How to Stop Your Baby’s Wheezing — and Prevent Asthma

Are you concerned when you hear your baby wheezing? You’re not alone. “Wheezing is very common in infants,” says Dr. Stanley J. Szefler, a pediatrician and the head of pediatric clinical pharmacology at National Jewish Health in Denver. “Almost one in three children has a wheezing episode at some time in early childhood.”

The good news: A new study published in Pediatric Allergy and Immunology has identified consistent risk factors for wheezing in infants — which means there are steps you can take to help prevent it.

Wheezing 101

Remember when you were a kid and you’d blow up a balloon, then squeeze the opening shut and let air out little by little to make funny noises? Think of that balloon as your baby’s lungs. Your baby’s airway is smaller in diameter than an adult’s, and it becomes even narrower when he has a cold. “The airway wall thickens and increases the resistance of air being moved in and out of the lungs,” explains Szefler. “The wheezing is the sound that you hear when he’s having trouble pushing air in and out of that narrowed passageway.”

Is It Asthma?

It’s true that wheezing is a classic asthma symptom. But don’t assume your baby suffers from asthma, which affects nearly 10 percent of children, according to the U.S. Centers for Disease Control and Prevention. Even a run-of-the-mill cold can cause wheezing sounds, and let’s face it: Your kid is a walking sniffle machine. His immune system hasn’t yet built up the antibodies necessary to fight off common viruses. Many infants who wheeze grow out of it as their immune system grows stronger and the airways get larger, so doctors advise against diagnosing children under age 4 with asthma.

However, keep in mind that even though wheezing does not necessarily indicate asthma, a baby who wheezes frequently is at higher risk for developing the condition. “About 50 percent of children who wheeze in early childhood will go on to have asthma,” says Szefler.

Prevent Wheezing

Researchers have identified three things you do take to keep your baby’s airways clear:

  1. Don’t smoke while you’re pregnant. In the Pediatric Allergy and Immunology study, smoking during pregnancy was linked to a 48 percent increased risk of recurrent wheezing in babies. “Some data suggests that maternal smoking may interfere with lung development. In fact, lung function is reduced in infants whose mother smoked in pregnancy,” says study author Dr. Luis Garcia-Marcos, professor of pediatrics and director of the Institute of Respiratory Health at the University of Murcia in Spain.
  2. Breast-feed. Other research has found that breast-feeding protects against various health conditions, including ear infections, sudden infant death syndrome (SIDS), asthma and diabetes. “Breast-feeding for three or more months was associated with a 20 percent decreased risk of recurrent wheezing compared to those who were breast-fed for a shorter period of time or not at all,” says Garcia-Marcos.
  3. Don’t send your child to day care too young. The study found that children who were in day care during the first year of life were 2.7 times more likely to experience recurrent wheezing. “Attending nursery school increases the chances of respiratory infections, which can trigger wheezing,” says Garcia-Marcos. The researchers also discovered that babies who suffered a cold in the first three months of life were about three times more likely than other babies to develop recurrent wheezing.

Treat Wheezing

Don’t panic if you notice your baby is wheezing. If he has a cold, it may be just a one-time episode. If the wheezing happens more than once and in the absence of a respiratory infection, then talk to your child’s pediatrician about an action plan. “The doctor may prescribe a medication … to prevent and/or relieve wheezing episodes,” says Szefler. Although the drugs prescribed are commonly used to treat asthma, doctors sometimes use them to help wheezing symptoms in young children, even before they’ve been diagnosed.



Moms and Dads: Why Stress Can Be Good For You

Stress has become a way of life in our 24-7 world — and with the holidays at our heels, it might seem like you’ll never get to relax again. Fortunately, there’s some good news: “Contrary to the widespread notion that stress is necessarily bad, short-term stressors enhance immune function and help the immune system respond more rapidly and effectively,” says Firdaus Dhabhar, a physician and the director of research at the Stanford Center on Stress and Health.

When you’re stressed, your body produces a hormone called cortisol, which triggers a fight-or-flight response by revving up your heart rate, blood pressure and blood sugar. When the stress lessens, your system returns to normal. Things get risky when stress becomes chronic — the kind of anxiety that never seems to go away. This can trigger inflammation and increase your risk of heart disease, obesity and depression.

Still, small doses of stress can actually improve your health. Check out these three surprising ways that small doses of stress can be good for you.

Surprise Benefit No. 1: Clearer thinking

The burst of nerves that you feel before you give a toast at a wedding or a presentation at the office has a silver lining: It could actually improve your memory.

In one study, researchers trained rats to complete a maze and then made half of them swim (to stress them out). When the rats were made to complete the maze again, “The animals that were forced to swim performed significantly better in the second maze test, suggesting that their working memory had improved,” says study author Eunice Y. Yuen, an assistant research professor at the State University of New York at Buffalo. “Cortisol enhances the transmission of certain chemicals in the prefrontal cortex, a key area in the brain that controls memory and executive function.”

Surprise Benefit No. 2: A stronger immune system

Feeling frazzled might bolster your immune system so that you’ll be primed to combat a cold or recover after an accident. To demonstrate exactly what happens to the immune system during a short period of stress, Dhabhar followed 57 patients undergoing knee surgery. “The body’s ‘soldiers’ (immune cells) leave their barracks and enter the blood stream. This mobilization of the body’s ‘army’ results in an increase in immune-cell numbers in the blood, sending the immune cells to potential ‘battle stations’ (skin and lymph nodes),” he explains. “Patients who experienced this immune cell redistribution induced by the acute, positive stress of the surgery showed enhanced recovery.”

In another study, Dhabhar and his colleagues subjected mice to stress for two and a half hours and discovered that the rodents activated more leukocytes — white blood cells that help the body fight infection and disease — than mice that were not stressed. In fact, just one session of acute stress increased certain types of leukocytes by 200 to 300 percent.

Surprise Benefit No. 3: Resilience

Experiencing (and conquering) stressful situations may give you the ability to thrive when challenges — from pesky traffic jams to company-wide layoffs — pop up. That’s what Salvatore R. Maddi, a psychology and social behavior professor at the University of California, Irvine, discovered through decades of research.

“Hardiness is the pattern of attitudes and skills that helps you transform stresses from potential disasters into growth opportunities,” he explains. In a landmark study in the 1970s and 1980s, Maddi followed executives who faced losing their jobs at a telephone company. “Those who addressed stress openly were the ones who not only survived, but also thrived. The managers who showed a pattern of denying and avoiding anxiety fell apart into mental and physical disorders,” says Maddi.

How to Maintain a Healthy Stress Level

So how can you determine whether the pressure you feel is boosting your health or undermining it? According to the American Psychological Association, red flags include frequent headaches, changes in sleeping and eating patterns, irritability, anxiety, and neck or back pain. Talk to your doctor if you’re experiencing the above, and try these four strategies to keep stress in check all season long:

  • Soothe yourself with scents. Buy scented candles, bath bubbles and shampoo. One study in the International Journal of Aromatherapy found that inhaling the scent of lavender for 10 minutes triggered an increase in blood flow and a decrease in systolic blood pressure — which translates to feelings of calmness and relaxation.
  • Plan ahead. “Anticipate the stresses of the holidays before they actually happen, and make a plan for solving the problems,” says Maddi. If last-minute gifts always drive you nuts, get an early jump on online shopping. If cooking dinner is too much after long days at work, stock your freezer with casseroles.
  • Spend time with your dog or cat. In one study in the journal Psychosomatic Medicine, people who had pets had lower heart rates and blood pressure levels. They also responded less to stress than those who didn’t have pets and recovered more quickly from stressful incidents when their fluffy friend was present.
  • Take a time-out. Take just five minutes a day to practice deep breathing or meditation. In one study from the University of California, Irvine, people who practiced meditation for 30 years showed a 40 to 50 percent lower response rate to stress than those who never tried it.



Twins – Celebrating One of Life’s Great Miracles

There can be no more joyous time than the moment of birth for an eager set of parents. The long awaited event has changed this couple during the short 9 months of conception, of which some of the changes are immediately reversible and some will endure. It has brought out the best (and sometimes the worst ) in people who naively thought that this was an easy accomplishment.

Imagine, if you will, the double enjoyment (or shock) of seeing two babies delivered at the same time and in the same place, and they are both yours. Yes folks, TWINS! Sometimes this blessed occurrence can be foreseen but many times it is a total surprise. Even without a family history of twins we all have heard of many couples delivering them without warning. Of course in this day and age the use of prenatal sonograms is very popular and therefore a true surprise at the time of delivery seldom happens.

A family history of twinning or using aids to conception (IVF, etc) raises the possibility of multiple births which is then incorporated into the pregnant psyche after a day or two of mild shock.

Such a blessed event happened to my daughter and her husband; all her babies were conceived through IVF. She already had a 2 year old boy when she found out about the twins. The delivery was smooth (easy for me to say!) and she had a beautiful boy and girl to add to the lineage.

Whether twins are fraternal, occurring from the fertilization of two separate eggs by two separate sperm, or identical, occurring from the fertilization of a single egg by a single sperm that then splits into two during very early conception, they will always maintain a bond that at times can border on the metaphysical. These identical twins really do share the same genetic structure, but even then there are significant differences easily seen by their parents. They develop their own language and means of communication, they easily comfort one and other, and at times can “feel” a similar sensation originating from the other twin who may be miles away. Don’t ask me how!

While there is such a close bond there is an immediate need to separate them in the parent’s minds… to think of each as individuals. They are not “they”; they are not “the twins”, they are very individual and unique persons with distinct and separate needs and feelings and should be seen as such and addressed as such. At times each one can act as a “control” in an observed occurrence as parents struggle to define what is normal and what is not, while direct and specific comparisons are not a good idea. In fact, scientific studies are done in twins because of similar genetic matter (more in identical), in which the age old question of nature versus nurture is approached.

Either way, these are very special children, born with an immediate friend to spend the early part of their life with and share experiences. When else does that happen except in marriage?

When to Keep a Sick Child Home

It’s cold and flu season, which means plenty of moms are facing that age-old parenting dilemma: Do I send my coughing, sniffly child to school? And if I make the wrong choice, will the school nurse call a few hours later asking me to take him back home?

Figuring out when to keep your child home from school and when he’s well enough to go back isn’t always easy, says Dr. Loraine Stern, associate clinical professor of pediatrics at UCLA School of Medicine in California.

“The truth is, you can’t always tell how sick a child really is,” says Stern. For instance, some kids may seem totally fine at breakfast but take a quick turn for the worse and end up very sick two hours later.

What to Do With a Flu

Of course, when it comes to such flu symptoms as high fever, vomiting and body aches, the answer is a no-brainer. “If your child is running a fever, you should keep her home because she’s not going to be able to sit at her desk and pay attention,” says Stern. This applies to seasonal flu as well as H1N1 virus (swine flu), she adds.

What to Do With a Cold

When your child has run-of-the-mill cold symptoms like a runny nose and cough, deciding whether to send or keep him home isn’t always cut and dry, says Stern. “Let’s face it, if you wait for children to have noses that are completely clear, they’re never going to go to school,” she says.

So, as long as your child doesn’t have a fever and is acting normal, it’s fine to send him to school with a minor cold. Even nasal discharge, as unpleasant as it may be, isn’t reason enough to keep a child home.

“Young children often have this at the end of a cold, and it’s perfectly normal and not contagious,” says Stern. “If the discharge goes on for seven to 10 days, it may be a sign of a sinus infection, but that’s not something that’s contagious either.”

On the other hand, a cough that’s bad enough to disturb other kids in the classroom is a good reason to keep a child home.

More Signs to Stay Home

Some signs to stay home are more clear-cut. For example, keep your child home if she has a highly contagious infection such as strep throat or conjunctivitis, says Stern. With strep throat, kids need to be on antibiotics for 24 hours before they can return to school. But with conjunctivitis (pinkeye), kids need only be under treatment, and they can go back to class. “That means the condition is getting better with medication but not necessarily cleared up yet,” says Stern.

Since ear infections are not contagious, there’s no reason to keep your child home when she has one, even if she’s taking antibiotics. “Yet the current thinking is that the majority of ear infections get better by themselves without antibiotics,” notes Stern.

Quick Reference Guide:

Here’s Stern’s cheat sheet on the do’s and don’ts of keeping a sick child home:

Keep your children home if they:

  • Have a fever.
  • Are unable to concentrate on schoolwork due to symptoms.
  • Have symptoms (such as diarrhea) that disrupt activities or distract classmates (such as a hacking cough).

Send your children to school if they:

  • Had a fever that has been gone for 24 hours.
  • Are alert and able to pay attention in class.
  • Don’t require a teacher to provide extra care.

And if you do have a sick child at home, try to see the silver lining. “Enjoy the time at home with him,” says Stern. “It’s a chance to do the kinds of things you don’t have a chance to do when everyone’s so busy — like curling up on the couch with your child in your lap and reading books together.”



Add low-cost therapy items to your special needs child’s gift list

Raising kids is expensive, but raising special needs kids can be VERY expensive. Holly Robinson Peete even cites that fact as one of the reasons she and her husband created their Holly Rod Foundation. As the holidays arrive you might want to give your special needs child a gift that doubles as a therapy item (or suggest the item to Grandma or Uncle Richie). As this article by special needs mom Marj Hatzell points out, many therapy items can be found for a lot less than in those medical catalogs.

As you look around for items to help your child with his or her challenges, think about the skills they need to practice. Last Christmas while my daughter was working on her fine motor skills I gave her a Disney Princess craft kit, which involved scrunching up colorful papers and sticking them to a pre-printed picture. She loved it and scrunched happily for a long time, blissfully unaware that she was building her hand strength and coordination. Another year I found a collapsible play tunnel and a balance board in the clearance section of sporting goods at Target. When one of my daughter’s therapists saw it she actually ran out to see if they had any more.

Hatzell has great ideas for creating your own therapy toys, too. She’s also a fan of the prices at Target, and also of IKEA. Find your local IKEA store.

Other financial resources for families with special needs kids:

PMD March 2005: Announcing the PedREST

In 2004 Pediatric Medical received notice that we were going to be granted our first patent – YEAH!!! We were finally ready to share our “creation” with the world

Our first opportunity came in March 2005 with something called the LifeSavers Conference. For those of you not familiar with it, Lifesavers is the premier national highway safety meeting in the United States dedicated to reducing the tragic toll of deaths and injuries on our nation’s roadways… The conference addresses a wide range of safety topics, from child passenger safety and occupant protection to roadway and vehicle safety and technology. It offers the latest information on advances in highway safety, highlights successful programs and draws attention to emerging safety issues.” It was to be held that year in North Carolina and seemed like the perfect place to “showcase” our new device. They even had a workshop scheduled on “transporting children on ambulances” being run by Dr. Marilyn Bull of Riley’s Children’s Hospital – well known for her work on ambulance safety. And for the icing on the cake – I had family in Charlotte – so I could attend the conference without having to rent a hotel room.

I made arrangements to attend the conference and not too long after drove to North Carolina for breakfast with my mother’s cousin and his girlfriend who worked for Britax (one of the most well-respected manufactures of child seats in the world – seriously what a coup)! Later that afternoon I met her over at the conference and she introduced me to the Britax folks in charge of new business development – who took one look at what we had and introduced us to SnugSeat – the company they partnered with to manufacture “specialty child seats”. Oh, and before I forget, while we were still at the Britax booth, some local EMS guys stopped by, saw our demo, and asked where they could get one. Can you say happy as a pig xxx xxxx??? (I’ll let you fill in the blanks)

Later that afternoon I attended the workshop on safe ambulance transport for kids. Unfortunately Dr Bull had been taken ill and could not attend herself – however her colleagues (Dr Judith Talty and Shayne Merritt) gave the presentation on her behalf. Their conclusion – which was no surprise to anyone, especially me – was that there really were no safe ways to transport little kids and that they hoped manufacturers would change this for the future.

At this point – totally “jazzed” – I waited until after the session and spoke with Dr Talty and Shayne. Both were floored by the PedREST presentation and asked me to please keep in touch and forward whatever I could to Dr Bull. Flying high I made the rounds of the other child seat manufacturers attending the conference (Graco, Evenflo, etc.) and finally, exhausted, headed for home.

5 days later I headed to Philadelphia for the EMS Today conference and there met with the top “players” in the EMS industry – Stryker, Ferno, Laerdal, Microtek Medical, Allied Health, etc. The response was tremendous, and the offers of encouragement and support, overwhelming! The PedREST was a hit!

Two weeks later, the following email arrived from Shayne Merritt:

Stephanie,

We will be passing this information on to Dr. Bull. In the meantime, if you have any photos or schematics that you could send for Dr. Bull, that would be helpful.

Your product is very intriguing and exciting since it’s success would fill an important need.

Shayne

As I look back on all of this, I can’t help but smile when I think about how on top of the world we were. The people we met…the welcome we received. I couldn’t have imagined a better way to start the next phase of our journey! Little did I know how much more of a journey lay ahead. To me, at that moment, the PedREST had officially arrived…

Until next time…