Charish Barry, MD Charish Barry, MD

Month: October 2015

UPDATED Media and Screen Time Recommendations

Posted on by Charish Barry, MD in

Where We Stand: TV Viewing Time

The American Academy of Pediatrics (AAP) recommends that parents and caregivers minimize or eliminate altogether media exposure for children under the age of two.

For older preschool-aged children, media limits are very appropriate and parents should have a strategy for managing electronic media when choosing to maximize its benefits.

Remember that supervised independent play for infants and young children has been shown to have superior benefit to the use of screen media when you cannot sit down and actively engage in play with your child. For example, have your child play with nesting cups on the floor nearby while you prepare dinner.

Also, avoid placing a television set in your child’s bedroom and recognize that your own media use can have a negative effect on children.

Additional Information:
How to Make a Family Media Use Plan
The Benefits of Limiting TV
What Children are NOT Doing When Watching TV
Why to Avoid TV Before Age 2
Sleep and Mental Health
Last Updated
8/20/2015
Source
Caring for Your Baby and Young Child: Birth to Age 5, 6th Edition (Copyright © 2015 American Academy of Pediatrics)

The Benefits of Limiting TV

The AAP discourages TV and other media use by children younger than 2 years and encourages interactive play. For older children, total entertainment screen time should be limited to less than 1 to 2 hours per day.

You’ll all discover more constructive ways to fill the time, separately and together. Some examples include:

Reading

Exercising

Taking part in outdoor activities

Talking more to one another

Expect to encounter resistance at first. After all, change is never easy. If yours is a household where the TV regularly blares for five, six or seven hours a day, wean the family gradually. Try cutting down by an hour a week or go cold turkey. The two-hour maximum includes time spent in front of any screen, including the computer and video games.

Make TV viewing an active choice, as if you were picking a movie from the newspaper. “How about if we watch at seven-thirty?”

Hide the remote! Eliminate channel surfing, which encourages passive viewing. When family members have to get up to change the channel, they may be more selective about the programs they watch. If nothing else, at least they’ll be getting some exercise.

When the show you wanted to watch is over, turn off the set. Also, if the program you choose isn’t compelling enough to watch actively, it’s not worth keeping on as background noise.

Make a household rule: no TV in your youngster’s bedroom. Although adolescents deserve their privacy, they hardly need another reason to isolate themselves from the rest of the family. Children should watch their favorite shows in a central area of the home. Even if you’re not sitting down with them, this allows for conversation when you’re passing through and enables you to  keep closer tabs on what they’re watching.

Whenever possible, videotape programs and watch them later. Fastforwarding through commercials will shave ten minutes off every hour of TV viewing, not to mention help your youngster hold on to her allowance longer. (When watching TV in “real time,” mute the sound during the breaks.) Taping shows ahead of time also allows you to hit the PAUSE button when you want to make a point or have a family discussion about something you’ve just seen onscreen. 

Discourage repeated viewings of the same video. The graphic language, violence and sexual content of movies rated PG-13 and R can have a cumulative effect on a child if they’re watched over and over again.

Harness the power of television in a positive way. For all its flaws, TV can be a valuable tool for learning and expanding one’s awareness of the world.

Here’s what you can do to help your child get the most enjoyment out of the experience:

>Peruse the TV listings for programs, specials, documentaries and other films that explore areas of interest to him.
>Use events in the news and subjects of fictitious programs as springboards for discussion.
>Encourage your youngster to broaden her horizons by watching programs that transport her to other times and places, or that expose her to different perspectives or philosophies.
>Make use of ratings systems to know whether or not a program or movie is appropriate for your child. The National Association of Broadcasters (NAB), the National Cable Television Association (NCTA) and the Motion Picture Association of America (MPAA) jointly developed the “TV Parental Guidelines,” similar to themovie-rating system adopted by the MPAA in 1966.

Talk back to your TV! Parents are rightfully perturbed about  the seemingly endless stream of violence and sex in television  programs and films, including those aimed at young people. We  should be equally concerned about what they don’t show: namely, the real-life consequences of such actions. For example, 75 percent of the violent scenes on TV fail to show the perpetrator expressing remorse, or being criticized or penalized  for his actions. Similarly, a study from the Henry J. Kaiser Family Foundation found that over a one-week period, roughly 90 percent of the television programs containing sex scenes did not include a single reference to the risk of pregnancy or acquiring a sexually transmitted disease from unprotected sex.
Last Updated
8/20/2015
Source
Adapted from Caring for Your Teenager (Copyright © 2003 American Academy of Pediatrics)

Schedule an Appointment at Petite Pediatrics

Dr. Charish Barry offers concierge-style care that is designed to provide highly personalized care to infants, children, and teens throughout the Santa Barbara area. She and her team of highly trained nurse practitioners will take the time to answer any questions you may have. Schedule an appointment at Petite Pediatrics today! Call our Santa Barbara office at (805) 845-1221.

(805) 845-1221

Insect Bites and Stings

Posted on by Charish Barry, MD in

Your child’s reaction to a bite or sting will depend on her sensitivity to the particular insect’s venom. While most children have only mild reactions, those who are allergic to certain insect venom can have severe symptoms that require emergency treatment.

In general, bites are usually not a serious problem, but in some cases, stings may be. While it is true that most stings (from yellow jackets, wasps, and fire ants, for example) may cause pain and localized swelling, severe anaphylactic reactions are possible, although uncommon.

If your child is having a severe reaction to an insect bite or sting, call for medical help immediately.  If your child is experiencing moderate pain or itching for a prolonged period of time, call (805) 845-1221 to schedule an appointment at Petite Pediatrics today. Our highly trained pediatrician, Dr. Charish Barry, can treat the bite or sting and test for allergies if deemed necessary.

Treatment

Although insect bites can be irritating, they usually begin to disappear by the next day and do not require a doctor’s treatment. To relieve the itchiness that accompanies bites by mosquitoes, flies, fleas, and bedbugs, apply a cool compress and/or calamine lotion freely on any part of your child’s body except the areas around her eyes and genitals. If your child is stung by a wasp or bee, soak a cloth in cold water and press it over the area of the sting to reduce pain and swelling. Call your pediatrician before using any other treatment, including creams or lotions containing antihistamines or home remedies. If the itching is severe, the doctor may prescribe oral antihistamines.

If your child disturbs a beehive, get him away from it as quickly as possible. The base of a honeybee’s sting emits an alarm pheromone (hormone) that makes other bees more likely to sting as well.

It is very important to remove a bee stinger quickly and completely from the skin. The quick removal of a bee stinger will prevent a large amount of venom from being pumped into the skin. If the stinger is visible, remove it by gently scraping it off horizontally with a credit card or your fingernail. Avoid squeezing the stinger with a pair of tweezers; doing this may release more venom into the skin. The skin may be more swollen on the second or third day after a bee sting or mosquito bite.

Keep your child’s fingernails short and clean to minimize the risk of infection from scratching. If infection does occur, the bite will become redder, larger, and more swollen. In some cases you may notice red streaks or yellowish fluid near the bite or your child may get a fever. Have your pediatrician examine any infected bite right away, because it may need to be treated with antibiotics.

Call for medical help immediately if your child has any of these other symptoms after being bitten or stung:

  • Sudden difficulty in breathing
  • Weakness, collapse, or unconsciousness
  • Hives or itching all over the body
  • Extreme swelling near the eyes, lips, or penis that makes it difficult for the child to see, eat, or urinate
  • Prevention
  • Some children with no other known allergies may have severe reactions to insect stings. But if you suspect that your child is allergy-prone, discuss the situation with your doctor. He may recommend a series of shots (hyposensitization injections) to decrease your child’s reaction to future insect stings (but not bites). In addition, he will prescribe a special auto-injection kit containing epinephrine for you to keep on hand for use if your child is stung.

It is impossible to prevent all insect bites, but you can minimize the number your child receives by following these guidelines.

Avoid areas where insects nest or congregate, such as garbage cans, stagnant pools of water, uncovered foods and sweets, and orchards and gardens where flowers are in bloom.
When you know your child will be exposed to insects, dress her in long pants and a lightweight longsleeved shirt.
Avoid dressing your child in clothing with bright colors or flowery prints, because they seem to attract insects.
Don’t use scented soaps, perfumes, or hair sprays on your child, because they also are inviting to insects.
Insect repellents are generally available without a prescription, but they should be used sparingly on infants and young children. In fact, the most common insecticides include DEET (N, N-diethyl-m-toluamide), which is a chemical not recommended for use in children under two months of age. Do not apply DEET-containing repellents more than once a day on older children.

The concentrations of DEET vary significantly from product to product—ranging from less than 10 percent to over 30 percent—so read the label of any product you purchase. Some products have concentrations much higher than 30 percent, and the higher the concentration of DEET, the longer the duration of action. Its effectiveness peaks at a concentration of 30 percent, however, which is also the maximum concentration currently recommended for children. The safety of DEET does not appear to be related to its level of concentration; therefore, a prudent approach is to select the lowest effective concentration for the amount of time your child spends outdoors. You should avoid products that include DEET plus a sunscreen, because sunscreen needs to be applied frequently while DEET should be applied only once a day. If you apply DEET more frequently, it may be associated with toxicity. Also be sure to wash off the DEET with soap and water at the end of the day.

An alternative to DEET is a product called picaridin (KBR 3023). While it has had wider use in Europe, picaridin has more recently become available in the US. It is a generally pleasant- smelling product without the oil residue associated with DEET, and is available in concentrations of 5 to 10 percent.

The American Academy of Pediatrics recommends that repellents used in children over six months of age have 30 percent DEET or 5 to 10 percent picaridin repellent, applied once before going outdoors. These repellents are effective in preventing bites by mosquitoes, ticks, fleas, chiggers, and biting flies, but have virtually no effect on stinging insects such as bees, hornets, and wasps. Contrary to popular belief, giving antihistamines continuously throughout the insect season does not appear to prevent reactions to bites.

Insect Bites and Stings

Mosquitoes
Water (pools, lakes, birdbaths)
Stinging sensation followed by small, red, itchy mound with tiny puncture mark at center.
Mosquitoes are attracted by bright colors and sweat.

Flies
Food, garbage, animal waste
Painful, itchy bumps; may turn into small blisters.
Bites often disappear in a day but may last longer.

Fleas
Cracks in floor, rugs, pet fur
Multiple small bumps clustered together; often where clothes fit tightly (waist, buttocks).
Fleas are most likely to be a problem in homes with pets.

Bedbugs
Cracks of walls, floors, crevices of furniture, bedding
Itchy red bumps occasionally topped by a blister; usually 2–3 in a row.
Bedbugs are most likely to bite at night and are less active in cold weather.

Fire ants
Mounds in pastures, meadows, lawns, and parks in southern states
Immediate pain and burning; swelling up to 1⁄2 inch (1.2 cm); cloudy fluid in area of bite.
Fire ants usually attack intruders.

Bees and wasps
Flowers, shrubs, picnic areas, beaches
Immediate pain and rapid swelling.
A few children have severe reactions, such as difficulty breathing and hives/swelling all over the body.

Ticks
Wooded areas
May not be noticeable; hidden on hair or on skin.
Don’t remove ticks with matches, lighted cigarettes, or nail polish remover; grasp the tick firmly with tweezers near the head; gently pull the tick straight out.

 

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