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Kids and Animal Bites – a Pediatrician’s Perspective

little boy and catAnimal bites are very common, particularly in young children due to their inquisitive nature.

The smaller the child is the more likely are the bites liable to be on the head and or neck – the most common place is however on the hands and arms. The most common bites are from our domesticated animals, cats and dogs. While a family pet is a good thing for teaching responsibility, a healthy dose of respect for other families’ pets should also be taught as not all pets are as friendly as yours, especially with strangers.

Children should be taught to approach other pets carefully and always from the front, offering a hand for the animal to smell first before touching. Wild animals are another issue entirely and it is best to be very conservative and teach your child to never go near a wild animal, no matter how “cute and cuddly” it looks. If your child comes in proximity with a wild animal that has been “domesticated” by ownership, the same should apply. More and more now there are increasing limits on the type of wild animals allowed to be kept as pets.

Let’s get back to cats and dogs.

A dog bite can be quite severe as dogs will grab and hold on to an arm or leg and toss their heads back and forth in an effort to subdue an “enemy”. If a dog unknown to you bites your child, and after seeking the care for the injury, you should contact your local health department as that animal will need to be investigated and sometimes placed under surveillance for several weeks. Your own pets should be vaccinated by your vet as recommended by authorities. Some dog bites, if severe enough, can be sutured closed but this must be done carefully and sometimes left open to avoid infection.

Cat bites while usually not as severe as dog bites, stand a greater chance of becoming infected as these are usually more of a puncture wound quality making infection a higher risk.

Contact your Doctor immediately should any bite occur for further information, but please teach your children the do’s and don’ts of approaching animals of all kinds.

Can Your Child Recognize a Rip Current?

The summer I turned 12 I visited my cousins in California. Boogie-boarding in the surf at Santa Monica I had a real scare. A rogue wave flattened me and started dragging me out to sea. 36 years later I can vividly remember the sensation of being in a washing machine, being churned around with the sand scraping against my back and stomach as I was dragged out to sea. The combination of panic and being under water for so long robbed me of the last of my oxygen as I desperately fought to get a foot hold on solid ground. Finally my feet connected with the ocean floor and I stood up – knee deep in water.

I felt foolish, never told my cousins or my aunt. I mean, it’s hard enough being 12, but almost drowning in under 2 feet of water? But I didn’t know. I didn’t understand how to read the ocean and I didn’t know what to do if the water behaved differently than in my local pool and Lake Michigan is a different story from the Pacific Ocean, although just as dangerous if you don’t know what to look for.

When I look at the primary misleading signals that water can give, rip tides or rip currents is probably one of the scariest and least understood, but understanding them prepares you for other events, such as the occasional rogue wave.

I’ll defer to the experts for all the information on rip current, but the most important thing that you need to know, and what you need to teach your children, is how to recognize a rip current, and how to escape if you do get caught.

  • First, a rip current is a strip of deceptively calm water. On either side you’ll see choppy waves, but the rip current is enticingly, beckoningly smooth. That’s the water heading out at a rate faster than an Olympic swimmer can paddle. So, first step, survey the water, and if you see a flat patch, avoid it.
  • Second, if you do get caught, don’t try to fight the water, you’ll never win. Swim slowly and steadily sideways, parallel with the shore. You will either be able to eventually leave the rip current or it will spit you out at the end of the rip current and you just need to swim back to shore.

Ideally you have also chosen to swim near a lifeguard and have checked out any signs warning of rip current or dangerous surf, but since water doesn’t always abide by the rules, it’s best to understand how water acts.

Of course the most important message is ‘don’t panic’, but it’s a lot easier to keep yourself, or your child from panicking if they understand what is happening to them, and go with the water instead of fighting it. I think Dora said it best in Finding Nemo, ‘Just keep swimming….just keep swimming’.

6 Layers of Protection That Keep Your Child Safe Around Water

Last updated on December 11th, 2021 at 09:33 pm

How many layers of protection does the child in this photo have? Coat to prevent against the elements? Check. Securely buckled into an approved car seat? Check. Extra blanket for warmth? Check. A car that has passed stringent safety tests? Check. But the most important layer is the one you can’t see – he is constantly being taught to always buckle up when he is going in a car – by your actions and possibly by your words. We can make our children’s environment safe by using car seats, safety belts, airbags and cars with good crash-test ratings, but unless we teach a child why those things exist and how to use them, we are only doing half the job of protecting them in the future.

‘Layers of protection’ is the buzzword of choice for drowning prevention. It makes sense for exactly the same reasons we teach children to buckle up. Young children are learning self-control and cause-and-effect – our job is to keep them safe while they are learning, but also to teach them how to be safe, and why, at the same time.

To keep your child safe around water, here are the basic layers of protection you need.

  1. Never leave a child unattended in the bathtub. Personally my rule-of-thumb is that they must excel on a swim team or choose to shower instead of bathe before this rule ends.
  2. If you have a pool, fence the pool. Not the yard, the pool. Look at installing self-closing gates, door alarms and pool alarms as an added layer of protection. Safety Turtle is a great portable choice for holidays and trips to Grandma’s.
  3. Always watch your child near water. Assign an adult to be a ‘Water Watcher’ for 10 minutes, give them a whistle, badge or a sign to hold to remind them that their only job is watching the kids, then rotate so that no one loses focus or misses out on the adult fun.
  4. Empty and turn over buckets, wading pools and anything else that can collect water. Think about covering any ornamental pools or bird baths while your children are under five.
  5. Learn CPR, because drowning happens in under 2 minutes in under 2 inches of water. Accidents do happen. Your local Red Cross or Park District will have classes.
  6. The most important layer though is teaching your child how to be safe around water. Talk to them about why there are fences, why you are watching them, why they need an adult around whenever they are near water – back up your actions with explanations. There is a book about water safety that young children (under 5) love, that can help you with this conversation. It’s called ‘Jabari Makes A Splash’.

With everyone of these actions you are sending two positive messages that will keep your child safe their whole life: Water is fun and you need to act responsibly and safely around water.

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Jabari, which means “brave” in Swahili, is a cute and lovable lion cub. Like most young children, he’s energetic, enthusiastic, curious, and sometimes even a bit mischievous. But Jabari always wants to do the right thing. Children will easily relate to him and want to emulate his positive behavior. Through Jabari’s stories and adventures, children will learn how to be safe in the water. And parents will learn the biggest lesson of all: Always watch your children while they’re in the water. ‘Jabari Makes A Splash’ is available on Amazon.com.

Sunburns and Children: Focus on Prevention

Last updated on July 17th, 2021 at 09:21 pm

Summer vacations are creeping up fast, and if you’re anything like my family, that means heading to the beach. We love the beach. Love days spent relaxing on blankets, digging in the sand, discovering hidden treasures, and being soothed by the sound of the surf.

Beach days, however, need not be synonymous with sunburns. Summer safety is important and sunburns can cause long-lasting damage to the skin and children are especially at risk. All it takes is for a child to have one blistering sunburn in his/her childhood or adolescence to more than double their chance of developing melanoma.

So when it comes to sunburns, we must focus on prevention.

Here are a few summer safety tips to Prevent Sunburns:

  • Think of a sun protection package that includes: light clothing that covers arms and legs, sun protective bathing suits, wide-brimmed hats, sunglasses, shade, and sunscreen.
  • Choose a sunscreen with both UVA and UVB protection. It should have an SPF of at least 15 (more than 45 is overkill). Reapply sunscreen every two hours.
  • Realize that the sun’s rays are most powerful and most damaging between the hours of 10 am to 4 pm.
  • Babies less than 6 months old should be kept out of direct sunlight. Seek shade for baby and keep him covered up. Apply sunscreen sparingly to exposed areas (i.e. cheeks and nose).
  • Check the safety of your sunscreen at the Environmental Working Group website. In general, opt for PABA free and choose a sunscreen with physical sun blockers (zinc oxide and titanium dioxide) versus chemical blockers (like retinyl palmitate or oxybenzone).
  • Remember to apply sunscreen and the rest of your sun protective package even on foggy days!

Recognizing a Sunburn:

  • Signs of sunburn begin to show 6-12 hours after exposure.
  • Skin will appear red, warm, and likely will be painful to touch.
  • The height of discomfort occurs within the first 24 hours.
  • Severe sunburns may blister.
  • A child could also appear ill: fever, headache, and dehydration. If this is the case, your child needs to be seen by a doctor immediately.

Treatment of Sunburns:

  • Soothe skin with a cool compress and/or a cool bath. Pat skin dry.
  • Apply water-based lotions. Aloe is okay but avoid lotions containing alcohol.
  • Dress in loose and light clothing.
  • Offer plenty of fluids to avoid dehydration.
  • Do not use first aid sprays or medicated creams on the skin.
  • Keep in mind that peeling of the skin is part of the healing process.
  • For babies less than 1-year-old, any sunburn should be evaluated by a doctor.

By all means, go and enjoy those lazy summer beach days, just remember to protect your child’s skin and prevent sunburns from happening. Make sun safety a rule, not just an option, for your whole family. That means you parents, you are just as important as your children.

Keeping Kids Safe: Common (& Not So Common) Choking Hazards

Last updated on December 20th, 2020 at 04:09 pm

Keeping kids safe is top on the minds of most parents, but sometimes hazards are just not that obvious. Introducing foods to infants and toddlers can be great fun, but it also brings opportunities for danger. A little knowledge about how to avoid choking can go a long way in avoiding serious emergencies.

I wrote in a previous post about using pixie stix to get kids to take their medicine. I am going to co-opt this old favorite treat for our lesson about choking hazards. What does a powdered candy have to do with choking hazards, you might ask?

The text and photo from this blog demonstrates that kids can make nearly anything into a choking hazard:

pixie_stix

“Looks like fun, right? Probably. But a tube of powdered candy of that size might as well be a loaded gun. It’s frickin dangerous. I know.

When I was thirteen and tried putting the whole mega-Pixie Stick worth of flavored sugar in my mouth, I laughed and inhaled and the moisture in my throat hardened the sugar into a moist sugar ball lodged squarely in my trachea.

One my friends knew the Heimlich maneuver and managed to dislodge the bright blue coagulation into a psychedelic pool of vibrantly scarlet regurgitated Big Red Cola. It was the [last] time I touched either Pixie Stix or Big Red.

It wasn’t my time but I think, when I’m ready, that is exactly how I want to go.”

I love this post for several reasons…

  1. This photo is a pediatrician’s nightmare.
  2. That someone could avoid impaling himself with the sharp plastic tube but instead manage to obstruct his trachea with powdered candy is a mark of real talent. It’s amazing that we have any children left unharmed.
  3. I love the word “frickin” and will try to use it as often as possible in this blog and in my real life. Not to worry, I will avoid using it around kids.
  4. Speaking of near-death-by-food, I almost poked my eye out with a loaf of bread once. That story will probably never make it into this blog, so contact me directly if you’re interested. It is as embarrassing as it sounds….
  5. Though the Olympics was more than a year ago, swimming boys still make me think of Michael Phelps. I love Michael Phelps. I’m not the only one.

Seriously though, while pixie stix are not usually cited as top choking hazards, choking is a real hazard for children, and food is the number one culprit.

It’s amazing what a mostly-toothless little one can manage to eat. Starting at about 9 months of age, babies can begin to manage foods of a variety of textures and shapes. But remember, kids less than 4 years old may not chew, grind, or gum food well and are at great risk for choking. The most common choking hazards are round firm foods (hot dogs, grapes, nuts, popcorn), and sticky/gooey foods like peanut butter or sticky snacks and candies. Chunks of uncooked vegetables and fruits can also make their way down the wrong tube. Candy and gum top the list of foods that send choking children to the emergency room.

Tips for Parents:

How can you prevent choking? Here are a few tips…

  • Take an infant and child CPR class: if you did not take one before your child was born, try to do so by 6 months of age, before your little one starts solids. If you have taken the class, review the course materials as a little refresher.
  • To avert the need to perform these life-saving maneuvers on your child, avoid potentially hazardous food until your child is four to five years old. Cook foods well or cut firm foods into pieces less than 1/2 inch in size.
  • Give your child small portions, adding to his plate as he finishes.
  • Make (and enforce) a household rule that all food is eaten at the table. In a chair. And no eating while running (with scissors). Or playing. Or lying down. Or in a car (or a bus or a taxicab or hot air balloon).
  • Limit distractions (tv, pets, games, clowns) at mealtime.
  • Watch out for “chipmunking”: hoarding food in the cheeks of an eager eater. Kids really do this.
  • Keep helpful older sibs from feeding the little one. They will not provide the same level of supervision that you will.
  • And most importantly, NEVER leave a young child alone while eating.

Useful Links:

First Aid Basics Every Parent Should Know

Last updated on November 8th, 2020 at 02:50 pm

No matter how protective you are as a parent, kids are just accident magnets. They scrape knees, bump heads and bust lips in their endless pursuit of exploration and fun. In fact, according to the National Safe Kids Campaign, one out of four children per year sustains an injury serious enough to require medical attention. While you can’t always keep your kids from getting hurt, you can be prepared to provide first aid when they are. Here are some common emergencies and guidelines on how to react:

Emergency Your kids are running barefoot in the backyard, when one of them cuts her foot on a sharp rock.

What to do “The first thing you should do is clean the cut and stop the bleeding,” says Dr. Richard E. Miller, a pediatrician at Cedars Sinai in Los Angeles. Wash it thoroughly with soap and water and then apply firm pressure using gauze or a clean washcloth. “If the cut is superficial, apply an antiseptic ointment and close the wound with a butterfly band-aid,” says Dr. Miller. “But if it’s a deep, open wound that won’t stop bleeding, or if any tissue or muscle is exposed, basic first aid may not be enough – go to the emergency room for stitches.”

Be prepared Always make sure that kids wear shoes when playing outside. And keep adhesive bandages, gauze and antiseptic ointment on hand at all times.

Emergency Your toddler sneaks up to the stove while you’re cooking and burns her hand on the pot.

What to do First aid is needed to quickly to reduce the temperature of the burn and limit the damage to skin. For first-degree burns (red skin, minor swelling and pain but no blisters), remove clothes from the burned area, run cool – not cold – water over the burn for 3 to 5 minutes. Or press a wet, cold compress. If the burn is small, loosely cover it in gauze or bandage. For second-degree burns (blisters, severe pain and redness) or third-degree burns (the surface looks dry and is waxy white, leathery, brown or charred, although there may be no pain or numbness), call 911. Keep your child lying down and elevate the burned area. Remove clothing from the burned area, unless it is stuck to the skin. Don’t break any blisters. Apply cool water over the burn area for 3 to 5 minutes and then cover it with a clean white cloth or sheet until help arrives.

Be prepared In the kitchen, turn pot handles toward the back of the stove while you cook. Never hold your baby while you cook. In the bathroom, always turn the cold water on first and off last, and test bath water with your elbow.

Emergency Your energetic son just knocked his tooth out on the bedpost while jumping on the bed.

What to do To stop the bleeding, firmly apply a piece of wet gauze to the gums until the bleeding stops. If he lost a baby tooth, there’s no need for concern: A permanent tooth will eventually grow in its place. But you should visit a dentist regardless just to make sure none of his underlying teeth were damaged. If the tooth he lost was a permanent one, time is of essence. The faster you act, the higher your odds of saving the tooth. The American Academy of Pediatric Dentists recommends holding the tooth by its crown and reinserting it into the socket, pressing it firmly in place with clean gauze. (If that’s not possible, place the tooth in a cup of milk, which will preserve the tooth’s roots.) Then visit a pediatric dentist immediately.

Be prepared Keep a pediatric dentist’s number on your refrigerator and in your cell phone.

Emergency You’re making breakfast when your toddler walks over to show you his new toy: an open bottle of prescription pills.

What to do Any time a child has potentially swallowed a hazardous substance, call your local poison control center immediately. If your child has collapsed or stopped breathing, call 911 first. Each case of poisoning is unique, and treatment varies greatly depending on what hazardous substance your child has ingested. Never take a wait-and-see attitude when it comes to poison emergencies. Seek immediate treatment.

Be prepared Poison-proof your home by storing all medication in childproof containers kept out of children’s reach. Post the number of your local poison control center somewhere highly visible, like your refrigerator.

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