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Some Helpful Allergy Tips

Posted on by Charish Barry, MD in , ,

When to Suspect an Allergy

  • Repeated or chronic cold-like symptoms that last more than a week or two, or develop at about the same time every year. These could include a runny nose, nasal stuffiness, sneezing, throat clearing, and itchy, watery eyes.
  • Recurrent coughing, wheezing, chest tightness, difficulty breathing, and other respiratory symptoms may be a sign of asthma. Coughing may be an isolated symptom; symptoms that increase at night or with exercise are suspicious for asthma.
  • Recurrent red, itchy, dry, sometime scaly rashes in the creases of the elbows and/or knees, or on the back of the neck, buttocks, wrists, or ankles.
  • Symptoms that occur repeatedly after eating a particular food that may include hives, swelling, gagging, coughing or wheezing, vomiting or significant abdominal pain.
  • Itching or tingling sensations in the mouth, throat and/or ears during certain times of year or after eating certain foods.

Common Allergies on the Homefront

  • Dust mites (dust mites are microscopic and are found in bedding, upholstered furniture and carpet as well as other places)
  • Furred animal allergens (dogs, cats, guinea pigs, gerbils, rabbits, etc.)
  • Pest allergens (cockroaches, mice, rats)
  • Pollen (trees, grasses, weeds)
  • Molds and fungi (including molds too small to be seen with the naked eye)
  • Foods (cow’s milk, eggs, peanuts, tree nuts, soy, wheat, fish and shellfish)

How to Manage Allergic Nasal Symptoms

  • Nasal allergy symptoms can be caused by a variety of environmental allergens including indoor allergens such as dust mites, pets, and pests as well as outdoor allergens such as pollens.  Molds, which can be found indoors and outdoors, can also trigger nasal allergy symptoms.
  • Allergy testing should be performed to determine what, if any, of these environmental allergens your child is allergic to.
    An important step in managing allergy symptoms is avoidance of the allergens that trigger the symptoms.
  • If your child is allergic to pets, the addition of pets to your family would not be recommended. If your child has allergy symptoms and is allergic to a pet that lives with your family, the only way to have a significant impact on your child’s exposure to pet allergens is to find the pet a new home.
  • If your child is allergic to pests, professional extermination, sealing holes and cracks that serve as entry points for pests, storing foods in plastic containers with lids and meticulous clean up of food remains can help to eliminate the pests and reduce allergen levels.
  • Dust mites congregate where moisture is retained and food for them (human skin scales) is plentiful. They are especially numerous in bedding, upholstered furniture, and rugs. Padded furnishings such as mattresses, box springs, and pillows should be encased in allergen-proof, zip-up covers, which are available through catalogs and specialized retailers. Wash linens weekly and other bedding, such as blankets, every 1 to 2 weeks in hot water. (The minimum temperature to kill mites is 130 degrees. If you set your water heater higher than 120 degrees, the recommended temperature to avoid accidental scald burns, take care if young children are present in the home.)
  • If your child is allergic to outdoor allergens, it can be helpful to use air conditioners when possible. Showering or bathing at the end of the day to remove allergens from body surfaces and hair can also be helpful. For patients with grass pollen allergy, remaining indoors when grass is mowed and avoiding playing in fields of tall grass may be helpful. Children with allergies to molds should avoid playing in piles of dead leaves in the fall.

Medications to Control Symptoms

Your child’s allergy treatment should start with your pediatrician, who may refer you to a pediatric allergy specialist for additional evaluations and treatments.

  • Antihistamines – Ones taken by mouth can help with itchy watery eyes, runny nose and sneezing, as well as itchy skin and hives. Some types may cause drowsiness.
  • Nasal Corticosteroids – Highly effective for allergy symptom control and are widely used to stop chronic symptoms. Safe to use in children over long periods of time. Must be used daily.
  • Allergy Immunotherapy – Immunotherapy, or allergy shots, may be recommended to reduce your child’s allergy symptoms. Allergy shots are only prescribed in patients with confirmed allergy. If allergen avoidance and medications are not successful, allergy shots for treatment of respiratory allergies to pollen, dust mites, cat and dog dander, and outdoor molds can help  decrease the need for daily medication.
  • Ask your doctor about additional therapies.

Managing Eczema (Atopic Dermatitis):

  • Steroid creams are very effective. When used sparingly and at the lowest strength that does the job, they are very safe.
  • Non-steroidal anti-inflammatory creams or ointments can be used for itching and redness and decrease the need for steroid creams.
  • Antihistamine medication may be prescribed to relieve the itching, and help break the itch-scratch cycle.
  • Long-sleeved sleepwear may also help prevent nighttime scratching.
    Soaps containing perfumes and deodorants may be too harsh for children’s sensitive skin.
  • Use laundry products that are free of dyes and perfumes and double-rinse clothes, towels and bedding.
  • Lukewarm soaking baths are good ways to treat the dry skin of eczema. Gently pat your child dry after the bath to avoid irritating the skin with rubbing. Then, liberally apply moisturizing cream right away.
  • Eczema, particularly when severe, may be associated with food allergies (e.g., milk, egg, peanut).
  • Launder new clothes thoroughly before your child wears them. Avoid fabric softener.

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.

Some Childrens TV Shows Are Bad for Their Brains

Posted on by Charish Barry, MD in , ,

Some Children’s TV Shows Are Bad for Their Brains

A new study in the October, 2011, issue of the journal, Pediatrics, finds that some TV shows may be worse than others. The study, “The Immediate Impact of Different Types of Television on Young Children’s Executive Function,” published online Sept. 12, tested 4-year-old children’s attention, problem solving, self regulation and other executive function abilities after they watched one of two cartoons for nine minutes. A control group of children received crayons and markers for free drawing for the same time period. The children who watched a fast-paced cartoon featuring an animated kitchen sponge did significantly worse on tests than the drawing group. There was no difference between the drawing group and children who watched a slower-paced, realistic Public Broadcasting Service cartoon about a typical preschool boy.

Study authors stated they cannot tell which features of the TV show created the effects, though they speculate the combination of fantastical events and the fast pacing are responsible. They conclude that parents should be aware that watching similar television shows may immediately impair young children’s executive function.

In a commentary, “The Effects of Fast-Paced Cartoons,” pediatrician and researcher Dimitri Christakis, MD, FAAP, discusses the study and the implications that media exposure has for children’s health.

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.

Getting to Know MyPlate

Posted on by Charish Barry, MD in ,

MyPyramid logo Any parent who has tried to navigate a well-stocked grocery store with a hungry child in tow knows it is a challenge. Weaving through endless aisles of candy, frozen pizza, chips, soda, and sugary cereals without at least one incident of pleading or bargaining is considered a major accomplishment.

But on a daily basis, where is the proper guidance to steer through the numerous food choices?

Getting to Know MyPlate

Since 1894, the United States Department of Agriculture (USDA) has been providing Americans with dietary guidelines. In general, they have focused on eating from specified food groups and emphasized moderation, proportionality, and variety. An updated version of the USDA’s guidelines is called MyPlate. It shows the image of a dinner plate divided into colored sections:

  • Orange—grains (eg, wheat, rice, oats, cornmeal, barley)
  • Purple—protein (eg, meat, chicken, fish, beans, eggs, soy products, nuts, seeds)
  • Red—fruits (eg, apples, bananas, strawberries, blueberries, oranges, peaches)
  • Green: vegetables (eg, broccoli, romaine lettuce, spinach, corn, carrots)

Plus, there is a blue cup to the right of the plate to symbolize dairy foods (eg, milk, cheese, yogurt).

An important feature of MyPlate is that each section is a particular size. This is to highlight the proportions that Americans should aim for when planning their meal, for example:

  • Half the plate should be fruits and veggies!
  • About a quarter of the plate should be grains (especially whole grains).
  • The rest should be protein.

Before Your Next Shopping Trip…

MyPlate provides parents with important concepts that virtually all experts agree on: making healthy food choices and practicing eating in moderation. So before hitting the grocery aisles with your little one, take the time to catch up on the suggestions found on MyPlate! The USDA’s main messages include:

  • Encourage your child to enjoy his food, but to eat portions that are right for his age and activity level.
  • Fill half of your child’s plate with fruits and vegetables.
  • Have your kid drink fat-free or low-fat (1%) milk.
  • Read food labels! Find out how much sodium is in packaged food. Choose lower sodium options!
  • Encourage your child to drink water. Leave the sugary drinks behind.

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.

Announcing New Crib Standards

Posted on by Charish Barry, MD in , ,

Beginning June 28, 2011, new federal safety standards prohibit the manufacture or sale of drop-side rail cribs. Crib safety standards have not been updated in nearly 30 years and these new rules are expected to improve the quality of cribs and make them safer for babies.

But drop-sides are not the only changes. The new regulations also require that all new cribs have stronger slats and mattress supports, better quality hardware, and to undergo more rigorous testing.

Since 2007, over 11 million cribs have been recalled. In addition, drop-sides were associated with 32 infant suffocation and strangulation deaths since 2000. These new standards will help prevent these tragedies and keep children safe in their cribs.

Child care centers, family child care homes, and places of public accommodation, such as hotels and motels have until December 28, 2012 to comply with these new rules.

What Parents Can Do

Please consider getting a new crib for your baby. If that is not possible, the AAP and the Consumer Product Safety Commission (CPSC) encourage you to check the crib frequently to make sure that all hardware is secured tightly and that there are no loose, missing, or broken parts. Also be sure to:

  • Check CPSC’s crib recall list to make sure that your crib has not been recalled.
  • Stop using the drop-side rail of your crib. If the crib has been recalled, see if you can get a free immobilizer from the manufacturer or retailer (immobilizers vary depending on the crib).
  • Consider using a portable play yard, so long as it is not a model that has been recalled.
  • As always, keep items like pillows, cushy bumper pads, quilts, comforters, stuffed toys, and positioning devices out of the crib.

Re-sale of Cribs

Keep in mind that these new rules also apply to the re-sale of cribs, including at garage and rummage sales, on online auction sites, or even by donation to thrift stores. Unsafe cribs should be disassembled and thrown away.

For more information on choosing a safe crib for your baby, click here.

You can also find more details about the new regulations from the CPSC here.

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.

Choosing Healthy Snacks

Posted on by Charish Barry, MD in , ,

If the snacks at your home have usually been cookies, doughnuts, and soft drinks, it’s time for a change. Two or 3 snacks a day are an important part of your child’s overall nutrition, so you need to make them just as nutritionally sound as her regular meals, while contributing to an overall program aimed at weight loss. Planning snacks ahead of time is helpful—prepackage some appropriate servings to have ready for kids in their lunches or when they get home from school. This is an opportunity to teach healthy choices and practices.

If you keep the pantry, refrigerator, and kitchen table stocked with plenty of low-fat, low-sugar snacks from the 5 major food groups, that’s what she’ll reach for. Of course, occasional treats like ice cream are fine. But for those snacks that your child typically grabs on her own, make sure they’re nutritious ones such as:

  • Fruit
  • Fresh strawberries
  • Low-fat/frozen yogurt
  • Air-popped popcorn
  • Celery stalks
  • Low-fat cheeses
  • Low-fat oatmeal cookies
  • Frozen juice bars (without added sugar)
  • Cucumber slices
  • Crackers
  • Frozen bananas
  • Sugar-free cereals
  • Baked potato chips
  • Unsalted pretzels
  • Bran muffins
  • Dried raisins or apricots

Adding a protein food with these snacks can make them more satisfying. Try adding a boiled egg, cheese stick, yogurt, natural peanut butter, or nuts (if your child is old enough so choking is not a concern).

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.

Sun and Water Safety this Summer

Posted on by Charish Barry, MD in , ,

Fun in the Sun

Babies under 6 months:

  • The two main recommendations from the AAP to prevent sunburn are to avoid sun exposure, and to dress infants in lightweight long pants, long-sleeved shirts, and brimmed hats that shade the neck to prevent sunburn. However, when adequate clothing and shade are not available, parents can apply a minimal amount of suncreen with at least 15 SPF (sun protection factor) to small areas, such as the infant’s face and the back of the hands. If an infant gets sunburn, apply cold compresses to the affected area.

For All Other Children:

  • The first, and best, line of defense against harmful ultraviolet radiation (UVR) exposure is covering up. Wear a hat with a three-inch brim or a bill facing forward, sunglasses (look for sunglasses that provide 97% -100% protection against both UVA and UVB rays), and cotton clothing with a tight weave.
  • Stay in the shade whenever possible, and limit sun exposure during the peak intensity hours – between 10 a.m. and 4 p.m.
  • On both sunny and cloudy days use a sunscreen with an SPF of 15 or greater that protects against UVA and UVB rays.
  • Be sure to apply enough sunscreen – about one ounce per sitting for a young adult.
  • Reapply sunscreen every two hours, or after swimming or sweating.
  • Use extra caution near water and sand (and even snow!) as they reflect UV rays and may result in sunburn more quickly.

Heat Stress in Exercising Children

  • The intensity of activities that last 15 minutes or more should be reduced whenever high heat and humidity reach critical levels.
  • At the beginning of a strenuous exercise program or after traveling to a warmer climate, the intensity and duration of exercise should be limited initially and then gradually increased during a period of 7 to 14 days to acclimatize to the heat, particularly if it is very humid.
  • Before prolonged physical activity, children should be well-hydrated and should not feel thirsty. For the first hour of exercise, water alone can be used. Kids should have water or a sports drink always available and drink every 20 minutes while exercising in the heat. Excessively hot and humid environments, more prolonged and strenuous exercise, and copious sweating should be reasons for children to substantially increase their fluid intake. After an hour of exercise, children need to drink a carbohydrate-electrolyte beverage to replace electrolytes lost in sweat and provide carbohydrates for energy.
  • Clothing should be light-colored and lightweight and limited to one layer of absorbent material to facilitate evaporation of sweat. Sweat-saturated shirts should be replaced by dry clothing.
  • Practices and games played in the heat should be shortened and more frequent water/hydration breaks should be instituted. Children should seek cooler environments if they feel excessively hot or fatigued.

Pool Safety

  • Never leave children alone in or near the pool or spa, even for a moment.
  • Install a fence at least 4 feet high around all four sides of the pool.
  • The fence should not have openings or protrusions that a young child could use to get over, under, or through.
  • Make sure pool gates open out from the pool, and self-close and self-latch at a height children can’t reach.
  • If the house serves as the fourth side of a fence surrounding a pool, install an alarm on the exit door to the yard and the pool.
    Keep rescue equipment (a shepherd’s hook – a long pole with a hook on the end – and life preserver) and a portable telephone near the pool. Choose a shepherd’s hook and other rescue equipment made of fiberglass or other materials that do not conduct electricity.
  • Avoid inflatable swimming aids such as “floaties.” They are not a substitute for approved life vests and can give children and parents a false sense of security.
  • Children ages 1 to 4 may be at a lower risk of drowning if they have had some formal swimming instruction. However, there is no evidence that swimming lessons or water survival skills courses can prevent drowning in babies younger than 1 year of age.
  • The decision to enroll a 1- to 4-year-old child in swimming lessons should be made by the parent and based on the child’s developmental readiness, but swim programs should never be seen as “drown proofing” a child of any age.
  • Whenever infants or toddlers are in or around water, an adult – preferably one who knows how to swim and perform CPR – should be within arm’s length, providing “touch supervision.”
  • Avoid entrapment: Suction from pool and spa drains can trap a swimmer underwater. Do not use a pool or spa if there are broken or missing drain covers.  Ask your pool operator if your pool or spa’s drains are compliant with the Pool and Spa Safety Act.  If you have a swimming pool or spa, ask your pool service representative to update your drains and other suction fitting with anti-entrapment drain covers and other devices or systems. See PoolSafely.gov for more information on the Virginia Graeme Baker Pool and Spa Safety Act.
  • Large inflatable above-ground pools have become increasingly popular for backyard use. Children may fall in if they lean against the soft side of an inflatable pool. Although such pools are often exempt from local pool fencing requirements, it is essential that they be surrounded by an appropriate fence just as a permanent pool would be so that children cannot gain unsupervised access.

Boating Safety

  • Children should wear life jackets at all times when on boats or near bodies of water.
  • Make sure the life jacket is the right size for your child. The jacket should not be loose. It should always be worn as instructed with all straps belted.
  • Blow-up water wings, toys, rafts and air mattresses should not be used as life jackets or personal flotation devices. Adults should wear life jackets for their own protection, and to set a good example.
  • Adolescents and adults should be warned of the dangers of boating when under the influence of alcohol, drugs, and even some prescription medications.

Open Water Swimming

  • Never swim alone. Even good swimmers need buddies!
  • A lifeguard (or another adult who knows about water rescue) needs to be watching children whenever they are in or near the water. Younger children should be closely supervised while in or near the water – use “touch supervision,” keeping no more than an arm’s length away.
  • Make sure your child knows never to dive into water except when permitted by an adult who knows the depth of the water and who has checked for underwater objects.
  • Never let your child swim in canals or any fast moving water.
  • Ocean swimming should only be allowed when a lifeguard is on duty.

Tips are available in Spanish here.

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.

Choosing Over-the-Counter Medicines for Your Child

Posted on by Charish Barry, MD in ,

“Over-the-counter” (OTC) means you can buy the medicine without a doctor’s script. Talk with your child’s doctor or pharmacist before giving your child any medicine, especially the first time.

All OTC medicines have the same kind of label. The label gives important information about the medicine. It says what it is for, how to use it, what is in it, and what to watch out for. Look on the box or bottle, where it says “Drug Facts.”

Check the chart on the label to see how much medicine to give. If you know your child’s weight, use that first. If not, go by age. Check the label to make sure it is safe for infants and toddlers younger than 2 years. If you are not sure, ask your child’s doctor.

Call the doctor right away if..

Your child throws up a lot or gets a rash after taking any medicine. Even if a medicine is safe, your child may be allergic to it.

Your child may or may not have side effects with any drug. Be sure to tell the doctor if your child has any side effects with a medicine.

Over-the-Counter Medicines

Type of medicine

What it’s used for

What else you need to know

Aspirin

Never give aspirin to your child unless your child’s doctor tells you it’s safe. Aspirin can cause a very serious liver disease called Reye syndrome. This is especially true when given to children with the flu or chickenpox.

Hydrocortisone (high-druh-KOR-tuh-zohn) or cortisone cream

Treats insect bites, mild skin rashes, poison ivy, and eczema (EGG-zu-muh).

Ask the doctor how often you can put it on your child’s skin. Don’t put any on your child’s face unless the doctor says it is OK.

Never use this cream on burns, infections, cuts, or broken skin.

Pain and fever medicine

Helps fever and headaches or body aches. Also can help with pain from bumps or soreness from a shot. Examples are acetaminophen (uh-SET-tuh-MIN-uh-fin) and ibuprofen (eye-byoo-PROH-fin). Tylenol is one brand name for acetaminophen. Advil and Motrin are brand names for ibuprofen.

Saline (saltwater) nose drops

May help if your baby is having trouble eating or sleeping because of a stuffy nose.

Put 1 to 2 drops into each side of the nose. Then use a bulb syringe to suck our the drops and mucus.

Using a bulb syringe can make the nose sore, so try not to use it too often.

Stomach medicines

Treats problems like heartburn, gas, not being able to pass stool (constipation), or loose, runny stools (diarrhea).

There are different kinds of medicines, depending on what the problem is. Talk with your child’s doctor before using any of them.

Most of these problems go away on their own. Sometimes just changing your child’s diet helps.

Some stomach medicines also contain aspirin, which can harm your child. See “Aspirin” on the first page of this handout.

via HealthyChildren.org – Choosing Over-the-Counter Medicines for Your Child.

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.

Important Update on the Use of Car Safety Seats

Posted on by Charish Barry, MD in , ,

The AAP has just released new recommendations regarding the use of car safety seats.

Parents are advised to keep toddlers in rear-facing car seats until age 2, or until they reach the maximum height and weight for their seat. Children should transition from a rear-facing seat to a forward-facing seat with a harness, until they reach the maximum weight or height for that seat. Then a booster will make sure the vehicle’s lap-and-shoulder belt fit properly. The shoulder belt should lie across the middle of the chest and shoulder, not near the neck or face. The lap belt should fit low and snug on the hips and upper thighs, not across the belly. Most children will need a booster seat until they have reached 4 feet 9 inches tall and are between 8 and 12 years old. Additionally, children should ride in the rear of a vehicle until they are 13 years old.

Although the Federal Aviation Administration permits children under age 2 to ride on an adult’s lap on an airplane, they are best protected by riding in an age- and size-appropriate restraint.

It’s important that your child use the most appropriate child safety seat.  Here is some information from the AAP that will be helpful to you as you ensure safe car riding for your child.

  • Car Safety Seats: Information for Families for 2011

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.

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