The Kid's Doctor: Your Partner in Parenting

Chicken Pox Shot May Protect Against Shingles, Too

sgalier — Fri, 03 Sep 2010 03:00:39 +0000

New findings suggest that children who are vaccinated against chicken pox may also have increased protection against shingles.

U.S. researchers looked at the health records of over 170,000 children in southern California who were vaccinated with the varicella (chicken pox) vaccine between 2002 and 2008.

2.5 years after receiving the chicken pox vaccine, only 122 cases of singles (herpes zoster) appeared in the children. Researchers say the rate is lower than what would be expected in unvaccinated children.

“The message to parents and pediatricians is: vaccinating your child against the chicken pox is also a good way to reduce their chances of getting herpes zoster,” study lead author HungFu Tseng, a research scientist and epidemiologist at the Kaiser Permanente Department of Research and Evaluation in Pasadena, Calif., said.

“More research is needed to identify the virus strains that cause herpes zoster,” Tseng added.

The study appeared in the Pediatric Infectious Disease Journal.

Nightmares & Night Terrors

Dina — Thu, 02 Sep 2010 10:00:14 +0000

I have been receiving a few emails about the difference between nightmares and night terrors. First off, nightmares and night terrors are common occurrences during the toddler, pre-school and early elementary years.

Nightmares are scary dreams that occur during REM sleep (which occurs towards the end of sleep when REM sleep is most intense) and dreams are vivid. A child awakens after a nightmare being scared, anxious and afraid to go back to bed.

Night terrors on the other hand occur during the first few hours after a child falls asleep, when non-REM sleep is the deepest. During a night terror your child may cry out, have dilated pupils, an increased heart rate, sweating and heavy breathing. They appear to be awake but in reality are only partially aroused and will have no memory of the event.

During a night terror a child will not recognize you or allow you to comfort them and may become even more agitated if you try to hold them. Parents are often equally frightened by the event, as it is disconcerting trying to decide why your child has awakened in such distress. Just like other familial traits, sleep disturbances (parasomnias) seem to run in families. A lot of work is being done to isolate genetic loci related to sleep habits.

Both nightmares and night terrors seem to be more frequent in children who have not had a good night’s sleep.

Try to have a regular bedtime routine, and limit television exposure prior to bedtime. Read books to your children about dreams and nightmares that incorporates their favorite characters in the same situation (one of our favorites was Franklin in the Dark, there was not a cuter turtle with a nightlight!).

Be creative and make a dream catcher to catch the bad dreams and keep them away, or discuss soothing images prior to bed. WE had “monster dust and wands ” that our boys used to spray the room before bed and they all had a favorite night light (how they slept with three nightlights blazing was beyond me).

Our middle son was the most creative; he blew up an alligator pool toy that he placed outside his bedroom door each night. When asked what he was doing he replied, “my alligator will eat the monsters before they come into my room! How can a parent argue with that?

That’s your daily dose, we’ll chat again tomorrow.

Send your question to Dr. Sue!

Moms & Dads Need Vaccines Too!

Dina — Wed, 01 Sep 2010 10:00:05 +0000

I saw a two-week-old baby the other day who is the second child for one of my many families. Their first is a precious 2 1/2 year old girl. I must admit, this is one family I really enjoy.

The mother was in and is doing well being a mother of two. Her infant son is gaining weight well and is as cute as a button.

The mom mentioned to me that they had all been sick with a cough and cold, but the baby is fine and asymptomatic. At any rate, the evening before the baby’s visit, the Dad was not feeling well, complaining about a headache, sore muscles and feeling badly and he had also noted a scratch on his leg. He reported to his wife that he had a temperature of 99.2 degrees.

By now it was 1:00 a.m. and she was tired as she went off to nurse the baby. A few minutes later, her husband came in to talk.

He told her he had figured out what was wrong with him, he thought he had tetanus (admittedly this was his internet diagnosis) due to the scratch on his leg and his symptoms of muscle aches etc. She told me she was LOL as he walked out of the room! They were both just too tired for him to have tetanus! So, with the fear of tetanus, he made a doctor’s appointment for the next day.

While I was seeing the baby and hearing this story, dad called mom to report the results of his doctor’s visit. Good news; no tetanus, and only sinusitis. The doctor put him on a round of antibiotics to treat his sinus infection. The doctor had also looked at the scrape on the dad’s leg and agreed that the he did NOT have tetanus but because he was due for an update on his immunizations, he received a Tdap vaccine while he was there. That was even better news!!!

As you know, I have talked about the need for adults to get updated immunizations and most importantly to vaccinate against pertussis (especially during the current pertussis outbreak). What an opportune time for this father’s internist to take the opportunity to vaccinate this father, which in turn will protect his own newborn son as well as the rest of the community.

Many of my young adult parents are unaware of the need for continued immunizations and have not received a Tdap vaccine.

All adults who are younger than 65 years of age, and who have not had a recent Tetanus shot, probably in the last 5 years, need to receive a Tdap vaccine that provides protection against tetanus, diphtheria and pertussis (whooping cough). This shot is then repeated every 10 years. In some cases new parents are receiving information about this vaccine from their Ob-Gyn.

Some new mother’s report to me that they were given the option of receiving the vaccine in the hospital after having their baby, but is seems to be dependent on the OB that delivered them, rather than a standard order for all women in the post partum unit. At the same time, the hospitals are not offering the vaccine for the father of the baby, so this means that the new dad needs to find a place to get his own Tdap.

It seems like we (the medical community) should make it a little easier and more consistent to get this vaccine, especially when we are having an outbreak in the U.S. and there have even been infant deaths reported in Northern California.

The funny story of a father who was convinced he had tetanus ended up with a happy ending for all. Dad got his Tdap, mom had a cold which she is recovering from and the baby slept 6 hours the other night!

That’s your Daily Dose for today. We’ll chat again tomorrow.

Send your question to Dr. Sue

Parents Not Taking Concussions Seriously Enough

sgalier — Tue, 31 Aug 2010 14:00:00 +0000

A recent study warns, children who suffer a concussion don’t just have a minor head bump, but a brain injury that parents, coaches and teachers need to take more seriously.

The researchers say parents often believe that a concussion injury is mild and doesn’t involve damage to the brain. However, “concussion really is a brain injury — there’s no question about that,” said lead researcher Dr. Carol DeMatteo, an associate clinical professor in the School of Rehabilitation Science at McMaster University, in Hamilton, Ontario..

“The term concussion is used frequently, but there are no real guidelines in using it with children,” DeMatteo said. “This means that many different types of injury of different severity can be called a concussion. This leads to misconceptions by families and coaches and teachers and children themselves.”

Dr. DeMatteo says these injuries should be called mild brain injuries instead of concussions and that may help these children get the care they need.

In the study, which appears in Pediatrics, DeMatteo’s group reviewed the medical records of 434 children seen at McMaster Children’s Hospital for a brain injury. About a 32 percent were diagnosed with concussion.

The researchers found that, compared with other brain injuries, children diagnosed with concussion spent less time in the hospital and fewer days out of school. They were also more likely to go back to school shortly after leaving the hospital.

If children go back to school or sports too soon after a concussion they are at an increased risk of having another head injury.

DeMatteo believes that children should see a doctor if they are showing signs of a concussion, such as fatigue, headache, memory problems, disturbed sleep or mood changes. These symptoms can affect school performance, and returning too soon to sports can increase the risk for another injury, she said.

Most importantly, having a subsequent head injury can boost the odds of doing permanent damage to the brain, DeMatteo noted.

Dealing With Dog Bites

Dina — Tue, 31 Aug 2010 10:00:21 +0000

I received an email via our iPhone App from a mom who was very worried after her daughter had been bitten by a friend’s dog. This is a common concern/query to the pediatrician. In fact, one of my own children was severely bitten by a friend’s dog, but I had somehow forgotten that experience and the 20 stitches to his face.

Tincture of time is the best remedy for many things. At any rate, I looked at the CDC’s website to find that there are over 5 million dog bites a year and about 800,000 require medical attention. No wonder the health care system is overflowing!

This mother was concerned as to what was the appropriate treatment. Her daughter’s bite was on the face (very common for a child) but small. It did break the skin. The first thing a parent should do is to stop the bleeding by applying pressure. Then, clean the area with warm water and soap. Dogs, like humans, have dirty mouths, so you want to wash and rinse well and even flush out the wound if it is deep.

If the bite wound is small, it is usually not sutured, as this may increase the risk for infection. On the other hand, facial wounds, and larger bites have to be well cleansed and irrigated, and may require suturing. The sooner this can be accomplished the better. For a child with a dog bite that has broken the skin, most pediatricians would recommend a 7-day course of an antibiotic, typically Augmentin (unless the child is penicillin allergic).

Rabies is usually not a risk in dogs that are family pets and in homes. If the dog is not known or their rabies status is unclear and you cannot find the dog, check with your pediatrician about rabies prophylaxis.

Lastly, you want to ensure minimal scarring by using a topical vitamin E cream on the healed skin and sunscreen. The less the sun exposure, the less scarring, especially if the face is involved. That really goes for all cuts and scars.

That’s your daily dose, we’ll chat again tomorrow.

Send your question to Dr. Sue!

Head Lice & Hollywood

Dina — Mon, 30 Aug 2010 10:00:05 +0000

Over the weekend, I dragged my family to see The Switch. It was a great escape movie and a perfect “chick flick” with a happy ending. What does this have to do with kids’ health? Well, one of the scenes was related to an elementary school child who had a case of head lice.

I listened intently while Jennifer Aniston instructed her best friend on how to treat her son’s head lice. And guess what? The information was somewhat incorrect!

The writers must have missed the 2010 American Academy of Pediatrics abstract on lice and treatment recommendations that not only endorsed banishing the “no nit” policy (which had prevented children from returning to school), but also stated that “no healthy child should be excluded from or allowed to miss school time because of head lice.”

By the time a case is diagnosed, the child has probably had the infestation for at least a month, so why keep him home now?

Nothing causes more angst and disgust than when parents find that their child has lice, yet it has nothing to do with cleanliness. It’s not unusual for everyone in the family to start scratching their heads and thinking they’re infested, too.

The latest recommendations begin with properly diagnosing the infestation; it is thought to be both “misdiagnosed and overtreated,” which may be causing resistance to over-the-counter products.

The two most commonly used products are Nix and Rid. It is important to know if your community is believed to be resistant to these two products. Depending on that information, you can start treatment; make sure to repeat the treatment in a week or 10 days to prevent new lice from repeating the life cycle.

Current recommendations advise washing all bedding and hair-care items used by the child within the previous 48 hours. In one study, changing the pillowcase alone was enough to minimize head lice transmission — but if you are washing, you might as well throw in all of the bedding.

Louse survival off of the scalp beyond 48 hours is extremely unlikely, so it is not necessary to call in the “lice busters” to exterminate your house. Washing, soaking or drying items at 130 degrees will kill stray lice or nits — and simply vacuuming the couch, car seat or other fabrics should be more than sufficient.

The perfect lice treatment would be both pediculicidal (killing the louse) and ovicidal (killing the eggs, too). The perfect treatment also would be safe, easy to use, inexpensive and would not have potential for developing resistance. But there currently is not a treatment method that fits this description.

Oh, by the way: We all enjoyed the movie, and the little boy is precious (and lice free by the end).

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

Send your question to Dr. Sue!

Helping Your Kids Make Healthier Choices

Mike — Sun, 29 Aug 2010 18:52:28 +0000

The childhood obesity numbers are rising, so what can parents do to ensure their child is not another number? We’ll reveal some simple solutions.

Ask The Kid’s Doctor

Mike — Sun, 29 Aug 2010 18:50:23 +0000

Dr. Sue answers your questions and phone calls.

Healthy Kids Strong Families Expo

Mike — Sun, 29 Aug 2010 18:48:22 +0000

Dr. Sue answers more of your emails and talk about the Healthy Kids Expo coming up in September.

Top 25 Baseball Players of All Time

Mike — Sun, 29 Aug 2010 18:46:43 +0000

Getting your child’s nose in a book is important. With baseball pennant races heating up, how about reading a book that spurs conversation with your kids.

The Kid's Doctor: Your Partner in Parenting

Chicken Pox Shot May Protect Against Shingles, Too

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Nightmares & Night Terrors

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Moms & Dads Need Vaccines Too!

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Parents Not Taking Concussions Seriously Enough

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Dealing With Dog Bites

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Head Lice & Hollywood

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Helping Your Kids Make Healthier Choices

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Ask The Kid’s Doctor

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Healthy Kids Strong Families Expo

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Top 25 Baseball Players of All Time

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