Pearls of Wisdom: Your Baby and Ear Infections

At some point or another, most babies and children will suffer through the pain and discomfort of an ear infection. The telltale signs may be all you need to know what’s happening… crying, tugging at her ear(s), and temperature are all indicators. In children that have learned to talk, you may hear complaints of throbbing pain or that your child is having trouble hearing. You’ll need to get baby to the pediatrician for treatment and relief of an ear infection.

Middle ear infections, or “otitis media,” is the most prevalent disease of childhood, second only to respiratory infections. There are an estimated 25 million yearly visits to the pediatrician resulting from ear infections.  Accurate diagnosis and treatment of otitis media are important not only because it affects a lot of our children but also because left untreated, it can lead to serious complications like meningitis or brain abscess. Middle ear infections that lead to fluid in the middle ear, known as effusions, could also affect a child’s hearing and subsequently, his speech and language development.

Nearly 86% of children have at least one episode of otitis media by 3 years of age, with peaks occurring from 6-36 months and 4-6 years of age. Available medical data shows that the occurrence of ear infections tends to decrease with age but is higher in the following groups: male children; kids belonging to lower socioeconomic groups; black children, and among those with craniofacial anomalies. Incidence is also higher during winter months and early spring.

Ear InfectionWhen an ear is infected, the “eustachian tube” or the canal connecting the middle ear and the back of the throat gets clogged. During healthy periods, this canal is filled with air; however, during cold weather, when other respiratory infections are present, or when a child also has allergies, this tube can get blocked. When the eustachian tube is blocked, fluid accumulates in the middle ear and attracts bacteria that thrives. As this condition progresses, pressure increases on the eardrum, impeding its ability to vibrate properly. This can affect hearing and cause a great deal of pain.

It is wise to see your pediatrician so he can examine your child’s ear with an instrument called and “otoscope.” After diagnosing him with an ear infection, he may prescribe an antibiotic such as amoxicillin to kill the bacteria and prevent more fluid accumulation. Many times, an antibiotic is not necessary and relief can be attained just by giving acetaminophen or ibuprofen. Antihistamines and decongestants may also be prescribed depending on your child’s symptoms and a physical exam. However, in instances where fever persists and pain worsens despite these medications, he should be re-examined to rule out any other serious concurrent infections. Occasionally, if a child has recurrent ear infections, your doctor may suggest insertion of ear tubes to aid in draining trapped fluid from the middle ear.

It’s important to note that ear infections are not contagious and oftentimes, a child may return to school or daycare after the symptoms abate; however, it is always important to finish the course of antibiotics prescribed. All patients should be re-evaluated 2 weeks after the start of treatment to ensure that inflammation has resolved and the mobility of the tympanic membrane is back to normal.

Periodic follow up is highly recommended for patients with recurrent ear infections. Your pediatrician will also perform a hearing test on your child to ensure that there are no residual effects on his hearing after the infection.

Recurring medical conditions can be very trying for both children and parents. Trust me, I know it sometimes seems as though you see your pediatrician more than you see your best friend! But hang in there… some of my best friends today are parents that were in my office with their kids once a month of more ;)    Silver linings, friends. Silver linings!

I hope you are all having a wonderful, safe, and happy summer!

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All information contained in this blog and on our web site(s) should be independently verified by you by a medical professional of your own choosing and you should always conduct your own research and due diligence before making any decision related to the subject matter of this blog or our web site. 

Dr. Pearl CenonDr. Pearl

A pediatrician in private practice in New Jersey for over 15 years, Dr. Cenon (we like to call her Dr. Pearl) also has two children of her own. Dr. Pearl’s husband, Kevin McDonough is also a pediatrician and they work together. She writes basic posts about topics that interest many parents, from skin care and nutrition to seasonal issues, such as allergies and colds. Her kind, approachable tone in each blog post will have you looking forward to the next one.

Pearls of Wisdom: Infant Nutrition

Infant FeedingWhen it comes to infants and children, basic nutrition choices have a lifetime impact on overall health and are key for satisfactory growth and avoidance of deficiency states. Adequate nutrition helps in the prevention of acute and chronic illnesses; maximizes physical and mental potential and provides reserves for stress. During infancy, it’s all about milk, whether breast milk, formula or a combination of the two. Breast milk and formulas contain enough nutrients needed by babies in the first year of life. Around 4 -6 months of age, most babies can start consuming solid foods like iron-fortified cereal, mashed fruits and vegetables, and pureed meats. As you introduce more foods, keep in mind that a healthy amount of fat is important for the babies’ brain and nerve developments – unless advised by your doctor for particular health reasons, low-fat options can be avoided.

The feeling of ease between infant and mother is essential to successful infant feeding. When mom can establish a comfortable, satisfying feeding practice, the result is usually emotional well-being of both the mother and infant. Remember that mom’s feelings are readily transmitted to the baby and greatly influence the emotional setting in which feeding takes place. Hence, a tense, anxious, and emotionally labile mother is more likely to develop a difficult feeding relationship with her baby. It’s helpful if she receives appropriate guidance and support from an empathetic family member, friend or physician.

Infant FeedingImmediately after birth, the infant can safely tolerate feedings to ensure a smooth transition from fetal to extrauterine life, to promote maternal- infant bonding and prevent hypoglycemia and electrolyte imbalances. It is critical that your infant receives enough fluids so he will not develop dehydration. Moms who wish to initiate breastfeeding in the delivery room are definitely encouraged to do so. Subsequent feedings either by breastfeeding or bottle feeding are given every 3-4 hours a day and at night. That’s a lot of eating! This is based on the time it takes for the infant’s stomach to empty and varies from 1-4 hours. Do not expect your baby’s feeding schedule to be consistent immediately after birth.  However, by the end of the first month, 90% of babies will establish a more regular feeding schedule. Majority of healthy formula-fed infants will want 6-9 feedings per day by the end of the first week of life. Some babies are satisfied with every four hour feedings, while others who have a faster gastric emptying time will want to eat every 2-3 hours. Interestingly, most breast-fed babies get hungry quicker and require more frequent feedings with shorter intervals. This just reinforces the fact that individual feeding needs vary and one infants’ feeding would not be expected to fit the pattern of another. The best parameter of successful infant feeding is weight gain by the time the baby reaches the second week of life.

Infants cry for various reasons and babies do not need to be fed every time they cry. Usually, sick babies are not interested in feeding and if an infant refuses food, this should act as a red flag to see your pediatrician. If your baby is constantly waking up every 1-2 hours, he may not be receiving enough milk at each feeding or be suffering from infantile colic. This can be addressed during your doctor’s visit and may involve discussions about formula choice and feeding practices. It is important to know that babies cry for reasons other than hunger. Some may just need to be picked up and held, others may continue to cry even after feeding so it’s important to carefully evaluate your infant’s health and behavior for other potential causes of distress. Try to discourage the habit of frequent small feedings, holding and feeding to pacify crying as he may become too reliant on you to calm him.

Infant FeedingThe post-partum period is oftentimes a period of much anxiety and insecurity for first-time parents who may be overwhelmed by the responsibilities that comes with having a new baby. The questions are endless: Am I feeding her enough?  Is she having diarrhea? Should I switch formulas? The list goes on and on. This is why anticipatory guidance sessions should be scheduled between you and your pediatrician. During each office visit, your doctor is already tracking your baby’s weight gain and monitoring whether her weight is steadily increasing. Normally, babies in the first four months of life gain 1 ½ lbs-2 lbs per month and grow 1-1 ½ inches. By the time he is a year old, he would have tripled his birth weight.  Breastfed babies also tend to be chubbier than formula-fed babies in the early months of life however they become leaner by nine months to one year of age.

Parents need to understand the goal of infant’s “self- regulation.” Once the infant establishes a regular feeding schedule, other family members are able to resume their normal daily routine with minimal disruptions. It doesn’t take long to achieve the confidence and calm of an experienced parent. Your baby will give you enough signals and clues as to how she likes to be treated, talked to, held and comforted.  This very special bond, once established will guide you through this challenging stage and the next.

All information contained in this blog and on our web site(s) should be independently verified by you by a medical professional of your own choosing and you should always conduct your own research and due diligence before making any decision related to the subject matter of this blog or our web site. 

———–

Dr. Pearl

Dr. Pearl Cenon

A pediatrician in private practice in New Jersey for over 15 years, Dr. Cenon (we like to call her Dr. Pearl) also has two children of her own. Dr. Pearl’s husband, Kevin McDonough is also a pediatrician and they work together. She writes basic posts about topics that interest many parents, from skin care and nutrition to seasonal issues, such as allergies and colds. Her kind, approachable tone in each blog post will have you looking forward to the next one.

Pearls of Wisdom: Picky Eaters

Although your toddler is beginning to develop his own taste palate and show preferences for food, he can be quite unpredictable when it comes to what he will eat at mealtime, with variations from day to day. Oftentimes their favorite food, or what you thought was their favorite food, could end up on the floor the next day. Likewise, the meal that ended up on the floor the day prior could turn out to be the food they can’t get enough of. Hot and cold as each day passes – just like the plate you put in front of them!

Most toddlers are — plain and simple — picky eaters. Others eat only certain foods – or refuse to do so as a way to assert independence. The amount of food they consume from one meal to the next can also change constantly and this inconsistency can cause a good deal of frustration to a parent or caregiver. The good news is, over time, your toddler’s eating patterns will reach equilibrium. Continuing to offer them healthy food choices and allow your youngster to find something he likes with or without you pushing them to do so will establish a regular and healthy diet.

Until they reach the age of four years old, children have not mastered the grinding motion essential in chewing food, so offer your picky eater safe finger foods such as baby crackers or a thin slices of banana; stay away from foods that could be choking hazards such as nuts, grapes, hard candy, hot dogs etc. Allow him to enjoy feeding himself and sit with him while he eats. This gives him a sense of independence and establishes a routine of sitting with the whole family during meals. Parents can utilize this time at the dinner table to model healthy eating habits that you want him to adopt as he gets older.  Remember that showing your children what to do and how to do it is much more effective than telling them without backing up those words with actions.

If your child refuses one food from a food group, offer him another form of the same food group. For example, try giving him chicken, pork or fish if he refuses to eat beef. If he won’t drink milk, substitute this for low-fat cheese or yogurt. Try pairing a food that he loves with a food that he refused in the past. Keep offering a food that was refused before repeatedly with breaks in between. Sometimes, it may take a few attempts before he actually develops a taste for it. Make food attractive and playful. For example, serve food with bright colors or make smiley faces or animal shapes using cut vegetables or fruit strips. Try to kick up a notch the nutritional value of dishes by adding healthy ingredients. For instance, you can add non-fat dry milk to shakes and soups or mixing fruits and vegetables like zucchini, sweet potatoes or apples to muffins, breads, meatloaf or pasta. Finally, be a good role model by practicing healthy eating habits and having sit down meals as a family at least 3-5 times a week.

Children have different nutritional requirements than adults.  Your child’s food portions are smaller compared to yours. A child who is thriving and energetic is more than likely getting enough food substrates to sustain both his growth and his energy requirements. If you have serious concerns about your child’s eating habits and are worried about his growth and development, make an appointment with your pediatrician. He can show you where your child’s height and weight is on the growth curve relative to other children his or her age, offer some reassurance and determine whether it’s necessary to pursue further workup or testing to look for any underlying medical problems.

All information contained in this blog and on our web site(s) should be independently verified by you by a medical professional of your own choosing and you should always conduct your own research and due diligence before making any decision related to the subject matter of this blog or our web site. 

———–

Dr. Pearl

Dr. Pearl Cenon

A pediatrician in private practice in New Jersey for over 15 years, Dr. Cenon (we like to call her Dr. Pearl) also has two children of her own. Dr. Pearl’s husband, Kevin McDonough is also a pediatrician and they work together. She writes basic posts about topics that interest many parents, from skin care and nutrition to seasonal issues, such as allergies and colds. Her kind, approachable tone in each blog post will have you looking forward to the next one.

Pearls of Wisdom: First Aid 101

School’s out and most youngsters are letting loose outside, which is what summer is all about, but during summer, there’s an increase in the chances of accidental injuries. Kids are prone to scrapes and bruises on their knees or elbows, but it’s every mother’s nightmare is to see her baby or toddler severely injured. The sight of blood can be frightening, but it’s important to stay calm and in control, especially in front of your toddler. Better and sound decisions are made when nerves are settled.

Cuts & Lacerations:

Firstly, apply direct pressure to stop all active bleeding using a clean gauze or cloth over the injury for at least five minutes. Do not release pressure prematurely as this may result in more bleeding. If bleeding resumes after continuous pressure, call your doctor right away. Even minor cuts to the head and/or face can bleed profusely because of the rich vascular supply to these areas. If the cut is small and you feel comfortable treating it at home, wash the wound with soap and water until you get rid of all dirt and debris. Apply an over-the-counter antibiotic ointment, e.g. Neosporin, then cover it with a sterile wrap. Applying a butterfly bandage to minor cuts to hold edges together during the healing process provides excellent protection.

Remember that even small cuts that don’t bleed excessively can still be deep (more than ½ inch) and need medical attention. Injury to the underlying nerves, muscles and tendons can occur even if a surface wound appears non-threatening. Lacerations on the face, chest and back may leave disfiguring scars if the wound does not heal properly. Suturing these types of wounds by a trained medical professional can ensure proper healing and result in less visible scars.

If in doubt, visit your doctor so she can examine the wound for foreign objects such as dirt or glass that can lead to infection and poor wound healing. Your child may not allow thorough examination of the wound, particularly if he is in pain and/or distress; in this situation, your doctor can apply a local anesthetic called lidocaine so she can examine it better.

Note from the BabyLegs team: BabyLegs can protect from scraped knees and elbows and can also be used to protect bandages and gauze, casts, and any other dressings.

Burns:

Serious burns in children can result from sunburn, hot-water scalds, fire or electrical contact, a hot iron or chemicals. As quickly as you can, submerge the burn area in cold water for as long as your child can withstand it to cool the area and relieve the pain. It is not recommended to use ice since this may delay healing. Rubbing on the burn area can also cause it to blister.

Soak any smoldering clothing in cold water followed by removal of any clothing from the burned area unless it is tightly adhering to the burned surface. In this instance, cut away as much clothing as possible. Cover the burn with a sterile gauze or a dry cloth and seek medical attention immediately. Stay away from home remedies such as applying butter, grease or powder on burns as all of these can only make the injury worse.

Animal Bites:

Majority of animal bites in children are inflicted by animals that the child knows, including the family cat or dog. Even though these bites are minor, they can cause disfigurement and scarring if bitten on the face, and can also result in anxiety and fear. There are estimated 4.7 million dog bites, 400,000 cat bites, 45,000 snake bites and 250,000 bites by other people (mostly children) reported annually from pediatric emergency centers. 50 out of every 100 people bitten by a cat get an infection, compared to 20 of every 100 following dog or human bites.

If active bleeding is noted, apply direct pressure to area for at least 5 minutes. Then wash wound thoroughly with soap and water and consult your pediatrician. Regardless of how minor the bite appears, contact your pediatrician so he can check if your child has been adequately immunized against tetanus or if he needs treatment for rabies.

Poisons:

Most children who swallow poisons recover, especially if they received immediate medical attention.

Once you discover that your child has ingested any form of poison, stay calm and notify your pediatrician. Also immediately call the national toll-free number for Poison Help Line at 1-800-222-1222 accessible 24 hours a day, 7 days a week. You will be speaking to experts who can give you step-by-step instructions on what to do depending on the type of poison your child ingested.

Nosebleeds:

Most nosebleeds are caused by a child picking the nose, an accidental blow to the nose, or sinusitis and allergies. In the event of a nosebleed, have your child sit down and using his thumb and index finger, pinch the area just behind the tip of nose while opening the mouth to breathe and placing head down between the knees. Younger children may require an adult to do this for them. Bleeding normally stops after 5-10 minutes. Usual blood loss from nosebleeds are minimal, however if bleeding continues for more than 10-15 minutes of pressure, call your doctor or take him to the emergency room for a possible cautery.

From my family to yours, I wish all of you BabyLeggers and fun, happy, and safe summer with your children. Enjoy them while they are young!

All information contained in this blog and on our web site(s) should be independently verified by you by a medical professional of your own choosing and you should always conduct your own research and due diligence before making any decision related to the subject matter of this blog or our web site. 

———–

Dr. Pearl

 

Dr. Pearl Cenon

A pediatrician in private practice in New Jersey for over 15 years, Dr. Cenon (we like to call her Dr. Pearl) also has two children of her own. Dr. Pearl’s husband, Kevin McDonough is also a pediatrician and they work together. She writes basic posts about topics that interest many parents, from skin care and nutrition to seasonal issues, such as allergies and colds. Her kind, approachable tone in each blog post will have you looking forward to the next one.

 

Pearls of Wisdom: Sun Safety Tips

A short season to many, summer means a jam packed season of vacations, barbecues, water parks and plenty of time spent outside with loads of sun exposure. Enjoying the warm weather is important physically, socially and mentally after a long and brutally cold winter. However, parents must be very aware of the damages done by UVR rays. Harmful damage by UV radiance is extremely dangerous to children, especially those that are fair skinned, freckle or sunburn easily, or have a history of melanoma in their family. It comes as no surprise that lifelong protection from the sun should start at an early age. Here are a few tips from the American Academy of Pediatrics on how to protect your children from the harmful effects of sun exposure.

Babies under 6 months:

  • Avoid direct sun exposure as much as possible in this age group.
  • Dress babies in lightweight long pants, long sleeved shirts and wide –brimmed hats that give ample coverage for the face and neck. Find shade under a tree, umbrella or the stroller canopy.
  • When proper clothing and shade are not available, parents can apply sunscreen with at least SPF 15 sparingly to small areas e.g. face, neck, and back of hands with special care around the eye area.
  • If they get sunburn, apply cool compresses to burnt areas.
  • Make sure babies are drinking enough water to stay hydrated.

1 year old and up:

  • The most effective line of defense against harmful UV ray exposure is covering up! Wear a hat with a three-inch brim or a bill that faces forward, sunglasses that provide 97%-100% protection against UVA and UVB rays, and cotton clothing with a tight weave, or UV protective clothing. The less light that shines through the fabric, the better.
  • Try to find shade when possible and limit sun exposure between the hours of 10 am to 4 pm, when UV rays are the strongest. Use sunscreen with SPF 15 or more on both sunny and cloudy days. Make sure you are applying enough (roughly one ounce per sitting for a young adult) and re-apply every 2 hours, or after excess sweating or coming out of the swimming pool.
  • Exercise more caution in areas near water, snow, concrete or sand as they reflect UV rays and cause sunburn even faster.
  • Sunscreen can offer protection from sunburn and some skin cancers, but only if used correctly. Always remember that sunscreen is used for sun protection and not as a reason to stay in the sun longer.

Choosing the right sunscreen:

  • Use a sunscreen with an SPF of 15 or more. The higher the SPF, the more UVB protection the sunscreen has.
  • Look for the label that says “broad spectrum”- which means it gives protection for both UVB and UVA rays.
  • Look for the new UVA star rating system on the label with one star offering the lowest UVA protection and four star the highest protection.
  • Choose a sunscreen with zinc oxide or titanium oxide on sensitive areas of the body. These products stay visible on the skin even after rubbing them in and some come in fun colors that kids will love.
  • Some brands of sunscreen may burn baby’s eyes, so look for a baby-friendly one that may even have “safe around the eye area” listed on the packaging.

Warm, sunny days are here and the sun certainly feels good on our skin, especially after a long, cold winter. But just remember that what feels good can also harm you and your children.  Protect your family this summer. My Pearl of Wisdom for today?  “Block the sun and have loads of fun!”

The BabyLegs team is happy to share Pearls of Wisdom with our readers and this week, we’d like to add that our BabyCool!  line of UVA/UVB protective warmers, made of breathable mesh fabric, is an excellent supplement to sunscreen and other protective sun apparel and accessories. The complete line of BabyCool! styles for both boys and girls can be viewed at www.babylegs.com.

All information contained in this blog and on our web site(s) should be independently verified by you by a medical professional of your own choosing and you should always conduct your own research and due diligence before making any decision related to the subject matter of this blog or our web site. 

———–

Dr. Pearl

 

Dr. Pearl Cenon

A pediatrician in private practice in New Jersey for over 15 years, Dr. Cenon (we like to call her Dr. Pearl) also has two children of her own. Dr. Pearl’s husband, Kevin McDonough is also a pediatrician and they work together. She writes basic posts about topics that interest many parents, from skin care and nutrition to seasonal issues, such as allergies and colds. Her kind, approachable tone in each blog post will have you looking forward to the next one.