hygiene Archives - Happy Healthy Kids

Handwashing without Tears

January 17, 2021 by Kelley Leave a Comment

This post was first published on a recent Global Handwashing Day in 2016—back in those simpler times when hand hygiene helped defend against garden-variety sniffles and barfing bugs, not a deadly pandemic.

Sure, kids these days are more attuned to the importance of handwashing, but on our homefront, at least, the simple task remains a chore. Despite my constant nagging that the boys suds up upon arrival home from school or sports, before eating, and after using the bathroom (every time!), compliance remains spotty, and initiative scant. It probably doesn’t help that our liquid soap is at the dregs level in two out of three bathrooms the children use. It’s clear we need to up our game.

Since we first covered hand hygiene on this blog, research has only grown to show that washing with good old soap and water beats just about any other germ-busting regimen out there, including sting-y sanitizers and pricey supplements. The trick is getting kids to wash without being reminded, and to do more than a quick rinse. Here’s a round-up of best expert advice I found; I’ll keep you posted as to which of these clicked for us.

Get the good soap. No, not that beautiful bottle you covet from Restoration Hardware. I mean the yummy-smelling stuff that’s in a bottle that’s easy to depress and won’t make a mess. Some faves: Method Mickey Mouse lemonade soap (Amazon, 2 for $10); these giant, inviting bottles of Every Soap for Every Kid, in scents like Tropical Coconut Twist (Amazon, 32 oz. for $13); Tru Kid Helping Hand Wash (Amazon, 8 oz. for $9); and, for potty trainers, the Sesame Street Bundle in varieties like Cookie Monster Crunch (Amazon, 3 for $15).

Buy stools to make washing up easier. Kids can’t wash well when they can’t reach the
faucet and soap comfortably. You can go colorful—Tundras makes a cute $9 stool in bright green, cobalt, and cranberry red—or fashionable, but make sure there’s one for every sink in the house. We love these Bee Stands from Ballard Designs, because they match our decor but still have a fun design.

Put some posters up around the bathroom. The Massachusetts state government made this eye-catching printout you can laminate for a few bucks at Staples; Etsy’s crafty artisans, as usual, up the ante with some cute printables (like this, for $5, from the Funky Art Shop) that actually serve as decor.

Check out the supplies in your school bathrooms, too. In a recent survey, kids who didn’t wash their hands at school cited lack of cleaning supplies (19%), not liking to use school bathrooms (21%), and bathrooms being “disgusting” (15%). Only 63 percent of kids say their school always has all the soap, water, paper towels and drying equipment needed to wash their hands. Some schools compensate by scattering sanitizers around, but bathrooms should be clean and fully equipped with hand washing materials as well. Poke around the bathrooms next time you visit the school, and talk to kids; if supplies are wanting, consider proposing a fundraiser to allow for better and more plentiful soap and towels for kids’ use.

Practice what you preach. The broken-record message: Model the behavior you want to see in your kids. According to Stanford’s division of public health, only two-thirds of grown-ups wash their hands after they use the restroom. Make a point of washing up together at the kitchen sink or bathroom before family dinner.

Ultimate Sick-Day Survival Kit

December 2, 2018 by Kelley 1 Comment

I’ll admit it: Even with a dozen years, three children, and countless sick days under my parenting belt, I still become a little unhinged when my kids are sick. At the first sign of glazed-over eyes, raspy cough, or the dreaded, telltale, 2 a.m. gag, my heart starts pounding, because I know my child and I are in for a few days of sleepless nights, home-from-school days, and round-the-clock cleaning. And that’s if it’s an illness is limited to one family member, which we all know is about as likely as a four-leaf clover in January.

I was a little cocky a few weeks ago, when it occurred to me that we’d gone three whole months without anything more than a sniffle. Of course, within, oh, minutes of that thought passing through my brain, my youngest refused his afternoon snack, just wanted to cuddle, and preceded to barf buckets on himself, his carseat and half of the minivan on the way to pick up my older sons at school. One week later, his older brother’s norovirus also presented itself in the car, this time on the way to a ski trip. After fishing around for plastic bags and coming up empty, the portable potty seat became a sick basin. Double ick. Granted, we were traveling, but it made me resolve to be better equipped for sudden sicknesses—which they all are, really—at home and on the go. For me, at least, having all the proper tools for keeping kids comfortable and the house disinfected at the ready goes a long way toward mitigating my anxiety over dealing with a tough bug.

After talking to some docs and veteran moms and thinking about what’s saved the day for us time and again in the past, I’ve come up with a list of must-have products for sick-day “success” (as it were). While good hand hygiene and a flu shot (find a nearby vaccination center here) may help keep illness at bay, these soothing products are worth stashing away in a closet or bathroom drawer for when sickness does strike. Note on chart, below: If viewing on a mobile devices, links in chart below might not direct you to correct products. Use links in descriptions below chart, instead.

1. Kid-Friendly Tissues. Puffs and other companies now have boxes with fun designs that appeal to kids, which just might make tykes more likely to reach for a tissue rather than their sibling’s shirt sleeve. Also, take this genius cue from Mommy Shorts (via Wide Awake) and use a rubber band to harness together a full square tissue box and an empty square tissue box. Voila—tissues and trash can in one.

2. Graco Battery Operated Nasal Aspirator. One of my babysitters is a nurse at Boston Children’s Hospital, and she says that this is what she and her colleagues use all the time on stuffed-up babies and toddlers who come through the E.R. It’s quick, simple, and painless.

3. Honey. Studies show it and doc-moms swear by it: A teaspoon or two of honey can help soothe a sore throat and quiet a cough, as good if not better than cough medicine.

4. Aquaphor. Smear a gob of this salve below runny noses to prevent drying and chafing, or on sore bottoms after a stomach bug.

5. Rectangular Wash Basin. Kids aren’t so skilled at aiming their puke in the right places. Stash a medium-sized—I find 8-quart to be perfect—plastic bin in a bathroom drawer, cabinet or shelf so it’s easy to grab when your child starts feeling queasy.

6. CareBags. What a terrific product: These bags, which fold-flat for easy storage in the car, have an absorbent bottom that eliminates odors, and an easy-tie top. Great to have on hand for car sickness of any type.

7. Gatorade. Research shows Gatorade is effective as Pedialyte at rehydrating kids after a stomach illness—and my guess is that 10 out of 10 kids would say it tastes better.

8. Pedialyte Pops. You can freeze these pops, which forces kids (little ones, especially) to rehydrate slowly after an illness.

9. Braun Ear Thermometer. While stick thermometers are considered the most accurate, it can be hard to get a good reading with a squirmy child. Braun’s ear thermometers are highly rated, easy to use, and, from my experience, can work without waking a sleeping child.

10. Acetaminophen suppositories. For the helpless-feeling times when a child has a fever but feels too ill to swallow (and keep down) medicine, these rectal suppositories are a lifesaver. Make sure you get a product formulated for your child’s age and weight.

11. Clorox Hydrogen Peroxide Wipes. This hospital-grade cleaner is now available for household use, and is one of the few products that can kill norovirus (the super-bad stomach illness) as well as most other germs. A little pricey, but totally worth it.

12. Large white hand towels. Get a stack of these soft towels and keep them in the laundry room for sick nights. They have multiple uses: a pillow-topper for kids with tummy bugs, a cool forehead compress for bringing down a fever, and a clean-up rag. Because they are white, you can easily bleach out germs and stains after use.

13. Disposable straw cups. Color-coded cups help you keep track of which drink is your sick child’s, and the straw makes it easier to sip while reclining on a bed or couch. Toss after your kid makes a full recovery.

14. Soft fleece blanket. Feverish kids have rapid temperature changes, and you probably don’t want them using your cashmere throw from the living room when they get the chills. Buy one of these fuzzy, inexpensive blankets in your child’s favorite color, and keep it on his shelf for sick days on the couch.

15. Nature DVD or streamed video. Sometimes, all your kid can handle is starting at a screen, but too much SpongeBob can make a headache worse. Many nature videos, with their soothing voices and sounds, set just the right mood. We like Disney’s Oceans and Earth series.

16. Maze books. For when your child starts to feel a little better and may be up for an activity, keep some maze books on hand. They re-engage the brain without taxing it, and some—like Kumon’s Around the World series—are really fun for kids and grown-ups to do together.

Keep Kids Safe from Ticks

June 3, 2017 by Kelley 1 Comment

You may not have appreciated the harsh winter, but there’s one species that did: ticks. According to scientists, the snow that covered much of the country acted like a cozy blanket for the critters, allowing them to survive and propagate in unusually high numbers. And they’re not just hanging out in the deep woods. “We’re finding plenty of infected ticks in built environments, places like city parks, playgrounds, work campuses, college campuses,” a Binghamton University researcher told CBS Boston last month.

What’s especially worrisome is that ticks’ favorite meal appears to be kids. Children between ages 5 to 14 are the most common carriers of Lyme disease, which can cause a wide range of serious medical problems, from joint pain and fatigue (in the early stages) as well as neurological, behavioral, and emotional disturbances (in more advanced cases). An early CDC study of 64 New Jersey grade schoolers with Lyme found that median duration of their illness was 363 days, and the mean number of school days missed because the child was too ill to attend was 103 days. 78% of the parents stated that their children experienced a fall in grade point average during the time of illness.

According to experts, it’s time that parents start thinking of tick prevention the way we do sun protection or hand washing. For those of us who grew up thinking that the little bugs were nothing more than an icky nuisance, taking daily measures against ticks is a hard new habit to start. But Nevena Zubcevik, D.O., an attending physician at Harvard Medical School and the Co-Director of The Dean Center for Tick Borne Illness at the Spaulding Rehabilitation Hospital, has generously shared these easy-to-follow guidelines for keeping kids safe from ticks this summer and beyond.

STARTING IN THE SPRING…make your home and yard an unhappy place for ticks.
Pruning excess bushes and making sure you keep the grass short in your yard is a good practice. So is spraying the yard for ticks—there are lawn-care companies who offer organic options to insecticides. If you have a dog, consider applying anti-tick medication monthly, even in winter months. Dogs and other pets frequently bring ticks into the house.

EVERY MORNING…Spray your kids with a research-proven tick repellent.
“Tick prevention, given the wide area of presence, should be a daily practice,” says Dr. Zubcevik. You don’t have to venture out to the woods to get a tick bite. Recent studies show that urban parks, yards and play areas have ticks that carry these diseases. The reason for the widespread presence of ticks is that they live on small rodents like mice, squirrels and rabbits. They are also found on migratory birds, so ticks carrying illnesses generally found in other parts of the country can now be detected most anywhere.
Long pants and socks are especially helpful for defending kids against ticks, which tend to attach to their hosts’ ankles and legs first. But it can be unreasonable to ask kids to wear long clothes on a hot summer’s day. A recent Consumer Report showed that sprays such as Repel with lemon eucalyptus or Sawyer with 20% picaridin have the capability of keeping mosquitoes and ticks away for up to 8 hours – and outperformed compounds with DEET in their testing. “Those compounds are also safer than DEET for repetitive use in children,” says Dr. Zubcevik.

IN THE EVENING…Check your kids’ bodies for ticks, and wash bodies and clothes.
Ticks mostly live on wood or bushes and tall grass. They’ll attach to your leg and can crawl up and enter the waist or hairline area. Since kids are short, they also often brush by a bush and end up with a tick in or around their earlobe, hair or armpit. A prompt shower with a full body tick check after being outdoors on daily basis can help find ticks that just attached and catch them before they have transmitted disease. Making sure you check between toes, in belly button and earlobes as well as the buttocks, groin and hair is key. Hair-drying in the summer can help kill small ticks that would otherwise be missed with a tick check – though time consuming, such practice can help long term prevention.

IF YOU FIND A TICK…Remove it, freeze it, and talk to a doctor.
If you find a tick you can use thin tweezers to catch the tick at the insert site, closest to the skin and gently jiggle the tick until it detaches. If the tick is embedded deep, then a visit to the doctor would be warranted, says Dr. Zubcevik. (Never burn or squeeze a tick. The tick carries most of the bacteria in the stomach and by squeezing it you run a risk of injecting the contents into the person. You should then keep the tick, and freeze it in a ziplock bag and then send it for testing.) The testing is done at UMass, and in five business days they will let you know whether the tick has any serious illnesses.
If the result is positive for a tick-borne illness, talk to your child’s pediatrician about options. There are some opposing views about prophylactic treatment. Some physicians say that because the diseases the ticks carry can be debilitating and in some cases life-threatening, it’s important to treat if there was evidence of a bite; while others disagree and prefer to wait for symptoms of illness. “The problem is that the longer you wait, the higher the chances the bacteria has had time to spread throughout the body, in which case it might be more difficult to treat,” Dr. Zubcevik says. Current studies at John’s Hopkins University show that up to 35% of people develop chronic symptoms despite treatment for Lyme. “We do not know what the exact reasons of these chronic symptoms are,” notes Dr. Zubcevik. “Scientists have postulated that it could be an autoimmune reaction that is triggered by the infection, chronic inflammation, or continued infection by the bacteria.”

ALWAYS BE ON THE LOOKOUT…for signs and symptoms of Lyme.
Red flags are flu like symptoms, joint pains or swollen joints, sudden change in behavior, sudden development of repetitive movements, lethargy, fatigue, and headaches. A classic “bulls-eye” shaped rash around the bite site may be present, but not always, and therefore should not be required for diagnosis of this illness.
One big reason kids are at high risk is that they generally do not communicate symptoms very well. Parents should know that in case their kids develop any symptoms that are new and concerning, they should be vigilant to find out whether or not their child needs treatment. “Currently we have very poor testing for Lyme disease,” says Dr. Zubcevik. “The current test misses 89% of Lyme disease cases in the first 8 weeks of infection.”
Since testing is so inadequate, Dr. Zubcevik warns, results should not be depended on exclusively for diagnosis. Symptoms and risk factors should also be strongly considered. “The treatment is actually quite benign,” she says. “We use antibiotics such as amoxicillin for children under the age of 8 and doxycycline for older kids. Both of these antibiotics have good safety records and are generally well tolerated. With these facts in mind, both parents and physicians should feel comfortable starting a patient on antibiotics if they clinically present as Lyme.”

Bottom line…As long as Lyme remains so tricky to diagnose and treat, taking precautions is key. “Parents should be vigilant with prevention,” says Dr. Zubcevik. “It’s what we have most control over.”

The Tick Toolkit
	Repel with lemon eucalyptus or Sawyer with 20% picaridin have been tested to keep mosquitoes and ticks at bay for up to 8 hours.
	Fine tip tweezers like these by TAMSCO will allow you to remove ticks more easily.
	When sprayed on a child's socks or clothes before heading out in grassy, wooded or overgrown areas, Permethrin helps repel ticks.
	Get kids jazzed for a nightly bath or shower with a fun soap, like Method's Mickey Mouse lemonade body and hair wash.

What You Need to Know this Flu Season

January 26, 2016 by Kelley Leave a Comment

Ever since my oldest son got the flu twice in three years despite being vaccinated, I go on high alert for news about “flu activity” come late January, when the virus typically starts to ramp up in the northeast. The flu is no joke—kids with a history of asthma or other respiratory issues are at high risk for pneumonia with the virus. Even my healthy son was listless, coughing, and had an around-the-clock 103-degree fever for a straight week.

Vaccine scientists predict what flu strain will be most prevalent from year to year and design a formula accordingly, so even the experts don’t know until the virus peaks how effective each season’s shots have been. Here’s what we know so far—and how we can help keep our kids as protected as possible.

1. This flu season looks mild—so far. As of last week, overall flu cases are low compared to recent years. Just three states—Maryland, Massachusetts and North Carolina—reported “widespread” flu activity across the state, and cases were “minimal” or “low” in 47 states. This time last year, only 17 states had minimal flu activity. Last flu season, the estimated number of flu-associated hospitalizations of 970,000 people in the United States was the highest ever during a single season, according to the Centers for Disease Control and Prevention. Many epidemiologists point to this winter’s warmer temperatures thus far as a partial explanation: Flu tends to circulate fastest in cold, dry conditions.

2. This year’s vaccine seems like a good match. The flu could be suffering from an even more formidable opponent than warm, humid conditions: a well-matched vaccine. Last year’s formula didn’t include coverage against the flu strain that wound up predominating for the better part of 2014-15. The 2015-16 vaccine covers either three or four strains of the flu, including the influenza A virus that’s striking people in greatest numbers thus far.

3. It’s not too late to get vaccinated. It takes about two weeks for the vaccination to set in, and since flu tends to peak in February and last through May, getting immunized now will cover you through the heart of sick season. While the vaccine isn’t 100 percent effective, it’s definitely your bet shot at either preventing the virus or shortening its severity and duration. I continue to vaccinate my kids even though my one son—for reasons doctors can’t definitively explain—has had an unlucky track record. Barring certain medical conditions, everyone 6 months and older should be vaccinated. Want to find the most convenient place to get your shot (or mist)? Check out this handy, searchable map. Most insurance plans cover shots in full, but vaccines are less than $50 (and at places like Costco, quite a bit less than that) out of pocket.

4. Good hygiene is as important as immunization. Getting kids in the habit of washing their hands—with regular soap—when returning home and just before eating can provide great defense. Keep alcohol-based hand sanitizer in your bag and the car and use a squirt after you’ve been in a well-trafficked place like the mall, a museum, or the library. And if they are hacking or feverish, do others a solid and teach them to cough into their elbows, even after the worst of their symptoms subside. Just as vaccines are as much a public service as personal protection, so are good hygiene habits.

5. If you suspect the flu, see a doctor right away. If your child runs a persistent fever, has headaches, is coughing, and/or feeling generally achy and unwell, flu is a possible culprit (even if he or she has been vaccinated). Make an appointment with the doctor sooner than later, since they can test for the flu easily and quickly. Once the flu is diagnosed, you can take extra care to keep your sick child away from siblings and other kids until their fever and symptoms subside; and if he or she is high risk for pneumonia or other complications, the doctor can possibly start your child on an antiviral medication that can reduce the flu’s duration and severity. But in most cases, ibuprofen or other fever-reducing medications (as well as plenty of rest, liquids, patience, and fun movies) will see sick kids—and tired parents—through a bout. For more ideas for keeping children comfortable during illness, check out HHK’s Sick Day Survival Kit.

photo credit: Influenza via Photo Pin, cc

Healthy New Year’s Resolutions for Kids

December 29, 2015 by Kelley 1 Comment

In late December, on one of the family walks we try to do around our local pond every weekend, my husband and I share our New Year’s resolutions with our kids—and prompt them to share theirs. But usually, little boys’ resolutions are either overly specific (“I won’t trip my little brother near that big rock again”) or overly broad (“I will be good”). But this year I will be able to provide some guidance, courtesy of the American Academy of Pediatrics, who recommends these ideas for preschoolers through high schoolers.

Preschoolers

I will clean up my toys by putting them where they belong.
I will let my parents help me brush my teeth twice a day. I will wash my hands after going to the bathroom and before eating.
I will help clear the table when I am done eating.
I will be friendly to all animals. I will remember to ask the owners if I can pet their animal first.
I will be nice to other kids who need a friend or look sad or lonely.
I will talk with my parent or a trusted adult when I need help or am scared.

Kids, 5 to 12 years old

I will drink reduced-fat milk and water every day, and drink soda and fruit drinks only at special times.
I will take care of my skin by putting on sunscreen before I go outdoors on bright, sunny days. I will try to stay in the shade whenever possible and wear a hat and sunglasses, especially when I’m playing sports.
I will try to find a sport (like basketball or soccer) or an activity (like playing tag, jumping rope, dancing or riding my bike) that I like and do it at least three times a week!
I will always wear a helmet when riding a bike, scooter or skateboard.
I will wear my seat belt every time I get in a car. I’ll sit in the back seat and use a booster seat until I am tall enough to use a lap/shoulder seat belt.
I’ll be friendly to kids who may have a hard time making friends by asking them to join activities such as sports or games.
I will always tell an adult about any bullying I may see or hear about to help keep school safe for everyone.
I will keep my personal information safe and not share my name, home address, school name or telephone number on the Internet. Also, I’ll never send a picture of myself to someone I chat with on the computer without asking my parent if it is okay.
I will try to talk with my parent or a trusted adult when I have a problem or feel stressed.
I promise to follow our household rules for videogames and internet use.

Kids, 13 years old and older

I will try to eat two servings of fruit and two servings of vegetables every day, and I will drink sodas only at special times.
I will take care of my body through physical activity and eating the right types and amounts of foods.
I will choose non-violent television shows and video games, and I will spend only one to two hours each day – at the most – on these activities. I promise to follow our household rules for videogames and Internet use.
I will help out in my community – through giving some of my time to help others, working with community groups or by joining a group that helps people in need.
When I feel angry or stressed out, I will take a break and find helpful ways to deal with the stress, such as exercising, reading, writing in a journal or talking about my problem with a parent or friend.
When faced with a difficult decision, I will talk about my choices with an adult whom I can trust.
When I notice my friends are struggling, being bullied or making risky choices, I will talk with a trusted adult and attempt to find a way that I can help them.
I will be careful about whom I choose to date, and always treat the other person with respect and without forcing them to do something or using violence. I will expect to be treated the same way in return.
I will resist peer pressure to try tobacco-cigarettes, drugs or alcohol. I will also avoid the use of e-cigarettes.
I agree not to use a cellphone or text message while driving and to always use a seat belt.

See more at AAP.com. And best wishes to all of our phenomenal followers for a healthy and happy 2016! Thanks so much for your support.

5 Common Summer Ailments in Kids

July 16, 2015 by Kelley Leave a Comment

Most of us associate sick days with wintertime. That’s when storefronts and commercials are dominated by cough syrup and Kleenex; not now, when sunscreen and beach balls take center stage. So when our kids spike a fever or complain of a sore throat on vacation, it may take us a bit longer to catch on—and, frankly, accept—that they’re under the weather.

As much of a drag as summer ailments are, it’s important they’re on every parents’ radar. Some health problems that go along with warm weather are as, if not more, serious to kids’ health than the coughs, colds, and flu that circulate during the school year. To get the scoop on what pediatricians are seeing in the office right now, I talked to my friend Laura Scharf, M.D., a pediatrician at Quincy (Ma.) Pediatric Associates who also serves as a physician at Camp Becket in the Berkshires, as well as HHK’s advisors Naline Lai, M.D. and Julie Kardos, M.D. of Two Peds in a Pod. Here, they weigh in on how to recognize and treat some of kids’ most common summer ailments. (In each case, be sure to consult with your child’s own healthcare provider for individualized treatment.)

Coxsackie (Hand, Foot, and Mouth Disease)
Common in kids, Coxsackie often spreads around pools, sprinkler parks, public bathrooms, and other “wet” places. Part of the large family of enteroviruses that live in our gut, different Coxsackie strains cause different symptoms, but hallmarks are a high fever and small, sometimes painful blisters around the mouth, hands, feet, and sometimes buttocks. “A new strain we’re seeing can also cause a more extensive rash, often on the lower legs,” says Dr. Scharf. Kids can also get runny noses and pinkeye.
How to treat: Ibuprofen or acetaminophen (administered as directed on the label) can control fever and pain. Soft, cool foods and drinks like yogurt and milkshakes can help soothe blisters in the mouth and throat. Symptoms usually go away in 3-7 days.

Summer Colds
Believe it or not, we’re seeing a lot of colds in the office, says Dr. Lai. Often caused by different enterovirus strains than the ones that cause Coxsackie, these colds may bring on a fever and cough. They circulate where a lot of kids congregate, like camps and daycare. “So it’s not surprising we saw a spike after the July 4th holiday,” Dr. Lai says.
Prevent and treat: Viral colds can’t be eradicated with an antibiotic. Rest and lots of fluids is the best prescription. Your child should feel better within a week; if not, see a doc.

Lyme Disease
Prevalent in the northeast, Pacific northwest, and midwest, particularly in woodsy areas (but not always), Lyme disease is the most common illness spread by infected ticks. (Other tick-borne illnesses include babesiosis, ehrlichiosis, and Rocky Mountain Spotted Fever. For a complete rundown, with geographic trends, check out the CDC’s page, here.) Kids who end up testing positive for Lyme come to the doctor’s office with a nagging fever, aches and pains, and sometimes a bulls-eye-shaped rash. Read more about diagnosing and treating Lyme in this previous HHK post I did with Lyme expert Nevena Zubcevik, D.O.).
Prevent and treat: Apply sprays with 20% picaridin or 30% DEET on your child before he or she goes outside for long periods, especially around wooded or grassy areas. See a doctor right away if he or she has a strange, circular rash or unexplained, recurring fevers or achiness (without other symptoms). Lyme can be diagnosed through blood tests (though false negatives are common, so be sure to follow up if symptoms persist), and treated successfully with antibiotics, especially if caught early.

Rashes
“Summer is rash season,” says Dr. Scharf. Some skin flare-ups are associated with illnesses, such as Coxsackie or Lyme, above. But our peds are also seeing a lot of bumps and welts due to photosensitivity (a reaction to excessive sunlight), contact dermatitis (sensitivity to a material or a product, often a new sunscreen), heat rash (when sweat gets trapped under clogged pores), poison ivy, and bug bites.
Prevent and treat: Limit sun exposure, especially if you have a sun-sensitive kid, and do a patch test to make sure a new sunscreen or product agrees with your child before sending him or her out for the day (sensitive kids often do best with mineral-based sunscreens with titanium dioxide or zinc oxide.) Teach your kids to avoid overgrown wooded areas and keep to paths to avoid poisinous plants. Dressing your child in loose, lightweight clothes can help ward off heat rash. If rashes develop, consult your pediatrician or dermatologist; treatments range from calamine lotion to topical steroids in more extreme cases, to temper welts and stave off itching. It’s important to keep sores clean with soap and water, and to teach kids try to avoid scratching too much, especially with unclean hands. “We see a lot of infected bug bites from this, “says Dr. Lai.

Stomach Bugs
Foodborne illnesses peak in summer months. Bacteria on food grows fastest in warm, moist conditions, and people are often cooking and eating far away from refrigerators and trusted heat sources that can regulate storage and cooking temperatures (think of picnics and beach barbecues). Illnesses usually strike within minutes or hours of eating a contaminated food, and can be mild or severe, causing abdominal pain, diarrhea, vomiting, and sometimes fever. Kids can also pick up bugs from swimming in—and often swallowing—contaminated water. Between 1978 and 2010, norovirus was the second-leading cause of illness outbreaks associated with untreated recreational water, such as lakes, according to the CDC.
Prevent and treat: Clean hands frequently when preparing food, and be sure to keep food that’s susceptible to bacteria (like raw meats) packaged tightly and separated from other edibles. Keep raw produce and meats cold with frequently changed ice packs if outdoors, and cook foods to recommended temperatures (145 for beef steaks, 160 for ground meats, and 165 for pork). The USDA recommends bringing a meat thermometer to picnics and cookouts. If a queasy stomach strikes, keep a child hydrated with plenty of non-acidic, non-dairy fluids. When kids are swimming, especially in untreated lakes or ponds, make sure they avoid swallowing water, and wash up afterwards.You can also replenish them gradually with small sips of oral rehydration solutions made with electrolytes.

Photo credit: Dave Jacquin via Flickr, cc license 2.0

When to Talk About the Birds and Bees

March 21, 2015 by Kelley Leave a Comment

My friend Beth recently sent me an email with an idea for a post. With her oldest son turning 9, she wondered if it was time to talk with him about the birds and bees.

Whaaat? I thought. My oldest is turning 9 soon, too, and I hadn’t thought that we were anywhere near “the talk.” I quickly started researching the topic, and it appeared that Beth was on the right track. Clearly, I was clueless, so I reached out to clinical psychologist Ellen Braaten, Ph.D. Dr. Braaten is the associate director of the Clay Center for Young Healthy Minds and the director of the Learning and Emotional Assessment Program (LEAP), both based at Massachusetts General Hospital, as well as a mom. Here’s what I learned.

There shouldn’t be one big sex talk, but an evolving conversation—starting very early.

Once a child gets to be verbal, you can do a few things to set the stage for later talks about how babies are made. Dr. Braaten advises always using the correct names for body parts, and also demonstrating and talking about loving, gentle relationships, generally. You can also talk about what it means to be a family, making sure to point out that there are different types of families.

There’s a good chance that your preschooler or early elementary schooler will take note that other grown-ups—maybe you or your partner—are expecting and having babies, and they might start asking more, shall we say, technical questions. “You can and should answer all questions that come up, and be truthful, without adding unnecessary details that might confuse or upset them,” says Dr. Braaten. If you and your partner conceived in the traditional way, she suggests saying something like, “Mommy and Daddy love each other, and Daddy shared a small part of himself with a small part of Mommy, and those parts started to grow into a baby.” If you have a curious child who presses for more details—but how did Daddy’s part get inside Mommy?—Dr. Braaten likes the idea of talking about parents sharing a very special hug, and leaving it at that for the time being. (If your child is adopted or is conceived via a donor or surrogate, you’ll obviously have a different type of conversation. For guidance, Dr. Braaten advises talking to friends in similar situations who have older children. “Other parents are always your best guides when it comes to this subject, in particular,” she says.)

Between 8 and 10 is a good time to talk to kids about puberty and the basics of sex.

“Kids should know when and how bodies change before they hit puberty,” says Dr. Braaten. “When you do this, the conversation will be less personal and therefore less embarrassing for them, making them far more inclined to listen and ask the important questions.” Talking about what happens during puberty to both sexes is also important to demystify the changes that they might notice in their peers. Dr. Braaten also recommends having both you and your spouse or partner present during the conversation so your child knows that either of you can field questions or concerns later.

After you’ve given them the basics, leave them with a good book about puberty so they can refer to it later. For girls, Dr. Braaten recommends The Care and Keeping of You, by the makers of the American Girl doll series. For boys, The Boys Body Book, published in 2013, is well reviewed. Let them know you’re available to talk about any questions they might have.

A conversation about puberty allows you to segue naturally into the basics of sex. You can explain that girls’ and boys’ bodies change in preparation for creating babies later in life, after they develop a very close and loving relationship with someone. You then have to judge for yourself if this or another time is best to explain, frankly, how sex occurs. For many kids, these details might be best addressed in a separate conversation a year or two later. Other children will ask a lot of questions during a discussion about puberty, in which case you should be honest and to-the-point. “At this stage, keep the explanation brief and biologically based,” Dr. Braaten. To limit the chance that your child might share his new knowledge with a not-yet-informed classmate, make it clear that these conversations—just like sex itself—are very private and personal, and shouldn’t be discussed at school.

After the basic pre-teen sex talk, regularly take advantage of opportunities to talk about tougher topics.

Once your children are teens, you’ll want to talk to them about birth control and safe sex. Take every opportunity to discuss these subjects when they arise organically: like when the topic is discussed in a movie you’re watching together, or when your child talks about something that’s happening to a friend.

Every so often, a kid will ask a difficult question totally out of the blue, or in an inopportune place. If you’re not ready to address it thoughtfully, says Dr. Braaten, you can always say, ‘That’s a really good question but I’m not sure how to answer it right now. I’m going to think about it and get back to you—promise.’ And be sure to follow up within a day or two.

Finally, try to be non-judgmental whenever possible, and make sure you allow everything to be on the table. That way, your child will be more apt to come to you when they’re having a problem. “Parents tend to be naïve about their kids sexuality—it’s jarring to find out that a 13-year-old girl knows about or is even doing a lot of things that seem very ‘adult,’” says Dr. Braaten. “But kids today are exposed to more sexual conversation and images than ever before, from the Internet to everyday commercials. It can be shocking and confusing to them. As hard or uncomfortable as it may be, stay ahead of the curve. You want to be the person they go to with the tough questions.”

Photo credit: photo credit: Bees on a Bluebell via Photo Pin, cc

Environmental Health Doctor’s Wish List

January 28, 2015 by Kelley Leave a Comment

This post is part of a “Wish List” series in which I ask experts in different kid-related fields—medicine, education, etc.—what they really want parents to know and do better. Interested in hearing from a certain type of expert? Please make a suggestion here.

For this installment of the expert “Wish List” series, we’re honored to share the wisdom of Jerome Paulson, M.D., a professor of pediatrics at George Washington University School of Medicine and Health Sciences and chair of the executive committee of the Council of Environmental Health for the American Academy of Pediatrics. Here, he tells us the five things he wishes every parent knew or did to help all kids—your own and future generations’ —consume healthier air, water, and food.

1. Consuming a variety of fresh, whole foods is more important than eating organic. We know that produce is full of antioxidants and other nutrients that help protect kids from all sorts of problems. But many people will be surprised to learn there’s actually no documented long-term health benefit of eating organic foods. Eat organic if you want to, but don’t limit your child’s intake of fresh fruits and vegetables, calcium-containing foods, and whole grains if buying organic makes these choices too expensive. If you want to be choosy about organic purchases, look at the Environmental Working Group’s Dirty Dozen and the Clean 15, here. They have an app that will allow for quick reference at the grocery store.

2. Take steps to be more energy conscious. Climate change is one of the major health problems facing the globe. Any parent concerned about the future of their children and the planet should make an effort to use public transportation and carpools whenever possible, buy the most fuel efficient vehicle consistent with safety and their budget they can find; conserve energy at home; and encourage their elected officials to change local, state, and national policy so the U.S. can contribute to climate change mitigation where possible and adapt to climate change where it must.

3. Avoid toiletries and cosmetics that include endocrine disrupting chemicals. Certain chemicals common in household products are thought to possibly interfere with many chemical processes in growing bodies and are known to have adverse health effects in animals. Err on the side of caution and avoid buying soaps, lotions, and makeup for your kids that contain triclosan, phthalates, parabens and certain other ingredients (for a full and helpful list, check out the EWG’s Skin Deep page, here).

4. Keep indoor air free of pollutants. Polluted indoor air is a big asthma risk. Don’t allow people to smoke in your home—ever—and work with your local school district to take steps to keep the school’s indoor air clean by avoiding air fresheners and keeping humidity down to inhibit mold growth. Moms Clean Air Force and the American Lung Association have great tips on their websites.

5. Take your shoes off when you enter the house. You’d be amazed by how much bad stuff is tracked in on the soles of shoes—pesticides and harmful chemicals, just to name a couple. Make a designated spot by the door where everyone in the family can stow their boots and sneakers, and get everyone into the habit of removing their shoes when they come into the house.

Photo credit: Odin Thomas via Photo Pin, cc

Bathing 201: Beyond the Baby Years

January 14, 2015 by Kelley 1 Comment

Bathing serves multiple functions in our house. Depending on the day and the kid, it can serve as a wind down tool or a wake-up call; sibling bonding time or much-needed alone time; a skin soother or grime remover. Our children take a bath or shower nearly every day, for these and other reasons. But when one of my sons scratched some dry skin on his hip so aggressively the other day that it started to bleed a bit, I started wondered if maybe we needed to cool it on his daily hot shower, at least during the winter. At the same time, doesn’t his current sport of ice hockey, perhaps the smelliest sport on the planet, call for it?

When our babies are first born, we’re given detailed information about how—and how often—to cleanse their hair, skin, and teeny tiny belly buttons. But when the newborn period is over, so is the annual well-visit spiel about bath time. And yet bathing is something our kids do nearly everyday, with major repercussions on hygiene, body awareness, dermatologic health, and even mood. Clearly, I needed someone to walk me through bathing 201. So I turned to pediatricians Julie Kardos, M.D. and Naline Lai, M.D., HHK advisory board members and creators of the Two Peds in a Pod blog, for age-by-age guidance. Here’s the nitty-gritty on getting kids clean, along with some product recs (based on my own research).

BABIES AND TODDLERS

How often to bathe? Three times a week or less. Be sure to wash their hands after diaper changes and potty time and before meals, however. If they really like bath time, you can do it everyday, but don’t soap areas other than their hands, face, and diaper area, and keep sessions short. The exception is children with eczema; daily bathing can be too drying. For these kids who love the bath, set up a basin of warm water and toys at the sink for them to play with.

What products to use? Mild, fragrance-free soaps or just plain water is best. “Generally, the less scented, the better,” says Dr. Kardos. Research shows that using a thick moisturizer on a young child’s skin everyday can cut their risk of eczema by half. Lotion can feel cold right out of a warm bath; try filling the bathroom sink halfway with hot water and let the bottle warm in there during bath time.

Keep in mind…This never goes without saying: Keep within arm’s reach of babies and toddlers while they’re bathing. Older siblings are fun tub companions, but terrible lifeguards. This is not time to catch up on Facebook, either, as tempting as our iPhones are. Digital distractions around the bath are a hazard for your child and your device.

ELEMENTARY SCHOOLERS

How often to bathe? Every other day works for most kids in the early grades. During the summer, though, you might want to make sure they have a quick shower or bath nearly everyday, in order to rinse off chlorine, sunscreen, and possible ticks, and clean any cuts or microabrasions. Make sure they lather up their hands, face, and genital area.

What products to use? Colorfully packaged soaps can motivate school-age kids to bathe, but try to choose brands with minimal fragrance, dyes, and chemicals. Highly-rated ones to try: Kiss My Face Kids’ Bubble Wash ($10, Amazon) Jason’s Kids Only! Tropical Twist Wash Bath Gel ($7, Amazon) and Tru Kids’ Bubbly Body Wash (Amazon, $9), all of which come in fun, gender-neutral designs. Avoid bubble baths, which seem like fun but can really dry out skin and irritate private parts (especially girls). If itchy, dry skin is a problem, fill the toe of a sock with skin-soothing oatmeal, tie or cinch the top, and let it float in the water.

Keep in mind…Kids this age love to lounge, splash, and test their breath-holding capacity underwater, so even if they’re swimmers, make sure you can hear them at all times if bathing takes place in the tub. One idea: Bring a laundry basket into the bathroom or a room adjacent to the bathroom and get some folding done during bath time.

‘TWEENS AND ‘TEENS

How often to bathe? Once kids are around 9 or 10, they really should bathe everyday to stay fresh and clean. Make sure they wash their hands, faces, genital areas, feet, and underarms, as well as the back and chest (which can become acne-prone). As early as possible, teach them to wash their faces at the sink after waking and before bedtime, too, so that if and when complexion issues arise, they will have already developed good habits. Place a mild face soap, like Cetaphil (they make an oily skin version,$10, Amazon ) on the edge of their sink to help remind them.

What products to use? Again, nothing fancy: low-fragrance, mild soaps are best. Bar soaps that contain lotion, like Dove ($7 for eight bars, Amazon), will keep skin from getting dry and itchy. If your ‘tween or ‘teen likes to use a bath poof or sponge, replace them regularly (they are bacteria magnets).

Keep in mind…Big kids need bathing instruction too, especially as they hit puberty. Speak frankly with them about how to clean themselves, including using their pads of their fingers to scrub their scalps and avoid flaking, washing their faces from the top down as opposed to center-out (as not to spread any secretions from their noses into eyes and mouths), and carefully but completely cleaning the groin area. Awkward? Sure! Helicopter-ish? I don’t think so. These are life skills that will boost hygiene, comfort, and even confidence during the trickiest time of childhood.

How Safe is Sanitizer?

November 12, 2014 by Kelley 2 Comments

Our children will probably never remember a time when hand sanitizer, which hit the market in 1996, wasn’t everywhere they looked. Plastic gel bottles bedeck just about every desk, bathroom, and car cup holder they come across, and holding out their hands for a squirt before snack time has become as routine as raising their hand in class. One of my son’s first multisyllabic utterings was “han-i-tizer.” (At six, he still calls it that.)

At the same time, we’ve been hearing a lot about how cleanliness may not be all that it’s cracked up to be. Turns out that babies who are exposed to an array of dirt and bacteria—through farm settings or pets, for instance—are less likely to develop allergies and asthma than children raised in spotless surroundings. Antibacterial soaps, which seem like such an excellent idea, have likely contributed to the growth of antibiotic-resistant bacterial infections in recent years, and may affect kids’ hormonal development, according to the FDA, which advises against them.

And yet, even as we start to go easier on the Lysol and chuck the Triclosan, hand sanitizer is still ubiquitous. Which got my friend Stacey and I wondering at school pickup the other day: Just how effective—and safe—is the habitual slathering of alcohol on our kids’ skin? Luckily, Thomas Sandora, MD, MPH, a pediatric infectious disease specialist at Boston Children’s Hospital, just down the road from us, is one of the world’s experts when it comes to hand hygiene. Dr. Sandora took time out of his busy schedule yesterday to gave me the scoop on sanitizer.

1. Sanitizers that include at least 60 percent alcohol reduce the risk of GI bugs, in particular. Dr. Sandora led two studies—one in which families with children in child care received hand sanitizer to use at home, and one in which sanitizer was used in elementary school classrooms. The groups who received and regularly used the sanitizer had fewer gastrointestinal illnesses. Alcohol can also fight many other forms of bacteria and some viruses (including the seasonal flu, and interestingly, Ebola).

2. …But it doesn’t defend against everything. Some viruses aren’t affected by alcohol—like norovirus, a particularly nasty and common GI illness. Cleansing thoroughly with ordinary soap and water does seem to be effective in killing norovirus and most other germs from skin surfaces, however, so if you’re able, wash your kids’ hands well before—or in lieu of—using sanitizer.

3. Alcohol-based sanitizers aren’t contributing to the superbug problem. Because alcohol essentially obliterates bacteria on contact, these bugs don’t have an opportunity to mutate into more resistant forms. Overused antibiotics and “antibacterial” products, on the other hand, seem to promote these adaptations, leading to hard-to-treat “superbugs” like MRSA and C. difficile.

4. The amount of sanitizer you apply counts. A couple drops on the center of your palm isn’t necessarily going to get the job done. Use about a dime size amount, and be sure to rub it all over your child’s hands, including the backs and fingertips. In Dr. Sandora’s research, he found that families who used sanitizer liberally were less likely to pass around respiratory illnesses than families who used just a little. But be sure to use it only on kids 24 months and older, and no more than about 5 to 10 times a day, to reduce the chance that excess alcohol is absorbed by the skin.

5. Keep the pumps out of kids’ reach. Between 2005 and 2009, the National Poison Data System received nearly 69,000 reports of potential sanitizer ingestion. Young kids may be drawn to the jelly-like fluid, so make sure to keep your sanitizer bottles in places little children can’t access. While a lick or a suck on a sanitized thumb shouldn’t cause a problem, a toddler who’s ingested the equivalent of a couple teaspoons or more should receive medical attention. (Skin irritation, notes Dr. Sandora, is mild and not common.)

6. Think of sanitizer as a team player rather than solo act. Hand hygiene is perhaps our key defense against a variety of illnesses, says Dr. Sandora. But it’s also helpful to remember to cough or sneeze into your elbow instead of your hand, use (and promptly toss) tissues, and avoid close contact with people who are sick. And don’t forget to get your flu vaccine—everyone 6 months and older should get it every year.

Photo credits: Niquimerret via Photo Pin, cc; Valerie Everett via Photo Pin, cc

Preschoolers

Kids, 5 to 1​2 years old

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Kids, 13 years old and older