When a new baby comes along, it can change the dynamic of your household. Other children may experience sibling rivalry or begin to act out. Our pets can have the same feelings. Below is a link to a good article on introducing a baby into a home with pets.
Pediatric Childcare & Wellness
Our blog featuring Dr. McKillip and Shelly Nalbone. Email topic requests to firstname.lastname@example.org
Your baby’s umbilical cord stump should be kept clean and dry until it falls off. The cord will usually fall off after the first couple of weeks of life. Fold the baby's diaper below the stump or buy newborn diapers with a cut-out space for the cord so it's exposed to the air and won't come in contact with urine. Sometimes you may see some yellowish discharge underneath the dried cord and there may be some oozing of blood for a few days as the cord separates. If you notice discharge from your baby’s cord, you can apply a small amount of rubbing alcohol with a cotton ball to help dry it out. Don't be afraid to lift up the dry part of the cord in order to apply rubbing alcohol to the moist part below. Call us immediately if there is red streaking, swelling or inflammation around the cord.
All kids need to hear positive feedback from parents. Here is a good article on how and what to compliment kids on.
Potty training is a big step for kids and parents. How do you know when is the right time to begin potty training? Potty-training success is based on physical and emotional readiness, not a specific age. Many kids show interest in potty training by age 2, but others might not be ready until age 2 1/2 or even older — and there's no rush. If you start potty training too early, it might take longer to train your child.
Is your child ready? Ask yourself these questions:
- Does your child seem interested in the potty chair or toilet, or in wearing underwear?
- Can your child understand and follow basic directions?
- Does your child tell you through words, facial expressions or posture when he or she needs to go?
- Does your child stay dry for periods of two hours or longer during the day?
- Does your child complain about wet or dirty diapers?
- Can your child pull down his or her pants and pull them up again?
- Can your child sit on and rise from a potty chair?
If you answered yes to most of these questions, your child may be ready to give it a try.
- Place a potty chair in the bathroom. Encourage your child to sit on the potty chair — with or without a diaper. You might dump the contents of a dirty diaper into the potty chair to show its purpose, or let your child see family members using the toilet.
- Schedule potty breaks often. If your child is interested, have him or her sit on the potty chair or toilet without a diaper for a few minutes several times a day. For boys, it's often best to master urination sitting down, and then move to standing up after bowel training is complete. Read a potty-training book or give your child a special toy to use while sitting on the potty chair or toilet. Stay with your child when he or she is in the bathroom. Even if your child simply sits there, offer praise for trying — and remind your child that he or she can try again later.
- When you notice signs that your child might need to use the toilet — such as squirming, squatting or holding the genital area — respond quickly. Help your child become familiar with these signals, stop what he or she is doing and head to the toilet. Praise your child for telling you when he or she has to go. When it's time to flush, let your child do the honors.
- Always be positive. Kids respond to positive reinforcement. Consider stickers or stars on a chart, trips to the park or extra bedtime stories as rewards for using the potty. Reinforce your child's effort with verbal praise, such as, "How exciting! You're learning to use the toilet just like big kids do!" Be positive even if a trip to the toilet isn't successful.
- After several weeks of successful potty breaks, your child might be ready to trade diapers for training pants or regular underwear. Celebrate this transition. Go on a special outing. Let your child select "big kid" underwear. Make sure that you dress your child in clothes that are easy to pull up and down while potty training.
- Nap and nighttime training might take months — or years — longer. In the meantime, use disposable training pants or plastic mattress covers when your child sleeps.
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. If you have any questions, feel free to call the office.
Babies are born with protection against certain diseases because antibodies from their mothers were passed to them through the placenta. After birth, breastfed babies get the continued benefits of additional antibodies in breast milk. But in both cases, the protection is only temporary. Immunization (vaccination) is a way of creating immunity to certain diseases by using small amounts of a killed or weakened microorganism that causes the particular disease. Microorganisms can be viruses (such as the measles virus) or they can be bacteria (such as pneumococcus). Vaccines stimulate the immune system to react as if there were a real infection — it fends off the "infection" and remembers the organism so that it can fight it quickly should it enter the body later.
Some parents may hesitate to have their kids vaccinated because they're worried that the children will have serious reactions or may get the illness the vaccine is supposed to prevent. Because the components of vaccines are weakened or killed — and in some cases, only parts of the microorganism are used — they're unlikely to cause any serious illness. Some vaccines may cause mild reactions, such as soreness where the shot was given or fever, but serious reactions are rare. The risks of vaccinations are small compared with the health risks associated with the diseases they're intended to prevent.
Parents who choose to skip vaccines or delay vaccination often do so because they’re concerned about sticking their baby with needles multiple times or worried that too many shots clustered in one visit can trigger complications. But vaccine advocates note that no evidence has been found to show that delaying vaccination is helpful for babies — and it can be harmful. “There is absolutely no scientific data that shows a delayed schedule is any safer,” says Wendy Sue Swanson, a pediatrician from Seattle Children’s Hospital. “Small decreases in vaccine coverage are known to lead to dramatic increases in the risk of vaccine preventable disease outbreaks,” says Amanda Dempsey, M.D., Ph.D., M.P.H., assistant professor in the department of pediatrics and communicable diseases and a member of the Child Health Evaluation and Research Unit at C.S. Mott Children’s Hospital. “Not following the recommended schedule leaves kids at risk for these diseases unnecessarily.” Following a vaccination schedule that deviates from those recommended by recognized groups such as the Centers for Disease Control and Prevention and the American Academy of Pediatrics leads to under- immunization. Under-immunization has been shown to significantly increase the risk of contracting and spreading vaccine preventable diseases like measles and whooping cough,” Dempsey adds.
The biggest medical problem with the delayed schedule is that it leaves babies open to disease for a longer period of time. If a baby is vaccinated by the CDC’s tried, tested and true vaccine schedule, that baby will have immunity to over 14 diseases by the age of two. We immunize children so young against these diseases because infancy is the time period that kids are MOST vulnerable to life-threatening diseases. The people at greatest risk of dying from vaccine-preventable disease are the very young and the very old. We recommend vaccines to save lives.
If you have questions or concerns about vaccines, talk to us. We are here to help you sort out information and misinformation.
Info for this article was obtained from the following sites:
Protecting your kids in the sun: General Guidelines
- Use sunscreen every day. Most sun damage occurs with day to day exposure, not necessarily with the annual trip to the beach.
- Avoid the strongest rays of the day between 10am-4pm.
- UV rays can still cause sun damage even on cloudy days. Even on overcast & cool days, UV rays travel through the clouds and can cause skin damage.
- Be extra careful near water, sand and snow. They reflect the UV rays and may result in sunburns more quickly.
- Cover up with clothing, hats, glasses, & umbrellas. Select clothes made with a tight weave - they protect better than clothes with a looser weave. If you’re not sure how tight a fabric’s weave is, hold it up to see how much light shines through. The less light, the better.
- Teens should avoid tanning beds. There is an increased risk of melanoma in people who have used tanning beds before age 35.
Protecting your kids in the sun: Guidelines for Infants
- Sunscreen is not recommended for babies under 6 months of age.
- Keep babies younger than 6 months out of direct sunlight. Find shade under a tree, umbrella, or the stroller canopy.
- Limit infant’s time out in the heat.
- Dress infants in lightweight, long pants, long sleeved shirts, & hats to shade the neck. If adequate clothing and shade are not available, parents can apply a minimal amount of sunscreen with at least an SPF 15 to small areas such as the face, and back of the hands.
- For kids age 6 months and older, select an SPF of 30 or higher to prevent both sunburn and tanning.
Sunscreen: Making Sense of SFP
- Choose a sunscreen that states on the label that it protects against both UVA and UVB rays (referred to as "broad-spectrum" sunscreen).
- Use water resistant formulas even if the kids are not going swimming.
- Apply sunscreen to all areas of the body, but be careful around the eyes. If your child rubs sunscreen into her eyes, wipe the eyes and hands clean with a damp cloth.
- Use enough sunscreen to cover all exposed areas, especially the face, nose, ears, feet, and hands and even the backs of the knees. Rub it in well.
- Apply sunscreen 15 to 30 minutes before going outdoors to give time for the sunscreen to bind and absorb into to the skin.
With the hot days of summer come summer sports: baseball, tennis, football practice, both in the neighborhood and at camp. Many kids will soon begin school sport and club practices in the Texas August heat. Before you send the kids out to practice -- or just for a long day of play in the sun -- learn to protect your child against the dangers of dehydration and heat illness.
1. What puts my child at risk for dehydration?
The same things that put you at risk for dehydration: prolonged exposure to high temperatures, direct sun, and high humidity, without sufficient rest and fluids. The difference is that 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.
2. What signs of dehydration should we watch for?
Early signs of dehydration 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.
3. What can I do to prevent dehydration in my child?
Make sure they drink cool water and sports drinks early and often. Send your child out to practice or play fully hydrated. Then, during play, make sure your child takes regular breaks to drink fluid, even if your child isn't thirsty. The American Academy of Pediatrics recommends five ounces of cold tap water or sports drink for a child weighing 88 pounds, and nine ounces for a teen weighing 132 pounds.
Get them acclimatized before summer practice. If your child is going to soccer camp, they shouldn't be sitting around doing nothing in May/June and then going out to play all day in July. It is a good idea to get kids outside jogging, riding a bike, and slowly building up their fitness and ability to handle the heat.
Know that dehydration is cumulative. 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, that may not show up for several days. 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.
For more info, check out this website. http://children.webmd.com/dehydration-heat-illness
This is the final article in the Childhood Obesity Series.
Tips to get kids moving
Many kids don't get enough physical activity. Although physical education (PE) in schools can help kids get up and moving, more and more schools are eliminating PE programs or cutting down the time spent on fitness activities. Some children get just 30 minutes of vigorous activity each week during PE. Families also lead busy lives and more and more children are spending their free time in front of the tv or playing video games. The American Academy of Pediatrics (AAP) recommends that kids over 2 years old not spend more than 1-2 hours a day in front of a screen. The AAP also discourages any screen time for children younger than 2 years old. It is important for kids to get up and get moving.
Current guidelines recommend that kids over 2 years old get at least 60 minutes of moderate to vigorous physical activity on most, preferably all, days of the week. Babies and toddlers should be active for 15 minutes every hour (a total of 3 hours for every 12 waking hours) each day.
Encourage kids' natural tendency to be active and help them build on developing skills. Take kids to the park, pool, or splashpad to encourage physical activity. Playing with push toys, hopscotch, or riding bikes and trikes is great exercise. Have family swimming races in the pool or get out the hula-hoops. Encourage kids to be physically active every day, whether through an organized sports team or a game of soccer during recess. You can also go to the track and walk or join a gym that has kid friendly activities like basketball or a climbing wall. There are some great video games that promote physical activity on Wii and X-box. Dancing games, skiing, tennis, boxing, and other fitness games provide for good indoor exercise.
More info can be found at these sites: Centers for Disease Control, Mayo Clinic, American Heart Association, and Kids Growth.
As discussed in the previous article, childhood obesity is on the rise in America. Obesity can cause many longterm health complications. The first step to combating childhood obesity is eating right. We all know the importance of eating healthy, but this can be challenging with our on the go lifestyles. Here are some tips that you can use.
- Don't reward kids for good behavior or try to stop bad behavior with sweets or treats. Come up with other solutions to modify their behavior.
- Don't maintain a clean-plate policy. Be aware of kids' hunger cues. Even babies who turn away from the bottle or breast send signals that they're full. If kids are satisfied, don't force them to continue eating. Reinforce the idea that they should only eat when they're hungry.
- Don't talk about "bad foods" or completely eliminate all sweets and favorite snacks from kids' diets. Kids may rebel and over eat these forbidden foods outside the home or sneak them in on their own.
- Make healthy food choices for the entire family. Here are some suggestions:
- Snack on hummus and raw veggies or baked veggie chips instead of chips and dip.
- Choose pizza made with whole wheat crust, skim cheese, and turkey sausage rather than pepperoni pizza.
- Have fresh fruits and veggies available at each meal and try different ways of preparing foods. Involve your kids, this makes it more fun for everyone.
- Limit processed and boxed foods in your diet.
- Make sure that you are monitoring portion sizes to avoid over eating. If your child is still hungry and wants seconds, have them in this order: veggies, fruits, protein, then carbs.
- Limit sugary drinks such as sodas and juice.
- Switch to skim milk
- Cook meals at home so that you can monitor calories and portion sizes
- Pre-cook healthy meals on Sunday for re-heating during the week. This will make dinnertime quick and easy, but also keep you from eating fast food after evening activities.
Eating right is an important part of healthy living, but remember to let your kids be kids. It is ok to have pizza and cake at a birthday party, burgers at the team picnic, and candy at Halloween. Moderation is key.
Stay tuned for the next article on exercising.
This is the first article in a series on Childhood Obesity and Changing Lifestyles
Childhood obesity is on the rise and rates of obesity have tripled in the past 30 years. 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. Although weight problems run in families, not all children with a family history of obesity will be overweight. Children whose parents or brothers or sisters are overweight may be at an increased risk of becoming overweight themselves, but this can be linked to shared family behaviors such as eating and activity habits.
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. For example, the average child spends approximately four hours each day watching television. As computers and video games become increasingly popular, the number of hours of inactivity may increase.
Obese children are at risk for developing medical problems that include:
- High blood pressure
- Type 2 diabetes
- Elevated blood cholesterol levels
- Bone and joint problems
- Liver and gall bladder disease
- Shortness of breath that makes exercise, sports, or any physical activity more difficult and may aggravate the symptoms or increase the chances of developing asthma
- Restless or disordered sleep patterns, such as obstructive sleep apnea
- Tendency to mature earlier (overweight kids may be taller and more sexually mature than their peers, raising expectations that they should act as old as they look, not as old as they are; overweight girls may have irregular menstrual cycles and fertility problems in adulthood)
- Obese children are more prone to low self-esteem, negative body image and depression.
- Excess weight at young ages has been linked to higher and earlier death rates in adulthood
People in the same family tend to have similar eating patterns, maintain the same levels of physical activity, and adopt the same attitudes toward being overweight. Studies have shown that a child's risk of obesity greatly increases if one or more parent is overweight or obese. The key to keeping kids of all ages at a healthy weight is taking a whole-family approach. Make healthy eating and exercise a family affair. Get your kids involved by letting them help you plan and prepare healthy meals, and take them along when you go grocery shopping so they can learn how to make good food choices. By involving the entire family, everyone is taught healthful habits and the overweight child does not feel singled out.
Stay tuned for the next article on Developing Health Eating Habits
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.
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 as long as your child feels well enough to swim.
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 because it can burn and cause pain.
Since we live in Texas, the summer sun is mostly unavoidable. Young babies are very sensitive to the heat and sun exposure. Here are some tips to help protect your children.
- Keep infants under 6 months out of the sun. The best protection is to keep your baby in the shade, if possible. If there's no natural shade, create your own with an umbrella or the canopy of the stroller. Put a hat on your baby to protect his head.
- Sunscreen is not generally recommended for babies under 6 months of age, but if there is no way to keep an infant out of the sun, you can apply a small amount of sunscreen—with a sun protection factor (SPF) of at least 15—to small areas such as the cheeks.
- Babies' skin is much thinner than that of adults and older children, and it absorbs the active, chemical ingredients in sunscreen more easily. This means that an infant's exposure to the chemicals in sunscreens is much greater, increasing the risk of allergic reaction or inflammation.
- Avoid exposure to the sun in the hours between 10 a.m. and 2 p.m., when ultraviolet (UV) rays are most intense.
- Watch your baby carefully to make sure he or she doesn't show warning signs of sunburn or dehydration. These include fussiness, redness and excessive crying.
- Give your baby formula, breast milk, or a small amount of water between feedings if you're out in the sun for more than a few minutes.
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
Getting kids to eat vegetables can be a real challenge for many parents. Here is a good recipe that you may want to try.
1 medium head of cauliflower
2 Tbl heavy cream
2 Tbl butter
1/3 cup shredded sharp cheddar
4 egg whites
salt & pepper to taste
oil for frying
Clean and trim cauliflower adding florets to a microwave safe bowl. Add the cream and butter to the bowl. Microwave for 5 minutes. Add the cauliflower and cheese to a magic bullet or food processor and blend until still chunky - kind of like a cooked oatmeal consistency. Season with salt and pepper. Whip the egg whites to a stiff peak. Fold 1/3 of the egg whites into the cauliflower mixture to lighten it up. Then fold the cauliflower mixture into the rest of the egg whites and gently mix until combined. Fit a pastry bag with a round or star tube or you can use a large ziplock bag with about a 3/4 inch opening in the corner. Spray the inside of the bag with nonstick spray. Gently squeeze out 1 inch sections onto a greased cookie sheet, cutting with a butter knife as you go.
When finished, bake in a 375 degree oven for 10-12 minutes (or longer if you're skipping the frying) until puffed and slightly browned. Remove from the oven and serve – or heat 1/4 inch of oil in a saute pan and when it's very hot add the tots. It doesn't need long, a minute per side to turn them golden brown and crispy. Serve immediately. These are still tasty after they cool but they start to lose their crunch only minutes after they come out of the oil so if crunch is what you're after, eat them right away!
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
Here is a link to a great article from KidsHealth.org on proper car seat use. Take a minute to read this! It is worth your time.
Is it a cold or allergies?
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.
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
Itchy, Watery eyes
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.