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Thursday, November 20, 2014

Ask a Pediatrician: Session 1

Every parent experiences some level of anxiety when their child is sick. We all worry whether our child is sick enough to see the pediatrician or just stay home and away from other children? Do we medicate them or not? In our first installment of ‘Ask a Pediatrician’, we’re providing several of the commonly most asked questions our pediatricians hear throughout the year and the answers you’re most anxious to hear.

1.    Is it ok to give my child cough and/or cold medicine?
The AAP along with other experts testified before the Food and Drug Administration (FDA) regarding the safety of cough and cold medications for young children.  The FDA’s recommendation is that children under the age of 4 years should never use cough or cold medications due to potential serious side effects.
Furthermore, the FDA advisory panel does not recommend the use of cough and cold medications in children 4-6 years of age because there has been no proven efficacy for relieving symptoms.
As for children over 6 years of age, the FDA advisory panel has no recommendations. 
Concerning all ages, the best treatment for nasal congestion is nasal saline drops or spray.  Honey is recommended for children over the age of 1 in the treatment and relief of a cough.  Please refrain from using multiple ingredient cough and cold medicines to avoid the risk of overdose.

2.    Should I give my child Tylenol or Ibuprofen prior to vaccines?
We would prefer that you wait until after your child receives their vaccinations to administer Tylenol or Ibuprofen.
For children under the age of 6 months, we recommend that you bring Tylenol with you to your child’s appointment, but refrain from giving the medication until after an accurate weight is obtained and vaccines have been given. Children over 6 months may have Tylenol or Ibuprofen following the administration of their vaccines.

3.    Can my child still receive their vaccinations if he or she has congestion or a cold?
As long as your child has not had a fever in the 24 hours prior to their vaccines, he or she should be OK to receive vaccinations.  However, vaccines will be given at the discretion of the provider once he or she evaluates your child.

4.    Could my child have the Flu?
First and foremost, if your child does not have a fever, he or she probably does not have the flu.  It is most likely a cold or virus.
Along with a fever, the most common symptoms are runny nose, sore throat and cough.  Your child may also experience more muscle pain, headache and chills than with a usual cold.

5.    Can my child have Tylenol or Ibuprofen along with his or her antibiotic?
Yes.  Please continue to give your child Tylenol or Ibuprofen as appropriate for his or her age, if he or she is experiencing fever, pain, or other discomfort.  The antibiotic your child is taking does not immediately relieve your child’s symptoms, therefore you should continue the use of Tylenol or Ibuprofen until the antibiotic has time to treat the infection.

6.    How long should I expect my child to continue with a fever once starting an antibiotic?
Your child may continue to have a fever for up to 72 hours after starting an antibiotic.  Should your child remain with fever after 72 hours, we request that you call our office and speak with a nurse.  Should your child develop new or worsening symptoms at any time, you should also call our office with an update.

Check back for more frequently asked questions, you might also want to check out our post about common children's ailments. Keep in mind, these are simply answers to commonly asked questions and are not intended to replace a medical diagnosis or visit to the doctor.
Let us know what you think about our new ‘Ask a Pediatrician’ format in the comments below.

If you have questions you’d like us to feature, you can include them with your comment, or connect with us on Facebook.

Tuesday, September 9, 2014

What Every Parent Should Know About the Enterovirus

We are sure you’ve heard on the news about the recent surge in hospital stays in children for a respiratory virus called Enterovirus D68 (EV-D68 while Enteroviruses are very common, EV-D68 is not).  We here at Northwest Pediatrics wanted to provide you some timely information on this virus.

Enterovirus symptoms are very similar to those of a very intense cold (sneezing, runny nose and cough).  Other symptoms include difficulty breathing, and in some cases a rash. Sometimes they can be accompanied by fever or wheezing.  However, it is the respiratory symptoms that stand this particular enterovirus apart from the others.  If your child starts developing symptoms of the common cold, there is no need to worry.  The beginning of a school year is a typical time of year to see a surge in viruses. However, please call the office if your child exhibits the above symptoms AND then develops a fever or a rash, or if your child has difficulty breathing. Children with asthma, or a history of breathing problems, are particularly susceptible for severe symptoms.  Reports indicate that these respiratory symptoms may come on quickly.  If your child is ever in an urgent or emergent situation, please call 911 immediately.

What makes children more susceptible is that the virus is often spread between those in close proximity to each other, and their immune systems are still developing .  There is no vaccine against enteroviruses, but we cannot stress enough following these few simple practices:

•    Wash your hands with soap and water for 20 seconds — particularly after going to the bathroom and changing diapers.
•    Clean and disinfect surfaces that are regularly touched by different people, such as toys and doorknobs.
•    Avoid shaking hands, kissing, hugging and sharing cups or eating utensils with people who may be sick. Please stay home if you feel unwell, and do not send your child to school sick.

Remember, symptoms of the common cold are not a reason for concern.  Just keep an eye out for any signs of respiratory distress such as wheezing, and trouble breathing.  Your best line of defense is practicing good hand washing, sanitizing, and limit close contact with those who may be sick.

Thursday, August 21, 2014

Child Socialization

Socialization is an important aspect of your child’s development for many reasons, but mainly because it teaches your child social behaviors, norms, interaction and conflict resolution. Socialization is how your child learns from you, and from others what is acceptable, what is not, and what actions result in discipline.

Parents are the first teachers and leaders in a child’s socialization since the process begins at birth. It has been noted that parents who spend quality time with their children – providing much needed attention and nurturing, listening and discussing – have children with higher self-confidence than those who place a higher priority on work – whether it’s work around the house or work brought home from the office. Certainly, you can spend time with children while engaging them in chores: It teaches them responsibility as well as turning those chores into a time well spent engaged in conversation. The laundry won’t do itself, but putting off time with the child in order to do the laundry teaches the child that clean laundry is a higher priority than he.

Discipline is only a small part of a child’s socialization, but it is important to note that emphasis should be placed on positive discipline. Having a child clean up spilled milk from a glass he overturned is an act of positive discipline. Verbally berating or spanking a child for spilling milk is negative discipline, and can be damaging to the child’s self-esteem.

Children with a high level of self-confidence and esteem are less afraid of being left by the parent – abandoned in his mind – even with a group of other children of the same age. You can help build your child’s confidence by regularly spending time at the library for group story hour; allowing him to stay with a grandparent or other adult family member for a few hours while you run errands; spending time at a public park with you and with other children. Playgrounds or The Children’s Museum are excellent opportunities for helping your child overcome any social anxiety he may feel.

Take advantage of all these opportunities to help your child ease into becoming independent. It can make the world of difference on the first day of school.

Thursday, August 7, 2014

The Importance of Sunscreen for Children

Whether it’s a cloudy, overcast day or its sunny and bright outside, winter, spring, summer, and fall, your child needs the protection of sunscreen when playing outdoors. UV rays from the sun are strongest and most harmful between 11 AM and 3 PM so it is important that your child be protected to prevent skin problems in the future. The best solution is to have your child spend as much time in the shade. If that isn’t possible, make sure that the clothes she wears covers her skin (dry clothing offers much more protection than wet). Provide a wide-brimmed hat to protect ears, nose, cheeks, and neck and encourage your child to wear sunglasses to protect against UVB rays.

Always apply sunscreen that provides protection from both UVA and UVB rays. The sunscreen you purchase should be at least SPF 15 if not higher. For best results:
  • Apply sunscreen at least 30 minutes before your child goes outside
  • Apply sunscreen every time your child gets wet, whether from swimming, showering, or perspiring due to exercise: Moisture makes the sunscreen less effective
  • Apply and reapply sunscreen to forehead, nose, cheeks, lips, and chin
Which sunscreen should you purchase? You may need to try different brands to find the gentlest formula for your child but make sure it’s free of PABA (para-aminobenzoic acid). If your child doesn’t like the liquid or mist type sunscreen because it runs into her eyes when she perspires, try the stick type sunscreen for better adhesion.

The importance of getting your child into the habit of using sunscreen now can last throughout her life while helping her prevent skin cancer as well as other dermatological issues.

Friday, June 6, 2014

Common Ailments in Children

Common Ailments in Children

What to Do About: Ringworm, Pinkeye, or Lice

Three of the most common childhood conditions are ringworm, conjunctivitis (pink eye), and lice. Here is some basic information regarding all three including how to identify them and how to treat them.

Ringworm is very common in children, but adults can get it too. It often appears like a round pink patch, or rough, scaly skin in the affected area. The patch will slowly increase in size, and may be accompanied by minor itching.  Ringworm is caused by a fungus called tinea that grows very much like a mushroom. It is easily spread from person to person by sharing or coming into direct contact with items such as combs or soiled clothing, shower floors and surfaces surrounding a swimming pool. Ringworm can also be contracted from cats, a common carrier.

The tinea fungus thrives in warm, moist areas and commonly affects the feet and toes, groin area, scalp, and waistline – any part or fold of the body that stays damp from sweat or swimming. For minor cases, keep the skin clean and dry. You can apply over the counter fungal creams such as Lotrimin, Lamisil or Micatin. In severe cases, or cases on your child’s scalp or eyebrows, be sure to make an appointment with your child’s pediatrician. It may be necessary to obtain prescriptions for antibiotics and/or specialty creams. Ringworm usually disappears in four weeks.

Conjunctivitis, also known as pink eye, is very common and very easily spread from person to person. It is caused by viruses, bacteria, shampoo, dirt, or pool chlorine, and allergens like pollen and dust. It isn’t serious unless the patient is a newborn. Infants must receive immediate medical attention to preserve baby’s vision.

Conjunctivitis causes itchy, runny, burning eyes, blurred vision, and lots of mucous or discharge. The whites of the eyes turn pink from the irritation. Call your pediatrician so that we can help you to evaluate if an appointment is necessary, or if prescription eye drops are needed.

Lice is probably the most annoying, and least dangerous of all childhood afflictions. Lice occurs in girls more often than boys aged 3-12 due to the sharing of combs, brushes, hair bows and barrettes, or from trying on hats in the department store. A nit looks like tiny light-colored bumps that are stuck to the shaft of the hair near the scalp, or adult lice looks like a white, crab-shaped bug not much bigger than a flake of dandruff. Adult lice go about crawling and feeding on the scalp.

We recommend immediately trying an over the counter brand of shampoo and scalp treatments found at your local pharmacy. There are also sprays for treating furniture. High heat and lack of oxygen is the bane of lice, so you can place bed linens, spreads, and pillows in the dryer on high heat for at least 30 minutes, longer if there is no danger of ruining the items. Follow up with laundering your bedding as usual. You can also place bedding in a sealed bag (think Space Bag) and vacuum out the air. Leave the items for at least two weeks to insure the demise of every louse.  If over the counter options do not work by ridding your child’s scalp of the lice, please call our office and we can help you determine whether a prescription treatment is needed.

Anytime you have medical questions or concerns, you should contact your Greensboro pediatrician at Northwest Pediatrics.

Wednesday, April 16, 2014

Children & Season Allergies

Children & Seasonal Allergies

Spring, summer, fall, and winter. Children – and adults – can suffer from seasonal allergies any time of year. We’ve provided 7 tips for helping you and your children find relief.

Allergy Relief for Children
  1. Indoor Air Quality. The air inside your home is under constant bombardment from allergens that are released by pets and soft surfaces where dust has settled: carpeting, upholstered furniture and mattresses, draperies, bedding and the like. Keep these surfaces as well as all the nooks and crannies in your home vacuumed free of dust.
  2. Prevent or remove mold/mildew. Warm, damp places are where mold and mildew reside. Keep shower and tub walls and floors properly sanitized to prevent mold or mildew from growing. Check under kitchen sinks and bathroom lavatories for any signs of mold or mildew and properly remove it immediately.
  3. Dry nasal passages are a bad cold or allergy waiting to happen. Make sure the air in your home stays properly moisturized to prevent nasal passages from drying out and over-producing mucous. A humidifier is a great way to do this!  Just remember that too much of a good thing can also have negative effects so keep air moist not damp. See if your child is willing to try a saline nasal rinse.  When used on a regular basis, it will aid in keeping the nasal passages moist and clear.
  4. Eat Right. Fresh fruits and veggies year round are great sources of nutrition and essential vitamins. Rather than cooking green, leafy vegetables, try steaming them instead. Steaming locks in vitamins whereas cooking in water (boiling) removes most of the nutrients. Fresh fruits are excellent nutrition when eaten raw or made into creamy smoothies. Make sure that the fats used in cooking are good fats – the unsaturated kinds such as olive oil and canola oil.
  5. Avoid Sugar. Sugar is addictive and can lower the immune system’s defenses.  Trade in the sweets for homemade dried fruits made from apples, apricots, mangoes, and other delectable fruits. Switch sweetened fruit juices for water and milk.
  6. Exercise. Teach your children – by example – the importance of getting enough exercise daily. Children have energy to burn and exercise is an important component to helping them grow big and strong. When your children are grown up, they will already know that the best stress reliever is exercise.
  7. Administer an antihistamine when necessary. Antihistamines provide temporary relief from sinus pressure, sneezing, scratchy throat, and itchy, watery eyes. Don’t wait until your child is suffering from symptoms before giving them an antihistamine. Always check with your child’s pediatrician first if you are unsure of dosing or if she has had allergic reactions to antihistamines in the past.

Contact Your Local Pediatrician >>

Friday, March 14, 2014

How to Establish a Bedtime

How to Establish a Bed Time

What Time is Bedtime Anyway?

A very common question from new parents is at what age should you begin to establish a bed time for your child?  Honestly, the earlier you begin is best, but most importantly, by the time your child begins sleeping through the night. Establishing a bed time for your child provides a level of comfort and security because she’ll know what to expect, and when to expect it. Not only does establishing a bedtime give a parent one on one quiet time with their child, but will also allow the parent time for themselves, or with a significant other afterwards. Also, establishing a bedtime early in life helps minimize the possibility of bedtime drama later in life.

Your bedtime routine could begin with a warm, soothing bath or a simple warm washcloth over their face and hands, changing her diaper, and putting on pajamas. Move into the child’s bedroom where you can lay baby in the crib or sit her on your lap in a nearby chair. Turn down the lights, sing a lullaby, tell a story, or read a book to relax them. You don’t have to wait until baby falls asleep before placing her in the crib. Although she may fuss a little at first, she’ll adapt to the routine in the coming days.

Your child’s bedroom should be a place of welcome and comfort, so consider a neutral location other than their bedroom for a timeout. This could avoid any association as her bedroom being a place of dread, and make establishing a pleasant bedtime routine more difficult.

Keep the bedtime routine short, simple, and relaxed. It’s much easier to lengthen a routine in the future than cutting back on the time spent. Do make sure it is quality time so that baby looks forward to the time she spends with you.

As she gets older, your child may need to release some energy before the bedtime routine begins. Play games such as peek-a-boo and patty-cake that will expel some energy, but not get baby too wound up. If you live in a location where loud noises from outside may disturb your child, consider purchasing a sound machine. These inexpensive gadgets produce sounds that induce relaxation such as white noise, a summer rain, and the waves of the ocean washing against the beach. You may find that you purchase one for yourself, too!

How much sleep should baby get? This varies from child to child but babies aged 1 to 18 months require as much as 11 to 16 hours of sleep per day, including naps. With that in mind, begin your bedtime routine at a time that will allow you time to complete it, have a little time to yourself, and get plenty of rest for tomorrow.