Cotton Swabs

Cotton-tipped swabs are not meant to be placed in ears. According to the American Academy of Pediatrics, the best thing to do with earwax is leave it alone. Trying to remove earwax can cause problems.

Putting cotton-tipped swabs into the ear canal pushes wax further into the ear. It can cause damages, dizziness, and balance problems. A child whose earwax is blocking the ear may have ringing or fullness, ear pain, itching, discharge, odor, and cough. Swabs also may tear or rupture the eardrum causing pain, bleeding, and permanent hearing loss.

For more information on earwax, please visit the HealthChildren.org.

Fever Medication

Every year hundreds of infants receive more than the recommended dose of  Tylenol for age. Rarely, these overdoses can cause liver failure or death. The overdoses are most likely related to dosing too frequently- that is more than every 6 hours AND from parents using two products that BOTH contain acetaminophen

e American Academy of Pediatrics does NOT recommend cough or cold medications for children under the age of two unless they are ordered by a physician.

When Is a Fever an Emergency?

While for the majority of children fever is not an emergency- there are a certain group of children that fever is considered dangerous. Think of the Three I’s

Think of the Three I’s

  • Immune compromised– children that do not have a well working immune system cannot fight off infection and therefore when they have fever they need to see their healthcare professional immediately
  • Immunization– babies less than two months of age are at higher risk for bacterial infection and if your child has not had his 2-month vaccines and has a temperature over 100 degrees rectally you should consider this a medical emergency and go directly to the emergency department
  • Intake– having a fever WILL make your child uncomfortable- especially if it is over 102.  Often this leads to poor drinking and if your child cannot drink enough they may become dehydrated. If you think your child might be dehydrated due to fever then bring them to see the doctor immediately.

Fever is Good – Most of the Time

For parents, doctors and pharmacy companies, fever has been thought to be “the enemy”. We should be scared of fever and make it go away as fast as possible. This may be a very dangerous idea for the following reasons.

Fever Facts

  • All animals, even single cell organisms, have fever. Therefore it is felt to be important in protecting us in some way.
  • Studies show that increasing the body temperature decreases the ability of bacteria to multiply and spread. That gives antibiotics a chance to work faster.
  • Newer studies also show that the increase in body temperature activates a special kind of white blood cells- aptly named “killer T cells”. The activation of these killers means that your body can fight virus infections better and may be the only “treatment” needed for getting rid of the most common form of infection.

Therefore- not letting your body have a fever when you have an infection may actually make the virus last longer and take the antibiotics longer to work for bacteria infections.

Fever Phobia

In 1980, Pediatrician  Dr. Barton Schmitt created the term “Fever Phobia” to describe the misconceptions that many parents and physicians have regarding fever. Since that initial study, many other researchers have looked at how parents react to a child with fever. Most all studies show that the majority of parents do not understand key concepts related to fever, such as what defines a fever, how dangerous is a fever and how should fever be treated.

Throughout the month of September, The Children’s Clinic will be providing daily information for parents about what defines a fever and how to treat fever in children. It is hoped that this factual information will help alleviate the myths and fears that are associated with fever and guide parents on when to call for an appointment and when to be concerned if their child develops fever.

Hungry or Bored?

Children sometimes use food for reasons other than hunger to satisfy themselves.  These reasons may be in response to their emotions or feelings.  Many things can trigger hunger such as:

  • boredom
  • depression
  • stress
  • frustration
  • insecurity
  • loneliness
  • fatigue

One way to keep your child from eating out of boredom is to steer them towards activities that keep them busy.  Also make sure your child eats three well-balanced meals and one snack each day.

A few things to do instead of eating would be:

  • walk the dog
  • walk around the neighborhood
  • kicking a ball around
  • painting a picture
  • running through sprinklers

Mumps – What You Should Know

Mumps has been in the headlines lately, and for a good reason.  We are in the midst of a significant outbreak in several areas of our state, and cases of mumps have recently shown up in Northeast Arkansas. Here are a few facts about this disease:

  • Mumps is a viral illness spread by coughing and salivary contact.  It is present throughout the world and is uncommon in the USA because we immunize for it.  The virus infects our respiratory tract and salivary glands, lasts for several days, and usually resolves without complications. After a 2-3 week incubation period, children and adults typically develop cough and congestion, sometimes fever and headache, and about two thirds have salivary gland inflammation with tender, firm swelling over one or both cheeks.  When it is suspected, mumps can be tested with a cheek swab – the result may take several days.  
  • Thought the disease is usually relatively mild and self-limited, it can cause occasional severe complications including swollen testicles in adolescent or adult males, viral meningitis, encephalitis, arthritis, or other glandular inflammation.  For women in early pregnancy, there may be a slight increased risk of spontaneous miscarriages.
  • There is no specific treatment for mumps, so the only effective approaches are containment and prevention.  Infected children can pass on the virus well before, and for about 1 week after the symptoms show up, so isolation of sick or highly susceptible individuals is important.  Mumps vaccine is part of every child’s routine immunization regimen and is usually given at 1 and 4 years of age.  Most, but not all children who’ve had both doses are fully immune.  

More information, including detailed isolation advice, is presented in a recent Arkansas Department of Health Newsletter (see below), and you may feel free to contact us if you have questions or concerns.  

 

Measles

What is measles?

Measles is a viral infection that begins with a fever that lasts for several days, followed by a cough, runny nose, and conjunctivitis (pink eye).  The rash starts on the face and upper neck, spreads down the back and trunk, and then extends to the extremities (arms and legs) to include the hands and feet. After about 5 days the rash then fades in the same order it appeared.

That all sounds fairly benign, so why should we worry about the measles?
Here’s why!

  • 1: 4 = require hospitalization
  •  1: 1000 = Get encephalitis(inflammation of the brain)
  •  1 or 2: 1000 = Will die from this illness either from pneumonia or encephalitis
  • Pregnant Unvaccinated Women or Women who’s antibodies to the vaccine are no longer protective= are at risk if they acquire measles during pregnancy for Miscarriage, Still birth, Prematurity, or Congenital Rubella Syndrome which consists of heart problems, Microcephaly(small head), hearing and vision problems, learning problems, and the list goes on.

How is measles spread?

  • A person with measles is contagious for 4 days before developing symptoms and remains contagious until 4 days after symptoms evolve.
  • The measles virus lives in the mucous of the nose and throat, and is spread when people sneeze or cough.
  • Droplets from coughing enter the air and can contaminate a space for up to 2 hours after person leaves
  • Incubation period(time from exposure to dev of disease) is 7-21 days.

Memphis had 3 distinct outbreaks and now 7 confirmed cases. The cases were not related to foreign travel and the health department could find no relationship between the outbreaks but are still investigating.

So what about the measles vaccine!

  • Introduced in 1963, and is combined with Mumps and Rubella to give the MMR (Measles, Mumps, and Rubella) vaccine. In 2000, Measles was felt to be eliminated in the United States, but there are still pockets of disease secondary to people traveling outside of the US and bringing it home or in populations which opt out of vaccines.
  • There is no scientific proof that the measles vaccine causes Autism, and the vaccine does not contain mercury.  The fear of both of these things has caused families to not vaccinate.
  • Nationally, 91.9% of children between 19-35 months of age have had at least one MMR vaccine as of 2013. However, Arkansas’s numbers were at 88.3% for the country (near the bottom but not the worst). The saddest part of these statistics, is that our state is at the very bottom of the list for this age group having received all of its vaccines at 57% (means only 57% of kids in Arkansas between 19-35 months of age are completely immunized).
  • At present the recommendations are that children receive 2 doses of the MMR vaccine. The first dose to be given between 12-15 months of age, and this would protect 93% of those exposed from getting measles. The second dose normally is given between 4-6 years of age,with entrance to school and raises the protection level to 97%(this means if you were exposed to measles you should be protected against not getting it 97% of the time). If the health department deems necessary, they will change timing of second vaccine and request it to be given 28 days after first.
  • Those less then 5 yrs of age are the one of the most susceptible groups, either because they are too young to vaccinate or have not gotten their second dose of the vaccine.

What about babies who aren’t vaccinated because they are too young?

Babies get passive immunity from their mothers (antibodies pass through the placenta), but no one is quite sure how long these last for. Thus this age group is very much at risk.

What other groups can’t receive the vaccine?

Pregnant women, those on steroids and other immunosuppressive medicines can not receive the MMR vaccine. This includes those individuals who have undergone transplants or are bring treated for cancer.

So the major take home point is that we need to get our children immunized with the MMR vaccine to protect them, but also to protect those in the community who are too young, pregnant, or unable to be vaccinated for other medical reasons. Stay informed by checking your local news and visiting our website for updates.