Saturday, January 29, 2011

Sledding, Snowmen, and Snow Ball Fights – Avoiding Frostbite

Four little snowpeople stomped up to my front door this morning.  Bundled in coats, gloves, and neckwarmers , they could barely see as adorable fuzzy hats with pom-poms slid down over their eyes.

“Mommy!  We’re co-o-o-ld!  Can we come inside?” they pleaded.  Their teeth chattered and they shivered.

I think they had been outside for about five minutes… maybe six.

That was after one hour of begging to go outside as soon as they saw the new snowfall on the ground, twenty minutes of breakfast while still asking to go outside, and another twenty minutes of going potty and getting dressed while I tried frantically to find four matching set of gloves.  (I think that gloves and socks have conspired to hang out together somewhere – where do they go?)

I remember playing outside for hours as a kid in the snow – with no care about the potential frostbite starting on my fingers and ears and nose.  What’s wrong with my kids?  Maybe they are just smarter than I was.  It's cold out there!

Keep your kids warm in the snow.  It’s fun – but can be dangerous.  Children are at higher risk for frostbite compared to adults.  They lose heat more easily than adults and are not as willing to give up having fun even if they are cold.

Frostbite is the result of prolonged cold exposure to our bodies.  This causes damage to the tissues.  Our fingers, toes, noses and ears are the most susceptible. 

There are different degrees of severity of frostbite.   First degree, or frostnip, is when the surface of the skin is frozen.  The skin has white, red, and yellow patches and often there is itching and pain and numbness.  Usually the injury is not permanent.

Second degree frostbite is more severe.  The skin is actually frozen and hard.  This can result in blisters a few days after the injury and can take weeks to months to heal .  Call your doctor or take your child to the nearest emergency room if this occurs.

Third and fourth degrees are much more severe and involve freezing of the muscles and deep tissues.  Your child should not be at risk for this unless they are trapped in the cold for a very long period of time.

If your child is complaining of pain, itching or numbness of fingers, toes, ears or nose after playing in the cold, remove all wet clothing.  Rewarm the area as quickly as possible without burning the skin.  Soak the body part in warm (not hot) water for 20-30 minutes.  The water temperature should be around 104 degrees F.    If the pain does not improve and the color does not return to normal within a few minutes, call your doctor immediately.

Dehydration is also an issue because in the cold, children do not realize that they are sweating and losing fluids.  Give your child fluids to drink (non-caffeinated).  A good rule of thumb is to have your child come in every one to two hours for a break to drink, eat a snack and warm up. 

Every year, over 20,000 kids are injured in sledding accidents.  Children between the ages of 10-14 years old are the most commonly injured.   Next most commonly injured are children ages 5-9 years.  Fractures and head injuries are the most common type of injury.  Running into trees, poles, stationary obstacles are the usual sources of injury.  Wearing a helmet is recommended.  At the very least, scope out where your children are sledding to make sure that it is free of dangerous obstacles.  Make sure that they are not sledding into streets where cars may hit them.  Do not allow your children to be pulled on sleds by ATVs, snowmobiles, or other motorized vehicles.

Keep safe, stay warm, and enjoy the snow (preferably indoors with a nice warm cup of cocoa)!  Thanks for reading!

Wednesday, January 19, 2011

Vomiting and Diarrhea - the Dreaded Stomach Bug

“I need to spit up!”  declares my three-year old.  

Hearing these words (which are code for I’m about to vomit right now), I launch myself off the couch, leap across dangerous obstacles composed of toys and books  to get across the living room to scoop him up off our off-white carpet.  Then running like mad cupping my hand strategically below his mouth, I repeat over and over, “Wait wait wait!  Throw up in the potty, not on the floor!  You’re okay, you’re okay!”  

And then, a few inches from our target destination of the bathroom toilet, he throws up.  Oh well… at least it’s easier to clean here.

The holiday season this year brought my family many presents… including a stomach virus.  I got it and my kids got it (my husband kept thinking he was getting it –but managed to avoid it).  Many people have unfortunately fallen prey to stomach viruses this year.  You or your family members may have been through it, too.   If so, I’m so sorry – I know how horrible it can be.   Luckily, it tends to go away in a few days leaving most of us wiped out, but okay.

Children are smaller and have less ability to tolerate vomiting and diarrhea compared to adults.  Therefore, they get dehydrated much quicker than grownups do. 

If your child is vomiting or having diarrhea, it is of utmost importance that your child stays hydrated.  Food or solids are not important while your child is vomiting.

Sometimes vomiting or diarrhea can be a symptom of a more serious illness. 

If you see any of the following, you should call your doctor:
  1. Projectile or forceful vomiting
  2. Blood in the vomit or diarrhea
  3. Severe stomach pain
  4. Fevers>104 F
  5. No improvement in vomiting in 24 hrs
  6. Persistent diarrhea more than 10 days
  7. Prolonged diarrhea after finishing antibiotic use.
  8. Your baby is less than four months old and is having vomiting or diarrhea
  9. Pain with urination or more frequent urination
  10. Severe headaches
  11. Drinking frequently
  12. Symptoms other than just vomiting or diarrhea
To help your child get through it, try the following:

For vomiting, give your child small sips of clear fluids that have electrolytes (such as Pedialyte).  If your child refuses to drink or is unable to keep fluids down, use a medicine syringe and squirt small amounts into his/her mouth every five minutes.  Your child needs to urinate at least three times a day.  If your child has not urinated for more than eight hours or is lethargic or can’t keep anything down, call your doctor immediately. 

Do not give milk or heavy foods, such as dairy or fried foods.  These are likely to come back up.  If your child wants to eat, give small amounts of bland foods such as crackers, toast or plain cereal.  Foods with lots of liquid are also good – such as popsicles, soup, and jello.

If your child has not thrown up for at least 12 hours, it is reasonable to try slowly advancing his/her diet.  Again, avoid heavy foods for the best chance of success.

For diarrhea (and no vomiting), give your child the BRAT diet (bananas, rice, applesauce and toast) to help firm up stools.  Lactose can be difficult to digest with diarrhea, so using a lactose-free milk or soy milk/formula temporarily may help with symptoms.

Probiotics are also useful for combating diarrhea.   Probiotics are the healthy bacteria that help to keep our digestive system healthy.  If your child is not vomiting, then eating yogurt is one way to get probiotics.  Many pharmacies and grocery stores carry probiotics in various forms that kids can eat  – granules for infants and toddlers, chewable tablets for young children, and capsules for older children and adults.

To prevent spreading the virus to others, wash your hands frequently!  The viral particles are in the vomit and the stool.  Wash your hands frequently and use antibacterial soaps and surface cleaners.  Make sure that other children do not share utensils, cups and food with the sick child.

Oh wait,  I think I hear something. 

“Mommy!  I need to spit up!”  Uh oh, gotta run… here we go again! 

Stay healthy, and thanks for reading!