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Parenting

Family Road Trip!

1:45

With gasoline prices at a reasonable level, many families may choose to skip the hassles of flying and opt for a road trip this summer.

While it may be true, “The best made plans of mice and men often go awry”, it’s still necessary to prepare as best you can for a family road trip; whether it’s to the Grand Canyon, the beach, the grandparents or all of the above.

Before the trip, make sure that the car is in good condition. Have it checked out by a mechanic and any trouble spots fixed. The tires should have plenty of tread and the recommended amount of air for highway travel.

Once you’re ready for the big trip, here are some suggestions to help make it a little less stressful and more fun.

Packing the car:

·      Pack an easily accessible small bag that contains clothes for the next day, an extra change of clothes (for spills), PJs, a toothbrush, and anything else you need for that day and night. It will be much easier to grab than trying to rummage through the big suitcase.

·      Take your toddler or young child’s blanket and pillow. This is extra important if your road trip includes an overnight stay. Kids like their own stuff, particularly at bedtime in a strange place.

·      Babies and toddlers drop, spill, and spit up. Keep a roll of paper towels and a box of wipes in the front seat for easy cleanups. Keep a garbage bag handy too.

The Ride:

Boredom is probably the biggest instigator of trouble for kids packed into a tight space. Prepare to fight boredom with a few tricks of your own.

·      Snacks. Although it only provides a short respite, any quiet time is appreciated. Go light on the sugar – too much can backfire. Choose fresh or dried fruit, whole grain muffins, popcorn, cheese sticks, milk etc. In other words, something healthy and age appropriate.

·      Portable DVD players. These can be a lifesaver. Load up on your children’s favorite movies and don’t forget the headsets if you have different aged kids. Eleven year-olds and three year-olds don’t typically share the same taste in movies and video games. New DVDs they haven’t already seen are a bonus. Let the kids pick out what they want to watch ahead of time. And, make sure you have an extra set of headsets; you know someone is either going to lose a pair or break a pair. That’s a given.

·      If there is more than one adult traveling – one of you can get in the backseat for a while. A little face-to-face contact, some patty-cake, and a few tickling games go a long way toward distracting a cranky baby or a bored toddler.

·      Make sure some favorite toys are within easy reach. You might add a new toy or two your little one hasn’t seen before. Remember etch-a-sketch? Tech savvy youngsters are coming up with some amazing etchings these days!

·      Don’t forget to plan for stops. You'll have to stop for feedings, diaper changes, and stretching breaks. You'll be much less stressed if you accept that it may take twice as long to get there as it did in your pre-kid days and plan accordingly. Pre-teens and teens are going to need to move around too. Besides, sitting for an extended length of time isn’t good for anyone.

Oh, and someone is going to need a potty break soon after the pre-arranged stop has happened. Be patient and pull over, it’s really a lot easier and less taxing than a yelling match about “why didn’t you go when we stopped 30 minutes ago?”

·      If your trip requires an overnight stay somewhere, think about booking a motel that has an indoor pool. It may cost a little more, but it's something to look forward to, and it will help your children sleep better. If they sleep better, you’ll probably sleep better too.

·      Don’t forget about books (or e-books) for the kids that like to read. Coloring books for the younger ones, and brush up on some travel games the whole family can join in on. Here are a few tried and true suggestions. I Spy (I spy with my little eye, something red.) The License Plate Game. Keep a list of all the different state license plates you see. The goal is to list as many states as possible- although Hawaii might be a real challenge anywhere but in Hawaii. The Memory Game. Start a story with one sentence. The next person has to say that sentence then add his or her own sentence to the story. The story can change pretty quickly as everyone tries to remember all the previous sentences and then come up with a new one.

While road trips can be a challenge, they are always an adventure and often become fond memories, as kids grow older.

Have fun this summer and don’t forget to take lots of pictures!

Story source: http://www.parents.com/fun/vacation/ideas/traveling-with-kids-ultimite-guide/

 

Daily Dose

More Zika Virus Cases

1:15 to read

I have been receiving a lot of phone calls from patient families, especially from mothers who are either pregnant or thinking about becoming pregnant, with their concerns and confusion over the Zika virus.  Several of these women have trips scheduled to Mexico and the Caribbean in the coming weeks, and called to ask what they should do?

While I don’t want to be an alarmist, I do think there is real concern that this virus seems ia spreading amid new reports of countries who have identified the Zika virus and associated microcephaly in newborns.  The list of countries grows daily, and in fact, the CDC website has being updated with a new map showing the distribution of the virus.  

The Zika virus is transmitted to humans by the bite of an Aedes mosquito that has been infected by the virus.  There is no human to human transmission, but a mosquito could bite an infected person and then become infected itself and go on to bite another human.  It is a cycle.  Travelers to Zika-affected countries will ultimately bring the virus back to the United States where it is expected to spread to states with warmer and humid climates (such as TX, FL, MS, LA and HA) as summer approaches.

The CDC has already issued a warning for pregnant women and those who are planning to become pregnant to avoid travel to the 20 countries ( and growing) who have known Zika virus. As I told my patients, is it worth it to go on vacation or to attend a wedding and risk ( even the slightest risk) becoming infected with this virus and having a child who is born with microcephaly (small head) and abnormal brain growth??? Short of wearing mosquito netting to cover yourself from head to toe, copious amounts of DEET insect repellent and staying inside (which is not foolproof) …I  just think it may be time to re-think plans to travel to these areas while more research and data is being gathered.  The World Health Organization and the CDC have researchers investigating all aspects of Zika virus, including trying to develop a vaccine, but all of this takes time. 

While for most people the Zika virus causes a mild illness with headache, fever, pink eye and joint aches, the effects on the unborn baby may be devastating. The CDC has also just issued guidelines for OB/Gyns who may see women who are pregnant that have returned from a trip to one of these areas with Zika and show signs of a “viral infection” with symptoms as above. In this case, the recommendation is that a blood test is done to confirm Zika virus and if the mother is positive she should have serial ultrasounds (every 3-4 weeks)  performed to monitor the baby’s head growth. Unfortunately, not all pregnant women who may be infected with the virus will have symptoms ( p to 80% of people may not feel ill ), and their babies could possibly be affected as well.  While it seems that the virus may be more likely to affect a fetus during the first trimester, it is difficult to pick up microcephaly on ultrasound before the second trimester.

So….this story continues to evolve and new recommendations should be expected as more information is gathered. But my advice continues to be…”why risk it?” . To have any concern, doubt,  or worry about exposure is enough for me to advise my patients to change their plans!

Stay tuned. This story is not going away…..

Daily Dose

Measles Exposure on an Airplane

Public health officials are warning passengers of possible exposure to measles on an airplane. Dr. Sue talks about how infectious diseases are just a plane ride away. I know you have read previous blogs on immunizations.  I have re-iterated many times, that despite the perception of some, many vaccine preventable diseases have not been eradicated from the United States and some may just be a “plane ride away”.

This is now the issue with a recent case of measles that occurred  in an unimmunized woman from New Mexico who was returning from a trip. The woman developed an illness, later confirmed to be measles, as she returned from London and subsequently travelled through no less than 4 different airports in the United States. The issue is that this one traveler, exposed many individuals on multiple airplane flights, as well as in 4 different airports.  As Dr. William Schaffner, an infectious disease specialist at Vanderbilt University stated, “the potential exposure of so many travelers in airport terminals is a cause for concern”. While most Americans have been immunized against measles (with the MMR vaccine), there are still those who remain unimmunized either due to the fact that they are too young, or because they choose not to be vaccinated (as had this woman who developed the “index case” of measles). Children do not receive their MMR vaccine until after their first birthday, and then receive a booster dose of MMR between the ages of 4–6 years. Therefore, a child who is less than 12 months of age, who may be up-to-date on all of their immunizations but is too young for MMR, may have been exposed to measles if they had been sitting within 5 airline rows of the woman who had undiagnosed measles. The same holds true for infants who might have been next to the woman in a security line, or at a Starbucks, or in the newsstand as she passed through these 4 various airports. It is also possibly an exposure for anyone of any age, who has never been immunized against measles, or who has not had the disease (older individuals). All of these exposures would have been accidental and never even noticed unless an exposed person subsequently develops measles. The incubation period for developing measles after an exposure is between 8-12 days, and measles will present with symptoms of fever, cough, runny nose, red eyes, and a body rash. So….here is just another example of the spread of an infectious disease.  This case involves travelers in airports from London, England, to Washington D.C., to Baltimore, to Denver, and ultimately to Albuquerque.  Now we need be alert for any further cases of measles in next several days and weeks.  Remember, measles is a respiratory virus, and it is spread via coughs and sneezes, and the virus may last in the air for up to 2 hours, without any one suspecting they are being exposed. If your child has not been immunized, this is a good reminder, run don’t walk, and get that MMR. That’s your daily dose for today.  We’ll chat again tomorrow.

Daily Dose

Travel Healthy During The Holidays

1:30 to read

With all of the viruses and illnesses popping up, I am getting a lot of questions about travel plans. Many parents are asking "should I travel with a sick child?"

In my opinion, we all must continue our lives, even in the face of flu fear, and a trip for a toddler to see his/her grandparents is important for everyone. We should all make our plans for trips to the visit family. While traveling, everyone needs to practice good hand washing and cough hygiene and be prepared to change plans if a family member is ill. Traveling while being acutely ill and running a fever is only exposing everyone else to you or your child’s illness and seems somewhat selfish.

None of us should be traveling within 24 hours of having a fever (that means without the benefit of fever reducing medications), and isolating a child or parent for several days will be better for everyone, than traveling while sick. Think of the greater good! With that being said, I am not a proponent of a newborn under the age of 2 months traveling, unless out of necessity.  I have always been fairly conservative about exposing a baby to crowds and closed in spaces (malls, movies, restaurants) and airplanes certainly fit that description.  With the uncertainty of this year’s flu season it seems like a really good year to stay put. A newborn’s immune system is still fragile, and the more often a newborn is exposed to large groups of people,  the better chance they have of getting sick in the first 6 – 12 weeks of life. This must have been what was called “confinement” in the olden days.

Staying home and enjoying the simplicity of life, with the excuse, “I have a newborn baby” gets you out of so many invitations and situations.  This is probably the only time that you can get away with that line, as after several months the realities of work, family commitments, and day to day living return and often that means with baby in tow. We all do what we have to do, but if you don’t have to take your newborn baby on a flight this holiday season, I would not. I also know that not everyone will abide by the “Do Not Travel While Sick” mantra, and exposure to illness is not uncommon during airline travel. There is not a way to sit 3 – 6 feet from another person on a plane! This is probably the time to have family come to you, and to make sure that they have all had their seasonal flu vaccines, and when available, the swine flu vaccine.

I don’t have a crystal ball to see how this winter season is going to unfold, but I do know that a sick infant has a better chance of ending up in the hospital if they develop a flu like illness.  The holidays will be a happier for all, if infants stay close to home and leave the travel to those with older children.

That's your daily dose for today.  We'll chat again tomorrow. Send your question to Dr. Sue!

Daily Dose

Family Road Trip with the Dog!

1.15 to read

Over the weekend, I had flashbacks of traveling with my children.  Why you ask? Because I am riding in our car with the family dog as the passenger! Now that the kids are out of the house, we find ourselves with a yellow labrador (as our boys say, “we are a BIG DOG family”), and she doesn’t like to be left behind. 

You know how your young children can sense that you are leaving?  If you are a working mother, you know that at a very early age your child seems to know the difference between your stay at home clothes and your work clothes.  If you have teens they also sense that you are preparing to leave and that text message trail  of “parent’s not home” most likely starts.   

At any rate, our dog is just like that. She knows when it is time for a walk, (she sees me putting on my tennis shoes), She gets confused on a day that I choose the gym over her! She also knows when the suitcases come out that something is up. She will head toward the garage almost as if she knows that there is a car trip ahead. 

So...just like young parents packing for a road trip, I am once again having to remember to pack but for the dog!  Dog food, treats (mum-mums for dogs?), chew sticks for distractions and of course her leash. Oh, can’t forget the favorite pillow either.   

We coax her (just like a 4 year old) to “potty” one last time before we load her into the car.  She gets the whole back seat (folded down for her of course). No car seats!  Too bad they don’t make iPad for dogs. I recently saw an ad for a cable TV station for dogs which will keep them entertained while their owners are out. It can’t be long before I can load a movie for her in the car.  (I may be on to something) 

Now, once in the car all is well for about 30 minutes as she gets used to the ride and then she starts to WHINE!  Do you need to potty? Are you car sick? Are you bored? I swear it is just like a flashback of 25 years ago when I was trying to figure out why my child was crying while strapped in their carseat.   Should we stop?  So, we pull over, but it is also now starting to rain.  We jump out and of course she looks around, doesn’t like the rain and heads straight back to the car without “going potty”! Years ago we had a very similar trip where after 4 different stops our child finally just gave up and threw up the minute we got him back in the car! That is still a vivid memory. 

After another “pit stop” our dog finally went to sleep, but of course we are approaching our destination! I wonder if I can carry her to bed without waking her up. Doubtful.  But I do love a family road trip with kids and/or the dog. It just feels like summer to me. 

Daily Dose

Plane Travel With Your Child

The best way to travel with a baby on a planeI had a question from a parent via our iPhone App about traveling overseas with a 4 month old.  I think it is actually quite an easy time to travel with an infant. 

By this age a baby not only is having a more regular sleep and wake schedule, they are also at the cutest age and are typically fairly easily entertained. They are so sweet and happy that it is also an good time for others to help you.  What person doesn’t want to come to your aid when you have a fussy infant.  You will see as your child gets older, there are less “helpers” for a crying toddler.

I also think that this is a good time to travel as your child has presumably already received their 2 and 4 month immunization series and have mounted and antibody response to some serious illnesses.  With that being said, an infant is not immune to viruses like RSV and flu, so if possible I would schedule travel in early fall, spring and summer and avoid the winter.  I realize that that may not be do-able, but for a vacation I like travelling with babies during “non-sick” season. It is also easier to fly long distances with an infant (lap child) when the flights might be less crowded and you can get a bulk-head seat which has “bassinets” or maybe an extra seat next to you that your infant car seat will fit in for traveling.  It can be expensive to buy a seat for an infant, and holding a baby while you are trying to sleep too just doesn’t work.  Hopefully you will be traveling with two parents to share the duty during an overnight flight. Lastly, I get a lot of questions about needing to have a baby “sucking” for take-off and landing.  I really don’t think that is necessary, especially if your infant is sleeping.  When I am travelling I often see parents awakening a sleeping baby once the pilot announces  “we are preparing to land”.  The baby wakes up, and starts to scream,  and then the parents are convinced that the baby’s ears hurt.  I really think the baby is tired and unhappy due to  being awakened. If they are awake and want to nurse , take a bottle or a pacifier that is fine but remember, “never wake a sleeping baby”.  I realized with my own children,  If I was “lucky” while they were all infants, we could fly  for 3 -4 hours while they slept and never peeped, either  for take-off or landing. On other trips we were not quite as fortunate and had a fussy baby mid flight, with presumably no ear problems. I think the “ear issue” is highly overrated. Their ears are no different than ours! Best time to fly with babies is really between 4 months and 12 months of age.  Once they are walkers it gets a lot harder!!  I would not attempt an overseas flight with a 1–2 year old, but that is me. I would wait till they were 3! That's your daily dose.  We'll chat again tomorrow! Send Dr. Sue your question!

Daily Dose

It's Vacation Time!

1.15 to read

We are getting ready to go on a vacation and I am getting excited. At the same time, I am missing those family trips that we used to take every summer. You see, the difference is that this is a vacation......no kids.  

As young parents we used to plan summer vacations with all of the children, and this usually involved us packing up the car (with way too much stuff) and driving to the beach, the mountains or to see the grandparents.  We had “stuff” piled in the back of the minivan, strapped on top with a carrier and all of our boys safely secured in their appropriate car seats/seat belts.  This was “pre” DVD in the cars as well, so as the kids got older we some how “rigged” a portable video player so the kids could watch a movie in the car.  

As the boys got older they somehow figured out how to add their Nintendo to the mix and there seemed to be wires throughout the car.  I am not sure that all of this was especially safe, but the kids assured us that they knew what they were doing.

Much of our “vacations” involved loading and unloading the car and keeping the peace between the three boys during the time we were traveling. In between, during the “vacation” we were always busy planning the days activities, swimming, mountain biking, hiking, surfing, golfing......the list was endless but exhausting. But you know what? It was all fabulous!!!! What wonderful memories those family trips were, but I am not sure they were a “vacation”.  My patients would ask if I was “taking a vacation” during the summer and I learned to reply, “ we are taking a trip”.

 I am now going on vacation and we will have a lot of time to ourselves, and don’t have an action packed agenda everyday.  Makes me nostalgic for the chaos and the family trips.  It is funny that you begin to forget how you longed for a “vacation” when you were a young family and now I wish that the kids could all come with us.    

So...pack up those cars and load up the kids and enjoy wherever your summer “trip” may take you. Take lots of pictures and try not to think that you are more tired when you get home than when you left.  It is another one of those times as a parent that goes by all too quickly. 

Happy Summer Vacation!

Daily Dose

Treating Kids Who Suffer with Motion Sickness

1.15 to read

If you’re planning the perfect getaway this summer with your family, don’t let motion sickness spoil your plans. Did you know 58% of children between the ages of four and 10 experience the symptoms of motion sickness? 

Motion sickness occurs when the inner ear, eyes and other areas of the body that detects motion, sends a mixed signal to the brain. 

Your child may begin to feel queasy with the initial nausea followed by a cold sweat, fatigue and loss of appetite. A younger non-verbal child may become restless, pale, sweaty and cries. At some point these symptoms are usually followed by vomiting. By then you have figured it out!

The best treatment for motion sickness is prevention! If you have already experienced motion sickness with your child then plan ahead.

If your child is over the age of two, place them in their car seat in the middle of the backseat and face them forward. Provide a small nutritious snack prior to the trip rather than a big meal, and avoid dairy.

Open the windows and do not let your child play video games or read while the car is in motion. Try to distract them by singing or talking. Sleeping may also be helpful, so at times you may plan your trip around naps and bedtime.

Frequent stops for a child who is feeling sick are a necessity. Letting them lay flat for a few minutes while the car is stopped and even applying a cool rag may make them feel better. Try small sips of carbonated beverages or crackers to help the nausea.

Expect the unexpected and be prepared.  Bring along zip lock bags and hand wipes in case of emergency. This will make everyone in the car a little happier.

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

Daily Dose

Vacation or Trip?

1.00 to read

Traveling with children during the summer may be termed a “vacation” but as most parents realize it is really a “trip”.  

According to the dictionary a vacation is “a period of suspension of work, study or other activity usually used for rest, recreation or travel.”  For most parents I do not see any rest in the planning or execution of a family vacation.  Lots of fun and so many great memories and stories from family vacations and adventures, but not always a restful period, hence the term family trip. 

When traveling with little children it takes a village of “stuff” to get away. Just the list alone takes weeks to prepare:  the car seat, pack and play, toys, favorite blanket and pillow and of course snacks for every possible situation. We once left several bags on the median at a major airport as we loaded the rental car. We did remember the carseat and child, (only had one at the time), but after a day I kept asking “where is the .....?” only to realize that we had left several suitcases behind. Unbelievably, they had been sent to lost and found and were flown on to us!! These days they would have blown them up! We were definitely “rookie” parents. Live and learn!  

Once a child is older, they too want to make a list, and I can remember my boys appearing at the door as we lined up the luggage with sacks full of their “stuff”, all of which was important and could not be left behind. Trying to condense and choose what went and stayed behind (usually involving some tears) was sometimes exhausting and we were not even loading the car yet!  Even worse for plane travel as you had to condense further, and now with bag charges it costs a fortune to just check bags. I guess the new rule may be, “everyone gets one favorite item”, but that too must be a lengthy discussion, so plan ahead. 

As the kids get older they just want to take their electronic stuff, but I think one of the points of a family trip is to “engage with one another”, so limiting electronics and having rules for how long and when they can be used is equally important.  That discussion never seems to go as planned!  The good news/bad news about technology. Some people pay big bucks to go where there is not any internet service and then the discussion is moot. 

So, I hope wherever you are traveling on your family TRIP, that you are “relaxed and resting” while navigating the highways and skyways with your children. 

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