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Your Child

“Holiday Asthma” and Children

2:00

Mix together a Christmas tree, decorations pulled out of dusty storage; perhaps a new kitten or puppy, plus dry heat in the house from cold temperatures and you’ve got a recipe for “Holiday Asthma.” Those are just a few of the things that can trigger a child’s asthma attack.

“Each individual‘s asthma triggers differ,” says Kristy Miller, a spokesperson for the Environment Protection Agency. "However, from an indoor environmental perspective, the primary asthma triggers include secondhand smoke, pet dander, mold, dust mites, and pest droppings. During the winter months, many people spend more time indoors, so steps should be taken to reduce or eliminate exposures to these environmental asthma triggers."

How you can you help your child avoid these common holiday triggers? We found helpful information when WebMD turned to an expert for advice.

One dangerous trigger is respiratory infection. Respiratory infections are rampant during the winter months, particularly during the holidays, when families travel around the country, with millions of other sneezing and coughing merry-makers.

“Asthma flair-ups are frequently due to infections,” says Richard Honsinger, MD, of the Los Alamos Medical Care Clinic. “And during the holidays, we see an increased number of respiratory infections with all the traveling and with people sharing their bugs that cause asthma symptoms to worsen.”

How can you avoid these harmful infections? One solution is to avoid traveling during one of the most contagious times of the year. The other is to make sure that your child and other family members properly wash their hands. That may sound too simple, but a good scrubbing with warm water and soap for at least 15 seconds--can reduce the number of germs your kids pick up over the course of the day, which in turn helps lowers the risk of catching a cold and triggering asthma.

Many families have switched from using real trees to artificial Christmas trees for convenience and to avoid allergies. However, the actual culprit may be the decorations.

“People get all their ornaments out of their basements and closets and they’re covered in dust,” Honsinger says.

The Christmas tree all lit up with warm lights and decorated with old bulbs is a perfect recipe for asthma trouble in kids, so wipe it down with a damp cloth before you set it up in the middle of your living room to remove outdoor allergens. Before you drag your holiday storage containers out of the basement, give them a good dusting so they’re free of mites, pest droppings and other unpleasant holiday treats, and wash decorations before you put them on the tree.

Roaring fireplaces not only provide a traditional backdrop for the holidays, but also come in handy for warming the house. Unfortunately, fireplaces can trigger asthma.

“Fireplaces and stoves and things that leak smoke are things that increase the asthma response,” says Honsinger. “It’s not a true allergy--you can’t test for smoke allergies on the skin--but we know that particulate matter or burning material in the air causes an increase in asthma symptoms.”

Particulate matter can also mean exhaust and cigarette smoke, explains Honsinger. So before you set off to visit family members or friends that smoke, remember to pack your child’s medicine – and be prepared to head home early if asthma symptoms flare up.

Then there is the new kitty or puppy issue. Giving your child a puppy or kitten for Christmas sounds like an enchanting idea, but don’t forget that that adorable little bundle is covered in dander--a common asthma trigger.

“Parents get their kids a new dog for Christmas, when they don’t know if the kids are allergic or not,” says Honsinger, who is a professor of clinical medicine at the University of New Mexico. “It’s a time of year when its cold, so pets are indoors more often than not, so their dander is inside as well and we see an influx of pet allergies and asthma symptoms.”

If your child has asthma, eczema or other allergies, it’s probably a good idea to have him or her skin tested for animal allergies -before you start picking out a puppy or kitten name.

During the winter months, cold air is something most people aren’t going to be to able to avoid unless you live in a warm region of the world and even then- surprises happen.

“We know that breathing cold, dry air will increase asthma symptoms,” says Honsinger. “It excites the receptors in the lung causing asthma to come on quickly.”

Cold air dries the lungs out, and makes the chest tighten, explains Honsinger. Warm, moist air, however, is just what a kid with asthma needs.

“During cold weather have your child wear a scarf when he’s outside,” says Honsinger. ”They breath through the cloth and it catches moisture. Then they breath back in through it and it warms the air and makes the air moist. Then they’re less likely to get that feeling of tightness.”

To be on the safe side, if your child is playing outside, monitor her peak flow every hour or so. 

“Use a peak flow meter so you can see how fast your child’s air is coming out,” says Honsinger. “Use a set of guidelines that you set up with your physician, so if the peak flow drops below a certain level, use medicine. If it drops further, you better seek help. It’s something to watch.”

Because pharmacies and pediatricians may have irregular hours during the holidays, be prepared in advance. “If your child has asthma, have your medicine supply intact over the holidays when everything closes down,” says Honsinger. “If your child uses an inhaler or a nebulizer, make sure you have these on hand, so if asthma symptoms flare up in the middle of Christmas, you have something at home to start treatment right away.”

If your child doesn’t respond to available treatment, take him or her to the emergency room. Asthma isn’t something you want to let get the upper hand.

By applying some of these tips, your child may be able to escape “Holiday asthma!”

Merry Christmas and Happy Holidays from the Kids Doctor!

Story source: Heather Hatfield, https://www.webmd.com/asthma/features/holiday-asthma-triggers-for-kids#1

Your Child

Mumps Cases on the Rise, 3rd Vaccine Dose May Be Needed

2:00

Mumps is a highly contagious disease that is on the rise.  Symptoms include uncomfortable swelling on one or both sides of the cheeks. These swollen salivary glands are the most characteristic sign of mumps, which is caused by a virus and usually spread through coughing. It occurs most often in children and teenagers 5 to 14 years old but anyone can catch the mumps virus at any age.

In addition to swelling, the region can become painful when touched or while chewing, especially when consuming foods that stimulate the release of salivary juices or drinking orange juice or other juices that are acidic. Other symptoms may include 

  • Fever lasting 3 to 5 days
  • Headache
  • Nausea
  • Occasional vomiting
  • Weakness
  • A decrease in appetite
  • Swelling and pain in the joints (and in boys, of the testes)

In 1967, the mumps vaccination program started, and then in 1971, a three-vaccine dose called MMR (mumps, measles and rubella) was made available to the public. This had a dramatic impact on reducing the number of reported mumps cases. Unfortunately, mumps cases are on the rise once again.

The typical schedule for the MMR vaccine is:

  • First dose at 12 through 15 months of age, and
  • Second dose at 4 through 6 years of age.
  • Teens and adults should also be up to date on MMR vaccinations.

In areas where there is an outbreak, some physicians are recommending that children receive a third dose of the MMR vaccine. States such as Washington, Arkansas, and Missouri have seen a significant increase in mumps in 2016 and early 2017. In Texas, cases are at a 20-year high.

The MMR vaccine protects against currently circulating mumps strains, but the effectiveness of the vaccine may decrease over time. That’s one reason cases may be on the upsurge. Another reason may be that some areas have a higher number of unvaccinated children, allowing the disease to spread quickly throughout a population.

Outbreaks can still occur in highly vaccinated U.S. communities, particularly in close-contact settings. In recent years, outbreaks have occurred in schools, colleges, and camps. However, high vaccination coverage helps limit the size, duration, and spread of mumps outbreaks.

A child with mumps will become contagious beginning a day or two before the swelling begins, and the contagious period will continue for about 5 days after the swelling has started. (It’s interesting to note that approximately one third of those infected with mumps do not show obvious swelling.) As a general guideline, keep your child with mumps away from school and child-care for 9 days after the gland swelling has begun.

If your child has the mumps, notify your doctor if your child’s condition becomes worse, especially if she develops abdominal pain, shows an unusual lack of energy, or (for boys) his testicles become painful.

Story sources: https://www.healthychildren.org/English/health-issues/vaccine-preventable-diseases/Pages/Mumps.aspx

https://www.cdc.gov/mumps/outbreaks.html

 

Your Child

Protect Against Heat-Related Illness and Dehydration

2:00

Think it’s hot where you are? Try spending a few minutes outside in the southwest part of the country. This year, several cities have already set records of the longest stretch of time with temperatures 115 degrees and higher, and we’re only half way through the summer.

Your family’s area may not be experiencing those kinds of extreme temperatures, but it doesn’t have to be that hot for a child to end up with a heat-related illness or dehydration when out of doors.

Kids are particularly vulnerable because a child's body surface area makes up a much greater proportion of his overall weight than an adult's, which means children face a much greater risk of dehydration and heat-related illness.

Longer daylight hours often means kids spend more time in the sun so it’s important to make sure your child doesn’t become dehydrated or over-heated.

The early signs of dehydration can include fatigue, thirst, dry lips and tongue, lack of energy, and feeling overheated. But if kids wait to drink until they feel thirsty, they're already dehydrated. Thirst doesn't really kick in until a child has lost 2% of his or her body weight as sweat.

Dehydration can cause three of the worse types of heat-related illnesses:

Heat cramps: Painful cramps of the abdominal muscles, arms or legs.

Heat Exhaustion: Dizziness, nausea, vomiting, headaches, weakness, muscle pain and sometimes unconsciousness.

Heat stroke: A child with heat stroke can have a temperature of 104 degrees or higher. Severe symptoms such as nausea and vomiting, seizures and disorientation or delirium can occur as well as a lack of sweating, shortness of breath, unconsciousness and even coma.

Any one of these heat-related illnesses requires immediate medical attention.

To prevent dehydration make sure your child drinks plenty of cool water and often. They should be hydrated before play and during – even if they tell you they are not thirsty. A good size drink for a child, according to the American Academy of Pediatrics, is 5 ounces of cold tap water for a child weighing 88 pounds, and nine ounces for a teen weighing 132 pounds. One ounce is about two kid-size gulps.

Dehydration can be a tricky thing to catch early. It is typically cumulative – meaning that it may take several days to reach a dangerous point.  If your child is 1% or 2% dehydrated on Monday and doesn't drink enough fluids that night, then gets 1% or 2% dehydrated again on Tuesday, that means your child is 3% or 4% dehydrated at the end of the day. "They may be gradually developing a problem, but it won't show up for several days," says Albert C. Hergenroeder, professor of pediatrics at Baylor College of Medicine and chief of the sports medicine clinic at Texas Children's Hospital.

One way to monitor your child’s hydration is to weigh him or her before and after a sport’s practice or game or playing outside. If his weight drops, he's not drinking enough during his workout.

A simple rule of thumb: if your child's urine is dark in color, rather than clear or light yellow, he or she may be becoming dehydrated.

If you suspect your child is getting over-heated, get him or her out of the sun and into a cooler place. Have the child start drinking plenty of cool fluids. The child should also take off any excess layers of clothing or bulky equipment. You can put cool, wet cloths on overheated skin. In cases of heat cramps, gentle stretches to the affected muscle should relieve the pain.

Kids with heat exhaustion should be treated in the same way but should not be allowed back on the field the same day. Monitor your child even more carefully, Hergenroeder says.

If your child doesn't improve, or can't take fluids, see a doctor.

Some children are going to be more prone to heat-related illness. The biggest risk is a previous episode of dehydration or heat illness. Other factors that can put your child at greater risk for heat illness include obesity, recent illness (especially if the child has been vomiting or has had diarrhea), and use of antihistamines or diuretics.

If a child has been indoors most of the summer, they may not have had a chance to adjust to the hotter weather. Kids should add a little more time out of doors each day until they acclimate to the heat. However, with some of the high temperatures we’re having, it’s best to schedule activities in the morning. It can still be 90 degrees with a humidity index of 107 at 9:00 pm in some places.

In a smart move, a growing number of athletic programs suggest that it is sometimes too hot to practice. In fact, many are restricting outdoors practice when the National Weather Service's heat index rises above a certain temperature. The heat index, measured in degrees Fahrenheit, is an accurate measure of how hot it really feels when the relative humidity is added to the actual temperature.

Kids need time out of doors and certainly time to play and have adventures. Parents can help keep their children from experiencing heat-related illnesses by making sure their child is hydrated and not spending too much time out of doors when the temperature or humidity index is high.

Story source: Roy Benaroch ,MD, http://www.webmd.com/children/dehydration-heat-illness#1

 

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