If there are two pearls of wisdom I can impart to you about toddlers it is this: they will have many boo-boos and there will be times you will be convinced your toddler is “always sick” and you should change your address to that of your pediatrician’s office.

Toddlers are the captains of the boo-boo and “bug” brigades.  While most boo-boos are minor and require nothing more than a kiss, and most “bugs” are viruses that clear before you can reach for the phone, there are times some injuries and illnesses can be serious and require more care. As with all things toddler, those times also tend to be very obvious once you know what the key factors are to focus on. Continue Reading

One of the most difficult issues for new parents, and grand-parents, is deciding if a very young infant (under 2 months of age) is sick. Some people go by “look”; others seem to have a built in radar that alerts them to when something may be wrong that at least prompts the call to the pediatrician. Pediatricians, too, develop a sixths sense with this age group. They have to because this group, above all others, deserves special attention when illness lurks.

Continue Reading

The last decade has produced some amazing changes in child health. Recently, I consulted some of the top pediatricians in the country to figure out where we’ve come from and where we are going next.  Some of these changes may surprise you, so hold on to your seat!

Continue Reading

With H1N1 now on the scene, part of the confusion is we have two flu viruses circulating: H1N1 and the Seasonal Flu that visits us each and every winter. While our attention has been focused on H1N1 since it’s arrival, let’s take a minute to remind ourselves about the Seasonal Flu and flu shot so we are prepared for it should it arrive this winter as it typically does as a chill enters the air.

Continue Reading

H1N1 has sure made our lives more complicated, hasn’t it?

It used to be complicated enough staying up to date with one influenza virus, the “seasonal” or winter flu, now we have H1N1, swine flu, to worry about, too. In other words, we now have two flu seasons instead of one.

H1N1 and “seasonal” flu have a few important differences:

1. H1N1 is a distinct virus from “seasonal” flu.
2. H1N1 doesn’t have a distinct season the way “seasonal” flu actually has. H1N1 seems to be perennial, meaning it seems to be able to run through all the seasons.
3. H1N1 seems to be more mild than “seasonal” flu, so far, but can still make people very ill and has cost people their lives.
4. H1N1 is very widespread and that hasn’t changed so far.

Continue Reading

You know one of these days it will happen. On the day when you least expect it (and often when it is least convenient) the school nurse will call in form you that your child has “flu like symptoms with a fever” and needs to be picked up. Now what?

Continue Reading

Technical Names: laryngotracheobronchitis

NickNames: croup, barking seal cough

What is it: infection of our trachea – the main tube in our throat

Typical Ages for Illness: infants and toddler most usually but occasionally younger elementary school children.

Typical Symptoms:barky, seal-like cough often worse at night; +/- fever; +/- trouble breathing. Often starts as a bad cold then suddenly worsens.

Etiology: most commonly parainfluenza virus types 1 and 2, but many winter/flu season viruses possible culprits including influenza, adenovirus and RSV.

Seasonal Issues: usually winter illness, sporadic cases during other seasons

How’s It Spread? person to person by respiratory droplets – i.e. getting coughed or sneezed on, or fomites – touching droplets on an object.

Incubation Period? 2 to 6 days

Symptom Duration: there is usually a few days of a early, cold like symptoms, then 1-3 days of the barky cough which tends to get worse over the first couple of nights before improving.

Treatment:

• cool steam, air – take child outside on front stoop if really barking
• possible steroids if cough is severe
• try taking the child into the bathroom with the shower running for steam

Call Your Pediatrician If:

• trouble breathing: fast rate, skin between abdomen or ribs sinking in
• stridor: tight, squeaky sound
• looking sick
• high fever
• drooling
• inability to talk a complete sentence

Prevention:

• good hand washing
• having the child cover his or her mouth when coughing, if possible
• cleaning toys and objects likely contaminated by respiratory droplets

School and After school Activity Issues

• may return to school when fever free for 24hours
• avoid large groups of kids if cough is not controlled to prevent further spread

Internet Resources for Parents

Kids Health Information on Croup

WebMD Information on Croup

Technical Name: Parvovirus B19

OtherNames:

Erythema Infectiosum (EI)

5TH Disease

What is it? A viral illness

Symptoms and Course:

Typically starts with a fever and mild viral symptoms such as tiredness, headache and cold symptoms, then  proceeds to a rash with slapped cheek appearance. Fever occurs in 15-30% of patient’s according to the AAP Red Book. The viral illness may occur a week before the rash. 10% of kids develop achiness of joints or true arthritis.

Spread: person to person via respiratory droplets, ie close contact

Incubation Period: 4 to 14 days, but sometimes up to 21 days, for initial illness with rash and joint symptoms occurring 2- 3 weeks later.

Diagnosis: usually clinical but a blood test can be done if needed.

Special Issues: there is often concern raised for pregnant women but risk of infection is very low given that most of us have likely been exposed during our lives. Pregnant women who are concerned about exposure should talk to their doctors about testing.

Treatment: supportive since illness is usually self-limited in it’s typical form

School Issues: Kids with the rash are  not contagious and may return to school and participate in activities.

Resources

CDC Parvovirus Information

KidsHealth Fifth Disease

Updated January 29, 2009

As of this post, the FDA has expand the peanut butter recall to include all products made by the Peanut Corporation of America in their Georgia plant since January 1, 2007. Retail jars of peanut butter that you can find at your local grocery store are still safe and not included in the recall.

Information on Salmonella Food Poisoning:

What symptoms should you watch for? The same as the stomach flu – fever, abdominal pain, diarrhea, vomiting.

When would symptoms occur if from tainted food? Within 6-72 hours of eating the food. So, if days have gone by, again, don’t worry.

How is food poisoning treated? Hydration is the main focus initially and then slowly advancing the diet. Your doctor’s office can best guide you depending on your symptoms.

When in doubt, call your pediatrician. Stool can be tested for Salmonella and this is one of the few intestinal infections we can treat with an antibiotic.

Internet Resources

Salmonella Infections (KidsHealth)

Food Safety (KidsHealth)

Food Poisoning (CDC)

Technical Names: Lyme Disease

Lyme Map: Lyme has a definite geographic distribution. According to the CDC you’ll find Lyme in these three areas:

• Northeast: Massachusetts to Maryland.
• North-central states: especially Wisconsin and Minnesota.
• West Coast: especially northern California.

Nicknames: Lyme Disease, Lyme

What it is: tic-borne infection from ticks of the Ixodes genussed by the bacteria borrelia borgoferi

Typical Ages for Illness: any

Typical Symptoms: Lyme Disease has three stages.

• Early: is a characteristic rash at the site of the tic bite called erythema migrans. Its main property is an expanding, red circle.
• The second phase is more disseminated: multiple erythema migrans patches occur in 15% of patients, other symptoms that can occur during this phase are arthritis, conjunctivitis, nerve palsies, headache and fatigue. Other uncommon issues can develop during this phase if untreated.
• Late disease is chronic arthritis of the large joints, usually knees. This is very, very uncommon in kids who have been treated.

Etiology: Borrelia burgdorferi , a spirochete bacteria

Seasonal Issues: spring and summer when tics are out; geographic distribution includes New England, eastern mid-Atlantic states, upper Midwest in Minnesota and Wisconsin.

How’s It Spread? Via tic bite of infected tic

Incubation Period: 1-55 days with a mean of 11 days. Late symptoms occur months toyears later.

Diagnosis: clinical if rash present; quick lab assay that will remain positive for life – so it can be used for diagnosis but not to confirm if treatment was effective.

Prevention: REMOVE THE TIC if you remove the tic with in 2 days, Lyme will not get transmitted from the tic to the person its attached to. So, the sooner than better. How to remove? Take a tweezers and grab the tic on the head. Gently pull up and the tic will release. Don’t worry if the tic’s small pincers stay attached to the skin – those don’t carry disease and will not cause harm.

Treatment:

Antibiotics for 14-21 days orally for early disease. More complicated disease and late disease needs to be treated longer and sometimes by IV antibiotics.

Call Your Pediatrician if your child has: A tic bite where a characteristic rash began to form.

School and After school Activity Issues: no restrictions. This is not contagious person to person.

Internet Resources For Parents

CDC Lyme Page

Tick Management Handbook

Tick Bite Prevention

Internet Resources for Kids and Teens

Lyme Info For Kids

Lyme Info For Teens