Twitter Facebook RSS Feed Print
Daily Dose

Homemade Cure for Coxsackie?

1:30 to read

Desperate times call for desperate measures…or so it seems according to several of my patient’s mothers who have resorted to all sorts of “cra-cra” stuff to “treat” their child’s “HFM” - hand foot and mouth infection.  Remember, HFM is a viral infection that most children get in the first several years of life. It may cause all sorts of symptoms but in a classic case the child develops a macular-papular (flat and/or raised) vesicular rash on the palms, soles and buttocks. In some children the rash is fairly mild and in others it can look pretty disgusting and uncomfortable…but it has to fade away on its own…with time.

 

There has been a lot of HFM in our area and much anxiety among parents about this infection….fueled a lot by social media identifying who has HFM and where they go to school and how many cases there are. (too much information!!). Parents are even posting…places to “stay away from”. So, some of my patient’s parents are scouring their child looking to see if there might be a bump..and could this be HFM and if so, what do I do to “stop” it!  That would be “nothing” besides good hand washing..as this is a viral infection and you may be exposed to it almost anywhere.

 

Since coxsackie virus has been around for years, this means that most adults had the virus when they were young.  But, several moms and dads whose children have HFM have also shown me a rash on their palms and soles, that I presume may be HFM? They are kind of freaked out and may be uncomfortable too…but this is not life threatening.  Even so,  several parents are resorting to THE GOOGLE to get their medical information… and one young mother kindly brought me all of the stuff that she had gotten to treat her son’s HFM as well as hers.  She was earnest in hoping that this was the “cure”…and did I know about all of these remedies?

 

Here we go, her potions!  Epsom salts for baths as this is an “antiviral”, turmeric and ginger in veggie juice, crushed garlic which she was mixing with small amounts of orange juice and squirting into her toddlers mouth with a syringe, lavender essential oil and lastly “virgin” coconut oil massages.   

 

I was most impressed that her sweet toddler was eating, drinking and bathing in all of this!!! Unfortunately, despite her best efforts it took about 2 weeks for his rash to totally disappear and she kept him under house arrest for most of that time!!  He really could have gone out long before that as he was over his acute illness, but she wanted every “mark” to have faded. She was most chagrined to hear that he might get HFM again. I am not sure the her “voo-doo” did any good, except in her mind. 

 

Lastly, if you do resort to “internet medicine” remember the oath, “first do no harm” and check with your pediatrician about some of the advice you might find on-line, not everything may be safe.

 

Daily Dose

Over The Counter Products

1:30 to read

So, if you have read my daily doses you are aware that my “news watching” comes from morning TV while I am getting ready for work!!  I often find myself talking to the TV, especially when it is a medical segment which includes pediatrics.  While I am excited that morning TV is covering health topics, some of the information may be a bit “misguided” when a pediatrician is not the one discussing a pediatric topic.

I “heard” another example of this the other morning when the morning shows were discussing the “top pharmacist picks for over the counter products”.  It seems they surveyed pharmacists  and then compiled a list of “favorite” name brand OTC products in numerous categories - I don’t  think there was much science behind this. At any rate, we all have our “favorite” go to “OTC” products which for one reason or another we prefer. Does that actually mean they are better?

So, here are a few that I had issue with:

Allergy medications: They picked Claritin, but why not Zyrtec or Allegra?  They are all second generation anti-histamines and there is not a great deal of data that one is better than another. If push came to shove and I could only pick one antihistamine it would be Benadryl (diphenhydramine) - despite its sedating properties it is still a great drug.

Topical antibacterial medication: They picked neosporin and I would pick polysporin. Neosporin contains neomycin which may cause an allergic contact reaction. Other than neomycin they are quite similar and both contain topical lidocaine for pain relief.  Guess what -  they are made by the same company!!  

Pain relief:  They picked Advil, but why not Motrin or generic ibuprofen.  I am frugal and buy whatever is on sale, same drug.  I always remind parents of this as sometimes they get confused and say, “Advil didn’t work so I gave them Motrin” double dosing them with same drug. Be careful.

GI complaints:  Pharmacists picked Pepto-Bismol. I do not recommend Pepto-Bismol to  children as it contains  bismuth subsalicylate which is related to aspirin and has been associated with Reye’s Syndrome.  The bottle is labelled “do not use under the age of 12 years” due to this concern, but parents may not read the fine print. There is a Children’s Pepto that contains only calcium carbonate and may be given to children as young as 2 years….really important to read the labels as there are many choices with similar names.

Lip balm: Their choice was Carmex. I do not recommend lip balm/gloss that contains menthol or camphor as it may actually damage the lips and cause more drying…so you apply more then it is a vicious cycle.  You want to use lip balm with bees wax or petrolatum and no fragrance. I like Aquaphor, Burt’s Bees and Vaseline.  

Formula: Their choice was Enfamil.  I recommend any of the formula brands including Simliac and Gerber as well as some Organic Formulas if my patients desire.  I don’t know why they would pick only one brand…no data on that either.

Sunscreen:  Their choice Neutrogena, which I also love. They make good products that are hypoallergenic and PABA free, and they have many different vehicles (spray, lotion, stick) to choose from. I am also a fan of Cerave products and they now have sunscreen for babies.  But the most important fact is to use a sunscreen of any brand with an SPF of at least 30 and one that contains zinc or titanium dioxide and no PABA or oxybenzone. 

Those are just a few of my comments and favorites.

 

Daily Dose

What New Babies Need

1:30 to read

I have many friends whose own children are now having babies and they always ask, “what all do we need to have/buy for a new baby these days?”  While many things have changed since I had my own children, many have not,  and I still think “less is more” is a good adage to follow, especially for a newborn.  We all have a tendency to buy too much, or the “latest and greatest” only to find out that it is not necessary.

Carseat - a rear facing car seat is a must for your newborn!!!  Look at all of the reviews on line and pick which seat works best for you.  Do you want one with a base that you can also clip on to a stroller?  Remember your baby will sit in a rear facing car seat until 2 years. This is one item I would spend my money on!!

The baby needs a place to sleep so buy a crib and a good mattress.  If you are going to have more than one baby I would buy something that will last through several children. I like having a crib (rather than a toddler bed), as your baby will be in the crib for several years and then can move to a regular bed…no need for an “in between”.  Do not use an “old” crib that has drop sides, due to safety concerns. So that means the one that I had kept in the garage (from my kids) was a throw away! I usually move the first child to a bed when I need the crib for the next baby…no specific age. Bumpers are no longer recommended, so that saves money too!

Changing table or dresser for the millions of diaper changes.  It is so helpful to not have to bend over each time. I would also buy a diaper cream (Dr. Smiths, Destin or Butt paste) to have on hand….your baby will probably get a diaper rash at some time during their time in a diaper.

Baby bath tub: while you can bathe your baby in the sink, the newer bathtubs do make it easier for a newborn and you can use it in the tub as well until your baby can sit up alone. Remember, you will NEVER leave your child in the tub alone…even with all of the seats, rings and things  that they sell to support your baby!!  For bathing I like gentle bath wash like Cetaphil, Cerave, and Eucerin products….good for all skin types.  Pick one!

Swaddle blankets: WOW there are a million on the market and they all “claim” to help your baby to sleep better. I don’t think any of the products say “it will also takes weeks to months for your baby to sleep through the night” , no matter what you use.  I do like the thin swaddle blankets as they are useful for a number of things besides swaddling. Once you have your baby have the nurses show you how to swaddle (quick and easy).  The Miracle Blanket, Woombie and Halo also make it easy to swaddle as well. Pick one (or two) and stick with that.  Remember, your baby is going to be put in their crib on their back whether swaddled or not!! NO TUMMY SLEEPING.  

Diaper Bag: again their are a million out there in all shapes, sizes and price points. In the beginning you need to have a pad for changing (you will end up changing that baby all sorts of weird places), diapers, burp clothes, wipes…as your baby gets bigger you will have bottles, cups, toys all shoved in there too. All of my patients seem to have a travel size Purell strapped to the side of the bag as well. I would get a bag that you can wipe out as there will be spills of all sorts of stuff in that bag I assure you!  Somehow, over time you go back to “less is more” and the diapers end up in your purse!!  

So…that is a start. Will do another post on some other products in the future. 

 

 

Play
1294 views in 2 years
Sportsmanship

Sportsmanship with Drew Pearson

Play
1304 views in 1 year
Fight the Flu

Fight the Flu

Your Child

Gluten-Free Diet Not Recommended for Healthy Children

2:00

A “gluten-free “ label on a food product is one sure way to increase sales as the popularity of such items continues to rise.

For people with Celiac disease or gluten sensitivity, eating gluten can cause diarrhea, abdominal pain, upset stomach and bloating. However, for healthy adults and particularly children, there are many reasons to avoid going gluten-free according to a commentary recently published in the Journal of Pediatrics, by Norelle Reilly.

Dr. Norelle Reilly is Assistant Professor of Pediatrics at Columbia University Medical Center and the director of pediatric celiac disease in the Division of Pediatric Gastroenterology and the Celiac Disease Center at Columbia University.

In a recent Time Magazine article, Reilly lays out four reasons why healthy children should not be on a gluten-free diet.

1. Gluten is not naturally toxic except for people with celiac disease, however, in almost all children, gluten travels through the intestine without causing disease and will never lead to problems. To date, science has not shown that there is a toxin in gluten that makes it bad for our bodies. A balanced diet containing fresh fruits and vegetables, lean proteins, and a variety of carbohydrate sources is the best way for healthy children to stay healthy, Reilly notes.

2. A gluten-free diet may not provide balanced nutrition for children. Some people assume that gluten-free food and healthy food as the same thing. Not necessarily so, says Reilly.

Many gluten-free substitutes for items such as breads and cookies are actually higher in fat and calories than gluten-containing varieties. Gluten-free items such as some cereals and breads may also not be nutrient fortified to the same degree as those with gluten. Folate and B-vitamins are often added to our usual starch staples, silently protecting people whose diets may not be very balanced from deficiency. Without these quiet sources of nutrition, vitamin deficiencies could develop, she writes.

Gluten-free foods are often fiber deficient, which is important for gastrointestinal health, including maintaining regular bowel movements. Quite commonly, children who initiate a gluten-free diet become constipated. Increased consumption of rice, a common gluten substitute, may also expose children to more arsenic in their diets, as arsenic is frequently present in the earth where rice is grown.

Reilly says that growing bodies and brains require balanced nutrition. For those children who need a gluten-free diet, balance can be implemented safely and healthfully with the guidance of an experienced registered dietitian to help avoid all of these and other nutritional pitfalls.

3. Have your child tested for celiac disease before putting them on a gluten-free diet. You can’t know for sure whether your child is gluten sensitive or has celiac disease until a physician has tested them. Symptoms alone are not enough to determine whether your child has celiac disease. Being on a gluten-free diet before having your child tested can make it more difficult to determine whether he or she actually does or does not have the disease.

Reilly suggests that if you are concerned that your child may have a problem with gluten, speak to your child’s doctor before banning it from your child’s diet. A child with celiac disease needs special monitoring over time and their family members may need to be tested. Even if you plan to give the diet a try regardless of the test result, it is extremely important for your child and family’s health to know why the diet is necessary.

4. A gluten-free diet is hard to maintain and expensive. For children who require this limited diet for long-term health, parents, schools, and the medical teamwork to make the child’s experience in school and at home as easy as possible.

Reilly notes that the children she has treated for celiac disease would trade in their gluten-free diet in an instant if they knew gluten would not make them sick.

In addition she adds, gluten-free foods are incredibly expensive and for many families the diet can be challenging to financially sustain in the long run.

Many adults prefer a gluten-free diet, but Reilly cautions that parents should check with their pediatrician or family doctor before putting their healthy children on the same eating plan.

Story source: Norelle Reilly, http://time.com/4329517/4-reasons-why-your-kids-should-not-be-gluten-free/

Daily Dose

New Sleep Guidelines for Your Baby

1:30 to read

I am sure that many of you heard about the latest recommendations on infant sleep that the American Academy of Pediatrics has released. The latest policy statement from the AAP recommends that all infants sleep in their parents room, but not in the parents bed,  for at least the first 6 months of life and preferably for the first year!!  This is big news and quite a change from the previous sleep recommendations which were published in 2011.

 

All of the latest recommendations regarding sleep are intended to help to reduce the incidence of SIDS (Sudden Infant Death Syndrome), which is the leading cause of death for children under the age of 1 year. SIDS in one of the greatest fears of all parents. While “the back to sleep” campaign has reduced the incidence of SIDS, there are still over 3,500 babies in the U.S. who die suddenly and unexpectedly every year while sleeping. (this includes some from suffocation and strangulation and not SIDS).

 

In addition, the recommendations re-iterate that the baby should not co-sleep with their parents, but should be in a crib or bassinet with a firm sleep surface, in the parents’ room. These new recommendations, may be driven by the reality that breast feeding mothers are exhausted and often fall asleep while nursing their baby. If the mother is sitting in a chair or on the couch and falls asleep the baby may be at risk of suffocation if they roll into a cushion or fall down between pillows. If the mother is in bed breast feeding and accidentally falls asleep at least the baby is on a firm surface - make sure when you do breast feed your baby in bed to remove all loose blankets and pillows in the area around your baby prior to feeding - just in case.

 

Although it has been a long ago, I always put our infants in their own cribs to sleep -  you might say I was obsessed. One night, shortly after the birth of our 3rd child I found myself on my hands and knees looking under the bed. When my husband was awakened and asked me “what are you doing?” I replied…”looking for the baby!” He then reminded me that I had put the baby in his crib in the nursery right after I had finished breastfeeding him.  I truly had no memory and thought he had fallen under our bed!! This, from someone who had previously stayed up for 36 hours during residency working in the hospital and thought I could handle sleep deprivation- clearly not true!! I just remember the feeling of being frantic! 

 

The AAP continues to recommend that the crib be essentially bare - in other words, no bumpers, no blankets, no stuffed toys, just the fitted crib sheet. The baby should always be placed on their back to sleep…once your baby learns to roll from back to front ( which typically happens after they have learned to roll tummy to back), they may be left to sleep on their tummy. Even with a baby in your room you cannot get up all night to keep trying to keep them from rolling over!  

 

The AAP does recommend using a pacifier for sleep times ( I am a huge pacifier fan as you know). The only problem with a pacifier is convincing The Parents that it is time to “get rid of the paci” once their baby is over a year old….. sometimes hard to sell that concept.

 

Lastly, the APP reiterated that they do not support the use of any of the devices sold to new parents to help “prevent”  SIDS. In other words, all of the technology being marketed including  “anti-SIDS mattresses, home cardiorespiratory monitors, and even fancy video monitors.  While many a well intentioned parent will invest a lot of unnecessary money and time trying to make the baby safe during sleep, the mantra “less is more” is now the best way to ensure safe sleep for your baby. I remind parents that there will be plenty of ways to spend that money  - start the college savings!

 

 

 

 

Your Child

Kid’s Allergies Linked to Depression and Anxiety

2:00

According to the Asthma and Allergy Foundation of America, 40 percent of U.S. children suffer from allergies. It is the third most common chronic disease in kids under the age of 18.

A new study suggests that children who have allergies at an early age are more likely to have problems with anxiety and depression than those that do not.

One reason may be that children with allergies tend to keep their troubles to themselves or  “internalize” them.

“I think the surprising finding for us was that allergic rhinitis has the strongest association with abnormal anxiety/depression/internalizing scores compared to other allergic diseases,” said lead author Dr. Maya K. Nanda of the division of Asthma, Allergy, and Immunology, at Children’s Mercy Hospital in Kansas City, Missouri.

Rhinitis is more commonly called “hay fever” and includes symptoms such as a runny nose, sneezing, and itchy or watery eyes.

The researchers studied 546 children who had skin tests and exams at age one, two, three, four and seven and whose parents completed behavioral assessments at age seven. They looked for signs of sneezing and itchy eyes, wheezing or skin inflammation related to allergies.

Parents answered 160 questions about their child’s behaviors and emotions, including how often they seemed worried, nervous, fearful, or sad.

Researchers found that the four-year–old children with hay fever symptoms or persistent wheezing tended to have higher depressive or anxiety scores than others at age seven.

The more allergies a child had, the higher the anxiety and depression scores.

“This study can't prove causation. It only describes a significant association between these disorders, however we have hypotheses on why these diseases are associated,” Nanda told Reuters Health by email.

Another reason for the association may be that children with allergic diseases may be at increased risk for abnormal internalizing scores due to an underlying biological mechanism, or because they modify their behavior in response to the allergies, she said.

Other studies support the idea that that a biologic mechanism involving allergy antibodies trigger production of other substances that affect the parts of the brain that control emotions.

In a 2005 study, Teodor T. Postolache, MD, associate professor of psychiatry and director of the mood and anxiety program at the University of Maryland School of Medicine in Baltimore found that peaks of tree pollen increased with levels of suicide in women.

Postolache says allergic rhinitis is known to cause specialized cells in the nose to release cytokines, a kind of inflammatory protein. Animal and human studies alike suggest that cytokines can affect brain function, triggering sadness, malaise, poor concentration, and increased sleepiness.

The new study took race, gender and other factors into account, “so the strong association between allergic disease and internalizing disorder we found is definitely present,” Nanda said.

The severity of mental health symptoms varied in this study. Some children had anxiety and depression that needs treatment, while others were at risk and required monitoring, she said.

“We think this study calls for better screening by pediatricians, allergists, and parents of children with allergic disease,” Nanda said. “Too often in my clinic I see allergic children with clinical anxiety (or) depressive symptoms; however, they are receiving no care for these conditions.”

“We don't know how treatment for allergic diseases may effect or change the risk for internalizing disorders and we hope to study this in the future,” Nanda said.

Experts hope that if parents know that allergies may contribute to their child’s mood or behavior, they will be more likely to keep a closer eye on their child for signs of depression or anxiety and seek treatment if necessary.

The study was presented in The Journal of Pediatrics.

Sources: Kathryn Doyle, http://www.reuters.com/article/us-health-kids-allergies-depression-idUSKBN0UC1TW20151230

David Freeman, http://www.webmd.com/allergies/features/allergies-depression

 

Your Child

Pre-teen Football Linked to Brain Changes in NFL Players

2:00

The start of a new school year also brings after-school sports programs. Late summer and fall is prime football season for many middle and high schools. In some states, it’s a hallowed tradition that boys and girls look forward to participating in whether it’s running down the field or cheering on the team.

While school football doesn’t typically offer the same ferocious body beating and brain –rattling that are seen in the National Football League (NFL), a new study shows that brain development can still be affected by playing football at a young age.

The study looked at the possible connection between a greater risk of altered brain development in NFL players who started playing football before the age of twelve as opposed to those players who began playing later in life.  The study is the first to show a link between early repetitive head trauma and future structural brain variations.

The study was small but interesting. It included a review of 40 former NFL players between the ages of 40 and 65 who played over 12 years of structured football with a minimum of 2 years at the NFL level.

One half of the players took up football prior to the age of 12 and half started at age 12 or later. The number of concussions suffered was very similar between the two groups. All of these players had a minimum of six months of memory and cognitive issues.

"To examine brain development in these players, we used an advanced technique called diffusor tensor imaging (DTI), a type of magnetic resonance imaging that specifically looks at the movement of water molecules along white matter tracts, which are the super-highways within the brain for relaying commands and information," study author Dr. Inga Koerte, professor of neurobiological research at the University of Munich and visiting professor at Harvard University, said in a press release.

The researches believe their findings add to the growing amount of scientific evidence that shows the brain may be especially vulnerable to injury between the ages of 10 and 12.

"Therefore, this development process may be disrupted by repeated head impacts in childhood possibly leading to lasting changes in brain structure," said study author Julie Stamm, currently a post-doctoral fellow at the University of Wisconsin School of Medicine and Public Health.

Despite finding a link to the brain development window where kids are more likely to suffer brain injury by repeated head impacts, the small size of the study means the results may not necessarily apply to non-professionals.

"The results of this study do not confirm a cause and effect relationship, only that there is an association between younger age of first exposure to tackle football and abnormal brain imaging patterns later in life," said study author Martha Shenton, a professor of psychiatry at Harvard Medical School.

Because of the intense publicity about and the findings of many studies on the short and long-term dangers of concussions, many school sports programs are looking at changing how they allow students to play in games associated with head injuries.  Where it was once common for coaches to let players continue playing after a particularly rough tackle or head butting, they are more likely now to insist that a field medical professional examine the child. Some schools are also implementing no tackle policies to protect very young players.

While traditional football isn’t likely to become extinct, parents and coaches can educate themselves about brain injuries and learn how to best protect young players from the chances of long and short-term disabilities.

Source: Brett Smith,  http://www.redorbit.com/news/health/1113407634/pre-teen-football-linked-to-more-severe-brain-changes-in-nfl-players-081115/

 

 

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

No need to be so structured when feeding your baby!

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.