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Child Health Topics

Search by category (lower right) or topic (search box on the top) to find information about common childhood illnesses, injuries and safety issues. Remember, if you have an urgent issue, please call our office: (925) 254-9203, option 6

Other excellent resources:
www.healthychildren.org - American Academy of Pediatrics website for parents
First 5 California - parenting advice for children ages 0-5 plus county based resources
Poison Control - (800) 222-1222

Appointments

When and How to Feed My Baby Peanut

9/26/2018

This topic is important to discuss with your doctor as there may be significant risks involved. A good time to bring it up is at your child's 4 month old check up. Since we receive many phone calls about it, however, the following is a brief summary of current guidelines.

Recent research has shown that children are less likely to develop peanut allergies if they are exposed to peanut as an infant. The best age to start peanut-containing foods depends on whether the child has eczema or other food allergies. Infants with severe eczema and/or other food allergies benefit the most if they have peanut between 4 and 6 months of age. These infants are also at the highest risk for allergic reaction, however, and may need allergy testing before they try peanut. Babies with mild eczema should be offered peanut-containing foods around 6 months old. Babies without eczema and without food allergies are at low risk of developing peanut allergy, so timing of introduction is less critical; it's fine to introduce peanut-containing foods anytime after 4 months of age.

Once you've determined with your doctor that your baby is ready to try peanut, click here* for instructions on how to feed peanut-containing purees safely, signs of allergic reaction, and recipes for purees with a good amount of peanut protein. Offering one of these purees 3 times in a week is considered an adequate exposure to peanut.

This website has more information and resources on this topic.

* Source: National Institute of Allergy and Infectious Diseases

Plantar Warts

9/24/2017

Plantar warts are warts which are on the bottom (or sole) of the foot. They can be frustrating because they can last a long time and they can feel like you constantly have a rock in your shoe!

Warts do not require urgent treatment in the office. If they are not painful or bothersome, they can be left alone and eventually (could be years) will resolve on their own. East Bay Pediatrics physicians recommend trying home treatment first. Then if desired, you can schedule an appointment at least two weeks later.

Home treatment, at bedtime:

Soak the foot in warm water for 5-10 minutes to soften the overlying skin, dry the foot.
Using a disposable emery board (the wart virus can stay on a pumice stone), try to remove the dead skin covering the wart.
Apply liquid OTC Compound W or a piece of medicated wart tape (Dr. Scholls or Mediplast) and cover the wart. Do not use the freezing kind of medication. If using the tape, try to have it just cover the wart so that healthy tissue is not irritated by the tape.
In the morning, wash off the tape and dry the foot.
Repeat steps 1 to 4 each night and continue until the wart resolves and the skin peels off.
After two weeks, if the wart is not beginning to resolve, an appointment can be made for possible treatment with liquid nitrogen. This entire cycle may need to be repeated a few times.

Eczema

7/22/2016

Eczema, or atopic dermatitis, is a very common childhood rash. Symptoms can range from very mild to quite severe, and it is important to understand the nature of the rash in order to manage it well. Eczema often runs in families, and it is often seen in patients or families where there are seasonal allergies, food allergies and asthma. The most important thing to know about eczema is that it is a chronic condition, that comes and goes, no matter how well it is treated. Some children do outgrow eczema as they get older, but others continue to have symptoms throughout their life.

Symptoms: Eczema usually causes an itchy, red, bumpy rash. Children with eczema usually have dry skin. Patches of eczema can be small or large, and are sometimes round or oval shaped. In babies, the rash is usually on cheeks, arms, legs and neck. It is usually not in the diaper area. In older children and adults, it is usually on the insides of elbows, backs of knees, wrists and ankles. Some people get it on their eyelids. In more severe cases, it can be widespread over their whole body. After eczema fades it sometimes leave pale spots (hypopigmentation) that are more noticeable in the summer time when the rest of the skin gets more tan.

Causes: For most children, there is no one cause of eczema. A small percentage of children with eczema have food allergies. When that food is removed from the diet, the eczema may improve (though doesn't usually go away completely). Many parents find that there are triggers that worsen their child's eczema. These may include very cold or very hot weather, viral illnesses, and detergents, lotions or soaps that are scented. Minimizing these triggers can lessen the eczema, but it is important to know that even if all of these triggers are avoided, eczema can still flare up.

Treatment: The most important element of treatment for eczema is moisturizing. Frequent moisturizing, particularly after baths, will help keep skin moist and prevent eczema from worsening. Most children with eczema do better with less frequent baths, maybe every 2 to 3 days. Some children need moisturizers applied several times a day, every day, and others only need it occasionally when the eczema is flaring up. If, despite good moisturizing, itchy patches of eczema remain, a topical steroid cream will help treat the eczema. Despite the worries of some parents, topical steroid creams are safe when used as directed. For mild eczema, over the counter 1% Hydrocortisone twice a day will help. If it is not helping after 1 week, call your doctor. For more severe eczema, a prescription strength topical steroid will be prescribed by your doctor. The goal is to use the lowest strength steroid for the shortest time needed to settle down the eczema flare.

Eczema is very itchy, and controlling scratching can also help the rash. In babies, keeping nails cut short and covering hands with socks at bed time can help. In older children a dose of an anti-histamine can decrease itching and keep the child from scratching.

Care of Bottles and Preparation of Formula

7/5/2016

IT IS NOT NECESSARY TO STERILIZE YOUR BABY’S WATER, BOTTLE OR NIPPLES. Washing them in a dishwasher or in hot soapy water and rinsing them thoroughly is adequate.

Several types of formulas are available on the market, including Similac Pro Advance.

1. Powdered formula is mixed like instant coffee. A scoop of powdered formula is added for each 2 ounces of water and stirred. Follow directions on the formula can to ensure that the right amount of water is added.

2. Ready-To-Use formula comes in small disposable bottles and quart cans. It needs no preparation and is very convenient, but more expensive than powdered formula.

Most tap water is safe for mixing formula for your baby. If you use bottled water, we recommend that you buy water with fluoride added.

Beginning Breast Feeding

7/5/2016

Breastfeeding is a natural way for women to feed their babies, but it is a learning experience for both you and your baby. Be patient with yourself and your baby, relax and enjoy this time together.

Find a comfortable place to feed your baby, allowing space for pillows to support your arms and to bring the baby level to your breasts. Position your baby so he/ she does not need to twist or strain to reach your breasts. Express some milk onto your nipple and touch your nipple to the baby’s lower lip. When your baby’s mouth opens wide, quickly pull your baby in to latch on. The nipple needs to be far back in the baby’s mouth. If you experience pain, break the suction by slipping your little finger in the corner of your baby's mouth between the gums and take the baby off the breast. Try again to latch the baby on, this may take several attempts.

Whenever possible offer both breasts during each breastfeeding session. Begin the next feeding with the breast with which you finished the last time.

During the newborn period, breastfeeding may take from 20-45 minutes. However, because newborn babies are often sleepy, this may require patience and persistence.

Babies need to breast feed at least 8-12 times in 24 hours the first few weeks in order to gain weight appropriately and stimulate a plentiful milk supply. After the first few days, you know your baby is getting enough milk if:

1. There are 4-6 wet diapers in a 24 hour period.
2. The urine is pale in color.
3. Stools are loose and change from black to mustard yellow in the first 5 days.
4. Your breasts feel softer after feedings

Continue to eat a well balanced diet high in protein and calcium. Drink whenever you are thirsty and rest when you can. If you have problems with breastfeeding, talk with your pediatrician about getting help.

Breast milk may be expressed into a clean, non-sterilized container and stored for up to 6 months in your freezer. Rewarming frozen breast milk under warm tap water or by exposure to room temperature provides a nice supplement to nursing.

Some medications are contraindicated (should not be taken) while a mother is breastfeeding. The list of these medications is frequently updated - please call our nurses or your obstetrician to ask whether your medication is safe with breastfeeding. In general, many seizure medications, all radioactive medications, stimulants, and illicit drugs should not be used while breastfeeding.

Newborn Feeding

7/5/2016

Although there are many unresolved questions about infant nutrition, current medical thinking suggests the following:

1. Breastmilk is the preferred nutritional source for a newborn; there is nothing wrong with formula feeding. For some families, formula feeding may be preferable.

2. Feed your baby on demand, which usually is about every 2 to 3 hours. You may want to wake your baby during the day if he or she sleeps more than 4 hours to maintain a modified on demand schedule.

3. The American Academy of Pediatrics (AAP) recommends that all infants receive a vitamin D supplement. Both multivitamin preparations (with vitamins A, C, and D) and vitamin D alone are available over the counter (OTC). The dose of vitamin D is 400IU per day until the baby reaches one year of age.

4. Infants do not need water or other fluids outside of breastmilk or formula. However, it is perfectly safe to offer your older baby (over 6 months of age) a small cup or bottle of tap water during or between meals if desired.

5. The age at which solid foods should be introduced varies with each family. From a medical standpoint, infants need only breastmilk or formula in the first year of life. Solid foods should not be given during the first month of life and are commonly introduced at 4 to 6 months of age. There is no proof that introducing solids will help babies sleep longer.Raw honey should not be given until after the first year of life because honey carries a risk of infant botulism ("floppy baby" syndrome). Cow's mlk should not replace formula or breastmilk in the first year because its negligible iron content can lead to anemia (low blood count).

Infant Cradle Cap

7/5/2016

The infant's scalp may show a yellow flaky rash which seems unrelated to temperature or bathing conditions. This cosmetic condition may be present from birth and is referred to as infant “seborrhea” or commonly called “cradle cap.” Baby oil or mineral oil may be applied to loosen the flakes prior to gentle brushing with a fine nylon baby brush. Simply washing thereafter with plain soap or baby shampoo once or twice per week will keep cradle cap under control until it disappears.

Ill Contacts and Your Newborn

7/5/2016

There is controversy in the medical community about how susceptible newborns are to colds and other common infectious illnesses. Prudently, when taken outside, infants should be dressed appropriately for the weather, and their heads should be covered when it is cold or rainy. Persons with obvious or known colds or other respiratory illnesses, should try to limit contact with the child. Everyone should wash their hands before handling an infant and avoid breathing on the child.

Colic

7/5/2016

Excessive fussiness, or colic, occurs in many babies. It usually begins when the baby is about 2 weeks old; it peaks at 6 to 8 weeks; and it usually resolves by 3 to 4 months of age. A colicky baby may cry an average of 3 hours a day. If your child is fussy, determine whether he or she is hungry, wet or ill. If these do not appear to be causing your baby’s fussiness, certain colic measures may be tried:

1. Motion techniques (rocking, walking in a snugli, wind-up swing, going for a ride in the car).
2. Noise (TV, stereo, dishwasher, vacuum cleaner or hair dryer).
3. Heat (heating pad on a low setting or warm water bottle). Caution: Newborns have thin, delicate skin. Use only low heat.

Any combination of the above measures may help to comfort your infant. If your baby’s fussiness seems to be excessive or if you are worried about it, please call our advice nurse.

Newborn Sleep

7/5/2016

Newborns sleep between 12 and 20 hours per day. The sleep pattern for each child varies. Day/Night sleep patterns do not become firmly established until about 4 to 6 months of age.

Infants should sleep on their backs; they should not sleep on their bellies or sides. Your baby's crib or bassinet should have a firm mattress. The space between the slats of your crib should measure no more than 2 3/4 inches.

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