Can “Man’s Best Friend” be Your Child’s Best Friend??

At the end of last month the headlines were about how a four year old girl was killed by a family dog. Last year there was a chilling story about a family dog that drug a newborn out of its crib- not even 24 hours after being brought home. No one knows why in either of these cases.

As a medic, I’ve seen more than my share of dog bite cases including one I will never, ever forget. Decades ago I was sent to transport a child across state to a teaching hospital for experimental surgery. The hope was that they would be able to create a new face for her to replace the one that the family dog chewed off. The father killed the dog on the spot. This did not end well for either human or canine.

I have six dogs so please don’t get me wrong. I’m not one of those anti-dog people. I love dogs and have had them my entire life. Dogs and kids belong together – responsibly. Just like kids and pools, kids and bikes and kids and the internet -responsibly with parental supervision.

Here are some of my tips for a long healthy kid-pet relationship.

• If someone (like an adoption professional) says your child and the pet you are interested in are not a good match- listen.
• Learn about the dog breed you are interested in adopting. Some dogs for example are bred to herd animals- by nipping. Some dogs are just too big and may even pose a suffocation hazard to babies.
• Socialize your dog to people of all ages and other pets soon and often.
• Correct (with compassion) unwanted behavior. Dogs aren’t psychic they must be taught what is acceptable.
• You would never leave your baby alone in a bathtub- don’t leave your baby alone with your pet either.
• Teach your children and dogs how to interact safely.

Remember those very cute Easter Bunnies? They often like to nibble. Cats have been found in babies cribs blamed for infant deaths- accused of ‘stealing the baby’s breath.’

My life has been so much richer and fuller from having pets in my life. Some of my fondest memories are of my dogs (and yes my children too). Our pets and our children both are depending on us to assure a long, safe and happy relationship.

Parents: How to Use Antibiotics Safely and Wisely

Since the first discovery of penicillin, antibiotics have been a useful and beneficial tool in fighting a wide variety of bacterial infections. But antibiotics must be used wisely and safely and only used when medically necessary in order to get the most benefit from them. For the last decade or more, health care professionals have been concerned because antibiotics have been over-prescribed, overused and misused for so long that many of them are losing their ability to fight illnesses. Many types of bacteria have already become resistant to some of the older “first-generation” antibiotics making them almost useless against some illnesses. New antibiotics are being developed but bacteria can adapt and become resistant to them to them too, if they are not used carefully. Doctors are trying to their part to stop antibiotics from being overused by not prescribing them unnecessarily. We can help, too, by learning more about these “miracle drugs” and how to use them properly and safely.

What Do Antibiotics Do?

Antibiotics fight bacteria. (Think of them as “bacteria-busters”!) There are many different kinds of bacteria that cause many different illnesses. Because of the wide variety of bacteria, there is also a wide variety of antibiotics that have been developed to treat them. When your doctor diagnoses a bacterial infection she will determine which antibiotic is appropriate for that particular infection.

If your doctor diagnoses a bacterial infection, ask her if it is absolutely necessary to use an antibiotic. Some bacterial infections can be cleared up without antibiotics when under a doctor’s supervision. For example, antibiotics used to be routinely and automatically prescribed for ear infections in young children. However, research has shown that many of these infections can heal on their own without antibiotics as long as a doctor is monitoring the infection. Talk with your doctor about the necessity of using an antibiotic, the pro’s and con’s of using one versus not using it, then follow her advice and directions.

Not all infections are bacterial. Most common, minor illnesses are caused by viruses. Viral and bacterial infections may share some of the same symptoms but they are very different infections and must be treated differently. If your doctor diagnoses a viral infection, it is unwise to pressure her into giving you a prescription for an antibiotic because antibiotics are useless against viruses. It would be a waste of money and would contribute to the problem of resistant bacteria due to antibiotic misuse.

When You or Your child is Prescribed an Antibiotic

The questions that you need to ask your doctor include:

• The name of the medicine (both brand name and generic name)
• The amount to be given (dosage)
• The times to be given (schedule)
• Possible side effects
• Potential drug interactions with any other medicine you are taking
• When to call or come back in if symptoms have not improved

Be sure that the doctor is aware of any other medications (including over-the-counter medications and herbal supplements) that are being used. If the antibiotic is for your child, ask about the taste and if it can be mixed with juice or food to disguise a bad taste. (We have been blessed with a pediatrician who tastes tests medicines so he can be honest with his patients about whether they are yucky or not. And if he has a choice of what to prescribe, he gives them the best tasting one.)

When You Go to the Pharmacy

Ask the pharmacist to give you written instructions on:

• When to take the medicine (schedule)
• How long you need to take it for (most of the time you will continue until all of the antibiotic is gone)
• How much to take (dosage)
• Side effects

Also ask whether or not the medicine:

• Can be taken with or without food
• Needs to be refrigerated
• Needs to be shaken well (if a liquid)
• Can be mixed with food or liquid to disguise a bad taste

Make sure the name of the medicine and the amount and times to be given on the label match what your doctor told you. Liquid medications need to be measured precisely, ask for a measuring device if you don’t have one. If other medications/supplements are being used, tell the pharmacist and ask about drug interactions. Some medications can be dangerous when mixed.

Taking or Giving the Antibiotic at Home

When giving or taking the antibiotic at home, make sure to stick as closely as possible to the scheduled times. If a dose is missed, do not double dose. If it is almost time for the next dose, then do not take the skipped dose, just take the next one on time. If it is still a few hours until the next dose, take the skipped one and then adjust the time to take the next one accordingly. If two or more doses have been skipped, call your doctor for instructions. Always call the doctor or pharmacist if you have questions.

Be sure to use a medication measuring cup, dropper, or oral syringe for liquid medications. Kitchen teaspoons and tablespoons can vary widely so don’t use them to measure medicine. (I wonder how many times we got the wrong dose when our moms gave us medicine using kitchen spoons?) Do not cut pills in half or crush them unless you have been told to or have checked with the pharmacist first because it could alter the effectiveness. Do not mix the antibiotic with juice, milk, or anything else to make it taste better unless the pharmacist says that it is okay to do so because certain antibiotics have to be taken on an empty stomach. Also, calcium and vitamin C can lessen the effectiveness of some antibiotics.

Always finish all of the prescribed antibiotic unless the doctor has instructed otherwise. Just because the symptoms may be alleviated after a few doses and you feel better, it does not mean that the infection is completely gone. Not finishing an antibiotic allows the remaining bacteria to learn how to adapt to the antibiotic and become resistant against it.

Side Effects

Common side effects of most antibiotics include: mild diarrhea, nausea, abdominal discomfort, and headaches. All antibiotics have the potential for side effects but that does not mean that every person will have the same ones. Most of the time, side effects are mild. If you have side effects that are moderate to severe, contact your doctor or pharmacist. Don’t stop using the medication without checking first. If your doctor instructs you to stop taking the medicine before it is finished, throw out the remaining amount. Do not save it for another illness.

Storing Antibiotics

Keep antibiotics (and, of course, all other medications) out of the reach of children. Put them in a cool, dry, dark, safe place or if it needs refrigeration, put it on the highest refrigerator shelf. Bathroom medicine cabinets are exposed to too much humidity which can lessen the effectiveness of some antibiotics.

If you have leftover antibiotics in your medicine cabinet, do not use them. Using or giving an antibiotic to one person that has been prescribed for another person can be very dangerous, even life-threatening. You would not have a full course of treatment and the antibiotic may not even be effective against the specific bacteria causing your illness. Instead, ask your pharmacist how to properly dispose of any leftover antibiotic. Do not throw any medicine in the trash because small children and pets could have access to them there.

When All the Medicine is Gone

Hopefully you will be feeling much better by the time you have finished all of your antibiotic. If, however, your symptoms haven’t cleared up and you are still feeling sick, call your doctor. She may want you to come back in for a re-check visit or she may call in a different, stronger antibiotic for you.

These guidelines are of a general nature and not intended to replace the advice and supervision of your physician or pharmacist.

Biting!!

Your beloved child is in a school situation for the first time and you’re just as proud as can be that there were no major hitches and life goes on in a relatively uncomplicated manner. You’ve received good reports from his/her teachers and you have looked over the Picasso-like paintings and drawings he/she has faithfully brought home to you. Life is good!

Just then word reaches you. He/she has done what??? Did you say bite someone in the class? You ask with incredulity. That just can’t be, not our little baby; it has never happened at home… unless you count the time he/she bit the dog’s tail and received a growl as a reward and warning at the same time. But there it was just wagging in his/her little face, and what’s a little person going to do, commands to the pet do not even work when the adults try to enforce Rover’s poor manners. A bite seems to get a lot of attention from the pet and parents alike- seems like a good plan!

In fact, biting another individual does indeed get a lot of attention and a certain amount of infantile pleasure at having the capacity and strength to cause such an immediate reaction. Gee, just can’t think of anything that works better; of course a dirty diaper can get a similar reaction but not as dramatic, and when you consider the discomfort of sitting in that mess for a period of time before it is noticed, it sure isn’t the best method. So, call it readily accessible weapons, or the need for immediate gratification, but your child has found out the age old secret and is trying it on some unsuspecting child of his or her approximate size and strength.

OK, that’s the facts, now what can you do about it? Well, the first thing is not to bite back- we would expect that of the dog but not of a parent. After all if he/she urinated on you just after dressing for the day would you turn around and reciprocate? Of course not so we need to develop a method that is civilized, explanatory, and requires some punishment if it persists.

First of all, I’ve found that you need to catch the child in the act, but if my experience holds true, the little devil will attempt this at home at some point. There are no studies to support my method of dealing with this issue except the good responses I receive from parents who are only too happy to stop this habit- FAST! There must be an immediate loud, forceful verbal “NO” (which it is almost impossible to suppress) followed in short order by a light flick to the side of the lips/mouth with one of your fingers. I’ve found this to be shocking enough for an immediate release to occur, but not forceful enough to cause any local damage. Your child will get the picture fairly quickly that this behavior is certainly something that should not and will not be repeated. Stick with it parents, it won’t take long and the problem will be gone.

Pediatric Safety Announcement

Please join us in welcoming pediatrician Dr Joseph Skoloff to the PedSafe Expert Team!

Hollywood shows us a family dealing with Aspergers on Parenthood

Tuesday night I got to watch NBC’s Parenthood, based on the Ron Howard film of the same name. With a cast of wonderful actors the show examines the intertwined lives of of one family and airs on Tuesday nights at 10pm. In last night’s episode one of the adult siblings learns that his son Max has Aspergers Syndrome. While the show will not give you any new information on the disorder it is a wonderful window into how the boy’s behavior affects his family. His older sister seems a bit jealous of all the attention he gets, yet she is the one who knows how to best manage him. His father wrestles to understand that this is a permanent condition and that he can’t just be “cured.” His mother seems to be preparing for what she knows will be a long, hard road. His uncle uses it as an excuse to juggle girlfriends.

The episode mentions some treatment options and therapies when the overwhelmed parents visit another couple with an Aspergers child and pokes fun at how hard it can be to get in to see some specialists. To watch the episode go here. Next week’s episode will feature some of the issues Max has with school.

Kid-Safe Your Backyard

The warmer weather is coming, and you’ll soon be preparing to transform your backyard into a summer playground. To keep the kids safe, follow these childproofing guidelines to cut back on the hidden hazards in your backyard and to make your summer play zone a safe place to be.

• Carefully inspect your playground equipment. According to the National Program for Playground Safety over 200,000 children per year are injured on playgrounds. Since most of these injuries are a result of falls, be sure that you have a proper shock absorbing surface underneath your play set. 12 inches of sand, mulch or rubber matting will offer your kids the best protection. You’ll also want to be sure that your play set is properly anchored to the ground, that surfaces are smooth, that protruding bolts are repaired and that all “S” shaped hooks are fully closed. Check your slide for any sharp edges and be sure that there is a clear exit area for sliders.
• Think twice about trampolines. If the nearly 250,000 trampoline injuries reported each year (according to the American Association of Orthopedic Surgeons) has not convinced you to steer clear of this backyard accessory, if you opt to purchase a trampoline for your kids, be sure it is a spring-less model that has a full safety enclosure. Since a majority of trampoline injuries occur from children colliding with other jumpers, it’s vitally important to continuously supervise your kids at play.
• Sandbox safety. If your sandbox is built directly on the ground, be sure to line it with landscape fabric to prevent weeds from growing up and to facilitate water drainage. You’ll also want to fill your sandbox with “sandbox sand.” Sold at home improvement stores, sandbox sand is smoother and cleaner than regular sand. You’ll also need to invest in a cover to keep pets and rodents (and their droppings!) out. Place a 5 gallon bucket upside down in your sandbox and properly secure a plastic tarp onto the sandbox. The bucket will prevent water from pooling on the top of the tarp which can be a safety issue for your kids and a breeding ground for bugs.
• Landscape Supplies and Equipment. Your kids are naturally curious and won’t hesitate to explore. Be sure all power equipment and lawn treatment products are stored and secured in a locked shed.
• Decks. Be sure to measure the space between the railing slots on your deck. If they are wide enough for your kids to trap a limb, utilize safety netting. You’ll also want to be sure a hard mounted gate is attached to the top and bottom of the stairs.
• Pools. Be sure your pool is properly barricaded. Install a fence that is at least 4 feet tall and be sure that there are no weak areas that your kids can squeeze through. Be sure the gate has a self-locking mechanism that your kids can’t open. You may also want to invest in a gate or pool alarm that will alert you if the gate has been opened or if someone falls into the pool. Remove steps and ladders when the pool isn’t in use (and keep step stools and ladders away from all fences). Never leave the cover halfway on your pool, as your child could swim under and become stuck. If your patio door leads directly to the pool, lock and alarm it. Inflatable pools should be drained, deflated and stored and secured when not in use.
• Check fences. Check your fence for loose hardware, splinters and missing slats. Be sure pickets are less than 5 inches apart and that there are no sharp edges for your kids to get caught on.
• Outdoor furniture. Be sure your outdoor seating is sturdy and safe. Secure garden swings properly to the ground and check to ensure cushions are securely fastened to seating.
• Koi Ponds. Fish ponds pose a special backyard hazard for children as their shallow depth can give parents, children and caregivers a false sense of security. Be sure pools of water of any depth are properly barricaded to prevent unauthorized access.
• Outdoor Outlets. Replace outdoor outlets with childproof outlets that your kids can’t open.
• BBQ’s and Grills. When not in use, store and secure grilling equipment. Propane tanks, matches, lighter fluid and sharp cooking utensils should all be inaccessible to your kids. When in use, never leave the cooking area unsupervised and be sure that the unit it cooled completely before storing away.
• Clothing. Require your kids to wear proper footwear and snug fit clothing when playing outdoors. Avoid articles of clothing with drawstrings or accessories that can easily become caught on play equipment.
• Establish Clear Boundaries and Rules. Having a list of backyard rules can help guide your kids in safe play. Establish any areas that are off limits, rules for riders on slides, trampolines and other play toys and safety guidelines for using play equipment.

While childproofing your backyard can help eliminate common safety hazards and create a safer environment for your children to play in, even the best safety measures do not substitute for parental supervision.