Daily Dose

Bright Light & Sneezing

1:30 to read

What is the connection between bright light and sneezing? DId you know it was hereditary?I have always noticed that I frequently sneeze when I walk outside, and this was especially noticeable this summer with all of the bright sunny HOT days that we experienced. I thought I had remembered that my mother often did this too and when I asked her she confirmed this.

I was recently reminded of this again when I was with my youngest son moving him back to school. It seemed that every time we walked outside to get another load of boxes he sneezed! We both sounded like “Sneezy” one of the Seven Dwarfs.

Of course my son announced, “Mom are you just realizing this? I have always sneezed just like Ohma and you do”. Oh well, I am finally catching on.

This of course piqued my curiosity and then I remembered that I had read something about “the photic sneeze reflex”.  It has also been name ACHOO: Autosomal Cholinergic Helio-Opthalmic Outburst (and you thought ACHOO was the sound you made!)

It is estimated that this reflex affects about 1 in 4 people. It is inherited in the autosomal dominant manner (remember your days in biology and big B and little b?) If you have the “sneezy gene” your child has a 50-50 chance of also having it.

This reflex has been known for a long time but there wasn’t much science as to the cause. But a recent study (very small only 20 people) compared photic sneezers to controls and found that when shown a shifting pattern of images, the visual cortex of the sneezers showed higher activity than those of the control subjects.

There needs to be much more research done on this topic with larger groups of people studied to further confirm this finding.  But, nevertheless, it is interesting that scientists are now trying to elucidate the mystery of the photic sneeze.

In the meantime I realized that another one of my son’s also has the gene. Funny how you suddenly recognize a familial pattern to sneezing only to find out it is in the genes. It also reminds me I have a blue eyed and 2 brown eyed children, back to those genes again.  Just like they taught me in medical school, take a good family history!

That’s your daily dose for today.  We’ll chat again tomorrow.

Daily Dose

Fruits & Veggies in a Pouch

1.15 to read

OK, I am back to the subject of “squeeze pouch foods” or as another cute 2 1/2 year old called it “squeegy fruit”.  I have written about this before as I was fascinated by these when they first hit the market. On the one hand, I get that they are convenient and are easy to use for those first months of pureed baby foods, but beyond that, I think they are given to older children.  

It seems that more and more kids are enjoying “squeegy fruit” and also “slurping” pureed vegetables. The issue is these pouches foods are being “masqueraded” as healthy foods.  Yes, they are fruits and vegetables often mixed together, but if you read the labels it gets a bit more complicated.

I see so many toddlers in my office who are happily “sucking down” a packet of apples and blueberries.  These parents are adamant that their kids don’t drink juice boxes or eat “junk food” but at the same time they are letting their children “suck down” several of these pouches a day.  This is also often in place of meals, as many of these children are described as “picky eaters”.  I saw a little boy today who had been vomiting, but was on the exam table with pouch to mouth as he “drank/ate” a combo of apples, peas and something else.  (note: not recommended when vomiting).

So....I decided to look up the nutritional value of these pouches....many of them although “all organic” or described as “healthy” do contain a lot of carbohydrate and sugars.  Actually, as much as two fruit roll ups!  Yes, I did a little comparison and 2 of the “dreaded” fruit rolls ups contain 23 grams of carbs and almost 11 grams of sugar.....while a 3.2 ounce pouch has somewhere between 19-24 grams of carbs and between 14-23 grams of sugar.  

The point of this is not to say that “squeeze pouches” are bad, or that a child should never have a fruit roll up.  Rather, it is to point out that even “healthy” snacks can be full of sugar.  Rather than a fruit roll up or a  squeeze pouch, what about a piece of fruit?  Sure, it may be a bit messier to cut up a piece of fruit, but those pouches are not teaching children about textures and chewing.

Pouches are great for travel, special occasions and babies. But, they are not for toddlers and certainly not for everyday consumption.  Oh lastly, they are bad for the teeth as well!  

Daily Dose

Kids Who Snore

1.30 to read

Does your child snore?  If so, have you discussed their snoring with your pediatrician.  A recent study published in Pediatrics supported the routine screening and tracking of snoring among preschoolers.  Pediatricians should routinely be inquiring about your child’s sleep habits, as well as any snoring that occurs on a regular basis, during your child’s routine visits.  

Snoring may be a sign of obstructive sleep apnea and/or sleep disordered breathing (SDB), and habitual snoring has been associated with both learning and behavioral problems in older children. But this study was the first to look at preschool children between the ages of 2-3 years.

The study looked at 249 children from birth until 3 years of age, and parents were asked report how often their child snored on a weekly basis at both 2 and 3 years of age.  Persistent snorers were defined as those children who snored more than 2x/week at both ages 2 and 3.  Persistent loud snoring occurred in 9% of the children who were studied.

The study then looked at behavior and as had been expected persistent snorers had significantly worse overall behavioral scores.  This was noted as hyperactivity, depression and attentional difficulties.  Motor development did not seem to be impacted by snoring.

So, intermittent snoring is  common in the 2 to 3 year old set and does not seem to be associated with any long term behavioral issues. It is quite common for a young child to snore during an upper respiratory illness as well .  But persistent snoring needs to be evaluated and may need to be treated with the removal of a child’s adenoids and tonsils.

If you are worried about snoring, talk to your doctor. More studies are being done on this subject as well, so stay tuned.

Daily Dose

What is Thrush?

1.15 to read

I get a lot of phone calls and questions from worried mothers who have noticed that their baby’s tongue has a bit of white coating and is this thrush?  Thrush is fungal infection of the mouth that is seen in babies (about 2-5% of babies), but thrush typically affects the sides of the inside of the baby’s mouth or under the lips and along the gum line. A white tongue alone is most likely residual milk. 

There are many cases of thrush that are mild enough that they may resolve on their own. On the other hand, a severe case of thrush may be painful and may make it difficult for a baby to feed, which then leads to a fussy, irritable baby. 

Thrush is caused by the fungus candida and despite everyone’s best efforts at cleanliness, candida like bread mold, can just happen.  Candida may be acquired at the time of delivery as the baby passes through the birth canal that is colonized with candida, or during nursing from the skin of the breast, or from a pacifier or the nipple of a bottle.  

Thrush is typically treated by wiping the inside of the mouth with a soft washcloth followed by an antifungal medication given as drops in the baby’s mouth after the baby has eaten. In a breast fed infant I treat the mother’s breast with a topical antifungal cream as well. 

Best way to look for thrush may be when you baby yawns and you get a good look at the inside of their mouths (bucal mucosa).  You don’t need to be a detective to find thrush, it is usually fairly evident and the biggest clue that it is not milk as it will not wipe off with a soft washcloth.

Daily Dose

Kids Need Vitamin D!

1.15 to read

During all of my check ups I discuss the importance of dairy products in a child’s diet to provide adequate calcium and vitamin D for bone growth and long term bone health.  It doesn’t seem that the little ones are difficult to get  to drink milk, eat string cheese, have a yogurt, but the older kids are definitely more challenging. 

Teenage girls seem to be one of the biggest problems when it comes to calcium intake. When I ask them if they drink milk, a typical response is “Uh, no”, then if I ask about other dairy they may say they drink the milk out of the cereal bowl, or they grab a frozen yogurt at lunch or have a slice of cheese on occasion.  When I ask them if they know how much calcium and viamin D they need during the tween and teen years I also get a blank look  but they do know how many texts they have on their cell phone plan!).  Answer is 1300 mg/day once you hit the teen years. 

With that being said, I am always encouraging more dairy products, milk and then a calcium/vitamin D supplement as well. Interestingly, they usually don’t balk at the idea of a vitamin, but the issue is getting them to stay on the supplement for more than a few days/weeks when they typically start to “forget”. 

So, I was seeing a family with two teenage daughters who had heard my calcium talk before. They were both non milk drinkers, competitive cheerleaders who needed strong bones and who by now could answer my calcium questions. When I asked if they were taking their calcium supplements the mother said, “they have access to calcium and vitamins” everyday......what a great line. Well put by a mom of teens! 

In fact, despite having “access” the girls readily admitted they “rarely” remembered to take them and might be more likely to up their dairy products everyday. 

Calcium and vitamin D metabolism is a hot topic and “banking calcium” during childhood is so important.....even with access to the supplement you have to swallow it to make a deposit. 

Daily Dose

Teens & Skincare

1.15 to read

I am seeing a lot of teens for their “routine” checkups and skin care is always part of our discussion. If you have a teen, you know how self-conscious they can be when it comes to their skin. Some teens are just blessed with good skin, and when you ask them what they do to their skin their reply is “nothing’. That is not the norm. Adolescence is the prime time for acne and whether the breakouts are mild or persistent, good skin care is the beginning for everyone. The first thing that all adolescents need to do is to wash their face twice a day. You do not need “fancy” skin potions or lotions either, the drugstore has more than enough choices to begin a good cleansing program. Using a mild soap- free cleanser may be enough to begin with , something like Purpose, Basis, Aquanil or Neutrogena. If the skin is more oily and acne prone try a cleanser that contains glycolic or salicylic acid , products like Neutrogena Acne wash, or Clean and Clear, you will need to read labels to look at the ingredients. These provide gentle exfoliation of the skin surface. Wash with a soft cloth but don’t scrub or buff, just wash. After washing your face in the morning, always apply a gentle non-comedogenic moisturizer WITH sunscreen. This will not cause acne, but will prevent sun damage that we all get on a daily basis. This is not the same as applying sunscreen for a day at the beach or lake. Again, I like Oil of Olay complete, or Neutrogena but there are many others out there, so find your favorite. At bedtime, after washing your face, if skin seems to be getting break outs begin using a 5% benzoyl peroxide lotion (you only need a dime size amount for the whole face) applied after your face has completely dried from the washing. If it is applied to a wet or damp face it may cause redness. Benzoyl peroxide products come in several strengths and may be titrated up in strength as tolerated. If this regimen is not working well it is probably time for a visit to the doctor to discuss some prescription products. More on that another day. That's your daily dose. We'll chat tomorrow. Send your question to Dr. Sue!

Daily Dose

Cold Weather & Colds

1.15 to read

It has been bitterly cold across the country including my home state of Texas. We have survived “icemageddon” which is finally starting to melt and kids around here are back in school. 

But one theme I keep hearing from parents is that this cold weather causes colds. NOT TRUE!  MYTH!   Viruses are the cause of most of the colds that are making both children and adults sniff and cough.  What does happen during the winter months is that we all tend to spend more time indoors and this is where it starts. Cold weather is not typically conducive to outdoor activities like the playground or bike riding. (but for some ice skating and sledding). In other words, we spend more time inside, gathered together in enclosed spaces. (malls, movies, house)  

But, when we all head indoor, the coughs and colds don’t stop, and the germs are easily spread from person to person. The more time we spend inside, whether we are in a mall shopping or in school, it makes it easier to catch a cold. 

Children are great at spreading germs, and not purposely. While they are learning to share at pre-school, this sharing also includes their viruses. Younger children are just learning to cover their mouths when they cough and they touch their noses and face all day long.  They also put everything in their mouths and then set it down for their friends to “share”.  It is not unusual for children between the ages of 1-3 years to get 5-6 colds during the winter months alone.

So....in reality, being outside, even in cold weather does not cause a cold. Rather,  it is that we spend more time inside sharing our germs. So, just bundle everyone up appropriately and do get some fresh air during the winter months. Remember cough hygiene and those flu vaccines as well.  Viruses do like cold, dry weather, but they love us being cooped up in the house even more.

Daily Dose

Baby Nursery or High-Tech Hideaway?

1.30 to read

My goodness, there really is a baby boom this summer! I have been seeing so many new babies and I am suddenly realizing that a new baby’s home nursery is “fancier” than an intensive care unit!  I can hardly keep up with all of the technology that new parents are talking about. They are asking me questions about setting up heart rate monitors, pulse oximeters and respiratory rate monitors - all for their precious new babies, none of whom have any underlying problems. These are just new parents with a lot of technology at their disposal.  

What did a parent do before all of this “uber” technology?  Ask your own parents- they just listened for the baby to cry. Incredible, huh?  No monitor or video monitor, just a crib in the nursery (which was typically close the parents room) and when the baby cried you went to check on them.  The market for newborn monitoring has gone through the roof and I am sure there is more to come. Of course every parent wants the very best for their baby, but is all of this really necessary?  Are you being overprotective?

In my opinion having the nursery as wired as an ICU is really causing parents even more anxiety as they are constantly looking to see what their baby is doing. They are technology addicts and cannot stop themselves.  Check the oxygen monitor, look at the video monitor, listen for breathing?   A newborn must feel some “invasion of privacy” as their every breath, movement and squeak is monitored,  I only wish some parents with misbehaving teens were this connected.

Every new parent is fearful of SIDS, that has been true for many years, and will always be a concern for parents.  Unfortunately, studies have shown that the best protection against SIDS is not a video monitor or a pad under your newborn to detect respiratory rate, if it was wouldn’t doctors be recommending this?  We would all be selling you a monitor. The best protection is simply back sleeping on a flat surface without blankets, pillows or toys in the crib.  

SIDS is typically a silent event and can occur even when the baby is in the room with you, or has a video monitor on them.  Being an anxious parent does not cause or prevent SIDS.  But, being able to enjoy your newborn is important. Not being able to leave the nursery to go to the kitchen, or even to leave the house without a video monitor streaming pictures of your baby just doesn’t seem healthy.  

So, I would save the money on the ICU nursery.  Buy a simple monitor so that you can hear your baby cry if you are in another area of the house, or in the yard with your other children, and put the money saved in the college fund!

Daily Dose

Jenny McCarthy on The View

1.30 to read

Do you watch “The View”?  I have enjoyed the show for years, although I must say I probably only see it once every few months (somehow my work schedule is just not conducive to daytime TV watching). So, I was “shocked” to find out that The View recently announced that one of the new hosts is going to be Jenny McCarthy. 

I will be honest, I am not a Jenny McCarthy fan.  I can remember the night that Jenny McCarthy was onLarry King Live discussing her son’s diagnosis of autism and her contention that his diagnosis was caused by his childhood vaccines. Little did I know how her own ideas and words could effect so many other parents and their decisions to immunize their own children.  I mean REALLY, a former Playboy Bunny who felt that all of the science in the world was wrong, telling the world that childhood vaccines caused autism.  Who would believe this, unfortunately a lot of people. Even highly educated people.

Our media staff contacted reprentatives inviting her to appear on The Kid's Doctor radio show, but they never responded.

As a mother, I do understand how any parent would like to be able to pinpoint the cause of their child’s illness and/or disability. But to disavow science and try and to use her celebrity to convince other parents not to vaccinate their children is reprehensible and wrong.  The data is just not there to link vaccines and autism.  PERIOD!

Unfortunately, many young parents who watched Jenny McCarthy did not notice that during the home videos she replayed over and over again on national TV, her child never made good eye contact even as a young baby and did not seem to have socialized and engaged even prior to his vaccines.  That was duly noted by developmental pediatricians, but that does not make national TV.

I have noticed that Jenny McCarthy has really stopped discussing vaccines and has moved on to other topics of expertise for her.....like relationships.  But regardless, the damage that she did during her  “anti-vaccine era” still continues to have legs, and for that reason I will no longer be watching The View. The only way I can express my ongoing concern about her views is to vote with my own TV, and hopefully effect her Nielsen ratings and Q scores. I hope you will as well.  

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