Daily Dose

Sunscreen Apps!

1.15 to read

Have you vacationed this summer and if so wherever you go you have probably had some sun exposure? Whether you are at the beach, in the mountains or out sightseeing it is important to make sure you are using sunscreen on a regular basis and that means all of the kids as well.

I am happy that I find more and more of my patients and their parents using sunscreen on a regular basis.  At this time of year it is a good idea to apply a liberal amount of sunscreen on your child to just start off the day.  I would always use a SPF of at least 30. Again, this is just for a normal day as your child may be in and out of the house, or on the playground at day camp, or day care.  Remember, this is just the “base” coat, and not enough for prolonged sun exposure.

While I was planning on some sun exposure during vacationing I came across an article about different apps that are available to help you calculate how much sun exposure you are getting and the risk of sunburn as well. Who knew how many different ones were available?  

You can use these apps and actually type in your location and your child’s skin type and then they calculate how long you can be in the sun. The apps also recommend sunscreen strengths as well.  Some of the apps actually have a timer to remind you how much longer you can be in the sun and when to reapply sunscreen.  How clever is this to use, especially for a teen who is spending the day at the lake and never seems to “remember” to reapply sunscreen.

I have decided that I am going to download a few of these apps and try them out over the next several weeks and see what I think.

Bottom line....keep re-applying sunscreen for any lengthy sun exposure...you don’t need an app for that advice.  

Daily Dose

How to Treat Poison Ivy

1.15 to read

With the long weekend here, many families are enjoying the outdoors. But with outdoor activity, your children may develop summer rashes like poison ivy, poison oak or poison sumac. Each plant is endemic to different areas of the country, but unfortunately all 50 states have one of these pesky plants. Teach your children the adage “leaves of three, let it be”, so they come to recognize the typical leaves of the poison ivy.

The rash of poison ivy (we will use this as the prototype) is caused by exposure of the skin to the plant sap urushiol, and the subsequent allergic reaction. Like most allergies, this reaction requires previous exposure to the plant, and upon re-exposure your child will develop an allergic contact dermatitis. This reaction may occur anywhere from hours to days after exposure, but typically occurs one to three days after the sap has come into contact with your child’s skin and they may then develop the typical linear rash with vesicles and papules that are itchy, red and swollen. Poison ivy is most common in people ages four to 30. During the spring and summer months I often see children who have a history of playing in the yard, down by a creek, exploring in the woods etc, who then develop a rash. I love the kids playing outside, but the rash of poison ivy may be extremely painful especially if it is on multiple surface areas, as in children who are in shorts and sleeveless clothes at this time of year. The typical fluid filled vesicles (blisters) of poison ivy will rupture (after scratching), ooze and will ultimately crust over and dry up, although this may take days to weeks. The fluid from the vesicles is NOT contagious and you cannot give the poison ivy to others once you have bathed and washed off the sap. You can get poison ivy from contact with your pet, toys, or your clothes etc. that came in contact with the sap, and have not have been washed off. If you know your child has come into contact with poison ivy try to bath them immediately and wash vigorously with soap and water within 5

Daily Dose

Are Parents Too Connected?

1.30 to read

Has your spouse, babysitter or other child care provider ever called you to come home “because the baby is crying”?  It seems that technology, which is readily at our finger tips 24/7, has created yet another dilemma - what to do if a baby is crying? 

Pre-cell phone days, there really was not much to do if you the parent left home and your baby/child started crying.  Outside of calling the restaurant, store, movie theater (directly), and asking them to page a parent, most of us just muddled through a crying child.  I also think that in most cases, said child eventually stopped crying (unless there was an obvious reason that could be “fixed”) and by the time you the parent returned home, all was typically well.  

But now, with a cell phone in every hand, it only takes one call to summon the parent of a crying child.  I think this is a good news/bad news dilemma.  The good news is: parents may feel more comfortable leaving their child with a babysitter, knowing that they may be reached in the event of an emergency.  The bad news is:  is a baby or child who is only crying, typically an emergency?  Depends on your definition. 

The reason I bring this up is that I often hear young parents, and especially mothers, tell me that during the first several months of their infant’s life, they cannot leave the house for more than minutes, before being called home....because the baby is crying.  Some of these mothers are really “stressed out and exhausted” and need a bit of a get-away to “re-boot”. I am not talking about a trip to the day spa. I am simply talking about an hour or 2 to go to the store or meet a friend for lunch or just sit alone in the park and read a book.  Just a bit of quiet after being home with a baby day in and day out for the first 4 weeks of their newborn’s life.  If you have been there you understand. 

But, now that they have a cell phone, there is CONSTANT communication.  The minute the baby cries, the cell phone rings....”the baby is CRYING, come home.”  My husband would tell you that his best parenting started the first time I left him alone with our first son and I actually went away for the weekend.  (I believe the baby was 6 or 7 weeks old and off I went breast pump in hand to a reunion.)  No cell phones then, and guess what, he did a great job!!!!  He told me how after the first 24 hours he figured out that he really didn’t have to have the baby in the bathroom with him in order to take a shower. He later told me that the first shower he took, not only was our son in the room in his “bouncy” chair, but he left the shower door open as the door got steamy and he couldn’t see the baby!! How cute is that. 

Technology, as wonderful as it is, may also enable us to “cop out” when things get a bit difficult.  That goes for parenting as well. 

Turnoff your phone off sometime and let the “other parent” or babysitter handle it for awhile. Being disconnected is NOT always a bad thing!

Daily Dose

Start the Back-to-School Sleep Routine Now

2.00 to read

Getting back into the routine of school days also means getting back to good bedtime routines.How can it be that school is just around the corner? Getting back into the routine of school days also means getting back to good bedtime routines. With that being said, you have to start the process now to ensure plenty of time to slowly get bedtimes re-adjusted. By starting early you can avoid the battles that some parent’s talk about when discussing bedtimes.

Children need a good night’s sleep to wake up happy, rested and ready to learn. Numerous studies have shown that elementary age kids need about 10 hours of sleep a night while tweens and teens still need a good 8 – 9 hours of sleep. I wonder how many children really get the recommended amount of sleep? I think too few. Unfortunately, I know from my own experience that teens seem to operate on a different sleep schedule and rarely are in bed as early as they should be. Most of us have relaxed bedtime a little during the summer and children are staying up later and sleeping longer in the mornings. This is great during the lazy summer months, when schedules are also different. But within a few weeks the morning alarms will ring forcing everyone to get up earlier to get to school. In order to try and minimize grouchy and tired children (and parents too) during those first days of school, going to bed on time will be a necessity. Working on re-adjusting betimes now will also make the transition from summer schedule to school schedule a little easier. If your children have been staying up later than usual, try pushing the bedtime back by 15 minutes each night and gradually shifting the bedtime to the “normal” hour. At the same time, especially for older children, you will need to awaken them a little earlier each day to re-set their clocks for early morning awakening. Why is it that pre-school children want to get up early, no matter what, while school-aged children are happy to sleep through alarms?  Such is life. Also, make sure that you are not only ensuring that you children get a good night’s sleep during the school year, but they also awaken in time for breakfast! Just like my mother used to say, “breakfast is the most important meal of the day’” and that adage is still true. A good night’s sleep followed by a healthy breakfast has been shown to improve mood, attention, focus and over all school performance, as well as even helping to prevent obesity. Start off the school year on the right foot. It is easier to begin with good habits than to try and break bad ones. That’s your daily dose, we’ll chat again tomorrow.

Daily Dose

Toddlers & Tantrums

1.15 to read

I see toddlers for check ups nearly every day and for both the 15 month and 18 month visit, there are many challenges for parents and the pediatrician (and of course the child). Toddlers are not at what I would call an EASY age.

As you know if you have a toddler, they are quite moody (just wait for teenagers) and they can “stop, drop and roll” into a tantrum in the blink of an eye.  So while I was examining an 18 month old this week ( she is one of three adorable girls), she suddenly became infuriated (her mother and I were really clueless as to what triggered this) and she jumped off of her mother’s lap and fell to the floor kicking and screaming. 

Now, for a first time parent this might be alarming behavior, but for a seasoned mother of three it was really no big deal. Appropriately, we all just ignored her as she laid on the floor and screamed (no, the mother was not worried about germs on the floor either) and we continued our conversation about her child’s less than stellar sleep habits.

After a few minutes her daughter calmed down, the older sisters got her a sticker and she left without a fuss. Her mother had already learned, like we all do, that the best way to stop tantrums is by ignoring them and letting your toddler have some time to “express her emotions” with age appropriate (although inappropriate for older children) behavior.  

Several days later, her mother sent me an email with another picture attached of the same child having yet another tantrum after she found her in her diaper with a sharpie pen happily marking all over herself (the photo above). Of course, the minute she took the marker away her daughter fell to the floor again to express her outrage! So funny that her mom thought to document it and send me another picture.

By the way, she also told me that she had taken practical advice and was working on having her daughter cry herself to sleep and it was working well!  Both the tantrums and sleep were improving by just ignoring her behavior. Back to those laws of natural consequences.  

Daily Dose

Treating Sunburn

1.15 to read

Is it hot enough for you and your kids?  I bet every day you look at the weather map and try to figure out the best ways to beat the heat. 

With kids taking the plunge to stay cool, many forget to re-apply sunscreen and end up with a bad sunburn.  Sunburn is no fun and can cause significant problems. 

Sunburns may cause first-degree burns and you know it when you see it…your child’s skin turns pink and red and is uncomfortable, and itchy. 

Sunburn may also cause second-degree burns where the burn actually penetrates the dermis and causes blistering and a deeper burn and more cell damage. With blistering may come scarring and also an increased risk of skin cancer and skin damage later in their lifetime. 

Repetitive sunburns are cumulative and can put your child at even more risk for melanoma. Recurrent sunburns are often seen on the nose, ears, chest, and shoulders. 

You may not notice symptoms until 2-4 hours after the damage has begun. You’ll see redness over the next 12 -24 hours with pain, swelling and blistering. Some children will even develop nausea, fever, vomiting or dizziness after a significant sunburn and are at risk for dehydration. 

The best way to treat sunburn begins by moisturizing the burned area to cool down the skin and reduce inflammation. Try a cool bath or apply cool, wet cloths.  I like a product called Domeboro.  It’s very soothing when added to a bath or to cloths that you can soak in the solution. 

Keep your kids hydrated to replace fluids.  You can also give your child a pain reliever like Tylenol or Motrin/Advil to help with discomfort.  Some children also respond to an oral antihistamine to help with itching. 

Do NOT let your child back in the sun until their symptoms are improved and even then they should wear sun protective clothing as well as sunscreen. Remember, you can even get a burn in the shade, under an umbrella or on a cloudy day. Most of us heard that from our own mother's but unfortunately did not believe it until we ourselves had experienced a sunburn.

 

 

Daily Dose

Monitoring Your Baby

1.30 to read

I have recently received several emails from patients which included attachments.  The attachments were videos of a baby in their crib with questions from parents about whether the baby was “breathing okay”, was “crying enough to be picked up”, or whether I thought “the baby was dreaming”. I had to laugh, as the first thing I thought of while watching all of these videos was: we are really just “too smart for our own britches”, which was a line often used by my dear deceased grandmother who died at the ripe age of 104!  In this case, she would be right as we have so much technology available to us but I’m not sure if it is really that helpful when we are talking about caring for a baby. 

Every parent wants to make sure that they are “watching” their newborn, infant or toddler as closely as possible. That is good parenting.  But, even a newborn does not need to have constant video monitoring with rewind and playback ability.  Just having your baby in the bassinet by your bed or in the nursery next door to your room is really sufficient.  

The idea is that you can hear your baby if they are crying.  You do not need to hear hiccups, and know that they latest for 18 minutes. If your baby is stretching and making normal “new baby” grunting and groaning sounds, you do not need to hear every noise. You do need to hear your baby crying because they are hungry, wet or uncomfortable.  That is when a parent is supposed to get up and go to their baby’s bed.  Watching them just making a few noises to get settled is not a call for intervention.  

I am the first doctor/mom to totally believe that a new baby needs to be held when fussy or irritable. I am not the “cry it out” doctor (let them cry for the first 5-6 months of life).  But, a baby can ooch and scooch and not need to be picked up and if you do not have a video monitor, you probably would not know they were ooching and scooching.  With video monitors on day and night a baby cannot even burp without the parent watching and wondering and “worrying” if that burp was significant.   

While we talk about our teens being “too connected”, maybe we parents need to think about that too.  Are “we” parents (and grandparents) being too connected to the baby?  Are we part of the problem of “instant” intervention, when many a baby might calm themselves if given the chance (and the parent never knew).  

Many generations of newborns and young babies were raised, successfully, without a video camera. Parents ears are a pretty good monitor too , for both babies and even teens.  Eavesdropping is still allowed! 

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

Why Doctors Fire Patients

1.30 to read

There was an article in the WSJ entitled “more doctors dismissing patients who refuse vaccines for their children”.  It was interesting to me as I too now only accept new patients who are going to vaccinate their children. This was not an easy decision on my part, and prior to the decision I had several families who refused vaccines completely, and another group that followed “an alternative” vaccine schedule. Even so, I was never comfortable with their decision and it always gave me pause and sleepless nights when their children would get sick. 

During the height of the debate over vaccine safety and the possible link to autism it seemed like much of my day was spent “debunking” vaccine myths. I spent a great deal of time discussing the reasons behind the AAP/ACIP (American Academy of Pediatrics and the Advisory Committee on Immunization Practices) recommended vaccine schedule and also explaining how vaccinations had saved lives, actually millions of lives. 

As more and more data was gathered, and the Wakefield papers were discredited, it became apparent that there was not a link between vaccines and autism. The arguments about thimerasol in vaccines were also moot as thimerasol is no longer the preservative used in vaccines (except for flu vaccine). With all of this being said I decided to take a stand and vaccinate all of my new patients, according to AAP guidelines. 

I discuss this decision with families even before their child is born. I tell them that it is important to pick a pediatrician that shares their beliefs as the  doctor patient relationship is a long one in pediatrics. (hopefully cradle to college)  It is analogous to dating; why would you pick a date on a match site if you held opposite beliefs to begin with?  

The same goes with picking a pediatrician, you need to start off the relationship on common ground. Even if there may be some other disagreements on subjects down the road, I think you need to begin the relationship holding similar beliefs. 

I have practiced long enough that I remember doing spinal taps in my office and treating children with meningitis or bacterial sepsis. There were long nights spent in the ICU with families and unfortunately a few patients died, while other survived but are deaf or have other residual effects from their disease.  It was devastating to me and I can’t even imagine for those families. I also bet that those families would have given anything to have a meningitis vaccine or a chickenpox vaccine for their now deceased children. 

I understand that every parent has to make their own decision for their children. At the same time I believe that it is also “my practice” and I get to choose how I practice pediatrics. With that being said, my parents choose to vaccinate their children and we happily start off the parenting/doctoring partnership together.  I also sleep better at night not worrying that their child will contract a vaccine preventable disease. 

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

Pages

Please fill in your e-mail address to be included in our newsletter.
You may opt out at any time.

 

DR SUE'S DAILY DOSE

Can essential oils boost your child's immune system and fend off colds and flu?