Tips of the Trade: Giving your Child Medications Part II:

Ear, nose or eye infections are generally treated with external drops. It is always easier to administer drops to a baby or young child if you lay him on a flat surface before you begin and enlist the help of another adult or an older child to keep him still and hold his head steady. An older child will probably be more co-operative and you will only need to ask him to tilt his head back or to the side, while you put the drops in.

Ear drops

1. Warm the drops to body temperature (hold the bottle in your hands for a few minutes or under a stream of warm, not hot, tap water) as cold drops can cause dizziness and nausea

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Practical Parenting: Baby Einstein and Brain Development

Most parents have heard the American Academy of Pediatrics recommendation that our children don't watch any television before age 2 and, then, fewer than 2 hours per day once they've turned 2 years old. 

And when I was pregnant, I had the best intentions of keeping our TV turned off during Henry's waking hours for the first 2 years.  But now, 23 months later, I will freely admit that we are big fans of Elmo, Blues Clues, and Thomas the Train at our house (this is one of many, humbling "real life reality checks" that has occured for me as a parent). 

Still, I try to be discerning when choosing which programs my little one watches - but what show is best for our kids?  I, like many of you, was initially thrilled with the idea of "Baby Einstein" but disappointing research revealed their claims of promoting children's development were overstated.  (See this link for more details on the Baby Einstein research http://www.mayoclinic.com/health/baby-einstein/AN01990).

So, in the midst of my quest for finding the best possible toddler TV shows, I was fascinated by the information presented in this16 minute video clip of a pediatrician, Dr. Dimitri Christakis, explaining the Over Stimulation Hypothesis - the neuroscience behind developmental changes resulting from early TV viewing.
http://www.youtube.com/watch?v=BoT7qH_uVNo

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Please, eat your peas! Tips for picky eaters

Toddlers and young children are notorious for being picky eaters. One day they’ll eat one food and it’s all they want – and then the next day, they won’t touch it! Sound familiar?

Assuming that they’re growing and developing appropriately, it is very normal for children to be picky eaters. You may feel like they don’t eat anything – but toddlers are amazingly capable of self regulating and they eat when they’re hungry! The tough part is getting them to eat what you want them to eat…

Here are some tips to help get your sweet peas to eat their peas!

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FYI: BPA - Why all the fuss?

You may have heard the announcement, earlier this week, that the FDA has issued a ban on the use of bisphenol A (BPA) in baby bottles and sippy cups as part of an effort by the American Chemistry Council to phase the chemical out. However, BPA use in other containers is still permitted. http://www.nytimes.com/2012/07/18/science/fda-bans-bpa-from-baby-bottles-and-sippy-cups.html

So why all the fuss?  With a quick glance down any aisle at Babies-R-Us you will see "BPA Free" plastered on the majority of baby products.  Here's an overview of what BPA is and why we encourage limited exposure (especially for young chidren)....and why you should care.

WHAT IS BPA?

- Bisphenol A is a chemical (that mimics estrogen), initially developed in the 1950s, primarily used in the production of two major plastics: polycarbonate and epoxy resin (plastics commonly used to make baby bottles, sippy cups, water bottles, medical equipment, and also used to line metal cans of food and infant formula).

- Over the past decade hundreds of studies reporting developmental, reproductive, behavioral and neurological effects of low dose exposure to bisphenol A have created a contentious debate over the chemical’s safety.

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Summer Safety: Always prepared!

You’re hour 3 into the 5 hour car trip to the beach and you happen to catch a glimpse of a flushed 4 year old face in the rear view mirror. He’s extra whiny and extra warm (as confirmed by a quick touch to the forehead), and you’re sure he has a fever...you think you stuck the thermometer and acetaminophen in a bag somewhere, but where is it?

Kids can get sick any time, any place - and you can guarantee that it never happens as planned! It’s helpful if you’re always prepared for illness or a scrape or fall everywhere you go - especially on summer vacations and road trips. It’s super easy to put together a first aid kit for your car or suitcase with the following items:

- Thermometer

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FYI: Smart Sunscreen Shopping

It can be slightly overwhelming staring down an aisle full of bottles of sunscreen and trying to discern which is the best for your children.

First, a brief primer on how sunscreen works:  Organic filters absorb harmful UV rays and are sometimes known as ‘absorbers’, or ‘chemical’ sunscreens. Inorganic filters act to reflect UV radiation away from the skin and are known as “physical or reflective” sunscreens. It can be helpful to think of organic filters as sponges, mopping up the UV radiation, and inorganic filters as mirrors, bouncing UV straight back off the skin

Now, here are two general rules of thumb to help you be a smart sunscreen shopper:

Rule 1: You do not need a sunscreen especially for children (although I recently found on a trip to the beach, that tear free options can be a lifesaver if your child is wiggly like mine and you find sunscreening a moving target to be challenging).

Rule 2: More expensive does not necessarily mean better quality.  According to Consumer Reports, several of the highest rated sunscreens are from Target and Walgreens (in fact, one of the dermatologists I trained under used to tell us all that Wal-mart brand was his favorite sunscreen of them all)

And now, my advice for what to look for when shopping for sunscreen for children:

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Summer Safety: The Buzzzz on Bee Stings

It’s summertime – kids are outside constantly and will inevitably encounter one of the most feared childhood enemies: the bee or wasp…

We’re all used to bees hovering around our sweet, sticky drink or food residue, but what we often forget is that bees and wasps may be nesting out in the yard where your child may be playing. These nests can be quite dangerous if disturbed - and hundreds of our winged friends might come out angry and attack (hence the term “mad as a hornet”). In fact, after one bee sting, a hormone is emitted that attracts other bees to sting as well – so get away from the area quickly if a bee hive is disturbed! Keep an eye on your yard for potential nesting areas – if you find one, be sure to exterminate it safely and properly before your children can find it.

In the event of a bee sting, children often experience rapid pain and/or itching, redness, and swelling at the site.

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Saying Goodbye; Saying Hello

Dr. Bill Satterwhite, another member of the Twin City Pediatrics family, joins us as he shares some insightful thoughts on learning to say a healthy 'goodbye' in order to welcome a healthy 'hello' in the world of parenting (and life)! 

This past weekend my wife and I waved "Goodbye" to our oldest son and some friends, who had joined us at the beach for the weekend. I felt both happy and sad to see him drive off. The moment reminded me of a wise quote from the husband of Beth Moore, an author and speaker, who said, "Learning to say 'Goodbye' is a necessary life skill."

Parenting is as much about 'goodbyes' as it is anything else. Take motherhood, for example. From the moment of birth, a mother's life is filled with 'goodbyes.' A mother says 'goodbye' to pregnancy. Goodbye to breast feeding. Goodbye to diapers. Goodbye to preschool, etc..., and on and on it goes. 

But saying 'Goodbye' is a necessary life skill because if you never say 'goodbye' to anything, you also never say 'hello' to anything. Goodbye to pregnancy but hello to a baby! Goodbye to preschool but hello to kindergarten! Healthy goodbyes always contain healthy hellos.

So we said a healthy goodbye to my son as he left the beach, and a healthy hello to his independent life. What have you said goodbye to lately that led to new hello? 

Dr. Bill Satterwhite

Keeping track of that spoonful of sugar...

Have you ever completely lost track of what day or dose of medication you're giving? I know I have... As a follow up to Dr. Brown's post on tips for giving your child medications, I thought I'd add this great idea for keeping track of medication doses. If you're a Pinterest fan like we are, you may have seen this idea circulating recently! 

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Tips of the Trade: Just a Spoonful of Sugar...Hints on How to Give Your Child Medicine

Read the Label.  Before asking your child to "open wide," step one in giving any medicine is knowing what the drug is, how to use it, what reactions to look for.  Dr. Bostein, pediatrician and acting director of the FDA Office of Drug Evaluation encourages parents to ask their doctor or pharmacist the following questions:

- What is the drug and what is it for?

- Will there be a problem with other drugs my child is taking?

- How often and for how long does my child need to take it?

- What side effects does it have?

- How soon will it start working?

Tips for Administering Liquid Medication with a syringe or medicine spoon or cup:

Infants and toddlers will usually take medication measured in a syringe (1 ml, 5 ml or 10 ml). 

- Give it slowly in their cheek

- Give a very small amount of medication in between screams/crying, most children will swallow it with their saliva

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Happy Fourth of July!!

Happy 4^th of July! Here’s hoping that everyone has a day full of family fun planned for the 4^th! If you haven’t yet decided how you’ll spend our nation’s birthday, here are several local activities that you might want to check out:

- Old Salem’s Independence Day Celebration – Old Salem, Winston-Salem, 9:30AM-4PM: celebrate with puppet shows, numerous tours, and more! Tickets are $21 for adults, $10 for children ages 6-16.

 - July 4th Red, White and Blue Party — Children’s Museum, Winston-Salem, 9AM-12PM: patriotic events, parade at 11AM, and popsicles at 11:30!

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book review: "Baby 411"

If you are in search of one comprehensive "go to guide" for your baby's first year of life - Baby411 is it!  Dr. Ari Brown, a pediatrician, and Denise Fields (author of another wonderful must read "Baby Bargains") have compiled a wonderful reference book for parents that has the perfect combination of medical information and practical parenting advice (both are moms of young children themselves). 

Some of my favorite sections include:

- Every chapter contains various practical parenting tips labeled "Helpful Hints." refutes some myths labeled "Old Wives Tales," identifies "Red Flags" for parents for things that require medical attention, summarizes the main points with under the heading "Bottom Line" and also provides "Insider Tips" from the MD including things like "The best time to schedule a pediatric appointment" and "How to make friends with your pediatric office staff"

- The feeding chapters include detailed explanation of how many ounces of breastmilk or formula a baby requires at various ages,   tips on troubleshooting the various challenges of breastfeeding (overproduction/engorgement, underproduction, nipple soreness/latch problems, etc), and when and how to introduce solid foods

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Splish, splash...it's summertime!

It is definitely summertime in NC! 90 and 100-degree days this week mean that we’ll all be trying to escape the blistering heat by heading to the pool, the lake, or the beach. In the midst of the relaxation, however, don’t forget to keep a close eye on your little ones! Water accidents can happen in no time, and unfortunately, drowning ranks second behind motor vehicle accidents as a leading cause of death in young children.

So, what can you do to keep your kids happily splashing this summer?

• Never leave your child unsupervised in the water. If your child is less than age 5, keep them within an arm’s length at all times. This goes for any body of water, including bathtubs!
• Children must wear life jackets while boating or near large bodies of water. Make sure the life jacket is the right size (labels should have weight requirements) and fits snugly with all of the proper belts snapped. For children under 5, pick one with a flotation collar in order to keep their heads out of the water. Stick one on the kids at the pool too – but never substitute a life jacket for adult supervision!
  
• Enforce safety rules at the pool – no running or horseplay! Never allow your little daredevil to dive into the shallow end of the pool and supervise while on the diving board.

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Spit Happens!

All babies spit up, right? It’s often at the worst moment – right after you’ve just changed your shirt and taken your shower for the day – and you feel like you’ll never go anywhere again without a spit up stain on your clothes.  Be reassured, however, it will get better! 

Most infants have a loose lower esophageal sphincter, which is the “rubberband-like” muscle at the top of the stomach that helps hold food down. Because of this, you’ll notice that most babies spit up more if they’re lying down or if they’ve eaten more than usual. Some babies will spit up any time and in any position, but there are a few things that may help with this:

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Practical Parenting: Infant Gear Top 10 - Beyond the Basics

When preparing for the arrival of your little bundle of joy, of course you need a crib, a car seat, diapers, a stroller, etc.  But here's my list of some of my favorite baby gear items that made my life easier with an infant or toddler in our house.  Can you survive the first 12 months of your baby's life without these things?  Absolutely.  But will these things make the chaotic first few months a little easier or less messy?  Absolutely!

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To Do: Create a Cocoon of Safety (prevent Pertussis)

If you thought the whooping cough (pertussis) was behind us, think again. It's the only vaccine-preventable disease that has recently been on the rise.  In fact, reported incidence of infant pertussis in the US has tripled since the 1980s. As of March 2012, pertussis outbreaks in Oregon, Washington, California, and Vermont have reached epidemic proportions.  And this week's Winston-Salem Journal featured a story about the pertussis outbreak right here in the Triad. http://www2.journalnow.com/news/2012/jun/20/1/pertussis-outbreak-reported-in-triad-ar-2372236/  

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FYI: Melanoma

- Melanoma is the most common form of cancer for young adults 25-29 years old and the 2nd most common form of cancer for young people 15-29 years old.

- And rates are increasing, between 1992 and 2004, melanoma incidence increased 45%
- Melanoma accounts for less than 5% of skin cancer cases, but it causes more than 75%of skin cancer deaths.
- Children with fair skin, freckles or red or blond hair have a higher risk of melanoma.
- Both genetic and environmental factors (UV radiation exposure) play a role in the pathogenesis of melanoma and just one blistering sunburn during childhood more than doubles a person's chances of developing melanoma later in life.
- If treated early, most melanomas are cured with surgical resection
- However, diagnosis and treatment, are delayed in 40 percent of childhood melanoma cases (and children who have been previously treated for melanoma are at an increased risk for recurrence later in life.)

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