All posts by Samantha Ahdoot, MD

Five Things That Worry Pediatricians More Than Parents

Most parents know the importance of protecting children with car seats, gates on stairs and locks on cabinets. Some hazards, however, don’t get the attention they deserve. Here are five less appreciated child safety risks that strike fear in the hearts of pediatricians.

  1. Ramen

Ramen is hot.  Very hot. It sits in open bowls on countertops.  Inquisitive little hands find these bowls and tip them over, resulting in spills of boiling water.  Instant soup is one of the leading causes of burns in young children. Parents should be very aware of where they place bowls of hot soup, as well as tea, bottle warmers, crockpots, or anything that contains hot water. Prevent scald injuries by placing these items on the back of the kitchen counter, out of the reach of prying little fingers

 2. Sofas

Parents of newborns are often exhausted.  It is all too easy for a new parent to doze off while holding their baby on the sofa, sometimes in the middle of a sleepless night.  Parents desperate to do laundry are tempted to place a sleeping baby on the sofa “just for a minute”. Beware of the sofa! It is a bad place for babies!  In the blink of an eye a baby can turn and fall off the edge, or get their face covered by cushions. Always place babies in a safe place, such as a bassinet or crib. Never place an infant on a sofa unattended. It only takes a minute to flip off the edge.

3. The Flu

Pediatricians are always reassuring parents about viruses and colds.  Not Influenza. The Flu is not a cold. It is high fever, vomiting, severe cough and misery for days.  Every pediatrician has been scared by a very sick child with the Flu. Young children, like grandparents, are at higher risk of complications, such as pneumonia, that can be life threatening. Parents of infants less than six months, please get the Flu shot!  There is no other way to protect babies who are too young to be vaccinated. Older children should get the shot themselves. It is always better to prevent the Flu than to try and treat it. The shot protects against severe disease even when it doesn’t prevent infection completely. The Flu shot has been around for decades and is extremely safe.   Just do it!

4. Walkers

First time parents hope their child walks early.  Second time parents know better! Babies on the go are babies looking for trouble. Walkers take babies places they shouldn’t be, like stairs or kitchens or even fireplaces.  Let your baby exercise in a jumper rather than a walker. It is much safer!

5. Grapes

Grapes, with their round shape and smooth covering, are just the right size to get stuck in little windpipes. Always cut grapes for children less than three years old to prevent choking.

Appreciation of these hazards will make your child safer and your pediatrician happier.   A winning combination!

 

When is a Cough more than a Cold?

Most children get several viral upper respiratory infections, or colds, in the winter season. Young children in childcare can appear to have one continuous cold for months, as one virus overlaps with another with no recovery in between.

Sometimes, however, colds can develop into more significant conditions. When should a child be brought to the doctor?  Here are some tips to help parents make that decision.

Fever

Fever is a nonspecific sign that your child is fighting an infection, whether it is a common virus or more serious condition.  Thanks to vaccines, fevers today are rarely due to serious infections.

High body temperature is not dangerous, and is part of how our bodies fight off infections. Even fevers as high as 104-105 do not hurt the body or cause brain damage, and are not a reason alone to go the hospital.  However, when children have high fevers, they look and feel terrible. It can be frightening.

Doctors recommend treating fevers of 101 or above so the child feels better.  It is ok, though not necessary, to treat lower fevers if treatment is helpful.

Pediatricians want to see children who have had a fever for more than three days.  Any fever with pain, whether in the throat, ear, head or elsewhere, should be evaluated by a doctor.

Breathing

It can be hard for children, particularly babies, to breath through congested noses. This is a mechanical problem, which improves somewhat with nasal saline drops, suctioning, and humidifiers.

Sometimes, however, colds can progress down into the lungs.

After a few days, a cough may get worse instead of better.  Children and babies may show signs of labored breathing, such as breathing fast, using their stomach muscles or sucking in around the ribs or clavicle with each breath.  

Whenever there is a concern for difficulty breathing, it is important to contact your pediatrician, even in the middle of the night.

Hydration

When children feel sick they often refuse to eat. Babies with congested noses struggle to feed, and older children may need a lot of encouragement.  While it is ok to skip solids for a couple of days, it is important that sick children drink fluids.

Fluids with electrolytes and calories are better than water. Milk and formula are fine, while clear fluids, such as electrolyte solutions, may be easier for children to keep down.  Older children often are happy to eat popsicles and juices that may not be part of their regular diet.

Minimal fluid intake can lead to dehydration, usually after a few days. Signs include decreasing urine output, dry lips or gums and absence of tears. Children with signs of dehydration need to be been by a doctor.

General Appearance

Children with viral infections look and feel lousy.  They are less active, fussy and don’t eat or sleep well. However, once the fever is reduced, they generally feel well enough to engage in reduced age-appropriate behaviors, such as sitting up, communicating and drinking. Children with very atypical behavior, such as marked weakness or irritability, particularly when without fever, need to be promptly evaluated by a physician.

Prolonged congestion

Sometimes the congestion just won’t go away.  If significant nasal congestion continues more than ten-fourteen days, children should be seen to make sure they have not developed a sinus infection.

Having a sick child at home is never easy. Thankfully, most childhood illnesses today resolve with time. Monitor your child, and contact your pediatrician for any of the concerns above so we can provide the care they need.