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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

Newborn Clothing

7/5/2016

 
New clothing should be washed in a mild detergent before wearing. Avoid the use of fabric softeners.

For taking baby home: diaper, shirt, hat, and blanket.

​As a general rule, dress your baby in the same weight clothing that you are wearing.

Bathing Your Newborn

7/5/2016

 
Frequency: 2-3 times a week; sponge bath only until cord has dried and fallen off

Soap: mild, without perfume

Lotion: usually unnecessary; fragrance-free mild baby lotion may be helpful for excessively dry skin

​Powder: none; talcum powder can be inhaled into your baby’s lungs and cause serious respiratory problems

Newborn Cord Care

7/5/2016

 
Keep the cord stump clean and dry; it will fall off about two weeks after birth. Cleaning/cleansing the base of the cord with alcohol or hydrogen peroxide is not necessary.

Some bleeding or discharge commonly occurs at the site of the cord. Call us ifthe bleeding seems excessive or if redness develops in the skin around the cord.

Newborn Jaundice

6/30/2016

 
Jaundice is a yellow discoloration of the skin caused by a pigment called bilirubin. Bilirubin, a by-product of red blood cell breakdown, is processed by the liver. Due to immaturity of the liver in newborns, nearly all newborns experience some degree of yellowness which is usually seen at about Day 3. Sometimes the extent of jaundice may require measurement of bilirubin by heelstick blood test. If the bilirubin is elevated, additional tests and/or treatment may be required.

For mild jaundice, more frequent feeding or exposing the baby to filtered sunlight at home may be useful. If additional fluids are needed, offer 1-2 ounces of formula after nursing two to three times per day. If you have any concerns about your baby's yellow appearance, call our advice nurse. The advice nurse may recommend
 an office visit and/or a bilirubin blood test.

Newborn Constipation

6/1/2016

 
Frequency of stools varies greatly. Many breast-fed babies have a stool after each feeding and some may go several days without having a stool. Formula-fed babies often have fewer stools than breast-fed babies. You should be concerned if your newborn has not had a stool in five days, if there is blood in the stool, or if the stools are rock hard. Straining, turning red and grunting does not necessarily mean constipation.

If your child is constipated, you may wish to try one or more of the following:

1. Prune juice.
2. Pediatric glycerine suppository.
​3. Gentle insertion of a lubricated thermometer into the rectum (1 inch).

How to Measure Your Child’s Temperature

1/27/2016

 
There are several different types of thermometers on the market, and deciding which to purchase can be a tricky decision. Depending on the age of your child, it matters which thermometer you use.

The three main types of thermometers are (1) a digital thermometer, (2) an ear thermometer, and (3) a temporal artery thermometer. You should not use the old mercury thermometers anymore, if you still have one in your home.

A fever is a temperature over 100.4 degrees F, or 38 degrees C.

For newborn infants under 3 months of age
Use a digital thermometer and measure a rectal temperature. Any digital thermometer can be used rectally; there is not a specific “rectal” thermometer. This is the most accurate way to measure core body temperature, and it is important to have an accurate temperature in this age group. Measure your baby’s temperature if he/she feels warm or is acting sick.  Signs of illness in this age group may include lethargy, poor feeding, or irritability.

For infants over 3 months of age and older children

You may use any type of thermometer you prefer. While a rectal temperature is still the most accurate, fevers in this older age group are not as potentially serious and it is not necessary to continue taking rectal temps.  Digital thermometers may be used orally, in the armpit, or rectally. Ear thermometers measure temperature in the ear, and temporal artery thermometers measure temperature on the forehead.

For more instructions on how to take your child's temperature, please check out this article on BabyCenter.com.

Sun Safety

5/19/2015

 
Now that summer has arrived, it is time to review a few facts about sun safety.

  • Sun exposure helps our bodies produce vitamin D, which allows our bodies to absorb calcium for stronger, healthier bones. We recommend that you get vitamin D through a healthy diet. Do not seek the sun.
  • Kids are exposed to approximately 50-80% of their lifetime sun exposure before age 18.
  • Sunlight consists of UVA and UVB rays. UVA rays can cause aging and wrinkling of the skin and UVB rays cause sunburns and can contribute to skin cancer or melanoma.
  • Anyone 6 month or older should use sunscreen. Sunscreen should be applied to all exposed areas and should be reapplied  at least every two hours or after swimming.
  • The best sunscreens are water resistant and are SPF 15 or higher in order to provide coverage against UVA and UVB light.
  • SPF stands for Sun Protection Factor and only reflects a products ability to screen out UVB rays. At present, there is no FDA-approved rating for UVA protection.  UVB protection does not increase proportionally with a designated SPF number. For example, SPF of 30 screens 97 percent of UVB rays while and SPF of 15 screens 93 percent of UVB rays. No sunscreen can provide 100 percent UVB protection.
  • Be Sun Smart by wearing a water-resistant sunscreen and protective clothing such as hats, glasses or longer sleeves. Seek the shade and avoid the sun when the rays are strongest between 10am and 4pm.

     Adapted from the American Academy of Dermatology

Measles

1/21/2015

 
Measles is a highly contagious virus with fever and rash. The fever and rash present at the same time. The rash is a red spotted rash which usually starts in the lower head and neck region then spreads to the trunk and outward.

If you suspect measles in your child, please call us first - do not come into our office. If the physician needs to evaluate your child, he or she will come out to you in your car.

Proper vaccination can be more than 99% effective in preventing measles. The first dose is usually given at 12-15 months of age and the second dose at about 4 years of age. If you are concerned that your child is behind on his or her measles vaccines, please call our office to schedule an immunization visit.

Head Lice

10/21/2014

 
Head lice is a frustrating problem that many families deal with at some point. Head lice is not dangerous and does not transmit any diseases.  It causes itchy scalp and can be spread by close contact (head to head, sharing hair brushes, hats, etc).  It is not a sign of poor hygiene. Unfortunately, lice have become resistant to many standard treatments, so it can be extremely difficult to get rid of it. There are a few approaches you can take to try to get rid of lice. Be sure to check all members of the family for lice, since it spreads easily in homes.

We recommend the following steps when your child has lice:
  • Clean combs, brushes and hair accessories in the dishwasher or get new ones.
  • Change child's clothes immediately after treatment. 
  • Machine wash all clothing and bedding that have been in contact with infected person(s) in the past 3-4 days. Use hot water and hot dryer. Non-washables can be vacuumed.
  • Vacuum everything that hair strands could fall on: rugs, furniture, car seats and car upholstery. 
  • Personal things that can't be washed or vacuumed can be tied up in plastic garbage bags for 2 days. Remember to keep bags out of children's reach! 
  • The use of environmental products (sprays, etc) is NOT recommended.

There are several treatment options for lice, including home treatments, professional treatments, and prescription medications:

Option 1: Treatment With Over the Counter Lice Medicine.   


Supplies: 
  • white vinegar
  • stripping shampoo (baby shampoo, Prell, White Rain) 
  • NIX brand cream rinse (Permethrin lice treatment) 
  • metal lice comb (bought separately). Inomed for example.
  • (optional) magnifying reading glasses (helps to see the nits)

Method: 

  1. Rinse hair with solution of ½ water and ½ vinegar over a sink, not in the shower or tub. 
  2. Use a fine-tooth comb (metal lice comb) and meticulously go through the hair, pulling off the nits. This can be very time-consuming.
  3. After this is done, wash hair with the stripping shampoo. Use no conditioners as these may protect the lice from treatment. Rinse and towel dry.
  4. Apply NIX brand cream to hair. Leave on the hair for at least 4 hours. The medication could be left on for up to 12 hours (or overnight). May cover head with a shower cap.
  5. Rinse hair only with clear water. Do not use vinegar at this point. This may neutralize the NIX.
  6. Go through the hair with a comb again and let hair air dry. Do not use conditioners, mousse, or hair spray for awhile. Again, these may help protect the nits and lice from treatments. 
  7. Comb through the child's wet hair every 2 days to look for and remove nits. This is critical because any remaining live nits can hatch and start the infection all over again.
  8. RETREAT the hair with NIX in 7-10 days.

Unfortunately, many families find that this method is not effective at killing all the lice, presumably due to resistance. It still can work as long as you carefully remove all nits and bugs in the week after treatment.

Option 2: Professional Lice Removal
There may be commercial establishments in your area that will check your child (and you, if you want) for lice. Then, if you request, they will remove the lice with a combination of manually removing them, applications of various natural oils shown to kill lice, or high heat. These can be very effective, but also quite expensive (expect to spend about $100 per person).

Option 3: Cetaphil Method
Some people find the approach developed by a dermatologist to be more effective than other home treatments.  Research studies have been done which show it to have a 95% efficacy rate. However, other families have found that this does not work all the time either. You can find out more information here: http://nuvoforheadlice.com/test/

Option 4:  Prescription Medication (Sklice)
Some patients will request a prescription for Sklice, which is considered to have less resistance than the over the counter treatments. However, there is still resistance, and it is best to still use a metal lice comb to remove nits and lice.

Enterovirus 68

9/16/2014

 
The following information about Enterovirus 68 is from your doctors at East Bay Pediatrics and from the Infectious Disease specialists at Children's Hospital Oakland.

1.   What is EV68?  Enterovirus 68 (EV68) is not a new virus, but over the past few years it has caused outbreaks of respiratory illness in the fall. These outbreaks are similar to what we see later in the year with influenza and RSV. What's different is that these outbreaks happen earlier in the fall and with a different virus.

2.   Who does this virus infect?  In the current outbreak, most patients are children under 16 with a prior history of asthma or wheezing. Symptoms include rapid onset of cough, wheezing and difficulty breathing. EV68 rarely causes fever. Most children with suspected EV68 infection respond quickly to supportive care that includes breathing treatments, such as inhalers prescribed by your doctor. 

3.   What should I look out for?  If your child develops rapid onset of cough, wheezing or difficulty breathing, start your child's usual asthma rescue medications if he or she has them and make an appointment with your doctor. If your child has never wheezed before and seems to be wheezing now, call for an appointment. While most patients do not require hospitalization, children can develop symptoms rapidly, so a quick call or same day visit may be necessary.

 4.   Is there an antibiotic I can take or a vaccine?  No, EV68 is a virus so antibiotics do not treat it and there are no currently available antiviral medications that treat EV68. There is also no vaccine. However, that does not mean that your child can't be treated. Children with severe respiratory distress can receive several forms of breathing treatments that reduce their symptoms and get them on the road to recovery.

5.   Who should be tested for EV68?  At this time, routine testing of patients with wheezing illnesses is not recommended. Patient with acute respiratory distress who are admitted to the hospital or ICU may be tested. Respiratory support should continue for other patients regardless of whether they have EV68 or another respiratory virus..

6.   Are pregnant women at risk?  Pregnant women have a greater chance of being infected if they do not have immunity (protection) from previous infection with EV68. However, most pregnant women who become infected will not get sick, or they will only have mild illness. Right now, there is no clear evidence that pregnant women with enterovirus infection will have severe complications, like miscarriage, stillbirth, or congenital defects. But, if a pregnant woman is infected shortly before delivery, she can pass the virus to her baby. These babies usually have only mild illness. In rare cases, they may have severe infection.

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    Remember, this page has general advice. If you have questions please call our nurses at (925) 254-9203 & choose option 6.

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