Tag Archives: all ages

The consequences of lead poisoning in children

The tragic, preventable events in Flint, Michigan, have brought to the nation’s attention the results of lead poisoning, especially in children. It’s a good time to remember that lead poisoning can be a risk, no matter where you live.

How are children exposed to lead? Lead can be inhaled in polluted air (which is why lead was removed from gasoline decades ago). Children can be exposed through paint containing lead, either by eating paint chips or when lead paint is removed and is introduced into the air. They can also ingest lead through tainted drinking water, which is what has happened in Flint.

Children are at greater risk than adults because their bodies absorb higher percentages of lead. In addition, their developing bodies are more easily and irreversibly damaged.

Some of the worst and most obvious problems that result from lead poisoning occur in the central nervous system. Brain development can be greatly affected, especially in those under the age of two. Such problems are permanent.

Other severe effects can include anemia, kidney problems, endocrine issues (including the inhibiting of normal growth), and gastrointestinal concerns (like vomiting and constipation). Both small motor and large motor skills suffer from lead poisoning.

Because lead so severely affects the central nervous system, children often exhibit serious behavioral problems like aggression, impulsive behavior, and difficulty with attention—problems that don’t end with childhood. Later in life, these individuals experience a much higher than normal incidence of substance abuse.

The growing understanding of the severity of the consequences of lead poisoning has caused the Centers for Disease Control and prevention to modify its definition of toxic lead levels over the past several decades to one twelfth of its former measurement (from 60 micrograms/deciliter in 1970 to 5 mcg/dL in the current definition).

So, what can we and you do to prevent lead poisoning? First, make sure you limit your child’s exposure to lead. If you’re concerned because you live in an older home, you can have your water tested to be certain that no lead is leeching into the system from pipes. Make sure that any lead paint has been removed.

In our office, we assess lead levels at the one year checkup. In addition, we have increased our frequency of using a verbal questionnaire to screen for risks, starting at six months of age.

Together, we can reduce or eliminate your child’s risk of toxic lead exposure.

***Much of the information in today’s blog was gleaned from “Pediatric News,” Vol. 50, number 3, March 2016.

Nosebleeds

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Most children will have nosebleeds from time to time, and causes range from hay fever to weather (cold, dry weather dries the membranes in the nose), from a familial trait to no explanation at all. Nosebleeds usually don’t last long and generally a child bleeds from only one nostril.

What to do when a nosebleed occurs? According to an article on the website of the American Academy of Pediatrics, here are the basic ways to control a nosebleed:

“Stay calm; the nosebleed is probably not serious, and you should try not to upset your child. Your child will pick up on your emotional cues.
Keep your child sitting or standing and leaning slightly forward. Don’t let him lie down or lean back because this will allow blood to flow down his throat and might make him vomit.
Don’t stuff tissues or another material into the nose to stop the bleeding.
Firmly pinch the soft part of your child’s nose—using a cold compress if you have one, otherwise your fingers—and keep the pressure on for a full 10 minutes. Don’t look to see if your child’s nose is bleeding during this time; you may start the flow again.
If bleeding hasn’t stopped after 10 minutes, repeat the pressure. If bleeding persists after your second try, call your pediatrician or take your child to the nearest emergency department.”

When should you be concerned enough to call your pediatrician or get to an emergency room? The article referenced above lists the guidelines to call the doctor if:

“Your child is pale, sweaty, or not responding to you.
You believe your child has lost a lot of blood.
Your child is bleeding from the mouth or vomiting blood or brown material that looks like coffee grounds.
Your child’s nose is bleeding after a blow or injury to any part of the head.”

Generally speaking, a nosebleed isn’t serious and you can easily stop it at home. However, check out the advice above if you have concerns.

Artwork by Corinne

Bullying is a serious matter

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October is National Bullying Prevention Awareness Month. That means now is a good time for us to talk about this important subject.

Bullying can occur at school or on the bus, in the neighborhood, on the playground— anywhere. Cyber bullying is also on the rise, where people use the internet or phone apps to harm others.

At the very least, bullying lowers self-esteem. But as we know, continual bullying can cause children and teens to withdraw socially, may create depression or other mental health issues, and can even result in physical harm.

Parental awareness is essential. It’s almost certain that your child will, at some point, either be on the receiving end of bullying behavior, or will bully someone else, or both. An article on the American Academy of Pediatrics (AAP) website references a study from 1999, in which four out of five teens admitted to participating in bullying behavior at least once a month. Those who have been bullied often go on to mistreat others.

Conversations about appropriate behavior and language need to begin early between parent and child. Don’t hesitate to correct your child or teen when you hear name-calling or witness unkind behavior, even between siblings. They can learn early the boundaries between acceptable and unacceptable behavior. Teach them how to express themselves, especially when hurt or angry, by using language that doesn’t cross the line into disrespect. Don’t tolerate violent acts against people or animals.

Of course, your kids are not always near you, and you won’t be aware of everything that happens to them or everything they do. Continue the conversation about bullying; remind them to walk away from confrontations and to inform a responsible adult if they experience or witness bullying. Talk about kindness; role-play sticky situations. Monitor their internet and cell phone activity and discuss what you find there.

Teach your kids some nonviolent and non-confrontational ways to handle conflict. There are excellent resources for this in the article mentioned above, also here and here.

Remember that school counselors and other therapists can be really helpful if your child or teen is a victim or perpetrator of bullying, and our office can always make a referral.

As children get older, remind them that they help create a safe environment for others. They can be a positive force by refusing to contribute to an atmosphere of hatred.

As the school year continues, things can get very hectic. Don’t forget to pay attention to what’s going on with your youngsters. Ask questions, be supportive, get help when needed. Let’s keep our schools and community safe for everyone’s children.

Artwork by Shawna

How to save money on your prescription medications!

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If you are buying any prescription medications for your child, your teen, or yourself, then you know how pricey they can be. Sometimes they are covered by insurance; sometimes insurance only pays a fraction; and there are drugs that are not covered by insurance and families that don’t have prescription coverage at all.

No matter your situation, there are still ways you can save, even as prescription drug prices continue to rise.

Buy a generic drug alternative. Not all drugs have generic versions, but when they do the generic is usually quite a bit less expensive. Ask your physician or pharmacist if there is a generic available for a particular drug.

Talk to the doctor. In addition to knowing about generic alternatives, your pediatrician may know of a less expensive option for the drug your child is taking. There won’t always be another alternative, but it’s certainly worth asking about.

Look for cheaper prices. If you think the drug prices at your pharmacy are too high, call around. Sometimes there can be quite a difference from one pharmacy to another.

Look online for coupons or other resources. Some pharmaceutical companies have special programs for uninsured patients, or for patients who have difficulty paying even with insurance. In addition, you can often find coupons for particular drugs from a pharmaceutical company.

Drugs aren’t likely to get cheaper anytime soon, and yet they are often necessary. We want to help you find less expensive alternatives. Please ask us.

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!

Spider bites

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Both spiders and ticks are common in our area. We’ll deal with ticks next time.

While most of their bites aren’t dangerous to most people, it’s good to be informed about different types of spiders, their bites, and diseases that might result from some of them.

Spiders use a venom to anesthetize and paralyze their tiny prey. The venom from most species is not dangerous to most humans (see below for exceptions). Watch for signs of infection and report those immediately to your pediatrician. If you are concerned that a bite is getting much larger, note the edges with a Sharpie marker so you can see if it’s continuing to grow.

The female black widow spider can be extremely poisonous to humans, sometimes even fatal. She has an hourglass shape and is dark colored with yellow or red on her abdomen. Symptoms can be severe muscle cramping and pain. Call EMS if you think someone has been bitten by a black widow spider.

The brown recluse spider is fairly common in Kentucky, and can also be fatal at times. People often don’t know they’ve been bitten until the bite starts to swell and get painful. Reactions greatly vary. Call EMS if you are concerned about a brown recluse bite.

According to this article by the American Academy of Pediatrics (AAP), here are things to watch for after a spider bite, and a signal to call your pediatrician or EMS:
• “Tiny fang marks
• Pain
• Pain begins as a dull ache at the bite site
• Pain spreads to the surrounding muscles
• Pain moves to the abdomen, back, chest, and legs
• Blister at the bite site
• Mild swelling and a blue-gray mark at the bite surrounded by lightening of skin color
• Progressive soft tissue damage; the skin becomes dark blue and then black (necrotic).”

Wash the affected area with soap and water, and treat a bite with an ice pack (make sure you put a layer of cloth between the ice pack and the skin) Another resource for your questions about spider bites is the Poison Control Center.

As with anything, whenever you have a concern, call our office.

Sports physicals – it’s time

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Your kids are on the move – literally, and all the time! If they are involved in a fall sport at school, then it’s time for their sports physical. Don’t forget that there is tremendous benefit to getting these physicals at your child’s pediatric office, rather than at a clinic or a school-sponsored physical day. The pediatrician has all your records including vaccinations, allergies, and your individualized and family medical history. He or she can discuss important sports information with you, including nutrition. And, of course, follow-up is always readily available, whether one week or six months from now. We are delighted to be working, with you as our partner, to make a medical home for your family here with us. If your child has a physical at a clinic or the school, that physical is not a part of our records, and we end up with an incomplete picture of his or her development and needs. Read our previous blog post for more reasons on why it’s wise to bring your child to the pediatrician when it’s time for a physical.

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!

Medical websites you can trust

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As we enter 2014, many families will decide to be healthier this year. One way to be on top of your health is to be knowledgeable. The problem is that there is so much information out there, it can be overwhelming. Even worse, a lot of the advice is misleading, incomplete, trying to sell a product, or just plain wrong.

What to do, then, if you’re looking answers to your pediatric health questions? We have a few sites we trust that you may find helpful.

Your first stop should be here, on our own website. There you’ll find 21 links that we trust to provide good information, on everything from general health and pediatrics to a few common illnesses and conditions, such as allergies, asthma, and disabilities. Here are a few of the best:

American Academy of Pediatrics. If you read our blog, you know that we refer to the AAP regularly. They are the go-to organization for reliable information on the health of children and teens, including physical, social, psychological, and intellectual health. Some of their pages are full of statistics and medical jargon, but check out healthychildren.org. It’s very readable, practical, and up-to-date. You can search your topic or question by typing it into the search box.
The National Institutes of Health has a huge amount of information. Some of it is written for health professionals, but much of it—particularly the medline plus section—is also written for the general population. It’s a great source of health information for all ages, birth to old age. You can even sign up here to receive e-mail updates on children’s health topics.
The Centers for Disease Control and Prevention gives you an alphabetized list of topics and diseases for your research.

If you have a particular issue you’re interested in researching, check with your pediatrician, who can suggest additional specific resources.

Happy internet hunting, and Happy New Year!

Artwork by Audrey

Gun safety

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According to the American Academy of Pediatrics (AAP), 44 million homes in the U.S. have at least one gun. In this season when your youngster may be visiting in homes of friends and relatives, or even spying for hidden stashes of gifts, it’s a good time to review gun safety.

If you own a gun, it needs to be unobtainable for a young person, not just out of sight. Children, even the very young, have an incredible knack for finding hidden things. A three-year-old, for example, found a gun hidden between his parents’ mattress and box springs. Guns should be unloaded and locked away in a cabinet for that purpose (preferably one that doesn’t have a glass or other see-through door). Ammunition should be kept in a separate, also locked, location.
Talk. Tell your children about the dangers of guns. Be clear about rules and firm about what privileges will be taken away if they break those rules.
Ask. If your child or teen is going to someone else’s home, ask whether or not that home has guns and, if so, how they are stored.
Don’t assume. Children are inquisitive; teens want to fit in. If they see a gun, no matter how well they know your rules, they are likely to want to touch it and play with it.
Also, don’t assume that your child would never choose to be violent toward herself or that he would never choose to harm others. Young people, no matter how good the parenting and how delightful the child, often make bad judgments, especially in the heat of a moment. In addition, mental illnesses such as depression can surface at nearly any age.
Some more statistics from the AAP: A gun kept in the home triples the risk of homicide. The risk of suicide is 5 times more likely if a gun is kept in the home.

For more information from the AAP, check out this link or this video.

Remember, safety is a huge part of staying healthy.

artwork by Corinne

Georgetown Pediatrics

Caring for your children.

Tag Archives: all ages

The consequences of lead poisoning in children

Nosebleeds

How to save money on your prescription medications!

Ticks

Spider bites

Sports physicals – it’s time

Sunburned!

Medical websites you can trust