With measles, Benjamin Franklin’s old saying, “An ounce of prevention is worth a pound of cure,” holds. Unfortunately, pediatricians don’t have any medication that kills the measles virus. Children who are hospitalized are given support, but nothing to kill the germ. For instance, pediatricians may give oxygen to children with measles pneumonia. Pediatricians may also give Vitamin A to help prevent blindness from measles, but again, vitamins do not stop the germ.
Giving your child the MMR (Measles, Mumps, and Rubella) vaccine is the best and most natural method to prevent measles. Immunizations prompt a body’s own immune system to make antibodies. These “germ fighters” are ready to defend your child when a nasty virus like measles appears. Pediatricians give this vaccine according to a tried and true vaccine schedule at 12-15 months of age and again at 4-6 years of age. The recent death of an unvaccinated child from measles in Texas serves as a tragic reminder of the risks of not vaccinating.
How nasty is this virus?
Pretty nasty. About 1 in 5 people infected with measles end up in the hospital, and pneumonia strikes about 1 out of about every 20 children with measles. If you think about a classroom of children, that’s a lot of kids.
Also, with measles, Friedrich Nietzsche’s old saying, “What does not kill you makes you stronger,” does not necessarily hold. Measles can cause “immune amnesia.” This means that measles causes your body to “forget” about prior viral infections. Remember your child’s first year of daycare when they seemed to catch “everything?” Surviving measles could mean that your child can “catch everything” again. You can read more about this problem here.
For information on what symptoms to watch for, read the Children’s Hospital of Philadelphia’s recent post about measles.
For more vaccine information, please refer back to our prior post about how vaccines work.
We kicked this ugly disease out of the United States once; we can do it again!
How to talk about a school shooting with your child
This is not the first time we have published this post. Again, a school shooting happened, and you may be wondering how to explain this tragedy to your children.
Understand that your kids sense your emotions. Not telling them about an event may make them concerned that they are the cause for your worried hushed conversations. Break away from your discussion with adults to say, “Do you know what we are talking about? We are not talking about you.”
While difficult, it is possible to talk about a school shooting with your child in an age-appropriate manner.
Even though an event may be far away, media makes it seem as if it happened next door, and sooner or later your children will see or hear about it. Tell the facts in a straight forward, age appropriate manner. Answer questions and don’t be afraid to answer with an “I don’t know.”
Preschoolers are concrete in their thinking—dragons are real and live under their bed, so don’t put any there that do not exist. For a preschooler a simple “Mom is sad because a lot of people got hurt,” will suffice. Young school-aged kids will want to know more details. And be prepared to grapple with more high level questions from teens.
Look for the helpers.
Mr. Fred Rogers, who hosted Mister Roger’s Neighborhood for 30 years, tells this story about seeing scary things on the news: “My mother would say to me, ‘Look for the helpers. You will always find people who are helping.’ To this day, especially in times of ‘disaster,’ I remember my mother’s words, and I am always comforted by realizing that there are still so many helpers-so many caring people in this world.”
What if the kids ask, “Will that happen here?” or “Why did that happen?” Again, reassure in a simple, straight-forward manner. For instance, you can say, “Many people are working hard to prevent something like that here.” Consider answering the question with a question. Asking “What do you think?” will give you an idea of exactly what your child fears. You can also reach out to other family supports for help with answers. Say to your child, ”I wonder what our minister or school counselor has to say about this, let’s ask.”
More ways to help your children
Routine is reassuring to children, so turn off the background 24 hour television and internet coverage and make dinner, take them to sports activities, and get the homework done.
Give your kids something tangible to do to be helpful. Help them set up a coin donation jar at school or put aside part of their allowance for a donation.
Some children become overly anxious and fearful. If your child’s worries interfere with her ability to conduct her daily activities, such as performing at school, sleeping, eating, and maintaining strong relationships with family and friends, then seek professional help.
Parent your children so they feel secure in themselves and secure in the world around them. You may not hold the answers to why a tragedy strikes, but you do hold the ability to comfort and reassure your children.
Every parent knows the struggle of battling a cold. The battle is especially hard when the cold germs land right before a birthday party, a holiday gathering, or a family trip. Here are tips on how to treat a cold.
Understanding Colds
Colds typically last about 1-2 weeks, with the first week often being the toughest. Common symptoms include a sore throat, runny nose, cough, and general fatigue. Sometimes, colds can cause a mild fever, and in some cases, a bit of tummy trouble. While there’s no magic cure, there are plenty of ways to make your kids more comfortable.
Tips for Treating Common Cold Symptoms
Sore Throat Not every sore throat means strep throat! If your child has a sore throat along with a runny nose and cough, it’s likely part of their cold. Post nasal drip hurts. To ease the discomfort, you can give a pain reliever like acetaminophen (e.g. Tylenol) every 4 hours or ibuprofen (e.g. Motrin, Advil) every 6 hours. Read this post to learn how these medicines differ from each other. Always check the label for dosing or call your doctor if you’re unsure.
For kids over one year old, honey can be a soothing remedy. Offer a teaspoon or two on its own or mix into warm, decaffeinated tea or in warm milk. Alternatively, offer ice pops- the cold helps numb throat pain. And don’t forget hydration! Offer plenty of fluids—breast milk or formula for babies, and juice, milk, or water for older kids.
Call the pediatrician: If your child’s throat pain is severe or they aren’t drinking enough fluids to urinate at least 3-4 times in 24 hours, it’s time to reach out to their doctor.
Runny or Stuffy Nose To prevent the irritation a runny nose, apply a dab of petroleum jelly (e.g. Vasoline) under their noses.
For stuffiness, try using saline drops or saline spray to help loosen up the mucus. If your baby struggles to breathe through their nose, gently suction out the mucus with a bulb syringe. But don’t overdo it—only suction if their stuffy nose prevents them from drinking or sleeping. Older kids can take long steamy showers and babies can take an extra bath to relieve their stuffiness.
For safety reasons, avoid decongestants and cold medicines for young children. Even for older kids, cold medicine often does not work and can cause unwanted side effects. We recommend avoiding formulations with multiple ingredients-it can be confusing to keep track of what is going into your child. For example, you might give your teen a dose of acetaminophen and then find out that the multisymptom cold medicine you gave already also contains acetaminophen.
Interesting pediatric fact: nose boogers can turn from clear to white to yellow to green, all in the same cold.
Call the pediatrician: If your child’s runny nose lasts more than two weeks or your child complains about facial pain or swelling, call your child’s doctor.
Coughing Keep your child well-hydrated, and if they’re over a year old, honey can help soothe that cough. Offer 1-2 teaspoons a few times a day or mix it into a warm drink.
Create a steam-filled environment. Try running a hot shower and sitting in the bathroom with your child while they breathe in the steam. If your child has asthma, make sure to follow their asthma action plan.
It is not necessary to confine your coughing child to their bed or to the couch. Walking around encourages deeper breathing which improves lung function. Likewise, have them do deep “yoga” breathes to “pop-out” their lungs.
Call the pediatrician: Call their doctor if their cough doesn’t improve after 10-14 days. If your child is having difficulty breathing, looks pale or blue, or becomes lethargic, take them to the closest Emergency Department.
Fever Colds can cause fevers, most often in the first few days. To treat a cold with fever-related discomfort, acetaminophen or ibuprofen can help. Check out our detailed post on managing fever for more information.
Call the pediatrician: If the fever lasts more than 2-3 days, or if it goes away for a day or more and then comes back, it’s best to consult your child’s doctor. The cold may have evolved into something else like an ear infection or pneumonia. Additionally, all babies younger than two months of age should be seen by a physician for fever of 100.4 or higher as soon as you realize they have a fever.
More Tips
Watch for pain. Depending on location, pain can be a sign of a new bacterial infection on top of a cold virus. For example, ear pain can signify an ear infection, chest or shoulder pain can signify pneumonia, and pain over the face (cheeks or forehead or behind the nose) can signify a sinus infection.
Hydrate, hydrate, hydrate! Thin that mucous. Signs of dehydration include lack of tears on crying, dry mouth and lips, and as we said above, a decrease in wet diapers/frequency of urination or dark urine. If your child is not eating, they will need sugar for energy and salt to keep up their blood pressure. Vary the beverages, do not give water only. Colds are a perfect time for chicken soup.
Fresh air can work wonders, so let your child play outside or crack a window to air out the house. Going outside in the cold does not actually cause colds.
Extra story time or playtime can distract kids from feeling under the weather.
Kids can return to school once they’ve been fever-free for at least 24 hours and their symptoms are improving.
May the germs fighting with impunity fall to your child’s immunity!
Keeping the Calm: three ways to decrease your child’s anxiety
We often hear about ways to chase away anxiety such as “deep breathing” and “grounding exercises” but how do you go about teaching your child those techniques? Drs. Kardos and Lai give three short ways to instill calmness into your child’s day. You can read more about childhood anxiety in this helpful post from The Children’s Hospital of Philadelphia.
Playing in the great outdoors really is great. But when your kids scamper inside, make sure they wash their hands. Now that the winter viral season has receded, the big reason to wash hands is spring allergy season. The pollen they’ve collected on their hands will make its way to their face exacerbating already itchy noses and eyes.
The easiest way to tell if your young child is experiencing seasonal allergies is if your nose starts to twitch. If your child’s nose also starts to twitch, they probably also have allergies. Allergies have a strong inheritance pattern. If both parents have allergies, up to 50-80 percent of their kids may have allergies. Keep in mind, allergies never cause a fever and since children need to be exposed to an irritant before they can be allergic to it, children under two years of age are less likely to have seasonal allergies—not enough seasons have passed.
For other ways to keep spring allergies in check- read up on this post contributed by Dr. Lai in the CHOP Health TIp of the Week.
Another reason to wash hands after zipping indoors? Poison ivy…but that’s a story for another day.
We know how it’s easy to spend money on the kids- just wait until they are old enough to get Venmo. Here are some money saving tips for parents to save a little dough and put that saving towards the next family vacation and orthodontia!
Parents local to Northampton Township, PA: We welcome you to come hear local pedatricians from The Children’s Hospital of Philadelphia and mental health experts talk about basic ways you can help manage anxiety and some information about medications for children and teens on February 8, 2024 at 6:30pm in the Northampton Library.
The talk is free and there will be time for questions. Please register so we set up enough chairs!
Special note: your Two Peds will be in attendance. Hope to see you there!
According to recent US Census data, 30 percent of households have a child under six years of age. So there is a good chance that you are wondering what to get a baby, toddler or preschooler for the holidays. Before you give up and fall back on electronic screen ideas like you did when you last took your toddler to a restaurant, here are holiday gift ideas for babies, toddlers, and preschoolers from your Two Peds, by ages and stages of development:
0-3 months: Babies this age have perfect hearing and enjoy looking at faces and objects with contrasting colors. Music, mobiles, and bright posters are some age-appropriate gift ideas. Infants self-soothe through sucking—if you can figure out what your nephew’s favorite type of binky is, wrap up a bunch—they are expensive and often disappear mysteriously.
3-6 months: Babies start to reach and grab at objects. There are all sorts of crinkly, textured baby toys out there for babies to enjoy. Give items big enough to hold onto but safe enough to put in their mouths. Remember that any object small enough to fit inside a paper towel tube is small enough to be a choking hazard. Personalize a cloth or vinyl book. The baby will appreciate the book and parents will enjoy the personalization and ability to clean the book.
6-12 months: Around six months, babies begin to sit up. Intellectually, they begin to understand “cause and effect.” Good choices of gifts include toys that allow a baby to activate- to make sounds, play music, or cause animals to pop up.
For a nine-month-old just starting to pull herself up to a standing position, a water or sand table will provide hours of entertainment in the upcoming year. Right now you can bring winter inside if you fill the water table with a mound of snow. Buy some inexpensive measuring cups and later in the summer a toddler will enjoy standing outside splashing in the water.
12-18 months: This is the age kids learn to stand and walk. They enjoy things they can push while walking such as shopping carts or plastic lawn mowers. Give gifts which promote joint attention. Joint attention is the kind of attention a child shares with people during moments of mutual discovery. Joint attention starts at two months of age when a parent smiles at their baby and their baby smiles back. Later, around 18 months, if a parent points at a dog in a book, the child will look at the dog, then look back at the parent, and smile. A child not only shows interest in the same object, but will acknowledge that both she and the parent are interested. Joint attention is thought to be important for social and emotional growth.
Toddlers enjoy making music: there are plenty of percussion sets out there!
18-24 months: Although kids this age cannot pedal yet, they enjoy riding on toys such as Big Wheels “Fred Flintstone” style. Dexterous enough to drink out of a cup and use a spoon and fork, toddlers can always use another place setting. Toddlers are also able to manipulate shape sorters and toys where they put a plastic ball into the top and the ball goes down a short maze/slide. Avoid the marble runs though, this age still puts choking hazards in their mouths. They also love containers to collect things, dump out, then collect again.
This is the age when kids love making animal sounds. Consider a zoo membership . When you count up how many words your toddler knows, animal noises count as words. (What does the lion say? “Roar!”) Many zoos have animal cams that you can first watch from afar. Pair with a stuffed animal and the entire family will enjoy making animal sounds together.
2-3 years: To encourage motor skills, offer tricycles, balls, bubbles, and boxes to crawl into and out of. Choose crayons over markers because crayons require a child to exert pressure and therefore develop hand strength. Swiping a phone or ipad does not develop fine motor skills in the same fashion.
Dolls, cars, and sand boxes all foster imagination. Don’t forget those indestructible board books so kids can “read” to themselves. By now, the plastic squirting fish bath toys you bought your niece last year are probably squirting out black specks of mold instead of water- get her a new set.
At three years, kids become more and more capable of self care. They start to pull shoes on themselves and can hang their coat up on a hook. The problem? They often can not reach hooks. Offer to purchase a set of cute hooks to hang low in your grandchild’s room or the mudroom.
Preschooler gifts
3-4 years: Now kids engage in elaborate imaginary play. They enjoy “dress up” clothes to create characters- superheroes, dancers, wizards, princesses, kings, queens, animals. Kids also enjoy props for their pretend play, such as plastic kitchen gadgets, magic wands, building blocks, pretend food and of course, a stethoscope. They become adept at pedaling tricycles or even riding small training-wheeled bikes and balance bikes. Other gift ideas include art supplies such as paint, markers, or side-walk chalk. Play-doh helps develop fine motor skills and hand strength. Children this age understand rules and turn-taking and can be taught simple card games such as “go fish,” “war,” and “matching.”
Three-year-olds recognize colors but can’t read- so they can finally play the classic board game Candyland®, and they can rote count in order to play the sequential numbers game Chutes and Ladders®. Preschool kids now understand and execute the process of washing their hands independently. One problem: they can’t reach the faucets on the sink. A personalized, sturdy step stool will be appreciated for years. Likewise, they love to help cook and will use a kitchen counter standing step with study sides for years to come.
Looking ahead, in the spring, a three or four-year-old may start participating in team sports (although they often go the wrong way down the field) or in other classes such as dance or swimming lessons. Give your relatives the gift of shin guards and soccer balls with a shirt. Offer to pay for swim lessons and package the gift certificate with a pair of goggles.
While three-year-olds still do not understand time, four-year-olds start to appreciate time better. Concepts such as yesterday and tomorrow take on more meaning. A good starter clock is a color clock. They signal time by color and are often used to signal to children when it’s time to get out of bed on weekends.
5-year-olds: Since 5-year-olds can hop on one foot, games like Twister® are fun. Kids this age start to understand time and charts. Get your child a calendar so they can count ahead to your next visit!. They can also work jigsaw puzzles with somewhat large pieces.
For any age, consider tickets to a junior high school musical or minor league sports game. Avoiding large venues not only saves money, but saves time parking and affords the ability to get in and out easily if needed.
The excitement of the surprise is sometimes as exciting as the gift itself. Hence, the reason unboxing youtube videos are as popular as ever. Wrap a child’s gift in layers of sparkly crunchy paper and the smiles will come even before the gift is seen.
Pediatrician and parents have waited patiently for effective protection for babies against severe RSV (respiratory syncytial virus) infections, and we finally have it.
Welcome, nirsevimab – otherwise known as brand name Beyfortus.
Nirsevimab protects against RSV, which is a nasty cold virus that attacks young lungs fiercely. While many babies with RSV end up with “just a cold,“ 20% to 30% with a first time infection end up with lung infections. Year after year hospitals fill with babies battling RSV. An additional problem with RSV: babies sick with RSV have a greater risk of developing asthma than babies who were never infected with RSV.
This viral season every newborn and any baby younger than eight months of age is eligible for a one time shot of nirsevimab. The shot gives protection in the form of antibodies to RSV.
Not a new type of medicine
A similar medication called palivizumab (brand name Synagis) has been around for years. However, only certain high risk babies, such as those who were born very prematurely, received it. Palivizumab consisted of monthly injections during RSV season (typically October through March).
Conveniently, one dose of nirsevimab gives protection against severe RSV for five months. All babies under eight months of age during RSV season will be eligible to receive this new protection.
Be sure to discuss nirsevimab with your pediatrician this fall.
For a more detailed account of nirsevimab recommendations read here.
The arrival of nirsevimab will make every pediatrician and lots of babies breathe a little easier this fall and winter.
