A friend posed an interesting question the other day: What do you do when your child's day care has sent home a note saying there are kids in his class that have been diagnosed with the H1N1 virus?

Your child isn't yet sick. He's shown no symptoms. The other children are presumably at home and recovering, and so not presently infecting him.

But my friend debated about whether to keep his son home from preschool anyway. Or whether he should ask a doctor for preventive TamiFlu. Or just ride it out and try not to worry.

This assumes your child hadn't been vaccinated against H1N1 yet.

What would you do?

Posted by Kate Shatzkin at 12:08 PM | Permalink | Comments (8)
Categories: Health
        

We knew it would come to this: I, the health editor and the mom editor, am sick. Sick at work.

So far, it just seems to be a bad head cold. Lots of sniffles. A headache, but no achy throat or cough. Yet.

Still, in these days of swine flu fear, I feel damned if I stay here at work sneezing into my sleeve, and damned if I go home, where I would undoubtedly be viewed from afar as a slacker. What if this is nothing and I get the H1N1 virus later, and people look at me like the lady who cried wolf? Or what if this is something bad, and I stay and infect my co-workers, despite my best attempts at hand-washing and sanitizing?

I suspect lots of you are facing, or will soon be facing, the same dilemma. So take our poll and help me figure out what to do:

Posted by Kate Shatzkin at 2:14 PM | Permalink | Comments (6)
Categories: Health
        

Ruh-roh -- the Mommy Wars are about to heat up. This story on our parenting page, from Chicago Tribune columnist Julie Deardorff, reports on a British study that compared a set of children of working women with a set of children whose moms stayed home. The kids of stay-at-home moms ate more fruits and vegetables, watched less TV, and walked more.

Ouch. Could someone please shoot me now?

I try. I do. And I'm told by our doctor that my kids are healthy. Still, this is great food for the mom-guilt monster.

As Deardorff points out, the study didn't look at the impact of working fathers. Even in 2009, we still assume that if a kid isn't practicing healthy habits, it's the mother's fault.

Posted by Kate Shatzkin at 10:13 AM | Permalink | Comments (3)
Categories: Food and Recipes, Health
        

Just when you thought you'd heard it all comes the story of an Arkansas woman who conceived a baby...after she was already pregnant with another. No, they're not twins, but separate pregnancies 2 1/2 weeks apart.

Fortunately, as a Greater Baltimore Medical Center fertility expert tells ABC News here, it's a rare case.

Posted by Kate Shatzkin at 10:36 AM | Permalink | Comments (0)
Categories: Babies and Toddlers, Expecting, Health
        

New parents are often shocked at how often complete strangers feel free to come right up and touch a tiny baby, without asking if it's OK to do so.

Even the common cold can turn dangerous for a new baby, much less swine flu. That means all the touching can drive a germ-phobic parent right up the wall.

One, a mom named Tara Williamson, decided to make the sign you see on the right, which you can hook right on to a stroller. And now she's selling them, for $7.95 apiece. (There's even one in Spanish.)

Of course, you could make one yourself for free. Or just summon your courage and tell the stranger (or, let's be honest, overly touchy acquaintance/relative/friend) to wash up first.

But something about the official-looking nature of this sign may be the ticket. It's passive-aggressive messaging at its finest, isn't it? Because after reading it, even with clean hands, who would dare to approach the baby?

Posted by Kate Shatzkin at 6:20 AM | Permalink | Comments (8)
        

Maria asked:
"How big does a kid have to be to sit in a car's front seat? There are lots of opinions out there ranging from 12 years old, to 16. What is the height and weight we should be looking for to make this transition?"

It's a good question. Remember when Britney Spears drove off from paparazzi with her baby on her lap?

At my request, Tracy Whitman, project coordinator for Maryland Kids in Safety Seats, wrote this reply:

"The Maryland Child Passenger Safety Law does not prohibit children from sitting in the front seat, with the exception of placing a rear-facing child in front of an active air bag. However, Kids In Safety Seats (KISS) suggests that parents follow the safety recommendation offered by the National Highway Traffic Safety Administration. That is, to keep all children under age 13 in the back seat. Currently, there are no weight or height suggestions as to when a child can safely ride in the front seat.

"Because there is no law requiring children to ride in the rear seat, we (KISS) find parents stating that they allow young children to ride in the front seat as a reward for good behavior or it may be viewed as a "rite of passage," when in fact, allowing children under age 13 to ride in the front seat places them in danger.

"There are two main concerns. The first is that front end collisions are the most frequent type of crash. A child seated in the front seat during a crash is at higher risk of injury due to the crash forces. During a crash, there is a tremendous amount of energy generated. This energy is distributed through the crumple zones and vehicle frame, into the seatbelts and then into the body. Injury is cause by the transfer of energy into human tissue. Because adults are larger and stronger, they can typically absorb crash energy. However, because children are smaller and more fragile, they cannot absorb the energy like an adult. If a child is positioned in a vehicle closer to the crash energy, there is a greater chance that a young child may be injured. Simply keeping children in the back moves them further from the energy distribution, creating a safer environment.

"The second concern is air bags. Air bags are supplemental restraints because they are designed to be used with the adult seat belt, for adult protection. Prior to age 13, children have very different body structures. Bone density and muscle tone both have a role in how the body will absorb the energy created by a rapid air bag deployment. Around age 13, children have a body structure that more closely resembles an adult, thus allowing them to withstand the crash better than a younger child.

"A final item to consider before a child is allowed to ride in a front seat is correct seat belt fit. Correct fit is when a child is seated all the way back in the vehicle seat, his/her knees bend comfortably over the edge of the seat, the lap portion of the belt is siting on the hip/lower thigh bones, the shoulder belt crosses over the center of the chest and rests on the clavicle and the child can stay seated upright and "in position" for the entire ride.

"Care givers with questions should contact the Kids In Safety Seats Program at 800-370-SEAT. "

AP Photo of Britney Spears driving by Kevork Djansezian

Posted by Kate Shatzkin at 6:39 AM | Permalink | Comments (3)
        

My colleague Kelly Brewington has a post over at the health blog about the testing of experimental swine flu vaccine, to start in the next few weeks at the University of Maryland's Center for Vaccine Development, among other sites around the country.

Researchers are looking for up to 1,000 volunteers to test the vaccine, many of them children. (The vaccine would be tested first on the adults).

On her blog, some writers are too worried about possible side effects to sign up their kids. But one woman wrote that she thought getting the vaccine early would be more likely to help protect her children against the swine flu.

I wouldn't do it, and not just because my children loathe getting shots.

Posted by Kate Shatzkin at 5:07 PM | Permalink | Comments (9)
Categories: Health
        

This week has been one of the most challenging in the eight years that my husband and I have been working parents. One or both of our children has been sick -- as in, sick enough to stay home and need a parent to care for them -- for the last six days. That means my husband and I have each worked from home several days this week.

We're lucky enough to work for pretty understanding employers that also have the technology to allow us to work pretty seamlessly at home. Still, this situation is scary for a number of reasons. First, we're worried about the kids, who apparently have coxsackie virus, a pretty common summer virus that seems to be making its way around the community. Because it's a virus, there's not much we can do but keep them comfortable and ride it out.

But frankly, in this recession, it's also scary to tell an employer you won't be in because your child is sick -- again. You wonder if your boss questions your work ethic or discovers he can get along without you. You try to make sure you're in touch and letting him know specifically what you've accomplished while working at home, but still.

And while you'd really rather take the day off and focus solely on the kids, you worry about that, too. If your work falls to others while you deal with the family emergency, you feel for your coworkers.

In our case, at the same time, I worry that the kids are watching too much TV and not getting enough attention as I try to work. Ideally we'd call in a family member, but the closest one is more than 1,000 miles away. And I don't feel right about asking a sitter to risk getting sick herself.

I'm curious about what others do about work during a child's prolonged illness. What are your strategies, at work and at home?

Posted by Kate Shatzkin at 2:19 PM | Permalink | Comments (1)
Categories: Health, Work-life balance
        

Sittercity, an online networking service for parents to find babysitters and other caregivers, sends word that it is offering a 20 percent discount on its signup fee this month to help parents coping with the sudden closure of schools due to swine flu. Sittercity also says it is working with the American Red Cross to help guide sitters in flu prevention.

When you sign up, use the promotion code FLU20 to get the discount.

Posted by Kate Shatzkin at 4:25 PM | Permalink | Comments (0)
Categories: Health
        

Now swine flu has caused Gov. Martin O'Malley to close four Maryland schools with suspected cases of the disease.

As a working parent, this strikes fear in my heart -- and not just for the most obvious reason that  swine flu appears to be spreading in our state. I'm also worried about what happens if my kids' school closes. How will my husband and I do our jobs while keeping them home? If the children congregate with other kids in a child-care setting, or even at a friend's house, supposedly that defeats the purpose of closing school. Colleagues probably wouldn't appreciate it if we brought the kids in to work.

Many working parents in the U.S. don't have paid sick time. And with layoffs a constant threat these days in so many industries, those who do have paid time off available are afraid to use it, especially if the schools are closed for an extended period.

I'd like to hear from you on this issue, especially if your children attend the affected schools (Milford Mill Academy in Baltimore County, Folger McKinsey Elementary in Anne Arundel County, Montpelier Elementary in Prince George's County, and Rockville High School in Montgomery County.)

How will you handle the work problem? And how will you keep the kids entertained without seeing their friends?

Posted by Kate Shatzkin at 8:00 AM | Permalink | Comments (13)
Categories: Health
        

Now that we have official word of the first death from the swine flu in the U.S. -- and, unfortunately, the victim was a toddler -- I'm throwing in a special consult to answer Ilana Bittner's timely question about swine flu. She wanted to know how to help kids guard against it without scaring them or making them seem "antisocial to their friends."

Pediatrician Daniel Levy, who's given us advice before, wrote back the following to answer Ilana's question:

Continue reading "Swine flu death: How to prepare kids" »

Posted by Kate Shatzkin at 11:49 AM | Permalink | Comments (1)
Categories: Health, The Monday Consult
        

Motrin learned the hard way this weekend that while mothers are an attractive and powerful demographic for purchasing power, an ad that comes off the wrong way can be a really unfortunate thing.

It all started when the company ran a spot promoting Motrin as an antidote to parenting back pain. Now that's something lots of parents experience; I wrote about it several years ago. But this particular ad said the problem lay with "the fashion" of wearing your baby in a sling, pouch, Baby Bjorn, etc. To lots of moms who twittered furiously about it and got in touch with the company, this was an insult -- they wear their babies to keep them close, not just to look like "official moms" (the ad's language).

There's a good summary of what's been happening on the New York Times' Motherlode blog. Here's one blogger's response. And you can follow the Twitter discussion here.

And the Motrin web site? I couldn't even call it up just now. But here's the ad in question, still alive on YouTube:

Posted by Kate Shatzkin at 12:02 PM | Permalink | Comments (7)
Categories: Health
        

A new study from the Johns Hopkins Bloomberg School of Public Health has found that children in the care of their grandparents are less likely to be injured than those in the care of someone outside their family, another relative, or even -- gulp -- their own mothers. This despite the perception by some that grandparents might not be the best caregivers, because they might not be up on modern safety practices.

We're looking for parents who are leaving their children with grandparents for a story on the study -- and for grandparents who are taking care of grandchildren. If you'd be willing to talk with a reporter, please e-mail Kelly Brewington.

Meanwhile, any thoughts on these findings?

Posted by Kate Shatzkin at 12:05 PM | Permalink | Comments (1)
Categories: Health
        

More troubling statistics are out today on the number of children taking prescription medications for chronic diseases that once were mostly confined to adults. Our story, by Stephanie Desmon, says there's been a surge in the numbers of children being treated for diabetes and asthma, according to a study that appears today in the journal Pediatrics. The rise is seen by doctors as caused in large part by the childhood obesity crisis.

Add this to last week's New York Times report on kidney stones showing up in kids as young as 5, and a parent has to wonder if there's any way to keep a child healthy in 2008, and what the future holds.

Posted by Kate Shatzkin at 10:06 AM | Permalink | Comments (0)
Categories: Health
        

Baltomommie wrote to ask for advice on how to help her preschooler stop grinding his teeth at night. She also wanted to know whether a sealant that dentists apply to children's teeth these days to prevent cavities would help protect his teeth from the wear and tear of grinding.

I sent the question to Shari Kohn, a pediatric dentist at Dentistry for Kids in Hunt Valley and a clinical instructor at the University of Maryland Dental School. She counsels patience.

"Many preschoolers grind their teeth," she wrote in an e-mail. "There are many different theories as to why - nothing has been proven. One theory is that grinding is a subconscious stress release. Another is that it is an inherited trait from a parent who grinds. Many parents tell me that their children started grinding when they started school. We also see grinding commonly in children who have a malocclusion or poor bite alignments who will need braces in the future."

There's not much a parent can do when a child is a preschooler, Kohn says, because night guards are a choking hazard at this age. She says most young kids won't suffer anything more than mild wear on their teeth from grinding, and that can be treated with desensitizing products. Most kids will lose their baby teeth before the wear from grinding becomes more severe; if they're still grinding and causing damage to permanent teeth, they'll probably be old enough to wear a night guard then. Children whose bite alignments are causing grinding can be referred to an orthodontist at that point, too.

Anti-cavity sealants aren't an answer to grinding, Kohn says, because they are designed to fill in grooves and pits of teeth, while grinding affects the cusps of teeth.

Posted by Kate Shatzkin at 6:46 AM | Permalink | Comments (1)
Categories: Health, The Monday Consult
        

It turns out that post-partum depression doesn't affect just mothers. According to a psychotherapist quoted in this CNN piece yesterday, 1,000 new fathers become depressed in the U.S. each day. An earlier story from U.S. News and World Report quotes another psychologist who says that 10 percent of fathers develop postpartum depression, but are less likely to recognize the signs than the 14 percent of mothers who do.

While mothers' depression is typically caused by the hormonal changes that take place during pregnancy and birth, the sudden changes in lifestyle can trigger depression in the fathers, the U.S. News story says. Sleep deprivation is one of the primary contributors.

There are ways to try to head off male post-partum depression before it starts. Here's a list of ideas and resources.

Posted by Kate Shatzkin at 11:06 AM | Permalink | Comments (0)
        

The American Academy of Pediatrics is doubling its recommendation on the amount of vitamin D kids should get each day, noting new research that suggests it may help prevent serious diseases. Most kids would have to take supplements to get the 400 units the organization now advises.

The best source of Vitamin D is sunlight, as this story about the change in recommendation points out, but we've all been slathering sunscreen on our kids to avoid skin cancer (which we still need to avoid). And kids who are breast-fed (which many pediatricians recommend for the first year of life) probably get less vitamin D than formula-fed babies, though they reap other benefits.

Posted by Kate Shatzkin at 2:34 PM | Permalink | Comments (0)
Categories: Health
        

Today's tips come from the American College of Foot and Ankle Surgeons, who want to see your kids' feet and ankles stay free of injury during the fall sports season. The organization sent along tips from Kansas City foot and ankle surgeon James Good, who says kids who play football, soccer, and basketball are most likely to suffer sprains and broken bones.

Here are his tips: 

"Have old sprains checked by a doctor before the season starts. A medical check-up can reveal whether your child's previously injured ankle might be vulnerable to sprains, and could possibly benefit from a supportive ankle brace during competition.

"Buy the right shoe for the sport. Different sports require different shoe gear. Players shouldn't mix baseball cleats with football shoes.

"Children should start the season with new shoes. Old shoes can wear down like a car tire and become uneven on the bottom, causing the ankle to tilt because the foot can't lie flat.

"Check playing fields for dips, divots and holes. Most sports-related ankle sprains are caused by jumping and running on uneven surfaces. That's why some surgeons recommend parents walk the field, especially when children compete in non-professional settings like public parks, for spots that could catch a player's foot and throw them to the ground. Alert coaching officials to any irregularities.

"Encourage stretching and warm-up exercises. Calf stretches and light jogging before competition helps warm up ligaments and blood vessels, reducing the risk for ankle injuries. 

Posted by Kate Shatzkin at 10:06 AM | Permalink | Comments (0)
        

I don't know quite what to say about this one. According to this story in the Chicago Tribune, some parents are taking their children to chickenpox parties because they don't trust the chickenpox vaccine. The theory is to give the kids natural immunity at a time when, because of their young ages, the symptoms of the disease are likely to be mild (although an infection can become serious).

Most pediatricians oppose this idea, the article says.

Have any of you heard of this happening around here?

Posted by Kate Shatzkin at 1:09 PM | Permalink | Comments (5)
Categories: Health
        

The New York Times devotes its Well section today to child health. You'll find stories on discipline, eating, exercise and more.

A few highlights from the articles:

--Don't pressure kids to "take a bite" of a particular food, and don't offer them a reward to do it. That might get them to try something, but they won't end up eating it as a habit. Instead, offer a variety of healthful foods and encourage, but don't force, them to try things.

--The TV debate isn't just about time limits. Pediatricians are starting to care more about the quality of the content children watch, and parents should too.

--We aren't giving our kids enough attention when they're being good. As one article points out, we use the times when they're busy to send e-mails or get on the phone. When they start acting up, that's when we turn to them....so they have incentive to do it again. (Yikes.)

Posted by Kate Shatzkin at 3:12 PM | Permalink | Comments (1)
Categories: Health
        

Your child cries out in the middle of the night that his leg hurts. You ask the doctor the next day, and she says it's probably growing pains. Growing pains aren't just a concept; they're a physical symptom, and they can be quite painful.

In the September issue of Wondertime magazine, Dr. Jack Maypole, a Boston pediatrician, offers these tips on growing pains:

 --Growing pains commonly diagnosed as pains or aches that come and go, usually in the muscles of the calves and thighs or behind the knees, Maypole says.

--They occur in about 25 to 40 percent of all children, peaking at ages 3 to 5 and 8 to 12.

 --Pain can be mildly irritating or severe and can last for minutes to several hours.

--Maypole recommends having the child stretch and/or rubbing his legs after periods of intense activity to avoid these pains. If they come anyway, a pain reliever (acetaminophen or ibuprofen)  can be given. But if your child needs it for several nights in a row, it's probably time to visit the doctor.

--A heating pad can help, but use it carefully.

--Another technique Maypole says often works: Help your child use visualization techniques, such as imaging his pain "hurtling into outer space," or thinking about a place or activity he likes.

--The good news: Maypole says that for most children, growing pains begin to go away as adolescence begins.

Posted by Kate Shatzkin at 1:21 PM | Permalink | Comments (1)
Categories: Health
        

Now that school is back in session, I thought you'd be interested in this MSNBC piece on the issue of whether parents who have their children vaccinated let them play with unvaccinated peers -- and vice versa. It's particularly timely in light of the unsettling news that measles cases have reached a 12-year high, causing a renewed push from the Centers for Disease Control for parents to have their children vaccinated.

The MSNBC story reports that there are worries on both sides about children with different vaccination histories playing together. Is this a question you ask of your fellow parents? If so, how do you go about it?

Posted by Kate Shatzkin at 12:39 PM | Permalink | Comments (5)
Categories: Health
        

Remember the Monday Consult on bike helmets? We were still left a bit in the dark about whether Kayris' toddler needed to ride a helmet while on a push toy.

Stephanie Yanovitz, statewide bicycle and pedestrian coordinator for the Maryland State Highway Administration, got back to me with this answer:

"Toddlers that are on rear hitches, tag-a-longs, or in the bike seats on bicycles are required to wear helmets. Other - play vehicles or toy - are not defined as 'vehicles'."

I asked her whether that meant that kids on play vehicles weren't required to wear helmets. She answered that that was technically so, but "you won't hear me say don't wear a helmet. It is still advised."

Posted by Kate Shatzkin at 6:18 AM | Permalink | Comments (1)
Categories: Health
        

A while ago Jon asked:

 “At what age can we REALLY start using the jogging stroller for jogging? The folks who work at the running store are, well, kinda macho about it (‘We started when she was 2 months old!’) and the books/literature online sometimes say as late as 8 months.”

I put the question to frequent expert Dr. Daniel Levy, an Owings Mills pediatrician who is a national spokesman for the American Academy of Pediatrics. Levy wrote back in an e-mail that around 4 months, most children would be able to lift their heads when placed on their stomachs, and therefore would have enough head control to ride in a jogging stroller.

“At that point, the head will not bounce around, and there will be minimal danger of the kinds of acceleration/deceleration that might cause injury,” he wrote.

If you’re wondering whether your child has sufficient head control for the jogging stroller, it couldn’t hurt to check with your own pediatrician to get his or her opinion.

By the way, today is the debut of the Monday Consult in the newspaper -- in our new You & Your Health section. Except here, you can add your own comments on the expert's opinion.

Posted by Kate Shatzkin at 6:27 AM | Permalink | Comments (5)
Categories: Health, The Monday Consult
        

Breaking news for all the moms who have been lamenting the departure of moms-group leader Dee Dee Franke from Greater Baltimore Medical Center:

She's coming back.

Franke, you'll remember, resigned recently after running groups for new moms at the hospital for years. She told me GBMC wanted to reduce her hours to only four a week, and that she needed more hours than that.

Michael Schwartzberg, a spokesman for GBMC, called today and said Franke and the hospital have worked things out, and that she'll be returning to run her groups. He also said the groups will be able to run longer than two hours each, which had been a point of contention.

Franke's Tuesday group, for parents of babies up to 8 weeks old, will take place from 10 a.m. to 2 p.m. It's free. Her Friday group, for parents of children up to 1 year old, will meet from 10 a.m. to 1 p.m., and costs $6 a class.

Franke will also resume running a free group for women with post-partum depression every first and third Monday of the month from 7 p.m. to 9 p.m.

Franke said she'll be back to run this Friday's group. Then she's going on vacation for a week, and after that will be running all three groups again.

"I am overjoyed to be a part of working with new mothers and babies again," she told me. "It's a neat job to see moms come in very vulnerable, and come out ready to grow."

Posted by Kate Shatzkin at 3:15 PM | Permalink | Comments (12)
Categories: Health
        

I've been meaning to post about this story on the preteen exercise slide from the Minneapolis Star-Tribune.

Some interesting research is finding that kids tend to be active for about three hours a day up to the age of 9. But by the time they're 15, the active time has gone down to less than an hour a day, and to just about 35 minutes on the weekends.

These seem to be telling numbers as we face the continuing child obesity crisis, which affects nearly a third of U.S. kids, according to the story.

I'm wondering what we can do about it. Schools have been squeezing out recreation time, especially for older kids, to make room for academics. After school, if your child doesn't make a sports team, it may be tough to draw him into activities when he'd rather be texting, text-messaging, or playing video games.

What are you doing to keep your kids active?

(Associated Press photo of young gymnasts in Beijing by Greg Baker)

Posted by Kate Shatzkin at 3:38 PM | Permalink | Comments (0)
Categories: Health
        

We've gotten a number of calls and e-mails over the past few days from new moms worried about changes in new-parent support at Greater Baltimore Medical Center, one of the area's largest maternity hospitals. GBMC has been known for its free new-mom support group and for its Lactation Station store, which along with breastfeeding supplies offered consultations for new parents and -- my personal favorite -- a free baby scale, where you could make sure your brand-new child was getting enough food without hysterically badgering your doctor.

The sad news is that Dee Dee Franke, whom many moms loved for her real-world approach to the overwhelming task of bringing up baby, has left GBMC. And the Lactation Station has moved to the "parent education" part of the hospital. Here's what my colleague Susan Reimer learned when she called Lanny Dowell, parent education coordinator for GBMC:

Of the Lactation Station, Dowell said: "We are not going to close. We have just relocated it to the Parent Education office. We have all the same services, except maternity bra fittings and maternity clothes. We're waiting on some construction so we have room for those."

Dowell said Franke resigned last Friday after the hospital asked her to keep her meetings within the 10 a.m. to noon time frame as a cost-saving measure. They had been running into the afternoon, Dowell said. "We had been hoping she would stay," Dowell said.

There was concern among the Lactation Station's faithful that the free services were pushed out by an expansion of GBMC's genetics department. But Dowell said none of the services have been cut.

And, she said, if the two-hour troubleshooting sessions on Tuesday (for mothers with babies up to 12 weeks old) and Friday (for mothers with babies older than 12 weeks) are not able to solve all the problems (generally nursing and sleeping issues), individual counseling sessions can still be made.

"I don't understand the miscommunication," she said. "We had signs everywhere and pamphlets about the move.

"If you are a new mom," she said, "please stop by and introduce yourself to us."

Still, I know a lot of folks will miss Franke. Full disclosure: I attended her group with my first child. Without her, that baby might not have ever learned to nap.

What do you think?

 (2004 photo of Dee Dee Franke by Sun photographer Amy Davis)

Posted by Kate Shatzkin at 9:00 AM | Permalink | Comments (18)
Categories: Health
        

This week's tip sheet topic comes to me as I slowly emerge from the fog of a nasty, flu-like virus that has been pummeling our household. For the kids this time, it mostly took the form of a bad cold, but it knocked their doddering parents on their backs with fever, chills and major headaches.

And it's not even the sick season. But it occurs to me that people with young kids are always trying to dodge the germs. And no matter how hard you try to wipe everything down with disinfectants and not share towels, those germs seem to find you sometimes.

Also, I must admit it's hard to keep from having those little ones hug and kiss you when they're sick.

So post your tips. How do you keep the germs at bay? And when a virus does enter the house, how do the rest of you avoid it?

Posted by Kate Shatzkin at 12:38 PM | Permalink | Comments (0)
Categories: Health
        

New research is helping to explain why breakthroughs can occur when autistic children undergo intensive education programs. According to this Associated Press story, six new genes have been linked to involvement in autism.

The good news is that the research published in today's edition of the journal Science found that the genes weren't necessarily missing in children with autism spectrum disorders. They were merely turned off, so to speak, instead of processing experiences that help a child's brain develop normally. In some cases, experts believe, intense therapy can get those genes working again.

Posted by Kate Shatzkin at 11:47 AM | Permalink | Comments (0)
Categories: Health
        

The American Academy of Pediatrics is releasing a new policy statement today that calls for widespread screening of children as young as 2 for high cholesterol and other risk factors for heart disease. The academy says alarming rates of high cholesterol in children, caused in part by our obesity epidemic, make the screening necessary.

If high cholesterol is found, young children might be treated with medication that physicians say could lower their risk for heart disease later in life.

What do you think? Is this a promising development that will save lives, a sad sign of our failure to provide healthful food and exercise for our children, or both?

Posted by Kate Shatzkin at 10:56 AM | Permalink | Comments (3)
Categories: Health
        

Hope you're enjoying your Fourth so far, and that you've scoped out yesterday's Tip Sheet for some places to watch the fireworks with your kids.

That's the happy part. The not-so-great part is that kids are often injured by fireworks on the Fourth of July. I was surprised to learn that for kids under the age of 5, a third of all fireworks injuries come from ordinary sparklers, which can burn at nearly 2,000 degrees.

That information comes from the American Academy of Opthalmology, which has released an information sheet with safety tips for the Fourth. I hope they'll help you and yours stay injury-free.

Posted by Kate Shatzkin at 7:44 AM | Permalink | Comments (0)
Categories: Health
        

It was one of those mornings. My kids got ready early, all excited for summer camp, wearing their matching camp shirts.

We got a bit of a late start, but took a detour to avoid traffic and were almost to our destination. When....I looked in the rear-view mirror and saw my son looking like something out of Friday the 13th. He had a major nosebleed.

I pulled over quickly, tilted his head back briefly to keep the blood from running everywhere (including further onto the beloved shirt) and pinched his nose to stop the bleeding. Once the bleeding had stopped and my daughter had gotten over the fact that blood had even flecked on the car window, we headed home for a more comprehensive cleanup and a new shirt.

Once I got to work, I surfed around the Web to see if I had done the right things. According to Kidshealth, which was created by the Nemours Foundation's Center for Children's Health Media, I went about it all wrong. (And, not surprisingly, he had another, smaller bleed later that morning.)

I should have had him sit up and tilted his head forward, not back, which can cause a child to gag or even vomit. I should have pinched the soft part of the nose just below the bridge for at least 10 minutes (my doctor recommended 15 when we called her) to stop the bleeding. No rushing allowed.

I think I knew some of these things, but forgot in the heat of the moment. So here's a handy instruction sheet from KidsHealth you might want to print. I may keep it in my car.

Posted by Kate Shatzkin at 7:41 AM | Permalink | Comments (6)
Categories: Health
        

This story from today's San Jose Mercury News explores how the health of a prospective father can be just as important as that of his wife in avoiding birth defects for his children.

While women are encouraged to eat healthfully and take vitamins while they're trying to get pregnant, men typically get no such advice, the story says. Yet a recent study from the University of California at Berkeley found that men who ate little folate had more sperm with the wrong number of chromosomes, which could lead to miscarriages and birth defects like Down syndrome, the story says.

So if you want to be a dad, it can't hurt to take a multivitamin and eat leafy greens rich in folate.

Men, have you made any changes to your diet to prepare for a pregnancy?

(Photo of arugula by Bob Fila/Chicago Tribune)

Posted by Kate Shatzkin at 11:27 AM | Permalink | Comments (0)
Categories: Health
        

As promised, here's my other pre-summer safety tip:

Johns Hopkins Children's Center is cautioning new parents that they should avoid giving infants water, even in the heat of summer when all kids need extra liquids. Each year, a press release reports, the children's center sees 3 or 4 babies who have suffered seizures because of drinking too much water.

Water flushes sodium from the body, and babies less than a year old may be more prone to these types of seizures than older children because their diet does not contain enough food sources to replenish the lost sodium. "Also, an infant's immature kidneys cannot flush out excess water fast enough, causing a dangerous buildup of water in the body," the release says.

Overdiluted formula can cause the same problem, so stick to breast milk and properly mixed formula, especially for babies not yet eating solid food.

One reason I'm mentioning this is because I've run into a few grandparents out there who think giving babies water is still a good idea, because that's what they did. Now, if you get into a dispute about it with your mother or mother-in-law, you can point to an "official" source.

Posted by Kate Shatzkin at 8:18 AM | Permalink | Comments (0)
Categories: Health
        

It feels a little funny to be talking about warm-weather safety on another unseasonably rainy, cool day, but summery weather is coming soon. (I really, really hope. Beginning to feel like I live in Seattle again, only without as much great coffee to get me through.)

Warm weather has its own dangers for kids that most of you probably know about, but these warnings bear repeating. In this post and the next, I'll pass along some warnings that have landed in my e-mail box the last few days.

 First: The U.S. Consumer Product Safety Commission reports that 18 children have fallen from windows since April, and two of them died. It's issuing these safety tips:

--Use window guards or window stops. (For windows on the 6th floor and below, install window guards that adults and older children can open easily in case of fire.) Install window stops so that windows open no more than 4 inches.

--Never depend on screens to keep children from falling out of windows.

--Whenever possible, open windows from the top -- not the bottom.

--Keep furniture away from windows to discourage children from climbing near windows.

 (Photo by Carlos Chavez, Los Angeles Times)

Posted by Kate Shatzkin at 1:51 PM | Permalink | Comments (0)
Categories: Health
        

I've been searching for answers to your questions on the emerging news about possible hazards in baby bottles and other containers from bisphenol-A. Here are a few resources for learning more:

--The Environmental Working Group has a guide to safe feeding for babies, including how to spot a bottle with BPA. In general, it says, avoid hard, plastic bottles labeled "7" or "PC."

--Julie's Health Club, a blog by a Chicago Tribune health writer who's also a mom, has a number of posts and links about this subject, including info about a new kind of bottle that is no. 7 plastic but is BPA-free.

--The Washington Post reports today that Wal-Mart will pull bottles and other products with BPA from its shelves in the U.S. soon.

Posted by Kate Shatzkin at 3:15 PM | Permalink | Comments (0)
Categories: Health
        

Parents have been talking today about increasing evidence that a chemical widely used in plastic baby bottles and other food and beverage containers can cause harm to humans.

Here's our story from yesterday, in which the federal National Toxicology Program reported that the compound bisphenol-a, or B.P.A., could be linked to precancerous prostate tumors, early puberty and urinary system problems in rats injected with it. The New York Times report today that Canada is about to label B.P.A. as toxic was the second most-emailed story on the Times' Web site when I checked just now.

We talked a bit earlier about glass baby bottles making a comeback, and now there's more reason for a parent to fret about this. When I saw one of my best mom pals this morning, it was at the top of her list of worries.

What do you think? Have you combed through your house to get rid of plastics you're worried about?

Posted by Kate Shatzkin at 1:32 PM | Permalink | Comments (6)
        

There's an interesting story on the Los Angeles Times web site today about parents wrestling with the circumcision decision. It's interesting to read the statistics behind the debate: In 1965, the story says, 85 percent of boys born in the U.S. were circumcised. In 2005, slightly more than half were.  

How did you make this decision for your son/s? And if you're expecting a boy, is this a topic of debate in your house as birth approaches?

Posted by Kate Shatzkin at 10:51 AM | Permalink | Comments (9)
        

The Food Allergy & Anaphalaxis Network is having a conference tomorrow in Baltimore called "Food Allergies: Living and Learning." The conference is open to the public (see prices below), and will include information on helping a child manage food allergies and reactions and on how and when to use epinephrine. There's a special lunch session for teens to discuss handling allergies while dating, traveling and dining out, with a concurrent (but separate) session for parents of teens.

The conference starts at 8:30 a.m. at the Sheraton Inner Harbor Hotel, 300 S. Charles St. Online registration is closed, but you can call the FAAN office at 800-929-4040 to register, or do so the morning of the conference.

The registration costs are: Member: $85; Guest: $75; Teen: $65; Nonmember/walk-in: $105; Nonmember Guest: $95; Nonmember Teen: $75.

Posted by Kate Shatzkin at 11:10 AM | Permalink | Comments (0)
Categories: Food and Recipes, Health, Things to Do
        

I've often been curious about what it's like to be a mom and a pediatrician. On one hand, it would seem you could breeze through life knowing how to handle all the health crises that put the rest of us in a panic.

On the other hand, maybe you know too much. Not to mention how exhausted you must be from taking calls from the rest of us day and night.

Anyway, I thought readers of this blog might be interested to know that two Washington-area pediatricians who graduated from the University of Maryland School of Medicine have launched mommydocs.com to answer parents' questions. You can listen to the doctors' podcasts and read their blog about common medical problems.

If you're a mom-pediatrician reader, I'd love to hear from you how you juggle parenthood and taking care of other people's children -- and whether you ever treat your children yourself.

Posted by Kate Shatzkin at 11:38 AM | Permalink | Comments (0)
Categories: Health
        

Susan Reimer is writing a piece for our Taste section about the increasing interest in veganism and vegetarianism on the part of teenage girls and young women, spurred in part by books like Skinny Bitch in the Kitch. She'd like to talk to a local parent or two of a vegan or vegetarian girl who's still living at home about how you integrate your daughter's diet with the family's, and about how you approach any health concerns you might have about the way your perhaps-still-growing girl eats.

If you'd be willing to talk to Susan, please email her at susan.reimer@baltsun.com.

Posted by Kate Shatzkin at 1:38 PM | Permalink | Comments (0)
Categories: Food and Recipes, Health
        

It's been debated for years whether there's a link between childhood vaccines and autism, with many research studies concluding there was no connection, and a small but vocal cadre of parents with autistic children fervently believing otherwise.

Now, the Sun reports today, federal health officials have acknowledged that a series of vaccines given to a now-9-year-old girl when she was living in Ellicott City years ago worsened an underlying condition and led her to be diagnosed with autism. The Centers for Disease Control is telling the public that the girl's case was unique, and that immunization is safe and vital to protect children from diseases. Still, officials are worried this case will make parents reluctant to have their children vaccinated.

How do you react to this news? I'd like to hear from pediatricians, parents, and pediatrician/parents.

Posted by Kate Shatzkin at 1:51 PM | Permalink | Comments (3)
Categories: Health
        

It hadn't occurred to me until recently that the inconveniences of having braces include not being able to eat a lot of things easily.

Hard foods. Sticky foods. Stuff that's difficult to brush away.

If you're dealing with these issues in your house, you might want to check out this link from the American Association of Orthodontists, which offers "braces-friendly recipes" from chefs like Chicago's Gale Gand.

That's her Chocolate-Baked Bananas Over Ice Cream at right. You can watch a video of Gand making the recipe here.

Just how painful, or not, has your experience with braces been? I'm sure parents with up-and-coming brace wearers (I may be included in this group) would love to hear how you've helped your children through it. Please tell us by commenting below.

(Photo courtesy of the American Association of Orthodontists)

Posted by Kate Shatzkin at 6:24 AM | Permalink | Comments (4)
        

Yesterday's post about the new multimedia symptom tracker at parenting.com sent me digging into the album for this picture last night. Baby girl was just 9 months, and my parents, bless their hearts, had treated my family, my brother and his wife to a Caribbean cruise.

The first or second night, my folks had offered to babysit while the two younger couples enjoyed a rare evening out sans kids. We had just climbed into the hot tub with our little umbrella drinks when my dad ran up in a panic.

Seal cough.

We raced down and found baby barking up a storm. I'd read about croup, but to hear it, in a baby so many miles from home, was really scary. I did remember the advice I'd read about getting the child some cool night air (just as Christine mentioned in her comment).

Fortunately, my folks had sprung for a balcony. The little girl and I stayed out there all night, and in the morning, my husband snapped this picture.

For me, it captures what parenting is all about. It's an image of an exhausted mother, to be sure, but she's in a beautiful place with a child who, so sick hours before, appears miraculously healed in that way only young kids do. What could be better?

Do you have pictures you love with your kids of times that were hard -- but worth it? Please send them to me in an email and I'll post them here. And do tell us the stories that go with them, either in a comment below or with the pictures.

(Photo courtesy of me)

Posted by Kate Shatzkin at 2:09 PM | Permalink | Comments (1)
Categories: Babies and Toddlers, Health
        

Parenting.com has a great new resource for parents -- an online symptom checker, developed in cooperation with the faculties of Harvard and Dartmouth medical schools, with audio and video of children with common illnesses. You can hear what croup with stridor sounds like and watch how a child with a stiff neck (a sign of meningitis) behaves.

It's painful to watch the videos of these sick children (though they are later seen getting better). But I suspect this will be valuable for many of you, especially when a child suddenly gets sick in the middle of the night. Sometimes all the books in the world just don't really tell you what you're looking for.

Posted by Kate Shatzkin at 12:20 PM | Permalink | Comments (1)
Categories: Babies and Toddlers, Health
        

I asked Dr. Daniel Levy, who helped us with Monday's Consult and is quoted in The Sun's stories on kids and flu today, to weigh in on the issues in my previous post. Here's his e-mailed comment:

Parents often fail to recognize the serious nature of influenza, which hospitalizes 20,000 children annually. More than half of all hospital admissions for flu are in the 0-2 years age group. Flu can often carry complications such as ear infection, sinusitis and pneumonia. School-aged children tend to be the spreaders of influenza in society, and we know immunizing that group tends to reduce the incidence of influenza in communities.

The new recommendations for flu vaccine make a lot of sense, based on what we know. Parents should keep abreast of the latest recommendations of the American Academy of Pediatrics on all vaccines, and protect their children from the burden of diseases that are preventable with a simple shot.

Dr. Dan

Posted by Kate Shatzkin at 3:40 PM | Permalink | Comments (0)
Categories: Health
        

A federal advisory panel yesterday recommended that all children 6 months through 17 years (except those with serious egg allergies) get the flu vaccine. If the Centers for Disease Control acts on this advice, it would be a shift from the current recommendation that only children from 6 months to 5 years old be vaccinated. Here's our story.

But the recommendations wouldn't take effect until 2009 because vaccine orders already have been placed for the next flu season, and there are concerns that there might not be enough to cover all those children.

This, it seems to me, leaves parents and pediatricians with an interesting dilemma in the meantime. Will more parents push for their kids between 5 and 18 to be vaccinated in 2008, knowing that this panel thinks it's a good idea? If you asked them now -- in the thick of a very bad flu season in Maryland, when many parents are nursing their own kids through flu and catching it from them -- the answer might be yes.

And how will pediatricians respond if they are asked this year to vaccinate a child who falls within the future, but not the current, recommendations? After all, one reason this year's flu season is bad is that the vaccine offered didn't exactly match the strains that are out there.

I'd like to hear both parents and pediatricians weigh in on this. Spread the word (but not the flu, please! :)

(Sun file photo by Jed Kirschbaum)

Posted by Kate Shatzkin at 10:43 AM | Permalink | Comments (2)
Categories: Health
        

Welcome to our first Monday Consult. Each week I'll look for an expert to answer your most pressing questions about parenting. Because he was this blog's very first commenter -- and had an interesting question -- this week's answer goes out to Hugh, whose 4-year-old daughter has been begging for Children's Motrin when she's clearly not sick.

For this question, I turned to Dr. Daniel Levy, a pediatrician in Owings Mills and president of the Maryland chapter of the American Academy of Pediatrics. Here's his e-mailed reply:

"With respect to your little 4 year old who loves Motrin, the most important issue here is safety. All medications should be stored in locked cabinets away from prying little hands and eyes. Kids should also know that any medication should only be given by a parent or caretaker.

"The second issue your reader raises is one of tantrums and feigned illness. The key to both items is this: Children are very process-oriented with their parents. That is, they pay most attention to facial expression, tone of voice, and gestures. If a parent maintains composure, speaks in an even voice, and reacts to what is being experienced instead of the content of the child's words, the child will soon learn to regulate her mood and behavior. In this instance, one might say, 'it looks like you are very upset, but I know you are not sick, and we give this medicine only when you have fever.' End of discussion. It is not necessary to have a whole repartee with a 4 year old.

"While the American Academy of Pediatrics does not recommend any of the cough and cold medications, medication to relieve pain or fever is still useful to ameliorate a child's discomfort. Ibuprofen and acetaminophen are both wonderful, safe products when given in doses recommended by the child's health care provider."

(Photo by me)

Posted by Kate Shatzkin at 7:15 AM | Permalink | Comments (0)
Categories: Health, The Monday Consult
        

If you're the parent of a teenager, you'll want to check out the Sun's "Ask the Expert" feature today on mononucleosis, the dreaded "kissing disease."

When I was a teenager, it seemed that kids were coming down with mono left and right, and that they were out of school for long stretches at a time. That's how I remember it, anyway. I'm wondering if that's so true today.

Has your teenager had an experience with mono? How did you take care of him or her? And how did it affect the family?

Posted by Kate Shatzkin at 10:37 AM | Permalink | Comments (2)
Categories: Health, Teens