Category Archives: infants

Sunburned!

As the summer gets going into full swing with Independence Day weekend, days by the pool and in the backyard, and lots of sports, sun exposure is always a concern.

How do you keep your kids healthy, happy and sunburn-free while still giving them lots of time outdoors? And when sunburn does occur, how should you treat it?

Prevention. Check out our blog from last summer about sunscreens here. Bottom line: use sunscreen liberally and limit sun exposure. You don’t have to get a sunburn to cause long-term skin damage.

Babies and toddlers. See this detailed article from the American Academy of Pediatrics (AAP). Very young children are especially vulnerable to sunburn and heat stroke. Under 6 months they should be kept out of direct sunlight and in the shade as much as possible. Use the sun cover on the stroller. Take a canopy to the older kids’ soccer games—it’s not only a good place to put the infant, but the rest of the family can get out of the sun, too. Be aware that reflective surfaces, like sand or the concrete around pools, can still allow for sunburn even when you’re under an umbrella or other cover, no matter what your age.

In addition to limiting time outside in the hot part of the day, here are other considerations for the very young:

Dress them in lightweight, light colored clothing that covers arms, legs and the head.
Use sunscreen on any exposed skin. There are several types that are appropriate for tender baby skin. Don’t ever spray directly onto the face, but into your hand first.
Put a brimmed hat on babies and toddlers, or spray their scalps with sunscreen. A fully-brimmed hat can protect scalp, ears, and partially protect face and neck.

Possible skin damage. Don’t forget that everyone, even those with darker skin, are at risk of skin damage from the sun. Exposure over time can lead to skin cancers later.

Treatment. Sooner or later, most everyone will have a sunburn no matter how hard you try to prevent it. What to do? It depends on the severity.

Minor burns (red, warm to the touch) can be treated with cool compresses, acetaminophen and rest.
More serious burns can cause blisters, fever and chills, headache or other feelings of malaise, even infection. If the burn is very serious, call your pediatrician.

So, by all means enjoy the summer sun, just be careful of getting too much exposure!

E. coli and other nasty things: how to have good food safety for your cookout or picnic

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The holiday weekend approaches, with plans for picnics, cookouts, reunions, and fun! At the same time we’re hearing about a recall of nearly 2 million pounds of ground beef that is possibly contaminated with E. coli bacteria. How can you be sure about the safety of the food you’re serving your family?

You are right to be cautious. Foodborne illnesses can be very serious, even deadly. E. coli, in particular, can cause organ failure, and children may be especially vulnerable.

Here are some basic rules to keep in mind.

Cook ground meats ALL the way through. Pink interiors mean raw meat, and when that meat is ground, microbes that used to be on the surface of the meat can now be deep inside it. If the meat is fully cooked, any E. coli should be taken care of.
Cook poultry completely through. Chicken, in particular, can be contaminated with Salmonella.
Don’t reuse the plate that held raw meat or poultry. It must be washed before being used to hold cooked meat or other foods. The same goes with knives and other utensils.
Keep food separate. Fruits and vegetables shouldn’t be stored in the same container with uncooked meat and poultry, for example.
Chill leftovers soon. This is important when you’re at a picnic and far from your refrigerator. Take a cooler and ice packs.
Keep your hands clean. Wash them often. Take hand sanitizer on your picnic. Don’t change a baby’s diaper while preparing food.
Wash your fruits and vegetables. When you clean poultry in the sink, be sure to sanitize the sink afterwards so that you don’t contaminate food, dishes and utensils.

More information is available here from the Centers for Disease Control and Prevention.

A fun holiday is a safe holiday. Enjoy the time together and have a great weekend!

I’m thirsty!

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School is almost out and warmer weather is on its way. Hydration is always important, but never more so than when you’re active in warm temperatures. What are the best things to give your kids to drink, and are there drinks they should avoid?

First, drinks to avoid completely:

Energy drinks. Make sure you know the difference between sports drinks and energy drinks. Energy drinks contain stimulants like caffeine and are not appropriate for children and teens. According to the American Academy of Pediatrics: “Caffeine… has been linked to a number of harmful health effects in children, including effects on the developing neurologic and cardiovascular systems.” Caffeine is a drug, and is addictive.
Caffeinated soft drinks. (See bullet point above about the ill effects of caffeine on children and teens.)

Drinks that are okay for occasional use:

Sports drinks. These replace electrolytes and calories lost from prolonged exercise.
Non-caffeinated soft drinks. They are okay on special occasions, but only for older children. Sodas are acidic and therefore are harmful for teeth. Add sugar to that equation and you could be creating some real dental health problems.
Sugary drinks, carbonated or not. These have been linked to childhood obesity in children as young as 4. As with soft drinks, all sugary drinks can cause tooth decay.
Fruit juices. Better options than carbonated drinks, and often a good source of vitamins, they are still calorie rich and shouldn’t be overused.

Drinks that are best:

Water. Always the best way to hydrate, water can be a great part of the healthy child’s diet throughout the day, even when they’re not thirsty. Your kid doesn’t like water? Check out the flavor packets and squirts that add flavors to water.
Low fat milk. If your child or teen can tolerate milk, it is an indispensable source of calcium. If she is unable to drink milk, talk to the pediatrician about alternate sources of calcium.

Finally, a note about very young children.

Nothing but breast milk or formula should go in a baby’s bottle. Even fruit juice is too sugary and can lead to tooth decay. Read here about beverages for the very young.
Children can start learning to use a cup at about 6 months. Still, limit juice to 4-6 ounces per day until the age of 2.
Wean completely from bottles at about 12-15 months of age.

What we drink becomes habit, and starting good drinking habits in childhood is an excellent way to build healthy bodies and teeth for a lifetime.

Apps to suit your life and lifestyle

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Last week we dealt with websites. Want to be more mobile? There are many apps for your smartphone or tablet that can help you keep your family healthy.

Here we’ve listed just a few to get you started, all of them inexpensive or free.

From the American Academy of Pediatrics, several great apps are available, all of which you can order here.
- KidsDoc. Cost: $1.99. This app helps you figure out what to do if your child is sick. You enter your child’s symptoms and are given advice, including options like: Call 911, Call Your Child’s Doctor Now, Call Your Child’s Doctor within 24 hours or Manage at Home. Suggestions for managing at home will tell you how to care for your child’s particular ailment.
- Car Seat Check. Cost: $1.99. Enter your child’s age, height, and weight. You’ll get reviews of appropriate car seats, installation help, and safety information.
- Healthy Children. Cost: FREE. Look up health information by age, find out what first aid is best for particular injuries, see what immunizations are needed for particular ages.
- ADHD Tracker 1.0. Cost: FREE. If your child, age 4-18, has already been diagnosed with (and treated for) ADHD, this app gives a streamlined way to complete and submit a behavioral assessment.
- Iron Kids. Cost: $3.99. Keep your child healthy and fit and sport-ready with this workout.
- Other sources and apps.
  - Ages and Stages. Cost: FREE. This app by Parenting magazine allows you to enter your own stage of pregnancy, or your child’s age, to get information tailored for you.
  - Breastfeeding Management 2. Cost: $1.99. The Massachusetts Breastfeeding Coalition sponsors this app. You can get answers to frequently asked questions; enter your child’s age, weight, and frequency of feeding to determine how many ounces each feeding should be (especially helpful if you’re pumping); research medications and breastfeeding.

Technology and health have always gone together. These apps can keep you up to date and on top of health issues.

Artwork by Kennedy, age 2

Our own dietician on staff!

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Did you know that Georgetown Pediatrics has our very own dietician? Amy Crist has been with us for about 9 months and is available by appointment through our office.

Working part-time for us, Amy is a registered dietician (RD) with a master’s degree, has also worked at Georgetown Community hospital, and makes her home right here in Georgetown.

Amy loves working with infants, children, adolescents and their parents in developing healthy eating habits, including those who have dietary restrictions. She is a frequent speaker at local elementary schools to teach children about healthy eating and nutrition. She’s even led a support group on breast feeding. She is happy to have an appointment with you and your child or teen to discuss:

breast feeding,
dietary restrictions and planning as a result of disease or condition (diabetes, drug therapies, etc.),
concerns about weight or eating disorders,
helping the whole family develop healthy eating habits,
diet and sports,
picky eaters,
and anything else you want to talk over with a dietician.

Call our office and set up an appointment soon!

Amy Crist, our dietician

Whooping cough–don’t take it lightly

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Whooping cough. It sounds like one of those old-fashioned diseases that shouldn’t be around anymore. In reality, it’s as modern as today’s news, and more common than you might think.

The good news is that it’s mostly preventable and treatable; the bad news is that it’s still a dangerous disease, especially for the very young.

A few confirmed cases of whooping cough (pertussis) in the Scott County Schools have spurred us to remind you of the dangers of this disease.

Whooping cough is a bacterial infection whose most striking symptom is described in its name—a loud, persistent cough that doesn’t easily go away. In an older child, there is a “whooping” sound made as the child tries to catch her breath between coughs. Infants may not “whoop,” but you should call the pediatrician if your infant has a persistent cough that seems to exhaust him, and his appetite has decreased.

This disease affects the lining of the bronchial tubes , and is very contagious because the vigorous coughing disperses the bacteria into the air. Anyone of any age can get it, but it’s most dangerous among the very young.

Infants and young children, in particular, can develop life-threatening illnesses from whooping cough, including pneumonia. Hospitalization is often required. This means that they, and the people around them, should be immunized.

We cannot stress enough the importance of getting the appropriate immunizations at the right ages. The pertussis vaccine doesn’t last forever, and must be taken at intervals to be effective.

Children should have a total of 5 pertussis (whooping cough) vaccines before they start school.
The youngest children are at highest risk and the most vulnerable to this disease, and should have vaccines at 2 months, 4 months, and 6 months of age.
Booster shots are given at 12-18 months, and
again at 4-5 years of age.
The College of Gynecology and Obstetrics recommends that pregnant women receive a pertussis vaccine with each pregnancy to reduce the chances of whooping cough in their newborn.
Caregivers and other adults who live or work with infants should also be re-immunized, because they’ve lost immunity from their childhood vaccines. They may not even realize they have whooping cough, because symptoms are not as severe. It may simply feel like a lingering cough from a cold, but they can transmit it to the children in their care.

When should you bring your child to the pediatrician for whooping cough? If he has cold symptoms, and you notice that the cough is worsening at about the time when it should be getting better, call our office for an immediate appointment.

There is a test we can do in the office, but it has to be sent to a lab, which takes several days. In the meantime, if the pediatrician suspects pertussis, your child will be started on a five-day course of antibiotics. The child is considered contagious and should not return to school or daycare until the five-day course has been completed.

To read more, check out this article from the American Academy of Pediatrics. Also, see our Facebook November 8 reposting of an article from two years ago by our own Dr. Hambrick. The experience of one of his own children having been made dangerously sick by this disease makes him particularly diligent in trying to keep your child healthy. artwork by Macy

: artwork by Macy

When is a fever something to be concerned about?

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That’s a great question, because we probably get more calls about fevers than about anything else.

The American Academy of Pediatrics published a brief article about fever and treating it, reminding parents that fever is the body’s way of fighting an illness, and the reason to treat it is to make the child more comfortable. They emphasize:

watching for signs of serious illness;
being careful of dosage amount based on the child’s weight;
keeping the child well-hydrated;
storing the medication in a safe place;
not waking the child up to administer the medication.

So, what should you be watching for, and when do you call the pediatrician? Here we’ve quoted a list from the same article that we think is quite helpful:

“Call your child’s doctor right away if your child has a fever and

Looks very ill, is unusually drowsy, or is very fussy.
Has been in a very hot place, such as an overheated car.
Has other symptoms, such as a stiff neck, severe headache, severe sore throat, severe ear pain, an unexplained rash, or repeated vomiting or diarrhea.
Has immune system problems, such as sickle cell disease or cancer, or is taking steroids.
Has had a seizure.
Is younger than 3 months (12 weeks) and has a temperature of 100.4°F (38.0°C) or higher.
Fever rises above 104°F (40°C) repeatedly for a child of any age.

“Also call your child’s doctor if

Your child still “acts sick” once his fever is brought down.
Your child seems to be getting worse.
The fever persists for more than 24 hours in a child younger than 2 years.
The fever persists for more than 3 days (72 hours) in a child 2 years of age or older.”

Don’t forget: since a fever is a sign of an illness, do NOT send your child back to school/daycare until his temperature has been under 101 for 24 hours.

Together, we’ll work at keeping your child healthy.

Artwork by Tori