2 girls 1 cup

Should Siblings Share: a Thermometer and Their Germs?

November 14th, 2009

Q:  My 2 year old has a fever and we have a newborn in the house.  I am trying to keep them separated as much as possible but I need to take both of their temperatures.  Is it safe to share a rectal thermometer? I clean it with alcohol between each use, but should I have a new thermometer for the baby?

A:  Yikes! It is hard enough to juggle a two year old with a newborn, but to have your older daughter get sick is really challenging.  I have a couple of quick tips for you.

First, yes, you may absolutely use the same rectal thermometer for both children. Cleaning it between uses is wise.  Second, depending on the maturity of your two year old, you should be able to take her temperature under her arm.  The secret to this is holding the thermometer in her armpit until the “beep” and then adding  one degree to whatever you get  to equal a rectal reading.  This is some what inaccurate, but it gives you a good ballpark and is easy to do.  You can sit with your daughter while reading a story and quietly be taking her temperature at the same time. This trick certainly is better than pinning her down for a rectal temp! No two year old likes that at all!

To minimize the risk of spreading infection from one child to another , trying to keep the children apart –as you are already doing– is smart. Another point to remember is that, as you go from one child to the other, you take germs back and forth.  To cut down on this, try wearing a bathrobe (or man’s shirt) while you are with the baby. Leave it in the baby’s room. This way, you can cuddle your older child but protect the baby from her germs. Finally, there is no substitute for washing your face and hands when you go from one child to the next.

All of this requires attention and a lot of extra work when you are already tired with a newborn. But these simple tricks should help keep your family healthy.  Best of luck!  Before long, your girls will be well –and enjoying each other!

Dr. Hippo

Reference:

http://www.aap.org/publiced/BR_Fever.htm

 

 

 

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What to Do? Here Comes the Flu!

September 16th, 2009

There are two major points for parents as the flu season approaches across North America.

First, the AAP has changed its guidelines for the “regular” seasonal flu that we all have come to expect every winter. 

This year, the AAP recommends that ALL children over age six months be vaccinated against the flu. They say:  “Annual trivalent seasonal influenza immunization is recommended for all children aged 6 months to 18 years of age.”  Please check with your pediatrician about when this vaccine will be available in your area and how soon your children can receive it!

And second, the “new flu” or the “2009 H1N1” is already here!  As Anne Schuchat, MD, Director of the CDC’s National Center for Immunization and Respiratory Diseases writes, “The 2009 H1N1 influenza virus never went away this summer — it’s still around, and we need to pay attention… “

The news is full of stories about college campuses already hit hard with the H1N1 flu, but schools with younger children have already been affected, too.  “The most recent increase in 2009 H1N1 influenza activity appears to be centered in the southeastern states, including Georgia, Mississippi, Alabama, and Florida. On September 4, 24 primary and secondary schools in Georgia, Indiana, Missouri, and Tennessee announced that they had sent home a total of 25,000 students with flu-like illness thought to be caused by the H1N1 strain.”  I have no doubt that these numbers will climb steadily over the upcoming winter months!!

What can you do to protect your child? There are three answers here:

1.     Vaccinate your child when the vaccine against H1N1 flu becomes available. Just approved by the FDA, this vaccine may be ready as soon as three weeks from now. It is expected that one shot will be all that is needed, and the first available vaccines will go to health care workers, pregnant women, and children. It is reassuring that Kathleen Sebelius, U.S. Secretary of Health and Human Services, has said:  “We’ll get the vaccine out the door as fast as it rolls out the production line.” Keep an eye out at your pediatrician’s office about when the vaccine is ready!

2.     Remember that all flu is spread via respiratory droplet. Therefore, the basics of hygiene are critically important:

a.     Cover your mouth with your ELBOW when you sneeze or cough and teach your children to do the same.

b.    Use Kleenex to blow your nose and throw the used tissues away.

c.     Wash your hands before eating and when coming in from “the world”, ie the grocery store, the post office, preschool, etc.

d.  Avoid sick playdates if possible and don’t send your child to school if she is sick!

3.     Do NOT ask for or expect to be given antiviral medicine “just in case” you or your child gets sick.  If you have (or your child has) a chronic illness which puts you at special risk, please discuss the appropriate use of antiviral medicine with your doctor. Note that Dr. Schuchat has said:  “Antivirals are a critical part of our tool kit in countering influenza, both H1N1 and other strains. But a key point is that most children, adolescents, and adults do not need antiviral medication if they develop a flu-like illness. Giving these medications when they are not needed could actually make things worse by promoting viral resistance.”

I hope this helps and will update further as more news comes out.  Sneeze safely and stay well!

Dr. Hippo

References:

1. http://www.aap.org/advocacy/releases/may09swineflu.htm

2. http://www.medscape.com/viewarticle/708580?sssdmh=dm1.526904&src=nldne&uac=138131HG

3. Aap@smartbrief. com September 14th

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Swimming Safely: Life Jackets in a Swimming Pool?

July 28th, 2009

Q:  A Mom from Massachusetts has asked:  “My neighbors have a swimming pool. I would like to take my children there—ages 3 and 18 months—but I am reluctant to have them wear life jackets which is my neighbor’s rule.  Isn’t she being overprotective and ridiculous?”

A:  You are asking an excellent question about swimming safety, and you have a very smart neighbor!

Watching both swimming and non-swimming children near water is of enormous and potentially life-saving importance.  It is unfortunately taken casually in this country which is why we have so many drownings every year.  Perhaps two pearls will help you make understand your neighbor’s perspective.

First, drowning is silent.  Parents are so used to hearing their children cry when they are hurt (and needing adult help) that they often rely on their ears when “watching” their children.  But, with drowning, a child is unable to cry out for help.  Therefore, you need to really watch a child in the water all of the time.  Drowning is silent and drowning is fast.

Second, the more people at a pool or beach having fun together, the greater the risk of harm to small children.  Parents and older siblings watching the little ones can easily get distracted, and the littlest head can slip under water unnoticed. This is obviously tragic. “Neighborhood” pools are a place where lots of families may gather and where young children may be at special risk. It is the rare family that has a “toddler” pool—with no deep end—at their home; but even a “toddler’ pool can of course prove deadly. A small child near a pool needs to be in “touch” arm’s length away from a grown-up at all times.

Your neighbor’s insistence that your children wear life jackets in her pool is her way of making sure that they stay safe.  This is an excellent idea and one recommended by many pediatric practices: all children  inside pool enclosures should be watched continuously (no texting!) and non-swimming children should have life jackets on.  If they get old enough that this embarrasses them, then it is time to learn to swim!

Thanks for an excellent question in the middle of the summer.

Dr. Hippo

Resources: 1. http://www.aap.org/publiced/BR_WaterSafety.htm

                         2. http://www.aap.org/advocacy/releases/summertips.cfm

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The (H1N1) Flu and the WHO

July 14th, 2009

Q: From Maine: “What is the latest on the H1N1 flu?”

A:  Yesterday, the World Health Organization (or WHO) declared that the new H1N1 virus is “unstoppable” and suggested that drug companies all over the world begin to prepare vaccines for what is expected to be an especially bad flu season beginning in the fall.

According to Dr. Marie-Paule Kieny, WHO director of the Initiative for Vaccine Research, “all countries will need access to vaccine.” The WHO has recommended that health care workers be the first to be vaccinated so that they may take care of the sick without becoming ill themselves.  A functional health care system is critical to helping those who do get sick.

We learned last winter that the H1N1 flu affects an unusual group of patients.  Unlike “traditional” seasonal flu infections which affect the elderly and those with chronic illnesses most severely, the new H1N1 flu affects younger people–including healthy children– and healthy adults. Obesity also may put patients at special risk if they get the H1N1flu. Dr. Kieny stated: “Obesity has been observed to be one of the risk factors for more severe reaction to H1N1 — something never before seen…It is not clear if obese people may have undiagnosed health problems that make them susceptible, or if obesity in and of itself is a risk.”

The CDC estimates at least a million people are infected in the United States alone. The United States has documented 211 deaths and WHO counted 429 early last week.

Clearly, we will need to watch the news and keep our eyes out as the fall unfolds! It seems very likely that several vaccines will become available to address the expected H1N1outbreak. Check with your pediatrician and doctor to learn what their recommendations are.  Who should be vaccinated, and when? No one knows yet for sure, but I am confident that we will be advised as early in the flu season as possible about what to expect and what to do.  Stay tuned and stay well!

 Dr. Hippo

Reference:  AAP Smartbrief, July 14, 2009 (Cited Reuter’s article written by Maggie Fox)

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What Has Happened to H1N1: Has the Swine Flu Flown Away?

June 11th, 2009

 

The H1N1 Flu (or the swine flu) has faded from the daily papers. But it is still very much with us around the world!!

Recently, the AAP wrote that “ the World Health Organization… is close to declaring a phase 6 alert for the swine flu virus that so far has infected almost 19,000 people, including 117 deaths, in 64 countries. The agency is considering how to address concerns about the mass confusion and panic that could result from declaring a global pandemic. Meanwhile, an 11-week-old boy became the fifth person in New York City to die from the new flu strain.”  One of the many puzzling features of this flu is that—instead of the frail and elderly– it affects the young and healthy!

Keep your eye out for further developments during the summer. I suspect that the flu will quiet down now but re-emerge in the fall when typical flu season begins.  It will be important to learn whether a vaccine has been developed in time for the 2009/2010 winter flu season.

In the meantime, keep washing your hands when you come in from shopping or playing at the park (or whatever) and especially before eating.

Dr. Hippo

Reference:  AAP Smartbrief (6/7/09)

 

 

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The Swine Flu (or influenza A, H1N1): Fighting Fear with Facts

April 29th, 2009

Q: From a pregnant mother: “The swine flu is all over the news. What is it, and what can I do to keep my family healthy?”

A: The swine flu is a new influenza A, H1N1 virus strain never before known to exist. It combines elements of previously seen swine influenza, avian influenza and human influenza and appears to be unusual because it can pass directly from person to person like the human flu we are more used to.

People are worried because cases of this flu virus have been have been documented in 10 states and Mexico during the past week. In addition, swine influenza cases also have been reported in Canada, New Zealand, Spain, France and Israel. There is concern that it could spread rapidly throughout the world. This would be a “pandemic”.

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Turn Around Your Toddlers: The Latest in Car-Seat Safety

April 17th, 2009

Q: A Rhode Island Mom has wondered: “My daughter is 15 months old and hates her car seat because she hates facing backward.  When can she turn around?”

A: This is a well timed question because there is breaking news from the AAP as of this April!  They now recommend that all children younger than two years old be restrained in rear-facing carseats.  This recommendation has come about because of alarming new data:

  • Toddlers from 12-23 months who ride in a rear facing car seat are five times safer than children their age riding in forward facing seats.
  • Children under the age of 2 are 75% less likely to die or suffer serious injury (if involved in a car accident) if they are in rear facing car seats rather than facing forward ones.

This is probably a great opportunity to remind all parents that–as children move from infant, to  rear- facing convertible, and then finally to forward facing booster seats– there is one common denominator: keeping children safe within the car! Many parents let children “loose” after they outgrow their booster seats at about age 4.  Children of all ages–like adults–need to be buckled in!

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