As a nurse, I think about things like “febrile seizures,” or brain damage from fevers, and rush for Acetaminophen or Ibuprofen (popularly consumed as Tylenol® or Motrin®).

But is rushing for one of these items the smartest thing to do? Is it crucial to maintain a normal temperature? And how do you monitor and treat a fever for your child in the best possible way?
 

Signs of Fever

Signs of a high fever include:

• hot dry skin
• temperature above 41 Celsius
  (105.8 Fahrenheit)

Click here for more information about how to spot a fever in children.
 

Fever Research Update

In a Clinical Report put out by the American Academy of Pediatrics in 2011, some important guidelines were outlined based on research studies of general healthy children. The findings of this study included the following:

• Fever is common in children
• Fever is the body’s way of fighting infection
• Some fevers can actually help a child recover faster from viruses
• Fever cannot make an illness worse
• Fever cannot cause long-term neurological problems
• It is rare for high fevers to cause convulsions or comas

Click here for the official research study overview.
 

Treating a Child’s Fever

Taking your child’s temperature
Get a good thermometer and learn how to take your child’s temperature. 

• Tips for Taking a Baby’s Temperature

Maintaining Body Temperature

• Keep the room temperature between 70-74 degrees Fahrenheit
• Dress your child in light cotton pajamas
• If your child has chills, cover with an extra blanket and remove when the chills stop 

Watch Your Child
Observe your child for signs of serious illness. Call your pediatrician with any of the symptoms below and report the temperature as well.

Rest and Hydrate
Make sure your child gets plenty of rest and give your child plenty of fluids to prevent dehydration and help the body cool itself. Good choices for hydration during a fever are: water, clear soups, popsicles and jello.
 

Acetaminophen or Ibuprofen

Look for next week’s post, where I’ll treat you to the latest updates about moms alternating acetaminophen and ibuprofen as fever treatment. The answer may surprise you. In the meantime, thanks for reading.

I have a little monkey of a toddler.

He is 18 months old and climbs EVERYTHING. In particular, he loves to climb up on our couch and watch the world go by outside. He leans on the window and giggles at the squirrels and birds in our yard.

The problem is, toddlers don’t have much in the way of safety awareness!  And my little one is no exception.

Since he’s become so mobile, I’ve had to start keeping the window behind the couch closed when he’s awake, so that he doesn’t push the screen out and accidentally fall out of the window.

Our house is a one-story ranch, so it wouldn’t be far for him to fall if he did accidentally do so, but being the safety-conscious, somewhat paranoid, pediatric rehab nurse mama that I am, I don’t want to take that chance! You see, I had no idea how frequently kids fall out of windows and experience life-threatening trauma as a result until I started working in the Division of Rehabilitative Medicine at Children’s Hospital Los Angeles.

Most children suffer a traumatic brain injury after a fall from a window. Some tragically die. The highest cause of traumatic brain injury in children ages 0-4 years old is falls.
More information on falls – injury statistics and incidence rates

Even infants will climb sofas as they explore their environment.

Kids Fall Headfirst

Kids are top-heavy by nature because of how they are built. So they usually fall headfirst. The ground below an open window might be grass, it might be bushes, or it might be cement (not exactly a soft landing when falling headfirst).

Parents’ Remorse

Now that I work in “rehab,” the Rehabilitative Medicine Division at Children’s Hospital Los Angeles, I have seen and heard grief-stricken parents sharing their remorse over what could have been prevented so easily. Some of the more heartbroken parents are the ones who saw the fall take place and didn’t get there in time. It is heartbreaking to hear them say things like, “I saw it happen, but I couldn’t get to Johnny in time,” or “I grabbed the edge of Susie’s dress, but it wasn’t enough and she slipped out of my grasp and fell.” Parents or other caregivers feel incredibly sad and guilty that they were not able to protect their child.

I see a photo like this and just cringe.

A Reason to Rearrange Your Furniture

I have become aware of how furniture is arranged in our house and the safety levels of each placement as a result of working in our hospital’s rehab department. I’m excited to share that there are some pretty simple ways to try to prevent a fall from a window. Most simply involve rearranging the furniture.

Watch for “Climbable Furniture”

Don’t place “climbable” furniture under a second (or third, or fourth) story window. This includes couches, chairs, and ESPECIALLY a child’s bed. Don’t forget other rooms like dens, offices and sitting areas in bedrooms. Older children will even climb dressers as well.

Close and Lock Windows

If you are forced to place furniture under a window, keep that window closed AND locked when small children are present. If you have a low-to-the-ground window, keep it closed and locked at all times when children are present.

Bars on Windows

Some parents choose to install bars on windows to overcome this safety issue. Barred windows can prevent kids from falling through an open window. However they do not represent a foolproof safety solution because they need to be able to be opened in case of a fire.

Rooms with Accessible Windows

There may be some instances where you simply may not be able to find a simple solution for the accessible windows in your home. In these cases, it will be crucial to provide close supervision when small children are in a room with accessible windows. And be sure to cover this topic with relatives and babysitters who watch your child.

Avoiding Accidents

I hope I’ve helped provide you with a few helpful tips that will help you know what to look for to avoid needless falls from windows. In the meantime, please let me know if you found any problem areas in your home and how you plan to rearrange the furniture to prevent head injuries for your child.

Despite the fact that I am a nurse, it’s still scary when my son runs up to me with blood dripping down his face from a bloody nose.

It can be equally scary for both parent and child to figure out how to make a nosebleed stop. As with most things, remaining calm as a parent is one of the most important things you can do as a first step to helping your child remain calm as well.

And, below, I’d like to share some tips for you regarding prevention and stopping bloody noses at your house.

Why Do Nosebleeds Happen?

Most bloody noses are due to one of the following causes:

• Dry membranes in the nose (dry air, or heated indoor air)
• Frequent nose picking
• Trauma (such as a soccer ball hit to the nose)

SPECIAL NOTE:  If the bloody nose follows an accident or injury to the head then seek medical attention immediately.

Preventing Nosebleeds

• Use a soft tissue when blowing the nose.
• Don’t forcefully blow or pick the nose.
• If you have dry nose membranes, your doctor may recommend the use of a special lubricant or humidifier to moisten the inside of your child’s nose.

Don’t Stop a Nosebleed This Way

• Don’t panic. It is much easier for your child to listen to your instructions if you appear calm.
• NEVER tilt your child’s head back. This will only make the blood flow down the throat to the stomach, or into the lungs. Your child may vomit blood later due to irritation of blood in the stomach.
• Don’t pick the nose after a nosebleed.
• After the bleeding is controlled, do NOT let your child blow the nose or the clot may be released and the bleeding may reoccur.
  

  Do not ask your child to lean back to control a nosebleed. Check below for the correct position.

Stopping a Bloody Nose

Here are the tips to follow:

• Sit up and lean slightly forward.
• Pinch the nose just below the bony part using your thumb and index finger.
• Hold the pinch for NO less than 5-10 minutes straight without looking.
• After 5-10 minutes release the pressure. If the bleeding has not stopped then repeat pinching your child’s nose for another 10 minutes.
• You may also put an ice pack on your child’s nose after the bleeding has stopped to constrict the blood vessels in the nose.
• After the nosebleed has stopped, keep your child’s head above the level of the heart (in other words, don’t take a nap immediately after the nosebleed or lay on the grass – keep them upright, either seated or playing).
  

  Do ask your child to lean forward and pinch their nose to control a nosebleed.

   

  

  This photo shows a close-up of the area on the nose to "pinch" to control a nosebleed.

SPECIAL NOTE:  If your child’s nosebleed does not stop after a second or third try, please seek medical attention immediately.

I hope these tips help. Remember to talk to your doctor if your child is experiencing frequent nosebleeds or if they are difficult to control. In the meantime, let me know if you have any questions by leaving a comment for me below.

I’m talking about good hand washing.

You may have heard from your doctor and news reports, especially during flu season, just how important it is to wash your hands.

In fact, proper and regular hand-washing can also prevent sicknesses like most types of infectious diarrhea, hepatitis A and meningitis.

However, you only enjoy these benefits if you’re washing your hands correctly. Now, you might be saying to yourself, “Wait a minute. There’s a right and a wrong way to wash my hands?” And the answer is, “Yes, there is!”

But, you’re not alone. Most people don’t know how to effectively wash their hands to prevent the spread of germs. Luckily, it’s easy to learn the proper technique. I’ve put together a video to help both you and your children learn how to wash your hands to help prevent the spread of disease.

Washing Your Hands Correctly

You can read the steps below while you watch. Download the one-page instructions here.

1. Wet your hands with warm water.
2. Apply enough soap to make a really good lather.
3. Rub your hands palm to palm.
4. Rub your palms around your hands.
5. Clean between your fingers by interlocking your fingers and pushing your palms up and down.
6. Rub the back of your fingers on your palms.
7. Rub the tips of your fingers and nails on your palms.
8. Grab your thumb with your other hand and rub in a rotational circle backwards and forwards.
9. Rub around your wrists.
10. Rinse your hands thoroughly.
11. Dry your hands thoroughly with a single paper towel.
12. Use the towel to turn off the water faucet.

Whistle While You Wash

So what do I mean by, “Whistle While You Wash?” To help you and your family remember how long the hand washing process should take, you can whistle or sing the lyrics to the Yankee Doodle song twice. The Happy Birthday song works just as well. The total time spent washing should add up to about 30 seconds.

With everything in life, practice leads to improvement, so be sure to take full advantage of opportunities to rehearse these steps with your children. It will help you to remember the steps and will reinforce them for your kids too. Now, enjoy your clean hands and know you have just done the single most important thing to prevent yourself from getting sick!

Also, don’t forget to get your family immunized for the flu this season. Here are some tips for preparing your kids for a trip to the doctor for shots, which should help make your appointment go that much smoother.

Here are links you can explore to learn more about the importance of hand-washing:

• Center for Disease Control and Prevention—Handwashing
• Henry the Hand – Champion Handwasher
• Global Handwashing Day

Unintentional injury remains one of the top five leading causes of death in children.

The Emergency Department at Children’s Hospital Los Angeles sees far too many accidents taking place in the home, ranging from falls, near drowning, poisonings and even burns.

While constant supervision is the best way to prevent injuries, using layers of protection can help reduce the risk of home-related injuries to children. Even the most watchful parents cannot keep kids completely out of harm’s way every second, and utilizing tools can aid even the busiest parent. 

As a nurse on the Rehabilitation Unit here at Children’s Hospital Los Angeles, I have taken care of children who have nearly drowned, fallen out of a two-story window, and those who have unintentionally overdosed on a family member’s medication, just to name a few. I have witnessed the devastation, stress and guilt these situations can cause a family.

That’s why I know it is so important for parents to look for potential hazards in their home and take steps to remove them before it’s too late.

I will address the two general safety area concerns within the home:

1. Drowning and water safety
2. Fall prevention

Drowning and Water Safety

The home environment has potential for many hidden drowning hazards for children. Drowning injuries and deaths can occur not only in oceans, pools and spas, but also in bathtubs, toilets and buckets.

• Never leave your child unattended in the bathtub or any body of water, even if they know how to swim. A child can drown in just 2 inches of water.
• Keep toilet lids closed and use toilet seat locks. Toddlers can fall headfirst into the toilet and drown. It is best to restrict access to danger zones in the home such as bathrooms and kitchens. This can be done with door handle locks or gates.
• Empty all buckets, containers and wading pools immediately after use and store upside down and out of reach of small children.

Please read Hot Days, Cool Water: Summer Safety Tips by my colleague, nurse Gloria Verret, to learn more about pool safety at home and how drowning can affect your child. 

Falls

As your child develops he or she will first roll over, then sit and crawl, and before you know it,  walk everywhere.

Your toddler will move faster than your eye can see, so consider some of these safety tips to prevent them from tumbling unsafely in your home:

• Use window guards to prevent your child from falling through screens or open windows. Open windows from the top down whenever possible.  
• Never leave a child unattended around stairs, even if they are in a gated area.
• Install hardware-mounted (they are sturdier than pressure-mounted) safety gates at the top and bottom of stairways.
• Keep hallways and stairways well-lit and free of clutter (especially toys … they attract children).
• Tack down rugs and runners to prevent tripping.
• Child safety seats (car seats) or bouncer seats should NEVER be placed on top of counters or furniture.
• Do not place an infant in the middle of an adult bed unattended.
• Move furniture away from windows. This reduces a child’s ability to climb up to a window.
• Secure shelves, TVs, dressers and other furniture that may tip over. Children often climb on furniture and injuries from tip-overs can be quite severe.

These are just a few of the things you can do to child-proof your home.  A few layers of protection can go a long way to keeping your children safe. Stay tuned … in my follow-up post, I’ll provide you with child-proofing tips for fire and poison safety!

Some of my favorite memories of childhood are of picnics in the park, barbeques in the backyard and potlucks at church. I loved the fun and sharing of friendships, families and conversation around delicious food. What I didn’t know is that sometimes, we were also sharing bacteria!

The bacteria were not invited to the party, but often showed up anyway. In fact, the Center for Disease Control and Prevention (CDC) estimates that every year, about 1 in 6 Americans (or 48 million people) gets sick, 128,000 are hospitalized and 3,000 die from foodborne illness, or what is commonly called food poisoning.

What is food poisoning?

Food poisoning can cause symptoms such as nausea, vomiting, diarrhea or fever. It is caused by eating food that has not been properly stored, prepared or cooked. There is a common misunderstanding that you can only get sick from bacteria found in improperly prepared or undercooked meats, but bacteria can be lurking on unwashed fruits and veggies too! I once got food poisoning from an unwashed watermelon. Slicing the unwashed fruit dragged the bacteria from the skin to the inside of the watermelon riding on the edge of the knife.

Potato and pasta salads are common at a lot of picnics and barbeques. Contrary to popular belief, store bought mayonnaise is not usually the culprit that causes spoilage because the eggs are pasteurized. Instead, bacteria seem to prefer homemade dishes that include eggs, potatoes as well as other ingredients.

Salmonella is the most common bacterial cause of diarrhea in food poisoning deaths. It is most often found in raw and undercooked eggs, undercooked poultry and meat, fresh fruits and vegetables.

How do I avoid food poisoning?

Bacteria grow best between 40 and 140 degrees Fahrenheit. This is what is known as the “danger zone.” To keep food poisoning from ruining a perfectly good picnic, follow these simple tips. Use the same basic rules for preparing and serving food outside as you would inside your kitchen.

Mind the Temperature

• Keep cold foods cold. Bring a cooler with plenty of ice or freezer packs to the event.
• Keep hot foods hot.
• Separate hot foods from cold foods.

Follow the Two Hour Rule

• Serve cooked food within two hours of preparation. Don’t let food sit for more than two hours on the table (exceptions are cookies, chips or cracker-type foods).

Divide and Conquer

• Separate cooked meats from uncooked meats.
• Do not use the same plates, cutting boards or utensils to prepare the meats that you do to serve them once they are cooked.
• Do not use the same plates or utensils to prepare raw meats and other types of food.

There are four basic principles that can help keep your picnics and barbeques safe and fun:

1. CLEAN—Wash hands and surfaces often.
2. SEPARATE—Don’t cross-contaminate!
3. COOK—Cook to proper temperature.
4. CHILL—Refrigerate promptly.

Follow these simple precautions and your summer parties will be filled with fun and great food, and you can avoid any trouble from that little microscopic party-crasher called bacteria!

In my last post, Hot Days, Cool Water: Summer Safety Tips, I shared important water safety tips for parents and really focused on what parents should remember when their children are playing in the pool.

But it’s too easy to forget that the pool isn’t the only place where kids are at risk for drowning.

This post discusses the importance of being vigilant while your children are playing in hot tubs, containers of water and in the ocean.

I’ll also discuss what dry drowning is and how to keep an open eye for its symptoms. 

Hot Tubs and Containers of Water

Many families allow children to play in or with containers of water such a “kiddie pools” or buckets of water. Some also allow their children to play in hot tubs (or Jacuzzis).

The same supervision is required during play time and it’s important to properly cover a hot tub when it’s not in use.

Ocean Safety Tips for Kids and Adults

For those of us lucky enough to live close to a coast, playing in the ocean is a great and inexpensive way for a family to cool off during the summer months.

However, it’s even more important for parents to keep a watchful eye on their children and follow these tips on an outing to the beach.

• Always swim with a buddy
• Stay near the lifeguard station
• Don’t wear heavy clothes, always wear a real swimsuit
• Listen to and obey the lifeguards and any warnings posted
• Don’t use alcohol when swimming

Dry Drowning

I recall a sad news story in which a child who seemed to recover easily from an episode of almost drowning only to die in the night from the injury to his lungs.

This phenomenon is called dry drowning and takes place when a person aspirates water into the lungs, which disrupts the supply of oxygen. This is a situation requiring medical treatment and a delay can lead to death.

Signs and Symptoms of Dry Drowning:

• Difficulty breathing, shallow breathing, fast breathing
• Pain in the chest when breathing
• Sudden change in mood
• Confusion
• Decreased energy, increased agitation
• Pale or blue skin
• Inability to speak clearly
• Sweaty skin
• Cough

If you have reason to believe your child could be suffering from dry drowning, take him or her to the emergency room for monitoring and treatment.

Smooth Swimming

In my first post on water safety, I shared my personal experience with my daughter which alerted me to how quickly and silently a child can slip beneath the water.  Any parent who’s had a near-drowning scare with their child knows just how quickly a little one can slip underneath the surface.

While I worried that this early experience would make her fearful of water, it turned out quite the opposite.  I placed her in swimming lessons where she learned to be a strong and confident swimmer. Ever since, she has been my swimming buddy, fearlessly diving into oceans and pools. She’s even a member of a champion collegiate water sports team, the University of California Berkeley Rowing Team!

For me, summer conjures up days of fun in oceans, lakes and pools because I love the water. It also reminds me of some close calls of my own, especially one episode involving my daughter.  In fact, I have told the story repeatedly—I will never forget that day.

On a hot summer day in Atlanta, Georgia, I took my then 2-year-old daughter to the neighborhood public pool. I walked behind her in the shallow end, with the water level just above her stomach. With a little trip, she went under.

The seconds felt like an eternity. While she floated, motionless, I pulled her out of the water. She was perfectly fine, but I realized then just how easily and silently children can drown.

As a nurse on the Rehabilitation Unit here at Children’s Hospital Los Angeles, I have taken care of children who have nearly drowned. I have witnessed the neurological devastation it can cause, including severe brain damage and comatose children. That’s why I know why it’s so important for parents to take care when their children are playing in any kind of water.

What is drowning?

Drowning describes death from asphyxia due to suffocation. This happens when liquid enters the lungs and prevents the absorption of oxygen, starves the victim’s brain of oxygen and causes myocardial infarction, or a heart attack.

Drowning is quick and silent. Victims cannot call for help as they do not have enough air. It is rare for a drowning victim to thrash. A child can drown in any amount of water in the time it takes to answer a phone.

For this reason, it is so important not to leave children unattended in or near water. Children can drown in just two inches of water, which can take place in bathtubs, toilets, buckets, anywhere free standing water is found.

According to the World Health Organization, drowning is the third leading cause of adult unintentional death. In the U.S., it is the second leading cause of death in children under the age of 12. The peak age is younger than 4, and between 5 and 25. In children less than 1 year old, deaths are usually in bathtubs. Pools are the cause of drowning death in children less than 5 and in young adults it is usually lakes and rivers, often involving diving or alcohol use.

How to Protect Your Children

If you have a private pool make sure you …

• have a secure locked fence or barrier around the pool
• install alarms to notify you someone has gotten into the pool area
• consider an underwater wave alarm
• make sure your pool has no drains or suctions that are unsecured, as children can become trapped in them
• keep the water clean and clear so that you can see the bottom and everyone in it
• Always have a parent in the pool with younger children so they understand that a parent should always be with them

If you are having a pool day …

• assign an adult to watch the pool undistracted from socializing and make sure the adult knows he/she is assigned to this duty
• make sure your children know how to swim
• make sure you know CPR and have a cell phone nearby to call for help if needed
• always have a parent in the pool with younger children so they understand a parent should always be with them

Always Follow the ABC’s of Drowning Prevention

            A for Adult Supervision
            B for Barriers
            C for CPR and classes

Always use a life jacket for children who cannot swim. Floaties do not provide any protection and should not be considered a water safety device.

Don’t Forget to Have Fun!

By taking the proper water safety precautions, you and your family can cool off this summer safely. Keep an eye out for my next post. I’ll continue this discussion of water safety with tips on how to keep your children safe in hot tubs, buckets of water and will explain what dry drowning is.

If you are a smoker, you should know there is no risk-free level of exposure to tobacco smoke. In adults, secondhand smoke can cause serious cardiovascular and respiratory diseases, including coronary heart disease and lung cancer.

In pregnant women, secondhand smoke has been shown to cause low birth weight as well as a host of other issues for the child. Basically, when you smoke around your children, they are smoking too and face the same (if not worse) health risks you do.

What is secondhand smoke and how is it harmful?

Second hand smoke is a combination of the smoke from a burning cigarette and the smoke exhaled by a smoker. Also known as environmental tobacco smoke (ETS), it is especially harmful to young children and can cause disease and premature death in adults and children who do not smoke.

California has some of the strictest laws against smoking in the nation … and for good reason. There are more than 4000 chemicals in tobacco smoke of which at least 250 are known to be harmful and more than 50 are known to cause cancer. [Source: LungsUSA.org]

A person’s risk of developing cancer from secondhand smoke is about 100 times greater than from outdoor cancer-causing pollutants with more than 3,000 non-smokers to dying of lung cancer each year. [Source: LungsUSA.org]

Who is at risk?

Although inhaling secondhand smoke is dangerous to everyone, fetuses, infants, and children are at most risk because it can damage their developing organs, such as the lungs and brain.

Secondhand smoke is responsible for between 150,000 and 300,000 lower respiratory tract infections in infants and children under 18 months of age, resulting in between 7,500 and 15,000 hospitalizations each year. 430 sudden infant death syndrome (SIDS) deaths in the U.S. annually result from secondhand smoke.

In infants, ETS often attributed as a cause for sudden death and is listed as a cause for more than 600,000 premature deaths a year. 31 percent of the deaths attributable to secondhand smoke occur in children. [Source: LungsUSA.org]

Let’s take a closer look at the specific risks children face when exposed to secondhand smoke in …

Fetal and Newborn Development

Maternal, fetal, and placental blood flow change when pregnant women smoke, although the long-term health effects of these changes are not known. Some studies suggest smoking during pregnancy can contribute to the occurrence of birth defects such as cleft lip or palate. Smoking mothers produce less milk and their babies tend to have a lower birth weight. Maternal smoking also is associated with neonatal death from SIDS, the major cause of death in infants between the ages of one month and a year.

Lungs and Respiratory Tract

Exposure to ETS decreases lung efficiency and impairs lung function in children of all ages. It increases both the frequency and severity of childhood asthma. Secondhand smoke can aggravate sinusitis, rhinitis, cystic fibrosis and chronic respiratory problems such as cough and postnasal drip. It also increases the number of childhood colds and sore throats.

In children under two, ETS exposure increases the likelihood of bronchitis and pneumonia.

Ears

Exposure to ETS increases both the number of ear infections a child will experience, and the duration of the illness. Inhaled smoke irritates the eustachian tube, which connects the back of the nose with the middle ear. This irritation can cause swelling in the middle ear and create an obstruction which interferes with pressure equalization, leading to possible pain, fluid and infection.

Ear infections and middle ear fluid are the most common cause of hearing loss in children. When they do not respond to medical treatment, the surgical insertion of tubes into the ears is often required.

Brain

Children of mothers who smoked during pregnancy are more likely to suffer behavioral problems such as hyperactivity than children of non-smoking mothers. Modest impairment in school performance and intellectual achievement has also been demonstrated.

Legacy of Addiction

About 40% of all children are regularly exposed to secondhand smoke at home. Youth exposed to secondhand smoke at home are 1 ½ – 2 times more likely to start smoking than those not exposed to this behavior. While these facts are alarming, you can decrease your child’s risk of becoming a smoker by taking action as an adult.

What can parents do?

You can take the following measures to ensure that your children are living in a smoke-free environment.

• If you smoke, stop now. Consult your physician for help, if needed. There are many new pharmaceutical products available to help you quit.
• If you have household members who smoke, do what you can to help them stop. If it is not possible for them to quit, do not allow them to smoke in your home or near your children.
• Also, do not smoke or allow smoking in your car. Make sure that your children’s schools and day-care facilities are smoke-free.

Resources to Support Quitting Smoking

• Tips from the American Lung Association
• The No Butts Helpline
• The American Lung Association Smokefree Air Challenge Petition

Would you know if your child has asthma?

Asthma affects as many as 10 to 12 percent of children in the United States and is the leading cause of chronic illness in children.

For unknown reasons, the incidence of asthma in children is steadily increasing.

While asthma symptoms can begin at any age, most children experience symptoms by age 5.

What is asthma?

Asthma is characterized by inflammation of the bronchial tubes with increased production of sticky secretions inside the tubes, making it hard to breathe.

It is important to note that not all children with asthma wheeze.

Chronic coughing may be the only obvious sign, but a child’s asthma may go unrecognized if the cough is attributed to recurrent bronchitis.   

Does your child have any of these symptoms?

Wheezing and/or Chest Tightness

Sometimes this takes place only with exercise or with a cold.

A young child who has frequent wheezing with colds or respiratory infections is more likely to have asthma if:

• A parent has asthma.
• The child shows signs of allergies, including the allergic skin condition eczema.
• The child wheezes even when he or she doesn’t have a cold or other infection.

Frequent Cough

May be more common at night, and the child may or may not cough up mucus. You may notice your child is tired during the day, possibly due to lack of sleep.

Shortness of Breath

This is a feeling of not getting enough air into the lungs. It may occur only once in a while, or often.   Shortness of breath can feel like tiredness or a decreased ability to do normal activities. Young children who are not yet verbal may experience feeding problems with shortness of breath while older children may describe tiredness, fatigue or just not being able to keep up with other kids their age.

Diagnosing Asthma

There is no specific test for asthma. Lung function tests—often used to confirm a diagnosis of asthma are very hard to do on children less than 6 years old.  Pulmonary function tests (PFT’s) measure how well your child can move air in and out of his or her lungs.  It helps tell your health care provider if your child has lung disease, how severe it is and the provider will recommend what medications may help. 

Click here to download the American Thoracic Society’s Patient Information Series on Pulmonary Function Testing in Children

To help your pediatrician make a correct diagnosis, be prepared with information. This includes information about family history of asthma or allergies, your child’s overall behavior, breathing patterns and his or her responses to foods or possible allergy triggers.

The doctor may use a four to six week trial of asthma medicines to see if they make a difference in your child’s symptoms.

Asthma Triggers

Spring is in the air, and so are your child’s asthma triggers.  Did you know that weather changes can trigger asthma?  

Other common triggers include:

• Pollen, dust mites, cockroaches and pet dander; cat dander is worse than dog.
• Inhaling cigarette smoke or having contact with someone who has smoked cigarettes (cigarette smoke permeates clothing).
• Chemicals including household cleaners, citronella candles and bug sprays.  Colognes and scented lotions are triggers.  Pool chlorine can be a problem;  indoor pools should be avoided as the chlorine is enclosed in the building.  Private pools are much better than public, because public pools tend to have much more chlorine in them.  Beach swimming is better than pool swimming.
  (Find answers to the Top 10+ questions about children and chemicals.)
• Stress: Even family stress can contribute to your child’s asthma!
• Cold and windy weather.
• Exercise: If your child is prescribed daily medications, make sure they’re taken prior to exercise, especially if your child is physically active.  Also, your child should have  their inhaler on hand.  Exercise-induced asthma may be caused by rapid movement of air into the lungs before it is warmed and humidified. This often occurs because of mouth breathing during exercise. 

To Help Prevent Symptoms

Armed with the knowledge of how your child’s asthma can be triggered, you can take preventive measures.

Avoid Infection

Effective ways to avoid infection include good hand washing, brushing teeth twice a day and seeing the dentist every six months.  Avoid contact with family and friends when they sick, stay out of crowds during cold and flu season and make sure to get your flu vaccine.

Work with Your Pediatrician

Get regular health care.  Make sure your child takes medications as prescribed.

Get an Asthma Action Plan

Your child’s health care provider can give you this—use it! Make sure your child’s school has a copy of it as well.  See an example here, provided by the American Lung Association.

Avoid Exposure to Pollutants

Radon, second-hand smoke, household chemicals and air pollution can worsen asthma symptoms.  According to an American Lung Association State of the Air 2011 report, the area comprised of Los Angeles, Long Beach and Riverside, is fourth in the nation with the worst short-term air pollution. It’s the second worst for year-round air pollution and number one for worst ozone pollution.

That’s why it’s so important for local parents to check news reports and keep asthmatic children inside when pollution levels are particularly high. A simple way to prevent your child’s exposure to smoke is also not to do it around your children.

Pests Be Gone!

Rid your home of pests like cockroaches and dust mites. You may need to remove a pet if your child’s asthma is severe enough. Speak with your pediatrician or asthma care provider before making final decisions about whether to get a pet or give one up.

Don’t Smoke

 Please remember, cigarette smoke affects your child even if you do not smoke in their presence. 

Early Exposure

Studies are showing that exposure to animals before children are 6 months old builds their immune response due to the endotoxins.   So take your baby to the zoo or on a trip to a farm.  He or she won’t remember the trip, but his immune system will. 

Don’t forget to have fun!

By taking the proper precautions, you can help your youngster breathe easy this spring and summer.

Exercise is very healthy for your child … and you! But be aware that running around on that fresh-cut lawn and breathing smoke from an outdoor barbeque or citronella candle can be triggers if your child’s asthma is sensitive to those things.

Having an asthma action plan handy is a good way to make sure that a little preparation goes a long way.