Infant

All Articles in the Category ‘Infant’

People Are Dying From The Flu

Screen Shot 2013-01-08 at 12.45.43 PMInfluenza virus causes “the flu.” It’s a crummy cold that spreads easily causing high fever, body aches, runny nose, terrible cough, and rarely it can cause vomiting and diarrhea, too. The flu isn’t the “stomach flu.” It’s deadlier than that. It’s more dangerous for babies and young children, and for the elderly. It’s also particularly dangerous for those with asthma, diabetes, and people with neurologic or immune problems. This post is a bit of a plea: people are dying from the flu and there are ways we can potentially save others’ lives. Click through to read 5 myths about the flu and watch a 3-min interview I did for HLN television yesterday.

The bad news: We’re having a bad flu season. More people have the flu this year than at any time last year. This is early—flu usually peaks in Feb or March. The most dominate strain of flu that’s moving around the US is the strain called H3N2—it’s known to cause more serious disease. As of today, we have over 80% of our states reporting widespread circulating levels of flu. Here in Washington many people have been hospitalized from complications of the flu. Further, in Washington 6 people have died, one of them a child under the age of 12. A healthy 17 year-old died in Minnesota just this week. Flu is not just your “common cold,” it can be far worse. Eighteen children have already died this season. As of November, we didn’t even have 1/2 of our population with a flu shot. The goal to protect us all is 90%.

I’ve never had a family in clinic get influenza illness and then refuse the flu shot the following year.  They come in early and often for their shots. It’s that bad of an illness.

The good news: We have a vaccine for the virus that causes the flu. The flu shot and flumist nasal spray are effective and that H3N2 strain that we’re worried about, it’s in the flu shot and the nasal flu spray this year. It’s not too late to get a flu shot. You’ll be protected against the flu somewhere from 10 day to 14 days after getting it. Go out now and protect yourself and your family. By getting a shot you protect yourself, your children, and all those more vulnerable in our community unable to get the shot (those infants under 6 mo of age, those on chemo, or those with contraindications to the shot).

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You Need A Carbon Monoxide Alarm

There’s a new law today in Washington State requiring carbon monoxide (CO) alarms in apartments, condos, and single-family residences. You should have a CO detector on every level of your home (more tips below). I know you’ve heard that CO poisoning is not only dangerous but also potentially fatal. We also often hear horrific stories of accidental deaths from carbon monoxide after natural disasters. A recent study found disaster related deaths are particularly common (your power’s wiped out so you bring in a generator or grill for heating or cooking and get exposed to CO). Using a generator indoors is the most common cause of CO poisoning, followed by use of a grill. Unfortunately, over 400 people die in the US each year from CO poisoning—all of which could be avoided with proper education and detection in the home. The odd thing is that we often get to see CO toxicity play out on our favorite television shows (think Mad Men)~ the ever-again scene where someone clogs up the exhaust pipe of a car with a banana or handkerchief and dies (or attempts to) due to the toxic fumes.

One generator running inside a home, garage, or basement creates the equivalent carbon monoxide of 6 idling cars. Precisely why a generator needs to be 20 feet from inside spaces and away from open windows/doors. Carbon monoxide is found in combustion fumes–it can be produced by cars and trucks, small gasoline engines, stoves, lanterns, burning charcoal and wood, gas ranges, and heating systems. You likely know all this. But…

The thing to know: carbon monoxide in and of itself is more dangerous to babies and young children. Infants in utero, newborns, and young children process carbon monoxide differently, have more severe reactions, and may see effects faster than adults. If you and your young child were in a room that was filling with carbon monoxide, it’s your baby or child that would suffer the consequences first. They may not know how to tell you about their complaints and if they were sleeping you may not even know. Hence all of us needing a CO detector.

carbon monoxide teaching fr CDC

The Science of Carbon Monoxide Poisoning:

The red blood cells in our blood circulate oxygen to all of our muscles and organs for survival. When carbon monoxide (CO) is in the air it can function as a disguised villain. When carbon monoxide is inhaled into the lungs via contaminated air, the red blood cell picks up the CO instead of just oxygen. Each carbon monoxide molecule that attaches to a red blood cell displaces a spot for oxygen. Therefore the circulating red blood cells go around the body without oxygen causing improper circulation. Organ failure and death can result after higher and higher level of our cells are bound to CO instead of oxygen.

The graphic is from the Centers For Disease Control (CDC)’s comprehensive review on CO poisoning.

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Baby Dies From Whooping Cough

camping out with babyNews of a whooping cough death in the Seattle area rang out yesterday. By afternoon, many of my patients in clinic had heard the news. Although the epidemic levels of whooping cough have gradually faded since a peak of cases here in May, the risk is still very real.

A newborn baby died from whooping cough on December 13th here in Washington State.

Newborn babies are at particularly elevated risk for serious complications from pertussis (whooping cough) infections. Unlike older children and adults who often have cough & coughing fits with vomiting, babies can have severe respiratory distress, pauses in breathing, or even stop breathing. Rarely it can be deadly.

Infants are most likely to catch whooping cough from a parent. We have to cocoon newborns everywhere: surround them with people who are vaccinated and less likely to spread whooping cough infection.

This tragic death serves up a reminder for we pediatricians, family docs, and clinicians everywhere to maintain our efforts and amp up our passion to keep babies surrounded by immunized family and friends. We can’t let up.

Are You Up To Date On Your Whooping Cough Shots?

More than anything, we need to ensure family members (mothers, fathers, grandparents, and siblings) all are up-to-date on their whooping cough shot. The shot is imperfect (meaning not everyone who gets the shot is always immune — most estimates find that 80% of us who get the shot are protected) and we know some of our immunity to whooping cough can fade year after year. So the more people immunized the less likely we are to have whooping cough in our community. Read full post »

Mix And Match: Goldilocks Formula

Often new parents are nervous about mixing and matching infant formula they offer their babies. They worry if they switch from one formula brand to another, they may cause their baby fussiness, stool changes, upset or worse–that they could put their baby at risk.

It’s safe to mix and match infant formulas if you are following standard mixing instructions. Really.

Although spitting up or gassiness is usually not due to the protein in formula (cow’s milk versus soy versus hypoallergenic), sometimes changing formula helps new babies and their parents who worry. Switching them up can even help clarify worries in some scenarios when a parent worries about excessive gassiness, intolerance, or significant urping or spitting up.

Experimentation with formula brands in an otherwise healthy newborn is okay. But it’s not necessary at all, either.

It’s fine to make a bottle that is ½ formula from the blue can and ½ formula from the yellow one. Fine to serve Simulac one week, Enfamil the next, Earth’s Best or Goodstart followed by Soy formula the following day. Fine to buy one brand that’s on sale only to buy the other brand next week. Read full post »

Should I Feed My Children Rice? Arsenic & Rice

Recent reports have heightened concerns about arsenic levels in rice products here in the US. This has left many parents wondering if we should be serving rice to babies and children. The video summarizes my current recommendations.

Read the report from the Pediatric Health Environmental Specialty Unit mentioned in the video. References on authors and sources are at the end of the report. This report is calm, informative, and backed by experts—there appear to be no false claims.

Remember, arsenic is a naturally occurring element on earth. However, natural doesn’t necessarily mean “good for you.” There are two types of arsenic–organic and inorganic. In general, it’s the inorganic arsenic that we worry about. The big picture goal for all of us is to eat a diverse diet full of a variety of foods thus protecting us by decreasing exposures to any one thing.

Arsenic is large quantities has been found to pose health risks. So taking steps to minimize consumption of foods high in arsenic may be beneficial. Before you bail on rice althogether, know that not every group is ready to tell you to rid your pantry of rice. Here’s what the American Academy of Pediatrics says currently (fall 2012).

5 Tips To Reduce Arsenic Consumption For Your Family:

  1. Have your water checked for arsenic if you have well water or a private water supply. The Environmental Protection Agency (EPA) mandates arsenic levels in public water. But if you have any questions or concerns about public water, call your water company and ask about report data. Read full post »

Why A Flu Shot Every Year?

We need a flu shot annually because influenza virus changes structure and shape as it moves around the globe each year. The strains that cause human disease are different from one year to the next, so we update and add to our protection annually by getting a shot or nasal flu spray. Children, especially those under age 5, are at higher risk for severe disease from influenza. In children and adults, influenza can cause a mild illness, but unfortunately, sometimes it can cause severe or even life-threatening complications. Children may have a more difficult time fighting off influenza partly because they don’t have years of exposure to other strains of flu and no real immunity built up. Therefore all children are considered a priority group for flu shots. Pregnant women, families with infants at home, and those with underlying medical problems like asthma, diabetes, or neurologic problems really need to get them, too.

It takes a well-orchestrated, worldwide effort to help predict which strains come to our country and which 3 strains are included in the annual flu shot or flu nasal spray here in The United States. The video explains more.

What You Need To Know About “Flu Season

How Experts Determine Flu Strains for Shots/Nasal Spray

Find A Flu Shot Clinic Near You

Every Year Is An Influenza Pandemic For Children (commentary)

New Data On Infant Sleep You’ll Want To Know

We had one of each in our house: one baby that we let cry for periods of time to self-soothe and one where I simply couldn’t bear to hear the crying in quite the same way. You’d think it would have been just the same for both of our boys, but it wasn’t. Clearly I wasn’t the same parent each time around.

There are many things that go into the equation of how we get our babies to sleep thought the night. And those of us who struggled after our babies after 6 months of age are in good company. Research shows that about 45% of mothers say they struggle with their 6-12 month-old’s sleep.

Solving the sleep solution requires a diverse mix of instinct, patience with personal and baby temperament, timing, mood, advice we get, and good luck.

The reality is that there isn’t one perfect way to help support an infant who’s learning to sleep through the night. But there are few pearls I believe in: Read full post »

Circumcision For Newborn Baby Boys

Last week, the American Academy of Pediatrics (AAP) issued an update to their circumcision policy statement that attracted significant attention. In it, the task force clarified the previous neutral policy for boys’ circumcision. The AAP stated that research has advanced since it’s most recent report in 2005 to conclude the health benefits of circumcision outweigh the procedure risks. Like any medical test or procedure, circumcision carries both benefit and risk. With global data expanding about benefits of circumcision and protection against sexually transmitted diseases, the AAP changed its stance. Risks from circumcision are reported to be very unlikely and happen less than 1% of the time. Most common side effects can be a small chance of bleeding or a need for antibiotic ointment. The most frequently reported adverse event from parents is a concern not enough foreskin was removed. Fortunately, circumcision revisions are very rare.

The statement doesn’t go so far as to recommend that boys undergo circumcision, rather the task force stated that the procedure should be done under sterile technique by a trained, experienced clinician. Importantly, they stated for the first time that it should be covered by Medicaid and insurance. This with the hope that every family ought to have the right to make a choice for or against circumcision, not just those with private insurance.

Clearly, the decision to circumcise a newborn baby boy isn’t made simply in the content of medical data. Families weigh religious traditions, cultural practices, family history, and medical information when choosing to circumcise or not. The AAP statement maintains and honors this belief. Ultimately, the decision is a private one for families to make. A pediatrician, family doctor, or ARNP should help you go over medical benefits/risks as needed. As a parent, you go over the rest. Read full post »

Hands-Only CPR

Although this video feels a little bit like a video game (and takes you back to the 1970’s), it’s 1 minute of your life you don’t want to miss. Recommendations for CPR have changed this past decade. If you don’t have time to re-certify, take 1 minute and watch this video. Don’t ever be afraid to help immediately in a emergency situation where a teen or adult has potentially suffered a cardiac arrest. Channel your inner-John Travolta. Your actions can only help. Check out the American Heart Association CPR page for more. You can take a CPR class IRL (in real life) or online.

Bystander CPR dramatically improves survival from cardiac arrest, yet far less than half of arrest victims receive this potentially lifesaving therapy.

Parents who have learned how to do CPR are often more confident about their ability to manage an emergency of any kind. As a mom, I always feel more confident after reviewing these recommendations.

CPR For Infants & Children Is Similar But Different

Click on these links for drawings and nice summaries of CPR recommendations. Hands-only CPR is not recommended for children. However, the rate of compressions for infants and children also matches the Stayin’ Alive beat…

Instructions for Infant CPR (babies under 1 year of age)

  • If alone, start CPR for 2 minutes, and then call 911.
  • CPR consists of doing 30 chest compressions (with your fingers) and then 2 gentle, 1-second rescue breaths, then 30 compressions again. Repeat.

Instructions for Child CPR (children under 8 years of age) &  Video Explanation

  • If alone, start CPR for 2 minutes, and then call 911.
  • CPR ratio is 30 compressions for every 2 breaths. This is the same compression-to-breath ratio as infants. However, the position of your hands for compression is different.

If you’re local, you can take infant, child, or adult CPR classes at Seattle Children’s.

Don’t Be Shy About Food Allergies

Food allergies have more than doubled in the developed, Western World over the last 50 years and the reasons remain unclear. Yet recent data finds 8% of children in the US with a food allergy with 1/3 of those children at risk for severe or life threatening reactions. A Pediatrics study published today has some sobering news about our ability to protect children from allergic ingestions. When it comes to allergies and deadly reactions 2 things are necessary:

  1. Avoidance of known triggers/allergens.
  2. Treatment of anaphylaxis (severe reactions) promptly with epinephrine.

Trouble is, children get exposed to known allergens by mistake and people are often nervous or unsure about how and when to use an Epipen (epinephrine in a pre-measured syringe). All parents/caregivers/teachers/coaches need to practice use of an Epipen & refresh why/when to administer it to an allergic child.

 The Study:

  • Researches followed over 500 infants and young children allergic to milk and eggs (and many to peanuts) between 3 and 15 months of age. During the 3 years of the study, the majority of children (72%) had an exposure to an allergen that caused a significant reaction. Of the allergic reactions, 42% were reactions to milk, 21% to egg, and just under 8% to peanut. Reactions were most severe when a child was exposed to peanut, followed by milk, and then egg.
  • Over 1/2 of the ingestions occurred after a non-parent adult offered an allergic food. Read full post »