Twitter Facebook RSS Feed Print
Your Child

Protect Against Heat-Related Illness and Dehydration

2:00

Think it’s hot where you are? Try spending a few minutes outside in the southwest part of the country. This year, several cities have already set records of the longest stretch of time with temperatures 115 degrees and higher, and we’re only half way through the summer.

Your family’s area may not be experiencing those kinds of extreme temperatures, but it doesn’t have to be that hot for a child to end up with a heat-related illness or dehydration when out of doors.

Kids are particularly vulnerable because a child's body surface area makes up a much greater proportion of his overall weight than an adult's, which means children face a much greater risk of dehydration and heat-related illness.

Longer daylight hours often means kids spend more time in the sun so it’s important to make sure your child doesn’t become dehydrated or over-heated.

The early signs of dehydration can include fatigue, thirst, dry lips and tongue, lack of energy, and feeling overheated. But if kids wait to drink until they feel thirsty, they're already dehydrated. Thirst doesn't really kick in until a child has lost 2% of his or her body weight as sweat.

Dehydration can cause three of the worse types of heat-related illnesses:

Heat cramps: Painful cramps of the abdominal muscles, arms or legs.

Heat Exhaustion: Dizziness, nausea, vomiting, headaches, weakness, muscle pain and sometimes unconsciousness.

Heat stroke: A child with heat stroke can have a temperature of 104 degrees or higher. Severe symptoms such as nausea and vomiting, seizures and disorientation or delirium can occur as well as a lack of sweating, shortness of breath, unconsciousness and even coma.

Any one of these heat-related illnesses requires immediate medical attention.

To prevent dehydration make sure your child drinks plenty of cool water and often. They should be hydrated before play and during – even if they tell you they are not thirsty. A good size drink for a child, according to the American Academy of Pediatrics, is 5 ounces of cold tap water for a child weighing 88 pounds, and nine ounces for a teen weighing 132 pounds. One ounce is about two kid-size gulps.

Dehydration can be a tricky thing to catch early. It is typically cumulative – meaning that it may take several days to reach a dangerous point.  If your child is 1% or 2% dehydrated on Monday and doesn't drink enough fluids that night, then gets 1% or 2% dehydrated again on Tuesday, that means your child is 3% or 4% dehydrated at the end of the day. "They may be gradually developing a problem, but it won't show up for several days," says Albert C. Hergenroeder, professor of pediatrics at Baylor College of Medicine and chief of the sports medicine clinic at Texas Children's Hospital.

One way to monitor your child’s hydration is to weigh him or her before and after a sport’s practice or game or playing outside. If his weight drops, he's not drinking enough during his workout.

A simple rule of thumb: if your child's urine is dark in color, rather than clear or light yellow, he or she may be becoming dehydrated.

If you suspect your child is getting over-heated, get him or her out of the sun and into a cooler place. Have the child start drinking plenty of cool fluids. The child should also take off any excess layers of clothing or bulky equipment. You can put cool, wet cloths on overheated skin. In cases of heat cramps, gentle stretches to the affected muscle should relieve the pain.

Kids with heat exhaustion should be treated in the same way but should not be allowed back on the field the same day. Monitor your child even more carefully, Hergenroeder says.

If your child doesn't improve, or can't take fluids, see a doctor.

Some children are going to be more prone to heat-related illness. The biggest risk is a previous episode of dehydration or heat illness. Other factors that can put your child at greater risk for heat illness include obesity, recent illness (especially if the child has been vomiting or has had diarrhea), and use of antihistamines or diuretics.

If a child has been indoors most of the summer, they may not have had a chance to adjust to the hotter weather. Kids should add a little more time out of doors each day until they acclimate to the heat. However, with some of the high temperatures we’re having, it’s best to schedule activities in the morning. It can still be 90 degrees with a humidity index of 107 at 9:00 pm in some places.

In a smart move, a growing number of athletic programs suggest that it is sometimes too hot to practice. In fact, many are restricting outdoors practice when the National Weather Service's heat index rises above a certain temperature. The heat index, measured in degrees Fahrenheit, is an accurate measure of how hot it really feels when the relative humidity is added to the actual temperature.

Kids need time out of doors and certainly time to play and have adventures. Parents can help keep their children from experiencing heat-related illnesses by making sure their child is hydrated and not spending too much time out of doors when the temperature or humidity index is high.

Story source: Roy Benaroch ,MD, http://www.webmd.com/children/dehydration-heat-illness#1

 

Daily Dose

Summer Viruses

1:30 to read

June….now seems like officially summer, although there are still some schools around the country in session, and even a couple in Dallas.  So, with summer here it is check up time in my pediatric office.  That means most days I am seeing very few sick patients, and most of the patients who come in for a visit other than a check up have a rash, a bug bite or maybe a swimmer’s ear.

 

But, with that being said there are also always some of those pesky summer viruses hanging around and many of them appear with just a fever. Many of the “sick” children I am seeing only have a fever, some of whom have a temperature as high as 103-104 degrees, with very few other symptoms.  Although these kids have a significant fever, once they are given an over the counter product like acetaminophen or ibuprofen they feel pretty well and even play for awhile. 

 

Fever is often just a symptom of a viral infection and these summer viruses have names…enterovirus, adenovirus, and even some left over parainfluenza virus.  We are definitely out of flu season….at least till next year.

 

Some of these summer viruses may have associated rashes which are more common with summer viral infections than winter viruses.

 

I have seen some kids with these summer viruses with prolonged fever, even 5-7 days which is a bit longer than a pediatrician and a parent want to see. But, with that being said, when I have seen these children they appear to look well and have not had any other physical findings.  I have often seen them again after having 5 or more days of fever, and it seems that many of them have adenoviral infections.  Adenovirus may also cause a myriad of other symptoms than just fever, including pink eye, sore throat, abdominal pain and vomiting and diarrhea and tummy cramps.  Rarely, some children will develop blood in their urine without having a urinary tract infection. 

 

Parents often ask me….where did they catch this? Remember that these are just viral infections and that there is not a vaccine for adenovirus. Once we see one virus in the community I know I will continue to see more and more children as it is “passed around”.  Best thing to do is to keep up good hand washing and keep your child home from the pool or summer activities if they have a fever.  

 

Daily Dose

National Safety Month

1:30 to read

June is National Safety Month…just in time for summer! It is a good reminder for all of us to try and prevent any injuries in our children. I do know from my own pediatric office that we see more injuries during the summer months. Whether it is from falls, bike accidents, pool incidents, household poisonings or burns, our phones stay busy.

 

So..this is the perfect time to re-think child proofing your home. Make sure that stairs are gated, both top and bottom. Cabinets need to have child proof latches to protect children from getting into breakable or sharp objects as well as medicines or household products that may be poisonous.  Put the number for Poison Control in your phone….1-800-222-1222. I am often surprised that a parent calls our office about a child who has “gotten into “ a possible poison…the first call should be to Poison Control. Keep the number posted in the house as well so a babysitter may also have it if necessary.

 

Learning to ride a bike a is “life skill” for sure….but that also includes learning to wear your helmet. I see most young children in our neighborhood who are still under the eye of a parent with a bike helmet, but once they are older I often see kids without helmets. Just saw a neighbor’s child ride down the street this evening..no helmet!!  Bike helmets are like a seat belt…not optional. Many “tween” boys will “debate” with me during their check ups about the need for a helmet,  as they tell me “ I am a great bike rider and don’t have wrecks”. Teach your children what the word ACCIDENT means and that just like a car…you never know what “the other guy may do”.  Accidents are NEVER planned and a bike helmet protects the head and brain. We can “fix” the broken arm or stitch a leg…but cannot “fix” a brain injury.

 

Texting and driving is unsafe and may even be illegal in your state. Texas just passed a law prohibiting texting and driving….but teens (and adults)  need to be reminded on a regular basis that texting is not allowed!!  Texting while driving is a leading cause of accidents and I just saw a mother who is pregnant, and was in the office with her 1 year old…she had just been involved in accident that totaled her car.  She was hit from behind by a teen who had been texting and never slowed down.  Fortunately both mother and child were buckled up and were not seriously injured.  If your child is found to be texting while they are driving you should have some serious consequences with both revoked driving privileges and no phone for a while. 

 

Lastly, this is a good month to remember to check your medicine cabinet and throw away any expired or unused medication.  There are some pharmacies that are having events where you can bring in expired medications and they will dispose of them properly. The number one place that  teens find drugs is in the home…keep all narcotics locked up and dispose of any unused medications!! I have had more than several parents who have told me that “drugs” had disappeared from their medicine cabinets after their own kids had had a lot of friends over…and who knows who may be “seeking” prescription medications. Locks on medicine cabinets and liquor cabinets are a must for families. 

What about taking a family first aid course at your local YMCA or Red Cross and spend a day getting your own family first aid kit together.  This is a great way to spend some time together and a productive activity. Have a fun and safe summer!!

Daily Dose

4th of July Celebrations!

1:30 to read

The 4th of July weekend is here, which means many families will celebrate with a long weekend with other families and friends. Let’s remember the importance of making it a safe holiday!   

Of course the celebration includes fireworks which are definitely fun to watch, but at the same time, when they are used by consumers (many of whom are children and teens) rather than by trained professionals, there are many associated risks.  Being on call in the ER as a new doctor was one of the scariest and longest nights in my life...and I can remember seeing children with burns...several which were disfiguring. Burns remain one of my biggest fears.

In 2013 there were an estimated 11,400 people treated in emergency rooms for fireworks related injuries, and the risk of fireworks injury was highest for children ages 0- years, followed by children 10-14 years. I know that having fireworks in your backyard or on the beach is fun, but also dangerous. Although I was used to my boys saying, “ Mom, you tell us that everything that is fun is too dangerous...which not only included fireworks, but trampolines, and motorcycles.”  I am sticking to that.

The majority of fireworks related injuries were to the extremities followed by those to the head (eyes, ears, face).  The greatest number of injuries were caused by small firecrackers, sparklers, and bottle rockets. Did you know that a sparkler burns as hot as 1200 degrees F, while water boils at 212 degrees F and wood burns at 575 degrees F!! Even a left over sparkler may cause a significant burn to little hands.

Fireworks are best left to the “hands” of the experts. Fireworks are dangerous and can be unpredictable, especially in the hands of amateurs (including parents).  Public firework displays are equally enjoyable and are carefully planned and executed. Especially with drought conditions and fires already raging in parts of the U.S. it is especially important to be aware of the risk of inadvertently setting a small fire from a misguided bottle rocket.  That small fire may lead to an even bigger fire which destroys acres of land as well as puts firefighters themselves at risk. No one wishes for that scenario but there were over 17,500 fires caused by fireworks in previous years. 

Start planning your holiday fireworks viewing now....from a safe venue! Happy 4th!

Daily Dose

Summer Series: A Lesson in Pool Safety

1.15 to read

Every year, over 900 children (14 years and younger) drown in swimming pool mishaps. Unfortunately, most of these drownings are totally preventable. Swimming pool season is in full swing so it is a good time to reiterate pool safety. Studies have shown that nine out of the 10 children over the age of 1 who died were “supervised”.  The best way to prevent any drowning is by having fencing surrounding all pools. That means four feet high on all four sides. It is amazing how even a young toddler can unlock a door, or climb on a chair and undo a latch or climb out of an open window into a yard with direct access to a pool. Children are clever, quick and quiet when they want to be. Drownings are silent, and many times the last place a parent looks for their missing child is at the bottom of the pool, long after it is too late. So, after fencing a pool with a locking gate, you also need to have the appropriate equipment at the pool while your children are swimming. The first thing that should always be nearby is a telephone. There should also be an appropriate rescue floatation ring available. Anyone supervising a child should be a “designated supervisor” so that they are totally aware that they are in charge and should be within arm’s reach of the “non swimmer” child at all times. Optimally, the supervising adult is also CPR trained (a good summer activity for all...so go take CPR class). Lastly, “The Virginia Graeme Baker Law” which is federal legislation passed in 2007, requires all pools to be retrofitted with new drains to avoid suction entrapment and drowning. Despite this act, it seems that not all pools, both public and private, have complied. It might be wise to inquire if your pool is updated, and new drains have been installed. At the same time it is a good idea to teach children to stay away from drains in general. Swimming is one of the highlights of summer for all ages, and safety is paramount!

Daily Dose

Water Safety

1:15 to read

I was reminded of the importance of pool safety after watching the news and hearing that 3 children were found in a nearby apartment pool, under water and unresponsive.  

There are about 3,500 fatal unintentional drownings per year, which is about 10 deaths per day.  Drowning is the second leading cause of death in children ages 1-14 years.  For every child who dies from drowning, there are 4 non-fatal drowning victims who suffer severe and life changing injuries.

Drowning is preventable!!  Although many people think of drowning victims screaming and yelling, drowning is actually quick and silent.  It only takes seconds (the time to grab a towel, or answer the phone) and a child may become submerged. Most drownings also occur in family pools.  Because I have always had a fear of drowning we did not build a pool until our boys were all older than 10 years and were excellent swimmers ( was I a bit over zealous with swim lessons and swim team, maybe...)?  Children as young as 2-3 years can safely begin swim lessons and begin the process of mastering how to tread water, floating and basic swim strokes. 

Another rule for safe swimming is “never swim alone!”.  Teach your children the importance of the buddy system when they are swimming, even in a backyard pool. Adults need to be designated “water watchers” and know that they are responsible for watching the children in the pool and will never leave them unattended. The “water watcher” should regularly scan the bottom of the pool, and will need to have a phone at the pool for emergency use only.  Adult water watchers have only 1 job...to watch the pool, no poolside chatting or distractions. It is a big job!

Anyone with a pool or who is a caregiver of children who are swimming needs to become CPR certified.  CPR skills can save lives and prevent brain damage.   

Lastly, if you have a pool you need layers of protection - which  means a barrier around your pool. I have heard many a family tell me that their child “could never get out the door to the pool, it has several locks and an alarm”.  Despite the best of intentions, no parent can watch their child 24 hours/day.  Toddlers have been known to push a stool over to unlock a door, or a door is inadvertently left unlocked or ajar. Remember, it only takes seconds for a child to become submerged. 

By the way, I am following my own advice and a pool fence is going up to protect our granddaughter...the bigger the better.

Daily Dose

West Nile Virus

1.50 to read

The temperatures are warming up around the country and “summer” iis only a few weeks away.  But the bugs are already coming out in full force and that includes those pesky mosquitos.  In Texas with warmer temperatures than other areas, I am already seeing lots of mosquito bites, which is already causing some anxiety due to the risk of West Nile Virus.

West Nile Virus (WNV) was first detected in the United States in 1999 and 2012 was the second worst outbreak of WNV disease (the worst was in 2003). WNV disease is a seasonal illness which typically is seen during summer and early fall, when mosquitos are at their peak.  

In 2012 there were a total of 5,674 cases of WNV in the U.S. reported to CDC and there were 286 deaths.  WNV has been reported in all 48 contiguous states as well as DC and Puerto Rico ( we can all head to Hawaii??). 75% of human WNV cases were reported from just 10 states, with Texas having the highest number. (1,868 cases and 89 deaths)

So....what do you need to know.  Number 1: WNV as the name states is a VIRUS, which means there is not an antibiotic used to treat the infection!! 

Secondly, about 80% of people (or 4/5) who are infected with WNV will NEVER show any symptoms of illness. Up to 20% of people who are infected will show symptoms of fever, headache, body aches , nausea or vomiting and some may also have swollen lymph nodes and a rash. These symptoms mimic many other viral illnesses so trying to decide if your child who has a fever and “the feel bads” has WNV or an enterovirus (like coxsackie) or and adenoviral infection is really not important.  

What do you do for all of these viral infections but treat the symptoms, right?  Give it a few days to see how your child is doing, treat the fever, keep them comfortable and hydrated and in a few days the illness will typically resolve and will be another unnamed nuisance viral illness.

About 1/150 people infected with WNV will develop severe illness with neurological problems including seizures, meningitis, and encephalitis. Those are the people who are at greatest risk of requiring medical care, which includes hospitalization and life support, which is most often seen in older people and in people who have other medical problems.

The best thing to do is to keep yourself protected from mosquito bites by using bug spray, closing windows and doors, draining standing water and avoiding peak exposure during the early morning and evening hours.  When you can wear long sleeves and long pants and socks to cover up from bites. For infants I would head out now to get some mosquito netting to cover strollers when a baby is outside (buy it now while available).

Lastly, don’t panic!!!  Some parents are already telling me they aren’t letting their children go outside!?  We have a long summer ahead and everyone needs fresh air and exercise.  Start shopping for bug spray....i am looking for buy one get one free deals! 

More on WNV as we get into the thick of the season although my zipcode in TX is already reporting WNV positive mosquitos.....maybe Hawaii? 

Daily Dose

Water Safety

1:30 to read

Memorial Day weekend is almost here and that means summer water activities. While the pool is a great place to stay cool it is also unfortunately associated with drowning.  Drowning is the leading cause of death in children between the ages of 1-4 years and is the second leading cause of accidental death for children under the age of 14.  

 

Drownings are more likely to happen not at the child’s own home, but while a child is at a swim party, or a neighbors house.  Drowning is a SILENT event. While most people think of drowning being noisy with lots of splashing and screaming (as depicted on TV and movies), children rarely scream, call for help or thrash around. They quietly go under water…..and don’t come back up.

 

Statistics show that in 35% of drownings there is no adult supervision, and 57% of drownings occur in residential pools.  About 40% of children drown when not swimming , but after accidentally falling into the water. I have witnessed this myself when filming a segment on pool safety at my own pool! The toddler, who was standing right next to me, slipped and fell right into the pool….but I was literally standing less than an arm’s length away, witnessed the entire event and pulled him right back out of the pool…both of us wet and scared!!! It only takes a second for this to happen.

 

The AAP now recommends that children begin formal swim lessons at younger ages as the risk of drowning is reduced by 88% with formal swim lessons.  The AAP does not endorse “survival swimming” lessons for young children. 

 

Drowning is preventable!! Make sure that your children have adult supervision whenever they swim, and don’t let children swim alone. Even teens can drown and should not swim alone….

When attending pool events, whether at home or away, designate an adult to be the “water watcher” so that no one assumes someone else is responsible. The “water watcher “is dedicated to one task, supervising the children…so no texting, socializing, drinking etc. while on duty.

 

Protecting children around the pool also means having the correct equipment!  Pools should all be enclosed by a non-climbable fence with a self locking gate, which ensures that no one can wander into the pool before there is adult is on duty!  Children who do not know how to swim should wear a Coast Guard approved personal flotation device , and not water wings or floaties. The pool deck should also have appropriate water rescue equipment ready, which includes pool noodles, safety rings and a first aid kit. Keep a phone nearby as well for ready access to call 911 if an emergency should occur. 

 

Swimming is fun and a great way to exercise. Don’t forget the sunscreen and make sure to re-apply throughout the day. Have a good Memorial Day and a safe start to summer!!! 

Daily Dose

Remember the Rules of Boating Safety

A tragic boating accident in our area during a Boy Scout outing to the lake has reminded me and many other parents of the necessity of following safe boating rules. While summer is here many families may have the opportunity for a boating outing. The best time to discuss boating safety and rules with your children is prior to even going on a boat.

Then another review of boating safety, (I would include jet skis in this too) should happen just before launching the boat on the water. Children of all ages should be taught boating safety and there should never be assumptions that they have heard all of the rules before. With the excitement of the day, many children and adolescents need to be continuously reminded of safe boating rules to ensure an accident free experience. All children and adults should have a Coast Guard certified life preserver (personal flotation device, PDF) and children should wear them at all times. In my opinion, adults should too, and model behavior for the kids. Whistles

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

What is ringworm & how do you treat it.

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

 

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