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Daily Dose

Diabetes On the Rise

1:30 to read

Diabetes continues to be a growing problem among our nation’s children.  Did you know that every year there are over 25,000 children diagnosed with diabetes?  

 

To begin with there are two different types of childhood diabetes, type 1 and type 2 and while both cause an elevated blood sugar, they also differ in many ways.

 

Type 1 diabetes was formerly called juvenile onset diabetes and is typically diagnosed in children and adolescents. Only 5% of those with diabetes have type 1 diabetes. Many parents worry that their child may develop diabetes because they eat too much sugar…and while eating sugar is not good for you, it does not directly cause type 1 diabetes.  Type 1 diabetes is an autoimmune disease in which the immune system attacks and destroys the beta cells ( insulin producing cells)  of the pancreas. Scientists are not exactly sure why this occurs, but it seems to be a combination of genetic and environmental factors, and actually has nothing to do with diet. 

 

Type 1 diabetes comes on suddenly and causes dependence on insulin for the rest of the child’s life. The symptoms of type 1 diabetes usually include extreme thirst, frequent urination (day and night), increased appetite and sudden weight loss. Children who develop type 1 diabetes appear tired, thin and sick. I tell many a parent who worry that their child is diabetic, that they really cannot miss the symptoms and just drinking a lot of water will not be the only symptom. 

 

Fortunately, the ways in which insulin is given continues to improve and most children now use an insulin pump which delivers insulin in a more consistent manner than in previous years.  But, even with new insulin delivery systems and the hopes for pancreas transplants, type 1 diabetes is challenging for a family to manage. 

 

Type 2 diabetes which was previously called “non insulin dependent diabetes” differs in that it was previously typically diagnosed in adults, but it is now rising in children.  In type 2 diabetes the body isn’t able to use insulin in the right way and the glucose in the blood stream is less able to enter the cells. This is called insulin resistance.  So, the pancreas tries to produce even more insulin to keep blood sugar levels normal. Over many years the pancreas may wear out completely. Type 2 diabetes is sometimes controlled with an oral medication rather than insulin.

 

Type 2 diabetes seems to develop more frequently in those children who are overweight, less active and often have a parent with diabetes. As more children in this country have developed obesity, the number of cases of type 2 diabetes has also continued to rise.  In many cases if a child changes their lifestyle and eats a healthy diet, loses weight and exercises the body may be able to restore normal insulin balance. In this way type 2 diabetes differs from type 1 diabetes.

 

If you are concerned that your child is showing any signs of diabetes make sure to consult your doctor.  Continue to promote healthy eating habits and daily exercise for all children!

 

 

Parenting

Picky Eaters and Personality

1:45

If you have a child that is a picky eater, the reason may have more to do with his or her personality than the food you give them, according to a new study.

Researchers found that little ones who were more naturally inhibited also tended to be picky eaters.

"From the time they're very young, some infants are more 'approaching' and react positively to new things, whereas other infants are more 'withdrawing' and react negatively to the same stimuli," said study author Kameron Moding.

"But very few studies have examined whether infants show similar approach and withdrawal behaviors in response to new foods, so this is what we wanted to investigate," added Moding. She is a postdoctoral fellow at University of Colorado, Denver.

Researchers observed how 136 infants responded to new foods and toys during the first 18 months of life. They found that the children who were more reserved about playing with new toys were also more reserved about trying new foods.

The researchers determined that there might be a link between personality types and attitudes about food.

"It was striking how consistently the responses to new foods related to the responses to new toys," Moding said in a Penn State news release.

"Not only were they associated at 12 months, but those responses also predicted reactions to new objects six months later. They also followed the same developmental pattern across the first year of life," she added.

Getting some children to try new foods can be a challenge, but Moding says parents shouldn’t give up offering a variety of foods to their kids.

Keep trying! Research from other labs has consistently shown that infants and children can learn to accept new foods if their caregivers continue to offer them," Moding said. "It can take as many as eight to 10 tries, but infants and children can learn to accept and eat even initially disliked foods."

Story source: Robert Preidt, https://consumer.healthday.com/caregiving-information-6/infant-and-child-care-health-news-410/picky-eater-it-might-just-be-your-child-s-personality-725183.html

Daily Dose

Staying Healthy In College

1:30 to read

It is almost time for the newly graduated high school graduates to head off to college. Such an exciting time…a new school for the young adult and once less child living at home - lots of changes for the entire family.

 

As I am doing these last “off to college” visits I continue to discuss the new germs that a student will be exposed to and the numerous viral illnesses they may contract in the first year. College students live in such close proximity in the “tiny” dorm rooms and not only do they share a TV or clothes or food, they share their germs. 

 

It is not unusual for a college student to get a few colds, some tummy bugs and lots of “I just don’t feel well” moments. So…I think every college kid deserves a medical kit (mommy made) to prepare them for their first (of many) illnesses when they are away from home.

 

I made college medical kits for all of my boys..who shrugged their shoulders and put it under their bed…that is until they got sick. Suddenly, they also had friends wanting to come share their medical kit.

 

The “college kit” is really a compilation of over the counter products that your kids have probably been used to having in their home.  I also put the directions as to when and how to use each one…just in case they don’t read the package directions or just in case they like to know you have had written a note.

 

These are the products that they will need:

 

Thermometer

Acetaminophen

Ibuprofen

Antacid

Cough medicine

Antihistamine

Decongestant

Medication for constipation

Antidiarrheal 

Throat lozenges

Gatorade packets

Tea bags

Soup/broth packages

 

If they have all of these item in their “box” they are ready for most of the illnesses they will face. They need to be able to take their temperature, treat their fever wen they have a random virus,  have broth and gatorade for tummy bugs and throat lozenges and cough and cold remedies.  

 

Label everything and then tuck a sweet note from you that they will find one night when they are feeling “pitiful”..just to remind them that Mom is always nearby,

 

Lastly, I would insist that they get a flu vaccine!  Flu is a whole different story…and one they really don’t want. So remind them all Fall to head to the health center or anywhere that is offering flu vaccine and get vaccinated!  I would  even offer to “pay” for their roommates to get their flu vaccine too…which will also help your child stay healthy.

 

Your Child

Young Kids Still Being Injured or Killed in ATVs Accidents

2:30

Despite safety warnings from pediatricians and child health experts, children under 16 are still driving or riding as passengers on all-terrain vehicles.  The number of young kids being injured or killed in ATV accidents has not changed much in recent years, according to a new study.

Since 2000, the American Academy of Pediatrics (AAP) has recommended that ATV use be restricted to youth aged 16 years and older who wear helmets, don’t take passengers and steer clear of roads.

“Too many young children are driving these machines - equivalent to a motorcycle in many ways,” said senior study author Dr. William Hennrikus, medical director of the Pediatric Bone and Joint Clinic at Penn State College of Medicine in Hershey, Pennsylvania. 

“Children should not drive an ATV until they’re over 16, just like driving a motorcycle,” Hennrikus said by email to Reuters. “Helmets should always be worn, just like a motorcycle.”

For the study, researchers examined data on 1,912 patients under age 18 who were injured while using an ATV and treated at trauma centers in Pennsylvania from 2004 to 2014. 

During this period, 28 children died in ATV crashes, a mortality rate of roughly one per every 100,000 kids in the population, researchers calculated.

Fewer than half of the children were wearing helmets and a street or roadway was were 15% of the crashes happened. Rural areas tend to have more ATV crashes.

Being a passenger or being pulled by the ATV was a factor in almost one in four injuries, the study also found. 

Half of the kids involved in ATV crashes were 14 or younger, and about 6 percent were no more than 5 years old. 

Boys accounted for three in every four patients.

Limitations of the study include the possibility that researchers underestimated injuries and deaths because they only looked at trauma center patients, not children who were treated elsewhere or died before they ever reached a trauma center.

Experts agree that age isn’t the only factor parents should consider when letting their child drive an ATV.

“Parents need to think not just about their child’s size, but also their ability to think, to react to emergency situations and to maintain safe, cautious control of a very powerful vehicle,” said David Schwebel, a sports injury researcher at the University of Alabama at Birmingham who wasn’t involved in the study.

All across the country children are riding on or driving ATVs with sometimes-serious consequences. Just in the past few months a 12-year old boy from New York died from injuries in an ATV crash. A 15-year old boy in Illinois was killed and his passenger, his 12-year old sister, was seriously injured when he lost control of the ATV. A 14-year old boy was killed in New Jersey after losing control and crashing his ATV into another 14-year olds ATV; 2 other children were seriously injured from that crash. None of the children were wearing helmets or seatbelts. 

“Helmets absolutely have to be used for any ride, even short, apparently safe ones,” Schwebel said by email. “Passengers should never ride on ATVs unless the ATV is designed for more than one person.”

While ATVs can be dangerous for adults, they pose a much higher risk for children.

“Children are not developmentally capable of operating these heavy, complex machines,” Sandra Hassink, president of the AAP, said. “The American Academy of Pediatrics warns all parents that no child under the age of 16 should drive or ride an ATV.”

Story source: Lisa Rapaport, http://www.reuters.com/article/us-health-children-atv-injuries-idUSKBN1A422F

https://www.aap.org/en-us/about-the-aap/aap-press-room/pages/AAPCFAATVs.aspx

 

Your Teen

10 Reasons Teens Act The Way They Do

2:30

Anyone in the midst of raising a teen knows that the adolescent years can be some of the most difficult to get through and understand.

As a parent or guardian of a teenager that wants to be more independent, but also needs supervision and guidance, the times can be challenging indeed.

If that’s the position you find yourself in, you may be asking – what’s going on in that youngster’s brain? Actually, there’s a lot happening!

There are several scientific reasons an adolescent brain can be similar to a toddler’s: After infancy, the brain's most dramatic growth spurt occurs in adolescence. Here’s 10 things you may not know about your teen’s brain.

10. Critical period of development. Adolescence is generally considered to be the years between 11 and 19. It’s easy to see the outward changes that occur in boys and girls during this time, but inside, their brains are working on overdrive.

"The brain continues to change throughout life, but there are huge leaps in development during adolescence," said Sara Johnson, an assistant professor at the Johns Hopkins Bloomberg School of Public Health.

Parents should understand that no matter how tall their son has sprouted or how grown-up their daughter dresses, "they are still in a developmental period that will affect the rest of their life," Johnson told LiveScience

9. The growing brain. Scientists used to believe the greatest leap in neuronal connections occurred in infancy, but brain imaging studies show that a second burst of neuronal sprouting happens right before puberty, peaking at about age 11 for girls and 12 for boys.

The adolescent's experiences shape this new grey matter, mostly following a "use it or lose it" strategy, Johnson said. The structural reorganization is thought to continue until the age of 25, and smaller changes continue throughout life.

8. New Thinking Skills. This increase in brain matter allows the teenager to become more interconnected and gain processing power, Johnson notes.

If given time and access to information, adolescents start to have the computational and decision-making skills of an adult. However, their decisions may be more emotional than objective because their brains rely more on the limbic system (the emotional seat of the brain) than the more rational prefrontal cortex.

"This duality of adolescent competence can be very confusing for parents," Johnson said, meaning that sometimes teens do things, like punching a wall or driving too fast, when, if asked, they clearly know better.

Sound familiar?

7.  Teen tantrums. While teens are acquiring amazing new skills during this time, they aren’t that good at using them yet, especially when it comes to social behavior and abstract thought.

That’s when parents can become the proverbial guinea pig. Many kids this age view conflict as a type of self-expression and may have trouble focusing on an abstract idea or understanding another's point of view.

Particularly in today’s heavy media influenced world, teens are dealing with a huge amount of social, emotional and cognitive flux says Sheryl Feinstein, author of Inside the Teenage Brain: Parenting a Work in Progress (Rowman and Littlefield, 2009.)

That’s when they need a more stable adult brain (parents) to help them stay calm and find the better path.

6. Intense emotions. Remember the limbic system mentioned earlier (the more emotional part of the brain)? It’s accelerated development, along with hormonal changes, may give rise to newly intense experiences of rage, fear, aggression (including towards oneself), excitement and sexual attraction.

Over the course of adolescence, the limbic system comes under greater control of the prefrontal cortex, the area just behind the forehead, which is associated with planning, impulse control and higher order thought.

As teens grow older, additional areas in the brain start to help it process emotions and gain equilibrium in decision-making and interpreting others. But until that time, teens can often misread parents and teachers Feinstein said.

5. Peer pressure. As teens become better at abstract thinking, their social anxiety begins to increase.  Ever wonder why your teen seems obsessed with what others are thinking and doing?

Abstract reasoning makes it possible to consider yourself from the eyes of another. Teens may use this new skill to ruminate about what others are thinking of them. In particular, peer approval has been shown to be highly rewarding to the teen brain, Johnson said, which may be why teens are more likely to take risks when other teens are around.

Friends also provide teens with opportunities to learn skills such as negotiating, compromise and group planning. "They are practicing adult social skills in a safe setting and they are really not good at it at first," Feinstein said. So even if all they do is sit around with their friends, teens are hard at work acquiring important life skills.

4. Measuring risk.  "The brakes come online somewhat later than the accelerator of the brain," said Johnson, referring to the development of the prefrontal cortex and the limbic system respectively.

At the same time, "teens need higher doses of risk to feel the same amount of rush adults do," Johnson said. Not a very comforting thought for parents.

This is a time when teens are vulnerable to engaging in risky behaviors, such as trying drugs, sex, getting into fights or jumping into unsafe water.

So what can a parent do during this risky time? "Continue to parent your child." Johnson said. Like all children, "teens have specific developmental vulnerabilities and they need parents to limit their behavior," she said.

It’s when being a parent to your child instead of trying to be their “friend” is more difficult but much more important for their physical and emotional safety.

3. Yes, parents are still important. According to Feinstein, a survey of teenagers revealed that 84 percent think highly of their mothers and 89 percent think highly of their fathers. And more than three-quarters of teenagers enjoy spending time with their parents; 79 percent enjoy hanging out with Mom and 76 percent like chilling with Dad. That’s not 100%, but it’s probably more than you thought.

One of the tasks of adolescence is separating from the family and establishing some autonomy, Feinstein said, but that does not mean a teen no longer needs parents – even if they say otherwise.

"They still need some structure and are looking to their parents to provide that structure," she said. "The parent that decides to treat a 16 or 17 year old as an adult is behaving unfairly and setting them up for failure." 

Listening to your teen and being a good role model, especially when dealing with stress and the other difficulties life can present, can help your teen figure out their own coping strategies.

2. Sleep. Ah, yes, sleep. Although teens need 9 to 10 hours of sleep a night, their bodies are telling them a different story. Part of the problem is a shift in circadian rhythms during adolescence: It makes sense to teen bodies to get up later and stay up later, Johnson said.

But due to early bussing and class schedules, many teens rack up sleep debt and "become increasingly cognitively impaired across the week," Johnson said. Sleep-deprivation only exacerbates moodiness and cloudy decision-making. And sleep is thought to aid the critical reorganization of the teen brain.

"There is a disconnect between teen’s bodies and our schedules," Johnson said.

Shutting down the electronics an hour before bedtime has been shown to help teens as well as adults get to sleep quicker and sleep better. No computer, TV, video games or cell phones.

1.The “I am the Center of the Universe” syndrome. You may have noticed that your teen’s hormones are causing quite a bit of havoc. Experts say that’s to be expected. But you may still wonder- what the heck is going on with my kid?

The hormone changes at puberty have huge affects on the brain, one of which is to spur the production of more receptors for oxytocin, according to a 2008 issue of the journal Developmental Review.

The increased sensitivity caused by oxytocin has a powerful impact on the area of the brain controlling one’s emotions. Teens develop a feeling of self-consciousness and may truly believe that everyone is watching him or her. These feelings peek around age 15.

While this may make a teen seem self-centered (and in their defense, they do have a lot going on), the changes in the teen brain may also spur some of the more idealistic efforts tackled by young people throughout history.

"It is the first time they are seeing themselves in the world," Johnson said, meaning their greater autonomy has opened their eyes to what lies beyond their families and schools. They are asking themselves, she continued, for perhaps the first time: What kind of person do I want to be and what type of place do I want the world to be?

Until their brains develop enough to handle shades of grey, their answers to these questions can be quite one-sided, Feinstein said, but the parents' job is to help them explore the questions, rather than give them answers.

And there you have it. Teen’s brains are exploding with new data, confusing signals and dueling desires. It’s a tough time in one’s development- but rest assured, what you teach them by example and compassion as well as how you gingerly help guide them will last a life-time. Even when you do the best you can, there are no guarantees that they will turn out the way you’re hoping they will – they are after all- individuals with a will and a mind of their own. But now you know a little more about why your teen acts the way they do.

Story Source: Robin Nixon, http://www.livescience.com/13850-10-facts-parent-teen-brain.html

Daily Dose

Jaundice in Newborns

1:30 to read

It is not at all uncommon for a healthy newborn to develop jaundice in the first several days of life. Bilirubin is produced when red blood cells are broken down. It is a yellow pigment that we all metabolize in the liver and then it is excreted in urine and stools. In an newborn, the body produces almost 2-3 times the bilirubin that an adult does. Because newborns are also “immature” their liver cannot keep up with the bilirubin production and therefore bilirubin levels rise. In some cases the bilirubin is high enough to cause a yellowing of the skin (jaundice), and this is termed physiologic jaundice of the newborn. 

 

Your infant will have their bilirubin level checked while they are in the hospital and your pediatrician will follow any bilirubin levels that seem to be rising. In most hospitals the bilirubin is tested transcutaneously (through the skin), and you may never know that you baby has been tested. If bilirubin levels seem to be high, a blood test will be performed to more accurately assess the bilirubin level. If bilirubin levels continue to rise a baby may then be put under phototherapy (special blue lights that breaks down bilirubin in the skin and help it to be eliminated). Phototherapy prevents extremely high levels of bilirubin which may get into the brain and could be toxic to the baby and cause brain damage.

 

When a baby is put under phototherapy they may be in a basinette or wrapped in a “bili-blanket”  and they will wear sunglasses to prevent any damage to their eyes from light. They are usually naked or only in a diaper so that as much skin is exposed as possible. In most cases the bilirubin levels have peaked by day of life 3 or 4 and the baby will no longer need phototherapy. While the baby is under the “bili-lights” they will continue to have blood tests (from their heels) to follow the bilirubin levels.

 

As babies are now being discharged in 24-48 hours after delivery some babies will develop jaundice after they have already gone home…so you your doctor will plan on seeing you 1 to 2 days after your are discharged. But, should you notice that your baby seems to be getting more jaundiced you should call you doctor and be seen sooner.  

 

Just this week I saw a baby who continued to become more jaundiced after he went home. At times I see this when a mother is breast feeding and her milk has not yet “come in”.  If a baby is not getting a lot of milk then they cannot poop and pee out bilirubin…somethings just take time to get going with feeding, peeing, pooping and liver maturation. So…this baby boy was started o home phototherapy. Rather than re-admitting him to the hospital, a pediatric home health care company sent out a nurse with a bill blanket who instructed the parents on the use of it. The baby was then able to feed at home every 2-3 hours, and the bili-blanket was used throughout the day and night. The parents lived so close to the office that they would bring the baby in for bilirubin tests, while in other cases the nurse will go to the home to do the testing.  Home phototherapy in an otherwise healthy infant does not disrupt the new family and really helps the mother establish her breast feeding and lets “everyone” sleep in their own beds!

 

This baby only required phototherapy for 24 hours…in some babies it may be longer. Once the bilirubin was back in a “safe range” the lights were discontinued and he will continue to process the bilirubin on his own. His little yellow face and eyes will be the last evidence of his newborn jaundice and “one for the baby books” as it should never be a problem again.

 

Parenting

When is Your Child Ready for a Cell Phone?

3:00

Did you know that ninety-five percent of Americans own a cell phone of some kind? The percentage of cell phone ownership among 18-29 year –olds is even higher at 100%, according to the Pew Research Center on Internet and Technology.

It’s no surprise that more and more young kids are asking their parents to get them one.

So, what is the appropriate age to give your child a phone? The answer depends on several factors.

There’s no doubt about the convenience of having a cell phone handy when you need to communicate with someone. If your child has a cell phone, you can call or text him to find out where he is and what he's doing and inform him of your own plans. It can make you feel safer just knowing where your kids are. And in an emergency, a cell phone can be crucial if your child needs to reach you -- or vice versa.

While there are many good reasons to have a cell phone on hand, there are some down sides too.

One thing to consider is that they can become addictive. Sending and receiving texts, playing video games, watching movies as well as checking in on social media sites can impact your child’s sleep patterns and psychological wellbeing. Do you think your child is able to handle that kind of extra stress? Are you willing to put in the time, or have the time yourself, to monitor your child’s phone use and lay down the rules about how often they can use their phone?

There are also other health considerations; cell phones use radio waves. That's radiation (though it's not like what you'd get from an X-ray). Can cell phone radiation affect your child’s health, especially if children start using phones at a very young age when their brains are still developing?

In 2011, an international study showed no link between cell phone use and brain tumors in adolescents and teens. The researchers pointed out, though, that the people in that study didn't use their phones as much as people do today. Many health experts believe more current studies need to be done over a longer period of time. It may be take several decades to find the answer.

Social interaction and cell phone use go hand in hand. It can often be positive thing. It's one way kids can learn to relate to other kids. But there is also the potential for "cyber bullying” which is social harassment via text, instant messaging, or other social media. Many smartphones have a "location sharing" feature, which could raise concerns about people stalking kids as they go from place to place.

There isn't a lot of research yet on how cell phones affect mental and emotional health. But early studies show that frequent texting and emailing can disrupt kids' concentration. It can also become compulsive if kids start being "on call" 24/7 to keep up with their friends. That’s one of the addictive challenges – even for adults.

A child’s age shouldn’t be the only determining factor before deciding on when children are ready for their own cell phone.

Caroline Knorr, parenting editor with the nonprofit group Common Sense Media, says, "Maturity and the ability to be responsible are more important than a child's numerical age.

She says, "We want our kids to be independent, to be able to walk home from school and play at the playground without us. We want them to have that old-fashioned, fun experience of being on their own, and cell phones can help with that. But parents have to do their research and talk to their children and make sure they're using the phones safely themselves, too."

As your child becomes more independent (think middle school or high school), they're closer to needing a phone than younger children whom you still take everywhere.

"Look for the developmental signs," Evans says. "Does your child lose his belongings? Is he generally a responsible kid? Can you trust him? Will he understand how to use the phone safely? The rate at which kids mature varies -- it will even be different among siblings."

And think long and hard about whether your child actually needs rather than just wants that phone. "Children really only need phones if they're traveling alone from place to place," Evans says. "Kids in carpools may not need phones, but kids traveling on a subway, bus or walking to school may. It's about who they are as individuals, what's going on in their lives, and how much they can handle, not a certain age or grade."

If you’ve made the decision that your little one can have a cell phone, here are some ideas to make it work for you and your child.

Should you check who your child is calling and what she's tweeting?

Absolutely, Knorr says. "I know that kids consider mobile devices to be personal property," she says. "And they don't want their parents snooping around. But I think parents are justified in saying, 'I understand this can be used for good but it also can be misused. So every now and then I'm going to check to make sure you're using it responsibly and respectfully.' Then make it an ongoing dialogue: 'Have you gotten weird texts?' 'Any calls that made you uncomfortable?' 'Who are you texting?'"

But you might want to skip the GPS locator services. Neither Knorr nor Evans recommends them unless your child is showing a pattern of getting into trouble.

"Most kids don't need GPS trackers on them," Evans says. "That's really feeding on our anxiety as parents more than meeting a true safety need."

"The issue is really about educating children how to use cell phones in appropriate ways," Evans says. "Cell phones can definitely be beneficial, as long as you know your individual child."

Start with a basic phone for a young child. There are still phones that do not include a camera, Internet access, games or texting.  You’ll most likely get some push back from your child on this, so be prepared to tell him or her why your starting with this type of phone. “ Remind her (or him) that phones are tools, not toys. "It's about safety, not social status or games," Knorr says.

If your child’s phone has texting or Internet abilities, set limits. Most cell phone companies allow you to cap the number of texts a user can send or receive as well as the number of minutes the cell phone can be used. You also can block Internet access and calls from unapproved numbers on most phones.

Designate times when the phone needs to be turned off such as meal times, study time, out walking and at least an hour before bedtime.

Provide your child with and teach them how to use earphones. Until more is known about the impact of cell phone radiation, it’s better to be safe than sorry.  However, also teach them the appropriate places to wear earphones. It can be dangerous for children (and adults) to wear them when walking or bicycling – they may not be able to hear oncoming traffic. It also can take their focus off of what is going on around them.

Teach your child good cell phone etiquette. Children aren't born knowing the rules about how to use cell phones respectfully, including not using them to spread rumors, not taking (or sending) photos without people's permission, not sending inappropriate photos or texts, not having personal conversations in public places – and, of course, never communicating with strangers, no matter how they present themselves. It's up to you to teach them. And by all means, make sure you obey the same rules. Children learn more by watching how their parents handle things than by simply being told what to do.

There’s also a clever contract you can sign with your child when you give them the cell phone. It sets certain rules that they agree to follow and is a good resource that can be reviewed time and time again. CTIA has it listed and printable at this link.

It’s a different world than when we were kids. For most parents, cell phones either didn’t exist or were not as complex and portable as they are now. So, when do you give your child his or her own cell phone? Only after careful consideration to how it will impact their life. Once he or she owns one, it will be an extreme challenge to take it back.

Story source:  Susan Davis, http://www.webmd.com/parenting/features/children-and-cell-phones#1

http://files.ctia.org/pdf/bsw/example_of_family_rules.pdf

 

 

Daily Dose

Penicillin Allergy

1:30 to read

Has your child ever been labelled “penicillin allergic”?  Interestingly, up to 10% of people (of all ages) report having a penicillin allergy, but only about 1% are truly allergic. I see this often in my own practice, especially when seeing a new patient and inquiring about drug allergies, and the parent replies, “ she is penicillin allergic, and developed a rash when she was younger”.  In many if not most of those cases the child is not allergic to penicillin.

 

Penicillins are a class of antibiotics known as beta-lactams and include not only penicillin but  amoxicillin, augmentin, oxacillin and nafcillin, just to name a few.  If you are incorrectly identified as penicillin allergic, when your doctor needs to prescribe an antibiotic they may resort to another class of antibiotic, which are not only more expensive but often may cause more side effects.  

 

Penicillins are the antibiotic of choice and the first line treatment for many pediatric bacterial illnesses including otitis ( ear infections ), strep throat, and sinus infections. They are not only effective, but they are typically inexpensive and have few side effects….which includes allergic reactions.

 

Penicillin allergy is an immune - mediated reaction which usually causes hives ( raised rash ), face or throat swelling, difficulty breathing and in some cases life threatening anaphylaxis.  Intolerance to penicillin is different than being allergic, and in this case symptoms are more likely nausea, diarrhea, headache or dizziness, which may make you uncomfortable but are not immune mediated. 

 

In pediatrics, many children present with a viral illness that includes several days of fever and upper respiratory symptoms, and are then also found to have an ear infection. They are given a prescription for amoxicillin and several days later develop a rash. Many viral infections in children also cause a rash, which is typically red, flat and covers the trunk, face and extremities and does not cause any other symptoms which are seen with a true penicillin allergy.  This rash is benign, but unfortunately many young children will be seen at an urgent care or even an ER due to the rash. The parents are told that their child is penicillin allergic and the antibiotic is changed…and the label “pen allergic” sticks….for many years or even life.  I even saw this rash occur in one of my own sons while on an antibiotic. He is NOT allergic!

 

The good news is that most children are truly not penicillin allergic, and if possible I try to see all of my patients who report a rash while they are on an antibiotic. At times this is not possible, and now with the advent of “smart phones” I have parents send me a picture of the child and the rash. This often helps in determining if the rash truly appears allergic and to identify if there are other symptoms.  Back to the “get a good history”. 

 

If I see an older patient who has had a rash on amoxil when they were little and had no other adverse effects (get a good history), I will sometimes try using a penicillin again, as most people also “outrgrow” their sensitivity after about 10 years. If it is my patient and I have seen the rash I tell the parents that this is not a “pen allergy” and I will use penicillins again.  Some  patients will report a “pen-allergy” but say I can take “augmentin” which is penicillin derivative, so that makes it easy to know they are not allergic.  If I am unsure if a child has had a true penicillin allergy I will refer them to a pediatric allergist for skin testing.  Skin testing is not painful and is an important method for documenting a true allergy. 

 

 

   

Parenting

Teaching Your Child Healthy Hair Care Habits

1:45

Teaching your child good hair care practices can help him or her maintain healthy and shiny locks throughout their life. It can also help prevent hair damage and skin conditions such as dandruff.

You’ve probably been washing your hair more years than you can remember by now, but there was a time when you had to learn what to do with shampoo and water.

If your child has reached the age where he or she can start washing their own hair, here are some tips to help them develop good hair care habits.

You’d be surprised how many kids think that washing their hair means just that – washing only their hair. Healthy skin and hair requires washing the scalp and the hair.

How often should your child wash his or her hair? The answer to that question depends on several factors. For example, during the summer, when kids are more likely to be playing outdoors or involved in sports, they may need to wash their hair as often as every other day. In the drier winter months when kids typically spend more time indoors, the schedule may be pushed back a day or two.

You also have to consider your child’s hair type. Does it tend to be dry or oily? Is it fine, curly, thick, thin or coarse? Different hair types require different care programs.

On an average, kids around 12 years old or who have started puberty and have fine, straight or thin hair, might need to shampoo as often as every other day. At this age, many kids are beginning to experience hormonal changes, causing their hair and scalp to be a little oilier.

For younger children, once or twice a week is sufficient – again, if they haven’t been doing something that would cause their hair to be excessively dirty.

For children with dry, curly or very coarse hair, washing their hair too often can be drying to the scalp and the hair. African American children often have at least a couple of these hair types. Washing their hair once a week or once every two weeks is sufficient if their hair isn’t too dirty. They may also benefit from using a moisturizing shampoo made especially for their hair type as well as a conditioner.

Healthy hair care begins with learning how to wash the hair without damaging it. When your child is ready to start shampooing, follow these steps to help your child develop healthy hair-care habits.

•       Wet hair and scalp with warm water. Shampoo works best on wet heads and hair.

•       Pour a quarter-size drop of shampoo in the palm of your child’s hand. Putting the shampoo in the hand first makes it easier to apply.

•       Tell your child to massage the shampoo gently into the scalp. When shampooing, it’s important to wash the scalp rather than the entire length of the hair. Washing only the hair often leads to flyaway hair that is dull and coarse. Rubbing shampoo into the hair can break hairs, leading to unhealthy looking hair.

•       Rinse well with warm water until the hair is suds-free. Rinsing well washes away shampoo and dirt.

•       Cover hair with a towel. Help your child wrap a towel around the wet hair. This helps to absorb the water. Rubbing hair dry with a towel can damage the hair, causing it to break.

•       Comb out damp hair gently. Use a wide-tooth comb, especially on curly hair. Don’t yank or pull the comb through the hair because that can pull out hair or break the hair.

•       Sometimes a de-tangling spray can help smooth out the hair and keep it from forming little tight knots.

To help kids develop good hair-care habits that help prevent hair damage, dermatologists give parents the following tips:

•       Make braids and ponytails loose and use covered rubber bands.

•       Consider styles that don’t require heat and chemical treatments.

•       When using heat on the hair, lower the heat.

•       Understand that chemicals in relaxers, dyes, and other hairstyling products often damage the hair. The longer the time between treatments, the better it is for your hair. 

•       After your child swims, make sure to wash away pool chemicals. If your child’s hair is normal to oily, shampooing works best. Children who have very dry or African American hair should rinse well and apply conditioner. Pool chemicals that are not washed away can damage hair.

•       Use a wide-tooth comb more often than a brush.

•       When outdoors, wear a wide-brimmed hat to protect the scalp and hair from the sun.

All hair needs to be treated gently, especially when it’s wet. Brushing or combing hair too frequently or in the wrong way (such as using a fine-toothed comb on very thick, curly hair or teasing hair) can lead to breakage. Hair extensions and braids can also cause breakage. Leaving them in too long or pulling them out without professional help can cause hair and scalp damage or even hair loss.

The condition of our hair can also tell us about our general health. Sometimes hair breakage and dry, brittle hair are signs of a medical problem, such as hypothyroidism or an eating disorder. If your child’s hair is breaking or falling out, even though he or she doesn’t treat it with chemicals or other styling products, tell your pediatrician.

Healthy hair doesn’t just happen; it’s the result of proper care and maintenance. Starting your child on healthy hair care habits early will most likely be how they think about and care for their scalp and hair the rest of their lives.

Story sources: https://www.aad.org/public/skin-hair-nails/hair-care/healthy-hair-habits-for-kids

http://naturalhairkids.com/basic-regimen/

 

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