriate position, you're tightening that harness and making it sure it's nice and snug. And last of course, double check and make sure that that car seat is secure.

Dr Mike Patrick:     Absolutely. And then, Morgan, when is the right time to transition from front-facing to, I'm sorry, from rear-facing to front-facing? I think in the past, And so some parents may hear from grandparents like, oh, this is the rule. I remember that it was like at a year of age, but that is not true anymore. Tell us more about that.

Dr Morgan Wurtz:     That's correct, yes. So the recommendation is actually to stay in a rear-facing car seat as long as possible. That's the safest option of any of these car seat booster seat belt options. And so we want children to stay in those rear-facing seats as long as possible. Now the car seat manufacturer will have a max weight and height for the rear-facing seat.

Dr Morgan Wurtz:     And so the recommendation is actually for the child to stay in that rear-facing seat until they exceed the highest weight or height allowed by the car seat manufacturer. So some parents do get a little concerned if, you know, are their legs too long? Are they going to be, you know, cramped up in there or at risk for injury? And actually the car seat manufacturer does take into account height. So that is a safe place to be as long as they're within those weight and height for the seat itself.

Dr Mike Patrick:     Yeah. And that may be a little bit different from 1 seat to another, correct?

Dr Morgan Wurtz:     Absolutely. Yes. So I would refer, I would recommend that parents, again, look at that manufacturer booklet that comes with the seat and so that they can know what those height and weight restrictions are for their particular seat that they have.

Dr Mike Patrick:     Yeah, yeah. And so again, the age is not important. It's your child's weight and their height or length. And that's what you want to check against the Carsey and don't be in a rush. You know, don't pick 1.

Dr Mike Patrick:     0, this 1, they'll be able to switch sooner because this 1 has a lower weight or less of a height. Really your kids are safer rear facing for as long as possible. And I know that's a tough thing because about the time that your kids can talk and they want to see what's happening out the front window. Absolutely. Of course, as a parent, you love them and you want them to enjoy the car trip.

Dr Mike Patrick:     So you may have to get a little creative in terms of convincing your kids that the right thing to do is to still be a rear facing, especially if you know, they're, they're smart cookies and they, they're going to do what they need to do to try to get their way too, but we want them to be safe. So the other transition point then is moving from a forward-facing car seat to a booster seat. When is the right time to do that?

Dr Morgan Wurtz:     Sure. So there's actually a similar, it's easy to remember. So it's a similar kind of process from switching from a car seat to a booster seat. Again, a car seat is a safer option than a booster seat. And so we do recommend that kids stay in a car seat for as long as possible.

Dr Morgan Wurtz:     There's not a specific age that goes along with that, just like with the rear-facing car seat. The front-facing is actually related to the weight and height of the car seat manufacturer for that particular seat. So once the child reaches that height or weight, then we would recommend going to a booster seat. Again, the child should be in the back seat with the booster seat still. So all of these options, rear-facing, front-facing, and booster seat are all in the backseat.

Dr Morgan Wurtz:     That's the safest spot for kids to ride. And, but the weight and height is what determines going from a front-facing car seat to a booster.

Dr Mike Patrick:     So even, and that's even more reason to keep the guide book that comes along with it, the instruction manual, because you may see what the ranges are when you purchase it and you know how tall or how much your child weighs when they start using that car seat or booster seat. But then it becomes kind of a question of, wait, when do we transition? And so having that manual around can be helpful as a reminder. But I'm sure you can also look it up. Those manuals are also, I mean, if you do lose it, don't lose heart, go to the manufacturer's website and you'll probably be able to find a copy of the manual there too.

Dr Mike Patrick:     And then are most of the things that we've talked about with car seats, also true for booster seats in terms of securing them and all of those things?

Dr Morgan Wurtz:     Yes. So the booster seat is the next step up for, from, or the next step from a front-facing to the booster. Again, we recommend that kids do ride in a booster in the back seat and we want them to use a booster seat until the vehicle lap and shoulder belt fits properly. So for a seat belt to fit properly, the lap belt must lie snugly against the upper thighs, not the stomach. And also the shoulder belt should lie snugly across the shoulder and the chest and not cross the neck or the face.

Dr Morgan Wurtz:     So when your child is able to have that seat belt fit properly, they can transition from the booster seat to the vehicles. Again, I'm reiterating this again that the backseat is the safest place when transitioning from a booster seat to the regular seat belt as well.

Dr Mike Patrick:     Yeah, absolutely. And I think that that sort of the way you described it really makes a lot of sense because we want to protect kids, we want to protect their necks, and we want to protect their bellies because, you know, you don't have bone there protecting the organs. And so a seat belt that squishes into the belly at a high rate of speed with a lot of energy can cause damage to the organs in the abdomen. And so again, it's really important that that lap belt lies across the hips and upper thighs, you know, crosses where there's bone and not where the soft belly is. So that's really important.

Dr Mike Patrick:     And then we don't want that shoulder harness to cross the neck at all. And we want it to fit snugly, just like you were used to just getting maybe 1 finger between the belt and your child's body and the car seat or the booster seat. The same thing is going to be true when they're just using, you know, when they're ready to just use the car's lap and shoulder harness, correct?

Dr Morgan Wurtz:     Yes, that's correct.

Dr Mike Patrick:     All right. And then what are some general safety tips for traveling safely with kids in the car, David? Aside from using car seats and booster seats appropriately, what are some other safety tips for parents?

Dr David Kling:     Yeah, great question. Yeah, I was going to actually say that, you know, we have already talked about that first step, right? Making sure that everyone is in an appropriate car seat or booster seat. Also everyone in the vehicle should make sure that they're nice and secure. So if you're the driver, you're the parent, you're a role model, you want to make sure that you are wearing your seatbelt.

Dr David Kling:     That way your child knows the importance of wearing a seatbelt. You also want to make sure that you're packing some essentials, depending on where you're traveling to or how long you're going to be in that car. Thinking about snacks, drinks, entertainment for your children, because again, if they're nice and entertained, maybe they'll be less distracting to you as a driver, and that's an important safety tip. Also, it's good to have a first aid kit available in your vehicle because you never know when you might need that, even as simple as needing a bandaid. And then of course, for everyone involved in the vehicle, avoiding distractions and especially for that driver, so making sure that no texting and driving and that you're being focused on your role as a driver, keeping everyone safe.

Dr Mike Patrick:     Yeah, yeah. And we've talked a lot about putting kids into the car seat. I did wanna mention, sometimes we hear stories in the news about parents who leave their kids in the car because they forget that they're there. You know, maybe they had a crazy morning and they drove straight to work and didn't stop at the daycare and just but in your brain, you think, oh, yeah, I stopped at the daycare, but you're really remembering yesterday and not today. So it's really important to check that backseat every time you get out of the car and just get in the habit of checking that backseat, right?

Dr David Kling:     Definitely very important. I agree.

Dr Mike Patrick:     And there are cars now with some safety features, you know, that may give you a little warning when you turn the car off. Of course, those are easy to start ignoring when you hear them over and over again. But that's a tragedy that is 100% preventable. We really want to get parents used to looking back there and making sure that their kid's not still in the back seat. Morgan, what can parents do to stay updated on recalls and safety notices?

Dr Mike Patrick:     Because sometimes these come up and unless you are searching for them, you might miss that your child's car seat's had a recall or there's a particular safety notice.

Dr Morgan Wurtz:     Absolutely. The manufacturer websites will have recall notices on there, but again, that would require you to kind of get in the habit of checking those websites. So you can sign up for email alerts about recalls through the National Highway Traffic Safety Administration or through Consumer Reports. And also, if you're getting your child's car seat checked by 1 of these child passenger safety technicians, they also would be able to help and make sure that your car seat is not having any recalls associated with it or any safety concerns.

Dr Mike Patrick:     And we'll put a couple links in the show notes. 1 is the National Highway Transportation Safety Administration recall site, And then recalls.gov is another place, not just for car seats, but for all sorts of products within the home. Those are great places to check. And again, we'll put links to those in the show notes. David, this whole episode is really sort of in response to something called T4CIP and their day of action.

Dr Mike Patrick:     Tell us more about what exactly is that.

Dr David Kling:     Yeah, T4CIP actually stands for Trainees for Child Injury Prevention. This is actually a year-long longitudinal experience for medical students, residents, as well as fellows to participate. You kind of have a passion for child injury prevention and want to learn more about it. Part of that experience is actually doing some day of actions in this part of the year. Our day of action, of course, is child passenger safety.

Dr David Kling:     And so we're actually doing a couple different things here at Nationwide but also nationally as well to kind of spread the word and share this information with parents. So our day of action is actually happening May 22nd which is next Wednesday. We are doing at Nationwide a specific blog post on our 700 Children's blog website. We'll be sharing information on our Nationwide Children's Hospital social media pages. You can also engage online through your social media channels using the hashtag check before you change.

Dr David Kling:     You also might notice if you call into Nationwide Children's Hospital that there's gonna be some on-hold messaging talking about child passenger safety for the months of May and June. And lastly, there is a webinar that's gonna be held by the trainees for child injury prevention. And we can also share that link with you guys. And of course we're doing this podcast.

Dr Mike Patrick:     Yeah, absolutely. And we'll put links in the show notes to sites that have more information on T4CIP, trainees for child injury prevention. And we'll have a link to a site that talks more about the Day of Action and I know you guys have a very active Instagram account. We'll put a link to that in the show notes as well. And then Morgan, tell us about emergency medicine here at Nationwide Children's Hospital.

Dr Morgan Wurtz:     So all 3 of us here work in the emergency department at Nationwide Children's Hospital. It's a 24-7 emergency department staffed by emergency medicine physicians, as well as there are, we have learners there as well, and we have an expert team of emergency medicine physicians as well as surgeons and any and multiple subspecialties of medicine and surgery as needed for any kind of injury or illness that a child may present to us with. Hopefully, we don't see your child in the emergency department, but we are available for any types of injury and illnesses that children may present with. We're able to care for all types of pediatric injuries. And in fact, we saw over 93,000 patients in the main campus emergency department last year.

Dr Mike Patrick:     Yeah, so it is a hopping place.

Dr Morgan Wurtz:     It is, yes.

Dr Mike Patrick:     But as you said, it's 24 7 and we are available whenever an emergency might strike your family. And of course we don't want that to happen as you said, but if it does, we are available. And then there's also an organization through children's called the center for injury research and policy. And this is kind of the research arm of child injury prevention, correct?

Dr Morgan Wurtz:     That's correct, yes.

Dr Mike Patrick:     Yeah, and we'll put a link to the Center for Injury Research and Policy in the show notes as well, and also a link to Pediatric Emergency Medicine if you are interested in learning more. So once again, Dr. David Kling and Dr. Morgan Wurtz with Pediatric Emergency Medicine at Nationwide Children's Hospital, thank you both so much for joining us today.

Dr David Kling:     Thank you.

Dr Morgan Wurtz:     Thanks for having us.

Dr Mike Patrick:     We We are back with just enough time to say thanks once again to all of you for taking time out of your day and making Pediacast a part of it. Really do appreciate that. Also thanks to our guests this week, Dr. David Kling and Dr. Morgan Wurtz, both with Pediatric Emergency Medicine at Nationwide Children's Hospital.

Dr Mike Patrick:     Don't forget You can find us wherever podcasts are found. We're in the Apple and Google podcast apps, iHeartRadio, Spotify, SoundCloud, Amazon Music, YouTube, and most other podcast apps for iOS and Android. Our landing site is pdacast.org. You'll find our entire archive of past programs there, along with show notes for each of the episodes, our terms of use agreement and that handy contact page. If you would like to suggest a future topic for the program, reviews are helpful wherever you get your podcasts.

Dr Mike Patrick:     We always appreciate when you share your thoughts about the show and we love connecting with you on social media. You'll find us on Facebook, Instagram, threads, LinkedIn, and Twitter X simply search for Pediacast. Also, don't forget about our sibling podcast, Pediacast CME. It is similar to this program. We do turn the science up a couple of notches and offer free continuing medical education credit for those who listen and that includes not only physicians but also nurse practitioners, physician assistants, nurses, pharmacists, psychologists, social workers, and dentists.

Dr Mike Patrick:     And since Nationwide Children's is jointly accredited by all of those professional organizations, it's likely we offer the exact credits you need to fulfill your state's continuing medical education requirements. Of course, you want to be sure the content of the episode matches your scope of practice. Shows and details are available at the landing site for that program, pediacastcme.org. You can also listen wherever podcasts are found. Simply search for pediacastcme.

Dr Mike Patrick:     Thanks again for stopping by. And until next time, this is Dr. Mike saying, stay safe, stay healthy, and stay involved with your kids. So long, everybody. So long, everybody.

Announcer:     This program is a production of Nationwide Children's. Thanks for listening. We'll see you next time on PediaCast.

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