The National Inhalant Prevention Coalition just released new findings showing kids are experimenting with everyday products and inhaling them to get high.

Many of these products are accessible in a child’s home providing easy access to a quick buzz.

Parents:  be aware of what common household products are in your home.  Talk with your children and explain to them just how dangerous inhaling these liquids and sprays can be.

If you don’t think it can happen in your home, take note.  The National Institute on Drug Abuse says one in five 8^th graders have tried inhalants.

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The National Center for Missing and Exploited Children has numerous resources for educating children about safety.  Interestingly, most perpetrators are not actually strangers, but are often someone the parents or another adult knows and may have been around the child on occasion. So, it seems that “stranger danger” may not be the appropriate term to use when teaching our children, especially younger, children about safety.

It is important that the conversation about safety begins with children at young ages. It is often easier to use teachable moments to begin the conversation with young children.  Talk to your child about “safe” strangers, as it is hard for a child to understand why you are talking to grocery store clerks, or people on the playground in the park, and yet they are strangers.

It may be best to teach a child to watch out for dangerous behaviors from adults, rather than saying “never talk to strangers”.  Talk about adults who might approach them for directions, or to find a missing pet and role play as to what they should  do. At the same time, teach them that they can turn to “strangers” such a store clerks or mothers with children for help if they are scared.

While talking about this subject use a calm reassuring manner.  You do not want to make your child “too” anxious as most people they will meet are not dangerous, and children do need to interact and trust numerous people around them that they will meet in  different situations.

Another good way to discuss the issue of “stranger danger” is by reading books to young children that deal with the issue. Several good books that I like are:  The Berenstein Bears Learn About Strangers; A Stranger in the Park; I  Can Play it Safe.  There are many other books out there too, so head to your library  or your local bookstore to get some more recommendations. The librarians are often helpful with finding “age appropriate” books.  Lastly, this is not a one time conversation, but should be discussed at different ages and stages of your child’s

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

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Weekly Health Headlines

Keeping you informed of the latest children’s health news

This week’s topic: RSV

Feed Your Family Right

Tips on how to make a nutrition plan for your entire family

Guest: Elisa Zied, author of Feed Your Family Right!: How to Make Smart Food and Fitness Choices for a Healthy Lifestyle

More Information: Elisa Zied Official Web site

Are You Raising a Worrier?

Guest: Dr. Kristy Hagar, author of Seven Steps to Help Your Child Worry Less

Ask Dr. Sue!

Send a question to Dr. Sue right now!

What’s Cooking with Chef Dad?

This week’s delicious and easy recipe: Citrus Ceviche

Tom Fleming, Executive Corporate Chef, Preferred Restaurant Management Group

Streaming Online: www.1037litefm.com

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Looking at the little research on these products two things come to mind:

1.  There have been multiple studies done on these products (in adults) that do not show them to be efficacious for treating common cough and cold symptoms.

2.  The research among children using these products show that dosing errors and accidental ingestions are the leading cause of adverse events.

This kind of leaves me thinking why use them at all in children? I really have never been much of a cold medicine giver in general, as I personally did not see my patients getting better any faster nor my own children.

We continued to use the good old grandmother tested remedies of lots of rest, fresh squeezed orange juice (sometimes in pays to be sick), chicken noodle soup (canned or home made), and a vaporizer or humidifier in their rooms at night.

I also know that younger children get more colds than anyone and no matter what you do you have to get through that too. But miraculously, as kids get older they get less colds and seem to tolerate them a little better.

So… for this winter in our practice we are not recommending the use of any of these products for kids and trying the gold standards rest, fluids, cool mist humidifier and tincture of time. We’ll see how it goes.

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

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Like so many things in medicine and life in general, “nothing stays the same”.  When I was beginning foods with my own young children we always started with them eating rice cereal and added vegetables, fruits and then meats.  The recommendations ( I don’t know if they were actually via the doctor or my friends) were to try a new food every 2 – 3 days.  We were not very “sophisticated” then either and there were only about 7 vegetables in the Gerber section and about the same number of fruits. I don’t think “organic” was even a word.

Over the years, as food allergies seemed to become more common,  there were newer guidelines which recommended restricting certain foods from a child’s diet.  In  theory it was thought that by delaying a child’s exposure to a food group,  they would have a more mature GI tract and immune system and therefore might not develop food allergies.

There were even some doctors recommending that pregnant and breast feeding women avoid certain foods too.   At the time, this seemed very restrictive to me, and by now my own children were living on peanut butter and fish sticks (both newly forbidden foods).  I don’t think many of the children born in the late 90’s ever saw a jar of Skippy.

In the past 2 years the theories regarding delayed introduction of foods have been “de-bunked” and we the pediatricians are returning to a more relaxed approach to feeding infants.  It seems that keeping children away from peanut butter and fish and eggs really did nothing to slow down the development of food allergies.  What it seemed to do was to make new parents quite uneasy about introducing new foods and many children were eating “less healthy” foods by avoiding some food groups.

Currently, I recommend that parents begin feeding their infants solid foods at about 5 – 6 months of age. It seems logical to me to start cereal, as a baby is usually happy in the morning at breakfast time, and that is a good time to begin spoon feeding. In reality it does not have to be cereal. There is some data that we should start protein first (meat, hmmm….breakfast sausage for babies?).

I then begin vegetables, simply because of taste, again with the thoughts that a baby will not eat carrots when given sweet pears first, but I really don’t think there is any study to substantiate that belief.  Then we just “plow” ahead with almost any food that can be pureed or mushed to spoon feed a baby.  So many mothers are making their own baby food, and that is really quite easy for certain foods.  There are now many more selections in the baby food aisle and babies are happily eating avocado, mango, beets, lentils and so on.

There is not a “FORBIDDEN” food, except for CHOKING issues.  So, peanut butter, cashew butter and almond butter are great sources of protein.  So too are bits of flaky fish such as salmon and tilapia.  By the time a baby is 8 -9 months old they are ready to explore some mushy finger foods too, and this does not have to be limited to cheerios, goldfish and puffs.  Pieces of overripe fruits (any kind) cut into small bits are great.  So too are noodles and sauce (tomato is fine) as well as eggs.

Unless you have another child with definite food allergies I would try everything.  The more foods your baby is exposed to the broader range of tastes and textures they will have tried.  Just remember to cut everything into tiny pieces and offer a little bit at a time.  The risk of choking seems to be greater than the risk of food allergies.

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

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If you don’t have a child with eczema you may not be as interested in some of this science. The newest theory is that children with eczema have extrinsically different skin in that they have a defective skin barrier which allows irritants into the skin resulting in inflammation. These children seem to have a defect in the filaggrin, which is a protein in the skin, and is important in maintaining skin hydration. There seems to be a mutation in the gene that makes this protein in the skin.

Eczema

Think of the top layer of the skin (barrier layer) as a “bricks and mortar” structure. Filaggrin is an important protein in maintaining the normal “mortar” between the cells and if you have defective “mortar” (filaggrin) then this is a major risk factor for development of atopic dermatitis. With the loss of the “mortar”, there is increased water loss in the skin.

There are also lipids called ceramides in the skin that play an important role in skin hydration, because they help bind water. Ceramides make up about 50 percent of the total lipids in the skin. The lipid layer is also important in the “mortar” between the skin cells. Patients with eczema may also have a defect in ceramide production that allows irritants to get into the skin and begin the inflammatory process that we see in eczema patients.

So, what does all of this mean? There are several products that are physiologic moisturizers that actually contain ceramides, and may repair the skin barrier. These products include CeraVe and Aveeno Advanced Care, as well as Epiceram (which is a prescription). There are also other topical therapies including Atopiclair and Mimyx that act as barrier creams but do not contain ceramides.

Lastly, she discussed the use of bleach baths to decrease staph aureus (bacterial) colonization of the skin which seems to also help decrease the inflammatory process of eczema. Staph elicits an immune response which may contribute to dermatitis. It also may induce steroid resistance, in other words, the topical steroids typically prescribed for eczema may not work as well when staph is around.

Staph acts as a “superantigen” and is a trigger for atopic derm. By using bleach baths with 1/8 cup bleach in a half foot of bath water and soaking your child for 5 or 10 minutes twice a week you can reduce the skin staph colonization. This may then reduce infection, inflammation and the need for antibiotics. You can also make a dilute bleach solution and put it in a spray bottle to use locally, especially for older kids who aren’t into baths. If a child has scratched themselves and has cracks and fissures, it is helpful to put a layer of Vaseline over the area before doing a bleach bath.

This is all new and interesting data just coming out in the pediatric dermatology literature that may change some of our treatments of eczema. Get out the bleach, but don’t get it on anything else!!

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

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In a touching moment during the Academy Awards, Sandra Bullock thanked her mom for “not letting me ride in cars with boys until I was 18 because she was right, I would have done what she said I was going to do.  For making me practice every day when I got home piano, ballet whatever it is I wanted to be.”

Ms. Bullock went on to say “she said to be an artist you had to practice every day and for reminding her daughter that there is no race nor religion, no class system, no color, no sexual orientation, that makes us better than anyone else.  We are all deserving of love.”

What can moms and dads take away from this?  Parenting is not easy.  You must be consistent and set ground rules.  There are times you are not going to win an award because of a decision you make in your child’s best interest.  Hang in there; you are setting the stage for your child to succeed!

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I just love 4 year olds, they are actually one of my favorite ages, as they are so talkative, inquisitive and do have wonderful imaginations.  They are often content to “play” in their own world or you may be a lucky enough parent or friend that they “invite” you into their imaginary world too.  A child’s imagination is a very important part of early childhood development.  Many experts believe that allowing children to develop their imaginations may actually be more important than constraining a child with academic skills such as learning letters and numbers.

To that idea, look at most developmental pre-school programs. While they do have structure for circle times with reading,  or games that involve beginning letter recognition or learning your telephone number, a preschoolers day is also filled with play. Much of that play  may be done in the “kitchen” within the classroom where many pretend meals are made, served and cleaned up.  There are usually blocks to build huge imaginary cities and a child rules over his or her own kingdom.  The dress up box is always a favorite for preschoolers of both genders as they dress up to be a clown or  princess or even the teacher.

I used to love watching my boys play with their stuffed animals and I would occasionally catch them being the “mean” parent and disciplining their animals for fighting and putting them in the “time-out” rocking chair while discussing with each of them the art of sharing.  They might not be able to share with their brothers, but they were good at teaching their dolls and stuffed bears how to.  Such cute memories.

By allowing children to think creatively and imaginatively, you are also helping them become more adaptable to other situations while also learning self-regulation.  Unfortunately, computers, video games and many battery operated toys have changed a child’s imaginary play in a negative way.  Children as young as 2 years, with even limited verbal skills, will sit passively watching a DVD on their mother’s phone or even use the video game controller or computer keyboard to turn on the sound,  but do not have the opportunity to play with Tupperware and wooden spoons or sit on the floor with blocks.

I am not worried that today’s children will not be adept at using a cell phone or computer when needed. I am concerned that they will not have had the opportunity to take old boxes to build forts, or hang sheets on their beds hooked together with clothespins to make a tent for the pretend camping trip.

Making up stories, games and far away places is an integral part of childhood. Eating mud pies, and tea made with rocks is too.  Applaud your child’s imagination and if you are fortunate, you will have an afternoon to spend with them in “their own world”.

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

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