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Happy Healthy Kids

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5 Kids’ Health News Stories of 2015

December 23, 2015 by Kelley Leave a Comment

most important kids' health news stories of 2015Unless you’ve been living under a rock, you know that 2015 was packed with big, debate shaping events, both here and abroad. In the global grand scheme of things, everyday kids’ health news may seem relatively unimportant, but to parents, good pediatric research—especially when paired with good, actionable advice—can lead to life altering positive changes. (Which is why I created this blog in the first place!) Here, I’m sharing the five, kids’ health headlines from 2015 that most fascinated—and in some cases, inspired—me.

1. Measles isn’t going away.

What started with a bout of measles among kids at Disneyland in December ballooned into a multi-state outbreak, affecting more than 100 kids in January alone. The CDC is “very concerned” about the possibility of an even larger outbreak down the road, says Tom Frieden, director of the Centers for Disease Control (CDC).

Besides being seriously dangerous, potentially leading to pneumonia, encephalitis, and even death, the problem with measles is that its one of the most contagious viruses there is. Measles spreads through the air when an infected person coughs or sneezes, and 90% of the people around an infected person will catch it if they aren’t protected, according to the CDC. So, talk to your pediatrician to make sure your children’s shots are completely up-to-date, and if your infant is too young for a vaccine, make sure he or she doesn’t come into contact with infected children.

2. Pets make for healthier kids.

In case your kids needed any more fodder for their case for a fluffy new friend: Mounting research shows that having animals in or around the house can lead to big health benefits for growing immune systems and developing brains. In November, Swedish scientists published data on one million children that found that dog exposure during infancy was associated with a 13% lower risk of asthma in school-age children, while farm animal exposure was linked to a 52% risk reduction. Separately, CDC-funded researchers discovered that kids with dogs, specifically, were less anxious than their peers, even after controlling for family income, age, gender, and other variables. Pets may be hard work, but it appears they give back more than companionship.

3. Big kids are seriously sleep deprived.

Think you’re tired? In August, the CDC revealed that 2 out of 3 high school students get less than the recommended eight hours of sleep per night for their age group. Too-early school start times are partially to blame: The average start for middle and high schools is 8:03, which many sleep experts believe is out of sync with adolescent sleep cycles. But screen-based gadgets may be the worst culprit: A Norwegian study of 10,000 teens found that more than 90 percent of girls and 80 percent of boys use a cell phone in the hour before bed, a practice that’s been strongly linked in recent research to thwarted sleep (the blue light can trick the brain into thinking it’s daytime). If your children own gadgets, consider putting the phones and pads to sleep in a different room than them, and be sure to revisit the National Sleep Foundation’s guidelines on how long children of different ages should snooze: it’s 10 to 13 hours per day for preschoolers, nine to 11 for kids between ages 6 and 13, and eight to 10 hours for teens.

4. Cutting back on a little sugar goes a long way.

If you had to choose just one healthier habit to adopt for your family this year, clearing the kitchen of too-sweet snacks may be your best bet. Endocrinologists at the USCF Benioff Children’s Hospital in San Francisco showed that lowering overweight kids’ sugar intake dramatically boosted their health—in just 10 days. Even without changing the amount of calories they were consuming or exercise they were doing, children who cut out almost all sweetened foods were able to improve their levels of blood sugar, cholesterol, fasting glucose and insulin (all markers for diabetes). They also reported feeling less hungry. Need inspiration? Print out these easy ways to cut back on sugar from nutritionist Dana White, R.D., here and post on the ‘fridge.

5. Beware of “overvaluing” kids.

It seems intuitive to tell kids how special they are, but a new study adds to growing evidence that this could do more harm than good. In the first prospective study of its kind, scientists from Ohio State University and the University of Amsterdam surveyed families four times over one-and-a-half years to see if they could identify which factors led children to have inflated views of themselves. They found that kids of parents who “overvalued” them—thought they were more special than others—developed narcissistic behaviors later on. (The full report is an interesting read: In order to measure parental overvaluation, researchers asked parents, among other questions, whether their 8- to 12-year-olds are familiar with not only real historic people, like Neil Armstrong, but also fictional ones, like “Queen Alberta.” As you might have guessed, quite a few parents held firm that their little Einsteins knew all about “Queen Alberta.”)

Rather than convincing yourself and your kids’ of their greatness, researchers recommend greater “parental warmth”: simply letting kids know, often, how much you love them. This leads to high levels of much healthier self-esteem, without the narcissism. The difference? “People with high self-esteem think they’re as good as others, whereas narcissists think they’re better than others,” says study co-author Brad Bushman, Ph.D.

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How to Comfort Kids with Colds

November 24, 2015 by Kelley Leave a Comment

how to comfort kids with coldsIf you have a child older than 9 or 10, you might remember a day when drugstore shelves were lined not only with cold medicines for kids, but formulas for babies—teeny little dropper bottles packing decongestants, cough suppressants and other ingredients. That changed in 2008, when the FDA issued an advisory against giving cold medicine to kids under 2. The AAP followed with an even stauncher stance: “Over-the-counter cough and cold medicines do not work for children younger than 6 years and in some cases may pose a health risk.”

These days, you’ll be hard-pressed to find a pediatrician who advocates medicating garden-variety viral colds in kids of any age. It’s nice to be advised against wasting any more money than I usually do at CVS, but at the same time, I’m left with a helpless feeling as the boys sneeze, sniffle, and cough their way to sleep. So I reached out to Drs. Julie Kardos and Naline Lai, the Philadelphia-based pediatricians behind Two Peds in a Pod and advisory board members for Happy Healthy Kids. With kids of their own at home and an office full of congested kids at work, they know what works, and what’s a waste of time. Here’s their advice for what really helps children with colds feel better.

DURING THE DAY…

napEncourage rest and naps. “Parents are often worried that kids will feel as miserable as we do with a cold,” say Drs. Kardos and Lai. “But, unlike adults, it’s not a big deal to let them sleep during the day.” And that’s what they should do. Rather than push kids who have more than a little sniffle, let them stay home and rest for a day or two. Waking up several times during the night because of annoying cold symptoms causes sleep deprivation which can make for a crankier kid. Naps help restore sleep and mood.watermelon slushy

Hydrate well. Give kids with colds a bit more than they normally drink. Fluids help the body flush out germs, thin out mucus, and replace fluids lost from cough and fever. For sore throats, acidic fruit juices can be irritating, “but frozen Slurpies actually taste great,” say the docs (for more sore throat advice, see this Two Peds in the Pod post).
HHK note: My kids love these watermelon slushies when they are sick. To make: Place 1 cup of seeded watermelon chunks in the freezer for at least 30 minutes. Place in a blender with cold water and a tablespoon of honey. Blitz and serve.

kids movie

 

Ease up on screen rules. “Distraction helps discomfort, and it’s (really!) okay to let kids watch some movies during the day. Relaxing on the couch takes a kid’s mind off of annoying cold symptoms.”

AT BEDTIME…bath
Start a warm bath or shower. A nice, steamy bath or shower always helps clear the head and may even help drain the nose.
saline nose spray
Use saline or suction. A quick mist of saline spray into kids’ noses before bed—and maybe an extra pillow or two and a box of tissues—can be just the thing to clear congestion before they fall asleep. For infants, help them blow their noses by using a bulb suction. However, be careful: Over-zealous suctioning can lead to a torn-up nose and an overlying bacterial infection. Use a bulb suction only a few times a day.
HHK note: Not all children are fans of feeling the spray tickle their noses, but for some reason, the colorful bottle and fun grape and orange scents of Boogie Mist helps sweeten the deal.
Run a cool-most humidifier in their bedrooms. humidifierMoist airs helps unclog stuffy noses and soothe dry-throat coughs. Cool is safer than warm: In case anyone falls on the humidifier while stumbling to your bed or the bathroom in the middle of the night, there’s no risk of a scalding injury.
HHK note: My boys loved picking out their favorite “pet” among Crane’s cute animal-themed humidifiers (choose from a frog, duck, owl, dog, elephant (here) or many others), and they are easy to clean.
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5 Common Summer Ailments in Kids

July 16, 2015 by Kelley Leave a Comment

common summer ailments in kidsMost 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

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Environmental Health Doctor’s Wish List

January 28, 2015 by Kelley Leave a Comment

environmental health kidsThis 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

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Prepping for a Doc Visit

December 15, 2014 by Kelley Leave a Comment

This is a guest post by Michelle Friedman, a mom, freelance writer, and marketer at Medical Scrubs Collection.

I walk into the bright glare of the waiting room, hanging onto coats and mittens, while handing out snacks and chasing after my toddler. I catch a whiff of hand sanitizer—and the sounds of wailing babies.prepping for a doc's visit

We’ve all been there. Well visits at the pediatrician are crucial for checking on your kids’ progress and getting them up-to-date on their shots, but not so great on the nerves. After a few disastrous experiences, I was forced to do a little research on how to make sure future well visits were more educational and less exasperating. Here’s what I’ve learned.

1. Come prepared with your own entertainment.

Different pediatricians have varying policies about the forms of entertainment they keep in their waiting rooms, due to a concern about spreading germs. Some doctors only have books or movies, while others have full entertainment stations. Regardless of what’s offered, bring along age-appropriate entertainment for your children to keep them busy during the inevitable wait. Books, small card games, and coloring books are all great ways to keep the kids busy. Educational apps that are kept as a treat just for the doctor’s office can keep their minds busy rather than their legs—because, let’s face it, an office full of sick kids are one of the last places we want our kids to “explore.”

2. Write down questions in advance.

 In the days leading up to my kids’ well visits I remember all the little things I want to ask the doctor, but once he’s in the room and I’m trying to keep them from jumping off the exam table, my mind goes blank. And before I know it the nurse is on her way with the shots, and the doctor is gone. The American Academy of Pediatrics recommends keeping a notepad dedicated for doctor’s office visits where you jot down questions as they come to you—seeing them in print really helps. You can bring up your questions at the beginning of the visit, or after the doctor is done examining your child. Check your list to make sure that all your questions were answered, and write down any instructions given.

3. Prepare the patient.

Kids, like adults, are afraid of the unknown. Before the well visit prepare your child by explaining the order of events and what will happen at the visit. (It might be tempting to “not worry” them with details beforehand, but that can lead to even more fear and distrust the next go-round.) Emphasize that the doctor and nurses care about them, and want them to feel well. KidsHealth.org offers a great resource that gives an in-depth look at the psychology behind children’s fears when visiting the doctor, and how to allay them. I have found that teaching my young son his doctors’ names helps alleviate the anxiety, by giving more of a personal feel to their caretakers. I also don’t cover up the truth: If he will be getting shots, I let him know. We discuss how the shot will only feel like a pinch for a moment. With a child who is really anxious, you can teach coping skills with a stress ball, which you can bring with you on the big day. You can also prepare young patients by playing doctor at home with dress up clothes and toy instruments. The role play will help familiarize your child with the concept, and might even make the whole process a little more fun.

4. Keep your cool.

I’ve learned that perhaps the most important thing that you can do for your child at a doctors visit is to be a calming force. Children are great at picking up vibes from their caregivers, and the slightest hint of tension will translate into anxiety and tantrums. Be prepared for the inevitable tears, and enjoy the opportunity to mark your children’s milestones.

Now that I’ve committed to some advance planning, my children’s well visits have become mostly pleasant experiences where they get a chance to form relationships with their doctor. And when they’re not? I’m learning to deal a little better with the chaos myself.

 

 

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How to Care for a Cough

December 1, 2014 by Kelley Leave a Comment

Does someone in your family have a cough right now? Better question: Who doesn’t? This time of year, classrooms resound with choruses of coughing children, whose parents likely wrestled, hours earlier, about whether or not to send them to school that day.

Trying to figure out the source and severity of a cough can be one of parenting’s great mysteries. I have three big coughers here cough medicineat our house: When a cold comes on, they never seem much afflicted by sore throats or even stuffy noses, but rather a constant, nagging, occasionally gag-inducing cough which makes it sound as if they are much sicker than they actually are. I’ve tried just about every cough medicine on the market to combat it, with little success (and a whole lot of middle-of-the-night crying, usually more about “wild cherry flavor”—is there a more vile substance known to man?—than the cough itself).

Our favorite pediatricians and site advisory board members, Julie Kardos, M.D. and Naline Lai, M.D., verified that they get as many questions about coughing as just about anything else. So the other day, they provided straight, no nonsense answers to the five big questions we all seem to have about coughs. Give it a read; it just might save you a trip to the doctor’s office. (Or, more likely, the drug store…read on.)

Q. When is a cough “normal,” and when does it warrant a trip to the doctor’s office?

A. Kids get, on average, 10 viruses a year, mostly in the winter. And most get coughs with those colds viruses. It’s normal for a cough to last two weeks, even after a child is feeling better.
If a cough progressively worsens, or comes with a fever after your child has had other cold symptoms, that could be a sign of a bacterial infection, and you should definitely see the doctor. Ditto if there’s any sign of breathing trouble with a cough. (Do the “lift the shirt test”: lift up your child’s shirt, and if his stomach is moving a lot, or his ribs are sticking out as he breathes, that’s a red flag.)  If a cough last more than two weeks, call his doctor, since he could have other issues such as a sinus infection, acid reflux or something anatomic pressing on his lungs.

Q. What if my child seems to cough like crazy every time they have a cold?

A. Some kids have a type of asthma that’s triggered by upper respiratory infections, and they cough a ton just when they’re sick. For these kids, doctors can prescribe specific asthma medications, which can help control the cough caused by a cold.

 Q. Does cough medicine work?

A. Cough suppressants don’t work. There are no convincing studies in children to suggest otherwise. If the cough is due to allergies—this is often diagnosed when a child coughs only in certain places, like just at home or school or around certain animals—Benadryl (diphenhydramine) can be helpful. If the cough is caused by a bacterial infection, treating that infection with antibiotics will help cure the cough.

 Q. Is there any harm to trying to suppress a cough?

A. Cough by itself isn’t evil at all. It’s the body’s way of getting rid of mucous. When people come to our office and they have nice clear lungs and are coughing up a storm, we say, “great!” A productive cough can make a child less likely to get pneumonia. Babies tend to get more complications from flu and other respiratory infections because they don’t have the strength to cough and mucous settles into the lungs and causes a bacterial infection.

 Q. Still, coughs can keep kids up at night. Are there ways to make a child more comfortable?

A. If a child is over a year, you can try a teaspoon or two of honey every few hours and before bed. A humidifier and drinking a lot of fluids during the day keeps the throat moist too, which can help. If they’re elementary school age, you can give them cough drops during the day for the same effect. If the cough sounds like a barking seal, it could be croup, which is just an inflammation of the vocal cords due to a cold (the grown-up equivalent is laryngitis). Opening a window and letting your child breathe fresh, cold air can help control a “croupy” cough. (For more on croup, tune in to this Two Peds in a Pod podcast.)
But the biggest thing to remember is that a cough often bothers parents more than kids. If your child is coughing but sleeping through it, there may not be anything more you need to do than wait patiently for the cold to run its course.

 

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How Safe is Sanitizer?

November 12, 2014 by Kelley 2 Comments

hand sanitizerOur 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.hand sanitizer

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

 

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Breathing Trouble in Kids: 9 Sneaky Signs

September 11, 2014 by Kelley Leave a Comment

When it comes to symptoms of sickness in my kids, the one that confuses and scares me most is breathing trouble. If you suspect a fever, you can consult a thermometer. Runny noses and coughs make themselves known, noisily. Stomach upset? There are (all-too) many tip-offs that, too. But respiratory distress can be sneaky. Labored breathing is often inaudible, invisible, and difficult for children, especially very little ones, to recognize and articulate. The problem is, it can potentially signal some of the most serious childhood emergencies, including pneumonia, asthma, and life-threatening allergies.

photo credit: Hey Paul Studios via photopin cc

photo credit: Hey Paul Studios via photopin cc

Case in point: One winter’s day five years ago, when my friend’s son was five months old, he seemed to be having trouble breathing. As a nurse, she knew to bring him to her son’s pediatrician’s office to get him checked out. A new pediatrician at the practice told her that the baby looked fine, that his difficulty breathing was probably just due to congestion, and that she could return in a couple of days “if (she) was nervous.” My friend, indeed, was still concerned, but went home, and undressed her son to bring him into the shower to try to clear his nasal passages. She saw that his ribs were protruding with the effort to breathe. “Screw the follow-up visit—I headed straight for the E.R.,” she says. Doctors there diagnosed the baby with pneumonia, and he spent five days in the hospital receiving supplemental oxygen and I.V. antibiotics.

You’ve probably read about the outbreak of Enterovirus D68, a serious respiratory infection that’s sending kids to the hospital in more than 10 states. With officials warning that the Enterovirus outbreak will likely continue to spread, and cold and flu season looming, it’s important to know what respiratory distress looks like in your child. Drs. Julie Kardos, M.D. and Naline Lai, M.D., HHK’s resident pediatrician advisers, recently wrote a post about this very subject on their blog, Two Peds in a Pod. Here, I share their nine telltale signs of breathing trouble, all of which warrant a visit to the doctor. (When in doubt, or if your doctor is inaccessible or your gut instinct is telling you to get a second opinion, always seek emergency help.)

Signs Of Breathing Trouble
Call A Doctor, Head to the E.R. or Call 911 ASAP
Breathing faster than normal
Flaring his nostrils with each breath
Chest or belly moves upward dramatically with each breath (lift up her shirt to look for this)
Ribs are sticking out with each breath (lift up his shirt to look for this)
Making grunting or wheezing sounds at the end of each exhalation
Refusal to breastfeed or bottle-feed (if an infant)
Difficulty talking (an older child)
Seems anxious or tired as he becomes "air hungry" (struggles to breathe)
Pale or blue at the lips
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Surprising Cause of Skipped Vaccines

August 21, 2014 by Kelley Leave a Comment

You’ve probably read that certain vaccine-preventable diseases like measles and whooping cough are making a comeback. (The first four months of 2014 saw more measles cases than in any year since 1996.) Breakouts tend to be focused in communities where there are large pockets of parents who choose against immunizing or delay it, out of religious or personal beliefs (like that shots trigger autism, despite rigorous research showing otherwise). This “opt out” trend has gotten a lot of press lately, but there’s another, less newsworthy reason why many parents aren’t getting their kids vaccinated on time: They just haven’t gotten around to it.

Last year, a study sponsored by the Centers for Disease Control (CDC) revealed that 49% of some 300,000 toddlers in managed care programs were late on certain immunizations by their second birthday. But only about 1 in 8 of those kids were undervaccinated due to “parent choice.” Most were likely behind due to logistical issues, such as missed well visits and sickness at the time of a scheduled appointment, said researchers in a Reuters report on the study. HHK advisory board member Julie Kardos, M.D., who runs a pediatric clinic outside of Philadelphia, has seen this phenomenon—and its possible repercussions—up close. One of her patients was a four-year-old boy who was behind on his vaccines, and was hospitalized for pneumonia. Before measles was identified as the cause, he exposed an entire E.R. to the illness, which is one of the most contagious diseases there is. (As Dr. Kardos and Naline Lai, M.D. write in their Two Peds in a Pod blog,  nine out of 10 unvaccinated people get sick from exposure to measles, and are contagious before symptoms begin.)

Photo by: Dawn Huczek

Photo by: Dawn Huczek

What scares me is that this type of scenario seems pretty plausible. There are an incredible number of vaccines to keep track of now—the CDC now recommends immunizations against 16 preventable diseases, and a child could realistically have had 24 vaccines administered by age 2. Plus, many days, our family’s collective schedule seems like a deck of cards, and one false move—misplaced car keys, say—can cause everything else to topple. I can see how many parents could believe fully in the importance of vaccines, but feel they can put them off—and off, and off some more—until work slows down or Billy gets over his cold (and do toddlers ever really get over their colds before another one starts?). Even more convincing are the moms and dads who, due to multiple jobs or a lack of easy transportation, feel like they literally can’t get their child to the doctor’s office, despite their best intentions.

The thing is, every single person in the community is responsible for keeping vaccine-preventable diseases at bay. When even just around 10% of kids miss a vaccine against certain illnesses, so-called “herd immunity” against that bug is compromised, and something as minor as one undervaccinated child’s exposure to an infected person in an airplane, mall or doctor’s office can cause an illness to seep into a community. (I wrote more extensively on this topic in a Parents magazine article a couple years ago.) And these vaccine-preventable illnesses are no joke: Measles, for instance, can not only cause pneumonia, but encephalitis, which can lead to permanent brain damage. Keeping on track with vaccines is key, and especially when your child is young, says Dr. Kardos. For toddlers and preschoolers, shots are numerous and frequent not because doctor’s want to torture them (or us), but because their growing immune systems are more vulnerable to illness.

Dr. Kardos suggests printing out the CDC immunization schedule (filter by your child’s age and your favorite format—even tri-fold!— here) and keeping it on your ‘fridge or bulletin board or in your wallet. There are also some new apps for your phone that can help you keep track. (I like Vaccines on the Go, an app put by the Vaccine Education Center at Children’s Hospital of Philadelphia). In most cases, doctors will remind you what vaccines your child needs once you show up to a well visit, but knowing the schedule in advance can help remind you just how important those regular visits are. It can also prompt you to pack a favorite book, lovey, or my personal savior, lollipop, in your diaper or tote bag when you know it’s going to be a “special” day at the doc’s office. Vaccines can be a pain—literally and otherwise—but few things you can do for your kid and community are more important.

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How to Measure Medicine

August 7, 2014 by Kelley Leave a Comment

The AAP has long warned against using kitchen spoons to measure out medicine, finding that parents who do so are likelier to overestimate the amount of medicine their kids need. So, why, then, I’ve wondered, are so many pediatric liquid medicine manufacturers still offering directions in teaspoons? What’s more, why do they include two different units of measurement on those little cups that come with the bottles—“tsp” on one, “ml” on the other? When you stumble out of bed to tend to a child who’s crying with fever for the third night in a row, those tiny acronyms are barely distinguishable—and that’s if you’re lucky enough to be dealing with a cup that has black writing, rather than clear raised letters, which you try to make out with your fingers, Braille-like, when holding the thing up to the bathroom nightlight proves fruitless. Nothing at 3 a.m. should be that hard.

medicine kit Turns out, the AAP has the same concerns. In a recent report, they’re advising that medicine companies ditch the teaspoon directives, and stick just to milliliters in their labels and measuring cups. In the meantime, think about designating a medicine syringe or cup per child per medicine bottle, and marking them up with a Sharpie. Put the child’s initials, the name of the medicine, and a line for correct dosage on the measuring device. Change them out as your child moves up the weight charts. Arrange possible needed meds in Tupperware bins, out of reach in a bathroom or bedroom closet. The next time you hear that telltale midnight wail, you’ll thank yourself.

 

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