Chldren

Zika Virus: An Update

Posted by

6

Aedes mosquito-01The Zika virus was first isolated from a Rhesus Macaque monkey in 1947 in the Zika Forest in Uganda (zika meaning “overgrown” in the Luganda language–gotta love useless trivia!); it was first isolated from a human in 1954 in Nigeria. It appeared sporadically along the equator in Africa and Asia for several decades until it spread to French Polynesia in 2013 and then to Latin America, Mexico, the Caribbean, and now the US.

Illness from Zika was rare until the pandemic began in 2007. The illness it caused was mild and self-limited until October 2015, when we began to see babies with microcephaly (very small brains) born to mothers who had been infected while pregnant. Evidence shows that these babies may also have eye abnormalities that will  effect their vision. There have been links to serious deformities in the joints in the arms and legs of affected babies. A report published August 30, 2016 noted that 6% of the babies affected by Zika also have hearing loss. According to the AAP as of November 4, 2016, their are five main birth defects: severe microcephaly with partially collapsed skull, decreased brain tissue with subcortical calcifications, extreme muscle tone, eye damage with macular scarring and increased pigment, and limited joint motion range.

There have now been more than 1500 cases of microcephaly in Brazil; in the most severe areas the incidence has been as high as 1:100 births.  On August 15, 2016 a state of emergency was declared in Puerto Rico, where they now have 10,690 confirmed Zika cases, including 1,035 pregnant women. Currently, more than 500 pregnant women in the US have shown evidence of a possible Zika infection.

Symptoms

Zika is a flavivirus related to Dengue, Chikungunya, and West Nile encephalitis. It is transmitted by several species of Aedes mosquitos which can, after biting an infected human, infect another person. Transmission has also been reported through blood transfusions and sexual contact.

The newly infected person may not have any symptoms at all, or may develop symptoms of illness within 2 weeks: fever, a bumpy red rash, sore joints, and pink eye. Less common symptoms include aching muscles, headache, and vomiting. The illness itself is usually mild and self limited.

Treatment

There is no preventative vaccine available yet and no treatment, other than pushing fluids, resting, and treating the symptoms with acetaminophen (Tylenol). The ill person should not take aspirin, ibuprofen (Motrin, Advil), or naproxen (Aleve) until Dengue fever is ruled out, to avoid the risk of bleeding.

Where is it?

As of now, local transmission has been reported in more than 0 countries and territories. Current recommendations are that women who are pregnant, especially in their first trimester, do not travel to any of these areas. If they have to travel, they should do what they can to protect themselves from mosquito bites: wear long pants and long sleeved shirts, preferably treated with permethrin insect repellant; sleep in air conditioned rooms, screened in areas or with permethrin treated mosquito nets; and wear insect repellant, because these mosquitos are active during the daytime.

If you do travel to these areas and develop the symptoms of Zika after returning home, pregnant or not, see your doctor. Avoid mosquitos for the first few days, so that you will not be the source of spreading infection.

Men who have had Zika should use barriers during sex for at least 6 months after the infection; women for 8 weeks. Use of a barrier is recommended for at least 8 weeks after travel to endemic areas even if you have no symptoms.

As of today, we have had 1962 confirmed cases of the infection in the US, with 413 in Florida. Twenty eight of those were caught from local mosquitos. We have the Aedes mosquito along our southern coast and in southern California.

Prevention

In all likelihood the same measures we used to contain Denque in the US will contain Zika, but its spread is still possible. Taking precautions is certainly sensible.

  • Get rid of standing, stagnant water.
  • Clean up piles of garbage, because mosquitos love to breed in trash.
  • Put up or repair your window screens.
  • Spray.

Another possibility to limit spread of the infection is releasing GMO mosquitos with a lethal gene, to decrease the population of the bugs. When this was done in the Caman Islands the mosquito population decreased by 80%.

If you are pregnant, stay out of the endemic areas when possible. Take sensible precautions: clean up standing water and trash, put up or repair window screens, and wear insect repellant.

And keep an eye out for current recommendations from public health officials, because the places and numbers change daily.

DomesticatedMomster
The Blogger's Pit Stop

All the Right Foods

Posted by

0

Little chief-cook tasting the carrot isolated on white

One of my favorite teachers once said “Never fight a battle with a child that you cannot win.” Excellent, timeless advice.

Luckily, children are young and inexperienced. We adults are old and treacherous–we can outsmart them.

This is particularly good advice when it comes to nourishing a child. The grown ups need to win food battles, because the losing side is populated with joint pain, back pain, heart disease, stroke and death. We have to set up this battle so that we cannot lose, because otherwise our child will suffer.

There are two keys to making this work.

The first is that children do not cry for what they don’t know exists. A three year old who doesn’t know about chicken nuggets and French fries does not beg for them. If it’s not too late, start on day one and keep only healthy food in the house, in the proportions you want them to consume. Eat at home. Then let them have it. Everything in the house is good for them, so you never have any arguments over what your urchins can or cannot eat. If they munch on healthy snacks throughout the day, like whole grain crackers with cheese or pieces of fruit or veggies, it really doesn’t matter if they eat formal meals.  There is no need to argue over what they need to eat before they leave the table.

If it is too late and they already have some bad habits, explain to them that you’re turning over a new leaf, eating healthier, and throwing out all the junk. Then do it, and put in earplugs. It gets better in about two weeks if you are consistent and don’t give in.

The second key is that “never” is a lot easier for a child to deal with than “sometimes.” “Never” is a shake of the head, a smile, and a change of subject. “Sometimes” is endless daily arguments over what they want today because sometimes they get it, sometimes you buy it, sometimes it’s O.K. It’s easier for the child as well: children are less stressed and develop healthier habits when they can eat when they’re hungry, eat whatever is available, and stop eating when they’re not hungry.

So what edibles do you bring into the house? Start with whole foods: things that look like they grew out of the ground or lived on it. Shop mostly around the outside of the grocery store where they keep the produce, meats, and dairy. Avoid the aisles unless there is something specific on them that you need. Don’t buy anything with ingredients that you can’t pronounce without a chemistry degree, and don’t buy sodas.

Make a meal plan for the week, taking into account what is in season, what you like to eat, and what your week is going to be like. Make meals ahead that you can reheat or reinvent later in the week when you have a crazy busy night. Throw together an extra pan of lasagna, bake a larger chicken than you need so you can make quick quesadillas, or save some leftovers for a shepherd’s pie. Plan ahead so you won’t be tempted by the drive through.

About 2/3 of everything children eat should be fruits, veggies and whole or enriched grains. This leaves only about 1/3 for proteins (meat, eggs, cheese, beans, and nuts) and starches (potatoes, bread, corn). That translates to a maximum of about 6 ounces per day of protein containing foods for a medium sized child, and 6 ounces of starch. Visually this is a portion about the size of a deck of cards, much less than the average child eats. This leaves lots of room in their stomachs for fruits, vegetables, and whole grains.

Children don’t overeat on a diet that is mostly fruits and veggies, which means you don’t have to chase them around trying to limit how much they eat so that they won’t get chubby. Feel free to let them have seconds, thirds and fourths on the broccoli and carrots, but sorry kid, that’s all the meat and potatoes we made.

Arrange the battlefield ahead of time in such a way that you have no chance of losing–you don’t even actually need to fight–so that your child will grow up healthy, nourished and strong, with good lifelong habits. Do this consistently and everyone’s lives will be less stressful. Your children will know that food is nourishment of the body, not an emotional crutch for the soul.

Below is a chart that should give you an idea of what the goals are for your child’s diet, based on their sex, age, and activity level:

diet table2

Reading Milestones

Posted by

5

ROARlogo2-01This week’s blog comes curtesy of the Reach out and Read program.

Reading together is the single most important thing you can do to develop language skills and learning ability in your children, especially between the ages of six months and five years. Nothing will do more to prepare kids to excel in school: reading increases their vocabulary, their understanding of phonics, familiarity with the printed word, storytelling ability, and comprehension. Snuggling up and reading with your children will also help them feel loved and secure; do this at bedtime and it will help them sleep.

All this is before we get to the actual contents of the books!

For tricks on how to read to tiny people, check out my blog on Growing Brains.

Read, love reading, and encourage your children to love reading and their world will open up with possibilities.

The Reach out and Read people have come up with a very neat chart of reading milestones by age, from six months to five years. I thought I should share. Just click on it to make it bigger:

Reading Milestones

Domesticated Momster

Parenting: How to Fight with a Child

Posted by

3

kidsfightingThe most basic principle of conflict resolution, that both parties in the conflict have to be treated as equals, flies out the window when that conflict is with a child or between children.

Equality is a tricky area in parenting. Yes, this child is in every way your equal in humanity and way ahead of you in potential. He or she is undeniably not your equal in size, power, or – for a while – intelligence and experience. If we allow a child equal power in a conflict what we get is a spoiled, obnoxious child who will put his or her own future in jeopardy by making bad decisions.

Equality is likewise tricky between two children, because we cannot count on children not to take advantage of their greater size, intelligence, or experience. A referee is needed.

When we are in conflict with our children, or they are in conflict with each other, we must treat them with respect as the complete human beings they are, while we decisively withhold the power they are grasping for.

The standard steps to conflict resolution apply, but they must be adjusted for the relative sizes of the combatants.

First, listen. It is all too easy to dismiss a child. You are the parent, you know what they are going to say, and you know what your decision is going to be, so why waste the time, right?

How did that attitude make you feel the last time you were on the receiving end of it?

Take a moment to listen to their side, even if it is ridiculous, because just knowing they are being listened to is a win for a child. This is much easier to do when your 4 year old is explaining to you why she thinks she should have ice cream for lunch, than it is when your 13 year old is explaining why it is not a problem that you caught him smoking. Give them the time to speak, no matter how tempting it is to cut them off.

Actually focus on them and pay attention to what they are saying. Don’t let your mind wander into thinking about what you will say next, or the errands you have to run.  The prize you get for listening is a better understanding of your progeny; as a bonus, they then have to listen to you, to be fair. Another win!

Sometimes it helps to set a timer prominently between you and give each person a minute to speak without interruption.

After one contender has their moment to speak, their opponent should repeat back what they heard. Sometimes what we mean to say is not what comes out of our mouths, and sometimes what we hear is not what was actually said.

Communicate, and insist that they communicate. Don’t fling insults and accusations. Don’t bring up past history. Don’t yell, because yelling looses it’s power quickly. Don’t threaten with ultimatums – they backfire. Never denigrate your child and never label them: labels stick, and children sometimes try to live up to them.  Sit down at their level, look them in the eye, speak at normal volume, and stick to the subject.

Don’t make assumptions, or jump to conclusions. Slow down and give yourself the time to fully understand, or mistakes will be made.

Summarize. After everyone has had a chance to make their points, sum them up. Name the problem, list the arguments on each side.

Start with areas of agreement. In every discussion there are points of agreement. Start with those points, and work from there. We agree that ice cream is delicious, and it does have calcium in it for your bones, but…

In the end, you are the parent and must make the decision that you feel is best. Listening to your children along the way does no harm, strengthens relationships, will make them feel valued, and will nourish their self esteem. Understanding their thought processes and point of view may also help prevent later conflicts. Avoid the pitfalls – jumping to conclusions, towering over your child, name calling – and you will not have damage to repair later.

The experience of being treated fairly and with respect will carry forward and encourage your children to demand respect as they become adults. And learning how to argue without destroying a relationship? Priceless.

Domesticated Momster

How to Nurture Self-confidence in Your Child

Posted by

0

skateboarder-01In the last several weeks I have seen a mother trying to make her daughter look prettier (she was beautiful without the make-up), a father pushing a son better built for track into football, and a parent making fun of a son’s drawings.

These parents might someday wonder why their children did not have the self-confidence to achieve more in life.

Let’s not do that.

So… top ten ways to nurture a confident child

  1. The most important single factor in building a child’s self esteem is unconditional love from their parents. Children need to be certain that no matter what dumb thing they do, or how badly they fail, you will love them. You may not always like what they’ve done, but you will always have their back. They will have the courage to try, when they are sure you will catch them if they fall.
  2. Give your child a chance at success by laying out clear expectations; they need to know what success is in order to achieve it. Nothing will destroy self-confidence more quickly than trying to shoot at a moving target. What do you hope to see in your child: honesty? hard work? creativity? Be consistent. If you want them to be honest, then you need to be stringently honest in your own life, and require it of them in every part of theirs. No telling your child not to lie, then suggesting a fib about their schoolwork! Expect hard work? Work alongside them, and let them know how much you appreciate their labor.  Exhibit, and reward, the behavior you want to see.
  3. Make your expectations something at which your individual child can succeed. Any child can give their best, work hard, be true to themselves, and be honest. Not every child can be a football star, brilliant musician, or great artist. If your expectation is that your child try new things and do his or her best, then they can succeed at putting paint on canvas, and they will feel pride in their accomplishment.
  4. Find activities in which your child will thrive. You may have to try a few new things; break out the ballet classes and art lessons. Learn to throw a ball. Read books, tour a museum, travel… Explore the world in which your child will live his or her life. Nothing will build self-esteem like success, so seek out and encourage activities they love or for which they have a talent.
  5. Be interested in what inspires them. It’s impossible not to be: you are interested in their hair color and their height, how could you not be interested in their minds and talents? In the end, if mom or dad is interested, they will know that their accomplishments – and they themselves – have value.
  6. Allow time for free play and creative activity. Children do amazing things when they are allowed access to their own imaginations. Freedom will allow them to get in touch with their innate abilities, so that they can discover their best future. Self-confidence thrives when we do work at which we excel.
  7. Examine your own mind. Any left over preconceptions that might injure your child? Your small human is new. He or she embodies a combination of mind, talent, and ability that has never existed before. If you think science is the most important subject, but gave birth to a poet, you need to make sure that small poet doesn’t get the idea that you would have been happier if he or she could grasp algebra.
  8. Expect them to fail: the only people who do not fail are those who do not try. Show them with your own behavior that failure is a learning opportunity, so they will not think that they have less worth when they, in turn, fail. Let them watch you try new things. When you fail, make sure they see you accept that failure and learn from it, so that you can succeed next time. When they fail, tell them it was great that they tried, and redirect them to what they can do differently next time, so that they will get better. No defeatist talk, for the entire duration of their childhood!
  9. Spend time with friends with like interests, and friends who are completely different. Friends who value the same things your child does will reinforce his or her worth; friends who are very different will teach your child that every person has equal grace, whether their talents lie in building an app, a home, or a business.
  10. Be true and honest. Your children know you, and will know when you are not being real. Children do amazing things every day: there is no need for fake, meaningless praise. You love this child, therefore you love and will value the things that he or she is good at, even if you never thought you would before you became a parent. True praise builds healthy self-confidence.

While you’re at it, work on your own confidence. The world has probably battered it a bit. Children will always follow our example. If that example is self-confidence, courage, and honesty, how far might they go?

4th of July: Avoid the Doctor!

Posted by

0

safety signSunshine, water, and fireworks. What else could you need? To avoid the ER afterwards!

Oddly, most 4th of July injuries actually have nothing to do with fireworks, and everything to do with parents being so busy that they are not as watchful as usual. Sports are more dangerous when we want to impress cousins. Teenagers tend to get more reckless during a celebration, and young children sneak away quickly.

Most injuries are from everyday activities and household objects made dangerous by the craziness. So,…

Top Ten things that will land you in my office after the fireworks:

1.  Drowning: The 4th is all about water. Every year pediatricians see drownings and near drownings on the 4th. Never leave any child alone for even a moment near open water, whether it is an ocean, a bathtub, or a water bucket.

All it takes is one moment of inattention for a child to slip away. If there is open water, you need to be within touching distance and focused on your child. Pools should be fenced in and closed off with a self-latching gate at the end of the day, and all the toys should be put away. Life vests are fabulous for a parent’s mental health and relaxation (swimmies and floaties are not life jackets). Life preservers and a shepherd’s crook should be placed obviously nearby wherever kids are swimming. For more tips on water safety, check out my summer safety tips.

2.  Fireworks: I know, it’s obvious, but it had to be on the list. Please leave them to the professionals. It’s not worth months in the burn unit and doing physical therapy.  No-one thinks it will happen to their kid, until it does.

3.  Choking: Toddlers will put anything in their mouths. This means that everybody needs to pick up his or her stuff. Items over 1¼ inch in diameter are generally safe. Items smaller than 1¼ inch can go straight into their gut or lung. The most dangerous items to swallow are button batteries and magnets; the most dangerous to choke on are grape sized (older children’s toys, hard candy) or stretchy (balloons, plastic bags, marshmallows). Clean up!

4.  Allergic reactions: Holidays provide a banquet of things to irritate children’s allergies. Plants, foods, cigarette smoke, bonfires and other people’s homes and pets come to mind. Avoid them if your child has allergies.

5.  Fires and electrical injuries are especially common during holidays. Decorations can be flammable, candles and fires are commonly nearby. Frayed and loose wires easily start fires. I have had an astounding number of children run through banked campfires after dark. Block them off please!  Keep your eyes open for dangers.

6.  Poisonings: The one I see most is an overdose on Grandma’s meds. At Grandma’s home they are left on countertops; at your home they are in her purse. A left over drink is also a common way to poison children. A little alcohol can drop a child’s blood sugar and throw him or her into a coma.

7.  Alcohol inside the grown-up: does this really need explanation?

8.  Dehydration/Food poisoning: Watch their intake. It’s hot and the kids are running around in endless circles. Bring lots of water (the stuff mother nature made for you, not the stuff with caffeine and sugar added). Food left out in the heat for hours can grow things that cause vomiting and diarrhea. If you don’t know where it came from and how long it’s been there, don’t eat it.

9.  Scarce common sense: If it doesn’t seem safe, don’t let people pressure you into it. Make them wear that bike helmet! Trampolines and motorized vehicles (Sea Doos, dirt bikes) are never a good idea.  Feel free to let watching your kids take precedence over seeing Uncle Joe’s trophy or Aunt Mary’s vacation photos. “He’ll be fine” doesn’t make him fine. Keep an eye on him.

10.  Politeness: Feel free to be rude and head for home when the kids get tired, if a situation feels out of control, or if your child is being exposed to something you aren’t happy with. Use the munchkin’s youth or fatigue as the excuse for you to head home, relax and read a bedtime story.

The point of celebrations is to solidify relationships and give hope for the future. Focus on family, rejoice in the day and be careful.  Keep plans simple, pick fewer things to do, and do them together. Be safe and stay healthy.

Trendy Poisons for your Kids

Posted by

0

tidepod-01Kids always seem to find new and interesting ways to hurt themselves, intentionally or accidentally. Poisoning is the #1 or #2 cause of injury death annually, fighting for that honor with car accidents. The annual numbers on poisonings are out (thank you, Annals of Emergency Medicine). The new winners are opioids, laundry detergent packets, bath salts, synthetic cannabinoids, and energy drinks.

Opioids are the traditional first place winner for deadly poisonings, and they are in that spot again this year. 90% of poisoning deaths involve drugs, and opioids are involved almost half the time. Opioids include all of the narcotic painkillers. They are intentionally abused because of the euphoria they induce; they are also accidentally ingested because people keep them laying around the house on countertops and in purses. When taken in high enough doses, the kids who took them forget to breathe; when taken chronically they are addictive.

The new second place finisher is laundry detergent packets. They are a problem because they are more concentrated than traditional laundry detergent, and can cause nausea, vomiting and sedation when taken by mouth, and irritation when put in contact with skin and eyes.

“Bath salts” have been popular since 2010. They are substituted cathinones (stimulants) which cause disorientation, extreme paranoia, and violent behavior. In 2012 there were 994 reported exposures and 16 deaths. They are called bath salts because they resemble Epsom salts, but are also known as plant food, ivory wave, vanilla sky, and bliss.

Synthetic cannabinoids (man made marijuanas) are common now and have an added level of danger above Mother Nature’s version. Kids have anxiety attacks, psychosis (loss of contact with reality), rapid heart rates, and seizures. In 2012 there were 5225 reported exposures and 6 deaths. The kids call this stuff spice, genie, Yucatán fire, or aroma. Drug screens do not pick it up.

Energy drinks are on the upswing, causing about half of the 2.3 million calls to poison control centers in 2012. They cause seizures and heart rhythm abnormalities.

The new kids on the block are the liquid nicotine refills for  e-cigarettes, which come in vials without child resistant closures. One teaspoon is enough to kill a child. Liquid nicotine is unregulated, which means that in 10 states and DC a child can buy it; it can be advertised to children in all but 4 states. In 2014 poison control received 3353 calls for exposure to nicotine products, up from 1543 the prior year. Children can be exposed by inhaling the vapor, by swallowing the liquid, or by absorbing it through their skin. Children experience a racing heartbeat, vomiting, and grunting breaths, before they loose control of the muscles in their upper body and die.

So take a few minutes to clean out your medicine cabinet. Throw out meds you don’t take anymore. Lock up the ones you do take, vapor refills, and laundry detergent packets. Don’t buy energy drinks. Talk to your kids about the risks of  drug use, and learn the language they are using. While you’re at it, lock up the rest of your cleaning products and pesticides as well.

Poison control’s phone number is 1-800-222-1222 in the US; keep it posted on or in every phone. They are excellent in an emergency, and they have more in depth analysis of which age groups are taking what and why on their site, if you are interested.

Be safe. Safe is always better than sorry.