Written by: Melissa Reffitt, CPNP

As the days gradually turn warmer, those of you spending days sitting on the bleachers supporting your young athlete may be watching those sweaty faces and wondering,

Is my child staying hydrated enough?

Do I need to stock up on that sports drink I saw on sale at the grocery store?

Would buying sports drinks provide better hydration after the game is over?

Marketing campaigns for sports and energy drinks have been successful in advertising to our adolescents and young athletes with the message that these drinks offer superior hydration and fuel for athletic performance. Sports drinks, such as Gatorade® or Powerade®, are flavored waters that contain carbohydrates (calories) in the form of sugar and may contain other vitamins or additives. Energy drinks, such as Monster Energy®, Red Bull®, or Rockstar®, contain stimulants like caffeine and guarana. They may also include vitamins, minerals, sugars or protein.

In truth, WATER is the best hydration for the vast majority of children’s sports activities. Here is a rule of thumb to keep in mind: for every 20 minutes of sports activity, 8 ounces (1 cup) of water is required to replace fluids lost. If your child is involved in a soccer game for 1 hour, he or she needs 24 ounces (3 cups) of water after the game is done. Sports drinks are not necessary for most sports activities. Only during times when elite players are playing for extended periods of time that do not allow for rest or eating would a sports drink potentially provide benefit. Carbohydrates, protein and vitamins are best obtained from eating healthy foods at meal times. To provide best ‘refueling’ for your athlete, make sure he or she is drinking water before, during, and after the game, and make sure a balanced meal is provided after the activity is completed. For more information on providing balanced nutrition go to www.choosemyplate.gov.

Your athlete may also claim a need to ‘boost’ their performance with an energy drink. Most of these drinks contain caffeine or guarana, a plant extract that contains caffeine. Caffeine can have dangerous side effects to an athlete’s body, including increasing heart rate and blood pressure, and loss of fluids (diuresis). Caffeine can also cause headaches and sleep disturbances. Caffeine is not appropriate to give to a child or teenager before, during or after sports participation.

Does your child seem to tire or fatigue more quickly than his or her peers when playing sports? Dehydration has been shown to cause a decline in sports performance. Make sure your child is well hydrated before the game. Can they keep a water bottle at their desk at school? Do they use the drinking fountain at school? Do they drink from their water bottle during the game? Have they eaten a balanced meal before the game (including fruit, vegetable, carbohydrate, and protein)?

Routine use of sports drinks can also be associated with excessive calorie consumption and risk for weight gain. If your child is overweight, sports drinks add additional unnecessary calories to their diet. After the game, a glass of low fat milk is actually a great choice for post-sports rehydration and protein replacement.

In summary, water is essential for hydration–before, during, and after children’s sports activities. Keep a water bottle handy for your young athlete!

Reference: Sports drinks and energy drinks for children and adolescents: are they appropriate? Pediatrics, 2011, (127), pp. 1182-1189.

FRESH SALSA

Serving size = 1/2 cup
Servings per recipe = 20

Ingredients

• 6 tomatoes, diced
• 1 large onion, chopped
• 2 green peppers, chopped
• 1 jalapaneo, chopped
• 1 tbsp chopped garlic
• 2 tbsp fresh cilantro
• 1 tsp salt
• 2 tbsp olive oil
• Juice of 1 lime

Preparation

1. Mix all ingredients together in a large mixing bowl.
2. Refrigerate 1 to 2 hours to let flavors blend, then serve.

Nutrition facts per serving

Allergic Rhinitis is an inflammation of the membranes of the nose and eyes, caused by sensitivity to pollens, dust mites, animal dander, and or molds. For some children these symptoms occur seasonally during pollen peaks in spring or fall and for others the symptoms last all year with flare ups during specific seasons.

Symptoms

The common symptoms are runny, stuffy nose, itchy eyes, nose, throat, sneezing spells, sometimes headache and fatigue. If symptoms go untreated or unrecognized they can lead to a sinus infection or an ear infection.

Common Allergens

The most common allergens are tree pollens (spring), grasses (late spring), weeds (summer and fall), ragweed (fall), and molds (primarily late fall and early spring). Other allergens are animal saliva, dander, and dust mites.

What can you do?

Avoidance is the best prevention. Dust mites live in bedding material, rugs, carpets, drapes, upholstered material. They prefer humid conditions and feed on skin cells, fabric material and food crumbs.

• Cover the mattress with allergen covers that zip shut.
• Keep floors free of carpets; damp mop or vacuum often.
• Wash bedding often in hot water, (warm water does not kill dust mites).
• Keep humidity below 50% when possible, may need dehumidifier in summer months
• Do not use feathers or down comforters, pillow or comforter should be synthetic or hypoallergenic material, such as Dacron
• Use HEPA filter on vacuum to help control molds, can also buy HEPA air filter for home

Controlling Outdoor Exposures

Pollen counts are highest during the early morning hours 5 a.m. and 10 a.m. Keep windows closed at night and during the day. Wash hair before bedtime, dry linens inside not outside.

Medications

Over the counter medications can be used to treat mild symptoms:  Zrytec, Claritin, or Allegra are common brands. Use as directed on packaging. If your child’s symptoms are severe or they develop a fever or ear pain, they should be seen by a health care provider. If medications are tried and not effective, your child should be seen as well.

This Blog was written by Genevieve Bastos, CPNP. Appointments can be made at (269) 552.2500.

• 3 medium bananas
• 2 tbsp lemon juice
• 1 low-fat graham cracker crust
• 1/2 pkg (4 oz) fat-free cream cheese, softened
• 1-1/2 cups skim milk
• 2 pkg (4 serving size) banana cream flavored sugar-free instant pudding and pie filling
• 1 tub (8 oz) fat-free whipped topping

Once you collect all of the necessary ingredients, you are ready to go! Follow the steps below and you will be enjoying in no time.

1. Slice bananas and dip in lemon juice to keep slices from darkening.  Drain slices on a layer of paper towels.  Arrange slices in bottom of graham cracker crust.  Set aside.
2. Beat cream cheese in large bowl until smooth. Gradually beat in milk until well blended. Add pudding mixes. Beat 2 minutes or until thickened and smooth. Gently stir in half of the whipped topping. Spoon into crust over banana slices.
3. Refrigerate 3 hours or until set.
4. Top with remaining whipped topping.

We hope you enjoy your day and are glad we could be a part of it. To get more great recipes like this, check out the Borgess Light Hearted Living Cookbook at cookbook.borgess.com or visit the Seasons Gift Shop located inside the Atrium at Borgess Medical Center..

1. Two bottom front teeth (central incisors)
2. Four upper front teeth (central incisors and lateral incisors)
3. Two lower lateral teeth (lateral incisors)
4. First four molars
5. Four canines or eye teeth (between lateral incisors and molars)
6. Remaining molars

The entire process of cutting all 20 primary teeth is normal complete by two and a half years old.  Permanent teeth start to show up when the child is in early elementary school.

Unfortunately, tooth decay is the most common chronic disease among children aged 5 to 17. It starts when teeth are exposed to any foods and liquids other than water for a long period of time.  Sugars in food and liquid are changed to acid by bacteria in the mouth. The acid eats away at the tooth enamel, the outer layer of the tooth, leading to cavities. Fortunately, it is preventable.

The most important thing you can do to prevent cavities is good oral hygiene. Even before any teeth have come through, get your baby used to having their mouth cleaned.  After feedings, gentle wipe your baby’s gums with water using a clean wash cloth or gauze. Or use a soft baby toothbrush. As baby grows and eats less frequently, develop a routine of brushing after meals or at least twice a day.  The easiest times are after breakfast and before bed.  Use a soft toothbrush designed for the age of your child with water or “baby” toothpaste that does not contain fluoride. Once your child is a toddler and wants to do everything his or herself, have the child brush first and then repeat the process yourself to be sure that each tooth is cleaned well.  Or you go first and let him or her finish. If any teeth are touching, start flossing once a day. Once your child is age 2 and can spit out the toothpaste, switch to a children’s toothpaste with fluoride.  Only use a pea-sized amount and get the toothpaste into the bristles so your child doesn’t just eat it. Take your child for a checkup with a dentist every 6 – 12 months.

In addition to brushing, there are things you can do to protect your child’s teeth:

• Don’t put your baby to bed with a bottle. Natural sugars in formula and milk will sit on the teeth over night and cause cavities.
• Teach your child to use a regular cup as young as possible.  A child using a regular cup is less likely to have liquid collect around their teeth compared to a bottle or sippy cup user. Start offering a cup with water at meals as soon as your child can sit up by his or herself. The only liquid offered in a sippy cup should be water. Other liquids should be in a regular cup with meals.
• Limit any juice, even diluted, to 4 to 6 ounces once a day and only serve it with a meal. Offer water between meals when your child gets thirsty.
• Avoid drinks that have sugar and acid like juice, sports drinks, soda pop and flavored drinks and teas. The sugar and acid promote cavity formation.
• Be careful with sweets and sticky foods. Fruit snacks and roll-ups, candy, and cookies, crackers and chips all have sugar in them and they can get stuck in molars, leading to cavities. Save them for mealtimes when you can brush as soon as you are finished eating. If your child is old enough to have gum, stick with sugar-free varieties or gum sweetened with xylitol.
• Brush teeth after giving medicine.  Many medicines contain acids and sugars that can lead to cavities.
• Be sure your child is getting the right amount of fluoride. Fluoride reduces cavities in children and adults and can even repair early stages of tooth decay before it becomes visible. If your community does not have fluoridated water or you use well water, talk to your dentist about using a supplement like bottled water with fluoride or a prescription tablet.

Nothing brightens up a day like a child’s smile. With proper care, that smile can last a lifetime. Remember, only brush the teeth you want to keep!

Author: Lisa Kanwischer PA-C, ProMed Pediatrics

Sources:

American Academy of Pediatrics
Consumer Guide to Dentistry
American Dental Association

Celiac Disease is an autoimmune disease (abnormal immune response against your own body) caused by an abnormal response to gluten, a protein in wheat and some other grains. Celiac Disease is also known by the names Celiac Sprue and Gluten Sensitive Enteropathy. Celiac Disease occurs in about 1% of the general population.

What causes Celiac Disease?

Celiac Disease is, at least in part, genetically mediated. Almost all people who develop Celiac Disease have either the HLA-DQ2 or the HLA-DQ8 gene or both. Not everyone with the DQ2 or DQ8 gene develops Celiac Disease, but the presence of one of these genes is a prerequisite.

In addition, it is possible that activation of yet another gene is also required to develop Celiac Disease. An alternative theory is that some other triggering event is required such as an infection. Adenovirus and rotavirus have been implicated in some studies.

What are the Symptoms of Celiac Disease?

Some people with Celiac Disease have few or no symptoms. Some people with Celiac Disease only recognize that they have had symptoms after they are treated and in retrospect notice that the symptoms went away.

People with Celiac Disease most commonly notice pain, gas and bloating and diarrhea when they eat gluten, a protein found in wheat, barley and rye. They may have a poor appetite (anorexia). They may also experience constipation at times.

These symptoms are in part due to villous atrophy (The absorbing fingers inside the gut wall are blunted.) and hypoplasia (not fully developed) of the small bowel architecture. This blunting of the villa leads to poor absorption of carbohydrates. Which, in turn, leads to bacterial overgrowth.

Children with Celiac Disease may not grow normally. They may come to medical attention for poor weight gain or short stature or both. Pubertal delays may also manifest themselves.

Because of the malabsorption caused by Celiac Disease various nutritional deficiencies may develop:

• Some people with Celiac Disease may have anemia from iron deficiency.
• Vitamin K deficiency may cause abnormal bleeding.
• Vitamin D and calcium deficiencies may lead to osteopenia or osteoporosis (loss of bone).
• Patients with B-6 deficiency may develop neurologic (nerve) symptoms.

Some may develop a skin rash called dermatitis herpetiformis. It is a raised red rash with clear blisters. It itches and may be confused with poison ivy. It can leave scars. Biopsy of the rash may lead to the diagnosis of Celiac Disease.

Patients with Celiac Disease may develop defective dental enamel. This, in turn, may lead to frequent tooth decay.

Mouth ulcers and lactose intolerance are present in some patients. Liver disease and arthritis also can occur. There is also an increased risk of developing some types of lymphomas and gastrointestinal cancers.

There is an association with hyposplenism (The spleen does not function properly.) that in turn leads to an increase in the infection rate.

There is an increased risk of developing Celiac Disease in patients with:

• Diabetes
• Thyroid disease
• IgA deficiency
• Down Syndrome
• Williams Syndrome
• Turner Syndrome

What are the tests for Celiac Disease?

Blood tests (serology) are commonly used to screen for Celiac Disease as the initial test. These tests look for abnormal antibodies produced in patients with Celiac Disease. These tests must be done before any treatment is begun or the tests may be falsely negative.

Additional blood tests are done in patients who are IgA deficient as the usual screening tests depend on the presence of IgA antibodies. And many patients with Celiac Disease are also IgA deficient.

Blood tests may also reveal the presence of DQ2 and DQ8 genes discussed earlier.

As a confirmatory test, biopsy of the small intestine while the patient is on a diet rich in gluten has been the gold standard. However, as the blood tests become more sensitive, some clinicians feel comfortable diagnosing Celiac Disease without requiring a biopsy. Biopsy may only be requested when the blood tests are equivocal.

Who should be tested?

Patients with the following symptoms, if not otherwise explained, who are on a gluten containing diet:

• Failure to thrive
• Persistent diarrhea
• Chronic constipation, recurrent abdominal pain, or vomiting
• Dental enamel hypoplasia of permanent teeth (symmetric distribution)
• Dermatitis herpetiformis
• Idiopathic (unknown cause) short stature
• Significant pubertal delay
• Iron deficiency anemia not responsive to supplementation

Patients with the following high risk factors:

• Relatives of patients with celiac disease
• Autoimmune thyroiditis
• Type 1 diabetes
• Down syndrome
• Turner syndrome
• Williams syndrome
• Selective IgA deficiency

How is Celiac Disease Treated?

While there is no cure for Celiac Disease, most of the symptoms and consequences of Celiac Disease can be reversed or prevented by strictly following a gluten free diet. This means avoiding all wheat, barley and rye flour. Gluten is used in the production of other foods. Gluten may also contaminate other grains if they are milled in the same facility.

Patients should read food labels carefully. Finding palatable foods that are gluten free has become much easier in recent years. Newly diagnosed patients would do well to arrange for consultation with a certified dietician.

Patients may be advised by their physicians to take extra amounts of vitamins K, B-6 and D, iron, as well as extra calcium.

Patients with Celiac Disease are more prone to certain infections. It is critical that they are up to date in all immunizations, but especially the immunizations that help prevent pneumonia.

Only rarely does Celiac Disease not respond to the treatments outlined above. In such cases steroids and or immunosuppressant agents may be considered.

After six months of successful treatment, the serology should be repeated to look for a decrease in harmful antibodies.

Can Celiac Disease be prevented?

There is some early research to suggest that prolonged breast-feeding with the slow and delayed introduction of gluten into the diet may be helpful for infants at increased risk of Celiac Disease.

Asymptomatic patients whose serology is positive may choose to foloow a gluten free diet.

What should I do if I suspect my child has Celiac Disease or is at risk for Celiac Disease?

You should make an appointment with you health care provider for an extended visit. Do not start your child on a gluten free diet until instructed. Starting your child on a gluten free diet prematurely may interfere with making a clear-cut diagnosis.

Other Helpful Links
www.nlm.nih.gov/medlineplus/celiacdisease.html
www.celiac.org
www.csaceliacs.org
www.cdhnf.org
www.uptodate.com

Eric J. Slosberg, M.D., a Board-Certified pediatrician, is accepting new patients at ProMed Pediatrics in Richland, call (269) 552-2500.

Influenza is a viral infection that causes sudden high fevers, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue.  Serious infections may develop following a case of influenza – especially in infants and children with serious underlying health conditions.  A child with asthma or heart problems or an immune problem who contracts influenza can have a severe and complicated illness that may put them in the hospital or worse.  A baby who contracts influenza can have severe health problems.  An influenza infection also has serious health consequences for adults, particularly those who have chronic breathing problems or people who are unfortunately going through chemotherapy. Other high-risk patients are those who have asthma, a weakened immune system, any heart, lung, kidney, blood or liver diseases, diabetes, or are pregnant.

Many people don’t get the flu shot because they are concerned about the feeling they get after the shot.  Mostly people have some soreness at the site of the injection.  If you are in the minority of people who feel different or have mild body aches after the vaccine, that feeling is your immune system “kicking in” and forming protective antibodies to influenza.  A lot of people refer to infections that cause vomiting and diarrhea as “the flu.”  It is not.  The viral infections that affect people’s guts are actually something different from influenza.

Every year, tens of thousands of Americans die from influenza.  Getting a needle stuck in your arm isn’t fun, but it is the least you can do to protect yourself and your loved ones against this serious and possibly life-threatening infection.

A Few Words About Safety

Vaccines are safe and they work. Vaccinating children and young adults may be the most important intervention I do as pediatrician.  There will likely always be controversy surrounding vaccination. However, the vaccine campaign is truly a victim of its own success. It is because vaccines are so effective at preventing illness that we even discuss whether or not they should be given. Because of vaccines, most of us have never seen a child with polio, tetanus, whooping cough, bacterial meningitis or even chickenpox. Because of vaccines, most of us have never known a friend or family member whose child died from one of these diseases.

If you still have doubts about vaccines, keep in mind that thousands of our brightest scientists and physicians have studied the safety and effectiveness of vaccinations for many years.  We are confident in recommending these vaccines and the schedule for when they should be given.

In the end, bad things unfortunately do happen to good people. We should take comfort knowing we have the power to prevent serious or life-threatening illnesses from striking those we love through safe and effective vaccines.

For more on the importance of vaccination, visit:

www.flu.gov

www.cdc.gov

www.whattoexpect.org/news/immunizations

www.vaccinateyourbaby.org

www.aap.org/immunization

www.cdc.gov/vaccines

Thomas R. Akland, DO, FACOP, FAAP is a Board-Certified Pediatrician, the Medical Director for Southwest Michigan Children’s Healthcare Access Program, and is accepting new patients at Borgess Family Medicine in Plainwell, call (269) 552-0100.

• Infants need 9 to 12 hours of sleep during the night and 2 to 5 hours of sleep during daytime hours (naps lasting from 20 minutes to 2 hours).
• Toddlers (1 to 3 years of age) need 12 to 14 hours of sleep over a 24 hour time period, usually a nap after lunch lasting 1 ½  to 3 hours.
• Preschoolers ( 3 to 5 years of age) need 11 to 13 hours of sleep; some need a day time nap and some outgrow the nap at 3 to 4 years old
• School age children (6 to 12 years of age) need 10 to 11 hours of sleep
• Teenagers need about 9 hours of sleep

Signs of sleep deprivation in a child can include:

• Mood.  Sleep deprivation may cause your child to be moody, irritable and cranky. In addition, he/she may have a difficult time regulating moods. Older children may become easily frustrated or be upset more easily. Infants and toddlers may be fussy or have more temper tantrums.
• Behavior. School-aged children who do not get enough sleep are more likely to have behavior problems, such as defiance and hyperactivity. Teenagers who are sleep deprived are more likely to engage in risk taking behaviors, such as drinking and driving fast.
• Cognitive Ability.  Inadequate sleep may result in problems with attention, memory, decision making, reaction time and creativity—all of which are important for school performance. Studies show that teenagers who get less sleep are more apt to get poor grades in school, have more tardiness/absences and fall asleep at school.

Here are some recommendations to help your child get the best sleep, to fall asleep easily, and maintain sleep.

• Sleep schedule. The bed time and wake time should be consistent from day to day, not more than an hour difference from school day to non school day.
• Bedtime routine.  A routine that last 20 to 30 minutes is best. Calm activities, books and reading are best. Avoid activities that require the parent’s presence, like rocking or holding to help the child get to sleep.
• Sleep environment.  Background noises, location, sleep partners, bedding, favorite toys, temperature of the room and lighting can all affect a child’s ability to fall asleep and maintain sleep.
• Sleep only zone.  Remove most toys, games, TVs, computers and video games from the bedroom.
• Caffeine.   Avoid drinks with caffeine after 3 p.m.
• Daytime routines.  Consistent schedules and regular mealtimes and playtimes also help to improve night time routines.
• Exercise.   Daily exercise also helps with initiating and maintaining sleep.
• Naps.  Nap times should be geared to your child’s age and needs. Long naps should be avoided.

Many children have nighttime fears at bedtime and most have these at some age. They are a normal part of development. Children have different fears at different stages of development, for example some young children are afraid of monsters. Young children have difficulty distinguishing the difference between real and imagined.  If your child is having difficulty with nighttime fears, your health care provider can help. Give us a call or come in for a visit.

Sleep or night terrors are common in children. They usually happen 1 to 2 hours after falling asleep and can last for a few minutes to an hour. Children who are having a sleep terror may have their eyes open, usually appear agitated, frightented, some may scream or cry or talk nonsense. Although difficult to watch, the sleep terror for the child is less traumatic than a typical nightmare or bad dream. Most children do not remember a sleep terror the next day.  Sleep terrors are not a sign of a traumatic event or psychological problem. Most children outgrow sleep terrors by adolescence, sleep terrors and sleep walking does often run in families. Stress, a full bladder, fever, illness, irregular sleep schedule, not getting enough sleep, some medications, sleeping in a different or noisy environment can all contribute to sleep terrors.

Contact your health care provider if you child has difficulty falling asleep, snores or experiences unusual awakenings or has sleep problems that are causing disruption during the day.

This blog was written by Genevieve Bastos, CPNP of Richland ProMed Peds. 269 552-2500.  For more information regarding sleep habits, bedtime routines or sleep problems, please call for an appointment.

Resources:  Mindell, JA & Owens JA (2003). A Clinical Guide to Pediatric Sleep: Diagnosis and Management of Sleep Problems. Phildelphia: Lippencott Williams & Wilkins. 

Obesity is an excessive amount of body weight in relation to a person’s height.  In children over two years of age, this can be measured by calculating their Body Mass Index (BMI).  BMI is calculated from the child’s weight and height.  It is a reliable indicator of body fat for most children and adolescents.  BMI should be assessed at every well child exam.  Once the BMI is defined, it can be plotted on a chart from the Centers for Disease Control (CDC), BMI-for-Age Growth Chart for Boys/Girls, to obtain a percentile ranking.  Children and adolescents with a BMI between 85% and 95% are considered overweight.  Those with a BMI greater than 95% are considered obese.

Why is this important?

It is important to monitor BMI because it is the best way to measure obesity on a large scale.  Children with elevated BMI levels are at risk for many health problems including:  asthma, sleep apnea, skin infections, joint pain, hypertension (elevated blood pressure), high cholesterol and type 2 diabetes.  Research has also indicated that obese children have lower self-esteem and self-confidence that has been linked to poor academic performance, fewer friends and depression.  For all these reasons, it is important to try and prevent childhood obesity and identify overweight and obese children quickly so they can begin lifestyle changes to maintain a healthy weight.

How big of a deal is it?

According to the CDC, approximately 17% of children and adolescents age two to 19 years old are obese.  One in three children from low-income families is overweight or obese by their fifth birthday.  Since 1980, obesity among children has almost tripled.

So what can we do?

Here are some easy changes that can be made at home to decrease obesity in your household:

• Eat five fruits or vegetables each day
• One hour of activity daily—does not have to be consecutive
• No more than two hours per day in front of the TV/computer/video games/phone
• Eat a healthy breakfast daily
• Limit pop to one can or glass a week
• Limit juice to one 6-8 oz. glass of 100% juice a day
• Fast food less than one time per week
• Limit sugar sweetened beverages
• Use only low fat dairy products
• Prepare food at home as a family and eat together at the table (without TV)
• Eat a diet rich in calcium and fiber
• Breastfeed exclusively until six months and maintain breastfeeding until 12 months of age

Choose one, two or three of these goals to work on as a family, once those have become routine, start on another goal to create a healthy lifestyle for the entire family.

Here are some frequently asked questions and links to resources:

Can you give me some meal suggestions that are tasty, convenient, and nutritious for my children?

http://www.aap.org/publiced/BR_WhatsToEat.htm

Feeding my child is very difficult. How can I make mealtimes less of a hassle?

http://www.aap.org/publiced/BR_FeedingKidsRight.htm

How do I know if my child is eating enough?

http://www.aap.org/publiced/BR_NutritionABC.htm

Resources:

http://www.aap.org/obesity/

http://www.aap.org/obesity/families_at_home.html?technology=1

This blog is presented by Megan Foley RN, CPNP. Please call Richland ProMed at 552-2500 to schedule an appointment to discuss obesity further with Megan Foley or one of the other providers.

In the U.S., more than 200,000 people every year are hospitalized with flu-related complications, and thousands die. While 90 percent of those who die from influenza are over 65, the flu still poses a serious health threat to kids. From September 2010 through August 2011, there were 115 deaths in children under age 18 due to confirmed influenza. Almost half of those kids were under the age of 5 and had no underlying illnesses or risk factors.

The flu season typically hits our area from November to March (peaking in January and February). The virus is spread mainly through tiny droplets (which become airborne when someone with the flu coughs, sneezes or talks). It’s possible to spread the flu before you know you’re sick. In fact, influenza is contagious one day before symptoms appear until five to seven days after becoming ill. Common symptoms of the flu include:

• Fever (unusually high) and chills
• Headache
• Sore throat
• Cough
• Runny or stuffy nose
• Extreme tiredness
• Nausea and vomiting (more likely in children)

Protection From Infection

Believe it or not, influenza has already been seen in Michigan—so put a flu shot on your to-do list today. The best way to protect yourself and your entire family from infection is to get the proper vaccination. The Centers for Disease Control and Prevention (CDC) recommends that everyone over the age of 6-months-old receives an annual flu vaccination. Getting vaccinated now will allow time for full immunity to develop before the flu season peaks. (Note: There is a small group of people who should not be vaccinated. Talk to your doctor before scheduling a flu shot to make sure you’re not in that group.)

This season’s vaccine protects against three flu strains: two influenza A (H1N1 and H3N2) and a strain of influenza B. There are three types of vaccines available:

• The traditional shot—approved for people 6 months and older. Containing killed viruses, the traditional shot sometimes causes soreness, redness or swelling (where the shot was given) and flu-like symptoms. Remember, these side effects are temporary and mild compared to suffering from a real bout with the flu. When given during pregnancy, the traditional vaccine protects the baby until 6 months of age, when the child can receive the shot.
• The nasal spray—approved for ages 2 to 49-years-old. While the nasal spray contains weakened viruses, it does not cause the flu. Mild and temporary side effects may include runny nose or nasal congestion, cough, fever, headache, muscle aches, abdominal pain and vomiting or diarrhea.
• The intradermal shot—approved for people 18 years and older. The intradermal flu vaccine is a shot that is injected into the skin instead of the muscle. A stronger dose is available for people over 65.

Along with vaccination, following these tips can also help you and those you love stay healthy throughout the flu season:

1. Sing “happy birthday” a lot. Washing your hands frequently with soap and water for at least 20 seconds (about the time it takes to sing “happy birthday”) reduces the spread of germs. 
2. Practice sneezing and coughing etiquette. To avoid spreading germs, cover your nose and mouth with a tissue or shirtsleeve when sneezing or coughing.
3. Keep it clean. Keep kitchen counters, bedside tables, bathroom surfaces and toys clean with a household disinfectant.
4. Schedule a sick day. If it’s at all possible, stay home from work (or school) if you have the flu.
5. You are what you eat. Eat a healthy, well-balanced diet rich in vitamins A, C and E. Foods that can boost the immune system include milk, eggs, citrus fruits, vegetables and nuts.
6. Get your z’s. Without proper sleep, you increase your odds of getting sick. Adults need at least seven hours of sleep per night (children need more).
7. Just relax. Find ways to reduce stress, including exercising, listening to music, practicing yoga, meditating or reading.
8. Kick the smoking habit. Smoking kills the fibers in your nose and lungs that help prevent mucus from clogging these airways. Breathing secondhand smoke is also unhealthy for those around you, particularly children.

About Medication

For the very ill or those at higher risk for complications, medications are available to relieve flu symptoms. Those who should seek treatment include:

• Children under 5 (especially under 2)
• People over 65
• Pregnant women and women who have recently given birth
• People with chronic conditions like asthma, or heart, lung or kidney disease
• People with weakened immune systems (such as those with cancer, diabetes, chronic infections and individuals on continued steroid therapy)
• People under 19-years-old who are on long-term aspirin therapy 

Medications, which work best if started within 48 hours of the start of symptoms, may shorten the time you are sick and can prevent complications. Side effects may include nausea and vomiting, and in children, confusion and abnormal behavior.

Lisa Kanwischer, P.A., is a certified physician assistant at ProMed Pediatrics.  For an appointment or more information, call ProMed Pediatrics in Richland at (269) 552.2500 or the Woodbridge location in Portage at (269)329-0944.