Healthy Tips

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Sun Safety

What's the best way to protect my child in the sun? Follow these simple rules to protect your family from sunburns now and from skin cancer later in life.

  • Keep babies younger than 6 months out of direct sunlight. Find shade under a tree, umbrella or the stroller canopy.
  • When possible, dress yourself and your kids in cool, comfortable clothing that covers the body, like lightweight cotton pants, long-sleeved shirts, and hats.
  • Select clothes made with a tight weave – they protect better than clothes with a looser weave. If you’re not sure how tight a fabric’s weave is, hold it up to see how much light shines through. The less light, the better.
  • Wear a hat or cap with a brim that faces forward to shield the face.
  • Limit your sun exposure between 10:00 a.m. and 4:00 p.m., when UV rays are strongest.
  • Wear sunglasses with at least 99% UV protection (look for child-sized sunglasses with UV protection for your child).
  • Use sunscreen.
  • Set a good example. You can be the best teacher by practicing sun protection yourself. Teach all members of your family how to protect their skin and eyes.

Sunscreen
Sunscreen can help protect the skin from sunburn and some skin cancers, but only if used correctly. Keep in mind that sunscreen should be used for sun protection, not as a reason to stay in the sun longer.

How to Pick Sunscreen

  • Use a sunscreen that says “broad-spectrum” on the label – that means it will screen out both UVB and UVA rays.
  • Use a sunscreen with an SPF (sun protection factor) of at least 15. The higher the SPF, the more UVB protection the sunscreen has.
  • Look for the new UVA “star” rating system on the label.
    • One star is low UVA protection.
    • Two stars is medium protection.
    • Three stars is high protection.
    • Four stars is the highest UVA protection available in an over-the-counter sunscreen product.
  • For sensitive areas of the body, such as the nose, cheeks, tops of the ears, and the shoulders, choose a sunscreen or sunblock with zinc oxide or titanium dioxide. While these products usually stay visible on the skin even after you rub them in, some now come in fun colors that kids enjoy.

Sunscreen for Babies

  • For babies younger than 6 months: Use sunscreen on small areas of the body, such as the face and the backs of the hands, if protective clothing and shade are not available.
  • For babies older than 6 months: Apply to all areas of the body, but be careful around the eyes. If your baby rubs sunscreen into her eyes, wipe the eyes and hands clean with a damp cloth. If the sunscreen irritates her skin, try a different brand or try a sunscreen stick or sunscreen or sunblock with titanium dioxide or zinc oxide. If a rash develops, talk with your child’s doctor.

How to Apply Sunscreen

  • Use enough sunscreen to cover all exposed areas, especially the face, nose, ears, feet and hands and even the backs of the knees. Rub it in well.
  • Apply sunscreen 15 to 30 minutes before going outdoors to give time for the sunscreen to bind and absorb into to the skin.
  • Use sunscreen any time you or your child might sunburn. Remember that you can get sunburn even on cloudy days. Also, UV rays can bounce back from water, sand, snow, and concrete so make sure you’re protected.
  • Reapply sunscreen every 2 hours. Sunscreen wears off after swimming, sweating, or just from soaking into the skin.

Last Updated: 5/11/2013

AAP Issues Advice on Managing Fevers in Children

A fever in a child can be worrying to parents and is one of the most common reasons parents seek a pediatrician's care. To help pediatricians educate parents and families about fever and "fever phobia," the American Academy of Pediatrics (AAP) has issued a clinical report, "Fever and Antipyretic Use in Children," published in the March 2011 print issue of Pediatrics (published online Feb. 28).

Fever is a physiological mechanism that has beneficial effects in fighting infection. Although many parents administer antipyretics (medications to reduce a fever), such as acetaminophen or ibuprofen, to a child to reduce a fever, the report emphasizes that the primary goal should be to help the child feel more comfortable, rather than to maintain a "normal" temperature.

Parents should focus on the general well-being of the child, his/her activity, observing the child for signs of serious illness and maintaining appropriate fluid intake. Parents should not wake up a sleeping child to administer a fever-reducer.

Antipyretics must be stored safely to avoid accidental ingestions. Parents should be aware that the correct dosage is based on the child's weight, and that an accurate measuring device should always be used.

While there is some evidence that combination therapy (alternating doses of ibuprofen and acetaminophen) may be more effective at lowering body temperature, questions remain about whether it is safe and whether it helps children feel more comfortable. Combination therapy also increases the risk of inaccurate dosing.

Check the dosage sheets under the Patient Info menu to make sure you are dosing the medications correctly.

The Flu

Flu is the short term for influenza. It is an illness caused by a respiratory virus. Influenza epidemics often occur in the winter months, although the flu season extends from the beginning of October through March. The infection can spread rapidly through communities as the virus is passed from person to person. When someone with the flu coughs or sneezes, the influenza virus gets into the air, and people nearby, including children, can inhale it. The virus also can be spread when your child touches a hard surface, such as a door handle, and then places his hand or fingers in his nose or rubs his eye.

When there is an outbreak or epidemic, usually during the winter months, the illness tends to be most pronounced in preschool or school-age children. Adult caregivers are easily exposed and can contract the disease. The virus usually is transmitted in the first several days of the illness.

You can suspect that your child has the flu if you observe the following signs or symptoms:

  • Sudden onset of fever (usually above 101 degrees Fahrenheit, or 38.3 degrees Celsius)
  • Chills and shakes accompanying the fever
  • Extreme tiredness or fatigue
  • Muscle aches and pains
  • Dry, hacking cough

After the first few days of these symptoms, a sore throat, stuffy nose, and continuing cough become most evident. The flu can last a week or even longer. A child with a common cold usually has a lower fever, a runny nose, and only a small amount of coughing. Children with the flu – or adults, for that matter – usually feel much sicker, more achy, and more miserable.

Healthy people, especially children, get over the flu in about a week or two, without any lingering problems. However, you might suspect a complication if your child says that his ear hurts or that he feels congested in his face and head or if his cough and fever persist.

Children who appear to have the greatest risk of complications from the flu are those with an underlying chronic medical condition, such as heart or lung disease, an immune problem, some blood diseases, or malignancy. As these children may have more severe disease or complications, they should, when possible, be kept away from children with the flu. Their pediatrician may suggest additional precautions that should be taken. If your child has flulike symptoms along with any difficulty breathing, seek medical attention right away.

Treatment
For all children with the flu who don’t feel well, lots of tender loving care is in order. Children can benefit from extra bed rest, extra fluids, and light, easy- to-digest meals. A cool mist humidifier or vaporizer in the room may add additional moisture to the air and make breathing through inflamed mucous membranes of the nose a little easier.

If your child is uncomfortable because of a fever, acetaminophen or ibuprofen in doses recommended by your pediatrician for his age and weight will help him feel better.

Ibuprofen is approved for use in children 6 months of age and older; however, it should never be given to children who are dehydrated or who are vomiting continuously.

It is extremely important not to give aspirin to a child who has the flu or is suspected of having the flu. Aspirin during bouts of influenza is associated with an increased risk of developing Reye syndrome.

Prevention
Since the flu virus is transmitted from person to person, a first step you can take to decrease the chances of family members getting the flu is to practice and teach good hygiene such as frequent hand- washing. If, for example, you have a child with the flu, do the following to prevent its spread:

  • Avoid kissing your infected child on or around the mouth, although he will need plenty of hugs during the illness.
  • Teach your child to cough or sneeze into a tissue or his arm, and if a tissue is used, make certain it is disposed of properly.
  • Make sure you and other caregivers wash hands both before and after caring for your child.
  • Wash your child’s utensils in hot, soapy water or in the dishwasher.
  • Don’t allow others to share drinking glasses or utensils, and never share toothbrushes.
  • Use disposable paper cups in the bathroom and kitchen.
  • Talk with your physician about giving antiviral medication to other household members over one year of age to prevent them from contracting the flu.

There is a vaccine to protect against the flu. The American Academy of Pediatrics recommends that the influenza vaccination be given annually to all healthy children starting at six months of age. Flu vaccines are especially important for children at high risk for complications from the flu such as those with a chronic disease such as asthma. If a child younger than 9 years old is being vaccinated for influenza for the first time, or only received one dose for the first time last flu season, he should be given two doses of the vaccine at least four weeks apart. Adults who live in the same household as someone who has a high risk for flu complications or who care for children under the age of five years should receive the flu vaccine yearly. The flu vaccine also can be given to any child whose parent requests it, although it is not approved for use in infants younger than 6 months old.

A nasal flu vaccine is also available for healthy children at least 2 years old. There is no needle involved, it is simply sprayed into the nose, and is as effective as the flu injection. The flu vaccine has few side effects. However, all flu vaccines are produced using eggs, so anyone who has an egg allergy should speak to their pediatrician or allergist about whether or not they should receive the flu vaccine. If a child or an adult has had a serious allergic reaction to eggs or egg products, you should discuss this with your pediatrician.

Antiviral medications to treat an influenza infection are now available by prescription. Such treatments must be initiated within 48 hours of the beginning of illness. Also, for chronically ill children, preventing influenza is important. If the child has not been immunized, using antiviral medication before the exposed child gets the disease can reduce the risk of infection.

Picky Eaters

Although toddlers are beginning to develop food preferences, they also can be unpredictable about what they may want for a particular meal on a specific day. Their favorite food one day will end up being thrown on the floor the next. The food that they had spit out, day after day, will unexpectedly turn into the one they can’t get enough of.

Picky eating is often the norm for toddlers. For weeks, they may eat 1 or 2 preferred foods – and nothing else. They may eat a big breakfast or lunch and then show no interest in eating much of anything else the rest of the day. Don’t become exasperated with this kind of behavior. Just make healthy food choices available to your youngster, and acknowledge that his appetite or food preferences today may be quite different than yesterday’s or tomorrow’s. That’s just the way toddlers are.

With time, your child’s appetite and eating behaviors will reach some equilibrium. He’ll find something he likes in a variety of healthy foods without much or any prompting from you. In the meantime, try dealing with picky eaters by giving them finger foods or table foods that they can feed to themselves. Just make sure these are healthy food choices such as slices of banana or small pieces of toast. Also avoid finger foods that could cause choking. Children don’t fully develop the grinding motion involved in chewing until they’re about 4 years old, so stick with foods that are small and easy to chew and avoid those that might be swallowed whole and get stuck in your toddler’s windpipe.

That means avoiding:

  • raw carrots
  • large sections of hot dogs
  • raw celery
  • raw cherries with pits
  • whole grapes
  • round, hard candy
  • peanuts and other nuts

Even when your toddler is feeding himself, it’s a good idea to sit with him while he eats. He’s also old enough to join the rest of the family in eating at the dinner table. Use these family meals to model the healthy eating that you want your child to adopt for the rest of his life.

TV Viewing Habits

The following are ways you can help your children develop positive viewing habits:

  1. Set limits. Limit your children's use of TV, movies, and video and computer games to no more than 1 or 2 hours per day. Do not let your children watch TV while doing homework. Do not put a TV in your children's bedrooms.
  2. Plan what to watch. Instead of flipping through channels, use a program guide and the TV ratings to help you and your children choose which shows to watch. Turn the TV on to watch the program, and turn it off when it is over.
  3. Watch TV with your children. Whenever possible, watch TV with your children and talk about what they see. If your children are very young, they may not be able to tell the difference between a show, a commercial, a cartoon or real life. Be especially careful of "reality-based" programs. Most of these shows are not appropriate for children.
  4. Find the right message. Some TV programs show people as stereotypes. If you see this, talk with your children about the real-life roles of women, the elderly, and people of other races.
  5. Help your children resist commercials. When your children ask for things they see on TV, explain that the purpose of commercials is to make people want things they may not need.
  6. Look for quality children's videos and DVDs. There are many quality videos and DVDs available for children. Check reviews before buying or renting programs or movies.
  7. Give other options. Watching TV can become a habit for your children. Help them find other things to do like playing; reading; learning a hobby, a sport, an instrument, or an art; or spending time with family, friends, or neighbors.
  8. Set a good example. As a role model, limiting your own TV viewing and choosing programs carefully will help your children do the same.
  9. Express your views. When you like or do not like something you see on TV, make yourself heard. Stations, networks and sponsors pay attention to letters from the public. If you think a commercial is misleading or inappropriately targeting children, write down the product name, channel, and time you saw the commercial and describe your concerns.
  10. Get more information. The following resources can provide you with more information about the proper role of TV in your children's lives:
    • Public service groups publish newsletters that review programs and give tips on how to make TV safe for you and your child.
    • You can ask the parent organization at your child's school.
    • Parents of your child's friends and classmates can also be helpful. Talk with other parents and agree to enforce similar rules about TV viewing.

The Flu (Seasonal Influenza)

What is the flu?
The influenza (flu) virus causes serious illness that may result in hospitalization or death. It mostly affects the breathing system, but may also affect the whole body. The flu season usually starts in the fall and ends in the spring.

People can get the flu many times in their lives. Flu viruses are always changing over time and from year to year. Three seasonal flu viruses are expected to make children sick again this flu season.

Signs of the Flu
All flu viruses cause a respiratory illness that can last a week or more. Flu symptoms include

  • A sudden fever (usually above 101°F or 38.3°C)
  • Chills and body shakes
  • Headache, body aches, and being a lot more tired than usual
  • Sore throat
  • Dry, hacking cough
  • Stuffy, runny nose

Some children may throw up (vomit) and have loose stools (diarrhea). Talk with your child’s doctor if your child has ear pain, a cough that won’t go away, or a fever that won’t go away. There can be serious complications, even death, from the flu, but these are uncommon.

How to Prevent the Flu

Get the flu vaccine every year!
Safe vaccines are made each year to protect against the flu. This year’s flu vaccine protects against the same 3 strains of influenza virus in last year’s vaccine. These are:

  • Influenza A (H3N2)
  • Influenza A (H1N1)
  • Influenza B

The number of vaccine doses your child needs this year depends on his age at the time the first dose is given and his flu vaccine history.

  • Children 6 months through 8 years of age should get 2 doses if they did not get a flu vaccine last year and 1 dose if they did.
  • Children 9 years and older need only 1 dose.

Everyone should get the flu vaccine each year to update their protection because

  • Protection from the flu vaccine lasts for about 6 to 12 months.
  • The virus strains in the vaccine may change, so your protection usually needs updating.

Who should get which flu vaccine?

There are 2 types of flu vaccine:

  • Trivalent inactivated influenza vaccine (TIV) is given as a shot. There are 2 kinds of shots. The intramuscular (into the muscle) shot is licensed and recommended for children 6 months and older and adults, including people with and without chronic medical conditions. The new intradermal (into the skin) shot has been licensed for the 2011–2012 season to use in people 18 through 64 years of age.
  • Vaccination is especially important for people at higher risk of getting severely ill from the flu and their close contacts, the close contacts of healthy children younger than 5 years, all health care personnel, and all pregnant (or postpartum) women.

  • Live-attenuated influenza vaccine (LAIV) is sprayed into the nose. LAIV is recommended for healthy children 2 years and older.

Both types of flu vaccine are very safe and work well to protect your child from the flu. Check with your doctor about which is best for your child and family.

Are there side effects of the flu vaccine?
There are very few side effects of the flu vaccine. The area where the TIV flu shot is given may be sore for a day or two. Fever may occur within 24 hours after in about 10% to 35% of children younger than 2 years but rarely in older children and adults.

Because LAIV is sprayed into the nose, your child might get a stuffy, runny nose within the first few days. LAIV may produce mild symptoms, including rhinitis, headache, wheezing, vomiting, muscle aches, and fever.

You or your children will not get the flu from the vaccine. It takes 2 weeks for the vaccine to start working, so people can catch the flu before they are protected.

Is the flu vaccine safe for children with egg allergies?
In the past, children with egg allergies were not recommended to get the flu vaccine because they might have a reaction. There is now enough scientific information to show that influenza vaccine given in a single, age-appropriate dose is well received by nearly all children and adults who have egg allergy. Check with your doctor if you have any questions.

  • Children with a history of mild egg allergy (hives) can get the flu vaccine safely at their doctor’s office.
  • Children with a history of severe egg allergy should have their doctor consult with their allergist before getting the flu vaccine.

When should my child get the flu vaccine?
The best time to get the flu vaccine is the early fall or as soon as it is available in your community. If your child does not get the flu vaccine right away, it is still important to get it anytime. The flu virus infects people in the fall, winter, and well into the spring each year. Your child can still be protected if she gets a flu vaccine as late as March, April or May. Ask your doctor if you have any questions about the flu vaccine.

Keep Flu Germs from spreading
The flu virus spreads easily through the air with coughing and sneezing, and through touching things like doorknobs or toys and then touching your eyes, nose, or mouth. Here are some tips that will help protect your family from getting sick.

  1. Everyone should wash their hands often. You can use soap and warm water for at least 20 seconds. That is about as long as singing the “Happy Birthday” song 2 times. And an alcohol-based hand cleanser or sanitizer works well too. Put enough on your hands to make them all wet, then rub them together until dry.
  2. Teach your child to cover his mouth and nose when coughing or sneezing. Show your child how to cough into the elbow or upper sleeve (not a hand) or use a tissue.
  3. Throw all tissues used for runny noses and sneezes in the trash right away.
  4. Wash dishes and utensils in hot, soapy water or the dishwasher.
  5. Don’t let children share pacifiers, cups, spoons, forks, washcloths, or towels without washing. Never share toothbrushes.
  6. Teach your child to try not to touch her eyes, nose, or mouth.
  7. Wash doorknobs, toilet handles, countertops, and even toys. Use a disinfectant wipe or a cloth with soap and hot water. (A disinfectant is a cleaner that kills germs.)

What if my child gets the flu?
Call the doctor right away if your child shows any signs of the flu and

  • is 3 months or younger and has a fever
  • has fast breathing or trouble breathing
  • looks very sick
  • is more sleepy than usual
  • is very fussy no matter what you do
  • cannot or will not drink anything
  • urinates (pees) very little

You should also call the doctor if your child shows signs of the flu and has a chronic medical condition, like:

  • Asthma, diabetes or heart problems
  • Sickle cell disease, cancerHIV or another disease that makes it hard to fight infections
  • Cerebral palsy or other nerve disorders of the brain and muscles that make it harder to cough up mucus and breathe
  • Morbid obesity (being very overweight)

Go to the emergency department right away if your child

  • has signs of the flu that keep getting worse
  • has blue skin color
  • will not wake up at all

Drugs to Treat the Flu
The doctor may be able to treat the flu with an antiviral medicine. These drugs work best if your child gets them within the first 1 to 2 days of showing signs of the flu.

Call the doctor within 24 hours to ask about antiviral drugs if your child is at high risk of influenza complications because he

  • has any serious health problem like asthma, diabetes, sickle cell disease, or cerebral palsy
  • is younger than 2 years, but especially if younger than 6 months (Young children are at an increased risk of influenza infection, hospitalization, and complications.)

Help Your Child Feel Better
Extra rest and a lot of fluids can help your child feel better. You can also give your child medicine to bring down the fever.

  • For a baby 6 months or younger, give acetaminophen. Tylenol is one brand of acetaminophen.
  • For a child older than 6 months, give either acetaminophen or ibuprofen. Advil and Motrin are brands of ibuprofen.
  • Never give any child aspirin. Aspirin puts the child at risk for Reye syndrome, a serious illness that affects the liver and brain.

Keep Your Child Home
Keep your child home from school or child care when she has a fever and other signs of the flu. Your child needs rest. Also, your child can give the flu to other children.

When can my child go back to school or child care?
Your child should stay home at least 24 hours after his fever is gone. Start counting time after you stop giving your child fever medicines like acetaminophen or ibuprofen. A temperature of 100.4°F (38°C) or higher is a sign of fever. Check with your child’s school or child care center to find out its rules about children staying home when they are ill.

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Cold

Children tend to have more colds than any other illness. In fact, children in daycare facilities or those with school-age siblings may have more colds. This is because colds are typically spread easily among children who are in close contact with one another. The good news is that most colds clear up within a week or two.

Colds are caused by viruses, which can easily spread from one person to another through a sneeze or cough.

Symptoms:

  • Sneezing
  • Runny or stuffy nose
  • Mild fever
  • Decreased appetite
  • Cough
  • Sore throat (in some cases difficulty swallowing)
  • Headache
  • Muscle aches

Treatment
There is no cure for the common cold. Give your child plenty of fluids and make sure they get extra rest. If your child has a cold without any complications, it should clear up within seven to ten days.

Acetaminophen or ibuprofen can relieve symptoms, such as fever, headache or muscle aches. Be sure to give your child the correct dosage based on their age or weight. Over the counter cold and cough medicines should never be given to infants and children under 2 years old. They could potentially experience life-threatening side effects. In fact, several studies indicate that over the counter cough and cold medicines do not relieve symptoms in children younger than 6.

Practicing simple methods at home can alleviate cold symptoms and make your child more comfortable. Saltwater or saline drops can ease nasal congestion. Fortunately, these can be purchased at your local pharmacy without a prescription. A cool-mist humidifier can also relieve congestion. Children older than three can be given hard candy or cough drops to ease a sore throat. Heating pads or a warm bath can alleviate aches and pains. And if your child is having trouble breathing, the steam from a hot shower can make breathing easier.

When to Call the Doctor
If your infant is three months old or younger, contact their pediatrician when they first begin to experience cold symptoms. With babies, symptoms can be misleading. Colds can rapidly develop into more serious illnesses, such as pneumonia or croup.

If your child is older than 3 months, contact their pediatrician if:

  • they have a fever over 102 degrees
  • their lips or nails turn blue
  • their cough persists beyond a week
  • they are breathing fast or having trouble breathing

The pediatrician may request you bring your child in for an appointment or that you monitor symptoms closely and contact the office if he or she does not get better each day and is not completely better within a week.

The Flu (Seasonal Influenza)

What is the flu?
The influenza (flu) virus causes serious illness that may result in hospitalization or death. It mostly affects the breathing system, but may also affect the whole body. The flu season usually starts in the fall and ends in the spring.

People can get the flu many times in their lives. Flu viruses are always changing over time and from year to year. Three seasonal flu viruses are expected to make children sick again this flu season.

Signs of the Flu
All flu viruses cause a respiratory illness that can last a week or more. Flu symptoms include

  • A sudden fever (usually above 101°F or 38.3°C)
  • Chills and body shakes
  • Headache, body aches, and being a lot more tired than usual
  • Sore throat
  • Dry, hacking cough
  • Stuffy, runny nose

Some children may throw up (vomit) and have loose stools (diarrhea). Talk with your child’s doctor if your child has ear pain, a cough that won’t go away, or a fever that won’t go away. There can be serious complications, even death, from the flu, but these are uncommon.

How to Prevent the Flu

Get the flu vaccine every year!
Safe vaccines are made each year to protect against the flu. This year’s flu vaccine protects against the same 3 strains of influenza virus in last year’s vaccine. These are:

  • Influenza A (H3N2)
  • Influenza A (H1N1)
  • Influenza B

The number of vaccine doses your child needs this year depends on his age at the time the first dose is given and his flu vaccine history.

  • Children 6 months through 8 years of age should get 2 doses if they did not get a flu vaccine last year and 1 dose if they did.
  • Children 9 years and older need only 1 dose.

Everyone should get the flu vaccine each year to update their protection because

  • Protection from the flu vaccine lasts for about 6 to 12 months.
  • The virus strains in the vaccine may change, so your protection usually needs updating.

Who should get which flu vaccine?

There are 2 types of flu vaccine:

  • Trivalent inactivated influenza vaccine (TIV) is given as a shot. There are 2 kinds of shots. The intramuscular (into the muscle) shot is licensed and recommended for children 6 months and older and adults, including people with and without chronic medical conditions. The new intradermal (into the skin) shot has been licensed for the 2011–2012 season to use in people 18 through 64 years of age.
  • Vaccination is especially important for people at higher risk of getting severely ill from the flu and their close contacts, the close contacts of healthy children younger than 5 years, all health care personnel, and all pregnant (or postpartum) women.

  • Live-attenuated influenza vaccine (LAIV) is sprayed into the nose. LAIV is recommended for healthy children 2 years and older.

Both types of flu vaccine are very safe and work well to protect your child from the flu. Check with your doctor about which is best for your child and family.

Are there side effects of the flu vaccine?
There are very few side effects of the flu vaccine. The area where the TIV flu shot is given may be sore for a day or two. Fever may occur within 24 hours after in about 10% to 35% of children younger than 2 years but rarely in older children and adults.

Because LAIV is sprayed into the nose, your child might get a stuffy, runny nose within the first few days. LAIV may produce mild symptoms, including rhinitis, headache, wheezing, vomiting, muscle aches, and fever.

You or your children will not get the flu from the vaccine. It takes 2 weeks for the vaccine to start working, so people can catch the flu before they are protected.

Is the flu vaccine safe for children with egg allergies?
In the past, children with egg allergies were not recommended to get the flu vaccine because they might have a reaction. There is now enough scientific information to show that influenza vaccine given in a single, age-appropriate dose is well received by nearly all children and adults who have egg allergy. Check with your doctor if you have any questions.

  • Children with a history of mild egg allergy (hives) can get the flu vaccine safely at their doctor’s office.
  • Children with a history of severe egg allergy should have their doctor consult with their allergist before getting the flu vaccine.

When should my child get the flu vaccine?
The best time to get the flu vaccine is the early fall or as soon as it is available in your community. If your child does not get the flu vaccine right away, it is still important to get it anytime. The flu virus infects people in the fall, winter, and well into the spring each year. Your child can still be protected if she gets a flu vaccine as late as March, April or May. Ask your doctor if you have any questions about the flu vaccine.

Keep Flu Germs from spreading
The flu virus spreads easily through the air with coughing and sneezing, and through touching things like doorknobs or toys and then touching your eyes, nose, or mouth. Here are some tips that will help protect your family from getting sick.

  1. Everyone should wash their hands often. You can use soap and warm water for at least 20 seconds. That is about as long as singing the “Happy Birthday” song 2 times. And an alcohol-based hand cleanser or sanitizer works well too. Put enough on your hands to make them all wet, then rub them together until dry.
  2. Teach your child to cover his mouth and nose when coughing or sneezing. Show your child how to cough into the elbow or upper sleeve (not a hand) or use a tissue.
  3. Throw all tissues used for runny noses and sneezes in the trash right away.
  4. Wash dishes and utensils in hot, soapy water or the dishwasher.
  5. Don’t let children share pacifiers, cups, spoons, forks, washcloths, or towels without washing. Never share toothbrushes.
  6. Teach your child to try not to touch her eyes, nose, or mouth.
  7. Wash doorknobs, toilet handles, countertops, and even toys. Use a disinfectant wipe or a cloth with soap and hot water. (A disinfectant is a cleaner that kills germs.)

What if my child gets the flu?
Call the doctor right away if your child shows any signs of the flu and

  • is 3 months or younger and has a fever
  • has fast breathing or trouble breathing
  • looks very sick
  • is more sleepy than usual
  • is very fussy no matter what you do
  • cannot or will not drink anything
  • urinates (pees) very little

You should also call the doctor if your child shows signs of the flu and has a chronic medical condition, like:

  • Asthma, diabetes or heart problems
  • Sickle cell disease, cancerHIV or another disease that makes it hard to fight infections
  • Cerebral palsy or other nerve disorders of the brain and muscles that make it harder to cough up mucus and breathe
  • Morbid obesity (being very overweight)

Go to the emergency department right away if your child

  • has signs of the flu that keep getting worse
  • has blue skin color
  • will not wake up at all

Drugs to Treat the Flu
The doctor may be able to treat the flu with an antiviral medicine. These drugs work best if your child gets them within the first 1 to 2 days of showing signs of the flu.

Call the doctor within 24 hours to ask about antiviral drugs if your child is at high risk of influenza complications because he

  • has any serious health problem like asthma, diabetes, sickle cell disease, or cerebral palsy
  • is younger than 2 years, but especially if younger than 6 months (Young children are at an increased risk of influenza infection, hospitalization, and complications.)

Help Your Child Feel Better
Extra rest and a lot of fluids can help your child feel better. You can also give your child medicine to bring down the fever.

  • For a baby 6 months or younger, give acetaminophen. Tylenol is one brand of acetaminophen.
  • For a child older than 6 months, give either acetaminophen or ibuprofen. Advil and Motrin are brands of ibuprofen.
  • Never give any child aspirin. Aspirin puts the child at risk for Reye syndrome, a serious illness that affects the liver and brain.

Keep Your Child Home
Keep your child home from school or child care when she has a fever and other signs of the flu. Your child needs rest. Also, your child can give the flu to other children.

When can my child go back to school or child care?
Your child should stay home at least 24 hours after his fever is gone. Start counting time after you stop giving your child fever medicines like acetaminophen or ibuprofen. A temperature of 100.4°F (38°C) or higher is a sign of fever. Check with your child’s school or child care center to find out its rules about children staying home when they are ill.

A great resource for books is available on the International Children's Digital Library website! Digital books are available for download in many languages, and they are free! Visit www.childrenslibrary.org or just google International Children's Digital Library.

Cold

Children tend to have more colds than any other illness. In fact, children in daycare facilities or those with school-age siblings may have more colds. This is because colds are typically spread easily among children who are in close contact with one another. The good news is that most colds clear up within a week or two.

Colds are caused by viruses, which can easily spread from one person to another through a sneeze or cough.

Symptoms:

  • Sneezing
  • Runny or stuffy nose
  • Mild fever
  • Decreased appetite
  • Cough
  • Sore throat (in some cases difficulty swallowing)
  • Headache
  • Muscle aches

Treatment
There is no cure for the common cold. Give your child plenty of fluids and make sure they get extra rest. If your child has a cold without any complications, it should clear up within seven to ten days.

Acetaminophen or ibuprofen can relieve symptoms, such as fever, headache or muscle aches. Be sure to give your child the correct dosage based on their age or weight. Over the counter cold and cough medicines should never be given to infants and children under 2 years old. They could potentially experience life-threatening side effects. In fact, several studies indicate that over the counter cough and cold medicines do not relieve symptoms in children younger than 6.

Practicing simple methods at home can alleviate cold symptoms and make your child more comfortable. Saltwater or saline drops can ease nasal congestion. Fortunately, these can be purchased at your local pharmacy without a prescription. A cool-mist humidifier can also relieve congestion. Children older than three can be given hard candy or cough drops to ease a sore throat. Heating pads or a warm bath can alleviate aches and pains. And if your child is having trouble breathing, the steam from a hot shower can make breathing easier.

When to Call the Doctor
If your infant is three months old or younger, contact their pediatrician when they first begin to experience cold symptoms. With babies, symptoms can be misleading. Colds can rapidly develop into more serious illnesses, such as pneumonia or croup.

If your child is older than 3 months, contact their pediatrician if:

  • they have a fever over 102 degrees
  • their lips or nails turn blue
  • their cough persists beyond a week
  • they are breathing fast or having trouble breathing

The pediatrician may request you bring your child in for an appointment or that you monitor symptoms closely and contact the office if he or she does not get better each day and is not completely better within a week.

The Flu (Seasonal Influenza)

What is the flu?
The influenza (flu) virus causes serious illness that may result in hospitalization or death. It mostly affects the breathing system, but may also affect the whole body. The flu season usually starts in the fall and ends in the spring.

People can get the flu many times in their lives. Flu viruses are always changing over time and from year to year. Three seasonal flu viruses are expected to make children sick again this flu season.

Signs of the Flu
All flu viruses cause a respiratory illness that can last a week or more. Flu symptoms include

  • A sudden fever (usually above 101°F or 38.3°C)
  • Chills and body shakes
  • Headache, body aches, and being a lot more tired than usual
  • Sore throat
  • Dry, hacking cough
  • Stuffy, runny nose

Some children may throw up (vomit) and have loose stools (diarrhea). Talk with your child’s doctor if your child has ear pain, a cough that won’t go away, or a fever that won’t go away. There can be serious complications, even death, from the flu, but these are uncommon.

How to Prevent the Flu

Get the flu vaccine every year!
Safe vaccines are made each year to protect against the flu. This year’s flu vaccine protects against the same 3 strains of influenza virus in last year’s vaccine. These are:

  • Influenza A (H3N2)
  • Influenza A (H1N1)
  • Influenza B

The number of vaccine doses your child needs this year depends on his age at the time the first dose is given and his flu vaccine history.

  • Children 6 months through 8 years of age should get 2 doses if they did not get a flu vaccine last year and 1 dose if they did.
  • Children 9 years and older need only 1 dose.

Everyone should get the flu vaccine each year to update their protection because

  • Protection from the flu vaccine lasts for about 6 to 12 months.
  • The virus strains in the vaccine may change, so your protection usually needs updating.

Who should get which flu vaccine?

There are 2 types of flu vaccine:

  • Trivalent inactivated influenza vaccine (TIV) is given as a shot. There are 2 kinds of shots. The intramuscular (into the muscle) shot is licensed and recommended for children 6 months and older and adults, including people with and without chronic medical conditions. The new intradermal (into the skin) shot has been licensed for the 2011–2012 season to use in people 18 through 64 years of age.
  • Vaccination is especially important for people at higher risk of getting severely ill from the flu and their close contacts, the close contacts of healthy children younger than 5 years, all health care personnel, and all pregnant (or postpartum) women.

  • Live-attenuated influenza vaccine (LAIV) is sprayed into the nose. LAIV is recommended for healthy children 2 years and older.

Both types of flu vaccine are very safe and work well to protect your child from the flu. Check with your doctor about which is best for your child and family.

Are there side effects of the flu vaccine?
There are very few side effects of the flu vaccine. The area where the TIV flu shot is given may be sore for a day or two. Fever may occur within 24 hours after in about 10% to 35% of children younger than 2 years but rarely in older children and adults.

Because LAIV is sprayed into the nose, your child might get a stuffy, runny nose within the first few days. LAIV may produce mild symptoms, including rhinitis, headache, wheezing, vomiting, muscle aches, and fever.

You or your children will not get the flu from the vaccine. It takes 2 weeks for the vaccine to start working, so people can catch the flu before they are protected.

Is the flu vaccine safe for children with egg allergies?
In the past, children with egg allergies were not recommended to get the flu vaccine because they might have a reaction. There is now enough scientific information to show that influenza vaccine given in a single, age-appropriate dose is well received by nearly all children and adults who have egg allergy. Check with your doctor if you have any questions.

  • Children with a history of mild egg allergy (hives) can get the flu vaccine safely at their doctor’s office.
  • Children with a history of severe egg allergy should have their doctor consult with their allergist before getting the flu vaccine.

When should my child get the flu vaccine?
The best time to get the flu vaccine is the early fall or as soon as it is available in your community. If your child does not get the flu vaccine right away, it is still important to get it anytime. The flu virus infects people in the fall, winter, and well into the spring each year. Your child can still be protected if she gets a flu vaccine as late as March, April or May. Ask your doctor if you have any questions about the flu vaccine.

Keep Flu Germs from spreading
The flu virus spreads easily through the air with coughing and sneezing, and through touching things like doorknobs or toys and then touching your eyes, nose, or mouth. Here are some tips that will help protect your family from getting sick.

  1. Everyone should wash their hands often. You can use soap and warm water for at least 20 seconds. That is about as long as singing the “Happy Birthday” song 2 times. And an alcohol-based hand cleanser or sanitizer works well too. Put enough on your hands to make them all wet, then rub them together until dry.
  2. Teach your child to cover his mouth and nose when coughing or sneezing. Show your child how to cough into the elbow or upper sleeve (not a hand) or use a tissue.
  3. Throw all tissues used for runny noses and sneezes in the trash right away.
  4. Wash dishes and utensils in hot, soapy water or the dishwasher.
  5. Don’t let children share pacifiers, cups, spoons, forks, washcloths, or towels without washing. Never share toothbrushes.
  6. Teach your child to try not to touch her eyes, nose, or mouth.
  7. Wash doorknobs, toilet handles, countertops, and even toys. Use a disinfectant wipe or a cloth with soap and hot water. (A disinfectant is a cleaner that kills germs.)

What if my child gets the flu?
Call the doctor right away if your child shows any signs of the flu and

  • is 3 months or younger and has a fever
  • has fast breathing or trouble breathing
  • looks very sick
  • is more sleepy than usual
  • is very fussy no matter what you do
  • cannot or will not drink anything
  • urinates (pees) very little

You should also call the doctor if your child shows signs of the flu and has a chronic medical condition, like:

  • Asthma, diabetes or heart problems
  • Sickle cell disease, cancerHIV or another disease that makes it hard to fight infections
  • Cerebral palsy or other nerve disorders of the brain and muscles that make it harder to cough up mucus and breathe
  • Morbid obesity (being very overweight)

Go to the emergency department right away if your child

  • has signs of the flu that keep getting worse
  • has blue skin color
  • will not wake up at all

Drugs to Treat the Flu
The doctor may be able to treat the flu with an antiviral medicine. These drugs work best if your child gets them within the first 1 to 2 days of showing signs of the flu.

Call the doctor within 24 hours to ask about antiviral drugs if your child is at high risk of influenza complications because he

  • has any serious health problem like asthma, diabetes, sickle cell disease, or cerebral palsy
  • is younger than 2 years, but especially if younger than 6 months (Young children are at an increased risk of influenza infection, hospitalization, and complications.)

Help Your Child Feel Better
Extra rest and a lot of fluids can help your child feel better. You can also give your child medicine to bring down the fever.

  • For a baby 6 months or younger, give acetaminophen. Tylenol is one brand of acetaminophen.
  • For a child older than 6 months, give either acetaminophen or ibuprofen. Advil and Motrin are brands of ibuprofen.
  • Never give any child aspirin. Aspirin puts the child at risk for Reye syndrome, a serious illness that affects the liver and brain.

Keep Your Child Home
Keep your child home from school or child care when she has a fever and other signs of the flu. Your child needs rest. Also, your child can give the flu to other children.

When can my child go back to school or child care?
Your child should stay home at least 24 hours after his fever is gone. Start counting time after you stop giving your child fever medicines like acetaminophen or ibuprofen. A temperature of 100.4°F (38°C) or higher is a sign of fever. Check with your child’s school or child care center to find out its rules about children staying home when they are ill.

A great resource for books is available on the International Children's Digital Library website! Digital books are available for download in many languages, and they are free! Visit www.childrenslibrary.org or just google International Children's Digital Library.

Cold

Children tend to have more colds than any other illness. In fact, children in daycare facilities or those with school-age siblings may have more colds. This is because colds are typically spread easily among children who are in close contact with one another. The good news is that most colds clear up within a week or two.

Colds are caused by viruses, which can easily spread from one person to another through a sneeze or cough.

Symptoms:

  • Sneezing
  • Runny or stuffy nose
  • Mild fever
  • Decreased appetite
  • Cough
  • Sore throat (in some cases difficulty swallowing)
  • Headache
  • Muscle aches

Treatment
There is no cure for the common cold. Give your child plenty of fluids and make sure they get extra rest. If your child has a cold without any complications, it should clear up within seven to ten days.

Acetaminophen or ibuprofen can relieve symptoms, such as fever, headache or muscle aches. Be sure to give your child the correct dosage based on their age or weight. Over the counter cold and cough medicines should never be given to infants and children under 2 years old. They could potentially experience life-threatening side effects. In fact, several studies indicate that over the counter cough and cold medicines do not relieve symptoms in children younger than 6.

Practicing simple methods at home can alleviate cold symptoms and make your child more comfortable. Saltwater or saline drops can ease nasal congestion. Fortunately, these can be purchased at your local pharmacy without a prescription. A cool-mist humidifier can also relieve congestion. Children older than three can be given hard candy or cough drops to ease a sore throat. Heating pads or a warm bath can alleviate aches and pains. And if your child is having trouble breathing, the steam from a hot shower can make breathing easier.

When to Call the Doctor
If your infant is three months old or younger, contact their pediatrician when they first begin to experience cold symptoms. With babies, symptoms can be misleading. Colds can rapidly develop into more serious illnesses, such as pneumonia or croup.

If your child is older than 3 months, contact their pediatrician if:

  • they have a fever over 102 degrees
  • their lips or nails turn blue
  • their cough persists beyond a week
  • they are breathing fast or having trouble breathing

The pediatrician may request you bring your child in for an appointment or that you monitor symptoms closely and contact the office if he or she does not get better each day and is not completely better within a week.