Monday, November 8, 2010

That Time of Year! Prepare to Beat Colds

You all know how it is, they go down for a nap fine and wake up with a fever! Well it is that time of year when the cold and flu viruses will again begin to circulate through daycares, schools, and families. I am going to discuss with you a few things that you can do for a cold that might help! First, I know that all of you have seen the multitude of medications touted to treat colds over the counter, some of them even marketed for babies. Please use caution, the FDA  made a strong push a couple of years ago to warn parents of the potential risks of over the counter cold medicines and children. The American Academy of Pediatrics agrees.

"Studies have shown cough and cold products are ineffective in treating symptoms of children under six years old, and may pose serious risks. A variety of rare, serious health problems have been associated with use of these medications in children, including death, convulsions, rapid heart rates and decreased levels of consciousness. (A review by the U.S. Centers for Disease Control and Prevention of national emergency department visits due to adverse drug events from cough and cold medications will be published in the online version of Pediatrics Jan. 28.)
“It is critically important for parents to receive clear information about the risks and lack of benefit from these drugs, and ways to help take care of children suffering from colds and coughs,” said Renee Jenkins, M.D., FAAP, president of the American Academy of Pediatrics. “We urge FDA to continue its analysis of the existing data on these medicines intended for children over age 2 and take appropriate action, including initiation of immediate, rigorous scientific studies as needed to determine the drugs’ safety and efficacy.”
Children metabolize and react to medications differently than adults, often in unanticipated ways. For more than 30 years the AAP has emphasized the importance of studying medicines in pediatric populations. As part of the FDA’s ongoing review of over-the-counter cough and cold medications, the AAP in October urged regulators to pursue further studies into whether these drugs have any benefit to children. The AAP also advised labeling that would inform parents that the products have been shown to be ineffective in children under 6 and could lead to serious adverse reactions."

So what can we do for our children when they have a cold? For a runny nose it is recommended to use saline nose drops, these can be purchased over the counter. You will want to use a couple of drops in each nostril followed by either using a bulb suction or having your child blow their nose to remove the mucus from the nasal cavity (think a childs version of netti pot, although a little less scary, same principle). Do this primarily when they are having difficulty eating or sleeping as over suctioning can cause the lining of the nasal mucosa to swell and make it more difficult to breathe. Another tip, especially when you are running heat in the house, use a humidifier in your childs room. This will moisten the air and help with dry nagging coughs. Warm apple juice or chicken broth can be used to help with a sore throat in younger children and suckers or hard candy can be helpful in older children (please monitor them for choking). Fevers will need to be treated any time they reach 102 rectally or if the child becomes uncomfortable. Dosage instructions can be found on the package insert. If at any time your child developed difficulty breathing, wheezing, decreased fluid intake, decreased urine output, you would need to notify your childs doctor.


Hope this information is helpful, but I hope that you won't need to use any of the tips!

Friday, October 29, 2010

Diaper Rash..... Miserable Baby = Miserable Parents

This topic hits close to home today. I arrived home last night to a baby with a diaper rash. This is something that we have only encountered a handful of times between both boys, but the couple of times we have experienced it.... NO FUN! We all know that when a baby is miserable it is hard for the parents to not be miserable as well. I have searched and searched for something that worked and have found a few great things. The most important thing is that keeping the baby as dry as possible, this may mean waking the child up an additional time at night for a diaper change. Also, maybe leaving a diaper off and allowing the bottom to air dry, laying them on a towel at naptime, if possible. When your child has a diaper rash it is also important to NOT use diaper wipes alone when cleaning the child's bottom. The wipes can leave a film of bacteria on the skin and can predispose the child to a staph infection. Instead use a mild soap, something like Dove, and warm water to clean the childs bottom after each messy diaper. You can also place your child in a tub of warm water with 2 tbsp of baking soda added to help remove the sting. Certainly, always supervise your child when they are in the bathtub...

Finally, when diaper rash creams are just not doing it, I have found a concoction that works wonders for a diaper rash.
Take Desitin or another diaper rash cream, corn starch, triple antibiotic ointment, and a little anti fungal cream. Mix diaper rash cream, corn starch, and triple antibiotic ointment in equal parts to obtain a paste like consistency. Add a little anti fungal cream (found usually in the foot care aisle, something like Lotrimin), this will help prevent yeast from growing. Apply with every diaper change and cover liberally, improvement should be seen in as little as 24 hours.

If at ANY time the childs bottom shows signs of the skin peeling off in sheets, the child starts running a fever, the area looks infected, or does not respond to the cream, they will need to see their pediatrician.

Thursday, October 28, 2010

Monitoring Hydration Status in Children...

One thing that you learn very early on as a parent is that you HATE to see your children sick. Any parent would do anything to make their children better. The other thing is that sometimes you can get so laser  focused on one particular symptom that you may miss something that is extrememly important. Any time your child has a decrease in fluid intake: not eating, drinking, vomitting, diarrhea, it is important that you closely monitor for signs and symptoms of dehydration. Much like the elderly population, children dehydrate quickly. The best way to monitor hydration status is to be aware of how often your child is urinating, either through monitoring how often you are changing a wet diaper or how often they are going to the bathroom to urinate. If the body is producing urine there is a significant chance that you child is staying hydrated. The body will not let go of excess fluid if it is starved for it. For younger children we really want to see a wet diaper every 4-6 hours with older children we want to see them go to the bathroom at least every 6-8 hours. Another way to monitor hydration status would be to check the inside of your childs mouth. If it feels moist, the child is reasonably hydrated. If the inside of the mouth feels dry and sticky, it is time to start to think about ways to prevent further dehydration. Also, if a child is crying but is unable to produce any tears, this might indicate an issue with the childs hydration status. In infants, a sunken soft spot can also be a late indicator of poor hydration status.

When your child is ill it is very important to be vigilant of their hydration status. This is something that is very easily monitored at home but can be a key indicator of how ill your child is and can determine the need to seek further medical care. Any time your child becomes lethargic, gray or ill looking, or overall your gut tells you something isn't right, it is time to contact your childs doctor.

Wednesday, October 27, 2010

The things we learn...

Well... I have had the idea to write this blog for a very long time, however have just now had the time to sit down and write. As the name of the blog mentions I am a registered nurse who is also the mother of 1 1/2 year old twin boys! Yes, I stay busy all the time. One thing I learned shortly after the boys were born is that they do not come with an instruction manual and despite all of my formal training with adult critical care and really sick adults, I knew very little about babies and some of the things that occur with them fairly often. My boys were also born 3 months prematurely which also meant that there were additional concerns that we have faced that other mothers may not have if their children were carried to term. All of this to say that I hope that some of the resources that I will provide through this blog will help each and every mom, or dad, who reads it and that I will be able to prevent some of the OH NO moments that I have had. I also encourage any comments to posts as we can use this forum as a place where "Moms can Help Moms!". If you have questions about something, please feel free to ask. I will do my best to answer or at least point you in the right direction. I hope that you enjoy this blog!