True or False?

Poison Ivy rash is not contagious

- True - Rubbing the rash won't spread poison ivy to other parts of your body (or to another person). You spread the rash only if the plant resin or oil has been left on your hands.

You can catch poison ivy simply by being near the plants

- False - Direct contact is needed to release plant resin or oil, but you can get poison ivy from forest fires, direct burning, or anything else that can cause the oil to become airborne such as a lawnmower, trimmer, etc.

Poisonous plants always have 3 leaves

- False - Poison ivy and poison oak do have 3 leaves on a cluster, but poison sumac has 7 to 13 leaves on a branch.

I cannot get a rash from a dead poison ivy plant

- False - The resin or oil stays active on any surface, including dead plants, for up to 5 years

I've been in poison ivy many times and never broken out. I'm immune.

- False- About 90% of people are allergic to the resin of poisonous plantsl, it's a matter of time and exposure. The more times you are exposed, the more likely it is that you will break out with an allergic rash. For the first time sufferer, it may take up to 7 to 10 days for the rash to appear.

If your child gets a poison plant rash, you can use oral Benedryl, Calamine lotion, or Hydrocortisone cream or call the office for an appointment.

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Otitis Media is an inflammation/infection of the inner ear, behind the ear drum. Otitis media usually occurs after an episode of upper respiratory colds and viruses. Some children with Otitis Media run fever & complain of ear pain. Otitis media is often treated with oral antibiotics.

Otitis Externa or "Swimmers Ear" is an inflammation/infection of the ear canal. Swimmers Ear is often caused by bacteria or fungi found in lakes, rivers, ocean water, or after frequent episodes of swimming in pools. Children with Swimmers Ear often complain of itching and pain of the ear canal that worsens with movement of the ear. Swimmers Ear is often treated with ear drops. Children with Swimmers Ear should not swim until the treatment has been completed.

True or False

Children should not swim if they have been diagnosed with otitis media.

-False. Otitis is an infection behind the ear drum, not of the ear canal. Swimming is ok.

Swimmers ear can be prevented.

-True. You can discourage bacterial and fungal growth in the ear canal by using equal parts of white vinegar and water. While this will not prevent all infections of swimmers ear, it will help to decrease the possibility of infection. Do not use alcohol in the ears

 

Colds are caused by hundreds of different viruses. When one of these viruses gets into your body, your immune system attacks. Some of the effects of this immune response are the classic symptoms of a cold, such as congestion and coughing.  The germs that cause colds are contagious. You can pick them up when an infected person sneezes, coughs, or you touch the germs with your hands.  Colds can last 10-14 days and do not respond to antibiotics.

Allergies are caused by an overactive immune system. For some reason, your body mistakes harmless substances -- such as mold or pollen -- for germs and attacks them. Your body releases chemicals such as histamine, just as it does when fighting a cold. This can cause swelling in your nasal passages, a runny nose, coughing, and sneezing. Allergies are not contagious, although some people may inherit a tendency to develop them.

Characteristic	Cold	Allergy
Duration	three-14 days	Days to months -- as long as you are exposed to the allergen
Time of year	Most often in the winter, but possible at any time	Any time of the year -- although the appearance of some allergens are seasonal
Onset of Symptoms	Symptoms take a few days to appear after infection with the virus.	Symptoms can begin immediately after exposure to the allergen
Cough	Often	Sometimes
Aches	Sometimes	Never
Fatigue	Sometimes	Sometimes
Fever	Sometimes	Never
Itchy, Watery eyes	Rarely	Often
Sore Throat	Often	Sometimes
Runny or Stuffy Nose	Often; usually yellow mucus	Often; usually clear mucus

If you have questions or concerns about your child’s symptoms please call the office.

 

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Strep throat is a bacterial throat infection that can make your throat feel sore and scratchy. Compared with a viral throat infection, strep throat symptoms are generally more severe. 

In general, signs and symptoms of strep throat include:

• Throat pain
• Difficulty swallowing
• Red and swollen tonsils, sometimes with white patches or streaks of pus
• Tiny red spots on the soft or hard palate — the area at the back of the roof of the mouth
• Swollen, tender lymph glands (nodes) in your neck
• Fever
• Headache
• Rash
• Stomachache and sometimes vomiting, especially in younger children

It's possible for your child to have many of these signs and symptoms, but not have strep throat. The cause of these signs and symptoms could be a viral infection or some other kind of illness. That's why there are tests specifically for strep throat

If your child has any of these symptoms, call the office for an appointment.

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Lice

The head louse is a tiny, wingless parasitic insect that lives among human hairs and feeds on extremely small amounts of blood drawn from the scalp. Although they may sound gross, lice (the plural of louse) are a very common problem, especially for kids ages 3 years to 12 years. 

Lice aren't dangerous and they don't spread disease, but they are contagious and can just be  annoying. Their bites may cause a child's scalp to become itchy and inflamed, and persistent scratching may lead to skin irritation and even infection.   Though very small, lice can be seen by the naked eye.   The adult louse is no bigger than a sesame seed and is grayish-white or tan.  Lice eggs (called nits) look like tiny yellow, tan, or brown dots before they hatch. Lice lay nits on hair shafts close to the scalp, where the temperature is perfect for keeping warm until they hatch. Nits look sort of like dandruff, only they can't be removed by brushing or shaking them off.

You want to treat head lice quickly as soon as you notice them because they can spread easily from person to person.  Lice are highly contagious and can spread quickly from person to person, especially in group settings (schools, childcare centers, slumber parties, sports activities, and camps).

Though they can't fly or jump, these tiny parasites have specially adapted claws that allow them to crawl and cling firmly to hair.  They spread mainly through head-to-head contact, but sharing clothing, bed linens, combs, brushes, and hats can also help pass them along. Kids are most prone to catching lice because they tend to have close physical contact with each other and often share personal items.

We recommend that you use a medicated shampoo, cream rinse, or lotion to kill the lice. These may be over-the-counter (OTC) or prescription medications, depending on what treatments have already been tried.  Medicated lice treatments usually kill the lice and nits, but it may take a few days for the itching to stop.

Here are some simple ways to get rid of the lice and their eggs, and help prevent a lice reinfestation:

• Wash all bed linens and clothing that's been recently worn by anyone in your home who's infested in very hot water (130° F [54.4° C]), then put them in the hot cycle of the dryer for at least 20 minutes.
• Have bed linens, clothing, and stuffed animals and plush toys that can't be washed dry-cleaned. Or, put them in airtight bags for 2 weeks.
• Vacuum carpets and any upholstered furniture (in your home or car).
• Soak hair-care items like combs, barrettes, hair ties or bands, headbands, and brushes in rubbing alcohol or medicated shampoo for 1 hour. You can also wash them in hot water or just throw them away.
• Because lice are easily passed from person to person in the same house, bedmates and infested family members will also need treatment to prevent the lice from coming back

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Molluscum contagiosum is a common skin disease that is caused by a virus. The disease is generally mild and should not be a reason for concern or worry.  Molluscum infection causes small white, pink, or flesh-colored bumps or growths with a dimple or pit in the center. The bumps are usually smooth and firm and can appear anywhere on the body. They may become sore, red, and swollen but are usually painless. The bumps normally disappear within 6 to 12 months without treatment and without leaving scars.  People with this skin disease can cause the bumps to spread to different parts of their body by touching or scratching a bump and then touching another part of the body.  The virus can also be spread from person to person.  This can happen if the growths on one person are touched by another person. It can also happen if the virus gets on an object that is touched by other people such as towels, clothing, and toys.

How to prevent spreading

• Wash hands well
• Do not scratch or pick
• Keep the bumps covered
• Do not share towels or other personal items

Treatment

There are treatments for molluscum such as…

• Surgical removal by scraping the lesions off the body
• Freezing the lesions with liquid nitrogen

However, treatment is not usually required because the bumps disappear on their own within 6 months. However, they may not go away completely for up to 4 years. In addition, not all treatments are successful for all people.

Information obtained at www.cdc.gov

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Hand, foot, & mouth (HFM) disease is a virus that is common among children from 6months to 4 yrs of age. If your child has hand, foot, & mouth disease, you may see red spots and/or blisters on the hands, feet, face, buttocks. Your child may also have small ulcers or sores in his/her mouth and a low grade fever. The fever and discomfort caused by HFM usually lasts 3-4 days and mouth sores typically resolve within 7 days. The sores on the body can last up to 10 days. Feed your child a soft diet and encourage plenty of fluids. Cold drinks & popsicles are good choices for children with mouth pain. HFM is contagious. Children may return to school or daycare once they are fever free for 24hrs.

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It’s 2 am. Your youngest child is upset and crying. And… they’re hot. The thermometer you have reads 102. You’re nervous. Your child is nervous. Fever can feel like your family’s worst enemy.

Believe it or not, and despite the fear often associated with it, fever is often your child’s friend.   Fever revs up the body’s immune system and activates it to fight off any viral or bacterial “invaders.”   So, when your child has a fever, it means her body is doing its job.  

Most pediatric experts agree: a fever is a temperature equal to or greater than 100.5 degrees.  That’s why when you make an appointment for your child for a “fever” we sometimes push you on the details: 100.2 you say?  Not a fever.  Felt your child and thought he was hot but didn’t take the temperature? Might have been a fever, but might not have.  We want to know, when possible, the actual temperature and how you took it (under the arm, in the mouth, in the ear, or on the skin).  Your child’s temperature depends on a number of factors, including how you take it. The closer we get to the core of the body, the more accurate it is. That’s why, when we measure the temperature of a baby, we often want to take the temperature in the baby’s bottom.  For older kids, a temperature taken in the mouth or the bottom is much more accurate than a temperature taken under the armpit.

A child’s age also matters a lot when it comes to fever.   Any child under a month of age needs to be evaluated by a doctor immediately if they have a fever, even if it only occurs once.

As kids get older and older, we are less concerned about low-grade fevers in otherwise healthy and vaccinated kids, but recommend an evaluation if your child has had a temperature for more than 2-3 days (or anytime you are concerned).  

Some things do worry us when it comes to fever. We worry when the fever lasts several days without a good explanation for it.  We worry when your child becomes dehydrated.  We worry when your child is lethargic. We worry when your child is not fully vaccinated.  Most of all, we worry about how your child “looks” overall, which is why we pay a lot of attention to this when you call or come in.  

It also doesn’t matter if the Acetaminophen or Ibuprofen you’ve been giving to treat your child’s fever makes it go away and stay away.  These medications are for your child’s comfort but don’t help to fight off the virus or bacteria your child has.  If they don’t completely eliminate the fever, it doesn’t mean they aren’t working, just that they wore off like they are supposed to.

Fever can be scary, but knowing what a fever does for the body is helpful. On average, kids will have 4 to 6 acute episodes of fever from birth to 2 years of age, so fever is here to stay, whether we like it or not. Think of it as an (often annoying, but very helpful) friend.

 

 

With so many medications available over the counter (OTC) how do you tell what is what?  Many parents have a hard time making sense of it all.  Below is a breakdown of the common ingredients & classes of OTC meds and what they are used for.

Fever Reducers/ Pain Relievers – These medications work to reduce fever and treat pain. 

Antihistamines –Antihistamines counteract the effects of histamine, a chemical released by the body during allergic reactions.  They can make people sleepy, but many infants and children sometimes become irritable after taking antihistamines.  Diphenhydramine, Brompheniramine, & Chlorpheniramine are common OTC antihistamines. 

Decongestants - Decongestants are the medications that treat stuffy, congested noses.   It's important to note that decongestants do not relieve a runny or itchy nose.  Decongestants can make some children irritable.  Pseudoephedrine and Phenylepherine are common OTC decongestants.

Cough suppressant - Cough suppressants are intended to decrease coughing by acting on the brain to suppress the urge to cough.  Dextromethorphan is a common OTC cough medicine.

Expectorants – Expectorants thin mucus and make it easier to cough up.

Many cold, cough, and allergy products are a mixture of 2 of the above medications.  When choosing a cold medication for your child, remember…

• For infants and children under age 4, use a cool mist humidifier in their room, normal saline & nasal suctioning as needed.
• Cold medications are not recommended for children under age 4.
• Children may have reactions to medications that alter their temperament.
• Select meds that treat the symptoms that your older child is having. 

If you have questions about medication dosing, visit our the “Resources” section of our website www.totdoc.com

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The head louse is a tiny, wingless parasitic insect that lives among human hairs and feeds on extremely small amounts of blood drawn from the scalp. Although they may sound gross, lice (the plural of louse) are a very common problem, especially for kids ages 3 years to 12 years. 

Lice aren't dangerous and they don't spread disease, but they are contagious and can just be  annoying. Their bites may cause a child's scalp to become itchy and inflamed, and persistent scratching may lead to skin irritation and even infection.   Though very small, lice can be seen by the naked eye.   The adult louse is no bigger than a sesame seed and is grayish-white or tan.  Lice eggs (called nits) look like tiny yellow, tan, or brown dots before they hatch. Lice lay nits on hair shafts close to the scalp, where the temperature is perfect for keeping warm until they hatch. Nits look sort of like dandruff, only they can't be removed by brushing or shaking them off.

You want to treat head lice quickly as soon as you notice them because they can spread easily from person to person.  Lice are highly contagious and can spread quickly from person to person, especially in group settings (schools, childcare centers, slumber parties, sports activities, and camps).

Though they can't fly or jump, these tiny parasites have specially adapted claws that allow them to crawl and cling firmly to hair.  They spread mainly through head-to-head contact, but sharing clothing, bed linens, combs, brushes, and hats can also help pass them along. Kids are most prone to catching lice because they tend to have close physical contact with each other and often share personal items.

We recommend that you use a medicated shampoo, cream rinse, or lotion to kill the lice. These may be over-the-counter (OTC) or prescription medications, depending on what treatments have already been tried.  Medicated lice treatments usually kill the lice and nits, but it may take a few days for the itching to stop.

Here are some simple ways to get rid of the lice and their eggs, and help prevent a lice reinfestation:

• Wash all bed linens and clothing that's been recently worn by anyone in your home who's infested in very hot water (130° F [54.4° C]), then put them in the hot cycle of the dryer for at least 20 minutes.
• Have bed linens, clothing, and stuffed animals and plush toys that can't be washed dry-cleaned. Or, put them in airtight bags for 2 weeks.
• Vacuum carpets and any upholstered furniture (in your home or car).
• Soak hair-care items like combs, barrettes, hair ties or bands, headbands, and brushes in rubbing alcohol or medicated shampoo for 1 hour. You can also wash them in hot water or just throw them away.
• Because lice are easily passed from person to person in the same house, bedmates and infested family members will also need treatment to prevent the lice from coming back

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Croup is a condition that causes an inflammation of the upper airways — the voice box (larynx) and windpipe (trachea).  It often leads to a barking cough or hoarseness, especially when a child cries.  At first, a child may have cold symptoms, like a stuffy or runny nose and a fever.   As the upper airway (the lining of the windpipe and the voice box) becomes progressively inflamed and swollen, the child may become hoarse, with a harsh, barking cough.  This loud cough, which is characteristic of croup, often sounds like the barking of a seal.   Symptoms of croup are often worse at night and when children are upset or crying.  Outbreaks of croup tend to occur in the fall and early winter when the viruses that cause croup peak. 

Most cases of croup are caused by viruses.  Croup is most common — and symptoms are most severe — in children 6 months to 3 years old, but can affect older kids, too.   Most cases of viral croup are mild and can be treated at home.  Here are some things that you can do at home if your child has croup.

• Breathing in moist air seems to make kids feel better.  The best way to expose your child to moist air is to use a cool mist humidifier, or run a hot shower to create a steam-filled bathroom where you can sit with your child for 10 minutes. Breathing in the mist will sometimes stop a child from severe coughing.
• In the cooler months, try taking your child outside for a few minutes to breath in the cool air — this may also alleviate symptoms. You can also try driving your child around in the car with the windows down.

The symptoms of croup generally peak 2 to 3 days after the symptoms of infection with a virus start. Viral croup usually lasts 3 to 7 days

Immediately call your doctor or seek medical attention if your child has: 

• difficulty breathing, including rapid or labored breathing 
• retractions: when the skin between the ribs pulls in with each breath 
• stridor: high-pitched or squeaking noise when inhaling 
• a pale or bluish color around the mouth 
• drooling or difficulty swallowing 
• a fatigued appearance 
• signs of dehydration

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Mosquitos have been a big problem in our area for the past few weeks.  When a mosquito bites an individual, various chemicals are injected into the skin. The red bumps are actually the body's reaction to these chemicals.   Most insect bites result in a red bump.  Some are larger (like a hive) and some have a small water blister in the center.  These are normal reactions to an insect bite.  Mosquito bites of the upper face can cause eyelid to swell up for several days.  With bites, the swelling can be red as well as large (especially age 1-5 years).  Insect bites of the upper face can cause severe swelling around the eye, but this is usually harmless.  The swelling is usually worse in the morning after lying down all night. It will improve after standing for a few hours.  If your child develops a fever, irritability or the skin in the area of the bite is tender to touch, call the office.   If you think you've been bitten by a mosquito, wash the bite with soap and water.  Put on some calamine lotion anti-itch cream to stop the itching.  Placing an ice pack on the bite may also help.   The best way to avoid mosquito bites is to wear an insect repellent.   Since mosquitoes lay their eggs in water, it's also a good idea to empty out buckets, flower pots, toys, and other things in your yard that may have collected water during a rainstorm.  Wear long-sleeved shirts and long pants to keep mosquitoes away from your skin.

Let’s test your knowledge about mosquito bites. 

True or False

A large hive at the bite site means your child is having an allergic reaction. False- this is a normal reaction

The area is red and there is a clear dot in the middle.  This means that the bite is infected.  False – this is a normal reaction

Most insect bites are itchy for several days.  True

The area may be red, pink, and swollen for up to 7 days.  True

 

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Many parents call and ask questions about their child’s legs and/or feet.  Here are some common conditions that we see in pediatrics.

Bowlegs  is a condition involving the shin and thigh (tibia and femur) bones in which the legs appear bowed out.  Having bowlegs is considered a normal part of growth in young children.   Over time, the leg alignment will correct and usually straightens out by about 4 years of age.   Occasionally, the bowing never fully corrects and some adults still have bowed legs. 

Knocked Knees is also a condition that is common in childhood.  Knock-knees is when children’s knees turn inward.  Most children also outgrow this condition by about 6yrs of age, but some people will still have the condition into adulthood.

Pigeon toes, or in-toeing, is a condition causing the toes to point in. It is common in infants and young children. If a child is pigeon toed,  it does not mean there is something wrong with the feet.   Usually, this will get better as the baby gets older, but some adults are still pigeon toed.

These conditions are variations of normal and typically do not cause any long term problems.  If you are concerned about your child’s legs or feet, mention it to us at the next check up visit. 

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This is the time of year that we like to call, "Snottin, Sneezin, Wheezin, Season",  as  many of our family and friends are sick with colds and flu. One of the best ways to prevent the spread of germs year round is good handwashing, but we cannot always avoid getting sick.  If you or a family member get sick, there are several things that you can do at home to treat your symptoms.

• Rest and increased fluids are a great place to start.
• Over the counter cold and cough meds will help treat symptoms for children over 4yrs of age.
• For children under age 4, use a cool mist humidifier in the room and normal saline followed by bulb suctioning of the nose as needed.
• If you or your child is sick, avoid young babies and the elderly. 
• Keep your child home from school if they have fever or you feel that they are too sick to concentrate in school.

 If your child has persistent symptoms, fever, ear pain, etc, call the office for an appointment.

Many parents have a hard time deciding if their kids are well enough to go to school. After all, what well-intentioned parent hasn't sent a child off with tissues in hand, only to get that mid-morning "come get your child" phone call?

But making the right decision isn't as tough as you might think. It basically boils down to one question: Can your child still participate in school activities? Having a sore throat, cough, or mild congestion does not necessarily mean that your child can't be active and participate in school activities.

Trust your instincts. If your child has the sniffles but hasn't slowed down at home, chances are he/she is well enough for the classroom. On the other hand, if he's been coughing all night and needs to be woken up in the morning (if he typically wakes up on his own), he may need to take it easy at home.

Of course, never send a child to school who has a fever, is nauseated, vomiting, or has diarrhea. Kids who lose their appetite, are clingy or lethargic, complain of pain, or who just don't seem to be acting "themselves" should also take a sick day.

Most daycares, preschools, and grade schools have rules about when to keep kids home. For example, pinkeye or strep throat usually necessitates a day home with appropriate treatment. Most centers won't let kids return to school until after a fever has broken naturally (without fever-reducing medicines) for at least 24 hours.

Remember, go with your gut. You know your kids best, and you know when they're able to make it through the day — and when they're not. If you have any questions, feel free to call us.

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 Many parents have a hard time deciding if their kids are well enough to go to school. After all, what well-intentioned parent hasn't sent a child off with tissues in hand, only to get that mid-morning "come get your child" phone call?

But making the right decision isn't as tough as you might think. It basically boils down to one question: Can your child still participate in school activities? Having a sore throat, cough, or mild congestion does not necessarily mean that your child can't be active and participate in school activities.

Trust your instincts. If your child has the sniffles but hasn't slowed down at home, chances are he/she is well enough for the classroom. On the other hand, if he's been coughing all night and needs to be woken up in the morning (if he typically wakes up on his own), he may need to take it easy at home.

Of course, never send a child to school who has a fever, is nauseated, vomiting, or has diarrhea. Kids who lose their appetite, are clingy or lethargic, complain of pain, or who just don't seem to be acting "themselves" should also take a sick day.

Most daycares, preschools, and grade schools have rules about when to keep kids home. For example, pinkeye or strep throat usually necessitates a day home with appropriate treatment. Most centers won't let kids return to school until after a fever has broken naturally (without fever-reducing medicines) for at least 24 hours.

Remember, go with your gut. You know your kids best, and you know when they're able to make it through the day — and when they're not. If you have any questions, feel free to call us.

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Normal breast tissue is present in both males and females of all ages. This tissue responds to hormonal changes and, therefore, certain lumps can come and go.

Breast lumps may appear at all ages:

Infants may have breast lumps related to estrogen from the mother. The lump generally goes away on its own as the estrogen clears from the baby's body. It can happen to boys and girls.

Young girls often develop "breast buds" that appear just before the beginning of puberty. These bumps may be tender. They are common around age 9, but may happen as early as age 6.

Teenage boys may develop breast enlargement and lumps because of hormonal changes in mid-puberty. Although this may distress the teen, the lumps or enlargement generally go away on their own over a period of months.

In teens, the buds may last up to 2 years, but they tend to go away within the first year. 

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Respiratory syncytial virus (RSV), which causes infection of the lungs and breathing passages, is a major cause of respiratory illness in young children. RSV is highly contagious and can be spread through droplets containing the virus when someone coughs or sneezes. It also can live on surfaces (such as countertops or doorknobs) and on hands and clothing, so can be easily spread when a person touches something contaminated. Because RSV can be easily spread by touching infected people or surfaces, frequent hand washing is key in preventing its transmission. Fortunately, most cases of RSV are mild and require no specific treatment from doctors. RSV season is usually from fall to early spring and we are already seeing cases in the community. Antibiotics aren't used because RSV is a virus and antibiotics are only effective against bacteria. Medication may sometimes be given to help open respiratory airways. If your child gets RSV or other respiratory viruses there are some things that you can do at home to make them feel better.

Make a child with an RSV infection as comfortable as possible, allow time for recovery, and provide plenty of fluids.

The last part can be tricky, however, because babies may not feel like drinking. In that case, offer fluids in small amounts at more frequent intervals than usual.

To help your child breathe easier, use a cool-mist vaporizer to keep the aire moist. If your child is uncomfortable & too young to blow his/her nose, use a nasal aspirator or bulb suction to remove nasal secretions.

Treat fever with acetaminophen as needed.

For more info see www.kidshealth.org