Millions of X-rays are performed on children every year – to determine whether a bone is broken, or whether a child has pneumonia, for instance. Kids are more likely to receive X-rays than any other sort of imaging exam.

While these tests help doctors provide proper treatment and save lives on a daily basis, they also expose children to radiation. And an organization called “Image Gently” wants parents to understand the importance of keeping that exposure as low as possible.

“Kids are more sensitive to radiation from imaging than adults, and cumulative radiation exposure to their smaller, developing bodies could have adverse effects over time,” says Marilyn Goske, M.D., founder and chair of Image Gently, which brings together more than 70 organizations representing around 800,000 imaging specialists.

Image Gently stresses that kids should always have an X-ray when there is a clear medical benefit, but suggests that parents ask the following questions when a doctor wants to order an X-ray or other imaging test for their child:

• What is the name of the test you would like to do on my child?

• Does the test involve ionizing radiation?

• How will having this exam improve my child’s health care?

• Are there alternatives that do not use radiation which are equally good?

• Will my child receive a “kid-size” radiation dose?

• Is the technologist performing the scan certified by ARRT (American Registry of Radiologic Technologists)?

• Is this facility accredited by the American College of Radiology?

The organization also suggests that parents keep track of the names and dates of any imaging tests their child receives, and where those tests were performed. Their website, ImageGently.org , includes a free downloadable wallet card where parents can record this information, and a wealth of additional information and resources.

New Purdue research shows that frequent child abuse by a parent can increase a child's cancer risk in adulthood, and the effects are especially significant when mothers abuse their daughters and fathers abuse their sons. The research was conducted by Kenneth Ferraro, distinguished professor of sociology and director of Purdue's Center on Aging and the Life Course, and sociology and gerontology graduate student Patricia Morton. Their work was funded by the National Institute on Aging and is published online by the Journal of Aging and Health. (Purdue University photo/Mark Simons)

Parents who swear at, hit, shove, or otherwise abuse their children are doing more than just immediate harm. They are also increasing the children’s risk of developing cancer later in life, say Purdue University researchers.

Looking at data from more than 2,100 adults who answered questions in the mid-1990s, the study found a link between abuse by parents – especially mothers abusing daughters and fathers abusing sons – and increased risk of cancer later in life.

Rather than asking participants directly about “abuse,” the survey included questions about how frequently a parent insulted or swore at them, refused to talk to them, threatened to hit them, threw something at them, pushed, grabbed, shoved, kicked, bit, punched, burned or scalded them as a child – and how often this happened. The more frequent and intense the abuse, the greater the cancer risk the study found.

“People often say that children are resilient and they’ll bounce back,” said lead author Kenneth Ferraro, a sociologist with Purdue’s Center on Aging and the Life Course, “but we found that there are events that can have long-term consequences on adult health.”

The authors aren’t certain why abuse by the same-sex parent had a greater effect on cancer risk, though they theorize the greater social bond between same-sex children and parents could be at work. “Other studies have shown that if a mother smokes, the daughter is more likely to smoke, and the same relationship is found when sons mirror their fathers’ behavior. More research is needed, but another possibility is that men may be more likely to physically abuse their sons, and mothers are more likely to physically abuse their daughters,” says co-author Patricia Morton, a gerontology graduate student at Purdue.

The study was funded by the National Institute on Aging and published online July 4 in the Journal of Aging and Health.

When your child is prescribed medication, ask questions and report problems. That’s the take-home message from U.S. Food and Drug Administration (FDA) experts on the heels of the latest report examining trends in pediatric prescription medications.

Diane Murphy, M.D., of FDA’s Office of Pediatric Therapeutics, explains that the report is part of the agency’s effort to increase the number of medications that have been studied in children by targeting areas for further research.

The report, published June 18 in Pediatrics, noted that the number of prescriptions for antibiotics had fallen, while prescriptions for ADHD drugs were on the rise. Murphy, one of the authors, says experts were delighted at the antibiotics trend. “Ever since I have been practicing medicine we have been trying to convince parents not to request antibiotics for viral illnesses,” she explains. And the increase in ADHD prescriptions was not a particular surprise. “We expected that some classes of drugs would go up, because they finally have been studied in children,” she says.

Because clinical trials in children are more complicated than those in adults, and there is less profit to be made on drugs targeted to kids, drug companies have been reluctant to study their products in children. Legislation is turning the situation around, but many medications commonly prescribed in children still have never been formally studied. “Even though we’ve made great strides, we’re about half way,” Murphy says.

One example mentioned in the report is lansoprazole (brand name Prevacid), an anti-reflux drug prescribed 350,000 times to infants in 2010, despite the fact that no studies have been conducted in infants to show its safety and effectiveness. Ann McMahon, M.D., also of the Office of Pediatric Therapeutics and another author of the report, is heading up a study on use of lansoprazole in infants – a complicated undertaking that won’t likely yield any results before 2013.

Meanwhile, Murphy and McMahon have this advice for any parent whose child has been prescribed medication.

• Be aware that many medications still have not been studied for use in children. Because of this, doctors often have to prescribe drugs “off label,” and many medications have been used this way in kids for years.

• Ask whether the medication has been studied for treatment of your child’s condition in children your child’s age. If it has not, ask whether there is an alternative medicine that has been studied in children, and why your doctor wants to use this one instead. The “off label” medication could be safer to use with other drugs your child is taking, or a better fit for some other reason. Or there may be no alternative.

• Ask whether there are any side-effects you should look out for. Some could be minor, such as interfering with appetite or sleep. Others could be serious.

• Make sure your doctor reports any side-effects or “adverse events” your child experiences to FDA. Even when a drug has been studied for use in children, these reports help shape labeling of drugs and help keep doctors informed about potential problems. “These studies [in children] are often small, and they don’t pick up some of the more unusual things,” McMahon says. In the case of one ADHD medication, “hallucinations” was listed among possible side-effects, but not featured prominently on the label. Once FDA began receiving reports, the labeling was changed to make sure parents were aware that if children taking the medication began to hallucinate, reducing the dosage or discontinuing the medication would correct the problem.

And, of course, don’t hesitate to contact your doctor if you are worried about symptoms your child experiences while taking medication.