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July 09, 2013
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Swim Safety
In the first ten seconds of being submerged, a child can inhale enough water to cause symptoms of near drowning (Schmitt, 2010).  Therefore, water safety is extremely important throughout the summer months.  Parents with infants or toddlers should practice “touch supervision” and be at least within an arm’s distance away (AAP, 2013c).  For older children, parents must pay constant attention and have no distractions such as cell phones, socializing, or drinking alcohol.  The supervising adult should also know how to swim (AAP, 2013c)!  The AAP recommends swim lessons for children as early as 1 year of age.  Studies have shown that toddlers are less likely to drown if they have had prior swim lessons (Schmitt, 2010).  Also, remember to enter water feet first and check how deep the water is; spinal cord injury, brain damage, and death can occur to those who dive into shallow waters (AAP, 2013c).

Insect Bites (AAP, 2013a)
Insect repellent with DEET protects against insects from biting the skin and may be used for children 2 years of age and older.  The amount of DEET in these repellents ranges from 10-30%.  DEET of a lower concentration such as 10% may protect for about 2 hours whereas, 24% may provide protection for up to 5 hours.  DEET higher than 30% does not offer additional protection.  It is not recommended to use products that combine DEET and Sunscreen as the DEET can make the SPF less effective.  Don’t forget to wash all insect repellent off when your child comes back inside for the night, and avoid areas that attract insects such as stagnant water, garbage cans, and flowerbeds.  Dress your child in lightweight long clothing and avoid bright, flowery prints.  Lastly, do not use scented soaps, perfumes, or hairsprays before going outside.

Ticks
Check your child’s skin for ticks at the end of every day.  Ticks do not jump or fly, rather, they crawl onto the skin.  They are usually found in underbrush and shrubbery, and you should be careful when picnicking, hiking, or playing in tick-infested areas.  A tick bite is painless and does not itch, so you may not notice when a tick has attached to the skin (Schmitt, 2011a).  Tick’s like dark places such as in the hair, on the scalp, armpits, behind the knees, neck, or groin.  If you find a tick, it should be removed right away with tweezers.  The area should be washed well with an antibacterial soap after removal.  Remember, a tick must be attached for 24 hours or more to transmit Lyme disease (Schmitt, 2011a).

One way to protect against ticks is using Permethrin, which is sprayed onto clothes (Not skin).  Duranon and Permanone are examples of products that contain Permethrin.  Again, this product should be sprayed onto clothing only: short sleeves, pants cuffs, hats, and shoes (Schmitt, 2011a).

Tiny deer ticks transmit Lyme disease.  Of children bitten by deer ticks, only 1% gets Lyme disease (Schmitt, 2011b).  Symptoms of Lyme disease may occur days to weeks after the bite, averaging about 11 days (Burns, Dunn, Brady, Starr, & Blosser, 2009).  A bull’s eye rash around the bite is the first stage of Lyme disease.  As the disease progresses, your child may develop more bulls eye-like rashes on the skin, as well as flu-like symptoms including: fever, headache, sore-throat, chills.  Joint pain is one of the later symptoms of progressive Lyme disease.  Fortunately, Lyme disease can be treated with a course of antibiotics (Burns et al., 2009). 

All-Terrain Vehicle
A reminder: Children who are too young to have a driver’s license should not operate off-road vehicles.  In fact, the nervous systems and judgment of children are not fully developed and so, it is particularly dangerous for children under 16 years of age to use these vehicles.  All riders old enough should wear helmets, sturdy shoes, eye goggles, and reflective clothing (AAP, 2013b).

 

References

American Academy of Pediatrics (AAP). (2013a). Insect repellents. Retrieved from http://www.healthychildren.org/English/safety-prevention/at-play/Pages/Insect-Repellents.aspx

American Academy of Pediatrics (AAP). (2013b).  Summer safety tips. Retrieved from http://www.healthychildren.org/English/news/Pages/Summer-Safety-Tips-Staying-Safe-Outdoors.aspx

American Academy of Pediatrics (AAP). (2013c). Water safety and young children. Retrieved from http://www.healthychildren.org/English/safety-prevention/at-play/Pages/Water-Safety-And-Young-Children.aspx

Burns, C.E., Dunn, A.M., Brady, M.A., Starr, N.B., 7 Blosser, C.G. (2009). Pediatric primary care (4thed.). St. Louis, MO: Saunders Elsevier.

Schmitt, B.D. (2011a). Insect bites. Retrieved from http://www.cpnonline.org/CRS/CRS/pa_insectis_hhg.htm

Schmitt, B.D (2011b). Lyme disease. Retrieved from http://www.cpnonline.org/CRS/CRS/pa_lymedis_hhg.htm

Schmitt, B.D. (2010). Swimming programs for infants or toddlers. Retrieved from http://www.cpnonline.org/CRS/CRS/pa_infswim_hhg.htm 

April 09, 2013
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Allergic Rhinitis

Spring is here, and the warm weather is definitely lifting our spirits!  Hopefully, you and your children are able to spend more time outside over the next several months.  While we all love the extra time outdoors, unfortunately, many of us will experience some seasonal allergy symptoms along the way. 

The nasal passageways are particularly vulnerable to inhaled allergens, resulting in an allergic response.   The response may include the following:

  1. Clear nasal discharge (Schmitt, 2011)
  2. Itchy nose with sneezing (Burns, Bunn, Brady, Starr, & Blosser, 2009)
  3. Itchy, watery, and pink eyes (Schmitt, 2011)
  4. Itchy throat (Burns et al., 2009)
  5. Sinus or ear congestion (Schmitt, 2011).
  6. Mouth breathing, snoring, nasal speech (Burns et al. 2009)
  7. Hoarseness to voice (Burns et al., 2009)

Typical allergens include pollen of trees, grasses, weeds (ragweed and other weeds), and outdoor molds (Burns et al., 2009).  There can be geographic variations, as well as climate changes, that will determine when allergens are released into the environment (Burns et al., 2009).  For example, in April and May, pollen causing hay fever is typically from trees.  In June and July, the pollen is usually from grass.  From August until the first frost, the pollen is from ragweed (Schmitt, 2011).  Allergic Rhinitis is a chronic condition that will probably come back every year during pollen season.  These symptoms usually begin to occur in children 3 years of age and older (Burns et al., 2009). Therefore, it’s important to know how to control the symptoms. 

Avoiding exposure to the allergen as much as possible is key to minimizing symptoms (Burns et al., 2009).  It is important to wash linens in hot water weekly.  This will eliminate any allergen that your child has brought inside or to bed with him that remained on his clothes or skin from the day.  Of course, a bath at night (remember to wash hair too!) will be helpful to remove the allergens directly off the body (Schmitt, 2011).  When it is windy outside, it would be best to stay indoors.  Close the windows to prevent wind blowing allergens into the house.  It would also be helpful to avoid long drives with the windows down in the car.  Avoid playing with pets that have been outside all day.  Lastly, use an air conditioner rather than a window fan in the summer; fans may pull pollen into the house (Schmitt, 2011).

Other tips include applying a cool compress to itchy or watery eyes for 10 minutes, and using saline spray in the nose to flush out any pollen that is in the nasal passageway.  Pharmacologic therapy includes oral and nasal antihistamines, as well as eye drops to help with symptoms.  Lastly, if symptoms are severe and have not improved with avoidance measures and pharmacologic therapy, allergen immunotherapy is indicated (Burns et al., 2009).

The severity of your child’s the allergy symptoms will determine what level of treatment is recommended or prescribed.

 

References

Burns, C.E., Dunn, A.M., Brady, M.A., Starr, N.B., 7 Blosser, C.G. (2009). Pediatric primary care (4th ed.). St. Louis, MO: Saunders Elsevier.

Schmitt, B.D. (2011). Hay fever (allergic rhinitis). Retrieved from http://www.cpnonline.org/CRS/CRS/pa_hayfever_hhg.htm

January 14, 2013
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Recap on Influenza Season
      Influenza viruses are constantly changing.  Each year experts pick the virus strains to be included in the vaccine that they anticipate will predominate during the given flu season (CDC, 2012). Receiving the flu vaccine does not guarantee you will not get the flu.  Rather, it will decrease your chance of getting the most common flu strains; if you are infected, you may experience a milder case.
      Children have the highest incidence of the illness occurring from infants up until children 14 years of age (Burns, Dunn, Brady, Starr, & Blosser, 2009).  Almost everyone who is at least 6 months of age should receive a flu vaccine.   There are a few groups who should not receive the flu vaccine: those who suffer from severe egg allergy, people with a history of Guillan-Barre syndrome, and people who experienced a previous severe allergic reaction to the flu vaccine (CDC, 2012). 
      Symptoms of the flu include a sudden onset of high fever, headache, chills, cold-like symptoms, dizziness, sore throat, pain in the back and extremities, and a dry cough.  In young children, vomiting, diarrhea, and croup may occur.  In severe infection, there may be complications involving the lungs and the heart (Burn et al., 2009).  Children with chronic conditions, such as asthma, may be at greater risk for these complications from the flu (CDC, 2012).
      Treatment includes supportive therapy such as bed rest, fluids, and fever-reducers such as Tylenol or ibuprofen (Burns et al., 2009).  Antiviral medications may be used as treatment, but in general are used only for children with moderate to severe infection.
      It’s not too late, hurry in and get your flu vaccine today!  It takes about 2 weeks after the vaccine for antibodies to develop in the body and provide protection against influenza.

Feeling Sluggish Post-Holiday?
For most of us, winter is a time of celebration when we gather with family and friends.  Unfortunately, we spend a lot of this time indoors, and perhaps indulge in a few holiday treats!   Children may become less active during the colder months and spend more time on the new electronics they received for the holidays.  Here are a few helpful hints and reminders about overweight/obesity in children.

Reminders (Flass & Brayden, 2012)

  1. Remove the TV, computers, and electronics from your child’s bedroom. TV in a child’s bedroom is associated with risk of being overweight.
  2. The number of hours per day a child spends watching TV or playing video games is directly associated with overweight.
  3. More time spent in front of the TV is also associated with children having more snacks, soda, or juices.
  4. Drinking sodas, juices, and eating extra snacks (particularly the cookies, chips, and crackers) directly leads to a higher calorie intake.

What can you do to help? (Flass & Brayden, 2012)

  1. Save desserts and treats (cookies, ice cream, cakes, and chips) for special occasions; you should eliminate them from your daily routine.
  2. Limit TV/Computer time to NO MORE than 2 hours per day.  TV is not recommended for children under 2 years of age.
  3. Get Active! Bundle up and head outdoor for a game of tag, playing in the snow, ice skating, rollerblading, or bike riding.  You and your child should be getting an hour of heart-pumping activity every day!
  4. Watch the portion sizes and the types of food you give your child.
  5. Involve your child in preparing meals; s/he may be more willing to try new healthy foods if s/he helped in the preparation.
  6. Eat meals together as a family.
  7. Limit fast food, take out, and eating out.  Rather, make some homemade and heart-healthy soups, like chicken noodle soup, to keep warm this winter!
  8. Get involved in your community and join activities that the whole family can enjoy.

Winter Safety Tips (AAP, 2012)
1. Even though it’s not summer, remember sunscreen!  The sun reflects off the snow and ice, so you can still get sunburn.  Use a sunscreen with SPF of at least 15 that is made for children, and apply it to your children’s skin 15-30 minutes prior to heading outdoors.
2. Think layers and moisture-wicking fabric, when bundling up for trips outside.  Younger children do not regulate their body temperature as well as adults do.  Therefore, they are at greater risk for hypothermia or frost bite.  In addition, a good rule of thumb is to dress your infant in one more layer of clothing than you wear.
3. Please be careful with long scarves, strings, and cords from jackets.  Strangulation is a real possibility, as the loose ends may get caught in sled blades or around slides in the playground.  Hoods on a sweatshirt can also block peripheral view for young children who are not paying attention to their surroundings.
4. Avoid reckless play when outside.  Always wear your helmet when snowboarding, skiing, sledding, or playing ice hockey.  Make sure that the hills you sled down don’t end with a pond that is not frozen solid or onto a street with motor vehicles.   Children should never ski, snowboard, sled ride, or ice skate alone. 
5. If your child gets winter nosebleeds, consider using a cool air humidifier in his/her bedroom.   Also, saline drops and petroleum jelly may be helpful to keep the nasal tissue moist.
6. Remember, loose blankets, quilts, and pillows should be kept out of the infant’s crib, as this can lead to Sudden Infant Death Syndrome (SIDS).  One-piece sleepers are a good alternative option.  If a blanket must be used, it should be tucked in around the crib mattress and reach no higher than the baby’s chest, so the face is less likely to become covered.

References

American Academy of Pediatrics (AAP). (2012, January 8). Winter safety tips. Retrieved from http://www.healthychildren.org/English/news/Pages/Winter-Safety.aspx?nfstatus=401&nftoken=00000000-0000-0000-0000-000000000000&nfstatusdescription=ERROR%3a+No+local+token

Burns, C.E., Dunn, A.M., Brady, M.A., Starr, N.B., 7 Blosser, C.G. (2009). Pediatric primary care (4th ed.). St. Louis, MO: Saunders Elsevier.

Center for Disease Control and Prevention (CDC). (2012, June 14). What you should know for the 2012-2013 influenza season. Retrieved from http://www.cdc.gov/flu/about/season/flu-season-2012-2013.htm

Flass, T., & Brayden ,R.  (2011, December 5). Obesity in children. Retrieved from http://www.cpnonline.org/CRS/CRS/pa_obesekid_pep.htm 

May 11, 2012
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It’s Flu Season!

Seasonal flu activity may begin as early as October and can occur as late as May (CDC, 2012), so it’s important to get vaccinated early!  Here are a few tips and information on the upcoming flu season:

Influenza viruses are constantly changing.  In fact, they can change from one season to the next.  Each year, experts pick the virus strains to be included in the vaccine that they anticipate will predominate during the given flu season (CDC, 2012). There is no way to predict how mild or severe the flu season will be, but ensuring you and your children are vaccinated is the best protection.  Receiving the flu vaccine does not guarantee you will not get the flu.  Rather, it will decrease your chance of getting the most common flu strains; and if you are infected, you may experience a milder case.

Children have the highest incidence of the illness occurring from infants up until children 14 years of age (Burns, Dunn, Brady, Starr, & Blosser, 2009).  Almost everyone who is at least 6 months of age should receive a flu vaccine.   There are a few groups who should not receive the flu vaccine: those who suffer from severe egg allergy, people with a history of Guillan-Barre syndrome, and people who experienced a previous severe allergic reaction to the flu vaccine (CDC, 2012). 

Symptoms of the flu include a sudden onset of high fever, headache, chills, cold-like symptoms, dizziness, and sore throat, pain in the back and extremities, and a dry cough.  In young children, vomiting, diarrhea, and croup may occur.  In severe infection, there may be complications involving the lungs and the heart (Burn et al., 2009).  Children with chronic conditions, such as asthma, may be at greater risk for these complications from the flu (CDC, 2012).

Treatment includes supportive therapy such as bed rest, fluids, and antipyretics such as Tylenol or ibuprofen (Burns et al., 2009).  Antiviral medications may be used as treatment, but in general are used only for children with moderate to severe infection.

Hurry in and get your flu vaccine today!  It takes 2 weeks after the vaccine for antibodies to develop in the body and provide protection against influenza. The CDC recommends vaccination as soon as the vaccine is available to provide protection for as many people as possible prior to the start of flu season (CDC, 2012).

Please visit the CDC website for more details about this year’s influenza vaccine:

http://www.cdc.gov/flu/about/season/flu-season-2012-2013.htm

 

References

Burns, C.E., Dunn, A.M., Brady, M.A., Starr, N.B., 7 Blosser, C.G. (2009). Pediatric primary care (4thed.). St. Louis, MO: Saunders Elsevier.

Center for Disease Control and Prevention (CDC). (2012, June 14). What you should know for the 2012-2013 influenza season. Retrieved from http://www.cdc.gov/flu/about/season/flu-season-2012-2013.htm 





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