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Your Baby

Exercising During Pregnancy

2:00

If you’re pregnant, you may be wondering if you should start or continue exercising. The answer is a resounding, yes!

Regular exercise throughout your pregnancy can help you stay healthy, improve your posture and help decrease common discomforts such as backaches and fatigue.

There is even evidence that physical activity may help prevent gestational diabetes, relieve stress and build more stamina needed for labor and delivery.

All of these benefits are good things.

If you were physically active before your pregnancy, there’s no need to stop. However, don’t try to exercise at your former level; instead, do what's most comfortable for you now. Low impact aerobics are encouraged versus high impact.

Check with your obstetrician for guidance if you are a competitive athlete, you may need specialized monitoring.

What if you have never been into exercise, should you start now that you are pregnant?  Absolutely!

You can safely begin an exercise program during pregnancy after consulting with your health care provider, but do not try a new, strenuous activity. Walking is considered safe to initiate when pregnant.

The American College of Obstetrics and Gynecology recommends 30 minutes or more of moderate exercise per day on most if not all days of the week, unless you have a medical or pregnancy complication.

While exercise is great for most moms-to-be, there are some women who should not exercise during pregnancy. They are women with medical problems such as asthma, heart disease or diabetes. If you have one of these conditions, check with your OB/GYN about your options and follow his or her recommendations.

Exercise may also be harmful if you have a pregnancy-related condition such as:

           ·      Bleeding or spotting

           ·      Low placenta

           ·      Threatened or recurrent miscarriage

           ·      Previous premature births or history of early labor

           ·      Weak cervix

Talk with your health care provider before beginning an exercise program. Your health care provider can also give you personal exercise guidelines, based on your medical history.

Most exercises are safe to perform during pregnancy as long as you don’t overdo it.

The safest and most productive activities are swimming, brisk walking, indoor stationary cycling, step or elliptical machines, and low-impact aerobics (taught by a certified aerobics instructor). These activities carry little risk of injury, benefit your entire body, and can be continued until birth.

What about jogging, tennis and racquetball? All these activities require balance and coordination– which may change as you progress during your pregnancy.  If you’re healthy and have discussed these sports with your OB/GYN, go ahead and enjoy, but in moderation.

There are certain exercises that can be harmful during pregnancy. What exercises should be avoided? They are:

·      Holding your breath during any activity.

·      Activities where falling is likely (such as skiing and horseback riding).

·      Contact sports such as softball, football, basketball, and volleyball.

·      Any exercise that may cause even mild abdominal trauma such as activities that include jarring motions or rapid changes in direction.

·      Activities that require extensive jumping, hopping, skipping, bouncing, or running.

·      Deep knee bends, full sit-ups, double leg raises, and straight-leg toe touches.

·      Bouncing while stretching.

·      Waist-twisting movements while standing.

·      Heavy exercise spurts followed by long periods of no activity.

              ·      Exercise in hot, humid weather.

Stretching exercises can help make the muscles limber and warm, which can be helpful during pregnancy.

Kegal exercises can help strengthen the muscles that support the bladder, uterus and bowels. By strengthening these muscles during your pregnancy, you can develop the ability to relax and control the muscles in preparation for labor and birth.

Tailor exercises strengthen the pelvic, hip, and thigh muscles and can help relieve low back pain.

Many health providers have DVDs, websites or exercise pamphlets with instructions and examples available for their pregnant patients. There are also classes with instructors trained in leading exercise programs specifically for pregnant women.

What should a pregnancy program consist of?

A total fitness program should strengthen and condition your muscles. Don’t forget to drink plenty of water and never exercise to the point of exhaustion.

Exercising during pregnancy has many advantages, but there are warning signals you should look out for. Stop exercising immediately and contact your health provider is you:

             ·      Feel chest pain.

             ·      Have abdominal pain, pelvic pain, or persistent contractions.

             ·      Have a headache.

             ·      Notice an absence or decrease in fetal movement.

             ·      Feel faint, dizzy, nauseous, or light-headed.

             ·      Feel cold or clammy.

            ·      Have vaginal bleeding.

            ·      Have a sudden gush of fluid from the vagina, or a trickle of fluid that leaks steadily.

            ·      Notice an irregular or rapid heartbeat.

           ·      Have sudden swelling in your ankles, hands, face, or calf pain.

           ·      Are short of breath.

           ·      Have difficulty walking.

           ·      Have muscle weakness.

The big question many women have after delivery is – when can I start working off these extra pounds? It’s best to start fitness routines gradually and follow your health provider’s recommendations. Too often, women who have just given birth are inundated with images of celebrities who look as though they have dropped 50 pounds and returned to their former sleek selves within weeks after delivery. However they accomplish this (think spandex & a personal trainer that works you relentlessly), it’s not necessary or even healthy to try to capture your former body immediately.

Most women can safely perform a low-impact activity one to two weeks after a vaginal birth (or three to four weeks after a cesarean birth). Do about half of your normal floor exercises and don't try to overdo it.

Exercising during pregnancy is not a “one routine fits all” kind of thing. You can strengthen your muscles and reap the benefits of exercise while pregnant, just do it under the guidance of your health provider. He or she knows your limits, your medical history and will be able to help you achieve the best results.

Story source:

Traci C. Johnson, MD, http://www.webmd.com/baby/guide/exercise-during-pregnancy.

 

 

Daily Dose

The Heat is Taking a Toll on Many

1:15 to read

This is a follow up last week’s Daily Dose on the toddler who burned his feet after playing outside on a very hot day. He has been being treated with daily dressing changes and debridement of the skin from the blistering on his feet. HIs mother called to tell me that the first few days were “BRUTAL” and extremely painful as the doctors popped the blisters and removed dead skin and then would scrub the area to prevent infection. His mother was also doing bandage changes at home.

But after those first horrible days, he is no longer having to go for “burn therapy” and she is managing the dressing changes on her own. She is fortunate to be a nurse, but having to change your own child’s dressings is a daunting task for any parent, even one who has done dressing changes before.

Her son is also now off all pain medication except for over the counter acetaminophen and ibuprofen, and is smiling and playing with his older brother. He is still not walking and is being “carried to and fro”, it seems that he realizes his feet have tender new skin.  The doctors also feel as is he will not have any significant scarring over the long term.  

The triple digit heat is continuing in many parts of the country and I just read about another child in Texas who died after being left in a car.  Remember, put something in the front seat to remind yourself that your child is in the car with you. A sleeping quiet baby can be momentarily forgotten when a parent is distracted….and even minutes in a hot car may be deadly.

Be aware of the many risks associated with these extreme temperatures, and make sure that your children have shoes on whenever they are going to be outside!!  Hoping that these extreme temperatures will moderate over the next few weeks…especially as children are heading back to school!

Your Toddler

More Small Children Poisoned by Detergent Pods

1:45

When detergent pods first became available, many families thought they were a convenient product for dishwashing and laundry. Grab a pod, pop it in and go. However, over time, warnings began to emerge that these colorful products proved too tempting to small children. The bright designs and little round shapes looked a lot like candy to toddlers and young children.

Even though the warnings have taken on a sense of urgency, a growing number of children are getting their hands and mouths on these products, with serious and sometimes fatal repercussions.

Among more than 62,000 calls made to emergency departments for poisoning from any kind of laundry or dishwashing detergent from 2013 to 2014, 17 children were in a coma, six stopped breathing, four had fluid in their lungs and difficulty breathing, and two died.

"Over 60 percent of these calls were due to laundry detergent packets," said lead researcher Dr. Gary Smith, director of the Center for Injury Research and Policy at Nationwide Children's Hospital, in Columbus, Ohio.

"That's about 30 children a day, or one child about every 45 minutes," he said. "Over the two years of the study, poisoning from detergent packets increased 17 percent, and in 2015 there was another 7 percent increase," Smith said.

Laundry detergent packets are more toxic than other forms of detergent and cause more hospitalizations and serious medical problems, Smith explained.

These packets look attractive to children, who could mistake them for food or candy, he said.

"All they have to do is put them in their mouth and bite down and the packet will burst, and once these toxic chemicals get down their throat the game's over," Smith added.

Given this growing problem, Smith said that parents of children under the age of 6 years should not have these products in the home. "They should use traditional detergents, which are far less toxic," he said.

Smith and colleagues analyzed data from calls made to U.S. poison control centers in 2013 and 2014 after unintentional exposures to laundry or dishwasher detergent involving children under the age of 6.

During those years, the number of poisonings increased for all types of detergents, but it was greatest for laundry detergent packets (17 percent), followed by dishwasher detergent packets (14 percent), the researchers found.

Smith noted that the liquid detergent were the most harmful to children.

Dr. Barbara Pena, research director in the emergency department at Nicklaus Children's Hospital in Miami, said companies have to do something to make these products safer.

People need to keep these products out of sight so children can't get into them, she said. "They should be treated just like medicine."

Ideally, parents of young children would not have them in the home, Pena said.

In response to the study, the American Cleaning Institute said Monday that manufacturers are working on a series of packaging and labeling steps that will be part of new international standards intended to reduce accidental exposure to the cleaning products.

The standards will include "secure package closures designed to challenge the typical strength, mental acuity and/or dexterity of a young child," the institute said in a news release.

There will also be first-aid instructions on the products' packages, the group said.

The report was published online in the journal Pediatrics.

It’s good that companies are researching safer packaging for their products, but ultimately, it’s up to the parents and caregivers of small children to make sure that their young child is safe from being poisoned by detergent pods.

Story source: Steve Reinberg, http://www.webmd.com/children/news/20160425/more-kids-being-poisoned-by-detergent-pods-study?print=true

Daily Dose

Leaving Your Child Home Alone

1.00 to read

I get asked the questions a lot "At what age can I leave my child home alone?"  There is no simple answer but a progressibe one.

I tend to think most children are ready to spend 20-30 minutes alone at home between the ages of 10-11, but every child is different.  It depends on a number of things including how your child feels about being alone, the length of time, and if you and your child have discussed how to handle emergencies and getting a hold of you or a neighbor in case there is an emergency or even just a question that needs to be answered.  

Well, this topic brought up an interesting question, what do you do when you leave your child alone and there is not a home phone?  I have never even given that a thought as I am “old school” and still have that landline in my house. It just gives me a “good feeling” to know that it is there, even if it rarely rings. (although the kids know to call the home number as I typically turn off the cell as soon as I hit the door from work).   

More and more families have given up a home phone and I think this brings up so many different topics for discussion, but for starts how does your child call you when you leave them alone?  Or how do they call the trusty neighbor if they need something.  Do you get them a cell phone? Do you have to have an extra cell phone to have at home?  It seems to me that a home phone is important for just that reason. In case of an emergency, your child can pick up the phone and call for help, assistance or just a friendly voice. I don’t think they need a cell phone!  

Also, landlines are relatively inexpensive. Cell phones for 8,10, 11 year olds?  Sounds inappropriate and expensive.  Wouldn’t it be easier to keep a home phone so children can learn to answer a phone, use good phone manners, and when you are ready to let them stay at home by themselves for a few minutes, there is always a phone available. I don’t know, just seems easy solution to me.    

What do you think? I would love to hear from you!

 

Your Toddler

High Chair Recall Due to Fall Danger

1:30

Nuna Baby Essentials has recalled eight models of their baby high chairs because the arm bar can bend or detach during use, posing a fall hazard to children.

Nuna has received 50 reports of the arm bar detaching, including six reports of children falling from the high chair. Four incidents resulted in injuries, including bruising and a cut on the forehead.

This recall includes ZAAZTM high chairs in eight models: HC-07-004 (pewter), HC-07-005 (carbon), HC-07-006 (plum), HC-07-009 (almond), HC-08-004 (pewter), HC-08-005 (carbon), HC-08-006 (plum) and HC-08-009 (almond). ZAAZ and the model number are printed under the high chair seat on a white sticker. These high chairs look like a regular kitchen table chair and have removable trays, arm bars footrests, seat pads and harnesses so that they can convert into toddler chairs. “Nuna” is printed above the footrest of the unit.

The high chairs were sold at Albee Baby, Giggle, Magic Bean, Nordstrom and other specialty stores nationwide and online at www.nuna.eu and www.wayfair.com and other online retailers from February 2013 through November 2015 for about between $250 and $300. 

Consumers should immediately stop using these recalled high chairs and contact the firm to receive a free new arm bar and instructions on how to replace it.

For more information, Nuna Baby Essentials has a toll-free number at 855-686-2872 from 8:30 a.m. to 4:30 p.m. ET Monday through Friday. Or consumers can go online at www.nuna.eu/usa/ and click on “Product Recall” under the “Support” section on the sidebar of the homepage for more information.

Source; http://www.cpsc.gov/en/Recalls/2016/Nuna-Baby-Essentials-Recalls-High-Chairs/

Your Toddler

Preparing For Your Toddler’s First Halloween

1:45

Remember your first Halloween? Most likely, you don’t. Like many kids, you were probably just a toddler when your parents dressed you in a costume and took you house to house in search of candy and other treats.

Now that you have a child of your own, preparing him or her for their first Halloween adventure can be a bit overwhelming.

Here are 7 tips to help ease parents and toddlers into the Halloween tradition:

1. Allow for plenty of prep time to help your child understand what Halloween is all about. Reading books and stories to your child about trick-or-treating—and Halloween in general—are great ways to help that discussion. You might even want to have your child practice in his or her costume before the big day. Toddlers need to know that Halloween is just for fun and the scary stuff is simply pretend. Some children may feel intimidated by costumes and crowds of people. If your little one doesn't want to partake in Halloween, then let that be okay. There is always next year, and 12 months can make a big difference!

2. Go out before it gets dark. If you’re planning on trick or treating in your neighborhood, try and time your outing before the sun goes down. This can help your child stay on his or her regular evening schedule. Toddlers need a consistent bedtime and starting early helps them keep that time in check. If your neighborhood tends to start Halloween festivities after dark, you might consider a center where activities are offered earlier in the day.

3. Watch out for tripping hazards. Toddlers aren’t quite in control of their walking abilities – even on a good day when nothing much is going on - walking can be a balancing act for tots. While you won't be able to prevent all of the tumbles, choosing a costume that is not too long or too bulky will help a great deal. Be sure to check the forecast before you go out and try to include layers if needed. Also remember to help your little one climb up and down any steps and porches.

4. Always have another costume on standby. Lots of toddlers are prone to toilet training accidents. If potty-training is still in its early stages, then there's a narrow window between "I have to go" and an accident. Keep that in mind when choosing a costume – the simpler, the better. There is also no harm in putting him or her in an easy-on, easy-off diaper. 

5. Know when to pack it in. You never know what you’re going to run into on Halloween. If a house or costume is too scary or he or she takes a tumble or maybe your toddler has had a rough day already, then you already know that a temper –tantrum could be right around the corner. Once your tot gets too tired or just can’t seem to cope any longer, it’s time to head home. But all is not lost! Once your little one is home and has recovered, you might want to see if he or she would prefer to help hand out candy to all the "big kids" for a little while. You know your child best and can read the signals he or she is sending. An hour or less of trick or treating may be plenty for a first time out.

6. Watch out for sugar overload. While Halloween and candy go hand in hand, make sure your little one doesn’t over do the sweets – besides all the common sense reasons children shouldn’t be eating too much candy - a sugar crash can make kids more susceptible to overwrought tantrums.

7. Keep an eye for any choking hazards. It's best to avoid eating while walking or running. Once your child is ready to enjoy treats at home, keep in mind that babies and toddlers should not have any hard candies, caramel apples, popcorn, gum, small candies (jelly beans, etc.), gummy candy, pumpkin seeds, or anything with whole nuts. Candy wrappers, stickers, small toys, or temporary tattoos can be a choking hazard, for tiny throats. As all parents know, babies and toddlers will put just about anything into their mouths!

Halloween is thought to have originated with the ancient Celtic festival of Samhain, when people would light bonfires and wear costumes to ward off roaming ghosts. The holiday has been observed and celebrated since ancient times and has also become an American tradition; exciting children’s imaginations every October 31st.  If this is your little one’s first Halloween, be prepared, have fun and don’t forget to take lots of pictures to share with family and friends!

Story source: Dina DiMaggio, MD, FAAP, https://www.healthychildren.org/English/safety-prevention/on-the-go/Pages/Easing-Infants-Toddlers-into-Halloween-Fun.aspx

Your Child

Hand Sanitizers Poisoning Young Children

2:00

Poison control centers across America have been seeing an increase in calls about children who are getting very sick from drinking hand sanitizers. Poison control officials are warning parents and school officials about this dangerous trend involving small children, basically getting drunk, on hand sanitizer.

“A doctor called us about a week and a half ago about two cases he saw the same day at the ER,” says Gaylord Lopez, PharmD, director of the Georgia Poison Center. “It was a 5- and a 6-year-old.”

The first patient, a 6-year-old girl, was picked up after school stumbling and slurring her words. She’d also fallen and hit her head. Her mother drove her straight to the ER, where doctors found out she’d eaten two to three squirts of strawberry-scented hand sanitizer from a big container sitting on her teacher’s desk.

Her blood alcohol level was 1.79, almost twice what would be considered the legal limit in an adult.

The second case was a 5-year-old boy, who came in with a blood alcohol level of 2.0. The culprit was hand sanitizer.

Lopez checked the national data and saw these cases were part of an unrecognized trend. In 2010, U.S. poison centers got more than 3,600 calls about kids under age 12 eating hand sanitizers. By 2013, that number had swelled to more than 16,000 calls.

“That’s a 400 percent increase,” Lopez says. “I was surprised more than anyone.”

Many of the hand sanitizer bottles come in bright colors and the sanitizer itself smells like bubble gum and other tasty treats such as lemonade and vanilla. All aromas a child might mistake for the real thing.

The big problem with these products are that they can be anywhere from 40 to 95 percent alcohol.

Drinking even just little bit can make kids intoxicated. It’s like drinking a shot or two of hard liquor.

“You and I don’t have any problem sending our kids with hand sanitizer in their backpacks. But what if I told you that was twice as potent as vodka. That’s like a parent sending a bottle of whiskey or rum to school,” Lopez says.

Alcohol poisoning can cause a child’s heart rate, blood pressure and breathing to slow. They may stagger, seem sleepy and vomit. Their blood sugar can drop rapidly leading to seizures and coma.

Lopez says hand sanitizers are often included in the list of school supplies parents should send to school. He says many adults he’s talked to don’t realize that hand sanitizers contain so much alcohol, or they don’t realize that it’s the kind of alcohol that can cause intoxication.

“I wanted to get the word out. Parents should be aware. Teachers should be aware.”

If you have hand sanitizer at home, keep it out of the reach of young children. If you send hand sanitizer with your child to school- especially during the flu and cold season- use the wipes instead.

You can learn more about hand sanitizer poisoning by calling the American Association of Poison Control Center for free advice at 1-800-222-1222.

If you suspect your child may have ingested sanitizer and is showing any of the above symptoms, take your child to the hospital immediately.

Source: Brenda Goodman, MA, http://www.webmd.com/children/news/20150915/hand-sanitizers-poisoning-kids

Your Child

Tips for Preventing Sports Injuries

1:30

The school year is about to wind down and it won’t be long before many kids will be signing up for summer sports programs.

If you’re child loves sports, there’s not a season where he or she can’t find one to participate in. Sports often help children stay in better physical shape, feel good about them selves and with team sports, enjoy social interaction and competition.

However, all sports have a certain amount of risks associated with them - some more than others. The more contact the sport provides, the greater the risk for a traumatic injury. Fortunately, traumatic injuries are rare and most sport injuries to young athletes are due to overuse.

The most common sport-related injuries are sprains (ligament injuries) , stress fractures( bone injuries)  and strains (muscle injuries).Since children’s bodies are still developing, any tenderness over a bone should be evaluated further by a medical provider even if there is minimal swelling or limitation in motion.

The American Academy of Pediatrics offers these tips to help reduce serious injuries in younger athletes:

•       Time off. Plan to have at least 1 day off per week from a particular sport to allow the body to recover. 

•       Wear the right gear.  Players should wear appropriate and properly fit protective equipment such as pads (neck, shoulder, elbow, chest, knee, shin), helmets, mouthpieces, face guards, protective cups, and/or eyewear. Young athletes should not assume that protective gear will always protect them when performing more dangerous or risky activities.

•       Strengthen muscles. Conditioning exercises during practice strengthens muscles used in play. 

•       Increase flexibility. Stretching exercises before and after games or practice can increase flexibility. Stretching should also be incorporated into a daily fitness plan.

•       Use the proper technique. This should be reinforced during the playing season. 

•       Take breaks. Rest periods during practice and games can reduce injuries and prevent heat illness.  

•       Play safe. Strict rules against headfirst sliding (baseball and softball), and spearing (football) should be enforced. 

•       Stop the activity if there is pain.

•       Avoid heat injury by drinking plenty of fluids before, during and after exercise or play; decrease or stop practices or competitions during high heat/humidity periods; wear light clothing. 

While physical injuries are easier to see, sports-related emotional stress can also cause problems for some children. The pressure to win at all costs can add a lot of emotional stress to children who are more interested in playing than always being first.

Not every team is going to win every game, and there will be times when kids involved in more singular sports won’t have a good day. It happens to everyone at some time or another; ask any pro athlete. Young athletes should be judged on effort, sportsmanship and hard work. They should be rewarded for trying hard and for improving their skills rather than punished or criticized for losing a game or competition.  The main goal should be to have fun and learn lifelong physical activity skills.

There are numerous sports that children can engage in and each one offers its own benefits. As parents, it’s important to encourage our children and keep them as healthy as possible.

Source: http://www.healthychildren.org/English/news/Pages/Tips-for-Sports-Injury-Prevention.aspx

Daily Dose

Summertime Can Mean Snakebites

1:15 to read

Due to wet weather, snakes are being oushed out into the open. What does it mean? There is a higher risk of being bitten by a snake. News reports have families on alert: snakes are being pushed out into the open.  More snakes mean the potential for more snakebites.  I have never treated a patient with a snakebite and thought they were quite uncommon. Unfortunately, a rattlesnake bit a friend of mine (they are out of the hospital and doing well) so upon review I have learned a lot more about venomous snakebites.

There are actually over 45,000 snakebites reported in the U.S. each year. The majority of these are due to non-poisonous snakes and often requires little or no treatment. The days of the old Cowboy movies showing rope tourniquets being applied to the area of the bite and the cutting and “sucking” of the venom are over! Don’t start practicing “movie medicine” if you find yourself dealing with a snakebite. There are about 8,000 venomous snakebites reported each year. Fortunately, with these large numbers and the advent of anti-venom, only six to eight people die each year secondary to a venomous snakebite. Unfortunately, due to their smaller size, children do not handle snakebites as well as adults, and the fatality rate is higher in children.

In the U.S. 99% of poisonous snakebites are by the subfamily pit viper, which includes rattlesnakes, copperheads and cottonmouths (YUCK). The other species of poisonous snake found in the U.S. is the coral snake. I am not going to detail the specific treatment for each type of bite, but if a snake bites your child the first thing to do is to determine if it was a poisonous snake. Non-poisonous snakebites cause minimal pain, no swelling and really only require local wound care with irrigation and antibacterial soap. If the bite is thought to be from a poisonous snake the child should be transported to the nearest hospital. Do not put a tourniquet around the bite, apply ice or suction the area of the bite as these are all thought to cause more tissue damage than benefit.

Pit viper bites typically cause symptoms of swelling, bruising and progression within minutes of the bite. Children typically have more severe symptoms with nausea, vomiting, sweating, muscle weakness and clotting abnormalities, all of which are a medical emergency. Anti-venom should be delivered within four hours of the bite and will be given until improvement in systemic symptoms is achieved. All of this is done in the ICU setting. That’s your daily dose, we’ll chat again tomorrow.

Send your question or comment to Dr. Sue right now!

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