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:

“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:

• For more ideas on avoiding choking on foods and other objects, check out this tip sheet from the AAP
• And since food is not the only thing that your kids can choke on, Safe Kids Worldwide gives good information about recalls on toys and tips for avoiding choking on toys.

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.

Warning! Your Kids & Grandkids Think Gummy Meds Are Delicious

Last updated on July 3rd, 2020 at 03:05 pm

Mommies and Daddies, Grandmas and Grandpas, listen up.  There are many prescription and non-prescription medications kept around the home that could be a danger for your children/grandchildren should they find these and “taste” them.

One of the more common of these “medicines” include the variety of vitamins, minerals and supplements found in homes now.  While most vitamins are “benign” when inappropriately ingested, there are some that might cause problems in children who ingest large amounts, such as vitamin D, A, and certain minerals in excess.  Not all supplements and “alternative” medical cures have been regulated by our FDA and therefore the correct dosages of these have not been calculated. While ingestion of a single chewable, gummy or regular tablet would probably be OK in a child, it is most of the time impossible to say how many have been consumed.  As a result, even in adults, the dosage is not accurate and this is magnified in a smaller lighter- weight child.  Therefore,  these should be kept out of the reach of children.

Also among the most common of these are the pain relievers- such as aspirin, acetaminophen, and ibuprofen.  Aspirin, fortunately, is not as popular as it used to be, but was responsible for a good proportion of accidental poisonings in children.  This medication in excess caused severe derangements in hydration and acid/base balance in children and occasionally led to death. Ibuprofen (Advil, Motrin) in excess could lead to kidney problems and possibly go on to kidney dysfunction and failure, while acetaminophen, also in excess, has been responsible for liver problems and possible liver failure and death.  Treatment for any of these “poisonings” is not 100% effective and so, like all other issues, prevention is the best medicine.  The problem with these meds is that they are very common in households and are considered to be “benign” so efforts to hide them are not realized.  Also, we can’t forget that “normal dosages” for these drugs vary with age and weight, and children are at much higher risk than adults for complications at much lower doses.  This rule holds for all medications and drugs.

The stronger pain medications that could be found around the home after surgery or injury are far more dangerous in that they are almost all depressants and can slow down heart rate and respirations to the point of coma and death.

Specific medications for specific ailments; high blood pressure, heart disease, cancer, etc. should always be kept locked up as, while these medications do a very good job for those who need them, can cause problems of varying nature if taken by those people (children) who do not need them. And again the rule of age and weight applies here also.

Antibiotics are found around the home when they are being used or if they are “saved to be used another day”. This is a very poor practice, but not uncommon, as the price of these drugs keeps going up- throw away any unused antibiotics.  Unless a person (child) is allergic to these medications, or consumes very large amounts they do not cause as many problems as the medications mentioned above.

As a rule, keep any medication and vitamins, minerals and supplements out of the reach of children and locked in a safe place- assume that any one or more of these could cause serious problems for your children or grandchildren.

If the child is found near an open bottle of any medication, particularly if there are traces of that medicine in or around his/her mouth or pills are found lying on the floor nearby, assume the worst and call poison control (everyone should have the phone number of local poison control centers nearby) and then the Doctor.  Have the bottle of the medicine in front of you when you call (if possible) so that you can answer any questions that are asked. Remember that prevention is the best “cure” for poisonings because there is often no good way of treating these problems after the fact.

US Toll-Free Poison Help Line

1-800-222-1222

Call is free and confidential

Connects you with your local poison control center

Cleaning Your Kid’s Ears: Are Q-Tips Safe?

Last updated on May 4th, 2020 at 11:51 am

A friend once told me with great disdain, while watching me wiggle a cotton swab deep in my ear canal with great satisfaction, “I never use Q-tips to clean out my ears.” Apparently a doctor once told him never to put anything smaller than his elbow into his ear, and he took these words as gospel.

Do you ever have the feeling when someone tells you some great truth, a law of the universe that you’ve been breaking for years in ignorance, that it’s remarkable that you have survived this long, having missed out on some basic manual on life along the way? I often wonder if the parents in my practice feel this way as I spout my wisdom on general health issues, and they look chagrined at having broken the rules with their child. The good news is, it’s hard to break your child. ..especially with things like the management of ear wax.

So what are the rules of proper ear hygiene? Though I think that my friend’s doctor was a bit dramatic, I do agree that for the most part, cotton swabs do more harm than good for children’s ears.

Here’s the lowdown.

Ear wax (otherwise known as cerumen) is icky, and sometimes smells quite foul, but it actually serves several important functions. It is created in the outer half of the ear canal, where it serves to lubricate the skin of the ear canal, and prevents flaking and itching. It also has antibacterial properties and protects the skin of the ear from infections like otitis externa, commonly known as swimmer’s ear.

Ear wax almost always comes out of the ear on its own accord. There are small hairs, called cilia, lining the outer half of the ear canal which act as a conveyor belt, pushing the old wax out as the new wax is formed. And so under most circumstances, ears clean themselves.

What is the harm of a little friendly assistance? There are several potential problems caused by good intentions. Often, especially in children’s small ear canals, using a cotton swab actually pushes the wax deeper into the canal, to the far recesses where there are no hairs to help remove it. In children who make a thick, moist wax, their ears often become so clogged with wax that their hearing becomes dulled, which can impact speech development in younger kids and learning and behavior in older kids.

And then there are those over-eager toddlers who wiggle a little too hard and deep and puncture their eardrum. This common injury usually heals very well, but sometimes the tiny bones that are essential for proper hearing are damaged or the membrane fails to heal and an innocent cleaning exercise can have profound impact on the life of a child.

In the end, though I was chagrined myself when I first heard this advice, I too now recommend avoiding q-tips or cotton-tipped swabs for ear hygiene.

Tips for Parents:

• The secret to clean ears is to use a wash cloth only on the outer, visible part of the ear to clean the wax as it naturally comes out. Internal cleaning is not necessary, and may be harmful.
• If you are concerned about your child’s hearing, visit your doctor to see if they have ears plugged with wax.
• Never allow your children to play with cotton swabs or place anything else (carrots included) in their ears.
• Itchy ears are often caused by over-zealous cleaning habits. A few drops of mineral oil can help soothe them while you wait for the ear’s natural lubricant to return.

Keeping Your Food Allergic Child Safe At The Grocery Store

Last updated on May 4th, 2020 at 11:59 am

When someone becomes a food allergic parent, this changes every single aspect of your daily routine. Allergy triggers are everywhere and must be avoided as much as possible. This means preparing ahead of time to ensure minimal risk of exposure. This may also mean that your new routines will be forced to change as your allergic child grows and goes through new stages of their childhood. One of the trickiest, most nerve-wracking stages can be the years that your child is touching everything to seek out their new environment. How does a parent keep their child safe, allow them to process their newest childhood developmental stage but also be able to tackle a simple chore such as going to the food store? Luckily, it can be done.

When my son was diagnosed with multiple food allergies, going food shopping became a new area of terror for me. We were surrounded by food and the worst part- most of his high allergy triggers were placed in open barrels throughout the store where anyone could touch them. We survived with little or no injury and I wanted to share my tips to make sure everyone else does the same. Food shopping for food allergy menus is stressful enough so let me help you focus your energy in other areas.

Always Have Medications

I cannot repeat this enough- ALWAYS have any necessary medications with you, no matter where you go. Always have two epinephrine auto injectors, antihistamine, and asthma inhalers- anything that you may need at a moment’s notice. Many people assume that they can avoid allergic triggers but there is no definite way of telling what, when or where an allergic reaction can happen.  Being prepared means always being one step ahead of a possibly fatal incident. Your child’s life is worth so much more than not taking 20 extra seconds to pack these items up with your belongings for your venture out.

Stress Doesn’t Help Your Child

I know this may seem like a given but it’s a fact; the more stress you show your child, the more they see it, feel it and react to it. The calmer you are in the way you approach situations, the calmer your child will also be. Not only does this teach your child to go into multiple situations with a more focused way of thinking but it will show your child to always begin in a more positive frame of mind. Stress can also trigger some people’s allergies so it is best avoided as much as possible. Not to mention anyone who is stressed too often does not treat their immune system to function as optimally as it should. Less stress within a child’s behavior is better health for the child and better health for parents.

Use Wipes

We have been deemed as the “germophobe” generation – use it to keep your child safe. Many food stores offer free sanitizing wipes at the entrance, use them. This may not remove all traces of possible allergens from the previous person who used your shopping cart but it will be better than risking a simple touch of a handle bar that was just grabbed with a handful of a food. Children eat all of the time and children touch everything all of the time- this includes your shopping cart. If you prefer a gentler wipe due to chemical or ingredients, pack your own. There are natural brands such as Water Wipes or you can even bring a bag that has your own wet wash cloth with a gentle soap on it.

Cover Everything

As mentioned before- children touch everything. When they are teething, they also taste, lick, bite and try to put everything in their mouth as well. For a child with food allergies, a shopping cart can be a disaster waiting to happen in the blink of an eye. One of the best items I ever found was a reusable shopping cart seat cover. This is a cloth item that you can bring with you and fits most sizes of shopping cart seats. There are multiple types available but I recommend one such as Infantino because:

1. You want a seat cover that will completely cover the entire shopping cart seat, including the handle bars.
2. You want something that is thicker and more padded to keep your child comfortable (some products are very thin and less padding causes a cranky child).
3. Your cart cover should include its own seat belt because those also go into your child’s mouth, which is another cross-contamination threat.
4. Other options to look for are attachable sippy cups or areas to attach your child’s snack container, teething ring or pacifier. All of these items will fall on the floor if not attached and this poses another allergy threat as well as an unhappy child who looks to these for comfort.

Travel With Food

The best way to entertain my child and keep him seated so I could get my shopping done was (plain and simple) food. I always brought safe snacks for him to have. I even made an effort  during our food shopping trips to see what other children were eating or what types of samples the store was giving out. If my child wanted to try it because he saw it, I would bring a similar food item so that he felt like he was also getting to try new foods like the other kids in the store.

It’s never about giving in to your child- it is about safety and planning out your routine as effectively as possible. Having a child with food allergies should never seem like something that cannot be a part of whatever you and your family do- there is always a way to do anything, you just need to find a new way to do it.

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