When Do I Take My Child to the Doctor?

19/365 - My head is hot and my feet are cold. Ha...Hee...Hachoo!
source: Micah Taylor via Flickr Creative Commons

In February, I had a very sick baby. My youngest child was 11 months old. He was running a high fever that wasn’t coming down with medicine. His breathing seemed labored. It was really scary for me! And still, because it was at night, after all the doctor’s offices had closed, I questioned whether or not to take him to an urgent care clinic or just wait until morning.

After calling the after-hours line at our pediatrician’s, we decided it was pretty urgent that we take little Joshua to the walk-in pediatrician’s clinic. And I’m glad that we did, because he had influenza A. (Despite having had a flu shot!) We were able to start treating it immediately and in a few days he was ship-shape.

Whether it’s day or night, though, I think we all question ourselves when it comes to taking our children to the doctor’s office. Is it worth exposing him to germs? Is she really sick, or is it just a cold?

According to pediatrician Jennifer Shu, here is when you should go ahead and at least call the office:

  • High, persistent fever – and always take your infant to the ER if her fever is over 100.4 rectally (under 3 months)
  • Labored or noisy (wheezy) breathing
  • Thick eye discharge that sticks the eyelids together
  • Not producing urine every 6-8 hours (due to vomiting or diarrhea)
  • Vomit or diarrhea containing blood
  • Extremely lethargy or a stiff neck

I think erring on the side of calling the nurse is never a bad thing … especially for Mommy and Daddy’s nerves! But if you’re stuck in a should-I-shouldn’t-I cycle, there are some pointers to consider.

Herbs and Breastfeeding

Sage
source: sporkist

Breastfeeding? Use caution with herbal supplements. Some herbs may lead to side effects in nursing babies. If you are breastfeeding, check with your pediatrician before using herbal supplements or teas.

While there is not much studied information on herbs and breastfeeding, here are some herbs that are known to lower milk supply in breastfeeding mothers:

  • Black Walnut
  • Chickweed
  • Herb Robert (Geranium robertianum)
  • Lemon Balm
  • Oregano
  • Parsley (Petroselinum crispum)
  • Peppermint (Mentha piperita)/Menthol
  • Periwinkle Herb (Vinca minor)
  • Sage (Salvia officinalis)
  • Sorrel (Rumex acetosa)
  • Spearmint
  • Thyme
  • Yarrow

Normal amounts of herbs used in cooking will probably not affect your milk supply or baby; this list refers to herbs taken medicinally. As always, though, do check with your pediatrician for the most current information.

Source: KellyMom.com

Depression in Children

Rosie

Could your child be depressed?

Depression is a serious mood disorder that often goes undetected in children because it may not look the same as it does in adults. Kids experience many of the same feelings and symptoms, but find it difficult to articulate and express. Diagnosis is also complicated by the fact that changes in academic, social, or emotional functioning can be normal childhood behaviors. For instance, increased temper tantrums and misbehavior could indicate depression rather than defiance.

Other signs and symptoms include:

  • Frequent irritation, sadness, anger, or boredom
  • Excessive crying
  • Withdrawal, loss of interest in hobbies, friends, or playing
  • Unexplained aches and pains; stomachaches and headaches are common
  • Difficulty concentrating
  • Sleeping too much or too little
  • Thinking about death or suicide

Children who appear depressed may actually be experiencing anxiety. Pay attention to your child. If she is showing symptoms that do not resolve with communication, support, and encouragement, a visit to the pediatrician is in order. Treatment generally includes professional counseling, medicines, and family work.

Thank you to ParentLife contributor Vonda Skelton and Dena Cabrera at Remuda Ranch for this pertinent information.

Have you ever suspected or confirmed your child is depressed rather than just sad or upset?

Photo used with permission of Flickr Creative Commons. Click on photo for source.

Growth Spurts: Development in the First Two Years

Free happy smiling baby face stock photo Creative Commons

Going to the pediatrician’s office with a small infant or toddler can be an adventure in itself. It’s even harder if you’re faced with unexpected questions or concerns. Here’s a short list of age-appropriate skills your pediatrician will probably ask you about.

Remember that each child is different. If you have a concern, talk to your pediatrician.

Gross Motor Development

  • Lifts up head (1 to 4 months)
  • Rolls front to back (3 to 6 months)
  • Rolls back to front (4 to 7 months)
  • Sits with support (4 to 7 months)
  • Sits without support (5 to 9 months)
  • Creeps (5 to 10 months)
  • Crawls (6 to 11 months)
  • Pulls up to stand (6 to 12 months)
  • Cruises (9 to 14 months)
  • Walks (9 to 17 months)
  • Runs (13 to 20 months)

Fine Motor Development

  • Bats at objects (2 to 5 months)
  • Discovers hands and feet (3 to 5 months)
  • Transfers objects from one hand to the other hand (4 to 7 months)
  • Finger feeds (5 to 10 months)

Social/Emotional Development

  • Social smiles (1 to 3 months)
  • Learns object permanence (6 to 12 months)
  • Goes through stranger anxiety (6 to 12 months)

Language Development

  • Coos (1 to 4 months)
  • Laughs (3 to 6 months)
  • Turns to voice (3 to 6 months)
  • Blows raspberries (3 to 6 months)
  • Jabbers (5 to 9 months)
  • Says “mama” and “dada” specifically (9 to 14 months)

Have you ever been concerned about one of your child’s development skills? I was convinced at 18 months that my daughter was never going to really talk. At 25 months, that seems laughable. She never STOPS talking now. I think sometimes we create things to worry about, don’t you? –Jessie, Resident ParentLife Blogger

Photo used with permission of Flickr Creative Commons.

Going to the Doctor: Birth to 1 Year

Here’s a little "extra" from our Growth Spurts: Birth to 1 Year article "Ah-Choo!" by Evelyn Hanes, R.N. — something we couldn’t quite squeeze in the November issue of ParentLife! The article speaks about when to take your infant to the doctor.

stethoscope

Your doctor’s office is not just for well-child checkups. Most offices have a “sick” area in the waiting room. During the worst of cold/flu/RSV season, they may take you immediately to a treatment room. This helps protect those who are not sick.

If your child is particularly fussy, he may not wait well. Ask for an appointment at the beginning of the day or immediately after the office lunch break for the shortest wait. Come with your biggest supply of patience! Your sanity may depend on a having a well-stocked diaper bag. Bring a couple of favorite toys and books as well as a snack and something to drink. Extra diapers and clothing are always a good idea. And do not forget the pacifier and “blankie” or other comforting object.

Try to keep your baby in your lap. The less he is able to touch toys and surfaces in the waiting room, the less chance he will pick up other germs. If your child does touch anything, keep his hands out of his mouth and wash them thoroughly as soon as possible. If at all possible, do not sit beside anyone who is coughing or sneezing.

It does not take long to realize that babies do not get sick on an appointed schedule. They get sick in the middle of the night or when you are out of town! Even in these inconvenient times, you should still have help readily available. All physician practices have a plan for handling after-hour problems. Find out what your provider’s plan is and do not hesitate to call when you think your child is sick.

Have you struggled with whether to take your infant to the doctor or not? How do you decide?

Photo used with permission of Flickr Creative Commons.

Fit & Trim Kids

In this month’s issue of ParentLife, Evelyn Hanes gave some very helpful guidelines for healthy weight loss in our "A Healthy Life" department. But what about the kids? What should children do to maintain a healthy weight? Check out the following guidelines for kids from the American Academy of Pediatrics (AAP).

  • July_12_eating.jpgEat five fruits and vegetables each day.
  • Participate in one hour of physical exercise each day.
  • Limit screen time to less than two hours each day.
  • Limit sugar sweetened drinks.
  • Eat breakfast every day.
  • Choose low-fat dairy products (ages 2 and up).
  • Eat meals together as a family.
  • Limit fast food, take out, and eating out.
  • Prepare foods at home as a family.
  • Eat a diet rich in calcium and fiber.

Following these guidelines for your child will help him grow healthy and strong … and they are good guildelines for the whole family!

What healthy habits does your family have that might help other families who want to lead a healthier lifestyle? Share your ideas with us by leaving a comment!

Smiles Across America

R4-SAA-Header.jpgTooth decay is considered the most common chronic childhood disease—five times more common than asthma—according to the U.S. Department of Health and Human Services. The department also reports that more than 51 million school hours are lost each year to dental-related illness. Fortunately, good oral health habits can keep tooth decay at bay.
 
To help teach students and parents this important lesson, Trident has partnered with Smiles Across America (SAA), a program that links schools and dental care providers to help fight untreated oral disease. The company’s support has enabled SAA to double the number of children it cares for and expand services for more children in underserved communities. 

The following are some great oral care tips for both parents and children to practice.

• Brush twice a day, after breakfast and before bedtime, to remove food particles and plaque. Plaque causes tooth decay and gum disease.
 
• Use a soft toothbrush so you don’t scratch teeth or gums.
 
• Brush both the teeth and gums, especially the areas where teeth and gums meet, and the chewing surfaces of teeth.
 
• Always brush after eating candy and other sugary or starchy snacks, and after drinking sugary sodas and juices.
 
• Adults should supervise tooth brushing, giving a second brushing after kids have brushed to make sure teeth are clean.
 
• Floss every day to remove food and plaque from between teeth and under gums. If plaque is not removed, it can harden into tartar—a hard, yellow buildup.
 
• Visit the dentist every six months to one year for cleanings and checkups, beginning at age 1, when baby teeth are coming in.

Have you been able to establish a good oral care routine with your family?

 
 

Back to School — Healthy

Our staff came across the following information from Dr. Stuart Fischer about how to eat healthy as a family during the back-to-school season, especially when a parent is struggling with weight issues. 

school-luncha.jpgTell the Truth

Be a great role model and tell the truth. Sit the family down for a heart-to-heart talk where the overweight parent should freely admit to the child that they are not a healthy weight and that some of their food choices have not been ideal. The parent should offer hope on how they will make healthy changes together – letting the children see how their lives can improve as a result.
 
Discover Your Personal Myths
The biggest issue in the weight-loss process for the parents is addressing “personal myths” – the excuses that people give themselves to rationalize their behavior. Once the parent recognizes these are excuses, they can move on to make the right choices for their family.
 
Make a Plan
The next step is to make a plan, keeping in mind that losing weight is actually quite simple. Work off more calories than you eat. Set a realistic weight-loss goal (no more than 2 pounds per week). Make a plan on how to incorporate more exercise in everyone’s day-to-day routine. Exercising two to three times a week is ideal at the beginning.
 
Cook and Shop Together

As a family, figure out what and how much you want to eat per day for your first week, then crunch the numbers and come up with a menu. There are tons of great healthy recipes online. Go shopping with your child and explain what foods are healthy. Teach kids to avoid “empty calories,” high-calorie foods with little to no nutritional content such as soda, sugary desserts, fast food, or potato chips.
 
Act on Other Issues
Everyone overeats for different reasons. Identify some of the issues causing them to eat, and then take mini-steps to change their behavior.
 
Reward, Reward, Reward
As the weight starts to come off, reward yourself in ways OTHER than food. It could be a new lip gloss, haircut, tickets for a game or play, outfit, purse, backpack, etc. Reward frequently but not lightly. A great time for a smaller reward would be after two weeks if everyone has been sticking to the plan and are on track for their weight-loss goals.
 
This is a great time to focus on good health for your sake and that of your child.  A new study shows that overweight and obese students are performing worse in school than their physically fit counterparts, jeopardizing their professional future as well as their health. For more information on Dr. Fischer and the celebrity consultants, please go to www.parkavenuediet.com.
 

Fun in the Sun — Safely!

56_Child-with-sunscreen.jpgDo you remember what if feels like to be sunburned? Miserable! That memory of the pain of sunburn is enough to remind me to slather on the sunscreen when I know I am going to be out in the sun for prolonged periods of time. However, I am occasionally reminded that sunburns can happen anytime of year and even on cloudy days. I forgot the sunscreen once this baseball season on what started out as a cloudy, rainy day. By the end of the game I had gotten my share of sun!

As you head outside this summer, here are some sun safety tips from the American Academy of Pediatrics (AAP) for your kids:

Babies Under 6 Months

  • Avoid sun exposure and dress infants in lightweight long pants, long-sleeved shirts, and brimmed hats that shade the neck to prevent sunburn.
  • When adequate clothing and shade are not available, parents can apply a minimal amount of suncreen with at least 15 SPF (sun protection factor) to small areas, such as the infant’s face and the back of the hands.
  • If an infant gets sunburn, apply cold compresses to the affected area.

For Young Children

  • Apply sunscreen at least 30 minutes before going outside.
  • Use sunscreen even on cloudy days.
  • The SPF should be at least 15 and protect against UVA and UVB rays.

For Older Children

  • The first, and best, line of defense against the sun is covering up. Wear a hat with a three-inch brim or a bill facing forward, sunglasses (look for sunglasses that block 99-100% of ultraviolet rays), and cotton clothing with a tight weave.
  • Stay in the shade whenever possible and limit sun exposure during the peak intensity hours — between 10:00 a.m. and 4:00 p.m.
  • Use a sunscreen with an SPF of 15 or greater. Be sure to apply enough sunscreen — about one ounce per sitting for a young adult.
  • Reapply sunscreen every two hours or after swimming or sweating.

How do you plan to have fun in the sun this summer?

Guard Against Sports Injuries

AAP banner.jpgIt’s that time of year again when the weather is getting warmer and kids are filling soccer fields and baseball diamonds for spring sports. Do you know how to prevent sports injuries in your kids? Here are some great tips brought to you by the American Academy of Pediatrics (AAP).

Injury Risks
All sports have a risk of injury. In general, the more contact in a sport, the greater the risk of injury.

Most injuries occur to ligaments (connect bones together), tendons (connect muscles to bones) and muscles. Only about 5 percent of sports injuries involve broken bones. However, the areas where bones grow in children are at more risk of injury during the rapid phases of growth. In a growing child, point tenderness over a bone should be evaluated further by a medical provider even if minimal swelling or limitation in motion is appreciated.

Most frequent sports injuries are sprains (injuries to ligaments) and strains (injuries to muscles), caused when an abnormal stress is placed on tendons, joints, bones and muscle. As always, contact your pediatrician if you have additional questions or concerns.

To reduce injury:
•    Wear the right gear. Players should wear appropriate and properly fit protective equipment such as pads (neck, shoulder, elbow, chest, knee, shin), helmets, mouthpieces, face guards, protective cups, and/or eyewear. Young athletes should not assume that protective gear will protect them from performing more dangerous or risky activities.
•    Strengthen muscles. Conditioning exercises before games and during practice strengthens muscles used in play.
•    Increase flexibility. Stretching exercises before and after games or practice can increase flexibility.
•    Use the proper technique. This should be reinforced during the playing season.
•    Take breaks. Rest periods during practice and games can reduce injuries and prevent heat illness.
•    Play safe. Strict rules against headfirst sliding (baseball and softball), spearing (football), and body checking (ice hockey) should be enforced.
•    Stop the activity if there is pain.
•    Avoid heat injury. Drink plenty of fluids before, during and after exercise or play; decrease or stop practices or competitions during high heat/humidity periods; wear light clothing.

The American Academy of Pediatrics is an organization of 60,000 pediatricians focused on the care of children. Check out their great Parenting Corner for the latest medical information for your child.

Are your kids playing a sport this spring?