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Daily Dose

Airborne & Your Kids

1.45 to read

It’s cold & flu season and I have already been receiving emails from parents asking what works/doesn’t work.  I reviewed a recent note from a well-meaning dad asking if he could give his 3 year old son Airborne to help “offset colds”. 

I myself have just recovered from my first cold of the “season” and have looked high and low for ANYTHING that might prevent or treat the common cold. As I tell my own patients on a daily basis, if I had the “magic pill” I would certainly not only manufacture it to distribute to everyone, but I would also be getting ready to accept Nobel Prize in medicine for solving the mystery of preventing the common cold!!  Airborne is NOT the magic potion and I see no reason to use it period.

I recently did an extensive review of complementary and alternative medicine for the common cold (selfishly trying to cure myself) and once again came up empty handed for any proven remedies. There are still a lot of ongoing studies (someone will win the Nobel Prize one day), but nothing so far has really proven to be the panacea.

Many people “swear” by Airborne.  I am just not sure what they are thinking it does. If you read their website it states, “there are scientific studies that the ingredients in Airborne have been shown to support the immune system”. I can’t find those studies anywhere. 

In 2008 a class action suit against Airborne resulted in a $23 million dollar fine for “misleading consumers and making false claims”, when Airborne claimed to “ward off colds”. They have now changed their advertising to the wording, “boosting the immune system” which also seems like deceptive advertising to me. Regardless, they continue to make millions (despite that huge fine).  My mother even called to say she thought she might take some before flying to visit at Thanksgiving asking, “did I think that would help her from getting sick?” OMG!

The ingredients in Airborne include Zinc, ginger, Echinacea, vitamins, minerals, and herbs.  This is what I commonly call “hocus pocus”.  Many of the ingredients in Airborne have been studied for use during a cold, without a lot of success.  Zinc is still being studied with varying outcomes, but there are still no definitive guidelines on using Zinc for a cold. Stay tuned for more as more studies are completed.

In the meantime, the answer to the email is NO; I would not give a 3 year old Airborne. What I would do is make sure that your child is getting nutritious meals, adequate sleep and that they learn to wash their hands and cover their mouths when they cough (hand hygiene). I would put the money you would spend on Airborne in their piggy bank for future college expenses.   I would also make sure to get your child their Flu vaccine. We do have data that vaccines work!

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

Daily Dose

Calming Parent's Fears About Night Terrors

1;30 to read

I received an e-mail from a viewer today about night terrors. Her concern was “my son is having what I think are nightmares, but he talks and makes no sense and seems to be afraid and I am not sure what is going on.”

Her description is perfect for night terrors, which typically occur in children during the pre-school and early elementary years. The peak age is between five and seven years, and night terrors usually resolve before adolescence. About three percent of children experience night terrors.

Night terrors are part of sleep disturbances known as parasomnias, and are characterized by partial arousal during non-REM sleep. Night terrors therefore typically occur during a child’s early hours of sleep, when non-REM sleep is deepest. Most children with night terrors will stay in their bed, but cry out and appear anxious and upset, but are also very confused. Some children may run down the hallway with heart racing and breathing fast as if they are being chased. Until you see a child having a night terror it is difficult to explain how anxiety provoking it is for a parent who doesn’t realize what is going on.

I speak from experience as our third child had classic night terrors, but the first time he appeared in a “semi” awake state screaming and sweating, I would have sworn he was in horrible pain. Not the case, as after about two to five minutes most children will calm down (on their own as you cannot awaken them or comfort them during the event) and return to sleep and have no recollection of the episode the following morning. It is a very helpless feeling until you realize that your child is really not awake at all.

The other big difference between night terrors and nightmares is that the child has no sense of dread or of being scared to sleep. They have no fear or anxiety about these events occurring, and while the sleep terror ends abruptly with rapid return to deep sleep there is complete amnesia to the event. The best treatment is in reassuring parents. It is also important to make sure that your child has a regular bedtime routine and that they are getting sufficient sleep. This sleep disturbance is really more disturbing to the family than the child and will resolve over time. Just remember to let babysitters know, as it may be quite unsettling for a new sitter who has just put precious children to bed!

That’s your daily dose, we’ll chat again tomorrow. Send your question to Dr. Sue right now!

Daily Dose

Mumps Cases Reported

1:15 to read

Just as college students are getting out of school or graduating, there have been two cases of mumps at The University of Texas.  This means that thousands (40-50,000) of students may be packing up and heading home to their hometown in and out of state, while others may be moving around the globe. 

The concern is that mumps, just like the issue with measles earlier this year, is contagious. The incubation period may be as long as 25 days, so some students may not realize that they may be incubating mumps before they actually become sick.  

Mumps is spread via respiratory droplets and a person with mumps is infectious 3 days before they may even show signs of the illness with the typical swollen parotid (salivary) gland along the cheek and jaw. Mumps may also cause swelling of the testicles (orchitis).  Once the illness is apparent the patient is contagious for about 4 more days....in other words a lot of time for possible exposure. 

This is another good time to check that your children have had two doses of MMR (mumps, measles and rubella) vaccine, which is given at 12 months and again between the ages of 4-5 years.  Adults who were born before 1957 are considered to be immune, but parents born after 1957 should also have had at least 1 dose of MMR vaccine.

So, once again doctors are on the alert for another vaccine preventable disease...with hopes that these 2 cases are the only ones. 

Daily Dose

Keeping A Good Bedtime Routine

As I wrap up sleep week, another common question I get from parents is how to have a consistent bedtime for children when your own schedule is not consistent. I think it is best for kids to maintain some sort of schedule as they do well with knowing expectations and consistency, and that goes for bedtime routines too.

That being said, if your schedule is inconsistent does that have to mean that your child’s is too? Not knowing the age of your child makes it a little harder. For a younger child bedtime can be at the same time but may have to be with a different caregiver, like a your-babysitter, spouse, or even having an older sibling help with the bedtime routine. I often got home later than I would have liked, and missed the bedtime routine with my kids when they were young, but felt it important enough that they went to bed on time that I would only get a goodnight hug and kiss long after they were asleep. On other days I made it a point to be able to be home for bedtime so that we had that experience together, even if only one night a week and weekends. With older kids, even if your schedule is inconsistent, I would let them know the expectations of bedtime and lights out, even if that meant that I was going to have to call them to check in that this was happening. I also utilized a college student to come over in the evening to supervise the evenings and bedtime when necessary in order that my crazy schedule or my husband’s travel schedule did not disrupt most bedtimes. There are so many studies that re-iterate the importance of bedtimes and good sleep to promote school readiness, attention in class, academic performance and success in kids that I tried to make their schedules as consistent as possible. That wraps up a special week focusing on sleep. We’ll chat again soon.

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Daily Dose

Feeling Thankful

1:00 to read

What better week to think about how many blessings I have. One of the blessings is the many families I am privileged to take care of.  While the world seems to be struggling with so much violence in the recent weeks, the pediatric office is still a haven of “normalcy” as I watch families raise their children. 

I continue to believe that parents strive to raise healthy, educated and well adjusted children and have many hopes for their future.  At the same time, worrying about the future can cause a lot of anxiety. While I often talk about raising resilient, grateful, humble, appreciative, and thoughtful children, if there was a recipe for doing this we would all certainly follow it. But the longer I practice the more I realize that there is not one path to raising a child.  What works for one child in the family doesn’t always work for the other.  Different situations in life may also call for re-evaluating and “re-setting” family values or parenting practices….parenting is never stagnant, it is fluid and every changing.

 But with that being said,  maybe the whole idea of parenting is really to be mindful. Mindfulness is something I too am really trying to work on. The idea of living in the moment and paying attention to the present.   That means enjoying where you are and what you are doing and not being distracted by the the next task, event or dilemma which clutters the mind and the moment.  Maybe that is the virtue we should be trying to teach our children, which means we need to practice mindfulness ourselves.

So for this Thanksgiving I am going to practice mindfulness and enjoy family and friends being together for a day to count our blessings, whatever they are. I am not going to worry about the next event, or holiday or work commitment ….I am going to be mindful and practice taking a big breath and re-centering myself to the present and the day of Thanksgiving for which I am grateful. 

Daily Dose

Meningitis Outbreak

1:30 to read

There has been another outbreak of the meningococcal disease among college students at The University of Oregon.  If you remember a year or so ago, there was an outbreak at Princeton University as well as one at UC Santa Barbara.  The meningococcal bacteria may cause a serious blood infection, meningitis or in some cases both diseases and may even be fatal.  

Meningococcal disease seems to cluster in adolescents who come into close contact with one another...such as on college campuses with students living in dorms and other residence halls.  The bacteria is spread via respiratory droplets which may occur when coming into close direct contact with an infected person...in other words even a roommate, or suite-mate.  

The latest cases of meningococcal disease in Oregon have been due to Serogroup B infection, which caused the outbreaks at the other universities as well.  Most colleges have required that students receive a meningococcal vaccine against Serogroups A, C, W, and Y (Menactra, Menveo) ...but until recently there had not been a vaccine against Type B disease.  The FDA recently approved two vaccines against serogroup B, and they are Trumenba and Bexsero.  These vaccines were given to thousands of students at Princeton and UCSB during the previous outbreaks, even before they were approved by the FDA, as they have been well studied and were already being given in Europe. 

Although these vaccines are not yet routinely recommended in the United States, in certain situations, such as people who are immunocompromised, or during an outbreak such as that at the University of Oregon, the vaccine may be recommended. You can see the guidelines for vaccine recommendations on the CDC website as well.

The early symptoms of the disease often mimics the flu with fever, body aches, headache, nausea.....but quickly progress to have far more serious symptoms.  As a pediatrician that takes care of a lot of college students (and who saw a case of Serogroup B disease several years ago), I am always on the alert.

Daily Dose

Henna Tattoo Warning

1.00 to read

Have you been on vacation or maybe somewhere during your travels when one of your children talked you into letting them get a henna tattoo?  I have written about the dangers of tattoos and managed to “forbid” my own children from getting tattoos (due to the risk of hepatitis, infection etc.) and I try to do the same with all of my patients as well.  I also discourage tattoos since they are “permanent” unless you want to go through the pain and expense to have laser tattoo removal in your later life! 

With that being said, I have always recommended that kids/teens “just get a henna tattoo”. You can find people to do henna tattoos all over the place and certainly many spring break beach destinations have people creating cute henna tattoos on kids all day long. Seems easy, harmless, painless and they are often very attractive (for the short term!) 

Well, I just read an interesting article from the journal Skin which discussed several cases of an allergic reaction to henna tattoos. These cases were all in teens who had gotten a henna tattoo while on vacation and then developed local reactions around the tattoo. The reactions varied from intense itching to redness and tenderness overlying the tattoo. In one case the area actually blistered while in another the “dragon tattoo” became hyperpigmented almost like a true tattoo, secondary to the allergic reaction. 

The journal article explained that the henna paste typically used by “henna tattoo artists” is not pure henna. There are usually different agents added to the paste to help darken the henna color. One of the additions may be a compound called PPD which is actually one of the most frequent contact allergens around.  PPD is also found in most hair dyes as well. 

There have been probably been millions of henna tattoos applied without problems. The literature only reports “more than 100 cases of contact dermatitis due to temporary tattoos”. 

So, with that being said I think the chance of having an allergic reaction to the fun beachside henna tattoo is pretty rare.  But, if your child does seem to have a weird reaction overlying the tattoo, you might be the one to figure out why! 

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

Daily Dose

How to Deal with Different Bed Times for Children

One of the questions I get from parents on an almost daily basis deals with sleep. So I thought I would spend the rest of the week answering some top sleep questions. Question #1: How do you get 2 younger kids to bed on good schedule when you have 2 older sibs too?

Having a bedtime schedule for both the younger and older kids helps. I would enjoy family dinnertime, and some activities together after dinner. Then separate the younger kids from the older ones. You might have older kids doing homework or independent reading (really dependents how much older they are) in a different area of the house while you take younger kids off for bathes and bedtime stories. Even if their bedtimes are only an hour apart, this will give you time alone with both sets of kids and age appropriate activities with each. Once the younger kids have had stories, prayers and are tucked in for the night you can now spend time with the older ones. I often found this a good time to do any review of spelling or homework they wanted me to look over etc and plan for the next day with them. Then we would enjoy “older version” of bedtime stories when they would read to me. Very relaxing, (must admit I sometimes found myself lulling to sleep while they read), and then I would read to them. It was a way to keep us both involved in reading aloud and I enjoyed most of Harry Potter books this way. They too liked saying prayers together, a hug and kiss and then to bed. Try to limit computer or TV for older kids prior to bed, as this seems to disrupt sleep. With that schedule I felt like both sets of kids had parent time, and you can also alternate Mom and Dad doing this routine depending on parent schedules etc. Divide and conquer seemed to work well in our home. That’s your daily dose on sleep for today; we’ll talk about it some more tomorrow.

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Daily Dose

Teens Are Stressed Out

1.30 to read

If you have a teen it is hard to not hear the words,  “I am just stressed out!” on a regular basis.  I don’t remember ever saying that as a teen but I am sure there must of been some version of that saying, although there just wasn’t that much stress when I was growing up.  

Our society as a whole is so much more stressful (I think both real and perceived) and parents often utter the same words. But while the teenage years are sometimes difficult, and may be stressful at times, these years should also be filled with friends, fun and downtime.  There should be “lazy” days to fill with just “whatever”. 

But when I talk to my adolescent patients they tell me quite the contrary.  They are always worried about grades and start discussing SAT and ACT tests long before high school.  They have almost every precious waking hour filled with school (with crazy competitive class schedules), after school activities and homework after that.  Far too many teens are getting too little sleep (do you have a teen that gets the recommended 8 hours/night?), poor nutrition, and too much time on the internet. 

Stressed teens report difficulty falling asleep, or staying asleep which may lead to further problems with concentration and mood.  I see many high school students who think they “have ADHD”, who have never had issues before, but suddenly say they cannot focus or concentrate, which may be exacerbated by lack of sleep.  Trying to get them to believe that is not always easy!  Poor nutrition is also a problem as well, but again a teen does not always see “eating junk food” as poor nutrition. Their brains need protein and vegetable and fruits to keep functioning at warp speed, but skipping meals is quite common. 

Stress can often be reduced by parental involvement in daily schedules. I don’t mean that you tell your teen what to do all of the time. But the security that comes from knowing that there is breakfast daily, and that there is a family meal for dinner and that there is a “bedtime” when the computer and phone go dark actually helps make a teens life less stressful. Having parents who sit down to help a teenager see their way through a stressful event or provide wisdom or perspective may also help to alleviate stress. There needs to be a balance of “not being involved” but “being available”.  That is sometimes easier said than done. 

Stress is always going to be a part of life, but teenagers should not perceive that their life is constant stress and anxiety. They have plenty of time for that once they are parents, right?

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