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Welcome to Dr. Carole's blog, where you can read information relevant to your child's health!

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Pink eye and other eye problems

Posted on December 15, 2017 at 5:25 AM

Viral pink eye (viral conjunctivitis)

- The most common kind

- Usually both eyes are affected; the eyes are bloodshot (the whites look pink) and have clear discharge (excess tears) and some crusting on eyelashes; eyes are itchy

- Can happen along with an upper respiratory infection (cough, congestion, sneezing, etc)

- Can turn into bacterial infection because it’s itchy and kids tend to rub their eyes and introduce dirt/bacteria

- Is contagious


Bacterial pink eye

- Usually only one eye is affected; the eye is bloodshot and has thicker discharge (pus), the discharge during the day can be clear but they usually wake up from naps or in the morning with yellow crust / eye crusted closed; eye is itchy

- Usually happens alone (not with other infections), unless it’s after a viral infection

- Is contagious


Allergic pink eye

- Both eyes are affected; they are bloodshot and itchy

- Can have sniffling, runny nose, cough, asthma attacks, and/or hives with it

- Not contagious


Treatment for pink eye

- For viral/bacterial, eyedrops. They need to stay home from school until the eye looks better, and need to continue eyedrops for 2 days after the eye looks better.

- For allergic, antihistamines or no treatment. They can go to school.


Periorbital cellulitis

- Redness and swelling around the eye (upper and lower eyelids)

- Sometimes the eye is bloodshot and watery, sometimes there is pus in the corner of the eye

- They may rub the eye

- More pain than itchiness

- Often happens after a sinus infection or after a bug bite on the face

- They need to see a doctor for antibiotics

- Not contagious; they can be at school

Staying hydrated in the winter

Posted on November 15, 2017 at 5:20 AM

How much water do kids need?

- Depends on weight; typical preschoolers need 35-40oz of water (adults need 64oz per day)

- There is water in almost all of the food we eat, so this can make calculating water intake a little tricky


Why we get dehydrated in winter

- Heaters dry out the air

- Children sweat playing outside in snowsuits and coming into a warm house from the outdoors

- Sun reflects off snow - they get at least as much sun exposure as summer


What to drink?

- Water is best

- Juice, milk, hot chocolate, soda, lemonade, and gatorade contain a lot of sugar

- Caffeinated beverages (tea, soda, coffee, hot chocolate) are dehydrating

- Broth is good but also contains salt, which holds water in the body and makes them more thirsty


Tips to get kids to drink more water

- Have them carry a water bottle

- Offer a super-slurper sticker when they finish a water bottle

- Have children drink a glass of water when they wake up in the morning, with each meal, and before playing outside

Hand washing and other ways to avoid flu

Posted on October 15, 2017 at 6:20 AM

How flu is spread

- Most viruses are spread by contact with respiratory secretions (saliva and mucus that are expelled when a person coughs or sneezes)

- Virus particles can linger on inanimate objects (toys, surfaces, doorknobs, sink handles, phones, computers, etc)

- Flu is also airborne, meaning it can travel across a room


What a sick person can do to not infect others

- Cough/sneeze into their elbow or shirt (so particles don’t get onto hands)

- Wash hands after blowing nose, eating, and coughing/sneezing

- Avoid kissing family members on the face

- Avoid putting hands and toys into mouth

- Wear a face mask in crowded public places (stores, public transportation, offices, etc)


Hand washing

- Any time you touch your face, you can introduce germs into your eyes, nose, and/or mouth

- Wash hands after touching surfaces, and also before eating

- Wash for at least 30 seconds with regular soap (not antibacterial) and hot water

- Rub vigorously and make sure you get all surfaces (including between fingers and under nails)


Other preventive measures

- Vitamin C - an antioxidant that boosts your immune system

- Zinc - actually kills viruses on contact

- Echinacea and other herbs - trigger an inflammatory response to prime the immune system to fight off viruses

- Rest and decrease stress - stress can wear down your immune system; not only emotional stress but also physical exertion and exposure to elements (extreme and/or changing hot and cold temperatures)

- Change the bathroom towels and make sure sick family members have their own towel - this is the most common way viruses spread through houses!

- If many people around you are sick with flu, you can wear a mask

- Flu vaccine - can help decrease your chances of getting flu, and if you still get flu it can decrease the severity

Sore throat with white spots - is it strep?

Posted on September 15, 2017 at 7:20 AM

Things you might see in all kinds of sore throats (pharyngitis)

- Throat pain, redness, enlarged tonsils

- Swollen lymph nodes (glands in neck)

- Trouble eating/swallowing, lack of appetite

- Fever

- White spots on tonsils


Viral sore throat

In addition to all those above, they tend to also have:

- Cough, sneezing, and/or runny nose

- Vomiting and diarrhea

- Fever is usually lower than 102

- There are many kinds of viruses that cause sore throat; some specific ones that tend to have white spots are mono and hand-foot-mouth


Treatment of viral sore throat:

- Gargle with salt water

- Drink lots of water, tea, broth

- Eat soft foods like yogurt, applesauce, mashed potatoes

- Take vitamin C, zinc, and echinacea

- Get extra rest

- Tylenol or ibuprofen for pain/fever


Mono (short for mononucleosis)

- A type of viral sore throat

- Children are very tired with this

- White spots on tonsils are flat patches (looks like strep)

- Lymph nodes are swollen and tender, and they may have swollen lymph nodes around their body and not just in the neck (armpits, groin, back of neck, etc.)

- When the spleen is swollen, it can be dangerous to engage in activities where they might fall and/or hit their abdomen (climbing, jumping on furniture/trampolines, contact sports) - children with mono must be kept out of these activities until cleared by a doctor

- Chilren can be tested for mono with a blood test


Hand, foot, and mouth disease

- A type of viral sore throat

- Spots on the tonsils are blisters; they may also have spots on the tongue and roof of mouth

- They may have red spots or blisters (white in the center and red around them) on the palms, soles, arms, and legs - not always there


Strep throat

- A bacterial infection

- Usually higher fever (102-104); children feel very tired when the fever is high

- White spots on tonsils are flat patches (looks like mono); they will usually also have red spots (called petechiae) on the roof of their mouth

- Coated tongue, bad breath (strep-y smell)

- Stomachache, vomiting without diarrhea - sometimes this comes before the sore throat

- Rash that feels rough (like sandpaper) on their trunk/back; might be itchy

- MUST be treated with antibiotics in children under age 6 (because if untreated it can cause rheumatic fever later, which is very serious). In children over age 6 and adults, it doesn’t have to be treated. Reasons to treat: feel better about 24 hours faster (24-48h instead of 48-72), and they can go back to school/work sooner (the next day if started by 5pm) because they are no longer contagious.


Diphtheria

- Bacterial infection

- Uncommon because of the DTaP vaccine, but can happen in unvaccinated children

- Large grayish-white spots on tonsils

- Serious swelling of throat and tonsils - can cause suffocation if not treated


How sore throats are spread

- Contact with saliva - sharing food/drinks, kissing on the face, bathroom towels

- Inanimate objects - anything a child puts in their mouth (i.e. toys) needs to be cleaned with soap and water

- Common surfaces - for children who frequently touch their mouths, anything they touch can be contagious (doorknobs, tabletops, knobs on the sink, phones, etc)


When to call a doctor

- When you suspect strep

- When a child is unable or unwilling to drink fluids

- When they have a fever over 101

Sore throat with white spots - is it strep?

Posted on September 15, 2017 at 7:20 AM

Things you might see in all kinds of sore throats (pharyngitis)

- Throat pain, redness, enlarged tonsils

- Swollen lymph nodes (glands in neck)

- Trouble eating/swallowing, lack of appetite

- Fever

- White spots on tonsils


Viral sore throat

In addition to all those above, they tend to also have:

- Cough, sneezing, and/or runny nose

- Vomiting and diarrhea

- Fever is usually lower than 102

- There are many kinds of viruses that cause sore throat; some specific ones that tend to have white spots are mono and hand-foot-mouth


Treatment of viral sore throat:

- Gargle with salt water

- Drink lots of water, tea, broth

- Eat soft foods like yogurt, applesauce, mashed potatoes

- Take vitamin C, zinc, and echinacea

- Get extra rest

- Tylenol or ibuprofen for pain/fever


Mono (short for mononucleosis)

- A type of viral sore throat

- Children are very tired with this

- White spots on tonsils are flat patches (looks like strep)

- Lymph nodes are swollen and tender, and they may have swollen lymph nodes around their body and not just in the neck (armpits, groin, back of neck, etc.)

- When the spleen is swollen, it can be dangerous to engage in activities where they might fall and/or hit their abdomen (climbing, jumping on furniture/trampolines, contact sports) - children with mono must be kept out of these activities until cleared by a doctor

- Chilren can be tested for mono with a blood test


Hand, foot, and mouth disease

- A type of viral sore throat

- Spots on the tonsils are blisters; they may also have spots on the tongue and roof of mouth

- They may have red spots or blisters (white in the center and red around them) on the palms, soles, arms, and legs - not always there


Strep throat

- A bacterial infection

- Usually higher fever (102-104); children feel very tired when the fever is high

- White spots on tonsils are flat patches (looks like mono); they will usually also have red spots (called petechiae) on the roof of their mouth

- Coated tongue, bad breath (strep-y smell)

- Stomachache, vomiting without diarrhea - sometimes this comes before the sore throat

- Rash that feels rough (like sandpaper) on their trunk/back; might be itchy

- MUST be treated with antibiotics in children under age 6 (because if untreated it can cause rheumatic fever later, which is very serious). In children over age 6 and adults, it doesn’t have to be treated. Reasons to treat: feel better about 24 hours faster (24-48h instead of 48-72), and they can go back to school/work sooner (the next day if started by 5pm) because they are no longer contagious.


Diphtheria

- Bacterial infection

- Uncommon because of the DTaP vaccine, but can happen in unvaccinated children

- Large grayish-white spots on tonsils

- Serious swelling of throat and tonsils - can cause suffocation if not treated


How sore throats are spread

- Contact with saliva - sharing food/drinks, kissing on the face, bathroom towels

- Inanimate objects - anything a child puts in their mouth (i.e. toys) needs to be cleaned with soap and water

- Common surfaces - for children who frequently touch their mouths, anything they touch can be contagious (doorknobs, tabletops, knobs on the sink, phones, etc)


When to call a doctor

- When you suspect strep

- When a child is unable or unwilling to drink fluids

- When they have a fever over 101

ADHD - how to recognize it and when to treat it

Posted on August 15, 2017 at 7:15 AM

What is ADHD?

- A neurodevelopmental disorder

- Impairs a child’s ability to function normally

- Not just “extra energy” or hyperactivity - a true medical diagnosis

- Difficulty filtering what is important

- 6 out of 9 symptoms must be present most or all of the time (without medication) to be diagnosed


Attention deficit (inattentive type)

- Poor attention to details or making careless mistakes

- Difficulty sustaining attention to tasks/activities

- Does not seem to listen when spoken to directly

- Does not follow through on instructions / fails to finish tasks (despite being cooperative and able to understand)

- Trouble organizing tasks and activities

- Avoids engaging in tasks that require sustained mental effort

- Loses things necessary for tasks or activities (school supplies, sports equipment, etc)

- Easily distracted

- Forgetful


Hyperactivity (hyperactive type)

- Fidgets with hands or squirms when seated

- Leaves seat at inappropriate times / without permission (when expected to stay seated for a reasonable amount of time)

- Runs around or climbs excessively at inappropriate times

- Has difficulty playing quietly or engaging in quiet activities

- Is “on the go” or “driven by a motor”

- Talks excessively

- Blurts out answers before a question has been completed

- Inability to wait in line

- Interrupts adults who are in conversation or children who are playing


Mixed type

- Has 6/9 features of both inattentive and hyperactive type


How to help?

- For inattentive type, allow child to engage in a mindless activity to keep them focused (fidget toy, doodling, etc.)

- Help child through processes that require multiple steps; don’t expect them to be able to remember/complete several steps on their own. Make charts / photo lists to explain common processes (such as a step-by-step photo on how to wash hands).

- Maintain eye contact when speaking with the child, and keep conversations short and simple (avoid long-winded explanations)

- Keep the environment organized and clear as possible, so it is harder to lose things

- Help children put toys away after playing with them, before moving onto the next toy

- Keep outside stimuli to a minimum; turn off background music / TV, close curtains if necessary, and maintain a clear work space

- Allow children enough time to play/run, do not expect them to stay seated for too long

- Let child sit on a yoga ball when they must remain seated, so they can wiggle

- Teach children to breathe 3 times or count to 10 in their head before interrupting

- Give children mental exercises for when they are feeling bored (think of as many things as you can that start with the same letter as your name, think of all the red objects you can, try to remember the names of everyone in your class, etc).


When a child might need medical treatment

- When they are impaired in daily activities (when you feel they are not functioning normally because of their symptoms)

- When they are falling behind their peers due to their inability to complete tasks

- When they expresse to you that they feel like they need help (they feel behind, different, or unable to live the way they think they should)


How ADHD medications work

- Stimulant medications activate the prefrontal cortex, which is the part of the brain used for organizing thoughts, maintaining focus, deciding what is important, and overriding urges

- Stimulant medications do NOT cause children to be sedated or turn them into “zombies”

- Other medications (antidepressants, anti-anxiety medicines, neuroleptics, and others) are more for the symptoms that go along with ADHD. They don’t treat the ADHD symptoms directly and are often sedating.

ADHD - how to recognize it and when to treat it

Posted on August 15, 2017 at 7:15 AM

What is ADHD?

- A neurodevelopmental disorder

- Impairs a child’s ability to function normally

- Not just “extra energy” or hyperactivity - a true medical diagnosis

- Difficulty filtering what is important

- 6 out of 9 symptoms must be present most or all of the time (without medication) to be diagnosed


Attention deficit (inattentive type)

- Poor attention to details or making careless mistakes

- Difficulty sustaining attention to tasks/activities

- Does not seem to listen when spoken to directly

- Does not follow through on instructions / fails to finish tasks (despite being cooperative and able to understand)

- Trouble organizing tasks and activities

- Avoids engaging in tasks that require sustained mental effort

- Loses things necessary for tasks or activities (school supplies, sports equipment, etc)

- Easily distracted

- Forgetful


Hyperactivity (hyperactive type)

- Fidgets with hands or squirms when seated

- Leaves seat at inappropriate times / without permission (when expected to stay seated for a reasonable amount of time)

- Runs around or climbs excessively at inappropriate times

- Has difficulty playing quietly or engaging in quiet activities

- Is “on the go” or “driven by a motor”

- Talks excessively

- Blurts out answers before a question has been completed

- Inability to wait in line

- Interrupts adults who are in conversation or children who are playing


Mixed type

- Has 6/9 features of both inattentive and hyperactive type


How to help?

- For inattentive type, allow child to engage in a mindless activity to keep them focused (fidget toy, doodling, etc.)

- Help child through processes that require multiple steps; don’t expect them to be able to remember/complete several steps on their own. Make charts / photo lists to explain common processes (such as a step-by-step photo on how to wash hands).

- Maintain eye contact when speaking with the child, and keep conversations short and simple (avoid long-winded explanations)

- Keep the environment organized and clear as possible, so it is harder to lose things

- Help children put toys away after playing with them, before moving onto the next toy

- Keep outside stimuli to a minimum; turn off background music / TV, close curtains if necessary, and maintain a clear work space

- Allow children enough time to play/run, do not expect them to stay seated for too long

- Let child sit on a yoga ball when they must remain seated, so they can wiggle

- Teach children to breathe 3 times or count to 10 in their head before interrupting

- Give children mental exercises for when they are feeling bored (think of as many things as you can that start with the same letter as your name, think of all the red objects you can, try to remember the names of everyone in your class, etc).


When a child might need medical treatment

- When they are impaired in daily activities (when you feel they are not functioning normally because of their symptoms)

- When they are falling behind their peers due to their inability to complete tasks

- When they expresse to you that they feel like they need help (they feel behind, different, or unable to live the way they think they should)


How ADHD medications work

- Stimulant medications activate the prefrontal cortex, which is the part of the brain used for organizing thoughts, maintaining focus, deciding what is important, and overriding urges

- Stimulant medications do NOT cause children to be sedated or turn them into “zombies”

- Other medications (antidepressants, anti-anxiety medicines, neuroleptics, and others) are more for the symptoms that go along with ADHD. They don’t treat the ADHD symptoms directly and are often sedating.

Protect against sunburn!

Posted on July 15, 2017 at 9:15 AM

Why it matters

- Sunburns sustained in childhood predispose to melanoma (skin cancer) later in life

- Even mild sunburns (“tans”) can lead to cancer


Sunscreen

- Use SPF 30 or higher (I recommend 50 in Colorado)

- Needs to be applied 30 minutes before going outside to be effective

- Needs to be reapplied after sweating or after playing in water (swimming, running through sprinkler, playing in water table, washing hands, etc.), even if it is waterproof sunscreen

- Be careful to avoid getting sunscreen in eyes!


Sunburns

- First degree burns - skin is red, tender, sometimes it peels several days later

- Treatment for first-degree sunburns:

- Keep the child indoors and apply sunscreen as soon as you see it starting to turn red

- Apply cool compresses such as damp washcloths or damp paper towels

- Have the child drink an entire glass (8oz) of water

- Parents should give a dose of ibuprofen to stop the inflammation and stop the burn from progressing - call me or another doctor for the correct dose

- Second degree burns - have blisters; should probably see a doctor

- Children with second-degree burns may require more extensive treatment, such as healing lotions and/or stronger pain medicine

Which vaccines does my child need?

Posted on June 15, 2017 at 9:10 AM

Required vaccines for school in Colorado: DTaP, Polio, Hib, HepB, PCV, MMR, Varicella


DTaP (Diphtheria, tetanus, and acellular pertussis)

- 5 doses - given at ages 2, 4, and 6 months, 15-18 months, and 4-6 years.

- Diphtheria - very rare since the vaccine came out - it’s a severe sore throat with a high fever; the bacteria can cause thin membranes to grow across the throat and the child can suffocate.

- Tetanus - a bacterial infection caused by deep puncture wounds (stepping on a nail, dog/cat bite, etc). The bacteria that causes tetanus lives in soil and creates spores, so it can happen in any person with a dirty wound that is deep. When a child sustains a puncture wound, wash it immediately with soap and water, then call the doctor. Tetanus is treated with strong antibiotics and two injections (tetanus toxoid and tetanus immune globulin).

- Pertussis - a.k.a whooping cough - starts off looking like a regular cold with a cough that doesn’t go away. The cough typically lasts up to 2 months. Children will cough several times in a row until they run out of air, then take a gasping breath (the “whoop”;). Sometimes children cough until they vomit, and sometimes they burst blood vessels in their face and eyes from coughing so hard. When a child is diagnosed with pertussis, the other people they came into contact with need to be tested and probably need preventive (prophylactic) antibiotic treatment.


Polio (polio virus, IPV = inactivated polio vaccine)

- 4 doses - given at 2 months, 4 months, 6-18 months, and 4-6 years

- Polio is a virus that is very contagious (airborne - it can travel across a room). It starts off as a flu-like illness, but causes paralysis of nerves. It can affect any nerve in the body and cause irreparable damage - it can cause a permanent limp, inability to use a hand, inability to see/hear on one side, or even death if it affects the diaphragm.

- Polio has no cure or antidote, only the vaccine to prevent it


HiB (Haemophilus Influenzae B)

- Typically 4 doses, given at 2, 4, 6, and 12-15 months. If a child missed the early doses but has one after they are a year old, that one dose is sufficient. A child over 5 does not need any more doses, even if they have never been vaccinated against HiB.

- HiB is a bacterial infection that only seriously affects children under age 5. It used to be one of the leading causes of death in young children by causing meningitis, sepsis, and pneumonia. Now that we have the vaccine, HiB disease is rare.

- HiB is spread through respiratory droplets and secretions, so a child with HiB disease is contagious when they sneeze, cough, or put objects in their mouth.

- HiB disease is treated with antibiotics


Hepatitis B

- 3 doses - given at birth, 1-2 months, and 6-18 months

- HepB is blood-borne, so it is spread through the placenta from an infected mother, or through needle sticks or sexual contact

- HepB has some treatment but is not currently curable. About 1/3 of people with HepB will develop chronic infection that leads to serious liver damage.


Pneumococcal vaccine (PCV - Strep pneumoniae)

- 4 doses - given at 2, 4, 6, and 12-15 mos

- PCV vaccine currently protects against 13 strains of strep. The strains it protects against are the ones that are most virulent, meaning the ones that progress beyond simple strep throat, ear infections, or sinus infections, and cause diseases such as meningitis, sepsis, and pneumonia.

- Strep is spread through direct contact with bodily secretions (mucus, saliva) and is treated with antibiotics


MMR (measles, mumps, and rubella)

- 2 doses - age 12-15 mos and 4-6 years

- Measles is a virus that causes a high fever, rash, and can cause meningitis (which can be fatal) and hearing loss (which is permanent). It is extremely contagious (airborne - can travel across a room). There is no cure, only the vaccine to prevent it.

- Mumps is a virus that causes painful swelling of the parotid gland (one of the salivary glands on the jaw), and in boys causes inflammation of the testes. It typically only affects one parotid gland and one testis, but in about 1/3 of boys, both testes are involved, and they are at risk of becoming sterile. There is no cure, only the vaccine to prevent it.

- Rubella is a virus that causes fever and a rash. It is usually pretty mild, but the reason we vaccinate children is to protect the unborn babies of women who are pregnant. Think of Zika virus, how it affects unborn babies. It’s a similar concept. When a pregnant woman gets rubella, she is at risk of having a miscarriage, or of her baby having serious birth defects and/or brain damage. Rubella is spread through respiratory droplets (coughing and sneezing). Rubella has no cure, only the vaccine to prevent it.


Varicella (chickenpox)

- 2 doses - age 12-15 mos and 4-6 years

- Starts as a fever and cough for about 2 days, some flu-like symptoms, and then the rash appears (blisters all over the body). Children who have only had one dose of the varicella vaccine (i.e. children aged 15 mos to 4 years) can still get chickenpox; they typically get a mild case if they do get it.

- Much like the rubella vaccine, the varicella vaccine was designed to protect unborn babies of women who are pregnant. When a pregnant woman gets varicella, she is at risk of having a miscarriage, or of her baby having serious birth defects and/or brain damage.

- A child who has had chickenpox does NOT need the varicella vaccine, but they do need documentation of when they had chickenpox.

- Varicella is spread through respiratory droplets (coughing and sneezing), or by direct contact with the rash. A child who has chicken pox needs to stay out of school until all of the blisters of the rash have popped and crusted over. They are also contagious for 2 days before the rash develops (when they have a cough and fever).

- Varicella has no cure, only the vaccine to prevent it. After a person has varicella, the virus can hid in their nerves and come out later in life as shingles.


Optional vaccines in Colorado: Rotavirus, Hepatitis A, Influenza


Rotavirus

- 3 doses, given at 2, 4, and 6 months

- Rotavirus is a virus that causes severe diarrhea and dehydration in babies. It’s spread by contact with the infected diarrhea. If you change the diaper of any child with diarrhea, be sure to wash your hands with soap and water afterward.

- Once a baby is more than 8 months old, they cannot get rotavirus vaccine.

- Rotavirus has no cure; typical treatment for babies and young children is being kept in the hospital for IV fluids


Hepatitis A

- 2 doses given at 12-15 months, and then again 6+ months later

- HepA is a virus that causes flu-like symptoms, diarrhea, and jaundice (yellow skin)

- HepA is spread through contact with infected fecal matter; the infected stool can get into water supplies and spread from ground water, from fruits and vegetables sprayed with infected water and/or not washed prior to consumption, and in restaurants from infected chefs failing to wash their hands

- HepA has no cure, only the vaccine to prevent it


Influenza

- Given as early as age 6 months. The first two doses need to be given 1 month apart, then it is given annually between October and May

- The flu vaccine is not 100% effective, meaning children who receive the vaccine can still get influenza

- Influenza causes constitutional symptoms (fever, muscle aches, fatigue), respiratory symptoms (cough, asthma attacks, etc), and GI symptoms (vomiting, diarrhea)

- Influenza is very contagious (airborne - can travel across a room)

- There is a specific antiviral treatment called Tamiflu for people who test positive for influenza virus - it must be given in the first 72 hours of being sick, and sometimes causes worse GI symptoms

- Children with influenza need to stay home from school until 24 hours after fever is gone or 24 hours after starting Tamiflu

What is positive guidance?

Posted on May 15, 2017 at 9:05 AM

- Guiding children’s behavior in a way that helps them feel confident, secure, and noticed

- Letting children know you are on their team

- Fostering self-esteem and independence

- It is done by establishing predictable routines, setting clear rules, having age-appropriate limits, and modeling kindness and respect


Benefits of positive guidance

- Children feel safe to trust limits and consequences; they are not surprised by a sudden consequence

- Children can self-regulate their behavior

- Children feel more independent and competent, which allows them to continue to develop in a healthy way

- Children learn to make wise choices, not necessarily self-indulgent choices

- Children learn to respect others


Using teamwork

- Be clear about roles - clarify who will do what, and when. This allows children to anticipate what is going on, and who to ask if they need an explanation or directions.

- Adults should be on the same page - this lets children know that if they ask one adult and get an answer that they don’t like, they will get the same answer if they ask another adult. One strategy to emphasize this is to echo instructions when you overhear an adult giving them to a child - a simple “yes, that’s right!” will do the trick. If you don’t agree with the other adult, be sure to talk with them away from the child, so you can still present a united front.

- Check in frequently with children and other adults. This shows children that you are all working together, rather than doing your own part of the task on your own.


Make it fun!

- Use humor - a funny voice or a silly rhyme can help ease tension and keep children engaged.

- Use puppets/toys to act things out - when you are explaining to the puppet/toy, the child is interested, more likely to learn, and less likely to become defensive for having done the “wrong” thing

- Use music - singing instructions to the tune of a familiar song can make them fun and catchy, and allow you to repeat the instructions multiple times without nagging


Make it work!

- Keep an eye on the child’s body language to guide them in a way they respond to without the child becoming distressed. Allow the child to “save face,” do not shame them for something they may have done wrong. Guide gently.

- Be honest; do not tell “white lies” as a quick fix (for example, saying there are no crackers left when really you just think they’ve had enough to eat)

- Be consistent with verbal and nonverbal cues; don’t use a soft voice with a harsh message, and do not be sarcastic - young children don’t understand sarcasm

- Redirect when you correct; simply telling a child to stop doing something will make them feel bad and they may have an outburst or just cry. Give them something to do instead - say “walk please!” instead of “don’t run!”

- Allow natural consequences when appropriate; for example, a child who intentionally breaks a crayon will have to color with a broken crayon.

- Give 2 choices whenever possible!

- Make chores into a game - “Let’s pick up all the red blocks! Now the yellow ones!”

- Validate feelings with empathy - “I know sharing is hard sometimes, and that you really want to keep playing with that. I’m proud of you for sharing with your friend.”

- Model appropriate behavior with other adults.

- Offer praise often, not just when the task is done, so children are motivated to continue. “Wow, you put away 3 stuffed animals already! Only a few more to go!”

Outdoor play is important!

Posted on April 15, 2017 at 11:45 AM

Health benefits

- Children who play outside regularly are happier, healthier, and stronger

- Immune system is stronger due to exposure to environment

- Sun exposure produces Vitamin D in the body

- Outdoor play can help prevent nearsightedness

- Children who play outdoors at school are more likely to play outdoors at home

- Children who enjoy the outdoors are more likely to enjoy hiking, jogging, biking, climbing, and other healthy outdoor activities as adults.

- Children who play more outdoors spend less time sedentary with screens (watching TV, playing video games, etc)

 

- Playgrounds are a fun and easy way for children to move/exercise and challenge their body

- Children naturally have more energy than adults, and need to move around, run, and play creatively. Playing outdoors is a great way for them to relieve the stress of sitting still for too long.


Development benefits

- Imagination and creativity are stimulated by being outside - this leads to better brain development

- Children learn basic physics - gravity, heat/cold, how water mixes with dirt and makes mud, which objects float in water, etc.

- Learn through senses - there are so many things to see, hear, smell, touch, and even taste outside

- Gain spatial awareness as they move through the environment

- Gain motor development - climb and jump off objects, ride a tricycle, walk on tiptoes, throw/kick balls, etc.


Social benefits

- Learn how to make friends and interact socially, and to work together and share with a friend

- Learn independently (without a parent’s direct guidance)

- Engage with and learn from older children, even if they are not directly playing with them

 

Overall happiness benefits

- Children learn to enjoy their environment

- Children become more self-sufficient as they learn to entertain themselves; less tendency toward boredom later in life

- Sun exposure reduces depression

- Children can yell, laugh, run, and really let go of pent-up emotions


Types of play outdoors

- Physical play - running, climbing, riding tricycle, scooters, throwing/kicking balls, digging, balancing, sliding, rolling, crawling, swinging, obstacle course

- Constructive play - water table, sand box, art, blocks, toys that stack / fit together, gardening, nature walk

- Social play - pushing another child on a swing, pulling a wagon with another child in it, constructive play together, having a picnic / tea party, parachute play

- Dramatic play - using imagination to create scenarios - play houses, forts, etc.

- Games with rules - red light green light, Simon says, follow the leader, ring around the rosy, duck duck goose, tag, etc.

 

Shut off the TV!

Posted on March 15, 2017 at 7:45 AM

Screen time

- The American Academy of Pediatrics (AAP) recommends less than 2 hours per day of screen time

- For children under age 2, the recommendation recently changed from no screen time to up to 1 hour of supervised / educational screen time - the parent should be interacting with their child while the screen is on, rather than using the screen as a babysitter.


Reasons to limit screen time

- Children younger than 18 months are unable to realize that symbols on a screen relate to objects in real life. While children under 18mos can learn to unlock a device, swipe through pictures, and so on, it does NOT translate to real-life skills.

- Watching TV before 18 months of age is associated with slower language development, poorer reading skills, worse short-term memory, decreased attention span, and increased frustration / impatience.

- Having > 2 hours of screen time is associated with obesity, depression, and aggression in preschool and school-age children.

- Children who watch violent programs are more likely to be aggressive and/or anxious.

- TV shows and video games often reinforce inappropriate behaviors, poor communication techniques, and gender and racial stereotypes.

- Children under age 8 don’t realize that advertisements are for selling products, and children under age 6 can’t tell the difference between an ad and a TV show. They may become angry or frustrated when a parent refuses to purchase something they saw in an ad.


Tips for sharing screen time with a child

- Watch an educational / interactive show together, and frequently ask the child questions about what is going on in the show. After the show, ask what they learned.

- Play a game on a screen together. Pause often and interact in real life.

- Read a story on a screen to your child.

- Video chat with a relative or friend who lives far away.

- Mute the TV / computer when an ad is playing, and use that time to talk with the child and distract them from the screen.

- When the child does see ads, explain to the child that the purpose is to make you want things you don’t necessarily need, and they try to trick us into thinking that buying the product will make us happier. Parents can ask questions like “do you really think it’s as good as they make it seem?” or “do you think that’s a healthy choice?” to get their child thinking critically about ads.

- Pay attention to the rating of the show or movie. PG movies are meant to be screened by parents first to determine whether they are appropriate for their child, as they may contain subject matter that is scary for young children. PG-13 is for children 13 and over, and that rating is determined by a qualified council of professionals; do not dismiss it. R rated movies are for children/adults 17 and over. Parents should be careful not to allow children to be in the room (or to wander in unseen) when they are watching PG-13 or R-rated movies.


Tips to limit screen time

- Do not leave a TV running in the background - it offers a hidden source of stimulation that can stress children

- No TV in the bedroom - it is harder to control how much screen time they have, plus they are more likely to have screen time close to bedtime

- No screens within 2 hours of bedtime - it interferes with delta wave activity in the brain and decreases the quality of sleep

- Have a rule such as no screen time on school days, screen time only during certain hours of the day, etc.

Colic - How to treat it and when to seek medical help

Posted on March 1, 2017 at 7:25 AM

Most babies will cry an average of 1.5 to 2 hours per day, but babies with colic cry more than 3 hours per day for 3 or more days per week. Colic usually happens between 3 weeks and 3 months old - all of these 3’s are considered the “rule of 3’s” for colic. True colic affects about 1 in 6 babies.

 

A colic cry is high-pitched, intense, and not relieved by normal measures (feeding, changing the diaper, or holding your baby).


 

Colic is thought to be caused by gas bubbles trapped in the intestines. It is also affected by a few things:

- Temperament; some babies are naturally fussier and cry more than others

- Allergies; babies with a true milk allergy or other food allergies tend to have more colic symptoms

- The emotions around the baby; babies who are under stress from a lot of charged emotions in the house tend to get more colic

- Infrequent feedings; babies who eat every 2 hours are less likely to get colic than those who eat every 3 hours

 


Ways colic can be treated:

- Physical therapy moves: bicycle legs, tummy rubs, tummy time, and back rubs can all help

- Medicines: simethicone is a medicine that is very safe because it’s not absorbed into the bloodstream, it simply breaks up large gas bubbles in the intestines into smaller ones that can pass through easier and with less pain

- Herbal remedies: mint, chamomile, fennel, and licorice tea, 2-4 oz per day at most (given a few sips at a time throughout the day)

- A warm (not hot!) water bottle on your baby’s tummy

- Slow rocking motions (in your lap in a glider, in an infant swing, a ride in the car, a walk in the stroller, etc.)

- A chiropractic adjustment; be sure the chiropractor is ICPA (international chiropractic pediatric certification) certified! You can check http://icpa4kids.org/ to find a certified pediatric chiropractor near you.

- Homeopathic remedies; check with a homeopath to choose the right remedy for your baby

 


Remedies that have not been proven to help colic, and might even make your baby worse:

- Gripe water; since it’s not FDA regulated, each formulation of gripe water is different, and some contain alcohol or other poisons. Check with your doctor before giving gripe water to your baby.

- Changing formula; this can actually upset your baby’s tummy more

- Sedative medications, antihistamines; these are dangerous in babies as they can suppress your baby’s breathing

 


When to see the doctor for colic:

- When your baby cries for more than 3 hours every day

- When your baby is having trouble eating, or has diarrhea or weight loss

- When colic symptoms happen before 2 weeks of age, or after 3 months of age

- When your baby has projectile vomiting (shoots more than 2 feet away) and is hungry after vomiting

 

 

Separation anxiety and other transitions

Posted on February 15, 2017 at 2:40 PM

Separation anxiety - what does it look like?

- Can occur any time from age 6 months through childhood

- Often occurs at the beginning but can begin later in the school year

- Symptoms: crying, tantrums, clinginess, physical symptoms (headaches, tummy aches, vomiting, etc.)

- Regressed behavior - accidents, thumb sucking, acting younger than their age

- Worse if a child is tired, hungry, or getting sick


Help for parents

Separation anxiety in children often starts with parents being nervous about leaving their child behind and/or missing their child, so here are some tips to help decrease your anxiety.

- Talk through your feelings / fears with a friend or your child's teacher

- Show your child around their new school

- Talk with other parents at the school

- Plan a coffee date or some other meeting with a friend after dropping their child off, so you have someone to talk to


Ways a parent can help a child before the transition

- Start with a warm up / trial run - visit the school together and play together

- Create a goodbye ritual - a special handshake, wave, high five, etc.

- Allow children to take a comfort object to school (such as a special toy)

- Listen to your child’s fears and other feelings

- Stay calm! If you are anxious or sad, your child will pick up on that

- Make sure you say goodbye to your child and don’t just sneak out, but don't make a big deal about leaving. A simple goodbye and see you later works.

- Be sure to allow enough time to properly say goodbye


Ways your child's school can help your child

- Distraction / redirection - have a teacher play with the child, or introduce them to a new friend who will play with them

- Ask teacher to offer choices to the child whenever possible

- Ask teacher to give positive reinforcement - praise the child for playing so well, being brave, or other efforts to separate

- Ask if they can have recovery time if needed - alone time, time sitting in a teacher’s lap, or other special time as appropriate.

- Set firm limits with your child; do not let them push you around. They do still need to integrate into the school day as soon as possible, and children find boundaries and limits reassuring.


Other transitions

- Children may become stubborn or defiant, or cry / melt down

- Offer choices, give positive reinforcement

- Listen to your child’s feelings; do not “bulldoze” over them or try to force them into transitions

- Explain things to your child before they happen (e.g. we are going to read a book, then we will wash our hands and then have a snack!)


When anxiety is severe…

- Some children still have a very hard time with separation anxiety or generalized anxiety

- If your child is becoming physically ill (e.g. vomiting, withdrawing/hiding in a corner, etc.) due to the anxiety, and you don’t see improvement within a few days, consider referring them for help

- Play therapy, talk therapy, and family counseling can all help immensely 

Burns - How to treat at home, and when to see a doctor

Posted on February 1, 2017 at 6:05 PM

Burns - How to treat at home, and when to see a doctor

 

Burns can be caused by many things, including UV rays from the sun (sunburn), water, grease, hot food, chemicals, electricity. They are classified by severity - first, second, third, and fourth degree.

 

First degree burns are your typical sunburn, where the skin looks pink/red and is dry and painful to touch. They can also be caused by hot water (between 120’F and 220’F), which is why I recommend that parents set their home boiler thermostat to 120 degrees. The pain of a first degree burn typically resolves in about 2 days, and it heals in 3-4 days without any scarring. Sometimes, about a week later, the skin becomes itchy and peels.

 

Second degree burns are typically caused by scalding liquids (boiling water, grease, hot oatmeal spilling on you, etc). Second degree burns cause the skin to turn red and blister, and they are quite painful. They take longer to heal than first degree burns - anywhere from days to weeks - and usually heal without scarring, but may scar depending on the severity.

 

Third degree burns are so bad that the nerves in the center of the burn get completely damaged, so the middle of the burn doesn’t hurt. However, there is always some surrounding second degree burn, so they do hurt on the edges. The skin and underlying fat/muscle in the center of a 3rd degree burn are white. These burns heal with scarring.

 

Fourth degree burns go all the way down to the bone, and thankfully they are extremely rare. I won’t talk about them any more here, but you can call or email me if you have questions about fourth degree burns.

 

Treatment at home for sunburn or other first degree burns:

1. As soon as you notice a burn forming, cool the area with cool (not cold) running water. Do NOT apply ice.

2. For sunburns, you can apply sunblock after the area is cooled down (even after the burn) to prevent it from getting worse.

3. Give the appropriate dose of ibuprofen - it is anti-inflammatory and will prevent the burn from getting worse.

4. Make sure to drink extra water - this will help it to heal faster.

 

Reasons to go to the doctor:

- Any burn in any child less than 2 years old

- Any burn (other than a mild sunburn) that is larger than 5% of the body surface area. A person’s palm is the size of 1% of body surface area, so you can use that as a guideline to estimate how much surface area is affected.

- Any burn that encircles (all the way around) an arm or leg

- Any electrical burn

- Any burn that looks like it might be infected (oozing, weeping, pus, or if there is fever)

- Any second degree burn that is larger than 1% (a palm-sized area)

- Any second degree burn that is on the hands, feet, face, or genitals

- Any third or fourth degree burn

 

Get over that cold!

Posted on January 12, 2017 at 3:25 PM

Do you have that horrible, lingering cold that's going around?  You know, the one with cough, congestion, runny nose, sinus pressure, ear pressure, and/or fever, that has been lasting for weeks?  Here are some tips to help you get over it quicker:

 

For adults and children who are over the age of 6:

1. Decongestants: I recommend Afrin nose spray and pseudoephedrine (the real Sudafed); I do NOT recommend phenylephrine because it has been shown in recent studies that it doesn’t work! These can only be used for 2-3 days; after that, they will cause rebound congestion.

2. Mucolytics (for thick mucus): guaifenesin (Mucinex) will thin out mucus, so this is great to help you cough out thick mucus that feels like it’s stuck.

3. Cough suppressants: Dextromethorphan is a great cough suppressant and will help you sleep, so if your cough is keeping you up at night, I recommend this one.

 

Remember: If you take a mucolytic with a cough suppressant, you thin your mucus but then decrease your ability to cough it out, essentially making you drown in your own mucus. (The infection will likely settle into your lungs and could lead to pneumonia, which nobody wants!)

 


Supportive care (for all ages):

1. Tylenol (for pain and fever) and/or ibuprofen (for pain, fever, and inflammation). Tylenol (acetaminophen) can be taken every 4 hours and ibuprofen (Advil/Motrin) every 6; if you find you need something in between, it is ok to alternate as long as you wait at least 4 hours between Tylenol doses and 6 between ibuprofen doses.

2. Saline nose spray, Netti pot / Neil Med sinus rinse - once or twice a day is usually all you need, but you can do it more often

3. Eucalyptus, menthol, and Vicks - great for cough suppression and to help you breathe easier, especially at night. Apply to the chest and/or bottoms of the feet.

4. Tea with honey, lemon, and ginger - the honey is a cough suppressant (the only cough suppressant that actually works in children and is safe), lemon for vitamin C, and ginger is a decongestant. Remember, no honey in babies who are less than a year old because they can get botulism (a deadly disease); after 1 year of age we have enough stomach acid to kill the botulism spores that live in honey so it’s safe. :)

5. Humidified air / steam - to break up thick mucus

6. Fluids (especially bone broth and herbal tea)

7. As much rest/sleep as possible

8. Wish Garden herbs makes a great herbal tincture called “get over it” and another called “kick-ass immune” - these are great when you are first starting to feel sick

9. Acupuncture +/- Chinese herbs - I recommend Teresa Sullivan or Suzanne Stricker

10. Chiropractic care (especially for sinus and/or ear pressure) - I recommend Hillary Rowenhurst, Birchann Paffenbarger, and/or Amada Reiss

11. Homeopathy - I recommend Dr. Kathi Fry or Margo Gasta

 


And one last thing - the most common way that colds and other viruses spread through households is through bathroom towels, so if someone is sick, make sure they use their own towel to dry their hands and face in the bathroom!

 

Rashes and other Allergic Reactions

Posted on January 1, 2017 at 2:35 PM

Hives:

- Wheal and flare - white swollen center, flat red surrounding area - Itchy, not painful

- Change/move over time

- Generally not dangerous on their own, unless they are in the mouth/throat

- Call a doctor immediately if your child also has cough, itchy throat, swollen lips, trouble swallowing, drooling, or vomiting


Contact dermatitis:

- Red, dry patch that is itchy and not painful

- Generally the same shape as the allergen

- Remove the allergen and it resolves on its own without treatment


Eczema

- Starts off as dry skin that is itchy, not painful

- Can be the same color as surrounding skin, or may be red

- Child needs to moisturize first! Also drinking more water will help moisturize the skin

- Discourage scratching - this can cause it to get worse (flare up) and/or get infected


Food allergies

- Common symptoms are rash, cough, itchy mouth/throat, swollen lips, trouble swallowing, drooling, or vomiting. Call me (or another doctor) immediately if the child develops any of these symptoms and/or if you suspect a food allergy.

- Pay attention to everything the child ate prior to developing symptoms

- The most common food allergens: milk, eggs, soy, wheat, fish, shellfish, nuts, peanuts.  Children typically outgrow the first 4 and do not outgrow the last 4. It is NOT safe to “test” whether they are still allergic by letting them eat the food.  

- Food allergy testing can be done at a doctor’s office


Hay fever / environmental allergies

- Typically mild - the child can still be at school, but inform parent that they have allergic symptoms

- Sneezing, itchy/watery eyes, cough/wheezing, skin rashes - the child may have some or all of these symptoms

- Common allergens: tree/grass pollen, dust, mold, animals (especially cats and dogs)

The four common causes of acne, and five steps to treat it

Posted on November 15, 2016 at 3:30 PM

Acne is mainly caused by 4 factors: sebum, hormones, an immune response, and bacteria.

 

Sebum is produced by sebaceous glands in the skin; it is a waxy substance that helps keep the skin and hair shafts moisturized. When sebum is being produced faster than it can leave the sebaceous gland, the gland gets plugged up and forms a blackhead (also called an open comedone). When the skin is dry, it produces more sebum. This is why over-washing your face, especially with harsh soaps, can actually CAUSE acne. Sebaceous glands can sometimes get plugged by dirt, oil, and sweat, so my first recommendation to help prevent acne is to wash your face once or twice a day (depending on how naturally oily your skin is), and to follow up with a gentle moisturizer.

 

Hormones such as testosterone and progesterone stimulate the sebaceous glands to produce more sebum. Steroid medications such as prednisone, and other medications such as dilantin, lithium, and isoniazid can have the same effect. If you feel a medication is causing you to have acne, speak to your doctor about it before stopping the medication. Cortisol is a steroid that is naturally produced in your body in response to stress, which is why acne flare-ups tend to occur in times of stress. Meditating daily is one great way to help reduce your cortisol level.

 

An immune response occurs when pressure increases in the sebaceous gland or blackhead quickly, and the trapped sebum bursts into the surrounding tissue. This can happen when a pimple forms suddenly, or when the outlet/surface of the blackhead is blocked. White blood cells come to remove the sebum that doesn’t belong there, and when white blood cells die they form pus. This is what forms a whitehead (also called a closed comedone, pustule, or boil). When the inflammation is very severe, they can form cysts (also called cystic acne), which can leave scars. Medicated face washes that contain benzoyl peroxide or salicylic acid break down the sebum plug to prevent inflammation. When washing with gentle soap and following up with moisturizer doesn’t do enough, the next step is to try one of these medicated face washes. Benzoyl peroxide can lighten your skin and hair (e.g. eyebrows) because it is a kind of bleach, and both medications can make you more sensitive to the sun, so remember to wear sunscreen if you are using these medicated face washes.

 

A bacteria called Propionobacterium acnes lives on the skin and can trigger inflammation in the sebum. When benzoyl peroxide and/or salicylic acid aren’t helping enough, the next step is to ask your doctor about a face wash or cream that contains an antibiotic or an oral antibiotic pill. Another medication that kills P. acnes is isotretinoin; this medication cannot be used if you are pregnant because it causes birth defects, and most doctors will make female patients take birth control pills if they are using isotretinoin. It is a very strong medication only reserved for severe cases. Antibiotics and isotretinoin are only available by prescription. Clorhexidine is an antiseptic that you can buy over the counter that kills skin bacteria, and is not as drying as other anti-bacterial soaps. It needs to be used twice daily to work. All anti-bacterial treatments need to be used for several weeks before your skin will clear up, and should be used in conjunction with medicated face washes for optimal effect.

 

Many people feel that eating certain foods (such as fried foods or chocolate) can worsen their acne, but this has not been proven in studies. It is believed that if you have greasy foods and then touch your face, the excess oil on your face CAN be a trigger for acne, but it’s not eating them that is the problem. One other correlation is that people tend to crave greasy foods and chocolate when they are stressed, and the stress increasing their cortisol is actually what is causing more acne.

 

In summary, here are my recommendations for acne. If one doesn’t work, continue on to the next step. And remember, if you already have acne, it can take 4-6 weeks for your skin to clear up, so don’t give up after a few days!

1. Try to decrease your level of stress by meditating or doing something else relaxing daily.

2. Wash your face once or twice daily with a gentle, unscented soap. After washing, gently pat your face dry and use a gentle moisturizer. Use only water-based cosmetics.

3. Use a medicated face wash that contains either benzoyl peroxide or salicylic acid.

4. Use a clorhexidine face wash twice a day, or ask your doctor about starting an antibiotic treatment (either a face wash, cream, or oral pill).

5. Ask your doctor for a referral to a dermatologist, who can prescribe isotretinoin.

 

If you have any questions, you can always call Doctor At Your Door at 720-418-1705.

The 8 most common food allergies in children, and how to test for them

Posted on September 16, 2016 at 4:35 PM

The most common food allergies in children are:

Dairy (cow’s milk)

Eggs

Peanuts

Tree nuts (almonds, walnuts, hazelnuts, brazil nuts, cashews, etc.)

Wheat

Soy

Fish

Shellfish

 

Children tend to outgrow dairy, egg, and soy allergies in the first few years of life, and do not tend to outgrow fish, shellfish, peanut, and tree nut allergies.

 

Reasons to suspect your child has a food allergy include:

Eczema (dry, itchy skin)

Hives (itchy red bumps that are usually larger than 1/4” in diameter, and seem to move and may spread over time)

Vomiting/diarrhea

Asthma (wheezing, coughing, and/or shortness of breath)

Turning pale or fainting

 

If your child has a food allergy, one or more of these symptoms will occur every time they eat that certain food. If your child has these symptoms, a food diary can help you identify the likely culprit. Write down everything that they eat for several days, along with their symptoms, and look for correlations. If your child has a severe reaction, STOP them from eating anything that they ate that day, go to the hospital, and then make an appointment to see an allergist.

 

An allergist or a pediatrician can test your child for food allergies. There are two main tests: the skin prick test and the blood test.

 

The skin prick test involves a rough plastic plate that the doctor puts drops of diluted food allergens onto, then presses onto your child’s skin. The plastic gently pricks the skin; it is not very painful, it just feels like someone pressing velcro against your skin. The allergen is introduced into the skin, and if your child is allergic to that food, a small bump like a mosquito bite will appear within 30 minutes. The doctor will measure the size of your child’s bumps on the skin to tell you how allergic they are to certain foods. This test can be pretty uncomfortable, because those little bumps itch just like mosquito bites, and sometimes your child will have a reaction to many of the allergens. It also requires you to stay at the doctor’s office for at least half an hour.

 

The blood test for food allergies looks for antibodies to certain foods. The good thing about the blood test is that it is fast (just one blood draw) and your doctor can test for many kinds of allergens at the same time. The bad news is that the blood test is not completely accurate, because your child has to eat enough of that food to cause antibodies to be formed.

 

Both types of allergy tests can be affected by allergy medications, so your child must avoid antihistamines (Benadryl, Claritin, Zyrtec, etc.) for a week before these test are done. They are also affected by steroid medications (such as prednisone), and these must be avoided for even longer.

 

Doctor At Your Door does not provide allergy testing at this time, but if you would like a referral to an allergist you can call us at 720-418-1705.

Measles in Denver!

Posted on July 20, 2016 at 1:35 AM

Last week, a child in Denver was diagnosed with measles. This is a big deal because measles is VERY contagious; it spreads by airborne transmission, meaning it can cross an entire room in seconds and expose everyone in it. Not everyone who is exposed will get measles; some people’s immune systems are able to fight it off, especially if they have already been vaccinated. But no vaccine is 100% protective.

 

The incubation period is 1-3 weeks, meaning that after a person is exposed to measles, they might get the symptoms of the disease in 1-3 weeks. Symptoms of measles are: fever over 101, cough, runny nose, pink eye, and a red spotty rash that starts on the face and migrates down the body.

 

The reason doctors worry so much about measles is not the disease itself, but the complications.

- 1 in 10 children will get an ear infection with measles, and about 1 in 10 of these will get permanent hearing loss

- 1 in 20 children with measles get pneumonia, which is the leading cause of death from measles

- 1 in 1,000 children will get brain damage

- 1-2 in 1,000 children will die from measles

- Pregnant woman who get measles can have a miscarriage or have a baby with birth defects

 

The child in Denver got sick while traveling internationally. This child went to the following locations while sick, and may have exposed people in these locations. If you were in one of these locations in the beginning of July, and you develop fever, cold symptoms, or a rash before August 5th, please call a doctor right away. You should wear a mask in public or at the doctor’s office, or better yet, have a doctor come to your home so you can be tested.

 

Exposure locations and times:

Kumon Math and Reading Center of Highlands Ranch

9362 S. Colorado Blvd. #D-08, Highlands Ranch, CO 80126

July 8, 3:30-6:40pm and July 11, 3:30-6:40pm


King Soopers

9551 S. University Blvd, Littleton, CO 80126

July 11, 4:30-7:45pm


Panda Express

9563 S. University Blvd., Highlands Ranch, CO 80126

July 11, 5:45-8pm


Southeast Denver Pediatrics

11960 Lioness Way #200, Parker, CO 80134

July 12, 9:50am-12:15pm; July 13, 9:50am-12:35pm; and July 14, 11:35am.–1:45pm


Target

10001 Commons St., Lone Tree, CO 80124

July 12, 11am-2pm


Sky Ridge Pediatric Emergency Department (Evergreen Building)

10107 Ridge Gate Pkwy, Lone Tree, CO 80124

July 14, 12:30-9:45pm


Pediatric Unit at Rocky Mountain Hospital for Children at Presbyterian St. Luke’s

2001 High Street., Denver, CO 80205

July 14, 8:30pm - July 15, 3:30am


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