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Daily Dose

Pool Safety

1:15 to read

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

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

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

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

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

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

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

 

 

 

   

Daily Dose

Drowning Is Silent!

1:15 to read

Summer is here and many families will spend time at the beach, lake, or pool. The first thing that comes to my mind (when I think of water) is safety!!  

Knowing that over 900 children between the ages of 1–14 die each year from drowning, the discussion of water safety is a necessary part of summer routines. Astoundingly, reports show that 9 out of 10 of those children who drowned were “under supervision”. The American Academy of Pediatrics has endorsed allowing children between the ages of 1-4 to take swimming lessons. It was previously thought that encouraging swimming lessons for children under the age of 4 years might actually contribute to increased drowning.   In fact, recent studies have suggested that children ages 1–4 may be less likely to drown if they have had formal swimming instruction. The AAP has not gone so far as to routinely recommend mandatory swimming lessons for this age group, but does endorse swimming lessons in younger children who are frequently exposed to water and are emotionally and physically able to participate.  

The AAP does not recommend formal “infant survival swimming lessons” for children under the age of 1 year. When I discuss water safety with my patients, I emphasize that drowning continues to be the second leading cause of death for children ages 1–19.  I often have interesting discussions with parents who have a backyard pool who do not believe that it is necessary to have a barrier around the pool. They will say, “we never let our child outside alone” or “he or she is always being supervised by an adult”.

As you might expect, these are usually first time parents who have yet to experience the cunningness of a toddler.  Just as our children watch us and learn how to feed themselves, or drink from a cup or climb out of a bed, they too watch us open a door, or take a stool out to reach something. A toddler is more than capable or figuring out how to reach a door handle even with a lock, or climb out a window to go outside and head straight for the pool. Drowning is SILENT!!  It is not like the movies with screaming and yelling. The child quietly goes beneath the water and sinks.  It only takes minutes and the consequences of drowning are devastating.  Even for a child who is found and resuscitated there may be a life-long brain injury and the worst case scenario, death.

All families with a pool should install a 4 sided fence that is at least 4 feet high to limit pool access. It must be difficult to climb and have a self-latching, self-closing gate. The arguments I hear about “landscape aesthetics” fall on deaf ears.  Every family should also know CPR. Sign your child up for swimming lessons, and have fun practicing flutter kicks and arm strokes. Just do it with an adult within arm’s reach of all new and novice swimmers and a fence around the pool!

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

Daily Dose

Treating Swimmer's Ear

1:15 to read

Swimming is one of the best ways to beat the summer heat, but that may also mean that your child will develop a painful swimmer’s ear, also known as otitis externa. Swimmer’s ear is a common summer infection of the external auditory canal, in other words the part of the ear that connects the outer ear (where the Q–tip goes, but really shouldn’t) to the inner ear.

Swimmer’s ear often develops in school age children that spend much of their summer in the water, whether in a pool, lake or even the ocean. The ear canal just never gets a chance to dry out, and the constant moisture disrupts the skin’s natural barrier to infection. The skin may then develop micro abrasions, which allow bacteria to penetrate, and a painful infection develops.  The most common bacterial infection is due to the bacteria Pseudomonas aeruginosa.

A child with a swimmer’s ear usually complains when you touch their ear or tug on their ear lobe. They will often complain when they are lying down and roll over on that ear. Swimmer’s ear may be extremely painful and awaken your child from sleep. When you have an inner ear infection (otitis media) the ear itself is not painful to the touch. In severe cases the ear canal may be so swollen that it appears smaller than usual, and appears red and tender. At some times you may see discharge from the ear canal due to the infection and subsequent inflammatory response.

The treatment of swimmer’s ear is to use an antibiotic drop instilled into the ear canal. I often use an antibiotic drop in combination with a steroid to provide anti-inflammatory effects too which will help to reduce the local swelling and irritation. In severe cases it may be difficult to get the dropper into the ear due to the swelling so the doctor may place a “wick” into the ear that will open the ear canal and allow the drops to enter. A child may also need pain control with either acetaminophen or ibuprofen. At the same time you are using topical drops the child needs to keep water out of the ear!! This is the hard part as they are such water creatures at this age. This also means not to get the ear wet when bathing or showering. I usually say for four to five days before returning to the water.

To help prevent swimmer’s ear you can either buy a premixed solution called Swim Ear, at the pharmacy or mix up your own thrifty bottle made with 1/2 white vinegar and 1/2 alcohol. It is handy to keep this by the back door if you have a pool or in the beach bag. At the end of swimming apply a few drops to each ear and wiggle the ear around. This will help dry out the ear. Once your child is a “fish” and their heads are under water a good deal of the time, this a good time to start using this product. It is unusual to see a your-baby, toddler etc with swimmer’s ear, as they are just not under water all day. But prevention is the key, a painful ear is not fun and staying out of the pool just adds insult to injury! That’s your daily dose, we’ll chat again tomorrow.

Send your question to Dr. Sue!

Daily Dose

Pay Attention Around The Pool

With summer heat spread across the country, many families seek relief by a pool. The first thing to think of is safety!With the summer heat enveloping the entire country, it certainly is time for trips to the pool.  The first thing that comes to my mind when I think of swimming pools is safety!!

Knowing that over 900 children between the ages of 1–14 years die each year from drowning,  the discussion of water safety is a necessary part of summer.  Astoundingly, reports show that 9 out of 10 of those children who drowned were “under supervision”. The AAP has recently endorsed allowing children between the ages of 1-4 to take swimming lessons. It was previously thought that encouraging swimming lessons for children under the age of 4 years might actually contribute to increased drowning. In fact, recent studies have suggested that children ages 1–4 may be less likely to drown if they have had formal swimming instruction. The AAP has not gone so far as to routinely recommend mandatory swimming lessons for this age group, but does endorse swimming lessons in younger children who are frequently exposed to water and are emotionally and physically able to participate. Just as with any childhood milestone, different children will become more adept swimmers at different ages.  The AAP does not recommend formal “infant survival swimming lessons” for children under the age of 1 year. I have heard many parents discuss infant swimming classes and I believe that parent- child pool time is great, but infant survival swimming has not been proven to be beneficial. The AAP continues to recommend that most children ages 4 and older should learn to swim.  Swimming is a life skill that everyone should attempt to master, just like jumping rope, riding a bike and swinging. When I am discussing water safety with my patients and families, I emphasize that drowning continues to be the second leading cause of death for children ages 1–19.  Because I practice in Texas, many families have a backyard pool of some sort, whether it be in ground, above ground or even a very large portable inflatable pool. All of these pose the risk of drowning. I often have interesting discussions with parents who have a backyard pool who do not believe that it is necessary to have a barrier around the pool. They will say, “we never let our child outside alone” or “he or she is always being supervised by an adult”.  As you might expect, these are usually first time parents who have yet to experience the cunningness of a toddler. Just as our children watch us and learn how to feed themselves, or drink from a cup or climb out of a bed, they too watch us open a door, or take a stool out to reach something. A toddler is more than capable or figuring out how to reach a door handle even with a lock, or climb out a window to go outside and head straight for the pool. Drowning is also SILENT!!  It is not like the movies with screaming and yelling. The child quietly goes beneath the water and sinks.  It only takes minutes and the consequences of drowning are devastating. Even for a child who is found and resuscitated there may be a life-long brain injury and the worst case scenario, death.  All families with a pool should install a 4 sided fence that is at least 4 feet high to limit pool access. It must be difficult to climb and have a self-latching, self-closing gate. The arguments I hear about “landscape aesthetics” fall on deaf ears. Every family should also know CPR. So sign your child up for swimming lessons, and have fun practicing flutter kicks and arm strokes. Just do it with an adult within arm’s reach of all new and novice swimmers and a fence around the pool! That's your daily dose for today.  We'll chat again tomorrow. Send your question or comment to Dr. Sue!

Your Child

Crypto in Swimming Pools Doubles in 2 Years

2:00

Many kids and adults won’t be waiting till the first official day of summer before cooling off in a waterpark or pool. Unfortunately, the chance of getting a pool-linked infection has doubled in the last year.

At least 32 outbreaks of cryptosporidiosis were reported in 2016, compared with 16 outbreaks in 2014, according to a new report from the U.S. Centers for Disease Control and Prevention.

Cryptosporidium is a microscopic parasite that causes the diarrheal disease cryptosporidiosis. Both the parasite and the disease are commonly known as "Crypto."

While this parasite can be spread in several different ways, water (drinking water and recreational water) is the most common way to spread the parasite.

Crypto is spread when people come in contact with the feces of an infected person, the CDC says. Not a pleasant thought.

Otherwise healthy people can be sick for up to three weeks with watery diarrhea, stomach cramps, nausea or vomiting, the CDC warns. The infection can become life-threatening in people with compromised immune systems.

The cause? Adults or children sick with crypto-caused diarrhea are swimming in public pools despite their illness and further spreading the parasite, said Michele Hlavsa, chief of the CDC's Healthy Swimming Program.

Not only do humans spread the parasite, but also infected animals. Swimming in ponds or “swimming holes,” or anywhere animals have access, is not a good idea.

You can become infected after accidentally swallowing the parasite. Crypto may be found in soil, food, water, or surfaces that have been contaminated with the feces from infected humans or animals. Crypto is not spread by contact with blood.

Once infected, people with decreased immunity are most at risk for severe disease. 

People also can contaminate pool water with crypto through just physical contact, said Lilly Kan, senior director of infectious disease and informatics with the National Association of County & City Health Officials (NACCHO).

For example, parents might spread the parasite if they change a child's crypto-contaminated diaper and then hop in the water without properly washing their hands, Kan said.

Hlavsa explained that crypto is resistant to chlorine, and can survive up to 10 days in even properly chlorinated pool water.

Parents should take kids on bathroom breaks often, and shouldn't count on swim diapers protecting other swimmers from exposure to a child's diarrhea, Hlavsa added.

"Swim diapers do not contain diarrhea," she said. "If water is getting into that diaper, then water is getting out."

To protect themselves, swimmers should avoid swallowing any pool water, and make sure that kids don't have pool toys that encourage swallowing the water, Hlavsa said.

While home pools are safer, because of the fewer number of people sharing the water, they are not fool proof. Make sure that no one with diarrhea or a stomach illness has been in the pool before you allow your kids to jump in a friend or family member’s pool. And it goes without saying, make sure your own kids stay out of your pool if they’ve had or have diarrhea. Crypto can easily spread to family and friends.

Good hygiene and common sense should help make this summer’s pool party a special one - where everyone just has a good time and no one goes home with an unwelcomed guest inside them.

Story sources: Dennis Thompson, https://consumer.healthday.com/gastrointestinal-information-15/diarrhea-health-news-186/the-water-s-not-fine-u-s-pool-linked-infection-doubles-in-2-years-722869.html

Https://www.cdc.gov/parasites/crypto/infection-sources.html

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