Posts Tagged ‘children’


Small pox, polio, diphtheria, tetanus, measles, mumps and rubella are all potentially life-threatening diseases that have been almost completely eliminated from our society during our lifetimes. The reason for this is the routine childhood immunization program that has been widely accepted in the United States, as well as most of the modern world.

We often hear about the supposed side effects of immunizations, but we rarely hear about children getting the very diseases that the vaccines protect against. That’s because the immunization program has worked so well in preventing diseases that could have killed millions and caused untold suffering.

In fact, we’ve been so successful immunizing children and preventing diseases that some might wonder whether vaccines are still needed.

Here’s why immunizations are still necessary:

– Newborn babies are immune to many diseases, because they have antibody protection from their mothers. This immunity is mostly gone by the end of the first year of life, leaving unvaccinated babies susceptible to the abovementioned vaccine-preventable illnesses.

– Although our country has virtually eliminated these diseases, many Third World countries with poor immunization programs are still plagued by vaccine-preventable illnesses. These diseases are only a plane ride away. An infected traveler could bring such an illness back to the States, where it could spread rapidly if people were not adequately immunized.

– In the U.S., pertussis (whooping cough) is making a comeback, and tetanus is still infecting some people.

– Widespread immunization is necessary because it helps to keep a disease from spreading within a population. This helps to protect those few who, whether by choice or by necessity, are not immunized.

Immunizations are safe. A decade ago, an unsubstantiated study tried to link immunizations to autism. A well-publicized article from England sounded the alarm connecting the measles, mumps and rubella vaccine to autism. This started a grassroots movement that has led many to reject all vaccinations. However, the majority of the authors of that article have withdrawn their support for it, and the lead author was found guilty of professional misconduct and had his license to practice medicine revoked.

Many well-controlled scientific studies have all concluded that there is no scientific or statistical relationship between immunizations and autism.

Unfortunately, the rates of immunized children entering kindergarten in Santa Cruz County are some of the lowest in the nation, with only 84 percent fully vaccinated. The San Lorenzo Valley is even lower, with just 65 percent fully immunized.

Just recently, Felton had a measles scare, prompting a major investigation. The outcome was favorable this time, as it did not infect anyone except the carrier, but a significant epidemic could spread through our area in the future because of our low immunization rates.

Until vaccine-preventable illnesses are eliminated worldwide, as with deadly smallpox — a result of the most successful immunization program ever — I strongly recommend that as many of our children as possible be routinely immunized and thus protected from potentially life-threatening diseases.

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Last year, my daughter complained to me about back pain. I wasn’t sure what was causing her discomfort until one day when I had to lift her school backpack out of my car. I almost threw my own back out.

I couldn’t believe how heavy it was. It weighed 20 pounds, and my daughter weighed 80 pounds.

Carrying a heavy backpack can be a source of low-level trauma leading to shoulder, neck and back pain in children. This is especially true for those school kids in middle and high school who have neither lockers nor desks to store their books in during the school day.

Experts recommend that children carry backpacks that weigh 10 percent or less of their body weight and no more than 15 percent.

The way a backpack is carried may contribute to the problem. Some kids wear their packs over only one shoulder, often because it’s “cool” or just plain easier. That causes them to walk unbalanced, causing abnormal stresses on their young developing spines.

A heavy backpack may make a bicycle rider top-heavy and less stable on the bike, potentially leading to accidental injuries.

A good backpack should have the following features:

– Lightweight construction

– Two wide, padded shoulder straps

– A padded back, for comfort and injury protection

– A waist belt and multiple compartments to distribute weight more evenly

We as parents need to be aware of this potential problem and be proactive in helping our children make best use of their backpacks.

Children should be taught to pick up their bags properly, by bending at the knees before lifting and using both hands.

Keeping straps tight will help with proper fit.

Remind children to use all of the backpack’s compartments, putting the heaviest items — such as textbooks — near the center of the back. They should not to carry around unnecessary personal items.

Also, take advantage of using available online books that don’t have to be carried around.

If your child continues to have back pain even after making the above adjustments, or has numbness, weakness or tingling in the arms or legs, consult with your doctor.

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I have recently seen an increase in what is called hand, foot and mouth disease, and an increased number of cases have been reported to the county health department. Some countries outside of the U.S. have seen an even greater number of infected people.

Hand, foot and mouth disease is a common illness caused by a virus that mostly affects children younger than 5 years of age. Child-care settings are frequent sources of the disease. Outbreaks usually occur during summer and fall months.

Most of those affected by this disease have no obvious symptoms. Those who do show symptoms will have perhaps a mild fever and small pimple-like lesions on the palms of the hands, the soles of the feet and inside the mouth.

Hand, foot and mouth disease is spread from person to person by bodily secretions, such as saliva, feces, and fluid from the pimple-like lesions and the nose or mouth. One can be infected by touching surfaces or objects that have been contaminated by infected individuals.

Transmission can be reduced by good hygiene. Individuals should wash hands thoroughly with soap and water, especially after changing diapers or using the toilet. Commonly used surfaces and soiled items, including toys, should be washed with soap and water or a solution of 1 tablespoon bleach in 4 cups water. People need to avoid kissing, face-to-face contact and sharing eating utensils or drinking containers with those who have hand, foot and mouth disease.

About a quarter of those affected recently by hand, foot and mouth disease are adults, who are showing a more severe rash and fever than the typical case. This rash often involves the extremities, face, buttocks and torso, in that order. Interestingly, it appears most commonly in skin previously damaged by sunburn or chronic conditions such as eczema.

There is no specific treatment for hand, foot and mouth disease. Treating symptoms of pain or fever with Tylenol or ibuprofen may be all that is necessary.

The most common complication of this disease is dehydration caused by sores in the mouth and throat making it very difficult to swallow. Affected children must be monitored closely for the amount of liquids they take in and the amount of urine they produce. Serious dehydration should be treated at a hospital emergency room.

Workers and students should not return to work or school until their fever has been gone for at least 24 hours and any skin lesions are dry and not oozing any liquid.

The good news is that this common disease usually has no long-term serious consequences and can, to some extent, be prevented by practicing good hygiene.

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Childhood Nutrition

March is National Nutrition Month. I would like to discuss the important topic of childhood nutrition. Whether you have a newborn or a teenager, what he or she eats is important to both physical and mental development.

The following are my recommendations supported by the American Academy of Pediatrics. 


From birth to 12 months, it’s all about milk, whether it’s breast milk, iron-fortified formula or a combination of the two. Whole milk is not to be given during this time. At four to six months babies can begin solid foods such as iron fortified baby cereal, strained fruits, vegetables and pureed meats. Fat restriction at this age is usually not necessary since fat helps to develop the brain and nerves.

Preschoolers, toddlers

At 12 months, children who have been weaned off breastfeeding may begin drinking whole milk. Low-fat milk would be better if there is a strong family history of obesity or heart disease. Calcium is necessary during this time to help build strong healthy bones and teeth. Milk is still one of the best calcium sources along with fortified cereals and juices. Fiber is also important to help fight obesity and promote digestion and prevent constipation.

Elementary school

Protein is important in this group. If a child won’t eat meat, plenty of protein can be found in beans, eggs and peanut butter. At this age, kids will start eating more not-so-healthy snacks and fast foods. It is important to monitor their intake of fats and salt and the ever-increasing consumption of sugar in all its many forms.


This is the time when junk food can become a bigger part of the diet. It’s also when some kids become very conscious of their weight and may develop eating disorders, such as bulimia and anorexia. Calorie requirements increase, as does the need for calcium. Low-fat milk and calcium-rich and -fortified foods are still very important. Girls who begin menstruating will need more iron-rich foods, such as meat and poultry, vegetables and beans, and fortified cereals and grains.

It is also now recommended that all children, beginning in the first two months of life, receive at least 400 IU of vitamin D daily. Discuss this with your doctor.

Getting our children to eat a healthy diet may not be an easy task. There’s too much childhood obesity (one in three children in America), diabetes and even heart disease. We need to monitor our children’s eating preferences and habits and be diligent about encouraging and explaining to them the benefits of a healthy, well-balanced diet.

For us parents, this may be a constant battle, but one well worth fighting to help ensure that our children will grow up to be healthy adults.

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I’d like to talk about several common activities involving children and how to ensure safety and avoid unnecessary injury.

Playground injuries, mostly from falls, account for more than 200,000 emergency room visits each year. The highest-risk group is 5 to 9 years of age. Young children need close adult supervision. Make sure that underneath the equipment, there is an adequate shock-absorbing material, such as chipped wood or any type of rubber product. Also, one ought to inspect the equipment to ensure that it appears to be in good repair.


Bicycling (300,000 emergency visits a year) and skateboarding (30,000 visits) are the leading causes of head-injury accidents in children. Proper safety for these activities includes adult supervision of younger children, routine bicycle maintenance and mandatory use of head-protective helmets. Helmets must be proper to the activity, and they must fit appropriately. But, most importantly, they must be worn!


Swimming accidents ending in drowning are the second leading cause of injury death among children age 14 and younger. All pools must be adequately fenced in and have properly functioning gates. Injury can be avoided by not running around the pool, not jumping onto floating objects and using a diving board only as it’s meant to be used. Again, adult supervision is paramount in preventing swim-related activities.


In 1971, trampoline injuries led to the NCAA eliminating the trampoline from sports competition. I’m sure it’s also why we don’t see this event in the Olympics. Trampoline injuries cause 80,000 emergency visits per year for children age 5 and younger. If you own a trampoline, do not allow a smaller child to be on a trampoline with a larger child, as the smaller one is 14 times more likely to be injured. In fact, one should follow the manufacturer’s recommendations and not allow more than one person on a trampoline at a time. Safety netting around the trampoline is essential to protect jumpers from injury. As with all the above activities, adult supervision is mandatory.

I hope you and your children have a fun, but safe, spring and summer.

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Over-the-counter cough and cold medications to alleviate cold symptoms in young children are being largely withdrawn from pharmacy shelves. This is because of unintentional misuse or overdose of these medications causing harm and, rarely, death, especially in children younger than 2.

These medications are frequently used in good faith, even though there is no scientific proof that these drugs are actually effective. This is a case in which the risks outweigh the benefits.

Health care providers are now asked not to advise the use of such drugs for children younger than 6. Some of the most common are PediaCare, Triaminic and Dimetapp.

I know this may sound discouraging when caring for a sick child, but there are useful non-drug treatments for cold and cough symptoms. Try the following, for example:

• Encourage the drinking of fluids to prevent dehydration and to help thin out mucus. Contrary to popular opinion, milk has not been proven to increase mucus formation.

• Control high fever or pain with either acetaminophen (Tylenol) or ibuprofen (Advil), giving doses once every six hours.

• Saline irrigation can be helpful for a congested or drippy nose. For infants, use rubber bulb suction to remove nasal secretions after applying saline nose drops or spray, or try sinus rinsing for older children.

• Use a cool-mist humidifier or vaporizer in the child’s room. To prevent contamination, the water inside should be replaced daily and the machine should be cleansed regularly according to the manufacturer’s recommendations. If possible, maintain indoor relative humidity between 40 percent and 50 percent.

• If a medication such as Tylenol or Advil is given, I do not advise the use of household kitchen spoons to measure doses of medication. Measuring devices that use units of milliliters (mLs,) usually are packaged with the medicine or can be obtained from a pharmacist.

• Honey can relieve coughs by increasing saliva, which coats the throat and relieves irritation. Suggested doses are half a teaspoon for children between 1 and 5 years, one teaspoon for children 6 to 11 years, and two teaspoons for children 12 and older. Do not give honey to a child younger than 1.

Sometimes, a visit to a doctor is called for. See your health care provider immediately for the following cases:

• A child younger than 2 months of age with any fever

• A child younger than 2 years of age with a fever lasting more than two or three days

• A child who complains of an earache or a severe sore throat

• Thick green nasal discharge that continues for more than seven to 10 days

• Mild symptoms that do not improve after 10 to 14 days

• A child who seems very ill to you

By the way, for children who have appropriately been prescribed antibiotics, I am frequently asked whether the drug needs to be refrigerated.

The two most commonly prescribed antibiotics — amoxicillin, which tastes like bubble gum or occasionally is fruit-flavored, and azithromycin (Zithromax), which has a cherry/vanilla/banana taste — can be kept at room temperature for up to 10 days. Refrigeration may improve the taste, but it isn’t needed to maintain potency.

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Pinkeye, medically known as conjunctivitis, is an inflammation or infection of the conjunctiva, the transparent thin tissue covering the surface of the eyeball and inner eyelids. This condition causes the affected eye or eyes to appear pink or even red because the tiny blood vessels on the surface of the eye become swollen, thus causing the pink color.

There are several causes of pinkeye. The most common form is caused by a virus infection that is often associated with a head cold. Virus pinkeye is highly contagious and passed on to others by direct contact with the patient and his or her secretions or with contaminated objects or surfaces. Patients usually report awakening in the morning with a crusty mucous in their eyes and perhaps a small amount of mucous during the daytime. One may have the sensation of grittiness, burning or just irritation. Usually both eyes are involved. Virus pinkeye will cure itself, so no treatment is necessary. Over-the-counter eye drops such as Naphcon-A may provide some relief from the symptoms. It has to run its course and is usually gone within one week but may take up to two weeks.

Another form of infectious pinkeye is caused by a bacterial infection. This is usually not associated with the common cold and is more common in children than in adults. It is also very contagious and is spread as mentioned above in virus pinkeye. Patients with this infection often have just one eye involved and it is usually “stuck shut” upon awakening. The affected eye or eyes usually produce a pus-like discharge throughout the entire day, which helps to differentiate it from virus pinkeye and only has mucous upon awakening. Bacterial pinkeye is treatable with prescription antibiotic eye drops, which will usually clear up the infection within a few days.

Another form of pinkeye is due to allergies. This is usually caused by airborne particles such as pollen or cat dander to which a person is allergic. A patient with this form of pinkeye usually has both eyes affected, has an itchy feeling and also can produce some crusting upon awakening. Prescription allergy eye drops from your doctor are available for more severe symptoms.

Contagiousness seems to be the greatest concern about pinkeye. As mentioned, the infectious varieties caused by either virus or bacteria are highly contagious from contact with the discharge from the eye. Children who are too young to understand the concepts of hygiene are the most contagious. That’s why it is so prevalent in preschool and kindergarten.

It is generally believed that a child who has been placed on antibiotic eye medicine can return to school after 24 hours of treatment. Although there is no scientific proof to support this concept, it does seem to work. My personal bias is that a person with infectious pinkeye is contagious as long as there is discharge from the eyes.

Practicing good hygiene is the best way of limiting the spread of pinkeye. Once you have symptoms of an infection, I suggest the following:

  • Don’t touch your eyes with your hands.
  • Wash your hands with soap and water thoroughly and frequently.
  • Don’t share towels or face cloths with anyone.
  • Change to new eye cosmetics, especially mascara.
  • Follow your eye doctor’s recommendation if you wear contact lenses.

If you have any of the following symptoms, see your doctor immediately:

  • Decreased vision
  • Sensitivity to bright light
  • Sensation of something painful in the eye.

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When students return to school, so does the issue of head lice.

These creatures have adapted quite well to societies throughout the world. Children are most commonly affected from interaction with other students, as well as the use of shared combs, headphones and beds.

Officially called Pediculosis capitis, this condition is second only to the common cold as the most common communicable illness in school children.

Lice are not dangerous and do not spread disease, and socioeconomic status is not a great factor in the occurrence of this condition. Girls are affected more commonly than boys, but hair length has not been reported as a factor.

The head louse is an insect between 3 and 4 millimeters in length, with a lifespan of about one month. The female deposits eggs in a sack, which is cemented firmly to the base of a hair follicle. These attached eggs, called nits, will hatch in eight days. They rapidly mature and soon begin feeding on blood through the scalp. They do not jump, fly or live on our pets.

The main symptom of lice infestation is an itchy scalp. The diagnosis is made by identifying the lice or nits, with the nits more visible than the actual lice. They are tan when they contain live eggs, white when they are empty. The back of the scalp above the neck is the most likely place to find evidence of head lice.

There are several ways to treat head lice. The most natural method is called wet combing, a welcome alternative to insecticides and the safest treatment for those younger than 2 years old. Combing is performed with a fine-tooth comb. The hair should be wet, with an added lubricant such as a hair conditioner or olive oil. Combing is done until no lice and nits are found. Repeated combing can be done every 3 or 4 days for several weeks.

For children older than 2, the most effective method for treating head lice is the use of topical insecticides. The most commonly used is Permethrin cream rinse (1 percent), sold over the counter by the name Nix. This is a relatively safe product when used as directed. The scalp should be shampooed, rinsed with water and towel-dried. Then Nix is applied and allowed to remain in the hair for 10 minutes before being washed out with water. A second treatment may be given in seven to 10 days if live lice (not nits alone) remain. Hair should still be combed to remove nits.

Washing contaminated clothing and bedding is also important. Lice can survive free from the scalp for up to two days, so vacuuming carpets and furniture is helpful.

The most common causes of ineffective treatment are not following through with the treatment and continued contact with others who are infested. Household members should be inspected and treated if necessary.

Our local schools have a “No Nits” policy, meaning that students remain out of school until all nits are gone from the scalp. This again demonstrates the importance of combing nits out of the hair.

Still, there is no need to panic about head lice. This condition can be cured with proper treatment and patience. If all your efforts seem in vain, see your health provider for more help.

At a glance
For an excellent Web site for more detailed information, especially regarding nit removal, visit http://www.doh.wa.gov/publicat/paperpubs/lice.htm.

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