Category Archives: Summer

Sun(ouch)burn

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Everyone now knows how important it is to limit sun exposure, especially in children. Being exposed to the sun’s rays can lead to skin damage and skin cancer later in life. It’s very important, then, to use sunscreen and to cover up while in the sun, and to limit exposure when possible.

Even so, just about every child will get sunburned at some point, and experience pain, blisters, or worse. When that happens, what should you do?

According to this article from the American Academy of Pediatrics (AAP):

“The signs of sunburn usually appear six to twelve hours after exposure, with the greatest discomfort during the first twenty- four hours. If your child’s burn is just red, warm, and painful, you can treat it yourself. Apply cool compresses to the burned areas or bathe the child in cool water. You also can give acetaminophen to help relieve the pain. (Check the package for appropriate dosage for her age and weight.)

“If the sunburn causes blisters, fever, chills, headache, or a general feeling of illness, call your pediatrician. Severe sunburn must be treated like any other serious burn, and if it’s very extensive, hospitalization sometimes is required. In addition, the blisters can become infected, requiring treatment with antibiotics. Sometimes extensive or severe sunburn also can lead to dehydration and, in some cases, fainting (heatstroke). Such cases need to be examined by your pediatrician or the nearest emergency facility.”

In our office we sometimes get requests for Silvadene (silver sulfadiazine) for sunburn or other burns, but we no longer use that topical medication. There are other products that are better, more effective, and easier to use at home.

Burns of any kind are no fun. Protect your child from the sun when possible. Use the AAP’s advice above when there’s a sunburn, and contact our office if necessary.

© 2016, MBS Writing Services, all rights reserved

Ticks

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Ticks and spiders are both arachnids, but their method of attacking the skin is very different. While a spider merely bites, a tick burrows under the skin to gorge itself on blood. Sometimes ticks on the body can go unnoticed for a few days, which is why it is important to do a body check of your kids when they have been playing outside in the spring and summer. Ticks like hiding places— under your child’s hair, between the toes, etc. After it is finished feeding, the tick will drop off the body.

How to remove a tick? Very carefully! See this brief description from the Centers for Disease Control and Prevention (CDC) about safe removal.

There are a few tick-borne diseases that can be very serious.

Rocky Mountain spotted fever (RMSF) is carried by the dog tick or wood  tick, which is usually about a quarter inch long. The disease is caused by a particular type of bacteria, and the symptoms, according to an American Academy of Pediatrics ( AAP) article, include: “Flu-like symptoms such as fever, muscle pain, severe headaches, vomiting, nausea, and loss of appetite. A rash develops in most cases of RMSF, typically before the sixth day of the illness. This rash tends to appear first on the wrists and ankles, but within hours it can spread to the torso. It can also spread to the palms of the hands and soles of the feet. The rash is red, spotted, and raised. Other symptoms may include joint pain, stomach pain, and diarrhea. In severe cases, the blood pressure can drop and the patient may become confused. As the infection spreads, many organs, including the brain, can be affected.”

If your child has any of these symptoms and you suspect a tick bite, call your pediatrician immediately.

Lyme disease is most common in the Northeast, North Central, and West Coast states. It is spread by deer ticks. The most common symptom is what is sometimes called a “bull’s-eye” rash. This rash is a pink or red circle that can expand over time, even to a diameter of several inches. Another AAP article lists further symptoms:

  • “Headache
  • Chills
  • Fever
  • Fatigue
  • Swollen glands, usually in the neck or groin
  • Aches and pains in the muscles or joints.”

Lyme disease is very treatable in most cases, but if left untreated can cause long-term health problems.

There is also another tick-borne disease that presents itself a little like Lyme disease. It’s called STARI (Southern Tick-Associated Rash Illness) and is most prevalent in, as you may guess, more southern states like ours. The organism that causes this disease is, as yet, unknown, but it is carried by the lone star tick. The rash is similar to the one caused by Lyme disease (see above) and other symptoms according to the CDC include “fatigue, fever, headache, muscle and joint pains.” If your child presents with any of these symptoms and you suspect she has been bitten by a tick, contact your pediatrician immediately. For easy-to-read information about STARI, there is a good series of short articles from the CDC here.

Use insect repellent and avoid places where ticks live, when possible. Have a safe and enjoyable rest of the summer and fall!

© MBS Writing Services, 2015, all rights reserved

Stinging insects

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Nothing quite puts a damper on outdoor fun like a sting from a bee, yellow jacket, hornet, or wasp.

Art by Corinne

Art by Corinne

While most stings, though annoying and painful, aren’t dangerous, sometimes they can be severe in certain cases.

First things first – how to avoid getting stung:

  • Check the spots where your child plays for nests of stinging insects. Nests can be in trees or bushes, on structures like houses and barns, under picnic tables or by the porch. If you see an unusual number of the same type of stinging insects in one area, it’s possible there is a nest nearby. Once you’ve located a nest, you should consider calling an exterminator. If it is a honey bee hive, locate a beekeeper who will almost certainly be interested in collecting a new hive, and who knows how to do that safely. On rare occasions you might see a honey bee swarm. This occurs when a hive has gotten too large and is in the process of dividing. Be very careful to avoid the swarm and call a beekeeper immediately.
  • Wear shoes outdoors. Even sandals or flip-flops are not good protection from stinging insects hiding in the grass.
  • Wear light-colored clothing, and don’t wear anything with a floral pattern. Bees can be attracted to that as if it were a real flower!
  • Watch what you eat outside. Insects are attracted to sweet foods and beverages and other food items like peanut butter.
  • Don’t allow your child to touch even a dead stinging insect; the stinger still contains venom.
  • As difficult as it may be, don’t swat at an insect because that may make it attack.
  • Read about these and other preventative measures in this article by the American Academy of Pediatrics. The article contains this additional warning: “If you have disturbed a nest and the insects swarm around you, curl up as tightly as you can to reduce exposed skin. Keep your face down and cover your head with your arms.”

So, what to do after a sting?

If the child or adult is highly allergic to stings, watch closely for signs of anaphylaxis. Another article by the AAP describes an anaphylactic reaction like this:

  • “A severe life-threatening allergic reaction is called anaphylaxis.
  • The main symptoms are difficulty breathing and swallowing starting within 2 hours of the sting.
  • Anaphylactic reactions to bee stings occur in 4 out of 1,000 children.
  • The onset of widespread hives or facial swelling alone following a bee sting is usually an isolated symptom, not the forerunner of anaphylaxis. Your child’s doctor will decide.”

In the case of anaphylaxis, administer epinephrine in the form of an EpiPen or AUVI-Q, if available, and call 911.

More common reactions to stings are redness and swelling, pain and itching.

If the stinger is in the skin (only honeybees leave their stingers behind), scrape it out with your fingernail, or if it’s completely under the skin just leave it alone and it will be shed naturally.

Here are the AAP’s recommendations for care after a sting:

  • “Meat Tenderizer:
    • Apply a meat tenderizer-water solution on a cotton ball for 20 minutes (EXCEPTION: near the eye). This may neutralize the venom and decrease pain and swelling.
    • If not available, apply aluminum-based deodorant or a baking soda solution for 20 minutes.
  • Local Cold: For persistent pain, massage with an ice cube for 10 minutes.
  • Pain Medicine: Give acetaminophen (e.g., Tylenol) or ibuprofen immediately for relief of pain and burning.
  • Antihistamine: If the sting becomes itchy, give a dose of Benadryl. (See Dosage chart)
  • Hydrocortisone Cream: For itching or swelling, apply 1% hydrocortisone cream to the sting area 3 times per day (No prescription needed).
  • Expected Course: Severe pain or burning at the site lasts 1 to 2 hours. Normal swelling from venom can increase for 24 hours following the sting. The redness can last 3 days and the swelling 7 days.
  • Call Your Doctor If:
    • Develops difficulty breathing or swallowing (mainly during the 2 hours after the sting) (call 911)
    • Redness lasts over 3 days
    • Swelling becomes huge or spreads beyond the wrist or ankle
    • Sting begins to look infected
    • Your child becomes worse
    • And remember, contact your doctor if your child develops any of the “Call Your Doctor” symptoms.”

© MBS Writing Services, 2015, all rights reserved

Bug bites

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It’s summertime. Mosquitoes and other bugs are in hot pursuit of you and your family. What’s the best way to keep from being bitten? When should you be concerned about a bite?

If your kids spend any time at all outside— which they should, for the exercise and fresh air— they will be bitten from time to time. “Bugs,” of course, is not an accurate scientific term. Even so, we’re using it here as an all-inclusive word to refer to insects (mosquitoes, bees, wasps, chiggers, biting flies, etc.) and arachnids (spiders, ticks, etc.).

Most bites on most people are relatively harmless, causing irritation, itching, and redness. Different bug bites can result in different types of skin reactions, and not all people react the same. Rarely, even serious allergic reactions or illness can result.

The best medicine, as always, is prevention. Avoid times and places where mosquitoes and other biting bugs congregate.

Mosquitoes are most active around dawn and dusk. They love standing water in puddles and ponds. You are more likely to attract mosquitoes if you’re wearing dark clothing, including socks. They are attracted to your perspiration and sometimes to a scent to you may be wearing. Biting flies may be most common in wooded areas and around animals or garbage.

Repellents can be very helpful, especially against mosquitoes. However, you need to be cautious when choosing a repellent, especially for children. DEET is particularly effective against mosquitoes and some other bugs, but should be used with caution (see below). This is also true of permethrin, which is effective against ticks. Insect repellents should not be used at all on children younger than two months old.

There is terrific information in this article from the American Academy of Pediatrics. Here is their list of do’s and don’ts when you use insect repellents:

“Dos:

  • Read the label and follow all directions and precautions.
  • Only apply insect repellents on the outside of your child’s clothing and on exposed skin. Note: Permethrin-containing products should not be applied to skin.
  • Spray repellents in open areas to avoid breathing them in.
  • Use just enough repellent to cover your child’s clothing and exposed skin. Using more doesn’t make the repellent more effective. Avoid reapplying unless needed.
  • Help apply insect repellent on young children. Supervise older children when using these products.
  • Wash your children’s skin with soap and water to remove any repellent when they return indoors, and wash their clothing before they wear it again.

   “Dont’s:

  • Never apply insect repellent to children younger than 2 months.
  • Never spray insect repellent directly onto your child’s face. Instead, spray a little on your hands first and then rub it on your child’s face. Avoid the eyes and mouth.
  • Do not spray insect repellent on cuts, wounds, or irritated skin.
  • Do not use products that combine DEET with sunscreen. The DEET may make the sun protection factor (SPF) less effective. These products can overexpose your child to DEET because the sunscreen needs to be reapplied often.”

To treat a bug bite, you may apply ice for a few minutes every hour or two. Calamine lotion may be applied to stop the itching. Some people also find that baking soda mixed with water decreases their itching.

When should you seek medical attention for a bug bite? If anaphylaxis (a severe allergic reaction, which may include difficulty breathing – see definition from the Mayo Clinic here) occurs, get to an emergency room immediately.  Sudden hives are also a cause for concern and could be a sign of anaphylaxis. Otherwise, if the bite begins to look infected, or the reddened area around it is increasing in size larger than a quarter, keep an eye on it and check with your pediatrician’s office. You can use a Sharpie to mark the edges of the red area in order to note its progression.

Next time, more about stinging insects.

© MBS Writing Services, all rights reserved, 2015

 

Younger children—don’t just focus on one sport

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Summertime is just around the corner, and it’s time for kids to be outside enjoying themselves.  Organized sports are often a part of that.  Whether you have big dreams for your child’s sports future (college scholarship, pro career) or she has dreams for herself, it’s important not to push too hard too soon.  Doing so can cause injury and, perhaps more importantly, can decrease the all-important fun factor.

Most children love to play with a ball even before they can walk.  As their bodies mature, they’ll enjoy learning to swim, running short distances, playing physical games like tag in the backyard.  Activities like these are great for children’s physical health and for helping them grow into well-rounded people.  Staying active prevents obesity, gives a boost to the immune system, improves mental outlook, and fosters the development of social skills (learning to play fair, settling disputes, taking turns, sharing).

Parents should be cautious by not encouraging a child to play one sport to the exclusion of others.  Focusing on one sport, whether it’s swimming, soccer, baseball, gymnastics or something else, can lead to specific injuries.  Swimmers may develop shoulder problems; gymnasts can damage joints; runners might get shin splints.  Keeping a variety of physical activities in a young child’s life enables the whole body to develop, get stronger and more flexible, and decrease the risk for injury.

Eventually your child may decide to specialize in one sport, but doing so too early goes against the recommendations of the American Academy of Pediatrics (AAP) Council on Sports Medicine and Fitness.  There’s a great article on the subject here.  It’s best for your child’s physical, mental and social development to generalize, try a lot of different sports and activities, and to simply have fun.

 

© MBS Writing Services, 2015.  All rights reserved.

Batter up!

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Baseball is here for the summer, for kids of all ages.  Grownups, too, for that matter.  If you’ve ever had a pitcher in the family, you know that shoulder injuries are common, and if you’ve ever watched a slow motion video of a pitcher’s action, you can see why.  It’s not an entirely natural motion, and done repetitively, it can cause injury.  Pain and swelling may occur and sometimes even surgery is required if the damage is severe.

Little League Baseball has guidelines in place, designed to prevent injury.  These rules govern both the number of pitches allowed per day, and the number of days rest required after pitching.  You can read their entire list of pitching rules here.

Both the number of pitches and the number of rest days are regulated by age.  Here is their list of pitching limits per day:

17-18         105 pitches per day

13-16         95 pitches per day

11-12                   85 pitches per day

9-10           75 pitches per day

7-8              50 pitches per day

 

And the rest day requirements, again quoting from their website:

Pitchers league age 14 and under

• If a player pitches 66 or more pitches in a day, four calendar days of rest must be observed.

• If a player pitches 51-65 pitches in a day, three calendar days of rest must be observed.

• If a player pitches 36-50 pitches in a day, two calendar days of rest must be observed.

• If a player pitches 21-35 pitches in a day, one calendar day of rest must be observed.

• If a player pitches 1-20 pitches in a day, no calendar day of rest is required.

Pitchers league age 15-18

• If a player pitches 76 or more pitches in a day, four calendar days of rest must be observed.

• If a player pitches 61-75 pitches in a day, three calendar days of rest must be observed.

• If a player pitches 46-60 pitches in a day, two calendar days of rest must be observed.

• If a player pitches 31-45 pitches in a day, one calendar day of rest must be observed.

• If a player pitches 1-30 pitches in a day, no calendar day of rest is required.

           A game official is required to keep the pitch counts for every pitcher in the game and to let the head umpire know when a pitcher has reached his/her limit.

For other notes on safety and required equipment for ALL baseball players at different positions, please read Little League’s equipment checklist here.

Fun and safety are the twins of any sport.  Insuring your child’s safety and health increases the fun quotient!

 

© MBS Writing Services, 2015, all rights reserved.

Sunburned!

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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!

© 2014, MBS Writing Services, all rights reserved

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!

© 2014, MBS Writing Services, all rights reserved

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.

© 2014, MBS Writing Services, all rights reserved

Tanning beds?

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Checking the thermometer—or even looking out the window—in Central Kentucky this week, it’s hard to believe that spring break is just around the corner. Many people will be heading south for a little sun and warmth.  Others are just dreaming of summer days here, with days by the pool or sunbathing in the back yard.  And still others are imagining prom pictures and how they’ll look in that special dress or tux.

Whether preparing for a trip south, wanting to look your best or thinking ahead to summer, lots of people turn to tanning beds for a “base tan” in March and April.

In Kentucky’s current legislative session a physician has introduced a bill banning the use of tanning beds in the state by anyone under the age of 18.  It’s a bill we support, and here’s why:

  • Indoor tanning (tanning beds) is associated with an increased incidence of skin cancers, including melanoma (the most dangerous kind).
  • The use of indoor tanning has increased among teens, especially girls, in recent years.
  • Depending on the particular tanning bed used, you may receive up to 15 times the UVA rays that you would receive from exposure to midday summer sun.
  • Tanning has cumulative effects.  The more sunburns, and even tanning, your body receives over the years increases the odds you will develop skin cancers.  Tanning also causes premature skin aging and damages all the layers of the skin.

A tan does not make you more healthy; the facts support the opposite—tanning causes long-term damage.

So, don’t allow or encourage your teens to use tanning beds.  Read more from the American Academy of Pediatrics here.

 

© 2014 MBS Writing Services, all rights reserved