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ISSUE 184 - 5/9/2005
WHEN YOUR CHILD HAS FREQUENT COLDS Some children seem to get one cold after another, having many a parent wondering whether there is something wrong with their child. In general. Frequent colds are completely normal. During infancy and preschool years, children Let an average of seven or eight colds each year, school age children average fi ve to six colds per year and adolescents and adults have about four colds per year. Colds account for more than one half of all acute illnesses with fever. One must distinguish between allergies. Which present with sneezing a lot, clear runny nose that lasts longer than one month but is not associated with fever, and a cold which presents with two to three days of fever ( up to 104 is not uncommon), and runny nose that may alternate between clear and colored. Colds usually last seven to fourteen days. The main reason children get all these infections is that these viruses are new to them and they haven’t vet developed immunity. There are at least 200 cold viruses. The younger the child, the fewer viruses he or she has been exposed to and the more likely they are to develop symptoms. Children who attend daycare, playgroups, church nurseries, or a preschool are directly exposed to more infections than children who don’t and so get colds more frequently. Likewise., the rate of colds triples in the winter when people spend more time crowded together indoors breathing recirculated air. Smoking in the home, car or other closed areas also increases a child’s susceptibility to colds and coughs. Colds are an unavoidable part of growing up and are one infection we can’t prevent or cure! One might think of colds as being an educational experience for your child’s immune system. On the other hand, children with immune system disease don’t get any more colds than the average child. Instead, they often have two or more bouts of pneumonia. Sinus infection, draining lymph nodes or boils and recover slowly from these infections. Tall: to your physician if your family is worried about a particular diagnosis so he or she can discuss this concern with you. When dealing with frequent colds. Look at your child’s general health. If your child is active and gaining weight, you don’t have to worry. Children get over colds by themselves and although you can reduce the symptoms, you can’t shorten the course of a cold. Do watch for secondary infections and see your physician if your child develops an ear infection. Fever persisting longer than three days, thick green drainage from the nose lasting longer thanes days, productive cough, or shortness of breath. Give acetaminophen or lbuprofen for fever and aches. Antihistamines, decongestants and cough suppressants are found over the counter in various combinations and help with the symptoms but should not be used more often than twice per day without consulting your physician. Your child may return to school or daycare once the fever is gone. There are no instant cures for colds and other viral illnesses. More importantly, they are not caused by enlarged tonsils, poor diet. lack of vitamins. bad weather. air conditioners. wet feet or not zipping up the coat! Make sure your child understands that good handwashing and avoiding drinking fountains and drinking from other people’s cups are some of the best ways to prevent the spread of infections. ISSUE 185 - 5/16/2005
IT'S ALLERGY SEASON! Take a look outside these days, and there are definite signs that spring is finally on the way. Trees are budding, flowers are blooming, grass is greener…and eyes are tearing, noses are stuffy, throats are itchy. Here in Colorado, the arrival of spring also heralds the arrival of springtime allergies. Seasonal allergic rhinitis, commonly known as hay fever, affects approximately 35 million people and one out of six Americans. These seasonal allergies are caused by substances caused allergens. Airborne pollens and molds are common springtime allergens. When a person with seasonal allergic rhinitis is exposed to pollens or molds, the persons immune system identifies the allergen as foreign and the allergic reaction is initiated. White blood cells of the immune system produce antibodies, which initiate the release of the chemical histamine. It is histamine, which causes the symptoms of runny nose, watery eyes, itching and sneezing. Early springtime allergies are often triggered by tree pollens, late spring and early summer symptoms are usually triggered by pollinating grasses, while late summer and fall symptoms are usually due to weeds, with ragweed allergy being the most common. Pollen season generally lasts from March until October here in Colorado. Thankfully, there are many treatment options to help allergy sufferers cope. There are both over the counter and prescription remedies available in the form of non-sedating antihistamines, decongestants, nasal sprays just to name a few. Your doctor can recommend which medications are most appropriate for your individual symptoms. It is usually advisable to begin taking medication one to two weeks before allergy season begins in your area. Lastly, Avoiding or lessening your exposure to springtime pollens can also help to control your symptoms and possibly reduce your need for medications. Some recommendations are to stay indoors during peak pollen activity (10 am to 4 pm), keep windows closed on days when pollen counts are high, keep car windows closed while driving, avoid freshly mowed grass which tends to stir up pollens and shower and wash your hair nightly to remove any accumulated pollens. If all else fails, hang in there. Pollens, and the havoc they wreak on allergy sufferers decline substantially after the first fall frost. ISSUE 186 - 5/23/2005
ARE THE PROGRAMS YOUR CHILDREN WATCH ON TV A POSITIVE INFLUENCE? by Helen Danahey, M.D. The average child spends 45 hours per week watching TV. and sees nearly 22,000 commercials each year. Here is what scientists interested in T.V.’s impact on children have found:
Parents must take an active role in choosing what children watch on T.V. Don’t let your child be a couch potato!
ISSUE 189 - 6/13/2005
SUN SAFETY by Lori H. Wertheimer, M.D. School’s out! Summer is finally here. Beautiful bright sunshine beckons us to finally get outdoors. Time to remember the sunscreen. Use of sunscreen protection is one of the principle means of protection from sunburn and skin damage from sun exposure. Sunscreen should be used on a daily basis, because even on cloudy days, eighty percent of the suns rays pass thru the clouds. Sunscreen used on a regular basis can even help repair some of the sun-damaged skin. Long term sun exposure or repeated sunburn substantially increases the risk for skin cancers. This is especially true for childhood sunburns because there is more time for early sun damage to lead to melanoma. Sunscreen should be applied 15-30 minutes BEFORE going outdoors in order to give the sunscreen time to take effect. Use sunscreen with a minimum SPF of 15 and apply liberally to all sun exposed areas, paying special attention to the face, ears, hands and arms. Coat skin liberally. A “shot glass” full is the amount needed to adequately cover your body. Sunscreen should be applied every two hours and after swimming or heavy perspiration. Don’t forget to protect your lips with an SPF 15 or greater lip balm. Sunscreens that contain ingredients such as benzophenones, oxybenzone, sulisobenzone, Titanium dioxide, zinc or avobenzone (Parsol 1789) offer more broad-spectrum coverage against both UVA and UVB rays and are preferable. Sunscreen can be applied safely to infants as young as 6 months but use special care around their eyes, hands and mouth. Pediatricians recommend keeping infants out of direct sun as much as possible, and keeping their skin protected with clothing, shade, wide brim hats and sunglasses. This is good advise for all of us! Sunburns, if they do occur, can be treated by drinking plenty of fluids, acetominophen, cool baths and moisturizers. Call your pediatrician for sunburns in young infants or sunburns that are accompanied by fever, severe pain, headache, nausea or vomiting. So get out there and enjoy the sun safely! ISSUE 190 - 6/20/2005
BED WETTING by Helen Danahey, M.D. Bed wetting is a very common occurrence in children. It can affect up to 40% of three year olds, 10% of six year olds and 3% of twelve year olds. Most of these children have inherited small bladders, which cannot hold all the urine produced at night. In addition, they don’t wake up to the signal of a full bladder. Physical causes are very rare, and your physician can easily detect them. Emotional problems do not cause bed wetting, but they can occur if the bed wetting is mishandled.. Bed wetting is an unconscious, uncontrollable event and a child should never be punished for it. Most children who are bed wetting overcome the problem between ages 6 and 10. Even without treatment, all children eventually get over it If your child is over 6 years of age and the bed wetting is bothering him or her, you may want to make an appointment with your physician to further evaluate and consider treatment options. In the meantime, if your child wets the bed frequently, here are some suggestions that might help. Encourage daytime fluids, especially in the morning and early afternoon. Encourage your child to hold their urine as long as they can. There are two signals produced by the bladder. The first signal can usually be overridden. This allows the bladder to stretch and hold more urine. The second signal usually indicates the bladder is full and its time to go! Discourage evening fluids. Don’t allow our child to drink more than 2 ounces of fluid during the 2 hours before bedtime. Discourage fluids containing caffeine including colas, Mountain Dew, tea, chocolate milk and coffee. Foods containing chocolate also have caffeine and should be avoided, especially in the evenings. Use a plastic or rubber mattress cover and have your child wear extra thick underwear in addition to pajamas. Encourage bladder stretching exercises by having your child hold their urine as long as possible during the day. Measure the size of the bladder by having the child hold it as long as he or she can, the catch the urine in a plastic 2 cup measuring cup. A child’s normal bladder capacity is I or more ounces per year of age. See if they can increase the amount they go over a period of time. Encourage them to wake up during the night if they feel the urge to go or even if they feel the least bit wet. A child should NEVER be punished for wetting the bed. But they should feel responsible for solving the challenging problem. When they are ready to seek help, make an appointment with your physician. If your child is otherwise normal, your doctor can provide you and your child with a variety of options to help solve the bed wetting. These could include the use of a bed wetting alarm, a self awakening program, or a nose spray containing a hormone called DDAVP which gets into the blood stream via the mucous membranes in the nose and tells the kidneys to produce less urine at night. ISSUE 191 - 6/27/2005
HOT WATER SAFETY by Helen Danahey, M.D. More than 37,000 children in the U.S. are treated every year for scald burns resulting from hot liquids and hot foods. Third degree burns can occur in ONE second in hot water at a temperature of 156 F, causing irreversible scarring and requiring hospitalization and skin grafting. About 1/3 of all burn victims are children. Many of these burns could be avoided with a few common sense precautions. Here are some suggestions to help you prevent hot water burns in your house. Turn down the hot water heater temperature to 120 F. If you do nothing else, do this! When filling the tub for a bath, turn the cold water on first. When the tub is full, turn off the hot water first then allow the cold water to run long enough to cool the spout. Before placing your child in the water, test the water with a temperature gauge. 90 F is comfortable and safe. Never let a child enter the bathtub while the water is running. Install mixing valves with built-in temperature and pressure regulators to prevent scalding when water is diverted by a toilet, dishwasher, washing machine or sprinkler being turned on or off. Children left alone in the bath may drown in as little as one inch of water or they may turn on the hot water and get burned. Never leave them alone in the bathroom or any area where they can turn on a hot water faucet. Turn off the phone or turn on the answering machine while you are with your small children during bath time so you won’t be tempted to leave them alone. If you use a vaporizer, make sure you set it up high enough that your young child will not be tempted to put their hand in the vapor as it comes out of the machine. And while it has nothing to do with water, curling iron burns are one of the most common childhood burns I personally see. Children are fascinated with that long tube that makes your hair curly and have no idea that it’s hot. Keep your hot curling iron out of their reach. Unplug it and put it up and out of reach when you’re finished. You will save your child much pain and misery. ISSUE 192 - 7/4/2005
INSECT REPELLENTS by Lori H. Wertheimer, M.D. One of the joys of summer is longer days and more hours of sunlight to enjoy the long summer days. Unfortunately, mosquitoes also enjoy being out and about during the long summer evenings. A common concern this time of year is the safety and efficacy of various insect repellents in preventing mosquito bites. Insect repellents help people reduce their exposure to mosquito bites that may potentially carry serious viruses such as West Nile virus. Mosquitoes are most likely to be active around dawn and dusk. It is important to apply insect repellent if you and your children plan on being outdoors during this time. The most effective insect repellents contain a chemical called DEET ( N,N-diethyl-m-toluamide). Mosquitoes are attracted to people by their skin odors and carbon dioxide from their breath. DEET makes people less attractive to mosquitoes, but does not kill them. The higher percentage of DEET, the longer the product stays effective. Choose a repellent that provides protection for the amount of time you will be outdoors. Some non-DEET containing products have been studied and do not seem to offer the same level of protection or last as long. DEET has been shown to be safe in children as young as two months of age. When applying repellent to children, apply the repellent to your own hands and then rub them on your child. Avoid children’s eyes and mouths. Do not put repellent on your child’s hands as they often put their hands in their mouths. You can protect skin covered by clothing by applying the repellent directly to your child’s clothes. It is safe to use both repellent and sunscreen together. However, since sunscreen needs to be applied more frequently than repellent, we recommend using each product separately, rather than a combined repellent/sunscreen product. Your pediatrician is a good source of information for safe and effective use of insect repellent products. Always remember to call if you have questions. ISSUE 205 - 10/3/2005
INFLUENZA by Helen Danahey, M.D. The influenza vaccine is now available. It is recommended for all children age 6 to 23 months, and anyone over 2 years of age with asthma, chronic lung disease, diabetes, renal disease, developmental disabilities, spinal cord injuries, seizures or any other debilitating disease that requires oxygen or frequent visits to the physician’s office. Also, any household contacts of children less than 6 months of age may receive the influenza vaccine. Please call now to schedule an appointment to receive the flu vaccine. There is often confusion when one mentions a vaccine for “the flu”! Unlike vomiting and diarrhea which is often called the stomach flu, influenza is a respiratory infection consisting of sudden onset of high fever, chills, cough, congestion, watery red eyes, headache, generalized muscle aches and pains, rapid heart rate and difficulty getting out of bed. Children have the highest attack rate – anywhere from 15 to 45% of children are affected every year. Influenza begins to spread through our area in December and ends around May. It is spread from person to person and is highly contagious from 24 hours before the onset of symptoms to one week after the start of symptoms, thus making it very difficult to avoid. The time from exposure to the development of symptoms is 1 to 3 days. Influenza is an orthomyxovirus and there are three antigenic types – A, B, and C. Influenza A has far worse symptoms than B. And C usually doesn’t cause disease in humans. The most important way to prevent Influenza is to vaccinate. There are several recommendations for vaccinations and several options. The injectible vaccine is recommended for all ages. Children under 9 years of age who have never been vaccinated for influenza will need a booster 1 month after the initial vaccination. For healthy people age 5 to 50 years, a live attenuated cold-adapted influenza virus vaccine is available in a nasal spray called Flu Mist. We will carry both this year. The influenza vaccine is contraindicated for anyone who has a history of severe allergic reaction to chicken or egg products or have had a previous reaction to the fl u vaccine. If you don’t get the vaccine, there are several medications that treat influenza. They work best, however, if started in the first 24 to 48 hours of symptoms to reduce severity and length of the disease. These medications include Amantadine (Symmetrel) Rimantidine (Flumadine) and Oseltamivir (Tamiflu). For those who are exposed to influenza in the household, two of these medications can be used to prevent other family members from getting the fl u. To diagnose flu, there is a rapid test done on nasal secretions that can be done in the doctor’s office. Results can be obtained in 10 minutes. ISSUE 207 - 10/17/2005
WHAT IS CROUP? by Helen Danahey, M.D. Croup is a viral infection that commonly affects children this time of year. The virus attacks the vocal cords, the voice box (larynx) and the wind pipe (trachea) causing a distinctive cough that is tight, low-pitched, and barky. The cough usually gets worse at night and better during the day with the 2nd and 3rd nights being the worst. The younger child has a smaller airway and is more likely to have significant respiratory symptoms with croup. They often develop stridor - a harsh raspy, vibrating sound when the child breathes in. Breathing in can become very difficult and can cause stridor with every breath. It is usually only present when crying or coughing when the croup is mild. Croup usually lasts for 5-6 days and worst symptoms are seen in children under 3 years of age. Treatment at home for croup consists of starting a humidifi er at night close to the bed. Avoid giving any antihistamines. It is okay to give Robitussin products to help with the cough. I recommend clear liquids especially in the evening before bedtime and cold fluids will help decrease the inflammation in the trachea. If your child is having difficulty sleeping because of difficulty breathing, then placing them in the bathroom with a hot shower running may help or bundle them up and take them outside in the cool night air. I often tell parents to head for the emergency room if your child is having difficulty breathing. You can always turn back home if they get better on the way. By all means, avoid smoking around your child as smoke can make croup worse. Call our office immediately if breathing becomes difficult, if your child develops drooling, spitting or great difficulty swallowing or your child develops retractions (tugging in) between the ribs. It is important to schedule an appointment if the fever lasts more than 3 days or the croup lasts more than 10 days. Oral steroids may be helpful in reducing the inflammation for those children who get recurrent croup. Schedule an appointment with your doctor first. |
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