Expert Video: Dealing with Sleepwalking in Children

In this brief video, a neurologist and sleep expert describes common symptoms and triggers of sleepwalking – a nighttime activity that as many as 20% of children will engage in at some point. She also gives advice on how to manage your child’s sleepwalking behavior before bed and during the night.

 

Editor’s Note: Video Highlights

  • Sleepwalking-in-childrenAnyone can sleepwalk – any time between the first and second year of life to as late as in their 70s
  • It occurs usually in the first part of the night when we have most of our deep sleep – and occurs as you wake very abruptly from deep sleep
  • Stress is the most common trigger of sleepwalking, but can also be seen in kids who are not very good at letting go at bedtime and carry a lot of mental activity to bed with them
  • There can be other triggers, like needing to go to the bathroom – so make sure they go before bedtime
  • Don’t limit daytime naps in order to prevent nighttime sleepwalking – this can contribute to the problem
  • During an episode, make sure they are safe and lead them gently back into bed before waking them briefly

Child Health & Safety News Roundup: 02-16-2015 to 02-22-2015

twitter thumbWelcome to Pediatric Safety’s weekly “Child Health & Safety News Roundup”- a recap of the past week’s child health and safety news headlines from around the world. Each day we use Twitter and Facebook to communicate relevant and timely health and safety information to the parents, medical professionals and other caregivers who follow us. Occasionally we may miss something, but we think overall we’re doing a pretty good job of keeping you informed. But for our friends and colleagues not on Twitter or FB (or who are but may have missed something), we offer you a recap of the past week’s top 9 events & stories.

PedSafe Child Health & Safety Headline of the Week:
Amid Measles Outbreak, Few Rules Exist Concerning Teacher Vaccinations http://t.co/rYr7zNvnmk

High Levels of Stress/Depression with Incoming College Kids

Teenager Girl Worried And Crying OutdoorsThe annual snapshot of incoming college freshmen was recently published (“The American Freshman: National Norms Fall 2014” also covered in a New York Times article) and provides yet more data indicating that our teens are feeling high and increasing levels of stress and depression in the face of significant academic expectations and life challenges.

The survey, which has been run for nearly a half-century by an institute at UCLA, covers a wide range of issues and perspectives relevant to recent high school graduates. The most recent publication showed some concerning trends:

  • Only 50.7% indicated they had good emotional health – the lowest level ever recorded
  • Over a third of respondents (34.6%) “felt overwhelmed” by the many expectations placed on them – academic or otherwise
  • Nearly 10% of students reported frequently feeling depressed over the previous year – their senior year in high school – a much higher rate than reported just 5 years ago (6.1%)
    • This is a higher rate of depression than seen across the US generally
  • Additionally, students with disabilities or chronic diseases – such as ADHD, learning disabilities, diabetes or autoimmune conditions – report much higher rates of rates of depression (15.5% to 22.4%)

Why does this matter? Well, the report further demonstrated that students who had suffered from frequent bouts of depression were less likely to be engaged in school – more of them come late to class or fall asleep during lectures and fewer reported studying or working on projects with classmates – all behaviors that can lead to a negative spiral in school. Furthermore, suicide is the third leading cause of death for college-age students.

However, as a mother of a frequently overwhelmed and stressed-out seventh-grader, the real concern for me is how long have these kids been feeling this way – and what can we do to improve this?? My son often has so much homework that he skimps on sleep and becomes down and moody when under particular pressure. I’ve sometimes taken to forcing him to go to bed and hand assignments in late for easier classes, just to better juggle the workload. But I know the situation is only going to get worse as he advances to higher grades.

What are your concerns about the pressures on our youth – and what strategies are you trying to help address the issue? We’d love to hear from you!

Common Skin Conditions & Treatments for Kids and Adults

The facts behind five common skin problems and the treatments available.

Warts

Most people develop a wart at some stage in their life, usually by the age of 20.

What are they?

Warts are flesh-coloured lumps, which can be 1mm to more than 1cm across. Warts can appear anywhere, but usually affect the hands and feet. A wart on the foot is called a verruca (plantar wart*). Genital warts appear around the genitals or anus.

What causes warts?

They are caused by infection with the human papilloma virus (HPV), which can be passed on through skin-to-skin contact and sometimes through surfaces such as floors and towels. If you have a wart, you can spread it to other people through close contact. You can also spread it to other parts of your own body.

What’s the treatment?

Most warts go away by themselves, but this can take up to two years. Treatments include:

  • Over-the-counter creams and gels (not for use on genital warts) – ask your pharmacist which ones may be suitable for you
  • Prescription chemicals to be dabbed on to the wart
  • Cryotherapy (freezing), which should be carried out by a practitioner trained in cryotherapy
  • Surgery and laser treatment, but these are not commonly used

There is limited evidence that duct tape placed over the wart can be effective.

These treatments may be painful and the warts may come back.

Do I need to see a doctor?

See your GP (family doctor*) if the wart is bothering you, if you want your GP to treat it, or if treatments from the pharmacy have not worked. If you have genital warts, it’s important to go to your GP or a genitourinary medicine (GUM) clinic so you can be given appropriate treatment.

Find out more about treating warts.

Girl applying dermatology cream on skinImpetigo

Impetigo is common in babies and children, but can affect anyone. It usually develops on the face and hands. In babies it affects the nappy (diaper*) area.

What is it?

Impetigo is an infection in the skin. Small blisters appear and burst, leaving yellow, moist, itchy patches that dry to a crust. The skin underneath can be red and inflamed.

What causes impetigo?

It is caused by bacteria that enter the skin through a cut, scratch or damage from an existing skin condition, such as eczema. Impetigo can be spread by direct contact and sharing towels or bedding with someone who has it.

What’s the treatment?

Impetigo is likely to clear up by itself within three weeks. However, it’s very contagious, so antibiotic cream or tablets should be used to get rid of it quickly.

Do I need to see a doctor?

See your GP (family doctor*) for a diagnosis and to prescribe antibiotics. Most people are not contagious after 48 hours of treatment or once their sores have dried. It’s sensible for children not to go to school or nursery until they are no longer contagious.

Find out more about treatment for impetigo.

Read Marilyn’s story of her young son’s impetigo.

Psoriasis

Psoriasis affects 2% of people in the UK. It usually begins between the ages of 11 and 45. Psoriasis runs in families, and one-third of people with psoriasis have a close relative with the condition. Psoriasis is not infectious.

What is it?

Psoriasis causes flaky, red patches on the skin. They can look shiny and cause itching or burning. They can be anywhere, but are more common on elbows, knees and the lower back.

What causes psoriasis?

Some of the body’s antibodies attack skin cells by mistake, causing them to reproduce too quickly and build up on the skin. Certain things may make symptoms worse, including alcohol, smoking and some medicines, such as anti-inflammatories (for example, ibuprofen) and beta-blockers (used to treat heart problems). It is not passed on through close contact.

What’s the treatment?

Treatments to reduce the patches depend on their severity. They include:

  • Creams containing vitamin D or vitamin A
  • Steroid creams
  • Tar preparations
  • Exposing the skin to ultraviolet (UV) light
  • Medication taken by mouth or injection

Do I need to see a doctor?

Most people are treated by their GP (family doctor*), but some are referred to a dermatologist (skin specialist).

Find out more about treatment for psoriasis.

Read about Ray’s experience of psoriasis.

Ringworm

Ringworm is common in children, but can affect anyone. It appears on the head, body, groin, feet, nails or beard area.

What is it?

Ringworm is not a worm, but a number of fungal infections that grow in a patch or circle on the skin. It can be a few millimetres to a few centimetres across. The patches or circles look red or silvery and can blister and ooze.

What causes ringworm?

Fungal spores enter the skin through a break, such as a scratch or a patch of eczema. Ringworm can be passed on through direct contact and sharing items such as towels, bedding or combs. It can also be passed on from the floor of shower or swimming pool areas. Pets can pass it to people.

What’s the treatment?

Antifungal creams, powders or tablets, available from the pharmacy, can be effective.

Do I need to see a doctor?

See your GP (family doctor*) if you aren’t sure if it’s ringworm, or if the infection has not responded to pharmacy treatment after two weeks.

Find out about the symptoms of ringworm.

Vitiligo

One in 100 people in the UK develops vitiligo. It can occur at any age, but more than half of cases begin before the age of 20. It affects men and women of any skin colour. Vitiligo is not infectious.

What is it?

Vitiligo causes pale white patches on the skin. These patches can occur anywhere, but are more noticeable on areas that are exposed to sunlight, such as the face and hands, and on dark or tanned skin. On the scalp, vitiligo can cause hair to turn white. Patches can be small or large, stay the same size, or grow. Vitiligo cannot be passed on through close contact.

What causes vitiligo?

It is caused by a lack of melanocyte cells, which colour the skin. These cells can be missing because:

  • The immune system isn’t working properly and attacks them
  • The skin has come into contact with certain chemicals or has been severely sunburnt

Vitiligo is also linked to having an overactive thyroid gland (hyperthyroidism).

What’s the treatment?

Treatment aims to restore skin colour and control the spread of vitiligo. Treatment can include:

  • Steroid creams
  • Ultraviolet A (UVA) light
  • Disguising the patches with coloured creams, some of which are available on prescription

If vitiligo affects more than 50% of the skin, treatment may involve lightening the healthy skin using prescription creams. It’s important that this treatment is carried out under the supervision of a doctor.

Creams that you can buy without a prescription that claim to lighten skin can contain harmful chemicals, so don’t use them.

Find out more about the risks of skin lightening.

Do I need to see a doctor?

See your GP (family doctor*) to confirm the diagnosis and prescribe treatment.

Find out more about treatment for vitiligo.

Read Elena’s story of life with vitiligo.

Editor’s Note: * clarification provided for our U.S. audience

Child Health & Safety News Roundup: 02-09-2015 to 02-15-2015

twitter thumbWelcome to Pediatric Safety’s weekly “Child Health & Safety News Roundup”- a recap of the past week’s child health and safety news headlines from around the world. Each day we use Twitter and Facebook to communicate relevant and timely health and safety information to the parents, medical professionals and other caregivers who follow us. Occasionally we may miss something, but we think overall we’re doing a pretty good job of keeping you informed. But for our friends and colleagues not on Twitter or FB (or who are but may have missed something), we offer you a recap of the past week’s top 10 events & stories.

PedSafe Child Health & Safety Headline of the Week:
Bulky coats and child safety seats don’t mix http://t.co/ZRNGQiYJ1I

Children and Choking: Prevention and What to Do

Child CPR

the Heimlich maneuver

Recently, in the classes I have been teaching there has been an overwhelming amount of questions regarding choking in children and how to prevent it and what to do when it happens? With choking being one of the top 5 killers of children in the United States, there is never a bad time to cover choking in children and what we as parents and caregivers can do to prevent and deal with the situation.

Let’s face it, children choke on almost anything. If you have children or are a caregiver to children then you know that children love to put new things into their mouths and taste test everything and the younger the child, the more stuff they will put in there without any regard for what it might be. The questions of how to prevent choking in children has a lot to do with age. What I tell new parents or soon to be parents and grandparents are to go home. This may sound silly but home is where the battlefield is. I tell them to go home and see their home from a new perspective. We as adults see the world from very high up, our perspective tends to make us look down on most things in our homes. A small child or infant will see the home from an entirely different perspective looking up at most things in the home. So what I recommend to the adults is to go home and lie down on the floor in every room and see what an infant might see. It’s a whole new world down there with things like splinters under wood furniture, nail heads or staples sticking out, strings from fabrics, and the most important thing of all being that the infant or small child will find everything you have lost under all your furniture, including pills, paperclips, popcorn, you name it. So as I said before, go home and gain a child’s perspective on your home.

Preventing choking in older children has mainly to do with food and how it is prepared and eaten. We have all said “don’t stuff your face” or “chew your food “a thousand times, but the preparation is where we can make a significant difference. What I tell parents is to cut, cut and cut again. With foods like hot dogs, grapes, fruit and many other solid foods, cutting beforehand is the key. Other, lesser known culprits like popcorn, peanuts and even cereals can be broken down by simply putting them in a bag beforehand and crushing them a little bit to break them down.

What to do when the choking begins are the most important and the most frightening, but thinking is the key.

Baby CPRIf you have an infant that starts choking at home, the first step should be to bring the infant to you by taking them out of whatever apparatus they are in at the moment, highchair or bouncer for example. Secondly, you should scream for anyone you are with to call 911 and inform them of a choking infant, or you may have to bring baby to the phone and call 911 while relieving the choking yourself. Even if the choking was sudden and the event ends right away, at least help is on the way. The third thing should be to be seated and position the infant face down with the legs straddling your arm and your hand on the infants jaw, all while keeping the baby’s head pointed down in order to use gravity should anything come out or loose. You will use the palm of your free hand to strike down, but towards the head of the infant, between the shoulder blades 5 times. Then you will put your free hand on the back of the baby’s head and sandwich the baby and flip them over to your other leg and then place your two fingers between the baby’s nipples and do 5 chest compressions or chest thrusts. You will repeat this until the object is removed, the baby starts breathing, or the baby becomes unconscious.

Should the baby go unresponsive, lie the baby down on a hard, flat surface and begin cpr on the baby.

Choking for the older child is much the same as choking for an adult, just on a smaller scale. If you notice an older child that appears to be choking, you can ask them “are you choking? “ and if given confirmation that they are choking then you will kneel down behind the child, so you can be roughly the same height, and use the Heimlich maneuver, (see the picture at the top of the page) the same one you use on adults, to relieve the choking. If it is unsuccessful and the older child becomes unresponsive then lay the child down on a hard, flat surface and begin cpr.

The most important times in this event are the identification of choking, the sooner the better, and the call to 911, again the sooner the better. There are a million things anyone can choke on and our homes are where most of the action takes place so please take a little time and do some prevention work around our homes and as always, I recommend taking an official American Heart Association CPR class in your area that will cover the CPR and choking (click here to find a course) and give you ample practice time so you can be better prepared.

Thank you and be safe.