Twitter Facebook RSS Feed Print
Daily Dose

Pool Safety

1:15 to read

As you know, water safety is paramont this time of year so I want to make sure your children are safe this summer.  Drowning is the leading cause of death for children between the ages of 1- 4 and the second leading cause of unintentional death for children under the age of 14.  Over 390 children die each year in their own backyard pools...tragically drowning is typically a SILENT event.

The first thing all pools need is a at least 4 foot tall fence surrounding all 4 sides of the pool. Now is the time to make sure that not only is your pool fenced but that it also is “tuned up” after the winter. That means that the self latching gate is working, that all pool furniture and toys are  moved away from the fence in order that children cannot climb up and over a fence, and you might even add a pool alarm that goes off if anyone enters the pool without supervision. 

If you have a door from the house to the pool there should be an alarm on the door as well as having a fence around the pool…this ensures “layers of protection”..the more layers to keep your child away from an unsupervised pool the better!  Children are clever, fast and tenacious.

Now once you decide to enjoy a day poolside you need to have several things on hand which include a portable phone, a flotation ring or hook, and always an adult within arms reach of a toddler or young child who has not yet learned to swim.  If there are several “non swimmers” in the pool with only 1 adult,  it is best to put all of the children in an approved flotation device as well.  The adult who is supervising the pool should ideally know CPR. I think that all “pool owners” should take CPR.

The person in charge of watching a child or children in the pool need to be identified and vigilant. That means staying off a cell phone or any electronics that might be distracting. It is also not the time for adults to be partying and alcohol is discouraged.  

Most children over the age of 4 years are ready for swimming lessons, but the AAP does recognize that there are some younger children between 1 -4 years who may be ready for swimming lessons, especially those that are frequently around water ( home pool, lake , beach). Each child will develop at differently.  Even a young child who has had swim lessons should not be considered “drown-proof” and never be unsupervised.

Lastly, don’t forget the sunscreen and remember to re-apply frequently to both you and your child!

 

 

 

   

Daily Dose

Bedtime!

1:30 to read

Bedtime….an important word for parents and for children. A new study in Pediatrics just reinforces how important bedtimes for children may be.  The research shows that preschool children who had an earlier bedtime were less likely to become obese in their teenage years. 

The study involved nearly 1,000 children who were born in 1991 and whose parents recorded their bedtimes when they were 4.5 years old.  The researchers then looked at the growth data (height/weight) for these children when they were 15 years of age.

Interestingly, the pre-school children who were in bed by 8:00 p.m. had half the risk of becoming obese as a teenager compared to those children who went to bed after 9 pm. Specifically, of the children who went to bed by 8 pm, only 10 percent were obese as teens, while 16 percent of those who went to bed between 8 and 9 pm developed obesity, and 23 percent of those children   who had bedtimes after 9 pm developed teenage obesity. 

While there has been much research surrounding sleep and obesity (as well as behavior), this study provides even more evidence to the possible “protective effect” of early bedtime and bedtime routines for young children.  If getting to bed on time and earlier can in some way help stem the obesity tide, it would seem like an easy recommendation for many parents to follow.  

As a mother I was always a “fan” of schedules and bedtimes…and actually putting your child to bed at night is such a wonderful time of day. The routine of a bath, snuggles, some books ( with wishes for just one more) and more hugs and kisses is such a wonderful memory I have of my own 3 boys. It just seemed that everyone was happier (and I guess healthier) when we had early bedtimes. I remember I had a friend who always had her 3 young children fed, bathed and in bed by 7:00 p.m. every night..and in those pre cell phone days we did not dare call her house after that time!!  

I also think bedtime routines are important for younger children year round. While it is more difficult to have regular bedtimes for older children during the summer months, children under elementary school age (and maybe even older) really do benefit from continuing on the same bedtime schedule during the summer months.  I think if you told your middle school or teenager this “rule” there  might be mutiny….but I know as well as a working parent, it is much easier to have a routine even when the kids are out of school…they would totally disagree!

I am excited about this study and using it as another resource when discussing sleep habits and bedtime routines with my patients.  This is especially important as we get ready to discuss back to school sleep routines….summer does fly by!

Daily Dose

Red Cheeks In Winter

1:15 to read

Why do children get red cheeks in winter?

It is the time of year for cold temperatures, low humidity and dry skin. It is funny, every year as the temperatures drop, I we start seeing these cute little babies and toddlers who have those bright red cheeks. I always say that they “look like British babies”.

Dry skin is just one of the many issues we see with colder temperatures, and babies red cheeks are one of the most evident. During the winter months we all experience dry skin and using moisturizer becomes very important.

I have written previous blogs about eczema, and while chapped skin is not synonymous with eczema, there are some similarities. The most important thing to prevent dry skin while the weather is cold is to use a moisturizer, and applying moisturizer is best on damp skin. After bathing your baby or child, pat them dry until they are just “a tad bit moist” and then take a moisturizer and apply it to the almost dry skin. The thicker the moisturizer the better, so a cream is preferable to a lotion. It will take a little more time to rub the cream in when the skin is a bit moist, but it will help the moisturizer penetrate the skin. The same thing goes for the face.

I always found that the best time for me to moisturize those rosy cheeks was really after the child had gone to sleep. When my children were younger I found that if I put the cream on when they were awake, that they either rubbed their faces more, or if they were verbal, complained about lotion on their faces. So…I decided that it worked best to have their bedtime routine, with baths, books, and prayers, and then once they were asleep I would slip in and lather up their faces and also even used Chap Stick on their dry little lips. Now, there is no science in this routine, but it seemed to work, and they were much more tolerant of lubricants when asleep than awake.

We are definitely in the low humidity season and the heat is on in the house (I am typing this as I sit by the fire with a blanket over my feet), so you can expect several months of dry skin and chapped cheeks. If moisturizers like Vanicream, Cerave, Aquaphor and Eucerin go on sale, stock up!!  April is a long way away.

Tags: 
Daily Dose

Chubby Toddlers & Weight Gain

1:30 to read

So, what goes on behind closed doors? During a child’s check up, I spend time showing parents (as well as older children) their child’s growth curve. This curve looks at a child’s weight and height, and for children 2 and older, their body mass index (BMI). This visual look at how their child is growing is always eagerly anticipated by parents as they can compare their own child to norms by age, otherwise called a cohort. 

I often then use the growth curve as a segue into the discussion about weight trends and a healthy weight for their child. I really like to start this conversation after the 1 year check up when a child has  stopped bottle feeding and now getting regular meals adn enjying table food. 

This discussion becomes especially important during the toddler years as there is growing data that rapid weight gain trends, in even this age group, may be associated with future obesity and morbidity. Discussions about improving eating habits and making dietary and activity recommendations needs to begin sooner rather than later. 

I found an article in this month’s journal of Archives of Pediatrics especially interesting as it relates to this subject.  A study out of the University of Maryland looked at the parental perception of a toddler’s (12-32 months) weight. The authors report that 87% of mothers of overweight toddlers were less likely to be accurate in their weight perceptions that were mothers of healthy weight toddlers. 

They also reported that 82% of the mothers of overweight toddlers were satisfied with their toddler’s body weight. Interestingly this same article pointed out that 4% of mothers of overweight children and 21% of mothers of healthy weight children wished that their children were larger. 

Part of this misconception may be related to the fact that being overweight is becoming normal.  That seems like a sad statement about our society in general. 

Further research has revealed that more than 75% of parents of overweight children report that “they had never heard that their children were overweight” and the rates are even higher for younger children. If this is the case, we as pediatricians need to be doing a better job.  

We need to begin counseling parents (and their children when age appropriate) about diet and activity even for toddlers. By doing this across all cultures we may be able to change perceptions of healthy weight in our youngest children in hopes that the pendulum of increasing obesity in this country may swing the other way. 

That’s your daily dose for today.  We’ll chat again tomorrow.

Daily Dose

Do You Have a Happy Spitter?

1.15 to read

New parents often come in concerned about their baby spitting up.  They typically  ask, “does my baby have gastroesophageal reflux (GER)?”.  I reassure them that “spit happens” and it occurs in more than 2/3 of perfectly healthy infants.  Whether you want to call it GER or spit up, it is regurgitation and in most cases it goes away with time. 

GER is defined as “the physiologic passage of gastric contents into the esophagus”, while GERD is “reflux associated with troublesome symptoms or complications”.  GER in infants is typically painless and does not affect growth. We call these babies “happy spitters”.  

For a “happy spitter” parents need to know that spitting gets worse before it gets better and typically lasts for 5-6 months, with the worst spitting occurring around 3-4 months of age.  

The best treatment for benign GER is lifestyle management.  Small things like thickening feedings with either rice or oatmeal cereal will often decrease the volume of spit up ( parents get sick of wearing towels over their shoulders). Thickening feedings does increase the calories a baby receives. There are also formulas available that contain thickening agents if parents prefer trying them that have the same amount of calories as other formulas.  Thickening feeds has been shown to decrease crying time in some irritable infants with GER and also increases sleep time for fussy babies.  It is always worth trying.

While many parents try putting their baby in a car seat to help with reflux and spitting, car seats may actually make the problem worse. Infants have less reflux when in the prone (tummy) position, but remember your baby must NEVER sleep on their TUMMY!

Babies who are spitters may also benefit from smaller more frequent feedings. When a baby is fussy, parents may try to keep feeding their baby and overfeeding may actually make the spitting worse. Just because a baby is crying, does not always mean they are hungry, especially if they have just been fed.  Sucking in and of itself may help reflux, so a pacifier may be the trick and provide non nutritive sucking.

For babies with GERD who are extremely irritable, may refuse feedings and even lose weight further work up and management with pharmacotherapy may be necessary.  Talk to your doctor about options if lifestyle management does not seem to help. 

Daily Dose

Kids & Good Manners

1.15 to read

I have been recalling a teaching moment while doing some Christmas shopping recently. I was at a nearby mall over the weekend when I noticed a little girl who had wandered away from her mother and headed straight to the Christmas ornaments in a local store. You know what happened next: the little girl,who was probably 2 1/2 or 3 years old, picks up an ornament and immediately she drops it and the ornament shatters. 

Well, almost simultaneously, the store clerk and the mother headed right to her.  The clerk was more than gracious and told the mom, “not to worry about it” and told the little girl “don’t not touch the broken glass it might hurt you,” and also said “accidents happen”. 

At this point, I was sure that the mother would get down at her child’s level and reprimand her as well as ask her to apologize to the nice clerk.  But I was surprised when the mom just hustled her daughter off and nothing was said!! What a good learning experience this would have been.  This would have been the most opportune time for this mother to talk to her daughter about “not touching with our hands” and “looking with our eyes”. It would have also been a great lesson in saying, “I’m sorry”. 

Teachable moments are so important to parenting, and are the best way a child learns.  As a parent, it is much easier to teach a lesson to your child “while they are in the act”, rather than days later when the moment is gone and the opportune situation has passed.   

For a young child, learning to look an adult (or even a peer) in the eye while apologizing and saying, “I am sorry” is a lesson that has to be taught. .  Every time your child realizes, “ I messed up” and apologizes, they are learning from their own mistakes. They are also taking responsibility for their own actions and choices. 

I am disappointed that this mother did not realize the importance of teaching her child to say “I am sorry”, she missed a great opportunity, but she can grab the next one!

Daily Dose

A Little TLC Goes A Long Way

Just what is TLC and how can it help your child feel better quicker?I can tell that I am aging!!  Not by the new “character lines” I see popping up (hate that), but rather by the way that language and jargon continues to change. I really have tried to stay up with new acronyms such as LOL, or POS, or even “keep it on the DL”.

But while we “mature” adults feel the need to keep up with the younger generation’s “language”, some of the older acronyms seem to be fading away.  I realized this today when I was seeing a young patient and his mother. The cute little 5 year old boy had one of those nasty winter time viruses with a fever and a cough. After finishing his exam and doing an influenza test on him (it was negative) I told the mom that the best way to treat his virus was with fever control and a little TLC.  She gave me this blank look and said, “is that a brand of cough syrup?”  I didn’t know whether to laugh or to cry. I thought that TLC was a universal acronym for all mothers (or maybe better put for parents) as even my own parents and grandparents would say, “you just need a little TLC”. For those of you who have read this far and still don’t know what I am talking about, TLC is the acronym for “tender loving care”.  What better way to treat your feverish, coughing, uncomfortable child, than with a little TLC. When my own children are sick, even now that they don’t all live at home, they still all want some TLC.  As much of a rule follower that I am, when your child is sick, the rules get broken for a while. That means that children get to sleep in their parent’s beds (I often moved after a few wild kicks and thrashing), but one parent remained with the feverish child sleeping next to mom or dad. There were all sorts of “forbidden fruits” given to a child who was sick, such as “slurpees”, ice cream and popsicles in bed, favorite foods all day long and even television without a  time limit. The homework might not get finished due to a fever and general “feel bads”, and the list of things to do just went away for a few days while a child was sick.  It was one of those lovely parenting moments when you could just “turn off the time” and snuggle with a sick child. In other words, lots of TLC. TLC has nursed many a child through numerous illnesses over the years.  I don’t think the directions for TLC have changed.  Just do anything that makes your child feel better. Games in bed, making cookies and jello to eat after an afternoon nap, and even getting to have a special TV tray to use while eating chicken noodle soup.  These “comfort foods” and pampering do make anyone who is sick feel a little bit better.  There are even studies to confirm this. So, remember TLC is not a new fancy cough syrup. It is the “tender loving care” a parent gives to a sick child. Some things never change with time and TLC is one of them.  Best of all, no need for a prescription or a copay! That’s your daily dose for today.  What’s your favorite TLC remedy for your kids? Comment below to share with all of us!

Daily Dose

Kids Who Snore

1.30 to read

Does your child snore?  If so, have you discussed their snoring with your pediatrician.  A recent study published in Pediatrics supported the routine screening and tracking of snoring among preschoolers.  Pediatricians should routinely be inquiring about your child’s sleep habits, as well as any snoring that occurs on a regular basis, during your child’s routine visits.  

Snoring may be a sign of obstructive sleep apnea and/or sleep disordered breathing (SDB), and habitual snoring has been associated with both learning and behavioral problems in older children. But this study was the first to look at preschool children between the ages of 2-3 years.

The study looked at 249 children from birth until 3 years of age, and parents were asked report how often their child snored on a weekly basis at both 2 and 3 years of age.  Persistent snorers were defined as those children who snored more than 2x/week at both ages 2 and 3.  Persistent loud snoring occurred in 9% of the children who were studied.

The study then looked at behavior and as had been expected persistent snorers had significantly worse overall behavioral scores.  This was noted as hyperactivity, depression and attentional difficulties.  Motor development did not seem to be impacted by snoring.

So, intermittent snoring is  common in the 2 to 3 year old set and does not seem to be associated with any long term behavioral issues. It is quite common for a young child to snore during an upper respiratory illness as well .  But persistent snoring needs to be evaluated and may need to be treated with the removal of a child’s adenoids and tonsils.

If you are worried about snoring, talk to your doctor. More studies are being done on this subject as well, so stay tuned.

Daily Dose

Fight The Flu

1:30 to read

It is National Influenza Immunization Week, and I am hopeful that most everyone reading this has already had their flu vaccine….but if not, it is NOT too late! Just like the after Thanksgiving sales being extended…..your opportunity to be vaccinated has not passed!  Lucky for you, there are still vaccines available. If you act quickly there may be some places having a two for one sale, a coupon for shopping after getting vaccinate or even free vaccines…no excuses, everyone in the family ( over 6 months) may be vaccinated.

All kidding aside, this is an important time to remind people that it is not too late to get your flu vaccine and as of the first week of December there has not been a significant amount of flu in the country. But with that being said, influenza typically circulates December thru February but some years flu may even last into April or May.  But one thing is sure, flu is coming!!

No one is immune from the flu and the best protection is to get a flu vaccine!!  I hear people tell me, “they have never had the flu before so why should I get a vaccine?”, or “ I got sick after I had the flu vaccine, so I am not getting it again”.   Both of those are myths and are just a few of the anecdotes that I hear from patients and their families.

It is recommended that everyone over the age of 6 months receive a flu vaccine as it is the best protection against getting sick from the flu, and by vaccinating everyone we are also protecting those infants under 6 months that cannot yet get a flu vaccine.  Infants have a higher incidence of complications from the flu ( as do children with asthma and other underlying health issues ), and those precious babies born during the late summer and into the winter depend on the community to help keep them healthy. This is especially important for infants and children in day care, as influenza is a respiratory virus that is spread when someone in close proximity has coughed or sneezed. So, check to make sure that everyone in your daycare center is vaccinated, including the parents.

Statistics show that flu vaccination activity drops off after the end of November, but it is never too late to get the vaccine.  Remember,  it does take about two weeks to develop immunity after being vaccinated.  People also tell me, “I think I have already had the flu this year”, but even if you have, you have not had all of the strains of influenza that are in the vaccine and yes…you could get sick again. This years flu vaccine is available as a trivalent vaccine (which contains 2 type A, flu and 1flu B) and a quadrivalent vaccine ( with 2 type A and 2 B strains), and either vaccine is fine….get whatever your doctor, health department, pharmacy, grocery store, or employer has.  Most children over the age of 2 years may also take the live attenuated intranasal flu vaccine ( because how many kids want a shot -right?) and it is a quadrivalent vaccine.

So now is the time to run…not walk to get your flu vaccine!!  Don’t delay, put it on the top of the holiday “to do list”.

Pages

Please fill in your e-mail address to be included in our newsletter.
You may opt out at any time.

 

DR SUE'S DAILY DOSE

Stay safe all summer long!

Please fill in your e-mail address to be included in our newsletter.
You may opt out at any time.

 

Please fill in your e-mail address to be included in our newsletter.
You may opt out at any time.