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RSV in Infants

Posted by Shelly
Shelly
Shelly Nalbone is a Pediatric Nurse Practitioner who has worked with children fo
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on Wednesday, December 18 2013
in Info on illnesses

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

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Constipation

Posted by Shelly
Shelly
Shelly Nalbone is a Pediatric Nurse Practitioner who has worked with children fo
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on Friday, December 06 2013
in Info on illnesses

Constipation is a very common problem among kids, but many parents are confused about what constipation really is. A child is considered constipated when he or she has fewer than three bowel movements in a week; has difficulty having a bowel movement; or when the stools are hard, dry, and unusually large.  A child who doesn't have a bowel movement every day isn't necessarily constipated.  Here is a diagram of types of stool.

109598518

Constipation:  Stool types 1 and 2

Normal Stools:  Stool types 3 and 4

Loose/Diarrhea Stools:  Stool types 5,6, and 7

Most of the time, constipation is due to a diet that doesn't include enough water and dietary fiber.   Here are some things that you can do if your child is constipated.

•Give your child more fluids. Drinking enough water and other liquids helps stools move more easily through the intestines. Most school-age children need 3 to 4 glasses of water each day. If your infant is constipated during the transition from breast milk or into solid foods, try serving just a few ounces of prune juice each day.

•Serve more fiber. Foods that are high in fiber, such as fruits, vegetables, and whole-grain bread, can help prevent constipation. Fiber can't be digested, so it helps clean out the intestines by moving the bowels along. Fiber doesn't have to be a turn-off for kids: Try apples, oatmeal, oranges, bananas, baked potatoes, and popcorn.

•Make sure kids get enough exercise. Physical activity helps the bowels move, so encourage your kids to get plenty of exercise.

•Develop a regular meal schedule. Eating is a natural stimulant for the bowels, regular meals may help kids develop routine bowel habits.

•Get kids into the habit of going at the same time each day to set a routine.   Have your child sit on the toilet for at least 10 minutes at about the same time each day, preferably after a meal.

Even if you do all of the right things, some kids will still have problems with constipation.  If you have questions about your child, call the office at (281)292-0999.

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The Stressful Holiday Season

Posted by Shelly
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Shelly Nalbone is a Pediatric Nurse Practitioner who has worked with children fo
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on Wednesday, December 04 2013
in Parenting Tips

The holidays are a fun time of year for most children with the anticipation of getting gifts, seeing family and being out of school. It is also an important time of year to be mindful of your children's safety.  Here are some tips to keep everyone safe.

  • Mistletoe, holly, poinsettias, and other plants are commonly used as decorations during the holidays. Like many plants, these are considered potentially poisonous and should be kept out of the reach of kids.
  • Alcohol poisoning is a common risk for children during the holiday season. Many parents host holiday parties where alcohol is served. Parents must take care to remove all empty and partially empty cups as soon as possible. Because kids imitate adults, many may drink the beverages they see adults drinking.
  • The needles of holiday trees, ornament hooks, and staples on package bows can cause painful cuts in the mouth and throat of a child who puts them in their mouth or swallows them.
  • Tree ornaments, light bulbs, icicles, tinsel, and small toys are potential choking hazards for small children because they may block the airway.
  • Keep breakable ornaments out of young kids' reach — or keep them off the tree until your children are older. If one does break, clean up the broken glass quickly.
  • Keep in mind that artificial snow and flocking materials are not edible, so you may want to avoid them if there are younger children in the home.
  • Be careful of heavy stocking holders that toddlers and preschoolers can pull down on top of themselves, which is becoming an increasing common hazard as use of these heavy stocking hangers become more popular.
  • Candles should never be left unattended, placed in an area where they can be easily knocked over or near flammable curtains or decorations.
  • Common holiday foods such as peanuts or popcorn are potential choking hazards and should not be given to children under age 4.

Always remember that the hustle and bustle of the holidays can be stressful on children and adults.  Try to slow down and spend time with family and friends to celebrate the reason for the season. 

Merry Christmas Everyone!!!

 

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Fever Is Your Friend

Posted by Shelly
Shelly
Shelly Nalbone is a Pediatric Nurse Practitioner who has worked with children fo
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on Monday, December 02 2013
in Info on illnesses

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.

 

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Giving Thanks

Posted by Shelly
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Shelly Nalbone is a Pediatric Nurse Practitioner who has worked with children fo
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on Thursday, November 21 2013
in General Info

As we approach Thanksgiving, we feel that it is important to teach our children that the day is not just about turkey and pumpkin pie, but about being thankful for each other and our many blessings, big and small.  Below is a link to a Focus on the Family article about teaching children  (by age groups) about giving thanks. 

We hope that everyone has a safe and blessed Thanksgiving. 

 

http://www.focusonthefamily.com/parenting/articles/give_thanks.aspx

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Infants 101

Posted by Shelly
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Shelly Nalbone is a Pediatric Nurse Practitioner who has worked with children fo
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on Wednesday, November 13 2013
in Infants

New parents often have questions about caring for their new baby.  Here are some common topics related to newborns:

Umbilical Cords

  • 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.

Infant Acne

  • Baby acne is pimples and whiteheads that develop on a newborn's skin. Baby acne can occur anywhere on the face, but usually appears on the cheeks, nose and forehead.  It commonly begins at two to three weeks of age and is usually gone before your baby is six months old. Baby acne is thought to be caused by Mom's hormones, which are still circulating in baby's bloodstream.   There's little you can do to prevent baby acne. The best treatment for baby acne is usually no treatment at all.

Swollen Breast Tissue

  • It's normal for babies (boys and girls) to have mild or even swollen, enlarged breasts and/or lumps under the nipple.  This is normal and it is from the effects of hormones that the baby received from his or her mother.  The same hormones that cause the mother's breasts to swell and milk glands to be stimulated can do the same to the baby's breasts. Their breasts may even secrete small amounts of milk, and while alarming to most parents, this is nothing to be worried about and the effects will wear off in a few weeks to months

Newborn Genitals

  • Girls:  Your newborn girl's genitals have been exposed to many hormones in the uterus. Newborns genitals are usually a little swollen and prominent for the first week.  Girls may also have a thick, milky discharge in the vagina.  At 2 or 3 days of age, your daughter may have a little bit of bleeding from her vagina. This is perfectly normal -- it is caused by the withdrawal of the hormones she was exposed to in the womb.   Clean your daughter's genitals as you would any other part of her body. Spread the labia and gently wash out the creases; there is no need to go any deeper. Nature takes care of naturally cleaning the inside of the vagina. Use warm water only -- there's no need for soaps. Remember, this sensitive tissue is the same as that inside the mouth.
  • Boys:  Three or four times a day, you will need to clean the circumcised area with warm water. Soap is not necessary. At each diaper change, you will want to apply a small amount of petroleum jelly to keep the area moist. It can take several days for the scab over an incision to fall off, and about the same amount of time or a little longer for the plastibell to fall off. Be sure not to pull on the plastibell as it can cause soreness and bleeding. After the circumcision is healed,  no further care is needed outside of normal good hygiene.

Peeling Skin

  • When babies are in the womb, they are covered with a white substance called vernix that is made up of shed skin cells and oil gland secretions. This waxy material protects your baby's skin until birth. After the vernix is washed off, the top layer of a baby's skin begins to dry up and peel off.  As newborn babies adjust to life outside the womb, the appearance of their skin may be startling to new parents.  During the first few weeks, your baby may have peeling or cracking of the skin, especially on the wrists, hands, ankles and feet. The peeling can last for the first few weeks of life. Overdue babies seem to peel more than babies born closer to their due date. This is normal and no treatment is necessary.  New babies also commonly develop bumps and rashes during the first weeks of life, but these skin conditions are usually normal and harmless. After your baby sheds the top layer of his skin, the underlying layer should be normal and healthy.  Do not try to treat your baby's peeling skin with harsh lotions or scented products, and do not scrub or try to peel your baby's skin.  Such measures can irritate sensitive newborn skin. Peeling newborn skin does not need to be treated because it is a normal part of your baby's development.

Cradle Cap

  • Cradle cap, the common term for infantile seborrheic dermatitis, causes scaly patches on a baby's scalp. Though cradle cap isn't serious, it can cause thick crusting and white or yellow scales.  Cradle cap usually resolves on its own within a few months. Self-care measures, such as washing your baby's scalp daily with a mild shampoo, can help loosen and remove the cradle cap scales.

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Flu is here!!!!

Posted by Shelly
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Shelly Nalbone is a Pediatric Nurse Practitioner who has worked with children fo
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on Wednesday, November 13 2013
in General Info
We have cases of the flu in The Woodlands.  If you have not gotten your flu vaccine, we recommend that you get it soon.  We still have some flu vaccines available, so call for an appointment before we run out.  (281)292-0999
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Sad to see her go...

Posted by Shelly
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Shelly Nalbone is a Pediatric Nurse Practitioner who has worked with children fo
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on Monday, November 11 2013
in General Info
We are very sad to have to say goodbye to Audra (back office Medical Assistant).  Audra has decided to stay home to take care of her new baby.  Audra, we are happy for you, but we will really miss you!!!!
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Lice

Posted by Shelly
Shelly
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on Monday, November 11 2013
in Info on illnesses

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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New Pediatric Urgent Care in Our Area

Posted by Shelly
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on Friday, November 08 2013
in General Info

If your kids are sick in the evening or on a weekend, check out Urgent Care for Kids. This is an after hours urgent care clinic specifically for children.

URGENT CARE FOR KIDS urgentcare

1640 Lake Woodlands
The Woodlands, TX 77380
281-367-0010
3pm-10pm Mon-Fri
9am-9pm Sat-Sun
www.urgentcarekids.com

 

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Puberty

Posted by Shelly
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Shelly Nalbone is a Pediatric Nurse Practitioner who has worked with children fo
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on Thursday, November 07 2013
in Teen Info

Your daughter is asking about getting her first bra, and your son comes home from soccer practice smelling like he's been digging on a road crew all day. What's going on? Welcome to puberty, the time when kids sprout up & fill out. Pubertal changes usually happen between ages 10 and 14 for girls and ages 12 and 16 for boys.

  • In females:
    • The first sign of puberty is usually breast development.
    • Other signs are the growth of hair in the pubic area and armpits, and acne.
    • Menstruation (or a period) usually happens last, about 1-2 yrs after breast development begins.
  • In males:
    • Puberty usually begins with the testicles and penis getting bigger.
    • Then hair grows in the pubic area and armpits.
    • Muscles grow, the voice deepens, and acne and facial hair develop as puberty continues.

Just as those hormones change the way the body looks on the outside, they also create changes on the inside. During puberty, kids might feel confused or have strong emotions that they have never had before. Kids might feel overly sensitive or become upset easily. Some kids lose their tempers more often and get angry with their friends or families. They also may feel anxious about how their changing body looks. Sometimes it can be hard to deal with all these new emotions. It's important to know that the your body is adjusting to the new hormones, so is the mind. You can remind your child that people usually aren't trying to hurt their feelings or upset them on purpose. It might not be the family or friends — it might be your new "puberty brain" trying to adjust.

For more info check out this link. http://kidshealth.org/parent/growth/growing/understanding_puberty.html

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Over the Counter Meds- What is What?

Posted by Shelly
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Shelly Nalbone is a Pediatric Nurse Practitioner who has worked with children fo
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on Wednesday, November 06 2013
in Info on illnesses

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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Happy Halloween!

Posted by Shelly
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Shelly Nalbone is a Pediatric Nurse Practitioner who has worked with children fo
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on Thursday, October 31 2013
in General Info

Have a safe and Happy Halloween from all of us!!!

20131031_102851

 

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Vomiting and Diarrhea

Posted by Shelly
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Shelly Nalbone is a Pediatric Nurse Practitioner who has worked with children fo
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on Wednesday, October 30 2013
in Info on illnesses
Vomiting can be caused by many things. Most of the time, vomiting in children is caused by gastroenteritis, usually due to a virus infecting the gastrointestinal tract.  Gastroenteritis or stomach virus can also cause nausea and diarrhea.  Vomiting and diarrhea usually do not last more than a few days.   Oral rehydration is something parents can do at home to help prevent dehydration or treat mild cases of illness.
Here are some tips:
  • Offer your child small amounts of oral electrolyte solution frequently.  We recommend giving about ½ to 1 ounce every 20-30 minutes.  If you offer too much, too soon, it will upset your child’s stomach and they can vomit.  Frozen oral electrolyte solution popsicles are also a good choice for children.
  • Once your child can keep this amount down for about an hour, you can gradually increase the amount of solution you're giving.
  • After your child goes for about 6-8 hours without vomiting, you can begin to reintroduce formula and/or solid foods slowly.
  • If your infant is exclusively breastfeeding and vomits (not just spits up, but vomits what seems like the entire feeding) more than once, then you can decrease the amount of time that you breastfeed by half.  You should offer feedings more frequently than usual.  (For example, feed for a total of 5-10 minutes every 2 hours)   After about 6- 8 hours without vomiting, you can resume breastfeeding normally.
  • For older children (over age 2) appropriate clear liquids include:  : ice chips or sips of water,  oral electrolyte solutions, frozen oral electrolyte solution pops, Gatorade/powerade, and Ginger Ale/7-up/Sprite.
Signs of dehydration:
  • Fewer than 4 wet diapers/day in infants or no urination for 6-8 hours.  Children should urinate at least once every 6-8 hours.
  • Dry mouth that looks sticky inside
  • Few or no tears when crying
  • Fussy behavior in infants
  • The soft spot on an infant's head that looks flatter than usual or somewhat sunken
  • Sunken eyes
  • Appears weak or limp
Vomiting due to gastroenteritis can spread to others, so your child should stay home from school or childcare until there's been no vomiting for at least 24 hours. And remember that hand washing is the best way to protect your family against many infections.
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Head Injuries

Posted by Shelly
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on Wednesday, October 23 2013
in Info on illnesses

Recently there has been a lot of media attention given to head injuries in pre-teen and teen athletes.  Schools, HealthCare providers, & Coaches all have a heightened awareness about this dangerous condition.  As a parent, what do I need to know?

A concussion is a form of mild brain injury that can occur after a blow to the head, such as a fall, but is most commonly associated with hits to the head during sports.  After the hit or blow to the head, a child with a concussion may lose consciousness, may forget things that happened before or after the injury (amnesia), could have a seizure, or could have one or more of the classic concussion symptoms described below.

•Physical symptoms - headaches, nausea, fatigue, visual problems, balance problems, sensitivity to light or noise, numbness and tingling, vomiting, dizziness

•Mental (thinking) symptoms - feeling mentally foggy, having problems concentrating or remembering, feeling slowed down

•Emotional symptoms - irritability, sadness, nervousness, or simply feeling more emotional

•Symptoms that affect sleep - drowsiness, sleeping more or less than usual, or having trouble falling asleep

More severe "red flag" symptoms that might indicate your child needs immediate medical attention might include a worsening headache, seizures, repeated vomiting, increasing confusion, or unusual changes in behavior, etc.

Parents, teachers, coaches, trainers, and a child who has had a concussion should be aware of all of these possible symptoms as he or she returns to school and sporting activities and should understand the importance of reporting all symptoms.  Experts now recommend a six-step gradual return to play plan for kids who have a concussion, with athletes moving to the next stage only if they remain free of all concussion symptoms.  Using this plan, the earliest a player with a concussion would be back in a normal game would be six days.

These return to play guidelines includes:

1. No activity - a recovery stage with complete physical and cognitive rest. This means no exercise or sports, but can also mean not going to school, or having a shortened day. This is a time to get lots of rest, get plenty of sleep, and eat well.

2. Light aerobic exercise to increase their heart rate (keep to less than 70% of maximum predicted heart rate), including walking, light jogging, swimming, or stationary cycling, but no resistance training.

3. Sport-specific exercise to add movement, such as skating drills or running drills, moderate jogging, brief running, moderate-intensity stationary cycling, but no head impact activities.

 4. Non-contact training drills to raise exercise, coordination, and cognitive load, including progression to more complex training drills and resistance training, sprinting and running, high-intensity stationary cycling.

5. Full contact practice to restore confidence and assess functional skills and following medical clearance may participate in normal training activities

6. Return to play

Keep in mind that you shouldn't move to the next stage until you are symptom free, which can keep some kids in the "no activity" stage for several days or longer.  And if the athlete develops symptoms while doing any of the stages, they should drop back to the previous stage and try again. Concussion symptoms should not come back during or after any of the exercises or activities during these return to play stages.

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Tips for a Safe and Fun Halloween

Posted by Shelly
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Shelly Nalbone is a Pediatric Nurse Practitioner who has worked with children fo
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on Thursday, October 10 2013
in General Info

boo2_0

Halloween is an exciting time of year for kids, and to help ensure they have a safe holiday, here are some tips from the American Academy of Pediatrics (AAP).

ALL DRESSED UP:

  • Plan costumes that are bright and reflective. Make sure that shoes fit well and that costumes are short enough to prevent tripping, entanglement or contact with flame.
  • Consider adding reflective tape or striping to costumes and Trick-or-Treat bags for greater visibility.
  • Because masks can limit or block eyesight, consider non-toxic makeup and decorative hats as safer alternatives. Hats should fit properly to prevent them from sliding over eyes.
  • When shopping for costumes, wigs and accessories look for and purchase those with a label clearly indicating they are flame resistant.
  • If a sword, cane, or stick is a part of your child's costume, make sure it is not sharp or too long. A child may be easily hurt by these accessories if he stumbles or trips.
  • Obtain flashlights with fresh batteries for all children and their escorts.
  • Do not use decorative contact lenses without an eye examination and a prescription from an eye care professional. While the packaging on decorative lenses will often make claims such as “one size fits all,” or “no need to see an eye specialist,” obtaining decorative contact lenses without a prescription is both dangerous and illegal. This can cause pain, inflammation, and serious eye disorders and infections, which may lead to permanent vision loss.
  • Teach children how to call 9-1-1 (or their local emergency number) if they have an emergency or become lost.

CARVING A NICHE:

  • Small children should never carve pumpkins. Children can draw a face with markers.  Then parents can do the cutting.
  • Consider using a flashlight or glow stick instead of a candle to light your pumpkin. If you do use a candle, a votive candle is safest.
  • Candlelit pumpkins should be placed on a sturdy table, away from curtains and other flammable objects, and should never be left unattended.

HOME SAFE HOME:

  • To keep homes safe for visiting trick-or-treaters, parents should remove from the porch and front yard anything a child could trip over such as garden hoses, toys, bikes and lawn decorations.
  • Parents should check outdoor lights and replace burned-out bulbs.
  • Wet leaves should be swept from sidewalks and steps.
  • Restrain pets so they do not inadvertently jump on or bite a trick-or-treater.

ON THE TRICK-OR-TREAT TRAIL:

  • A parent or responsible adult should always accompany young children on their neighborhood rounds.
  • If your older children are going alone, plan and review the route that is acceptable to you. Agree on a specific time when they should return home.
  • Only go to homes with a porch light on and never enter a home or car for a treat.
  • Because pedestrian injuries are the most common injuries to children on Halloween, remind Trick-or Treaters:
  • Stay in a group and communicate where they will be going.
  • Carry a cell phone for quick communication.
  • Remain on well-lit streets and always use the sidewalk.
  • If no sidewalk is available, walk at the far edge of the roadway facing traffic.
  • Never cut across yards.
  • Only cross the street as a group in established crosswalks (as recognized by local custom). Never cross between parked cars or out driveways.
  • Don't assume the right of way. Motorists may have trouble seeing Trick-or-Treaters. Just because one car stops, doesn't mean others will!
  • Law enforcement authorities should be notified immediately of any suspicious or unlawful activity.

HEALTHY HALLOWEEN:

  • A good meal prior to parties and trick-or-treating will discourage youngsters from filling up on Halloween treats.
  • Consider purchasing non-food treats for those who visit your home, such as coloring books or pens and pencils.
  • Wait until children are home to sort and check treats. Though tampering is rare, a responsible adult should closely examine all treats and throw away any spoiled, unwrapped or suspicious items.
  • Try to ration treats for the days following Halloween.

HAVE FUN!!

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Encouraging Kids to Eat Healthy

Posted by Shelly
Shelly
Shelly Nalbone is a Pediatric Nurse Practitioner who has worked with children fo
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on Monday, October 07 2013
in Parenting Tips

Many parents struggle with getting sufficient fruits and veggies in their child's diet.  Here are some ways to try to increase fruit and vegetable intake in kids.

kids_frugal_food1

  • Play with your food:  Serve fun and colorful appetizers such as carrots, cucumbers, and red or yellow bell peppers. Let kids dip there veggies in ranch or hummus.  Don’t be afraid to have a little fun making designs or shapes with food.
  • Open a restaurant:  Let your child help plan the meal, shop for the ingredients, prepare and serve the meal.  Kids love to measure and stir so get them involved in the kitchen.  If they spent the time preparing the food, they are more likely to try it.
  • Travel the World:  Be adventurous and cook around the world.  Have your child choose a country or location and find recipes for common foods for that location and start cooking.  This is a great way to introduce your child to different flavors and cultures of the world.  You can have your kids tell family member something interesting about the country.  This is great dinnertime conversation and a fun learning experience.
  • Be a Scientist or Engineer:  Kids usually love gadgets and science.  Teach kids how things work in the kitchen.  Make a fruit and yogurt smoothie while teaching them how the blender purees fruits.  You can also weave a science lesson in and discuss how a fruit is changing from a solid to a liquid.  Always incorporate a safety lesson too!
  • Play the Name Game:  Help kids create fun names for veggies.  If your child does not like carrots, he may like dressing up as superman for dinner and eating “x-ray vision carrots” or “power punch broccoli”.  Your little princess may love the “Princess peas”, “Beauty and the Beast beans, or “Snow White spinach”.
  • Be a Farmer:  Set up a garden and grow some veggies.  Kids will enjoy planting the seeds or plants, and watching them grow.

These are just a few ways to encourage your kids to eat healthy.  If you have an idea, share it with us.

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Flu

Posted by Shelly
Shelly
Shelly Nalbone is a Pediatric Nurse Practitioner who has worked with children fo
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on Thursday, October 03 2013
in Info on illnesses

The flu is caused by a virus and usually occurs from October through May.  The rates of infection are highest among children, and flu symptoms can last a week or longer. For most people, the flu can cause fever, cough, sore throat, headache, chills, muscle aches, and fatigue.  Some people can get much sicker, and can develop symptoms such as high fever or pneumonia. On average, about 36,000 people die each year from influenza.  Because influenza viruses are always changing, scientists work every year to match the viruses in the vaccine to those most likely to cause flu that year.

The Centers for Disease Control and Prevention (CDC) recommends a yearly flu (influenza) vaccine for all children 6 months and older, given as soon as the vaccine is available each year.   To allow adequate time for production of protective antibody levels, vaccination should occur before the onset of influenza activity in the community and should be offered throughout the influenza season.

Depending on your child's age, you might be able to choose between a flu shot and the nasal spray vaccine:

  • Flu shot: Flu shots can be given to children 6 months and older.
  • Nasal spray:  The nasal spray flu vaccine (FluMist) can be given to children 2 years and older.

 

Information for this post was obtained from the following sources:  American Academy of Pediatrics, American Academy of Family Practice, and The Centers for Disease Control and Prevention.

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Strep Throat

Posted by Shelly
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Shelly Nalbone is a Pediatric Nurse Practitioner who has worked with children fo
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on Monday, September 30 2013
in Info on illnesses

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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Roseola

Posted by Shelly
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Shelly Nalbone is a Pediatric Nurse Practitioner who has worked with children fo
User is currently offline
on Thursday, September 26 2013
in Info on illnesses

Roseola is a mild illness caused by a virus. It is generally harmless and is most common in children 6 months to 2 years of age.   The virus is spread through tiny droplets of fluid from the nose and throat of infected people when they laugh, talk, sneeze, or cough.   Roseola often starts with a sudden high fever that lasts 2 to 3 days, although it can last up to 8 days. The rapid increase in temperature may be the first sign of roseola and often occurs before you realize that your child has a fever. The fever ends suddenly.   After the fever ends, a rosy-pink rash may appear mostly on the trunk (torso), neck, and arms. The rash is not itchy and may last a few days.   A child with roseola may appear fussy or irritable and may have a decreased appetite, but most children behave almost normally.

If your child has roseola, keep him or her at home until there has been no fever for 24 hours and he or she is feeling better.   Roseola does not usually require medical treatment and will go away in a few days. 

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