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Daily Dose

Do Essential Oils Boost Immune System?

1:30 to read

Although it is still hot and officially summer, soon everyone will be heading back to school  and coughs and colds (and eventually flu, another topic) will be just around the corner. I had a patient ask me about the use of essential oils. Her 2 1/2 year old daughter is heading to preschool for the first time and she “had heard from her friends that essential oils help a child’s immunity during cold season”.

Unfortunately, there is very little data at all to confirm that statement. I only wish that rubbing a bit of lavender oil on would help prevent the common cold. While it may smell great and be relaxing....there is no data that I can find to show that there is any reproducible science to the claims that essential oils boost the immune system.  

While I was researching I found many sites stating that “eucalyptus oil is an anti-viral” and “peppermint oil is an anti-pyretic (fever reducer)”.  Tea tree oil is touted as being “both anti -bacterial and anti-fungal” (I don’t know of other drugs that can claim both!).  But, I just don’t see any data to support all of this. 

The word essential refers to the essence of the plant the oil is derived from, rather than being “essential” to your health. While in most cases essential oils (which are highly concentrated) used as aromatherapy are not harmful for adults, it may be a different story in children, especially those under the age of 6. While labels may say  “natural” it may not always mean safe.  Many oils are poisonous if ingested and there have been reports of accidental overdoses in children with several different oils. In one report tea tree oil and lavender oil applied topically have been shown to cause breast enlargement in boys.  Oil of eucalyptus and peppermint are high in menthol and cineole.  These substances may cause children to become drowsy have decreased respirations.  While there are articles stating that the use of menthol (Vicks) on a child’s feet may be helpful during a cold for reducing a cough, do not use this if child is young enough to put their feet in their mouths. 

I must say that I sometime use a few drops of eucalyptus oil in the shower when I have a cold as I think it smells great and seems to help “open up” my head. Whether this is in “my mind” or a response from my olfactory centers which sends calming messages to respiratory center is not clear. But, I am not ingesting it or using it topically. 

 

Daily Dose

Do Essential Oils Boost Immune System?

1.30 to read

Although it is still hot and officially summer, soon everyone will be heading back to school  and coughs and colds (and eventually flu, another topic) will be just around the corner. I had a patient ask me about the use of essential oils. Her 2 1/2 year old daughter is heading to preschool for the first time and she “had heard from her friends that essential oils help a child’s immunity during cold season”.

Unfortunately, there is very little data at all to confirm that statement. I only wish that rubbing a bit of lavender oil on would help prevent the common cold. While it may smell great and be relaxing....there is no data that I can find to show that there is any reproducible science to the claims that essential oils boost the immune system.  

While I was researching I found many sites stating that “eucalyptus oil is an anti-viral” and “peppermint oil is an anti-pyretic (fever reducer)”.  Tea tree oil is touted as being “both anti -bacterial and anti-fungal” (I don’t know of other drugs that can claim both!).  But, I just don’t see any data to support all of this. 

The word essential refers to the essence of the plant the oil is derived from, rather than being “essential” to your health. While in most cases essential oils (which are highly concentrated) used as aromatherapy are not harmful for adults, it may be a different story in children, especially those under the age of 6. While labels may say  “natural” it may not always mean safe.  Many oils are poisonous if ingested and there have been reports of accidental overdoses in children with several different oils. In one report tea tree oil and lavender oil applied topically have been shown to cause breast enlargement in boys.  Oil of eucalyptus and peppermint are high in menthol and cineole.  These substances may cause children to become drowsy have decreased respirations.  While there are articles stating that the use of menthol (Vicks) on a child’s feet may be helpful during a cold for reducing a cough, do not use this if child is young enough to put their feet in their mouths. 

I must say that I sometime use a few drops of eucalyptus oil in the shower when I have a cold as I think it smells great and seems to help “open up” my head. Whether this is in “my mind” or a response from my olfactory centers which sends calming messages to respiratory center is not clear. But, I am not ingesting it or using it topically. 

 

 

Daily Dose

Travel Healthy During The Holidays

1:30 to read

With all of the viruses and illnesses popping up, I am getting a lot of questions about travel plans. Many parents are asking "should I travel with a sick child?"

In my opinion, we all must continue our lives, even in the face of flu fear, and a trip for a toddler to see his/her grandparents is important for everyone. We should all make our plans for trips to the visit family. While traveling, everyone needs to practice good hand washing and cough hygiene and be prepared to change plans if a family member is ill. Traveling while being acutely ill and running a fever is only exposing everyone else to you or your child’s illness and seems somewhat selfish.

None of us should be traveling within 24 hours of having a fever (that means without the benefit of fever reducing medications), and isolating a child or parent for several days will be better for everyone, than traveling while sick. Think of the greater good! With that being said, I am not a proponent of a newborn under the age of 2 months traveling, unless out of necessity.  I have always been fairly conservative about exposing a baby to crowds and closed in spaces (malls, movies, restaurants) and airplanes certainly fit that description.  With the uncertainty of this year’s flu season it seems like a really good year to stay put. A newborn’s immune system is still fragile, and the more often a newborn is exposed to large groups of people,  the better chance they have of getting sick in the first 6 – 12 weeks of life. This must have been what was called “confinement” in the olden days.

Staying home and enjoying the simplicity of life, with the excuse, “I have a newborn baby” gets you out of so many invitations and situations.  This is probably the only time that you can get away with that line, as after several months the realities of work, family commitments, and day to day living return and often that means with baby in tow. We all do what we have to do, but if you don’t have to take your newborn baby on a flight this holiday season, I would not. I also know that not everyone will abide by the “Do Not Travel While Sick” mantra, and exposure to illness is not uncommon during airline travel. There is not a way to sit 3 – 6 feet from another person on a plane! This is probably the time to have family come to you, and to make sure that they have all had their seasonal flu vaccines, and when available, the swine flu vaccine.

I don’t have a crystal ball to see how this winter season is going to unfold, but I do know that a sick infant has a better chance of ending up in the hospital if they develop a flu like illness.  The holidays will be a happier for all, if infants stay close to home and leave the travel to those with older children.

That's your daily dose for today.  We'll chat again tomorrow. Send your question to Dr. Sue!

Daily Dose

The Truth About Antibiotics

1:30 to read

Despite warmer than normal temperatures in much of the country it is certainly already cough and cold season. Our office background music is already a lot of coughing coming from children of all ages…and a few of their parents too. In fact, a few of our nurses and docs are fighting a fall cold as well.

 

This makes it timely to discuss (once again) the difference between a cold which is a viral infection and a bacterial infection (example strep throat).  Viruses are NOT treated with antibiotics!! In other words, antibiotics are not useful when you have the common cold. Asking your doctor to put you on an antibiotic “just in case “ it might help is not advised, and doctors should be taking the time to explain the difference between a viral infection and a bacterial infection, rather than writing an unnecessary antibiotic prescription.  

 

While some people (fewer and fewer young parents) still think an antibiotic is necessary, the overuse of antibiotics has been called “one of the world’s most pressing public health problems”s, by the CDC. Not only does the overuse of antibiotics promote drug resistance, it may also cause other health concerns as well. While antibiotics kill many different bacteria, they may also kill “good bacteria” which in fact help the body to stay healthy. Sometimes, taking antibiotics may cause diarrhea and may even allow “bad bacteria” like clostridium difficile to take over and cause a serious secondary infection.  

 

At the same time that there are too many antibiotic prescriptions being written for routine viral upper respiratory infections, a new study in JAMA also found that bacterial infections (sinusitis, strep throat, community acquired pneumonias), are not being treated with appropriate “first line” antibiotics such as penicillin or amoxicillin.  Of the 44 million patients who received an antibiotic prescription for the treatment of sinusitis, strep throat, or ear infections, only 52% were given a prescription for the appropriate first line antibiotic. When a doctor prescribes a broader spectrum, often newer antibiotic, instead of the recommended first line drug, they too are responsible for increasing antibiotic resistance.

 

So, you should actually be happy when your pediatrician reassures you that your child does not need an antibiotic, and that fever control with an over the counter product, extra fluids and rest will actually do the trick to get them well.  I “brag” about my patients who have never taken an antibiotic…..as they have never had a bacterial illness, and tell their parents how smart they are for not asking for an antibiotic “just because”.

 

At the same time, if your child does have a bacterial infection, ask the doctor if they are using a “first line” drug and if not why…? It could be because your child has drug allergies to penicillins, or that your child has had a recent first line drug and has not improved or has had ‘back to back” infections necessitating the use of a broader spectrum antibiotic.  Whatever the reason, always good to ask.

 

Keep washing those hands, teach your child about good cough hygiene and run don’t walk to get your flu vaccines….November is here and flu usually won’t be too far behind.

 

 

  

Daily Dose

Colds & Suctioning Your Child's Nose

1:30 to read

I am beginning to sound like a broken record, but we are in the throes of cold and flu season and unfortunately there are a few more months of this.  As every parent knows, colds (aka upper respiratory infections) are “age neutral”. 

In other words, there is not an age group that is immune to getting a cold and for every age child (and adult for that matter), the symptoms are the same. Congested nostrils, scratchy sore throat, cough, and just plain old feeling “yucky”. When an infant gets a stuffy nose, whether it is from “normal” newborn congestion, or from a cold, they often have a difficult time eating as an infant is a nose breather.  When they are nursing and their nose is “stopped  up”, they cannot breath or even eat, so it is sometimes necessary to clear their nasal passage to allow them to “suck” on the bottle or breast. 

Of course it is self evident that an infant cannot blow their nose, or rub or pick their nose so they must either be fortunate enough to sneeze those” boogers” out or have another means to clear the nose.  This is typically accomplished by using that wonderful “bulb syringe”. In our area they are called “blue bulb syringes” and every baby leaves the hospital with one tucked into their discharge pack.  As a new parent the blue bulb syringe looked daunting as the tip of the syringe appeared to be bigger than the baby’s nose.  But, if you have ever watched a seasoned nurse suck out a newborn’s nose, they can somehow manage to get the entire tip inside a baby’s nose. For the rest of us the tip just seemed to get inside the nostril and despite my best efforts at suctioning nothing came out. Once a nurse showed me the right “technique” I got to be a pretty good “suctioner”.  With the addition of a little nasal saline, which you can buy in pre made spray bottles, or which may be made at home with table salt and warm water, the suctioning gets a little easier as the nose drops helped to suction the mucous.

Now, I have become a firm believer that there is a place for suctioning a baby’s nose, but once a child is over about 6 months of age they KNOW  what you are getting ready to do. I am convinced that a 6 month baby with a cold sees the “blue bulb syringe” approaching their face and their eyes become dilated in fear of being suctioned!!  Then they begin to wail, and I know that when I cry I just make more mucous and the more I cry the more I make. So a baby with an already stuffy nose gets even more congested and “snotty” and the bulb syringe is only on an approach to their nose. It also takes at least two people to suction out a 6 – 12 month old baby’s nose as they can now purposely move away , and hit out to you to keep you away from their face and nose. It is like they are saying, “ I am not going to give in to the bulb syringe” without a fight! I swore I would not have a child with a “green runny nose” that was not suctioned.

As most parents know, don’t swear about anything, or you will be forever breaking unreasonable promises to yourself!  I think bulb suctioning is best for young infant’s and once they start to cry and put up a fight I would use other methods to help clear those congested noses.  Go back to the age old sitting in a bathroom which has been steamed up with hot water from a the shower. Or try a cool mist humidifier with some vapor rub in the mist (aroma therapy).  Those noses will ultimately run and the Kleenex will come out for perpetual wiping. Unfortunately, it takes most children many years before they learn to blow their nose, but what an accomplishment that is!!!  An important milestone for sure.

That's your daily dose for today. We'll chat again tomorrow. Send your question or comment to Dr. Sue!

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Flu

Fight The Flu

Daily Dose

Latest Flu News

Dr. SUe discusses the latest news about seasonal flu and H1N1It seems like a while since I have discussed one of the favorite topics this fall, swine flu (novel H1N1).  Now that there is less swine flu in the U.S., actually less than 14 states are reporting widespread flu (the latest update will be released today), there is less hysteria and at the same time less concern for prevention.  

Influenza, and particularly swine flu, is always difficult to predict when and where it will occur, but one thing that seems certain, there will be more flu in the U.S. in the New Year, as flu typically lasts in some parts of the country until May.  Many infectious disease experts worry that swine flu (novel H1N1) will peak again as it has in some parts of the southern hemisphere.  If this turns out to be the case, there are many more people who will become ill. If the current statistics are correct, and 1 out of 6 Americans has already had swine flu, that still leaves MILLIONS more who are at risk of becoming ill. Unfortunately, with illness we will also see deaths, and the swine flu seems to be infecting a younger population and therefore there are more pediatric deaths being reported. All of this is important, as the only way to try and prevent disease is through vaccination.  When novel H1N1 vaccine was first shipped to my pediatric office in October, we could not keep up with the phone calls or provide enough vaccine for those that wanted it.  Remember it is recommended for all children from 6 months – 24 years of age.  That is really my entire practice. It is also recommended for parents and caregivers who have infants under 6 months of age, as these young babies cannot be vaccinated against flu.  But, what I have seen happening, is that now that novel H1N1 is not rampant in our area, the desire for vaccine is also waning.  Human nature is quite interesting, we want what we cannot have, and once the “Frenzy” passes, the desire also wanes. I know this right now from my own Christmas shopping,  as I am desperate to find a “marshmallow gun”.  I am sure that once the “game” of locating one is over, or Christmas arrives, I too will not feel like I “need” a marshmallow gun. There will be something else to replace the gun. This should not be the case with flu vaccines. Do not be complacent and forget to get your swine flu vaccine (or your seasonal flu for that matter).  The swine flu vaccine is safe, and post marketing surveillance continues and has not shown any problems with the vaccine in terms of safety. The latest recall was not due to safety, but rather to concern that the lots of vaccine that were recalled may provide less immunity than expected. In other words, it wont’ hurt you, but it may not provide as much protection as a good vaccine should. Those lots have already been pulled and those infants will be getting a second dose of swine flu vaccine any way, and that should boost their antibody level. Give your children a Christmas present and get their flu vaccines. We may not know which flu is coming, but just like Santa comes each year, we know that flu will too. Who wants to be home sick for a week, hospitalized, or even worse, have someone in your own family become a statistic.   Just because you have been lucky enough never to have had the flu before, does not mean that you are immune.  Don’t test it, get the vaccine and remember children under 10 years need to get a second dose of vaccine to provide optimum immunity and protection. That's your daily dose.  Heave a wonderful weekend!

Daily Dose

The Flu Vaccine For Moms-To-Be

I have the opportunity to see (not treat) a lot of pregnant women in my practice and they have been asking me my opinion about flu vaccine during pregnancy.

They were inquiring about both seasonal flu vaccine and H1N1 (swine) flu vaccine. The statistics surrounding pregnancy, influenza and secondary infections or other complications have been documented for several years. Retrospective studies done in the late 1990s showed that healthy pregnant women were more likely to have complications from influenza and had higher death rates than expected. This was especially noted in women in the last trimester of their pregnancies. Due to these studies the CDC and ACOG (American College of Obstetrics and Gynecology) recommended that all pregnant women receive seasonal influenza vaccine. Despite these recommendations, more than 50 percent of OB’s recently surveyed do not routinely recommend flu vaccine and do not provide vaccine in their offices. I see many expectant mothers who are totally surprised when I ask them if they have received a flu vaccine from their OB. In fact only 1 in 7 pregnant women are being vaccinated. This may be partially due to the fact that OB’s have not routinely been vaccine providers, as we pediatricians have been, and are now becoming more aware about universal recommendations for flu vaccine in pregnancy and are ordering vaccine for their patients to receive during routine obstetrical visits. Flu vaccine is safe throughout pregnancy. This year is especially significant in that the H1N1 (swine) flu has also caused serious complications and deaths in pregnant women. The data shows that a disproportionate number of the deaths seen from swine flu (about 6 percent) were in pregnant women. Pregnant women are four times more likely to be hospitalized than other flu sufferers. This may be due physiological changes in lung function during pregnancy, as well as to differences in immune function. Regardless of the reasons, pregnancy in and of itself puts a woman at increased risk of serious complications, hospitalization and even death. Pregnancy is typically a time that we see the “the glow of pregnancy”, not complications or even death from having the flu. As an added benefit of vaccination, the antibodies that a pregnant woman will produce after vaccination will then be transported across the placenta to help protect the newborn. Passive transport of maternal antibodies may be the best protection for a newborn in the first two months of life. This is especially important for those infants being born during the height of the flu season. As you know we cannot give an infant flu vaccine until they are six months of age. With both H1N1 influenza currently circulating throughout the U.S. and seasonal flu yet to come, now is the time to make sure that you are vaccinated, especially if you are pregnant. Lastly, pregnant women should not receive live –attenuated flu vaccine (Flu-mist), but should receive the injectable flu vaccine for both seasonal flu and H1N1. You may receive both flu vaccines on the same day.  It is equally important for the father of the baby to be immunized against both types of flu to minimize the newborn’s risk of exposure as well. The best protection for a newborn is vaccination of those who will be caring for the infant during the flu season!! That’s your daily dose, we’ll chat again soon.

Daily Dose

Hand-Foot-Mouth Disease

1:30 to read

I am back on my soap box about what is a newsworthy announcement…..especially as it pertains to viral infections. While I know that day care centers and pre-schools are “keen” on posting notices or sending emails to parents about the latest virus to be found at school, I am still baffled as to the necessity to do this and alarm parents. Aren’t there HIPPA violations or something?  Knowing that a child in school has been diagnosed with  “hand-foot-mouth" disease (HFMD) does not seem to be anything out of the ordinary. Pediatricians are used to seeing HFMD, sometimes daily, and yes it does seem that these viral illnesses cluster at different times of the year. But, with that being said, does it really do any one any good, and does it maybe actually “worry” already anxious parents about possible exposure. Are we forgetting that children are exposed to these pesky viral infections all of the time…and that in most cases they are fairly minor, inconvenient and cause several days of fever and generally not feeling well.  End of story.

But now HFMD has made the national news….as there have been 22 cases of HFMD diagnosed at Florida State University…..which has an enrollment of over 41,000 students!!!  Statistically speaking, that is not a significant “attack” rate….and this news is being reported on all of the networks.  While I realize that adolescents and young adults are less likely to acquire HFMD and they may feel worse than a toddler who in most cases seems to “power through”  with fever reducing medication, popsicles and ice cream, is this really a national news story?  

HFMD is caused by an enterovirus (Coxsackie A16) and typically causes several days of fever and not feeing well followed by small ulcers and blisters that may occur in the throat (painful) as well as on the hands and feet. (younger children seem to often get a rash on their buttocks too).  HFMD may be spread in a variety of ways including direct contact with saliva or fluid from the blisters that may occur on the hands and feet, from fecal contamination, and also when a person coughs or sneezes in close proximity. The virus may also live on surfaces that we touch and then touch our eyes, nose or mouth and cause infection.  As I always say, “good hand washing” and keeping yourself home when sick is the best way to prevent the spread of a virus. While I believe in good sanitation and clean public spaces is it really necessary to “wipe down” classrooms, dorms, cafeterias and even toys in school due to several cases of HFMD. Do you have to do this all day long?  HFMD is not a bacterial disease like meningitis and does not have life threatening consequences.  There will be another viral infection  (or 2 or 3 or 4)  soon to follow and one of these will be influenza.

So, rather than talking about HFMD and mass “cleaning efforts” I think we should focus on another way to prevent illness. VACCINATIONS!  We do know that vaccines work to prevent disease and despite the science behind that, there are still those that “opt out” of vaccines, and this includes getting a flu vaccine.  I wonder if there are students at FSU who have opted out of vaccines and if so how many….maybe more than 22/41,000?  At the same time, how many of those students will opt “in” and get a flu vaccine? That is the bigger story ….get vaccinated for flu now…so we don’t have another even bigger “outbreak”.   I know there will be more than 22 students who get the flu at FSU and will that make the news?  It is the same thing for schools everywhere…lets put up signs about flu vaccines and keep those numbers down.I hope the news reports this.

 

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