Category Archives: toddlers

Screen time for young children

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Screens are a big part of modern life, from television to computers to phones to tablets. Every family must make decisions about how much time their children can or should spend in front of a screen. Like so many things, the right decision varies with the age of the child.

Does my child’s pediatrician have thoughts about how much screen time is too much for myEmily Sweigert, age 5 young child? Actually, yes.

The American Academy of Child and Adolescent Psychology has these recommendations for children aged 5 and under.

  • “Until 18 months of age limit screen use to video chatting along with an adult (for example, with a parent who is out of town).
  • Between 18 and 24 months screen time should be limited to watching educational programming with a caregiver.
  • For children 2-5, limit non-educational screen time to about 1 hour per weekday and 3 hours on the weekend days.”

What we know about young children is that they need human interaction, face-to-face. Screens are not a substitute for that. We offer them no help, and may do them harm, if we teach them (even unintentionally) from an early age that screens are better than human contact. Age-appropriate games, singing and talking to and with your children, eye contact, reading to them daily—all these are more beneficial than setting them in front of a screen for hours at a time.

Remember that you are a far better teacher to your young children than any device can be. Educational programs aimed at very young children (under 18 months) are not helpful for the children to watch, because their brains can’t process the information. What you can do, though, is watch the program and mimic what the educator does as you interact with your child.

Here’s a quote from a pediatrician on the American Academy of Pediatrics website. You can read the entire blog here.

“A toddler learns a lot more from banging pans on the floor while you cook dinner than he does from watching a screen for the same amount of time, because every now and then the two of you look at each other.

Just having the TV on in the background, even if “no one is watching it,” is enough to delay language development. Normally a parent speaks about 940 words per hour when a toddler is around. With the television on, that number falls by 770! Fewer words means less learning.”

Your child learns more from you than you can imagine. Remember that as you consider screen exposure.

New information about preventing peanut allergies

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An extensive study of children and peanut allergies has recently been released, and it encourages pediatricians to re-assess the recommendations that have been in place for some time. The study, called LEAP (Learning Early About Peanut Allergy), looked at children who have a severe or mild risk of developing peanut allergy and those who don’t.

Peanut allergies have been on the rise in recent years. Conventional wisdom has been that infants and toddlers should not be given peanuts or peanut products until they were older. That wisdom is now changing as a result of the LEAP study, conducted by the National Institute of Allergy and Infectious Diseases (NIAID).

The director of NIAID said in a recent press release: “We expect that widespread implementation of these guidelines by health care providers will prevent the development of peanut allergy in many susceptible children and ultimately reduce the prevalence of peanut allergy in the United States.”

So, what are the new guidelines, and what should parents do about introducing peanuts to the diets of their young children?

For babies who are considered to be at NO risk for developing a peanut allergy, parents can begin introducing peanut butter with solid foods at about six months of age. The LEAP study concludes that once peanut butter is introduced and tolerated with no allergic reaction, it should remain in the baby’s diet with some regularity.

There are different guidelines for babies and young children who are determined to be at moderate or severe risk of developing peanut allergy. How do you know whether or not your child is at risk? There are several factors that contribute to that risk, and it’s a conversation you should have with your child’s pediatrician in the office before introducing peanut butter into the diet.

Your concerns are our concerns, and we look forward to answering any questions you may have at your child’s next checkup.

Fluoride varnish: a new treatment for very young children

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Tooth decay, as you know, continues to be a growing problem among children and adolescents. Sugary diets and infrequent brushing can lead to cavities at young ages. And tooth decay at a young age almost always is a sign of more tooth decay as the child grows.

How to get ahead of the problem early? The American Academy of Pediatrics (AAP) recommends a fluoride varnish two to four times per year for very young children who have yet to visit a dentist. We will begin offering a fluoride varnish in our office soon.

Will insurance cover such an important treatment? You bet. All insurances are required to cover fluoride varnish, but some have a limit on how many treatments per year, even though it is a recommended service as often as every 3 months.

We’ve written before about the importance of fluoride in protecting the enamel of children’s teeth. New guidelines emerged from the AAP to stress brushing with a tiny amount of fluoride toothpaste even in the very young, although previous guidelines had recommended no fluoride before the age of 2.

Now the guidelines have been strengthened further to encourage a fluoride varnish.

Fluoride is a mineral that strengthens tooth enamel, which covers each tooth. Yes, there is fluoride in public water systems, but it may not be enough. In addition, many in our community drink water from wells and cisterns, or drink bottled water.

A fluoride varnish is simple to apply in the pediatrician’s office, with a small brush to coat the top and sides of each tooth. It’s a liquid that hardens quickly, and the teeth should be brushed about 4 to 12 hours afterwards at home. The treatment is painless, and most children like the taste. The varnish may temporarily leave a dull or yellowed appearance, but the teeth will return to a normal color after the varnish is brushed off.

This article from the AAP contains more information about fluoride varnish, including how to care for your child’s teeth immediately after the varnish is applied:

  • “Your child can eat and drink right after the fluoride varnish is applied. But only give your child soft foods and cold or warm (not hot) foods or liquids.
  • Do not brush or floss teeth for at least 4 to 6 hours. Your child’s doctor may tell you to wait until the next morning to brush or floss. Remind your child to spit when rinsing, if he knows how to spit.”

Dental health can’t start too early. Talk to your pediatrician soon about a fluoride varnish to protect your child’s teeth in the years to come.

© 2016 MBS Writing Services, 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

 

Roseola

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Let’s say this first: anytime your infant or young child has a fever of 102°F for twenty-four hours, call the pediatrician.  The issue may be minor or serious, and the doctor should help you determine what it might be.

One possibility is roseola, usually not a series condition, which is yet another in the herpes family of viruses.  (It is not the same as the herpes strains that cause genital herpes or cold sores.)  It’s human herpes virus 6 (HHV-6) and is relatively common in children aged six months to two years.

Symptoms, in addition to the fever (which may last up to a week), may include a cough and runny nose, less appetite and mild diarrhea.  Finally, after the fever is gone, generally a slightly raised red rash will appear.  It usually starts on the torso before spreading to the rest of the body.

Roseola is contagious, and a child with a fever should be kept away from other youngsters until the fever is gone.  Once roseola is at the rash stage the child is no longer contagious and can return to daycare.  The incubation period is one to two weeks.

If the pediatrician suspects roseola in your child, you might be asked to treat the fever with age-appropriate doses of acetaminophen (always be sure to check dosing instructions and note that they have changed in the last few years) and keep him hydrated.  The doctor may want to talk to you again to make sure the child isn’t sick with something more serious.

You can find out more about roseola in the two articles from which our research was drawn, here and here.  Both articles were published by the American Academy of Pediatrics.

© MBS Writing Services, all rights reserved

Stomach virus season

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Yes, we’re starting to see some fall/winter viruses that cause gastrointestinal (GI) problems. By the end of winter, Rotavirus will have been our most common offender, but now that kids are back in school, lots of viruses are happy. Families who get the viruses… not so much.

 

GI viruses like school, daycare and home settings because these places have children who haven’t always learned good hygiene practices. Prevention is always the best action against these diseases, so don’t forget to CLEAN door handles, toilet seats, other bathroom surfaces, television remotes. Also be sure to wash hands before cooking, serving and eating food.

 

Another way to hinder a virus is to keep your child home when she’s sick, preventing the spread to other children and adults. That may have been where she came into contact with the virus. Let’s not spread the “love.”

 

When can you send him back to school or daycare? Make sure he has been fever free for 24 hours (without a fever reducer), is able to tolerate small amounts of bland foods, has gone at least 12 hours since his last episode of vomiting and has had no more than 3 episodes of diarrhea in 8 hours.

 

Contact our office if diarrhea and vomiting don’t subside within three days or if diarrhea is bloody, if there’s been no urine output for 10 hours, or if the fever is high or doesn’t subside. We have a nurse available for advice on the phone, and we often can call in prescriptions for nausea for older children, unless we think they need to be seen in the office first.

 

More information? See our blog from last spring which includes a link to the American Academy of Pediatrics article on Rotavirus. Also, our blog regarding when to be concerned about a fever.

 

Stay healthy this winter!

 

 

 

© 2014, MBS Writing Services, all rights reserved

 

 

 

When to start fighting tooth decay? When the baby’s FIRST TOOTH starts to come in.

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You are so excited about your child’s first teeth that it doesn’t occur to you to think about tooth decay yet.  But the fight against tooth decay, according the American Academy of Pediatrics (AAP), starts from the first baby tooth. That is also when they recommend starting to brush with a tiny amount of fluoride toothpaste.

You may be thinking, “What?!  My pediatrician (or dentist) told me no fluoride before the age of two years.”  You’d be right.  This is a BIG change in recommendations, and it is indeed new.

Dental health is important for overall health, and tooth decay can start early.  Decay in a young child’s teeth “is the single greatest risk factor” for decay in permanent teeth, according to a recent article by the AAP, which also states that “59% of 12- to 19-year-olds” have at least one cavity.

The administration of fluoride in a proper amount is still one of the best ways to prevent tooth decay, as it preserves the enamel that coats the tooth.  Many children and teens don’t get enough fluoride to act against tooth decay.

How to make sure your child is getting enough fluoride:

  • Start at the very beginning.  As soon as you see the first tooth erupting from the gum, you should brush it with a fluoride toothpaste, but only a very small amount.  The AAP guidelines, which you can find here, recommend a “smear” about the size of a grain of rice until the age of three.
  • For 3- to 6-year-olds, increase the amount to pea-sized.  Brush teeth twice a day, with adult assistance, and make sure that the child doesn’t swallow the toothpaste.  It’s even best if they don’t rinse with water.
  • Drink tap water.  In Scott County the public water is fluoridated, but if you use a well or cistern your water will only contain minimal amounts of fluoride.  Bottled water typically doesn’t contain much, if any, fluoride.  If you worry about tap water, use a filter.
  • Check with your pediatrician or dentist especially if you don’t have public water to make sure your child or teen is getting enough fluoride.

Are there any downsides to using fluoride?  Yes, it’s possible to get too much and create a rare condition called fluorosis, that causes discoloration of the teeth.  You can read about fluorosis here.  Again, this is rare, but if you’re concerned about it, speak to your pediatrician or dentist.

For other information on preventing tooth decay, check out these AAP articles:

Take good care of your child’s teeth for beautiful smiles throughout their lives.

© 2014 MBS Writing Services, all rights reserved