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Pediatric Childcare & Wellness

Our blog featuring Dr. McKillip and Shelly Nalbone. Email topic requests to shellynp@totdoc.com

Blog entries categorized under Staying Healthy

Staying Healthy

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Ant Bites

by Shelly
Shelly
Shelly Nalbone is a Pediatric Nurse Practitioner who has worked with children fo
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on Monday, April 23 2012
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This is the time of year that children play outside and can come in contact with different insects. Fire ants are common in this area. Fire ants are small, reddish-brown ants, & they are aggressive. They are sensitive to vibration and movement, and will sting when the object they're on moves (for example, a child running through the gras with bare feet who knocks into an ant mound). Fire ants are so named because their venom induces a painful, fiery sensation. When disturbed, fire ants are very aggressive. Because of the ant's aggressive nature, an attack usually results in several stings. The ant injects a venom when it stings that causes the release of histamine, a chemical in our bodies that can produce pain, itching, swelling and redness of the skin. Within seconds, a small red welt appears. Which enlarges rapidly, depending on the amount of venom that was injected. This reaction persists for up to an hour, and than a small blister containing clear fluid appears. Over the next half day or so, the fluid in the blister turns cloudy, and the area begins to itch. If the child scratches too vigorously, the skin can be secondarily infected.

Treatment for Fire Ant Bites

1. Remove all ants from the child's body to prevent further stinging

2. If a child is stung, apply ice to the bite site for 10 to 15 minutes.

3. Elevate the extremity where the child was bit.

4. Clean and clip the child's fingernails to prevent any secondary infection that can result from scratching the bite.

5. Check our website for the correct dose of an oral antihistamine (Benadryl) to reduce itching and inflammation

6. A small percentage of children stung -- probably less than 0 .5 percent -- experience a severe reaction. These occur within minutes of a sting and vary in severity. A child who is stung and within minutes begins to experience hives, weakness, dizziness, wheezing, difficulty swallowing, shortness of breath or confusion should be taken immediately to the nearest emergency room.

7. Watch the area for signs of infection over the next couple of days.

8. Reaction to fire ant stings is similar to reaction to the stings of bees, wasps, hornets and yellow jackets. The overwhelming majority of fire ant stings are medically uncomplicated and are more of a nuisance than a serious problem.

When it comes to fire ants, the best treatment is avoidance. To help children avoid fire ants, parents should regularly check their yards and their children's play areas for the presence of the ants and their mounds. Then they should either eliminate the ants or make sure children avoid them.

Information obtained from kidsgrowth.com

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Alcohol Consumption While Breastfeeding

by Shelly
Shelly
Shelly Nalbone is a Pediatric Nurse Practitioner who has worked with children fo
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on Friday, April 13 2012
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Many mothers ask whether or not it is safe to have an alcoholic beverage while they are breastfeeding there baby.  Below is a link to the LaLeche webpage with  info on this topic.

http://www.llli.org/faq/alcohol.html

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Moles and Skin Cancer in Children and Teens

by Shelly
Shelly
Shelly Nalbone is a Pediatric Nurse Practitioner who has worked with children fo
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on Thursday, March 22 2012
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We often do not think about moles or skin cancer in children, but everyone should be aware of what to look for.  Kids can, and do, have moles that can be pre-cancerous and children and teens are diagnosed with skin cancer.  Most moles in children are normal and cause no problems if they are of normal shape, size, and color.  Moles that are atypical or abnormal should be looked at by a healthcare provider.  Here are some things to look for on your child's skin. 

Indicators of an atypical mole in a child include the ABCDs.

  • Asymmetry or irregular shape:  The mole should be circular or oval in shape and not asymmetrical.
  • Borders:  The borders should be clear and defined, not blurred or jagged in shape
  • Color:  The color should be uniform throughout the mole
  • Diameter:  The diameter should be less than 5 millimeters, about the size of a pencil eraser.

It is important to remember that sun damage can increase a person’s risk for skin cancer.   Try to stay out of the sun during peak hours if 11am-3pm.  Remind teens that while tans do look nice, it is not good for the skin.  Avoid use of tanning beds and don’t forget to apply sunscreen and to reapply every 2 hours and after coming out of the water to prevent sun damage.

Here is a link to an article on skin cancer in children and teens. 

http://www.skin-cancer.org/skin-cancer-in-children/

If there is an area on your child’s skin that you are concerned about, let us know.

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Insect Repellant and Kids

by Shelly
Shelly
Shelly Nalbone is a Pediatric Nurse Practitioner who has worked with children fo
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on Thursday, March 08 2012
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Many parents often ask if insect repellent is safe to use on their children. The American Academy of Pediatrics recommends that repellents with DEET should not be used on infants less than 2 months old. Here are some helpful hints when using repellent on a child that is over 2 mo of age.

  • Apply insect repellent to your own hands and then rub them on your child. Avoid children's eyes and mouth and use it sparingly around their ears.
  • Do not apply repellent to children's hands. (Children may tend to put their hands in their mouths.)
  • Do not use insect repellent on open wounds
  • Do not allow young children to apply insect repellent to themselves; have an adult do it for them.
  • Keep repellents out of reach of children.
  • Avoid scented soaps and other things that might attract mosquitoes
  • Use mosquito netting over strollers to protect
  • Wash off insect repellents with soap and water once you bring your baby inside

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Fun Food For Kids

by Shelly
Shelly
Shelly Nalbone is a Pediatric Nurse Practitioner who has worked with children fo
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on Thursday, March 08 2012
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Here is a link to some fun ideas to make healthy foods interesting for kids.

http://littlepageturners.blogspot.com/2010/04/edible-insects.html

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Rainy Day Activities

by Shelly
Shelly
Shelly Nalbone is a Pediatric Nurse Practitioner who has worked with children fo
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on Monday, February 13 2012
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Below is a link with some good ideas for rainy day activities for kids.

http://familyfitness.about.com/od/waystoplay/tp/rainy_day_activities.htm

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Finger Foods for Babies

by Shelly
Shelly
Shelly Nalbone is a Pediatric Nurse Practitioner who has worked with children fo
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on Monday, November 28 2011
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By the time they're 9 months old, most babies have developed the fine motor skills — the small, precise movements — needed to pick up small pieces of food and feed themselves.

Allow your child to self-feed as much as possible, though you'll still be helping out by spoon-feeding cereal and other important dietary elements. Encouraging finger feeding helps your child learn about textures and independence.  If you have not already done so, it is time to introduce table/finger foods.  Do not limit your baby to just Gerber puffs.

By 9 months, most babies are ready to try table food and should be able to try many of the things that you eat.    Here are some suggestions.

  • Zucchini, carrots, potatoes, sweet potatoes, beans, or other well-cooked veggies.   
  • Pieces of ripe banana, soft pears or peaches, and cooked apples
  • Well-cooked pasta
  • Dry cereals and crackers such as cheerios, graham crackers, & ritz crackers.  Ask yourself, does it melt in the mouth? Some dry cereals and crackers that are light and flaky will melt in the mouth.
  • Shredded cheeses  and  cottage cheese
  • Small pieces of soft, cooked beef and chicken are other good choices

Food should be cut into small pieces. The sizes will vary depending on the food's texture.   You should avoid the following foods that can be choking hazards.

  • Pieces of raw vegetables or hard fruits
  • Whole grapes, berries, cherry or grape tomatoes (instead, peel and slice or cut in quarters)
  • Raisins and other dried fruit
  • Peanuts, nuts, and seeds
  • Peanut butter and other nut or seed butters
  • Whole hot dogs and sausages (peel and cut these in very small pieces)
  • Untoasted bread, especially white bread that sticks together
  • Chunks of cheese or meat
  • Candy (hard candy, jelly beans, gummies, chewing gum)
  • Popcorn, pretzels, corn chips, and other snack foods
  • Marshmallows
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Obesity and Kids

by Shelly
Shelly
Shelly Nalbone is a Pediatric Nurse Practitioner who has worked with children fo
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on Monday, September 12 2011
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Up to one out of every five children in the US is overweight or obese, and this number is continuing to grow. Children have fewer weight related health and medical problems than adults. However, overweight children are at high risk of becoming overweight adolescents and adults, placing them at risk of developing chronic diseases such as heart disease and diabetes later in life. They are also more prone to develop stress, sadness, and low self-esteem. Being overweight during childhood and adolescence increases the risk of developing high cholesterol, hypertension, respiratory ailments, orthopedic problems, depression and type 2 diabetes as a youth.

Children become overweight and obese for a variety of reasons. The most common causes are genetic factors, lack of physical activity, unhealthy eating patterns, or a combination of these factors. Only in rare cases is being overweight caused by a medical condition such as a hormonal problem. A physical exam and some blood tests can rule out the possibility of a medical condition as the cause for obesity.

A child's total diet and activity level play an important role in determining a child's weight. Today, many children spend a lot time being inactive. As computers and video games become increasingly popular, the number of hours of inactivity may increase. As a society, we also regularly overdo portion sizes and often eat on the go. Kids should eat a good variety of fruits, veggies, protein, dairy, and grains. Fast food is ok in moderation and there are healthy options to choose from. Try to choose fruit instead of french fries, grilled rather than fried foods, and monitor portion sizes.

So how much is too much? A good way to judge portion sizes is to look at your child's hands. Here are some examples.

Meats-  A child-size portion of meat is about what would fit in your child's palm

Fruits, Veggies,Whole-grain carbs, & Dairy- a serving is roughly the size of his fist

The great thing about this system is that it works no matter what your child's age -- because his hand grows as he, and his appetite, does. So you don't have to memorize portion sizes.

Remember that all family members need structured exercise and appropriate portions of healthy foods.

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Do your kids have time to just be kids?

by Shelly
Shelly
Shelly Nalbone is a Pediatric Nurse Practitioner who has worked with children fo
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on Friday, August 26 2011
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Some parents feel it's more productive to keep their kids constantly occupied rather leave free time for playing, exploring, and learning on their own. They might also feel that their kids will miss out on key experiences if they aren't doing what other kids are. But most parents usually just want what seems best for their kids. Even when intentions are good, though, kids can easily become overscheduled. The pressure to participate in a handful of activities all the time and to "keep up" can be physically and emotionally exhausting for parents and kids alike. Some kids in our society have almost no time left to themselves, often because they are overscheduled with activities such as sports, boy scouts, church activities, playdates, parties, homework, running errands with parents, etc. Of course, organized activities and sports are beneficial, too. They foster social skills and are opportunities for play and exercise. They teach sportsmanship, self-discipline, and conflict resolution. Most of all, they're fun! The key is to keep them that way and ensure that kids, and parents, aren't overwhelmed. Overscheduling children can cause stress, anxiety, problems sleeping, and difficulties in school for some children. While some children can handle busy schedules well, others may have a difficult time. There may not be a "right" number of activities for every child, but ask yourself these questions to check if your child's getting enough downtime.

Does he/she act grouchy, mopey, or irritable when it is time to leave for an activity?

Is he/she always sleepy during the day or does he/she have trouble falling asleep at bedtime?

Are grades slipping? Does he/she have time to finish homework?

Is he/she complaining of stomachaches, headaches, or mysterious illnesses?

Is he/she over-anxious about getting approval from authority figures?

When you're heading out the door, does he/she throw a tantrum or "lose" equipment?

Can he keep track of where's he's supposed to be?

Is your child happy after the day's activities?

Is her schedule draining you or your family members?

If your child is having some of the issues, here are some things that you can do.

Schedule free time each day, and ask if you can spend some of that time with them doing what they want to do.

Parents are encouraged to build time into each week for family time as well.

Evaluate what activities are important to your child and pick the top 2.

Remember that you can help your child grow, develop, and learn just as much as the karate coach.

 

 

 

 

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Kids, Sports, & Hydration

by Shelly
Shelly
Shelly Nalbone is a Pediatric Nurse Practitioner who has worked with children fo
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on Friday, August 12 2011
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Any child who exercises in the heat might be at risk of dehydration. The concern is often greatest for young athletes who participate in sports that require wearing full protective gear, such as football, or sports that involve playing in a hot environment.  Young athletes should be encouraged to drink plenty of fluids before practice and during regular beverage breaks — even if they aren't thirsty.  For long sporting events, such as tournaments, hydration should begin the night before the competition.  Even mild dehydration can affect your child's athletic performance and make him or her lethargic and irritable. Left untreated, dehydration increases the risk of other heat-related illnesses, including heat cramps, heat exhaustion and heatstroke.

Encourage your child to pay attention to early signs and symptoms of dehydration, including:

  • Dry or sticky mouth
  • Thirst
  • Headache
  • Dizziness
  • Cramps
  • Excessive fatigue

Teach your child the signs and symptoms of dehydration, as well as the importance of speaking up if they occur.  Make sure clothing is light-colored, lightweight and loosefitting, or exposes as much of the skin as possible.  This will help protect your child from the sun.

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If it has wheels, the kids need to wear a helmet

by Shelly
Shelly
Shelly Nalbone is a Pediatric Nurse Practitioner who has worked with children fo
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on Tuesday, July 19 2011
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No matter what age or level of experience, whenever you ride a bike, inline skate, scooter, or ride ripsticks, a helmet should be worn.   Cuts, bruises, and even broken bones will heal, but damage to the brain can be permanent. Even a low-speed fall can result in serious head injury. Such injuries can be prevented by wearing a helmet.  During a fall or crash, a helmet absorbs much of the force of impact that would otherwise be directed to the head.

Tips to help children understand the importance of wearing helmets:

  • Teach by example. Always use your helmet when riding bikes, skating, that pose a potential for collision.
  • Start children wearing helmets at a young age when they begin riding a tricycle. 
  • Buy a helmet that fits your child now, not one to grow into.
  • Be aware that your child is more likely to wear a helmet if he or she likes the way it looks.  Encourage your child to help choose the helmet or decorate it with stickers.
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