Fun in the Sun!

“Can we play in the sprinkler, Mommy?” asked my 4-year old daughter.  I looked up from my computer to see sweet puppy-eyes on a cute little face asking me to grant her this one simple request.  It was hot outside and the pools weren’t open yet.   It sounded like a perfectly fun and reasonable thing to do today.

Then I thought about what I had to do to set this up.  Herd four excited kids into bathing suits, sunblock each squirmy kid (perhaps one of their least favorite activities of all time), find the sprinkler toy thing (I bought it last summer on sale... where did I put it?), turn on the water feed to our backyard hose faucet (still off from the winter), and then all the cleanup that would be involved afterwards (from the wet toys to the wet kids).  So… being the slightly distracted mom that I was (focusing on something for work on the computer), I paused to figure out how I could get out of this one.

“The neighbors are playing in theirs,” she quickly added, noticing my hesitation.  “We NEVER get to play in our sprinkler… PLEEEEEEEEEEEE-ASE?!?!”  (puppy eyes again)

So I gave in.

And they had a blast!  Even I had fun as I sprayed my screaming, laughing kids (and myself) with our hose as I tried to figure out how the new sprinkler contraption worked.    All in all, it was a good couple of hours in the near-summer heat.  The kids were wonderfully exhausted afterwards, ate dinner without complaint, and went to bed early.  Happiness and contentment all around.

Summer is a great time to be outside, to be at the pool and play in the water.  It’s the time most of us go on vacations – often to the beach or other sunny places.  So, being safe in the sun is incredibly important to ensure that we are just having fun and that no harm will come from it.

With skin cancer being the most common form of cancer in the United States, it is vital to protect your kids (and yourself) from too much sun exposure.  Each year there are more new cases of skin cancer than the combined cancers of the breast, prostate, lung and colon.  One in five Americans will be diagnosed with skin cancer in their lifetime.  Depending on the study you read, anywhere from 23-80% of a person’s lifetime exposure to the sun occurs before age 18, so it's important to limit the ultraviolet (UV) radiation exposure to your child's skin.  Prolonged exposure to UV rays from the sun is thought to contribute to skin cancer and precancerous skin conditions.  

To protect your child, here are some things you can do:

1.      1.  Use sunblock (starting at any age – including your one-month old!).  Use a waterproof sunscreen of SPF 45 or higher.  Make sure that it’s rated to protect against UVA and UVB rays.  Reapply frequently, especially if your child is getting into the water.  Even on cloudy days, apply sunblock because ultraviolet rays penetrate the clouds and are still being absorbed by our skin. 

2.      2.  Wear long sleeve sunshirts and pants that protect against UV rays. 

3.      3.  Wide-brimmed sunhats are useful, especially the kind that extends down to cover the back of the neck.

4.      4.  Choose sunglasses that block 99-100% of UVA and UVB rays.

5.      5.  Avoid being outside during peak sun hours between 10 a.m. and 4 p.m. if possible.  If your child’s shadow is shorter than your child, then the sun is very strong and it’s time to find shade or be indoors.

6.      6.  Give extra water and fluids to prevent dehydration.  Avoid caffeinated fluids which can actually cause dehydration because caffeine is a diuretic and makes your body need to urinate more.

Kids with fair skin, freckles, have light colored eyes (blue or green), or have red or blond hair are all at higher risk for developing skin cancer.  Boys are at higher risk than girls.  Your child is also at higher risk for melanoma if you have a family history of skin cancer.  

What to Do for a Sunburn? 

Despite your best efforts to protect your child from the sun,  he/she may end up with a sunburn.  Unfortunately, there is not a quick fix for this.  Sunburns can take several days to heal and the full extent of the burn is sometimes not visible until 12-24 hours after the sun exposure.

Here are some things to try:

1.       1.  Cool it down – a cool bath, placing cool towels or cool compresses to the sunburned area

2.       2.  Aloe or moisturizing creams – put the cream on a on small area of skin first to make sure that your child is not allergic to aloe or the ingredients in the cream.  Do not use benzocaine numbing sprays, especially on children under two years of age.  Rarely, benzocaine can cause a disease that prevents oxygen from being carried on red blood cells in the body correctly.

3.       3.  Do not pop blisters open – the skin on the blister protects the immature skin underneath from infection.

4.       4.  Taking Tylenol or Motrin for pain can be helpful.

5.       5.  Do not pick at the peeling skin – use a moisturizing cream.

Call your child’s doctor if there is severe sunburn that covers a large portion of the body with blisters, or if your child also has one of the following symptoms:

Fever

Headache

Confusion, paleness

Nausea or vomiting

Muscle cramps or pains

Fainting

These can be signs of heat exhaustion which is more serious than just a sunburn.

Luckily, with good care, you can prevent sunburns and keep your child’s skin safe.  Pools open this weekend, so hopefully the weather will be good and everyone will have a great start to the summer swim season.  Happy Memorial Day, and thanks for reading!

What Do You Mean I Have to Share? – Teaching fairness

“Waaaahh!” came a cry from the basement.  

Uh-oh, I thought… what is it now?  I was sitting in our living room, the door to the basement nearby.

Stomp, stomp, stomp up the stairs.  The wails increased in volume as the victim got closer.  The crier was trying hard to maintain the ferocity of cry so that mommy would be dutifully impressed by the audacity of the crime.  The cry was definitely the “I’m insulted” or “I’m mad” cry, as opposed to the “I’m hurt” cry.  

“Mommy, he took my toy!” cried my four-year old daughter.  She buried her head in my lap, sobbing pitifully.

“I had it first!” proclaimed her six-year old brother, holding the prized item high above his head, trailing close behind her.  “It’s mine.  I got it for my birthday!”

“You need to share,” I said to them (for I think the thousandth time in their lives). 

“You’ve had it for a long time now,” I said to my son. “You can play with it for five more minutes, and then it’s her turn.”

Then I said to both children.  “I’m going to set the kitchen timer. When it beeps you need to switch.”

They both nodded, problem solved, and ran off happily together back to the basement as if nothing had just happened.

All was quiet on homefront for about fifteen more minutes.  Then… “waaaahh!”  It was another child.  I waited for the report of the horrible crime this time.  Stomp, stomp, stomp… “Mommy!”

Learning to share is a normal developmental process and can be a challenging concept to teach. 

It is important to realize that the sense of fairness or empathy for others changes as a child develops.  A toddler to three-year old is only aware of his/her own personal feelings.  They have not yet developed the ability to understand that what they do may hurt or negatively affect other people.  “The world revolves around ME” is the motto of a two-year old.  

As children get to age four and five, they start to realize that other people have feelings, too.  This is when sharing and fairness becomes easier for them to understand. When you are teaching, you can explain why he/she should be kind and share. At this age, they can remember what it feels like when someone doesn’t share with them.  They can start to understand that what they do can make others feel badly.

So how can you deal with arguments over sharing?

Prevention – If you know that both kids are going to want something that you are going to give them, you can prevent the fight by setting guidelines early on.  Such as, “I have something fun for both of you.  John will get to use it for five minutes, and then Susie can have it for the next five minutes.”  Get them to agree on the rules of sharing beforehand.

If your young child is having a playdate, put your child’s prized possessions away so that the visiting child won’t be tempted to play with them.  Talk about sharing toys before the playdate so that your child understands that someone else will be playing with her toys.

Intervene early – When you hear arguments beginning, distract them if you can.  Steer them to another activity that is less contentious.

Give age-appropriate guidance – spending time giving a two-year old a lecture about how sharing/hitting/biting hurts others and would they like it if someone did that to them, and don’t they understand that it isn’t fair to hog a toy the whole time, and so on… It’s a little bit like Charlie Brown’s teachers saying “wah wah wah wah wah” to the children.  Your preschooler is not capable of understanding all of the nuances of being nice. 

Time them – A kitchen timer is a great way to help little ones to share and avoid fights.  By saying that they can each play with a popular toy for five minutes, until the beeper goes off, is a concrete idea that they can understand. 

Be short and sweet in your teachings – “You need to share.  Give Jason the red one and you can have the blue one.”  If your child cannot manage to do that, then take away the offending items and move on to another activity. 

Praise sharing behavior – It is important to give praise when your child shares (either on his own or with your prompting).  This will reinforce the “good” behavior that you want.  If you focus too much on the less desirable or “bad” behavior, it will reinforce the “bad” behavior. Children want naturally crave attention from their parents.  Even it is negative attention, it is still attention.  (Think of the game that toddlers love of throwing something on the floor and you picking it up over and over again… they’ll keep doing it because you are paying attention to their behavior.)

When your child spontaneously shares or goes out of their way to help another child, it’s a great moment for any parent.  Some children are natural helpers and learn early that it feels good to make others happy.  Others need more coaching, but do not despair, for they will learn this, too.

Happy Mother’s Day next week to all the moms reading this blog!  Hope you have a wonderful, relaxing, peaceful day!  Thanks for reading!

Aaahh-choo! Spring is here!

As I listen to my kids happily playing basketball in the driveway, digging dirt in the front yard (my daughter is planting an orange tree apparently), and throwing sand anywhere but inside the sand table on the deck, I’m sitting in the kitchen enjoying the sunshine and cool breeze that wafts through my backdoor.  All the windows are open, and I can feel the stuffiness of the house being gently blown outdoors.  I inhale and take a deep breath of the wonderful fresh spring air… and then, I sneeze.

And then I sneeze again.  And again. 

Sniff... sniff...  sniff... (clear throat)… (blink-blink)… I love spring... really… I do… (cough)… but boy, do I suffer from allergies!

My kids do, too.  At least three of them have seasonal allergies.  I’m waiting to see if the youngest one is going to also.  Kids generally do not develop allergies to the environment (pollen, mold, etc) until they are around three years old or older.  The immune system is not usually ready to start recognizing that allergens, such as pollen, are something to be allergic to until then.  It is possible for younger children to have seasonal allergies, but it is less common.  Younger children tend to have food-related allergies if they have any.

If there is a strong family history of allergies, asthma or eczema, or if your child has asthma/wheezing or eczema, then the chances of your child having seasonal or environmental allergies are higher.

Testing for allergies can be performed by an allergist through skin testing.  Your pediatrician may be able to do blood testing for allergies called RAST testing.  While there are differing opinions, it is generally thought that skin testing is more accurate when diagnosing environmental allergies.  This includes allergies to trees, grasses, molds, dust mites, molds, cockroach dander, cats, and dogs.

Skin testing is performed by putting small drops of diluted allergen (such as extracts from grasses) on the skin and then pricking the skin under the drop.  If you are allergic, you will develop a red, itchy bump (called a wheal).  The size of the wheal can indicate how allergic you are to the substance.  The testing is briefly uncomfortable, but many children tolerate it without difficulty.

Testing is useful so that you can identify what your child is allergic to and make adjustments as needed.  For example, if your child is allergic to dust mites, there are special coverings that you can put on your child’s pillow and bed mattress to reduce the number of dust mites that your child is exposed to at night.  If your child is allergic to pollen, you can avoid too many outdoor activities when the pollen count is high.

Allergies can be managed usually with over-the-counter medications.  These include Claritin, Zyrtec, and now Allegra.  These come in liquid, dissolvable tablet and swallow tablet forms. Benadryl can be useful for short-term treatment, but can sometimes make children very drowsy.  If your child has many allergies or has significant other problems triggered by allergies, such as wheezing, then allergy shots may be useful.  Allergy shots help your child’s body get “used to” the substance that he/she is allergic to by introducing it to the body in very small amounts and gradually increasing the amounts over time.

Common symptoms of allergies include runny nose, sneezing, itchy eyes and/or mild sore throat without fever.  If your child has fever, severe cough, eye discharge, or persistent thick nasal discharge or cough (especially if more than two weeks), then it's not just allergies, and you should call your child’s doctor.

Enjoy the spring weather, and (aah-choo!) thanks for reading!

Ouch! Head Injuries... When to Worry

“Sandy, we have a situation,” my nanny said in a panicky voice over the phone.  I was at work when I received this call and felt instant fear when I heard her dreaded words. 

“What’s wrong?” I asked, trying to remain calm.  My mind was racing through many horrific scenarios.  What could have happened to my kids?  Were they okay?  Why was she calling?

As it turned out, my oldest son had been climbing up on a structure in our basement and had fallen off of it landing headfirst onto a toy with a sharp edge.  He had cut his head on top pretty badly. The cut had been bleeding a lot and was scaring him and my nanny.  The good news was that he was alert, could talk and remembered what had happened. 

My nanny had done the right thing.  She applied pressure to the wound with a clean towel.  But it took a long time to stop bleeding.  She didn’t know that the scalp is rich with blood vessels.  A cut on the scalp can really bleed impressively.

Because he was alert, acting normally, wasn’t vomiting, and wasn’t bleeding anymore, I asked her to bring him to my office.  He ended up needing seven staples (like metal stitches) for a good-sized laceration on his scalp.  As a kid with a high pain tolerance, he was very calm through the whole procedure.  He was even reading a book when Dr. Dakin was putting the staples in!

Even I was impressed with his tolerance and patience with the whole procedure.  Nonetheless, I think (hope) he learned that climbing up on things in the basement and hanging over the top of them headfirst is generally a bad idea.

Head injuries can be very frightening.  With active children, they are extremely common though.  The horrible sound of your child’s head hitting a surface from a fall is one of the worst in the world.  Most parents can remember those moments quite clearly. 

So, what do you do and when should you worry?

At any age, if your child loses consciousness, is having seizures, or has significant injury/bleeding, call 911 immediately.

If your child seems very drowsy, has multiple episodes of vomiting, or is acting strangely, go to your nearest emergency room.

If your child appears alert, cried immediately at the time of injury, is not vomiting, and is behaving normally, it is reasonable to watch your child closely.  If your child is under age two, call your doctor for guidance.  If you are worried or there is a change in your child’s behavior, you should call your child’s doctor. 

For most minor head injuries without open wounds, you should put ice on the area that was hurt to help reduce swelling. Watch your child closely for the first 24-48 hrs after the head injury.  Avoid giving Tylenol or Motrin so that you don’t mask any symptoms.  You should wake your child at least once that night to make sure that he/she is okay.  Avoid contact sports or any activities that could result in another head injury until your child is completely symptom-free.  If the head injury occurred while playing sports, consult your team doctor or your child’s doctor for when it is safe to return to play.

Symptoms to call your child’s doctor about:

1. Any behavioral changes or changes in alertness

2. More than one episode of vomiting

3. Persistent or severe headache

4. Weakness or loss of strength

Bleeding inside the head is the main worry after a head injury.  Bleeding or swelling inside the head usually takes place during the first 24-48 hours after an injury and can cause life-threatening pressure on the brain.  This pressure results in headaches, irritability, recurrent vomiting, vision/pupil changes, and changes in alertness. 

Most people will check their child’s pupils to see if they are the same size.  While it is fine to do this, unequal pupils usually show up only after there is quite a bit of pressure from an internal brain bleed.  Just because the pupils are the same size early on, it does not mean that all is well. 

Watch for other signs such as the ones mentioned above.  While internal bleeding is rare from mild head injuries, you should watch your child carefully for signs and symptoms. 

My son’s cut has almost completely healed.  He has impressed many of his friends with his staples.  His 3-year old brother has already asked for staples for his boo-boo’s.  Hopefully, I have convinced him that staples are not for all boo-boo’s. (Not to mention that I have put all household staplers high out of reach just in case anyone gets any ideas!)  Kids... always an adventure...

Stay safe and thanks for reading!

Valentine’s Day – Cards, Candy and Love

“Mom, I’m tired of writing my name,” whines my six-year old.  “Can you do it?”

I’m sitting at my kitchen table with my four kids, surrounded by a hundred Valentine's cards.  Literally – 100.  That’s twenty-five for each child’s class.  My youngest child, who is in preschool, has no idea what Valentine’s Day is for… but he understands that the pencils that we are giving to his classmates has Toy Story characters on them… and he wants them all. 

“Mine!” he proclaims while stuffing them into a grocery bag.  “My pencils!”  

So, I explain patiently that they are for his friends at school for Valentine’s Day.  He pauses, looks up at me while I speak to him, and then promptly goes back to stashing away his precious pencil collection.  After some negotiation, he is satisfied with two pencils for himself and giving the rest to his friends.

Then I look over to my four-year old who is trying very hard to write her name on all the cards.  She has managed to fit the first three letters of her name in the blank spot next to the “From:” line, but has consistently run out of space for the last two letters of her name.  So… she just writes them in wherever she has space on the card. Oh well, at least she’s writing!  Hopefully, her classmates can figure out that it’s from her. 

I don’t know about your kids, but mine don’t actually notice who the cards are from.  They just dig through their Valentines’ bags for the goodies and then toss the rest aside.

Valentine’s Day is the holiday to celebrate love.  Some believe that the origin of the holiday dates back to the Middle Ages. 

I have memories of excitedly opening my decorated bag to find the cards inside.  Back when I was in school, it was mostly cards.  Treats were just an occasional thing.  My favorite one was the little box of chalky sugar hearts with phrases like “BE MINE” stamped on them.  They are still a classic today.  Pure sugar… wow.

Elementary and preschools are usually good about making sure that every child gets something on Valentine’s Day.  If you are creative, it’s a great time to get your child involved with making cards for their friends.  They can learn important skills such as coloring, cutting, gluing, taping, and writing.  Plus it helps them to feel good about giving their classmates something that they’ve created.

As your child gets older and Valentine’s celebrations no longer involve making crafts and decorating bags and boxes, you may want to consider making Valentine’s Day a special day for the family.

Pre-teens and adolescents may find Valentine’s Day somewhat stressful if their friends have started dating.  In order to prevent your child from feeling lonely, left out or pressured about Valentine’s Day, try to make it a celebration about love in general.  Valentine’s parties and decorations, special family meals, and love notes from you can make any child feel special and create a fun atmosphere for this special day. 

As with Halloween and Easter, the candy quota from this holiday can be pretty intense.  Try to limit the amount of sugar your kids eat on a single day and set a date after which you toss the rest or take it somewhere else were other people can enjoy it.  (But of course, the good chocolate gets put in a special hiding place for parents only.) 

Have a Happy Valentine’s Day!  Thanks for reading!

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!

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!

Coughs, stuffy noses, and fevers – Welcome to Winter!

“How can I help with the cough?” is one of the most common questions I get in the office during the winter cold season. 

When cold weather arrives, we all stay indoors and we share our germs.  Viruses love the winter season because it’s the best time to travel from one person to another and then to another.   Kids who are around many other people tend to catch more colds and viruses than ones who are not.   Common exposures come from daycare, school, and their brothers and sisters. 

Children build immunity by fighting illnesses from viruses.  Their immune systems learn how to fight these bugs, and then hopefully, will be more protected in the future as they encounter new viruses.  Any pediatrician will tell you that they’ve never been sicker than their first few years in training or in practice due to the large number of viruses that we’re exposed to.  If you’ve never been exposed to a virus, then your chances of catching it is much higher.  However, once you’ve battled the illness, then your immune system has a memory that will help it to fight future similar viruses.

So, when a baby is born, EVERY virus is new to his system.  It’s no wonder that babies will catch colds.  When a baby or toddler starts childcare, very often they have a new cold or illness every two weeks for a while.  Then when they reach elementary school, they are less likely to get sick because they’ve already had many of the viruses.

When a new virus emerges, like the H1N1 flu virus, we are all susceptible since none of our immune systems are prepped to fight it off. 

Most cold viruses can last up to two weeks.  Many people get concerned if their child is still congested or coughing a little after one week.  However, two weeks is still reasonable.  Fevers should be less than 103-104 F and should only occur during the first three days of illness.  If your child has a fever later, has a high fever, is breathing fast, or working hard to breathe, you should call your doctor immediately for guidance. 

Most coughs are protective.  The cough reflex is designed to protect your lungs from drainage that is trying to go down into them.  However, occasionally coughs can be more ominous and can be a sign of infection (bronchitis, pneumonia) or wheezing/asthma.  If your child seems to have a bad cough, has a fever with the cough or has difficulty catching his/her breath, call your doctor.

So, what to do when your child has a cold?  Well… it depends on the age of your child.

Young Infants (under 6 months of age):  At this age, colds can be especially miserable because they can’t clear their own noses.  If congested, it is hard for your baby to feed since your child has to breathe through his/her nose when drinking or eating. Putting a few drops of nasal saline in each nostril and then suctioning the nose will help.  Sleeping upright in car seat or elevating your baby’s mattress may be helpful (do not use a pillow).   A humidifier (cool or warm) next to where your baby sleeps will also help.  Hydration is important, so small frequent feeds are good if your baby can’t eat his/her usual amount.  While fevers may be part of a viral illness, young babies need to be checked if they have a fever to rule out other illnesses (especially babies under 3 months of age).   Call your doctor if your baby has ANY fever>100.4 (rectally), has trouble feeding, is breathing fast, has coughing fits, is vomiting or is not improving.   No over-the-counter cough medications are recommended at this age.

Older Infants and Toddlers:  Children this age also have difficulty when their noses are stuffy and they are coughing.  Sleeping is a challenge and often they will lose their appetites and drink less.  While eating less is okay, it is important that your child drink enough fluids and stay hydrated.  Clear fluids, like Pedialyte, will help to hydrate without increasing the mucous production like milk-products can.  Nasal saline is also useful to clear stuffy noses.   Suctioning your child’s nose will help him/her to breathe easier.  A humidifier (cool or warm) will help to quiet coughs and make nighttime easier to manage.   Sometimes, babies tend to collect mucous in their throats or upper airway and then vomit the mucous after coughing.  While messy, this can be normal and is their way of getting rid of the drainage.  However, if your baby has a high fever (>103-104), has difficulty drinking, is working hard to breathe, is vomiting other than with cough, or has a fever after the first three days of illness, call your doctor.  No over-the-counter cough medications are recommended at this age.

Preschool-aged children:   Kids aged 2-5 often have colds in the winter, especially if they are in preschool.  The sharing of viruses is inevitable when every child seems to have a runny nose in class!  For this age, you can help by taking care of the symptoms.  Again, nasal saline is useful and teaching your child to blow his/her nose is important to prevent secondary infections such as sinusitis or ear infections.  To help with sleeping, use a humidifier and have your child sleep upright on pillows.  A teaspoon of dark honey has been shown to be as effective as cough suppressants.  Over-the-counter cold medications are not recommended at this age.  If your child has high fever (>103-104), has difficulty breathing, or has a fever after the first three days of illness, call your child’s doctor. 

School-aged children:  For older children, it’s primarily night time that is difficult.  Run a humidifier, keep your child hydrated, and use nasal saline sprays to help.  A teaspoon of dark honey can be effective for quieting coughs at this age.  Over-the-counter cold medications can be used sparingly.  It is important to pick a medicine that specifically treats your child’s symptoms.  Multi-symptom cold medicines have active ingredients for each symptom – fever, cough, congestion, runny nose, and so on.  Do not give your child medication for symptoms that your child doesn’t have.  Also, while cough suppressant might make it easier to sleep, try not to use it during the day.  Cough has a purpose (to protect your lungs from drainage), so suppressing it may lead to further complications.  High fevers (>104), fever after the 1^st three days of the cold, or difficulty breathing are all symptoms for which you should call your child’s doctor.

Hope you and your family have a safe and healthy holiday season!  Thanks for reading!

Flying With Kids

I awkwardly pulled my laptop out from under the seat in front of me while trying not to spill the little plastic cup of soda and bag of pretzels precariously balanced on my airplane tray table. My son across the aisle from me whined, “Mommy, I’m hungry!”  Then his brother said, “I need to go potty!”
 

Meanwhile, my two youngest children sitting next to me were impatiently waiting for me to start the Dora movie on the laptop.  “We want Dora!” they chanted.  They had not yet comprehended how computers are not instant satisfaction on startup.  At the same time, my husband (who was sitting next to the two older children across the aisle) had his eyes closed, resolutely ignoring the boys as they tried to get someone’s attention to feed them and take them to the bathroom.

Hmmm… Are we there yet?  

Thank goodness it was only a two hour flight.  The last flight we took as a family was over four hours and that was easily the maximum capacity for my two-year old for flying on a plane.  After that, I vowed no more long flights until he was older.

Flying with kids can be a challenge or it can be smooth-sailing.  Very much it depends on the age of your child, the length of your flight, and the time of day of your flight.  

I love to travel, and I really enjoy taking my kids places so that they can experience sights and adventures that I never had the opportunity to see and do as a child.  I even actually enjoy flying with my kids (usually).  However, I enjoy it more when they are older than three years of age and when I have enough adults around to help me.  Let’s just say it’s a little less stressful and a whole lot less to pack.

It’s amazing how much STUFF a baby needs.  I remember taking my oldest on a flight when he was five-months old.  He was a tiny little baby, and he had an entire full-size suitcase dedicated to him and his STUFF.  You know what I’m talking about – the diapers, the wipes, the bottles, the warmer, the clothes, and the backup clothes, the baby soaps and shampoos, the bibs, and the backup bibs, the blankets, etc.  Not mention the car seat, portable high chair, toys, and so on.  

So, how to survive a flight with your little one?  Here are some ideas (based on age):

Young Infant – the nice part of this age is that entertainment is not necessary.  Most of the times they are content to eat, sleep and poop as they normally do when not in an airplane.  The biggest issue will be helping them to “pop” their ears and equalize the pressure in them during the flight.  Generally, if your ears are popping, their little ears are trying to do the same.   To help your baby with this, make sure that he/she is swallowing during takeoff and landing.  You can do this by feeding your baby during these time periods.   Just make sure to pack extra clothes and diapers, including extra clothes for you in case of unexpected spit-up or diaper accidents.

Check the TSA website listed later in this blog post to familiarize yourself with rules regarding bringing formula or breastmilk onto the airplane.

Older Infant/Toddler – This is a challenging age for flying.  You can certainly fly successfully with a toddler, but timing is of utmost importance in this age group.  Choose your flight time by avoiding anything near naptime or bedtime.  Tired toddlers make lousy travel companions.  Pack plenty of snacks, favorite toys and distractions.   If at all possible, try to book nonstop flights to minimize the total travel time.  For really long flights, a break in the middle at a connecting city for a few hours may be ideal – however leave enough time so that you won’t be running for a connecting flight with a toddler in tow.  

Bring your stroller all the way to the gate and check it in at the gate just before you board.  It will make getting all your belongings and your baby to the plane easier.  Also, bring an empty sippy cup and then buy something in the airport to fill it, or ask them to fill it on the airplane with water or juice.

 

Some pediatricians recommend bringing along an weight-appropriate dose of Benedryl along in case your toddler is really having a difficult time with the trip.  Benedryl is an allergy medication that generally causes drowsiness as a side effect.  However, be aware that a small percentage of children actually get hyper on Benedryl.  Therefore, it is wise to test this at home before you discover that your toddler is wild after taking Benedryl on the airplane!

Children Ages 2-4 Years Old – This age group generally loves airplanes… at least they love looking at them.  Flying in them may be a different issue.  Reading about flying or going on an airplane is a good idea if this is your child’s first trip.

I usually try to buy a surprise activity for each child to do on the airplane – a new coloring book or new activity that travels well.  The fun of trying out a new coloring book and new markers will entertain most children for at least a portion of the trip.  Don’t give it to them until you are actually on the plane to enhance the surprise (and distraction) factor.

Also, while I don’t normally advocate video watching – a portable DVD player or laptop or ipod can work wonders to keep little minds occupied for a good portion of longer trips.   Taking a few walks up and down the aisle midflight helps to break the monotony of sitting in the seat.  Feeding children in this age group just before you fly, or bringing food on the plane, is also a great way to pass the time.

School-Aged Children and Older – Luckily, this age group tends to be able to entertain themselves.  Favorite activities include books, handheld games, and MP3’s make flying a more enjoyable and less boring experience for this group. Let them pack their own backpack and have them each carry their own carry-on.  It makes traveling much easier (especially if you can pack things for a younger sibling in their bag also!). 

Again, food is an excellent way to pass the time, so bring a meal onboard and give them something to do.  This will also ensure that they will not be hungry during the flight.

With the many travel rules these days from TSA, it’s a good idea to check out their website for rules about traveling with children.  They have a useful website at:  http://www.tsa.gov/travelers/airtravel/children

So, I hope this helps if you have little ones traveling by plane this holiday season!  If you tried some tricks for successful flying that have worked for your children, please share them by posting a comment!  

Thanks for reading and Happy Thanksgiving!