Day: March 29, 2016

ALLERGIES

Allergies

Allergies and asthma, which typically start in childhood, are by far the most common chronic diseases among children in the United States. Consider the following statistics:

Some 50 million Americans have allergies (about 1 in 5 people in this country).
The most common type of allergy is hay fever (allergic rhinitis); the medical cost of treating it, when direct and indirect costs are added up, now exceeds $7 billion a year.
More than 17 million Americans have asthma, and about one-fourth of these are younger than 18 years. Asthma accounts for about 4,000 deaths a year.
Seventy to 80% of school-aged children with asthma also have allergies, which are among the most common triggers for asthma, closely tied with viral respiratory infections.
If one parent has allergies, there’s a 25% chance that a child will also be allergic. The risk is more than doubled to 60% to 70% if both parents have allergies.
Many aspects of allergies, eczema, and asthma still are not fully understood. But advances in the diagnosis and treatment of these disorders are helping millions of sufferers.

What Are Allergies?
Many people mistakenly use the word allergy to refer to a disease or almost any unpleasant or adverse reaction. We often hear someone say, “I have allergies,” “He’s allergic to hard work,” or “She’s allergic to anything that’s green.” In reality, allergies are reactions that are usually caused by an overactive immune system. These reactions can occur in a variety of organs in the body, resulting in diseases such as asthma, hay fever, and eczema.

Your immune system is made up of a number of different cells that come from organs throughout the body—principally bone marrow, the thymus gland, and a network of lymph nodes and lymph tissue scattered throughout the body, including the spleen, gastrointestinal tract, tonsils, and the adenoid (an olive-shaped structure that is located at the top of the throat behind the nose).

Normally, it’s the immune system that protects the body against disease by searching out and destroying foreign invaders, such as viruses and bacteria. In an allergic reaction, the immune system overreacts and goes into action against a normally harmless substance, such as pollen or animal dander. These allergy-provoking substances are called allergens.

Who Is at Risk?
Although allergies can develop at any age, they most commonly show up during childhood or early adulthood. A search of family medical histories of a child with allergies will usually turn up a close relative who also has allergies. If one parent, brother, or sister has allergies, there is a 25% chance that a child will also have allergies. The risk is much higher if both parents are allergic. But the child will not necessarily be allergic to the same substances as the parents or always show the same type of allergic disease (eg, hay fever, asthma, eczema).

Symptoms Associated With Allergies
Eyes, Ears, Nose, Mouth
Red, teary, or itchy eyes
Puffiness around the eyes
Sneezing
Runny nose
Itchy nose, nose rubbing
Postnasal drip
Nasal swelling and congestion
Itchy ear canals
Itching of the mouth and throat

Lungs
Hacking dry cough or cough that produces clear mucus
Wheezing (noisy breathing)
Feeling of tightness in the chest
Low exercise tolerance
Rapid breathing; shortness of breath

Skin
Eczema (patches of itchy, red skin rash)
Hives (welts)

Intestines
Cramps and intestinal discomfort
Diarrhea
Nausea or vomiting

Miscellaneous
Headache
Feelings of restlessness, irritability
Excessive fatigue

When to Suspect an Allergy
Allergies can result in various types of conditions. Some are easy to identify by the pattern of symptoms that invariably follows exposure to a particular substance; others are more subtle and may masquerade as other conditions. Here are some common clues that should lead you to suspect your child may have an allergy.

Patches of bumps or itchy, red skin that won’t go away
Development of hives—intensely itchy skin eruptions that usually last for a few hours and move from one part of the body to another
Repeated or chronic cold-like symptoms, such as a runny nose, nasal stuffiness, sneezing, and throat clearing, that last more than a week or two, or develop at about the same time every year
Nose rubbing, sniffling, snorting, sneezing, or drippy nose
Itchy, runny eyes
Itching or tingling sensations in the mouth and throat
Coughing, wheezing, difficulty breathing, and other respiratory symptoms
Unexplained bouts of diarrhea, abdominal cramps, and other intestinal symptoms.

Where does ASTHMA fit in?
Although allergies can trigger asthma and asthma is often associated with allergies, they are actually 2 different things. In simple terms, asthma is a chronic condition originating in the lungs, whereas allergies describe reactions that originate in the immune system and can affect many organs, including the lungs. Many different substances and circumstances can trigger an asthma attack—exercise, exposure to cold air, a viral infection, air pollution, noxious fumes, tobacco smoke, and for many asthma sufferers, a host of allergens. In fact, about 80% of children with asthma also have allergies. Although allergies are important in triggering asthma, severe asthma exacerbations are often set off by the good old common cold virus, totally unrelated to allergy.
Last Updated
11/21/2015
Source
Guide to Your Childs Allergies and Asthma (Copyright © 2011 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

Ear Infections

Ear Infection Information

When is it an Ear Infection?
A typical middle ear infection in a child begins with either a viral infection (such as a common cold) or unhealthy bacterial growth. Sometimes the middle ear becomes inflamed and causes fluid buildup behind the eardrum. In other cases, the eustachian tubes — the narrow passageways connecting the middle ear to the back of the nose — become swollen.

Children are more prone to both of these problems for several reasons. The passages in their ears are narrower, shorter, and more horizontal than the adult versions. Because it’s easier for germs to reach the middle ear, it’s also easier for fluid to get trapped there. And just as children are still developing, so are their immune systems. Once the infection takes hold, it’s harder for a child’s body to fight it than it is for a healthy adult’s.

The symptoms of an ear infection may be hard to detect. A child who constantly tugs or pulls at the ear could simply be exploring, or simply showing a self-soothing reflex — even though that tops the list of signals listed in many books and Web sites.

Other symptoms can include:
More crying than usual, especially when lying down
Trouble sleeping or hearing
Fever or headache
Fluid coming out of the ears
Doctors can use special instruments to see if an infection is present.

Treatment: Less May Be More
Perhaps the most surprising news is that common ear infections rarely require medication or any other action, except when severe or in young infants. “The body’s immune system can usually resolve them,” says Dr. Robert M. Jacobson, chair of the Mayo Clinic’s Department of Pediatric and Adolescent Medicine. “More and more studies show that children treated or untreated are at the same place 10 days out. We are constantly amazed at how many ear infections resolve on their own.”

It’s true: Fewer doctors are relying on antibiotics. As Dr. Jacobson points out, it’s important to understand that taking antibiotics might or might not speed recovery, and overusing them can lead to bacteria developing resistance to the drugs, as the germs mutate to defend themselves against medicine. As a result, many pediatricians have adopted a wait-and-see approach, rather than prescribing antibiotics at the first sign of infection.

Asking the parents to observe the child for 48 to 72 hours is becoming the most common first step among pediatricians. That doesn’t mean that an office visit isn’t a good idea, however. Doctors can prescribe numbing drops and suggest over-the-counter pain relievers to treat symptoms, which can help the child feel better as she recovers.

Along with getting away from prescriptions, pediatricians are also shying away from ear tubes, a procedure in which a small tube is surgically inserted in the ear to drain fluid. According to Dr. Jacobson, tube placement is best used with those children who have recurring hearing problems caused by multiple infections.

“Tubes don’t actually stop ear infections, just symptoms and fluid retention,” says Dr. Jacobson. “We don’t want to do it too often because there is an increased risk of damage to the eardrum.”

According to Dr. Jacobson, diagnosis and treatment should be a three-step process:
First, the pediatrician determines whether or not an ear infection is present.
Second, the pediatrician and parent discuss risk factors and how to reduce them.
Finally, observation and treatment of symptoms ensure the child is recovering without pain.
Reducing the Risks for Ear Infection
While parents can’t head off every germ that’s headed for their children, they can take steps to reduce their children’s risks.

Avoid Secondhand Smoke Exposure
Smoking is a huge contributor to childhood illness. Ear infections are no exception to that rule. Smoking is addictive and hard to quit, but not every smoker realizes the harmful effects that secondhand smoke could have on his or her child. Quitting is just as important for your child’s health as your own.

Proper Hygiene
Bad hygiene habits are another major problem. Children in child care are more exposed to widespread bacteria, as are those who drink from a bottle as opposed to asippy cup, says Dr. Jacobson. That’s because bottles have more surface area for germs to live on. Teach children to wash their hands frequently to prevent the spread of germs that spread illness.

Keep Your Child Up-To-Date with Vaccines
Talk with your child’s doctor about the vaccines that protect against pneumonia and meningitis. Studies show that vaccinated children experience fewer ear infections.

Breastfeed Your Baby
Breastfeed infants for the first year. Breast milk has many substances that protect your baby from a variety of diseases and infections. Because of these protective substances, breastfed children are less likely to have bacterial or viral infections, such as ear infections.

Get A Flu Shot
Consider getting immunized against influenza. Aside from protecting against this yearly disease, it can help prevent ear infections.
Last Updated
11/21/2015
Source
Adapted from Healthy Children Magazine, Summer 2007
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

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

Baby Teeth Eruption Charts

Eruption Charts

Teeth vary in size, shape and their location in the jaws. These differences enable teeth to work together to help you chew, speak and smile. They also help give your face its shape and form. At birth people usually have 20 primary (baby) teeth, which often erupt about 6 months of age. They are then shed at various times throughout childhood. By age 21, all 32 of the permanent teeth have usually erupted.

View the following eruption charts:

 

Baby Teeth

A child’s primary teeth, sometimes called “baby teeth,” are as important as the permanent adult teeth.

When Do Baby Teeth Come In?
A baby’s 20 primary teeth are already present in the jaws at birth and typically begin to appear when a baby is between 6 months and 1 year.

Check out this baby teeth eruption chart to see the order in which teeth break through and at what ages you can expect specific teeth to appear.

When teeth first come in, some babies may have sore or tender gums. Gently rubbing your child’s gums with a clean finger, a small, cool spoon or a wet gauze pad can be soothing. You can also give the baby a clean teething ring to chew on. If your child is still cranky and in pain, consult your dentist or physician. Most children have a full set of 20 primary teeth by the time they are 3.

Why Baby Teeth Matter
Not only do primary teeth help children chew and speak, they also hold space in the jaws for permanent teeth that are growing under the gums. When a baby tooth is lost too early, the permanent teeth can drift into the empty space and make it difficult for other adult teeth to find room when they come in. This can make teeth crooked or crowded. That’s why starting infants off with good oral care can help protect their teeth for decades to come.

When Should I Start Taking My Child to the Dentist?
The ADA recommends that a dentist examine a child within six months after the first tooth comes in and no later than the first birthday. A dental visit at an early age is a “well-baby checkup” for the teeth. Besides checking for tooth decay and other problems, the dentist can show you how to clean the child’s teeth properly and how to evaluate any adverse habits such as thumbsucking.

How to Care for Your Child’s Teeth
It’s important to care for your baby’s teeth from the start. Here’s what to do:

Begin cleaning your baby’s mouth during the first few days after birth by wiping the gums with a clean, moist gauze pad or washcloth. As soon as teeth appear, decay can occur. A baby’s front four teeth usually push through the gums at about 6 months of age, although some children don’t have their first tooth until 12 or 14 months.
For children younger than 3 years, caregivers should begin brushing children’s teeth as soon as they begin to come into the mouth by using fluoride toothpaste in an amount no more than a smear or the size of a grain of rice. Brush teeth thoroughly twice per day (morning and night) or as directed by a dentist or physician. Supervise children’s brushing to ensure that they use of the appropriate amount of toothpaste.
For children 3 to 6 years of age, use a pea-sized amount of fluoride toothpaste. Brush teeth thoroughly twice per day (morning and night) or as directed by a dentist or physician. Supervise children’s brushing and remind them not to swallow the toothpaste.
Until you’re comfortable that your child can brush on his or her own, continue to brush your child’s teeth twice a day with a child-size toothbrush and a pea-sized amount of fluoride toothpaste. When your child has two teeth that touch, you should begin flossing their teeth daily.

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

UPDATES Car Seat Safety

Car Seat Checkup

Using a car seat correctly makes a big difference. Even the right seat for your child’s size must be used correctly to properly protect your child in a crash. Here are car seat tips from the American Academy of Pediatrics (AAP).

Does your car have air bags?
Never place a rear-facing car seat in the front seat of a vehicle that has a front passenger air bag. If the air bag inflates, it will hit the back of the car seat, right where your baby’s head rests, and could cause serious injury or death.
The safest place for all children younger than 13 years to ride is in the back seat.
If an older child must ride in the front seat, a child in a forward-facing car seat with a harness may be the best choice. Be sure you move the vehicle seat as far back from the dashboard (and air bag) as possible.
Is your child facing the right way for weight, height, and age?
All infants and toddlers should ride in a rear-facing car seat until they are at least 2 years of age or reach the highest weight or height allowed by their car seat manufacturer.
Any child who has outgrown the rear-facing weight or height limit for his car seat should use a forward-facing seat with a harness for as long as possible, up to the highest weight or height allowed by his car seat manufacturer.
Is the harness snug?
Harness straps should fi t snugly against your child’s body. Check the car seat instructions to learn how to adjust the straps.
Place the chest clip at armpit level to keep the harness straps secure on the shoulders.
Does the car seat fit correctly in your vehicle?
Not all car seats fi t properly in all vehicles.
Read the section on car seats in the owner’s manual for your car.
Can you use the LATCH system?
LATCH (lower anchors and tethers for children) is a car seat attachment system that can be used instead of the seat belt to install the seat. These systems are equally safe, but in some cases, it may be easier to install the car seat using LATCH.
Vehicles with the LATCH system have anchors located in the back seat, where the seat cushions meet. Tether anchors are located behind the seat, either on the panel behind the seat (in sedans) or back of the seat, ceiling, or floor (in most minivans, SUVs, and hatchbacks). All car seats have attachments that fasten to these anchors. Nearly all passenger vehicles and all car seats made on or after September 1, 2002, are equipped to use LATCH. All lower anchors are rated for a maximum weight of 65 pounds (total weight includes car seat and child).
The top tether improves safety provided by the seat. Use the tether for all forward-facing seats, even those installed using the vehicle seat belt.
Always follow both the car seat and vehicle manufacturer instructions, including weight limits, for lower anchors and tethers. Remember, weight limits are different for different car seats and different vehicles.
Is the seat belt or LATCH strap in the right place and pulled tight?
Route the seat belt or LATCH strap through the correct path. Convertible seats have different belt paths for when they are used rear facing or forward facing (check your instructions to make sure).
Pull the belt tight. Apply weight into the seat with your hand while tightening the seat belt or LATCH strap. When the car safety seat is installed, be sure it does not move more than an inch side to side or toward the front of the car.
If you install the car seat using your vehicle’s seat belt, you must make sure the seat belt locks to keep a tight fit. In most newer cars, you can lock the seat belt by pulling it all the way out and then allowing it to retract to keep the seat belt tight around the car seat. Many car seats have built-in lock-offs to lock the belt.
It is best to use the tether that comes with your car seat to the highest weight allowed by your vehicle and the manufacturer of your car seat. Check your vehicle owner’s manual and car seat instructions for how and when to use the tether and lower anchors.
Has your child outgrown the forward-facing seat?

All children whose weight or height is above the forward-facing limit for their car seat should use a belt-positioning booster seat until the vehicle seat belt fits properly, typically when they have reached 4 feet 9 inches in height and are 8 through 12 years of age.
A seat belt fits properly when the shoulder belt lies across the middle of the chest and shoulder, not the neck or throat; the lap belt is low and snug across the upper thighs, not the belly; and the child is tall enough to sit against the vehicle seat back with her knees bent over the edge of the seat without slouching and can comfortably stay in this position throughout the trip.

Do you have the instructions for the car seat?

Follow them and keep them with the car seat.
Keep your child in the car seat until she reaches the weight or height limit set by the manufacturer. Follow the instructions to determine whether your child should ride rear facing or forward facing and whether to install the seat using LATCH or the vehicle seat belt.
Has the car seat been recalled?
You can find out by calling the manufacturer or the National Highway Traffic Safety Administration (NHTSA) Vehicle Safety Hotline at 888/327-4236 or the NHTSA Web site.
Follow the manufacturer’s instructions for making any repairs to your car seat.
Be sure to fill in and mail in the registration card that comes with the car seat. It will be important in case the seat is recalled.
Do you know the history of your child’s car seat?
Do not use a used car seat if you do not know the history of the seat.
Do not use a car seat that has been in a crash, has been recalled, is too old (check the expiration date), has any cracks in its frame, or is missing parts.
Make sure it has a label from the manufacturer and instructions.
Call the car seat manufacturer if you have questions about the safety of your seat.
Questions
If you have questions or need help installing your car seat, find a certified child passenger safety technician (CPST). Lists of certified CPSTs and child seat-fitting stations are available on the following Web sites:

NHTSA Parents Central
SeatCheck
National Child Passenger Safety Certified Technicians
Additional Information from HealthyChildren.org:
Car Seats: Information for Families
Car Seats: Product Listing
Car Seats and Obese Children: Suggestions for Parents

Figure 1 adapted from National Highway Traffic Safety Administration. LATCH Makes Child Safety Seat Installation as Easy as 1-2-3. 2011. DOT HS publication 809 489. Published March 2011. Accessed November 5, 2015.

Figures 2, 3, 4, 5, and 6 by Anthony Alex LeTourneau.​

Last Updated
2/16/2016
Source
Car Seat Checkup (Copyright © 2016 American Academy of Pediatrics)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

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

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