Some viruses cause symptoms that resemble bacterial infections, and some bacteria can cause symptoms that resemble viral infections. Your child's physician can determine what type of illness your child has and recommend the proper type of treatment.

 

 

 

 

What are resistant bacteria?

Each time you take an antibiotic, bacteria are killed. Sometimes, bacteria may be resistant or become resistant. Resistant bacteria do not respond to the antibiotics and continue to cause infection. A common misconception is that a person's body becomes resistant to specific drugs. However, it is the bacteria, not people, that become resistant to the drugs.

 

Each time you take or give your child an antibiotic unnecessarily or improperly, you increase the chance of developing drug-resistant bacteria. Therefore, it is critically important to take antibiotics only when necessary. Because of these resistant bacteria, some diseases that used to be easy to treat are now becoming nearly impossible to treat.

 

Bacteria can develop resistance to certain medications.

• Drug resistance happens when bacteria develop ways to survive the use of medications meant to kill or weaken them.
• If a germ becomes resistant to many drugs, treating the infections can become difficult or even impossible.
• Someone with an infection that is resistant to a certain medication can pass that resistant infection to another person. In this way, a hard-to-treat illness can be spread from person to person. In some cases, the illness can lead to serious disability or even death.

 

When are antibiotics needed?

This complicated question, which should be answered by your child's physician, depends on the specific diagnosis. For example, there are several types of ear infections - most need antibiotics, but some do not. Most cases of sore throat are caused by viruses. One kind, strep throat, diagnosed by a laboratory test, requires antibiotics.

 

Viral infections can sometimes lead to bacterial infections. However, treating viral infections with antibiotics in order to prevent bacterial infections is not recommended.

• Remember that antibiotics do not work against colds and flu, and that unnecessary antibiotics can be harmful.

 

 

• Consult your child's pediatrician about antibiotics and find out about the differences between viruses and bacteria, and when antibiotics should and should not be used.
• If your child does receive an antibiotic, be sure to give it exactly as prescribed to decrease the development of resistant bacteria.
• Antibiotic resistance is particularly dangerous for children, but it can occur in adults, as well.

 

Remember that taking antibiotics appropriately and making sure your child receives the proper immunizations will help prevent having to take more dangerous and more costly medications. Consult your child's physician for more information.

 

Skin Conditions

 

The skin is the largest organ of the body, covering the entire body. As the outer protective covering of the body, it is exposed to the environment, making it vulnerable to growths, rashes, discolorations, cysts, burns, injuries, infections, and other disorders.

There are many common skin disorders that require the clinical care of a physician or other healthcare professional. Listed in the directory below are some, for which we have provided a brief overview.

 

Acne

 

What is acne?

Acne is a disorder of the hair follicles and sebaceous glands. With acne, the sebaceous glands are clogged, which leads to pimples and cysts.

 

Acne is very common - nearly 17 million people in the US are affected by this condition. Acne most often begins in puberty. During puberty, the male sex hormones (androgens) increase in both boys and girls, causing the sebaceous glands to become more active - resulting in increased production of sebum.

 

How does acne develop?

The sebaceous glands produce oil (sebum) which normally travels via hair follicles to the skin surface. However, skin cells can plug the follicles, blocking the oil coming from the sebaceous glands. When follicles become plugged, skin bacteria (called Propionibacterium acnes, or P. acnes) begin to grow inside the follicles, causing inflammation. Acne progresses in the following manner:

1. Incomplete blockage of the hair follicle results in blackheads (a semisolid, black plug).
2. Complete blockage of the hair follicle results in whiteheads (a semisolid, white plug).
3. Infection and irritation cause whiteheads to form.

 

 

 

 

Eventually, the plugged follicle bursts, spilling oil, skin cells, and the bacteria onto the skin surface. In turn, the skin becomes irritated and pimples or lesions begin to develop. The basic acne lesion is called a comedo.

 

Acne can be superficial (pimples without abscesses) or deep (when the inflamed pimples push down into the skin, causing pus-filled cysts that rupture and result in larger abscesses).

 

What causes acne?

Rising hormone levels during puberty may cause acne. In addition, acne is often inherited. Other causes of acne may include the following:

• hormone level changes during the menstrual cycle in women
• certain drugs (such as corticosteroids, lithium, and barbiturates)
• oil and grease from the scalp, mineral or cooking oil, and certain cosmetics may worsen acne
• bacteria inside pimples

 

Acne can be aggravated by squeezing the pimples or by scrubbing the skin too hard.

 

What are the symptoms of acne?

Acne can occur anywhere on the body. However, acne most often appears in areas where there is a high concentration of sebaceous glands, including the following:

• face
• chest
• upper back
• shoulders
• neck

 

The following are the most common symptoms of acne. However, each child may experience symptoms differently. Symptoms may include:

• blackheads
• whiteheads
• pus-filled lesions that may be painful
• nodules (solid, raised bumps)

 

 

 

The symptoms of acne may resemble other skin conditions. Always consult your child's physician for a diagnosis.

 

Treatment of acne:

Specific treatment will be determined by your child's physician based on:

• your child's age, overall health, and medical history
• severity of the acne
• your child's tolerance for specific medications, procedures, or therapies
• expectations for the course of the condition
• your opinion or preference

 

The goal of acne treatment is to minimize scarring and improve appearance. Treatment for acne will include topical or systemic drug therapy. Depending upon the severity of acne, topical medications (medications applied to the skin) or systemic medications (medications taken orally) may be prescribed by your child's physician. In some cases, a combination of both topical and systemic medications may be recommended.

 

Systemic medications to treat acne:

Systemic antibiotics are often prescribed to treat moderate to severe acne, and may include the following:

• doxycycline
• erythromycin
• tetracycline

 

Treatment for severe, cystic, or inflammatory acne:

Isotretinoin (Accutane®), an oral drug, may be prescribed for individuals with severe, cystic, or inflammatory acne that cannot be effectively treated by other methods to prevent extensive scarring. Isotretinoin reduces the size of the sebaceous glands that produce the skin oil, increases skin cell shedding, and affects the hair follicles, thereby reducing the development of acne lesions. Isotretinoin can clear acne in 85 percent of patients. However, the drug has major unwanted side effects, including psychiatric side effects. It is very important to discuss this prescription medication with your child's physician.

 

 

 

Isotretinoin must not be taken by women who are pregnant or who are able to become pregnant, because there is a very high likelihood of birth defects occurring

in babies whose mothers took the medication during pregnancy. Isotretinoin can also cause miscarriage or premature birth. Because of these effects and to minimize fetal exposure, isotretinoin is approved for marketing only under a special restricted distribution program approved by the US Food and Drug Administration (FDA). This program is called iPLEDGE.

 

The goal of the iPLEDGE program is to prevent pregnancies in females taking isotretinoin and to prevent pregnant females from taking isotretinoin. Requirements of the iPLEDGE program include:

• Isotretinoin must only be prescribed by prescribers who are registered and activated with the iPLEDGE program.
• Isotretinoin must only be dispensed by a pharmacy registered and activated with iPLEDGE.
• Isotretinoin must only be dispensed to patients who are registered with and meet all the requirements of iPLEDGE
• Female patients who can get pregnant are required to use birth control for one month prior to treatment, during treatment, and for one month after stopping treatment.
• Pregnancy tests are required before, during, and after treatment.

 

Bites and Stings

 

Regardless of how careful you are about animals in your home, or how many precautions you take when your child is outdoors playing, animal and insect bites and stings may occur. By remaining calm and knowing some basic first-aid techniques, you can help your child overcome both the fear and the trauma of bites and stings.

 

There are many different types of bites or stings that may require clinical care by a physician or other healthcare professional. Listed in the directory below are some, for which we have provided a brief overview.

 

Bites and Stings: Insects

 

Fleas, mites, and chiggers:

 

Fleas, mites, and chiggers often bite humans, but are not poisonous. It is sometimes difficult to assess which type of insect caused the bite, or if the rash is caused by poison ivy or other skin conditions.

 

What are the symptoms of a flea, mite, or chigger bite?

The following are the most common symptoms of a flea, mite, or chigger bite. However, each individual may experience symptoms differently. Symptoms may include:

• small, raised skin lesions
• pain or itching
• dermatitis (inflammation of the skin)
• allergic-type reactions in hypersensitive persons with swelling or blistering

 

The symptoms of a flea, mite, or chigger bite may resemble other conditions or medical problems. Always consult your physician for a diagnosis.

 

 

 

 

 

Treatment for bites caused by fleas, mites and chiggers:

Specific treatment for these insect bites will be determined by your physician.

 

Some general guidelines for treatment may include the following:

• Clean the area well with soap and water.
• Use an antihistamine, if needed, for itching.
• Take acetaminophen, if needed, for discomfort.

 

When should I call my physician?

Call your physician if any, or all, of the following symptoms are present:

• persistent pain or itching
• signs of infection at the site such as increased redness, warmth, swelling, or drainage
• fever

 

Call 911 or your local emergency medical service (EMS) if the individual has signs of a severe allergic reaction such as trouble breathing, tightness in the throat or chest, feeling faint, dizziness, hives, and/or nausea and vomiting.

 

Tick bites:

 

Ticks are small insects that live in grass, bushes, wooded areas, and seashores. They attach their bodies onto a human or animal host and prefer hairy areas such as the scalp, behind the ear, in the armpit and groin, and also between fingers and toes. Tick bites often occur at night and occur more in the spring and summer months.

 

What to do if you find a tick on your child:

• Do not touch the tick with your bare hand. If you do not have a pair of tweezers, take your child to your nearest healthcare facility where the tick can be removed safely.
• Use a pair of tweezers to remove the tick. Grab the tick firmly by its mouth or head as close to your child's skin as possible.
• Pull up slowly and steadily without twisting until it lets go. Do not squeeze the tick, use petroleum jelly, solvents, knives, or a lit match to kill the tick.

 

 

• Save the tick and place it in a plastic container or bag so it can be tested for disease, if necessary.
• Wash the area of the bite well with soap and water and apply an antiseptic lotion or cream.
• Call your child's physician to find out about follow-up care and testing of the tick for spirochetes (organisms that may be carried by the tick).

 

Regardless of how careful you are about animals in your home, or how many precautions you take when your child is outdoors playing, animal and insect bites and stings are sometimes unavoidable.

 

By remaining calm and knowing some basic first-aid techniques, you can help your child overcome both the fear and the trauma of bites and stings.

 

Facts about insect stings:

 

Bees, wasps, yellow jackets, and hornets belong to a class of insects called Hymenoptera. Most insect stings cause only minor discomfort. Stings can occur anywhere on the body and can be painful and frightening for a child. Yellow jackets

cause the most allergic reactions in the US. Stings from these insects cause three to four times more deaths than poisonous snake bites, due to severe allergic reaction. Fire ants, usually found in southern states, can sting multiple times, and the sites are more likely to become infected.

 

The two greatest risks from most insect stings are allergic reaction (which can sometimes be fatal if the allergic reaction is severe enough) and infection (more common and less serious).

 

What are the symptoms of an insect sting?

The following are the most common symptoms of insect stings. However, each child may experience symptoms differently. Symptoms may include:

• local skin reactions at the site or surrounding the sting, including the following:
• pain
• swelling

 

• redness
• itching
• warmth
• small amounts of bleeding or drainage
• hives
• generalized symptoms that indicate a more serious and possibly life-threatening allergic reaction, including the following:
• coughing
• tickling in the throat
• tightness in the throat or chest
• breathing problems or wheezing
• nausea or vomiting
• dizziness or fainting
• sweating
• anxiety
• itching and rash elsewhere on the body, remote from the site of the sting

 

Treatment for stings:

Specific treatment for stings will be determined by your child's physician. Large local reactions usually do not lead to generalized reactions. However, they can be life threatening if the sting occurs in the mouth, nose, or throat area. This is due to swelling that can close off the airway.

 

Treatment for local skin reactions only may include:

• Calm your child and let him/her know that you can help.
• Remove the stinger by gently scraping across the site with a blunt-edged object, such as a credit card or dull knife. Do not try to pull it out, as this may release more venom.
• Wash the area well with soap and water.
• Apply a cold or ice pack wrapped in a cloth to help reduce swelling and pain (10 minutes on and 10 minutes off for 30 to 60 minutes).
• If the sting occurs on an arm or leg, elevate the limb to help reduce swelling.
• To help reduce the itching, consider the following:

 

 

 

• Apply a paste of baking soda and water and leave it on for 15 to 20 minutes.
• Apply a paste of non-seasoned meat tenderizer and water and leave it on for 15 to 20 minutes.
• Apply a wet tea bag and leave it on for 15 to 20 minutes.
• Use an over-the-counter product made to use on insect stings.
• Apply an antihistamine or corticosteroid cream or calamine lotion.
• Give acetaminophen for pain.
• Give an over-the-counter antihistamine, if approved by your child's physician. Be sure to follow dosage instructions carefully for your child.
• Observe your child closely for the next hour for any signs of allergic reaction that would warrant emergency medical treatment.

 

Call 911 or your local emergency medical service (EMS) and seek emergency care immediately if your child is stung in the mouth, nose, or throat area, or for any signs of a systemic or generalized reaction.

 

Emergency medical treatment may include the following:

• intravenous (IV) antihistamines
• epinephrine
• corticosteroids or other medications
• lab tests
• breathing support

 

Prevention of insect stings:

Some general guidelines to help reduce the possibility of insect stings while outdoors include:

• Avoid perfumes, hairsprays, and other scented products.
• Avoid brightly colored clothing.
• Do not let your child walk or play outside barefoot.
• Spray your child's clothing with insect repellent made for children.
• Make sure your child avoids locations of hives and nests. Have the nests removed by professionals.
• Teach your child that if an insect comes near to stay calm and walk away slowly.

 

Some additional preventive measures for children who have a known or suspected allergy to stings include the following:

• Carry a bee sting kit (such as Epi-Pen®) at all times and make sure your child knows how to use it. These products are available by prescription.
• Make sure your child wears long-sleeve shirts and long pants when playing outdoors.
• See an allergist for allergy testing and treatment.

 

Bites and Stings: Animals

 

All animal bites require treatment based on the type and severity of the wound. Whether the bite is from a family pet or an animal in the wild, scratches and bites can become infected and cause scarring. Animals can also carry diseases that can be transmitted through a bite. Bites that break the skin and bites of the scalp, face, hand, wrist, or foot are more likely to become infected. Cat scratches, even from a kitten, can carry "cat scratch disease," a bacterial infection.

 

Other animals can transmit rabies and tetanus. Rodents such as mice, rats, squirrels, chipmunks, hamsters, guinea pigs, gerbils, and rabbits are at low risk to carry rabies.

 

The most common type of animal bite is a dog bite. Almost a million Americans are attacked by dogs each year - about half of them are children. Follow these guidelines to help decrease the chance of your child being bit by an animal:

• Never leave a young child alone with an animal.
• Teach your child not to tease or hurt an animal.
• Teach your child to avoid strange dogs, cats, and other animals.
• Have your pets licensed and immunized against rabies, and other diseases.
• Keep your pets in a fenced yard or confined to a leash.

 

How to respond to dog or cat bites and scratches:

When your child is bitten or scratched by an animal, remain calm and reassure your child that you can help. Specific treatment for an animal bite will be determined by your child's physician. Treatment may include:

 

 

• For superficial bites from a familiar household pet who is immunized and in good health:
• Wash the wound with soap and water under pressure from a faucet for at least five minutes, but do not scrub as this may bruise the tissue. Apply an antiseptic lotion or cream.
• Watch for signs of infection at the site, such as increased redness or pain, swelling, or drainage, or if your child develops a fever. Call your child's physician or healthcare provider right away if any of these occur.
• For deeper bites or puncture wounds from any animal, or for any bite from a strange animal:
• If the bite or scratch is bleeding, apply pressure to it with a clean bandage or towel to stop the bleeding.
• Wash the wound with soap and water under pressure from a faucet for at least five minutes, but do not scrub as this may bruise the tissue.
• Dry the wound and cover it with a sterile dressing. Do not use tape or butterfly bandages to close the wound as this could trap harmful bacteria in the wound.
• Call your child's physician or healthcare provider for help in reporting the attack and to decide if additional treatment, such as antibiotics, a tetanus booster, or rabies vaccination is needed. This is especially important for bites on the face or for bites that cause deeper puncture wounds of the skin.
• If possible, locate the animal that inflicted the wound. Some animals need to be captured, confined, and observed for rabies. Do not try to capture the animal yourself; instead contact the nearest animal warden or animal control office in your area.
• If the animal cannot be found, or if the animal is a high-risk species (raccoon, skunk, or bat), or the animal attack was unprovoked, your child may need a series of rabies shots.

 

Call your child's physician or healthcare provider for any flu-like signs such as fever, headache, malaise, decreased appetite, or swollen glands following an animal bite.

 

 

Blisters

 

What is a blister?

A blister is a bump on the skin containing fluid. Blisters are usually circular in shape. The fluid that forms underneath the skin can be bloody or clear.

 

What causes a blister?

Blisters are caused by injury, allergic reactions, or infections, which may include the following:

• burns/scalds
• sunburns
• friction (from a shoe, for example)
• contact dermatitis
• impetigo (a contagious infection of the skin)
• viral infections (including chickenpox and herpes zoster)

 

The symptoms of a blister may resemble other skin conditions or medical problems. Always consult your child's physician for a diagnosis.

 

First-aid for blisters:

Blisters often heal spontaneously. Treatment will vary according to the cause. Some general guidelines for treatment may include:

• Wash the area with soap and water.
• A cold or ice pack may help reduce swelling and discomfort.
• Keep the area clean and dry - do not burst or puncture the blister.
• If the blister bursts, place an adhesive bandage or dressing on the area to keep it clean.
• Observe the area for signs of infection such as increased warmth, swelling, redness, drainage, pus formation, or pain. If you notice any signs of infection, call your child's physician. Antibiotics may be needed.

 

 

 

 

 

 

 

Burns

 

According to the latest data available from the National SAFE KIDS Campaign, consider the following statistics:

• Accidental, or unintentional, injury is a leading cause of death among children, teens, and young adults.
• Leading causes of accidental injury at home are burns, drowning, suffocation, choking, poisonings, falls, and fire arms. 
• Burns and fires are the fifth most common cause of accidental death in children and adults, and account for an estimated 4,000 adult and child deaths per year. 
• Nearly 75 percent of all scalding burns in children are preventable.
• Nearly 2,900 adults and children die every year in fires, or from other burn injuries.
• Toddlers and children are more often burned by a scalding or flames.
• The majority of children ages 4 and under, who are hospitalized for burn-related injuries, suffer from scalds burns (65 percent) or contact burns (20 percent).
• Hot tap water burns cause more deaths and hospitalizations than burns from any other hot liquids.

 

Heat and cold injuries:

Children are much more vulnerable to changes in the temperature of the environment because they produce and lose heat faster than adults. Because they are so often busy playing and having fun, children tend to pay less attention to when they are becoming too hot or too cold until problems occur. It is important for you to protect your child from the sun and from heat and cold exposures that may cause them illness or injury. Knowing what to do in case a burn or thermal injury occurs can help prevent a medical emergency.

 

Caring for a heat-induced or thermal burn:

• Remove the child from the heat source.
• Cool the affected area with cold water or cold compresses until pain is reduced or alleviated.
• If a blister has formed, do not break it.

 

 

• Protect the burn with a dry, sterile, gauze bandage or with a clean bed sheet or cloth.
• If your child's clothing is stuck to the burned area, do not attempt to remove it. Instead, cut around the clothing leaving the burn intact.
• Do not apply any ointments, oils, or sprays to the burned area.
• If the burn is serious, seek medical attention or dial 911 for emergency medical attention.

 

Caring for an electrical burn:

• Call or send someone to call 911 for emergency medical assistance. Significant electrical injuries will need medical care.
• Unplug the appliance or device that has caused the injury or turn off the electrical current.
• If the child is in contact with the electrical current do not touch them until you turn off the source or the circuit breaker.
• Determine that the child is still breathing. If the child is not breathing, begin cardiopulmonary resuscitation (CPR).
• Cover the burned area with a sterile gauze bandage or clean bed sheet.
• Maintain your child's normal body temperature, and take the child to an emergency center.
• Be aware that a child may experience "shock" after an electrical burn. If your child is showing signs of shock, send someone to call 911 immediately.
• Do not give your child anything to eat or drink.
• Place the child on his/her back, unless a neck or back injury is suspected.
• If the child has vomited or has a serious injury to the face or mouth area, you may lay the child on his/her side.
• Keep your child warm with blankets or extra clothing, but do not use a heat source to warm them.
• Elevate your child's feet and legs, using a prop or pillow.

 

What are the symptoms of shock?

The following are the most common symptoms of shock. However, each child may experience symptoms differently. Symptoms of shock may include:

• cold sweat
• weakness
• irregular breathing

 

• chills
• pale or blue-colored lips
• pale or blue-colored fingernails
• a fast, but weak pulse
• nausea

 

The symptoms may resemble other conditions or medical problems. Consult your child's physician immediately for diagnosis and treatment.

 

Contact Dermatitis

 

What is contact dermatitis?

Contact dermatitis is a physiological reaction that occurs after skin comes in contact with certain substances. Irritants to the skin cause the vast majority of these reactions. The remaining reactions are caused by allergens, which trigger an allergic response.

 

Adults are most commonly affected by allergic contact dermatitis, but it can affect persons of all ages. 

 

What causes irritant contact dermatitis?

The most common causes of irritants to children include the following:

• soaps
• saliva
• different foods
• detergents
• baby lotions
• perfumes

 

Plants, as well as metals, cosmetics, and medications may also cause contact dermatitis:

• Poison Ivy: Poison ivy, the plant family that also includes poison oak and sumac, is a common cause of a contact dermatitis reaction.

 

 

 

• Metals: Nearly 3,000 chemical agents are capable of causing allergic contact dermatitis. Nickel, chrome, and mercury are the most common metals that cause contact dermatitis:
• Nickel is found in costume jewelry, belt buckles, and wristwatches, as well as zippers, snaps, and hooks on clothing. Contact with objects that are chrome-plated, which contain nickel, may also cause skin reactions in children who are sensitive to nickel.
• Mercury, which is found in contact lens solutions, may cause problems for some children.
• Latex: Some children have an allergy or sensitivity to latex (rubber). Reactions can be seen when products made from latex come in contact with the child's skin. Latex is found in products made with natural rubber latex, such as rubber toys, balloons, bells, rubber gloves, and pacifiers or nipples.
• Cosmetics: Many types of cosmetics can cause allergic contact dermatitis. Permanent hair dye that contains paraphenylenediamine is the most common cause. Other products that may cause problems include dyes used in clothing, perfumes, eye shadow, nail polish, lipstick, and some sunscreens.
• Medications: Neomycin, which is found in antibiotic creams, is a common cause of medication contact dermatitis. Local anesthetics, such as novocaine or paraben, are other possible causes.

 

What are the symptoms of contact dermatitis?

The following are some of the other symptoms associated with contact dermatitis. However, each child may experience symptoms differently. Symptoms may include:

• mild redness and swelling of the skin
• blistering of the skin
• itching
• scaling and temporary thickening of skin

 

The most severe reaction is at the contact site. The symptoms of contact dermatitis may resemble other skin conditions. Always consult your child's physician for a diagnosis.

 

 

 

 

 

Treatment for contact dermatitis:

The best treatment is to identify and avoid the substances that may have caused the allergic contact dermatitis. The following is recommended by the American Academy of Allergy, Asthma, and Immunology, for mild to moderate reactions:

• Thoroughly wash skin with soap and water as soon after the exposure as possible.
• Wash clothing and all objects that touched plant resins (poison ivy/oak) to prevent re-exposure.
• Use wet, cold compresses to soothe and relieve inflammation if blisters are broken.
• For severe reactions, always contact your child’s physician.

 

Cradle Cap / Seborrheic Dermatitis

 

What is seborrheic dermatitis (cradle cap)?

Also called cradle cap, seborrheic dermatitis in the infant is characterized by fine white scales. However, seborrheic dermatitis can also occur in the diaper area, face, neck, and trunk. Seborrheic dermatitis in this age group usually clears within the first year.

 

What causes cradle cap?

The exact cause of this skin condition is not known.

 

What does cradle cap look like?

The following are the most common signs and symptoms of cradle cap. However, each child may experience symptoms differently. Symptoms include dry or greasy scales on the scalp.

 

How is cradle cap diagnosed?

Cradle cap is usually diagnosed based on physical examination of your child. The rash involved with cradle cap is unique, and can usually be diagnosed simply on physical examination.

 

 

 

 

Treatment for cradle cap:

Specific treatment for cradle cap will be determined by your child's physician based on:

• your child's age, overall health, and medical history
• extent of the condition
• your child's tolerance for specific medications, procedures, or therapies
• expectations for the course of the condition
• your opinion or preference

 

Although the condition responds to treatment, it may recur. Treatment is usually effective in helping symptoms and may include:

• rubbing the scalp with baby oil or petroleum jelly (to soften crusts before washing)
• special shampoo, as prescribed by your child's physician
• Corticosteroid cream or lotion

 

Diaper Rash

 

What is diaper dermatitis?

Diaper dermatitis, commonly known as a diaper rash, is a term used to describe different skin rashes in the diapered area. The rash is usually red, scaling and, rarely, ulcerated. It is most commonly seen in infants between the ages of 9 to 12 months, but may begin within the first 2 months of life.

 

What causes diaper dermatitis?

Possible contributors to diaper dermatitis include the following:

• Irritation - from urine and feces trapped in the diaper.
• Candida diaper dermatitis - dermatitis caused by a yeast infection in the diaper area, often preceded by diaper dermatitis.
• Seborrheic diaper dermatitis - a common, chronic skin condition that can affect the diaper area as well as other locations on the body.

Other less common causes of dermatitis in the diaper area include the following:

• Impetigo - dermatitis caused by a bacterial infection.
• Perianal streptococcal disease - dermatitis caused by a streptococcus.
• Allergic dermatitis - a type of dermatitis that is rare in the first 2 years of life, but may be caused by soaps and detergents, or the diaper.

 

What are the symptoms of diaper dermatitis?

The symptoms of diaper dermatitis vary depending on the cause of the dermatitis, and may be different for each child that is affected. The following are common characteristics of the rash that may occur with each type of infection:

• Candida diaper dermatitis - this rash usually begins in the creases or folds of the thighs and in the diaper area, and then spreads. The rash is usually a deep, red, shiny rash with red, satellite lesions. This type of rash may be associated with thrush, a yeast infection in the baby's mouth.
• Seborrheic diaper dermatitis - this rash also affects the skin folds in the groin area and is usually pink. Infants may also have this rash on their face, scalp, or neck at the same time.
• Contact diaper dermatitis - this rash is mostly seen on the buttocks and may extend to the thighs, stomach, and waist area, but does not generally involve folds in the area. The rash is usually red and shiny.

 

The symptoms of diaper dermatitis may resemble other skin conditions. always consult your child's physician for a diagnosis.

 

How is diaper dermatitis diagnosed?

Diaper dermatitis is usually diagnosed based on the location and appearance of the rash during physical examination of your child. In addition, your child's physician may do skin scraping to aid in the diagnosis.

 

Treatment for diaper dermatitis:

Treatment for diaper dermatitis will vary based on the cause of the dermatitis. Specific treatment for diaper dermatitis will also be determined by your physician based on:

• your child's age, overall health, and medical history
• extent of the condition
• your child's tolerance for specific medications, procedures, or therapies
• expectations for the course of the condition
• your opinion or preference

 

 

 

 

 

Treatment may include:

• removal of the diaper for a few days
• medicated diaper cream (as prescribed by your child's physician)
• anti-inflammatory creams
• moisture-resistant diaper creams

 

Proper skin care is also very important in preventing diaper dermatitis. This includes:

• keeping the diaper area clean and dry.
• changing diapers frequently.
• allowing the diaper area to air dry at times.
• limiting the use of soap and other harsh cleaners in the diaper area.

 

Impetigo

 

What is impetigo?

Impetigo is a superficial infection of the skin, caused by bacteria. The lesions are often grouped and have a red base. The lesions open and become crusty and have a "honey-color," which is typical of impetigo. Impetigo is very contagious and can be spread throughout a household, with children re-infecting themselves or other family members.

 

What causes impetigo?

Common bacteria, some of which are found normally on the skin, cause impetigo. When the bacteria enter an open area in the skin, the infection can occur. The most common bacteria that cause impetigo include the following:

• group A ß - hemolytic streptococcus
• Staphylococcus aureus

 

Impetigo is more common in children than adults, but adults may also have the infection. Impetigo is made worse by poor hygiene and warm temperatures.

 

What are the symptoms of impetigo?

Impetigo usually occurs on the face, neck, arms, and limbs, but the lesions may appear on any part of the body. Impetigo starts as a small vesicle or fluid-filled lesion. The lesion then ruptures and the fluid drains leaving areas that are covered

 

with the honey-colored crusts. The lesions may all look different, with different sizes and shapes. Your child may also have swollen lymph nodes (small lumps that are located mostly in the neck, arm, under the arm and in the groin area). The lymph nodes become enlarged when your child's body is fighting an infection.

 

The symptoms of impetigo may resemble other skin conditions. Always consult your child's physician for a diagnosis.

 

How is impetigo diagnosed?

Impetigo is usually diagnosed based on a medical history and physical examination of your child. The lesions of impetigo are unique and usually allow for a diagnosis based simply on physical examination. In addition, your child's physician may order a culture of your child's lesion to confirm the diagnosis and the type of bacteria that is present.

 

Treatment for impetigo:

Specific treatment for impetigo will be determined by your child's physician based on:

• your child's age, overall health, and medical history
• extent of the condition
• your child's tolerance for specific medications, procedures, or therapies
• expectations for the course of the condition
• your opinion or preference

Treatment may include:

• For a child with many lesions, oral antibiotics may be prescribed.
• If your child only has a few lesions, your child's physician may prescribe a topical antibiotic applied directly to the lesions.
• Your child should wash daily with an antibacterial soap to help decrease the chance of spreading the infection.
• Proper hand washing technique by everyone in the household is very important to help decrease the chance of spreading the infection.
• Keep your child's fingernails short to help decrease the chance of scratching and spreading the infection.
• Avoid sharing of garments, towels, etc. to prevent the spreading of the infection.

 

 

Lice

 

What are lice?

Lice are tiny insects that can infest the skin anywhere on the body. Lice infection is characterized by intense itching. Lice are highly contagious, spreading from person-to-person by close body contact, shared clothes, and other items (such as hats, hairbrushes, and combs). There are three types of human lice:

• head lice
• body lice
• pubic lice

 

Facts about lice:

 

Head lice:

• Head lice are seen mostly in child care settings and among school-aged children.
• The child usually has itching in the head area.
• Lice, or the eggs (called nits), can usually be seen on the hair, behind the ears, and on the neck.

Body lice:

• Body lice are usually seen in people with poor hygiene.
• Body lice are rare in children.
• Body lice cause severe itching, which is often worse at night.
• With body lice, in some cases, lice and eggs can be found in the seams of clothes.

Pubic lice:

• Pubic lice are very contagious and can be transmitted through sexual contact or by contaminated items such as towels and clothes.
• Pubic lice can affect the pubic hair, but also can cause infections of the hair on the chest, abdomen, thighs, and eyebrows.
• Itching of the affected area is a common symptom of pubic lice.

 

How are lice diagnosed?

The eggs laid by lice are usually visible to the naked eye, making it easy for your child's physician to diagnose. Pubic lice leave small brown spots on the parts of clothing that come into contact with the genitals or anus.

 

Treatment for lice:

Specific treatment for lice will be determined by your child's physician based on:

• your child's age, overall health, and medical history
• extent of the infestation
• your child's tolerance for specific medications, procedures, or therapies
• expectations for the course of the infestation
• your opinion or preference

Lice are treatable. Treatment may include:

• For head lice and pubic lice:
• Application of a medicated cream rinse or shampoo is usually effective treatment for head and/or pubic lice. Specific instructions need to be followed. Discuss this with your child's physician. Examples of medicated cream rinses or shampoos include the following:
• malathion (Ovide®) - this is a new treatment that is safe and effective for lice and nits
• lindane (Kwell®) - do not use if there are open sores on the head because of toxicity
• pyrethrins (RID®) - this treatment does not kill nits (lice eggs)
• permethrin cream rinse (NIX®) - this treatment does not always work due to lice resistance
• Nits need to be removed from the hair with a fine-tooth comb.
• Combs and brushes should be soaked in hot water with the shampoo for period of at least 15 minutes.
• Children can return to school or daycare the day following their first treatment for head lice.
• For body lice:
• Medications are usually not needed to treat body lice.
• Treatment for body lice usually consists of improving hygiene and washing clothes.
• Bed sheets and blankets should be washed in hot water and dried in a hot dryer.

 

 

 

 

 

Poison Ivy / Poison Oak

 

What is poison ivy/poison oak?

There are three native American plants that collectively may be called poison ivy:

• poison ivy
• poison oak
• poison sumac

 

These plants can cause an allergic reaction in nearly 85 percent of the population. To be allergic to poison ivy, your child must first be "sensitized" to the oils. This means that next time there is contact with the plant, a rash may occur.

 

What causes an allergic reaction?

The resin in the plants contains an oily substance called urushiol. Urushiol is easily transferred from the plants to other objects, including toys, garments, and animals. This chemical can remain active for a year or longer. It is important to know that the oils can also be transferred from clothing, pets, and can be present in the smoke from a burning plant.

 

What are the symptoms of an allergic reaction to poison ivy/poison oak?

The reaction is usually contact dermatitis, which may occur several hours, days, or even weeks after exposure. The dermatitis is characterized by a rash followed by bumps and blisters that itch. Sometimes, swelling occurs in the area of contact. Eventually, the blisters break, ooze, and then crust over.

 

Treatment for poison ivy/poison oak:

Making sure your child avoids the poisonous plants is the best treatment. It is important to teach your children what the plants look like and not to touch them.

 

If contact with the plants has already occurred, you should remove the oils from the skin as soon as possible. Cleansing with an ordinary soap within six hours after the initial exposure has proven to be effective. Repeat the cleaning with the soap three times. There are also alcohol-based wipes that help remove the oils. Wash all clothes and shoes also, because the oils can remain on these.

 

 

 

If the blisters and rash are on the face, near the genitals, or all over the body, your child's physician should be notified. After a medical history and physical examination, your child's physician may prescribe a steroid cream, oral steroids, or steroid injections to help with the swelling and itching.

 

Is poison ivy/poison oak contagious?

Poison ivy/ poison oak cannot be spread from person to person by touching the blisters, or from the fluid inside the blisters. It can be spread, however, if the oils remain on the skin, clothes, or shoes. This is why washing your child's hands, clothes, and shoes as soon as possible is very important.

 

Preventing poison ivy/poison oak:

• Teach all family members to recognize the plants.
• Make sure your child wears long pants and long sleeves when poison ivy or poison oak are in the vicinity.
• Wash all clothes and shoes immediately after your child has been outside.
• Make sure your child does not touch a pet that might have been in contact with a poisonous plant.
• Wash your child's hands thoroughly.

 

Sunburn

 

What is sunburn?

Sunburn is a visible reaction of the skin's exposure to ultraviolet (UV) radiation, the invisible rays that are part of sunlight. Ultraviolet rays can also cause invisible damage to the skin. Excessive and/or multiple sunburns cause premature aging of the skin and lead to skin cancer. Skin cancer is the most common type of cancer in the US and exposure to the sun is the leading cause of skin cancer.

 

Children often spend a good part of their day playing outdoors in the sun, especially during the summer. Children who have fair skin, moles, or freckles, or who have a family history of skin cancer, are more likely to develop skin cancer in later years.

 

 

 

Exposure to the sun during daily activities and play causes the most sun damage. Overexposure to sunlight before age 18 is most damaging to the skin.

• UV rays are strongest during summer months when the sun is directly overhead (normally between 10:00 a.m. and 3:00 p.m.).

 

What are the symptoms of sunburn?

The following are the most common symptoms of sunburn. However, each child may experience symptoms differently. Symptoms may include:

redness swelling of the skin pain blisters fever chills weakness dry, itching, and peeling skin days after the burn

The symptoms of sunburn may resemble other skin conditions. Always consult your child's physician for a diagnosis.

 

First-aid for sunburn:

• Have your child take a cool bath or use cool compresses on the sunburned area.
• Give your child acetaminophen or ibuprofen for discomfort. Be sure to follow the directions on the container.
• Apply a topical moisturizer, aloe gel, hydrocortisone cream, or a topical pain reliever to sunburned skin. Avoid commercial products that contain Benadryl or benzocaine, because of the possibility of skin irritation or allergy.
• If blisters are present, do not break them open, as infection can occur.
• Keep your child out of the sun until the burn is healed.

 

 

 

 

 

 

When should I call my child's physician?

Specific treatment for sunburn will be determined by your child's physician and may depend on the severity of the sunburn. In general, call your child's physician if:

• the sunburn is severe or forms blisters.
• your child has symptoms of heat stress such as fever, chills, nausea, vomiting, or feeling faint.

 

Preventing sunburn:

Protection from the sun should start at birth and continue throughout your child's life. It is estimated that 60 to 80 percent of total lifetime sun exposure occurs in the first 18 years of life.

 

What are sunscreens?

Sunscreens protect the skin against sunburns and play an important role in blocking the penetration of ultraviolet (UV) radiation. However, no sunscreen blocks UV radiation 100 percent.

 

Terms used on sunscreen labels can be confusing. The protection provided by a sunscreen is indicated by the sun protection factor (SPF) listed on the product label. A product with an SPF higher than 15 is called a sunblock.

 

How to use sunscreens:

A sunscreen protects from sunburn and minimizes suntan by absorbing UV rays. Using sunscreens correctly is important in protecting the skin. Consider the following recommendations:

• Choose a sunscreen for children and test it on your child's wrist before using. If your child develops skin or eye irritation, choose another brand. Apply the sunscreen very carefully around the eyes.
• Choose a broad-spectrum sunscreen that filters out both ultraviolet A (UVA) and ultraviolet B (UVB) rays.
• Apply sunscreens to all exposed areas of skin, including those easily overlooked areas, such as the rims of the ears, the lips, the back of the neck, and tops of the feet.

 

 

 

• Use sunscreens for all children over 6 months of age, regardless of skin or complexion type, because all skin types need protection from UV rays. Even dark-skinned children can have painful sunburns.
• Apply sunscreens 30 minutes before going out into the sun to give it time to work. Use it liberally and reapply it every two hours after being in the water or after exercising or sweating. Sunscreens are not just for the beach - use them when your child is playing outdoors in the yard or participating in sports.
• Use a waterproof or water-resistant sunscreen.
• Use of a sunscreen with SPF of 20 to 30 offers substantial protection from sunburn and prevents tanning. High SPF sunscreens protect from burning for longer periods of time than do sunscreens with lower a SPF. Talk with your older child or teenager about using sunscreen and why it's important. Set a good example for them by using sunscreen yourself.
• Teach your teenager to avoid tanning beds and salons. Most tanning beds and salons use ultraviolet-A bulbs. Research has shown that UVA rays may contribute to premature aging of the skin and skin cancer.
• The American Academy of Pediatrics (AAP) states that sunscreen may be used on infants younger than 6 months old if adequate clothing and shade are not available. Using sunscreen on small areas of skin on an infant is not harmful, according to the AAP. Parents should still try to avoid sun exposure and dress the infant in lightweight clothing that covers most surface areas of skin. However, parents also may apply a minimal amount of sunscreen to the infant's face and back of the hands. Always consult your infant's physician for more information.

 

 

Eye Conditions

 

According to the American Academy of Ophthalmology, early detection and treatment of many sight-threatening diseases may cure or slow the progression of vision loss.

 

When it comes to children, the most important preventive steps are routine eye examinations, visual screening tests, and preventing eye trauma. Newborns are examined in the nursery for eye infections and eye disorders. Children should receive their first comprehensive eye examination by age 3, unless a specific condition or history of family childhood vision problems warrants an earlier examination. Annual visual screening tests and eye examinations should be performed on children 5 years and older.

 

Eye trauma is an important cause of vision loss in children. Eye trauma refers to any injury to the eye. The National Society to Prevent Blindness states that about one-third of preventable eye loss in children under 10 years of age is from trauma to the eye. As a parent, you can help your child avoid eye trauma with the proper use of safety equipment during sports and recreational activities.

 

Listed in the directory below are some common eye conditions in growing children, for which we have provided a brief overview.

 

 

Conjunctivitis

 

What is conjunctivitis?

Conjunctivitis, also known as "pink eye," is an inflammation of the conjunctiva of the eye. The conjunctiva is the membrane that lines the inside of the eye and also a thin membrane that covers the actual eye.

 

 

 

 

 

 

What causes conjunctivitis?

There are many different causes of conjunctivitis. The following are the most common causes:

• bacteria, including:
• Staphylococcus aureus
• Haemophilus influenza
• Streptococcus pneumoniae
• Neisseria gonorrhea
• Chlamydia trachomatis
• viruses, including:
• adenoviruses
• herpes virus
• chemicals (seen mostly in the newborn period after the use of medicine in the eye to prevent other problems)
• allergies

 

What are the different types of conjunctivitis?

Conjunctivitis is usually divided into at least two categories, newborn conjunctivitis and childhood conjunctivitis, with different causes and treatments for each.

• Newborn Conjunctivitis: The following are the most common causes and treatment options of newborn conjunctivitis:
• Chemical Conjunctivitis - This is related to an irritation in the eye from the use of eye drops that are given to the newborn to help prevent a bacterial infection. Sometimes, the newborn reacts to the drops and may develop a chemical conjunctivitis. The eyes are usually mildly red and inflamed, starting a few hours after the drops have been placed in the eye, and lasts for only 24 to 36 hours. This type of conjunctivitis usually requires no treatment.
• Gonococcal Conjunctivitis - This is caused by a bacteria called Neisseria gonorrhea. The newborn obtains this type of conjunctivitis by the passage through the birth canal from an infected mother. This type of conjunctivitis may be prevented with the use of eye drops in newborns at birth. The newborn eyes usually are very red, with thick drainage and swelling of the eyelids. This type usually starts about 2 to 4 days after birth. Treatment for gonococcal conjunctivitis usually will include antibiotics through an intravenous (IV) catheter.

 

• Inclusion Conjunctivitis - This is caused by an infection with chlamydia trachomatis, obtained by passage through the birth canal from an infected mother. The symptoms include moderate thick drainage from the eyes, redness of the eyes, swelling of the conjunctiva, and some swelling of the eyelids. This type of conjunctivitis usually starts 5 to 12 days after birth. Treatment usually will include oral antibiotics.
• Other bacterial Causes - After the first week of life, other bacteria may be the cause of conjunctivitis in the newborn. The eyes may be red and swollen with some drainage. Treatment depends on the type of bacteria that has caused the infection. Treatment usually will include antibiotic drops or ointments to the eye, warm compresses to the eye, and proper hygiene when touching the infected eyes.
• Childhood Conjunctivitis: Childhood conjunctivitis is a swelling of the conjunctiva and may also include an infection. It is a very common problem in children. Also, large outbreaks of conjunctivitis are often seen in daycare settings or schools. The following are the most common causes of childhood conjunctivitis:
• bacteria
• viral
• allergies
• herpes

 

What are the symptoms of childhood conjunctivitis?

The following are the most common symptoms of childhood conjunctivitis. However, each child may experience symptoms differently. Symptoms may include:

• itchy, irritated eyes
• clear, thin drainage (usually seen with viral or allergic causes)
• sneezing and runny nose (usually see with allergic causes)
• stringy discharge from the eyes (usually seen with allergic causes)
• thick, green drainage (usually seen with bacterial causes)
• ear infection (usually seen with bacterial causes)
• lesion with a crusty appearance (usually seen with herpes infection)
• eyes that are matted together in the morning
• swelling of the eyelids
• redness of the conjunctiva

 

• discomfort when the child looks at a light
• burning in the eyes

 

The symptoms of conjunctivitis may resemble other medical conditions or problems. Always consult your child's physician for a diagnosis.

 

How is conjunctivitis diagnosed?

Conjunctivitis is usually diagnosed based on a complete medical history and physical examination of your child's eye. Cultures of the eye drainage are usually not required, but may be done to help confirm the cause of the infection.

 

Treatment for conjunctivitis:

Specific treatment for conjunctivitis will be determined by your physician based on:

• your child's age, overall health, and medical history
• extent of the condition
• your child's tolerance for specific medications, procedures, or therapies
• expectations for the course of the condition
• your opinion or preference

 

Specific treatment depends on the underlying cause of the conjunctivitis.

• Bacterial causes: Your child's physician may order antibiotic drops to put in the eyes.
• Viral causes: Viral conjunctivitis usually does not require treatment. Your child's physician may order antibiotic drops for the eyes to help decrease the chance of a secondary infection.
• Allergic causes: Treatment for conjunctivitis caused by allergies usually will involve treating the allergies. Your child's physician may order oral medications or eye drops to help with the allergies.
• Herpes: If your child has an infection of the eye caused by a herpes infection, your child's physician may refer you to an eye care specialist. Your child may be given both oral medications and eye drops. This is a more serious type of infection and may result in scarring of the eye and loss of vision.

 

 

 

Infection can be spread from one eye to the other, or to other people, by touching the affected eye or drainage from the eye. Proper hand washing is very important. Drainage from the eye is contagious for 24 to 48 hours after beginning treatment.

 

Eye Injury (Black Eye)

 

What is ecchymosis or bruising of the eye?

Ecchymosis, or more commonly known as a “black eye," usually occurs from some type of trauma to the eye, causing the tissue around the eye to become bruised. Your child's physician will examine the eye closely to make sure there is no damage to the actual eye itself.

 

Treatment for a black eye:

Specific treatment for a black eye will be determined by your child's physician based on:

• your child's age, overall health, and medical history
• extent of the injury
• your child's tolerance for specific medications, procedures, or therapies
• expectations for the course of the injury
• your opinion or preference

 

Most black eyes heal completely and do not cause any damage to the eye. Treatment may include:

• cold compresses to the eye for the first 24 hours
• warm compresses to the eye after the first 24 hours
• continued compresses until the swelling stops
• keep the child's head elevated to help decrease the amount of swelling

 

It is important to know that the swelling and bruise may appear to spread and go down the cheek or to the other eye. This is normal. Consult your child's physician if the bruising and swelling does not resolve on its own.

 

 

 

 

 

 

Ear, Nose, and Throat Conditions

 

Children can have many problems with their ears, nose, and throat. In fact, ear infections alone account for millions of doctor's appointments each year. Listed in the directory below are some common conditions of the ear, nose, and throat in the growing child, for which we have provided a brief overview.

 

Otitis Media

 

What is Otitis Media (OM)?

Otitis media is inflammation located in the middle ear. Otitis media can occur as a result of a cold, sore throat, or respiratory infection.

 

Facts about Otitis Media:

• More than 80 percent of children have at least one episode of otitis media by the time they are 3 years of age.
• Nearly half of these children have three or more episodes by the time they are 3 years of age.
• Otitis media can also affect adults, although it is primarily a condition that occurs in children.
• Otitis media is the most common diagnosis for children in the US.
• Otitis media occurs more often in the winter and early spring.

 

Who is at risk for getting ear infections?

While any child may develop an ear infection, the following are some of the factors that may increase your child's risk of developing ear infections:

• being around someone who smokes
• family history of ear infections
• a poor immune system
• spends time in a daycare setting
• absence of breastfeeding
• having a cold
• bottle-fed while laying on his/her back

 

 

 

What causes Otitis Media?

Middle ear infections are usually a result of a malfunction of the Eustachian tube, a canal that links the middle ear with the throat area. The Eustachian tube helps to equalize the pressure between the outer ear and the middle ear. When this tube is not working properly, it prevents normal drainage of fluid from the middle ear, causing a buildup of fluid behind the eardrum. When this fluid cannot drain, it allows for the growth of bacteria and viruses in the ear that can lead to acute otitis media. The following are some of the reasons that the Eustachian tube may not work properly:

• a cold or allergy which can lead to swelling and congestion of the lining of the nose, throat, and Eustachian tube (this swelling prevents the normal flow of fluids)
• a malformation of the Eustachian tube

 

What are the different types of otitis media?

Different types of otitis media include the following:

• acute otitis media (AOM) - the middle ear infection occurs abruptly causing swelling and redness. Fluid and mucus become trapped inside the ear, causing the child to have a fever, ear pain, and hearing loss.
• otitis media with effusion (OME) - fluid (effusion) and mucus continue to accumulate in the middle ear after an initial infection subsides. The child may experience a feeling of fullness in the ear and hearing loss.

 

What are the symptoms of otitis media?

The following are the most common symptoms of otitis media. However, each child may experience symptoms differently. Symptoms may include:

• unusual irritability
• difficulty sleeping or staying asleep
• tugging or pulling at one or both ears
• fever
• fluid draining from ear(s)
• loss of balance
• hearing difficulties
• ear pain
• nausea and vomiting
• diarrhea

 

• decreased appetite
• congestion

 

The symptoms of otitis media may resemble other conditions or medical problems. Always consult your child's physician for a diagnosis.

 

How is otitis media diagnosed?

In addition to a complete medical history and physical examination, your child's physician will inspect the outer ear(s) and eardrum(s) using an otoscope. The otoscope is a lighted instrument that allows the physician to see inside the ear. A pneumatic otoscope blows a puff of air into the ear to test eardrum movement.

 

Tympanometry, is a test that can be performed in most physicians' offices to help determine how the middle ear is functioning. It does not tell if the child is hearing or not, but helps to detect any changes in pressure in the middle ear. This is a difficult test to perform in younger children because the child needs to remain still and not cry, talk, or move.

 

A hearing test may be performed for children who have frequent ear infections.

 

Treatment for otitis media:

Specific treatment for otitis media will be determined by your child's physician based on the following:

• your child's age, overall health, and medical history
• extent of the condition
• your child's tolerance for specific medications, procedures, or therapies
• expectations for the course of the condition
• your opinion or preference

 

Treatment may include:

• antibiotic medication by mouth or ear drops
• medication (for pain)

 

If fluid remains in the ear(s) for longer than three months, your child's physician may suggest that small tubes be placed in the ear(s). This surgical procedure, called myringotomy, involves making a small opening in the eardrum to drain the

 

fluid and relieve the pressure from the middle ear. A small tube is placed in the opening of the eardrum to ventilate the middle ear and to prevent fluid from accumulating. The child's hearing is restored after the fluid is drained. The tubes usually fall out on their own after six to twelve months.

 

Your child's surgeon may also recommend the removal of the adenoids (lymph tissue located in the space above the soft roof of the mouth, also called nasopharynx) if they are infected. Removal of the adenoids has shown to help some children with otitis media.

 

Treatment will depend upon the type of otitis media. Consult your child's physician regarding treatment options.

 

What are the effects of otitis media?

In addition to the symptoms of otitis media listed above, untreated otitis media can result in any/all of the following:

• infection in other parts of the head
• permanent hearing loss
• problems with speech and language development

 

 

Nosebleeds

 

Nosebleeds can be a scary occurrence, but are usually not dangerous. The medical term for nosebleed is epistaxis. They are fairly common in children, especially in dry climates or during the winter months when dry heat inside homes and buildings can cause drying, cracking, or crusting inside the nose. Many times, children outgrow the tendency for nosebleeds during their teenage years.

 

The front part of the nose contains many fragile blood vessels that can be damaged easily. Most nosebleeds in children occur in the front part of the nose close to the nostrils.

 

 

 

 

What causes a nosebleed?

Nosebleeds are caused by many factors, but some of the most common causes include the following:

• picking the nose
• blowing the nose too hard
• injury to the nose
• over-dry air
• colds and allergies
• foreign body in the nose

 

Many times no apparent cause for a nosebleed can be found.

 

First-aid for nosebleeds:

• Calm your child and let him/her know you can help.
• Pinch the nostrils together for five to ten minutes without checking to see if bleeding has stopped.
• Have your child sit up and lean forward to avoid swallowing blood.
• Apply ice or a cold water compress to the bridge of the nose.
• If bleeding does not stop, try the above steps one more time.
• Do not pack your child's nose with tissues or gauze.

 

When should I call my child's physician?

Specific treatment for nosebleeds, that require more than minor treatment at home, will be determined by your child's physician. In general, call your child's physician for nosebleeds if:

• you are unable to stop the nosebleed or if it recurs.
• your child also has a nose injury that may indicate a more serious problem (such as a fractured nose or other trauma to the head).
• there is a large amount or rapid loss of blood.
• your child feels faint, weak, ill, or has trouble breathing.
• your child has bleeding from other parts of the body (such as in the stool, urine, or gums) or bruises easily.
• there is a foreign body stuck in your child's nose.

 

 

 

 

Prevention of nosebleeds:

If your child has frequent nosebleeds, some general guidelines to help prevent nosebleeds from occurring include the following:

• Use a cool mist humidifier in your child's room at night if the air in your home is dry. Be sure to follow the manufacturer's advice for cleaning the humidifier so that germs and mold do not grow in it.
• Teach your child not to pick his/her nose or blow it too forcefully.
• Apply petroleum jelly inside the nostrils several times a day, especially at bedtime, to help keep the area moist.
• Use saline (salt water) drops or a saline nose spray, as directed by your child's physician.
• See your child's physician for treatment of allergies that may contribute to frequent nosebleeds.

 

 

Gastrointestinal Conditions

 

A healthy digestive system processes the foods and liquids that we eat, replenishing vitamins, minerals, proteins, carbohydrates, and fats that are vital for the body to function properly. From time to time, infants and children experience digestive conditions, such as vomiting or diarrhea. Listed in the directory below are some common digestive conditions in the growing child, for which we have provided a brief overview.

 

Colic

 

What is colic?

Colic is a problem that affects some babies during the first three to four months of life. It can be very stressful and frustrating to parents. It is defined by the "rule of three": crying at least 3 hours per day, more than 3 days per week, and for 3 weeks duration or more. Colic usually begins suddenly, with loud and mostly continuous crying.

 

What causes colic?

Physicians are not certain what causes colic. There are several theories about why colic may or may not occur, including the following:

• Adjusting to each other: One theory about colic relates to the adjustments that a new baby and his/her parents have to make to each other. Until babies learn to talk, one way they communicate with adults is by crying. Parents have to learn to interpret the reasons their baby is crying, and then figure out what to do to make the baby happy. Is the baby hungry? Wet? Cold? Hot? Tired? Bored? A baby will cry for these reasons, as well as for other problems, and parents must try to determine what is causing their baby's stress, often by trial and error. New parents, especially, may have trouble reading their baby's cues and responding appropriately. The baby may continue to cry simply because its needs have not yet been met.
• Temperament and adjusting to the world: Newborns must also make adjustments to the world they are living in. Not all babies have the same temperament. Some adjust to lights, loud noises, and all the other timulation around them with no trouble, while others are not able to adapt as easily.

 

Just like adults, some babies are easy-going, and some are impatient. Crying may be one way for a baby to vent feelings as he/she is getting adjusted to the world. Babies have been noted to cry for specific lengths of time every day, as they are getting used to the world, and as their parents are learning to interpret their needs.

• Oversensitivity to gas: Another possible reason for excessive crying in babies might be due to an oversensitivity to gas in the intestine. Physicians do not think that babies with colic produce more gas than others, but simply that the normal amount of gas that is produced as food is digested is uncomfortable for some babies. If a baby with colic seems to pass more gas than other babies do, it is probably due to swallowing more air while crying for prolonged periods of time.
• Milk allergy: Milk allergies may cause abdominal pain, but usually also cause diarrhea. A baby who cannot tolerate cow's milk and responds to a change in formula may have a milk allergy.

 

What are the symptoms of colic?

A child who is otherwise well, who cries or is fussy several hours a day, especially from 6 pm to 10 pm, with no apparent reason, may have colic. Also, babies with colic may burp frequently or pass a significant amount of gas, but this is thought to be due to swallowing air while crying, and is not a cause of colic. The face may be flushed. The abdomen may be tense with legs drawn toward it. The hands may be clenched and the feet are often cold.

 

The symptoms of colic may resemble other conditions or medical problems. Always consult your child's physician for a diagnosis.

 

Who is at risk for colic?

Infants who are either under or over fed may be more susceptible to colic. Those who are allergic to formula or something in the mother's diet (if breastfed), are prone to colic symptoms. Infants in the 0 to 3 month age range who are started on cereal or other high carbohydrate food are also likely to develop colic as a result of excessive fermentation. Lastly, an emotionally unstable environment may contribute to colic symptoms in an infant.

 

 

 

Why is colic a concern?

Colic may become a concern due to the following reasons:

• frustrating and stressful to parents
• parents and infant lose sleep
• infant may be overfed in an attempt to stop the crying

 

Babies with colic usually grow and gain weight appropriately, despite being fussy or irritable, being gassy, and losing sleep.

 

How is colic diagnosed or evaluated?

A physician will examine your baby and obtain a medical history. Questions might be asked about how long and how often your child cries, if you have noticed anything that seems to trigger the crying, and what comfort measures are effective, if any. Blood tests and x-rays or other imaging tests may be done to determine if there are other problems present.

 

When should we contact a physician?

Before assuming your child has colic, you should look for other signs of illness. These may include, but are not limited to, the following:

• not sucking or drinking a bottle well
• drinking less milk than usual
• vomiting
• diarrhea
• becoming more irritable when held or touched
• strange sounding cry
• change in breathing rate or effort
• being more sleepy or sluggish than usual

 

Call your child's physician if you note any of these symptoms, or if your baby is crying excessively. Your child's physician will examine your child to make sure other problems are not present that might be causing colic-like symptoms.

 

Dealing with colic:

Learning how to interpret your baby's cry can be helpful in dealing with colic. It does take some time for parents and babies to become accustomed to each other.

 

 

Remember, babies will cry for a certain length of time every day under normal circumstances. Other suggestions include the following:

• Make sure your baby is not hungry, but do not force feed if he/she is not interested in the bottle or breast.
• Change your baby's position. Sit him/her up if lying down. Let your baby face forward if you are carrying or holding him/her facing your chest. Babies like to see different views of the world.
• Give your baby interesting things to look at: different shapes, colors, textures, and sizes. Talk to your baby. Sing softly to your baby.
• Rock your baby.
• Walk your baby.
• Place your baby in an infant swing on a slow setting.
• Let your baby lay on his/her belly on your lap or on the bed, and rub his/her back. Never leave your baby unattended on a bed, sofa, or other soft surface.
• Go for a ride in the car. The motion of the car often soothes babies.
• Try using something in your child's room that makes a repetitive sound, like a wind-up alarm clock or heartbeat audio tape.
• Hold and cuddle your baby. Babies cannot be spoiled by too much attention. However, they can have problems later in life if they are ignored and their needs are not met as infants.
• Let an adult family member or friend (or a responsible babysitter) care for your baby from time to time so that you can take a break. Taking care of yourself and lowering your stress level may help your baby as well.

 

What is the long-term outlook for a child with colic?

The symptoms of colic usually resolve by the time a baby is about 4 months of age. Consult your child's physician for more information.

 

 

 

 

 

 

 

 

Constipation

 

What is constipation?

Constipation is defined as:

• a decrease in frequency of bowel movements, compared to a child's usual pattern (some physicians define constipation as fewer than three bowel movements per week).
• the passage of hard, often times large caliber dry bowel movements.
• bowel movements that are difficult or painful to push out.

 

What causes constipation?

Sometimes, there is no identifiable reason for constipation in children. However, some of the causes may include:

• diet
• Some children eat too much of foods that are high in fat and low in fiber (such as fast foods, "junk" foods, and soft drinks).
• Some children do not drink enough water and liquids.
• lack of exercise
• Children who stay inside, watching TV and playing video games, do not get enough exercise. Exercise helps move digested food through the intestines.
• emotional issues
• Pre-school and school-aged children are sometimes embarrassed to use public bathrooms and hold in their bowel movements, causing constipation.
• Toddlers can be overwhelmed by toilet training, especially when a parent is more anxious for the child to be out of diapers than the child is.
• Toddlers can also become involved in power-struggles with their parents as they learn to assert their independence, and may intentionally, hold bowel movements in.
• Some children who experience stress at school, with their friends, or in the family, may have constipation.

 

 

 

• busy children
• Some children ignore signals their intestines give them to have a bowel movement. This can happen when children are too busy playing and forget to go to the bathroom.
• Constipation can also be a problem when children start a new school year, since they are no longer able to go to the bathroom whenever the urge strikes and have to change their bowel routine.
• Once a child becomes constipated, a vicious cycle can develop. Hard, dry stools can be painful to push out, and the child can avoid using the bathroom to avoid the discomfort. Eventually, the intestine will not be able to sense the presence of stool.

 

Physical problems that can cause constipation include the following:

• abnormalities of the intestinal tract, rectum, or anus
• problems of the nervous system, such as cerebral palsy
• endocrine problems, such as hypothyroidism
• certain medications (i.e., iron preparations and narcotics such as codeine)

 

Why is constipation a concern?

Hard stools can irritate or tear the lining of the anus (fissure), making it painful to have a bowel movement. The child may avoid having a bowel movement, which can cause further constipation.

 

What are the symptoms of constipation?

The following are the most common symptoms of constipation. However, each individual may experience symptoms differently. Symptoms may include:

• not having a bowel movement for several days, or passing hard, dry stools
• abdominal bloating, cramps, or pain
• decreased appetite
• clenching teeth, crossing legs, squeezing buttocks together, turning red in the face as the child tries to hold in a bowel movement to avoid discomfort
• small liquid or soft stool smears that soil the child's underwear

 

The symptoms of constipation may resemble other conditions or medical problems. Always consult your child's physician for a diagnosis.

 

 

How is constipation diagnosed?

A physician will examine your child and obtain a complete medical history. Depending on the age of your child, you might be asked questions such as:

• How old was your baby when he/she had their first stool?
• How often does your child have a bowel movement?
• Does your child complain of pain when he/she has a bowel movement?
• Have you been trying to toilet train your toddler recently?
• What does your child's diet consist of?
• Have there been any stressful events in your child's life lately?
• How often does your child soil his/her pants?

 

Occasionally, your child's physician may want to perform other diagnostic tests to determine if there are any problems. These tests may include:

• digital rectal examination (DRE) - a physician or healthcare provider inserts a gloved finger into the rectum to feel for anything unusual or abnormal.
• abdominal x-ray - a diagnostic test to evaluate the amount of stool in the large intestine.
• barium enema - a procedure performed to examine the large intestine for abnormalities. A fluid called barium (a metallic, chemical, chalky, liquid used to coat the inside of organs so that they will show up on an x-ray) is given into the rectum as an enema. An x-ray of the abdomen shows strictures (narrowed areas), obstructions (blockages), and other problems.
• anorectal manometry - a test that measures the strength of the muscles in the anus, nerve reflexes, ability to sense rectal distention, and coordination of muscles during defecation.
• rectal biopsy - a test that takes a sample of the cells in the rectum to be examined under a microscope for any problems.

 

When should you contact a physician?

Do not hesitate to contact your child's physician if you have any questions or concerns about your child's bowel habits or patterns. The National Institutes of Health recommends that you talk to your child's physician if:

• episodes of constipation last longer than 3 weeks.
• the child is unable to participate in normal activities because of constipation.
• normal pushing is not enough to expel a stool.
• liquid or soft stool leaks out of the anus.

 

• small, painful tears appear in the skin around the anus.
• hemorrhoids develop.

 

Treatment for constipation:

Specific treatment for constipation will be determined by your child's physician based on the following:

• your child's age, overall health, and medical history
• extent of the condition
• type of condition
• your child's tolerance for specific medications, procedures, or therapies
• expectations for the course of the condition
• your opinion or preference

 

Treatment may include:

• Diet changes – Often, making changes in your child's diet will help constipation. Consider the following suggestions:

• Increase the amount of fiber in your child's diet by:
  • adding more fruits and vegetables.
  • adding more whole grain cereals and breads (check the nutritional labels on food pack ages for foods that have more fiber).
• Offer your child fruit juice instead of soft drinks.
• Encourage your child to drink more fluids, especially water.
• Limit fast foods and junk foods that are usually high in fats and offer more well-balanced meals and snacks.
• Limit drinks with caffeine, such as cola drinks and tea.
• Limit whole milk to 16 ounces a day for the child over 2 years of age, but do not eliminate milk altogether. Children need the calcium in milk to help their bones grow strong.

Plan to serve your child's meals on a regular schedule. Often, eating a meal will stimulate a bowel movement within 30 minutes to an hour. Serve breakfast early so your child does not have to rush off to school and miss the opportunity to have a bowel movement.

 

• Increase exercise - Increasing the amount of exercise your child gets can also help with constipation. Exercise aids digestion by helping the normal movements the intestines make to push food forward as it is digested.

 

People who do not move around much are often constipated. Encourage your child to go outside and play rather than watch TV or engage in other indoor activities.

• Proper bowel habits - Have your child sit on the toilet at least twice a day for at least 10 minutes, preferably shortly after a meal. Make this time pleasant; do not scold or criticize the child if they are unable to have a bowel movement. Giving stickers or other small rewards, and making posters that chart your child's progress can help motivate and encourage him/her.

 

If these methods do not help, or if your physician notices other problems, he/she may recommend laxatives, stool softeners, or an enema. These products should ONLY be used with the recommendation of your child's physician. DO NOT use them without consulting with your child's physician first.

 

What is the long-term outlook for a child with constipation?

The outlook depends on what type of condition caused the constipation. Those children with diseases of the intestine, such as Hirschsprung's disease, may have chronic problems. However, most of the time, constipation is a temporary situation.

 

 

 

Diarrhea

 

What is diarrhea?

Diarrhea is defined either as watery stool or increased frequency (or both) when compared to a normal amount. It is a common problem that may last a few days and disappear on its own.

 

Diarrhea may be:

• acute (short-term, lasting less than two weeks), which is usually related to bacterial or viral infections.
• chronic (long-term, lasting longer than two weeks), which is usually related to functional disorders, such as irritable bowel syndrome, or may be due to diseases such as ulcerative colitis, Crohn's disease, celiac sprue, or Giardia.

 

 

 

 

What causes diarrhea?

Diarrhea in children may be caused by a number of conditions, including the following:

• bacterial infection
• viral infection
• food intolerances or allergies
• parasites
• reaction to medications

 

What are the symptoms of diarrhea?

The following are the most common symptoms for diarrhea. However, each child may experience symptoms differently. Severe diarrhea may indicate a serious disease, making it important to consult your child's physician if any/all of the following symptoms persist:

• cramping
• abdominal pain
• bloating
• nausea
• urgent need to use the restroom
• fever
• bloody stools

 

The symptoms of diarrhea may resemble other conditions or medical problems. Always consult your child's physician for a diagnosis.

 

Warning signs of severe diarrhea:

You should call your pediatrician if your child is less than 6 months of age or presents any of the following symptoms:

• abdominal pain
• blood in the stool
• frequent vomiting
• loss of appetite for liquids
• high fever
• dry, sticky mouth
• weight loss
• urinates less frequently (wets fewer than 6 diapers per day)

 

• frequent diarrhea
• extreme thirst
• no tears when crying
• depressed fontanelle (soft spot) on infant's head

 

How is diarrhea diagnosed?

In addition to a complete physical examination and laboratory tests for blood and urine, the child's physician may request:

• laboratory examination of stool sample
• additional blood tests

 

Treatment for diarrhea:

Specific treatment for diarrhea will be determined by your child's physician based on:

• your child's age, overall health, and medical history
• extent of the condition
• your child's tolerance for specific medications, procedures, or therapies
• the expectations for the course of the condition
• your opinion or preference

 

Treatment usually involves replacing lost fluids. Antibiotics may be prescribed when bacterial infections are the cause. A child with diarrhea can have regular fluids or special fluids (such as Pedialyte™ or Gatorade™) for diarrhea. Do not use anti-diarrheal medications unless recommended by your child's physician.

 

 

Summer Signs and Preventions

 

Tips for Preventing Heat-Related Illness

 

The best defense is prevention.  Here are some prevention tips:

 

• Drink more fluids (nonalcoholic), regardless of your activity level. Don’t wait until you’re thirsty to drink.  Warning: If your doctor generally limits the amount of fluid you drink or has you on water pills, ask him how much you should drink while the weather is hot.

 

• Don’t drink liquids that contain caffeine, alcohol, or large amounts of sugar – these actually cause you to lose more body fluid.  Also, avoid very cold drinks, because they can cause stomach cramps.

 

• Stay indoors and, if at all possible, stay in an air-conditioned place.  If your program does not have air conditioning, go to the shopping mall or public library – even a few hours spent in air conditioning can help your body stay cooler when you go back into the heat.  Call your local health department to see if there are any heat-relief shelters in your area.

 

• Electric fans may provide comfort, but when the temperature is in the high 90s, fans will not prevent heat-related illness.  Taking a cool shower or bath, or moving to an air-conditioned place is a much better way to cool off.  If fans are used in your program, make sure that the children’s safety is your first priority.  Electric cords should not be in reach of children.  Fan blades should be completely covered.

 

• Wear lightweight, light-colored, loose-fitting clothing.

 

• NEVER leave anyone, adult or child in a closed, parked vehicle.

 

 

 

• Although anyone at any time can suffer from heat-related illness, some people are at greater risk than others.  Check regularly on:

 

• Infants and young children
• People aged 65 or older
• People who have a mental illness
• Those who are physically ill, especially with heart disease or high blood pressure

 

• Visit adults at risk at least twice a day and closely watch them for signs of heat exhaustion or heat stroke.  Infants and young children, of course, need much more frequent watching.

 

If you must be out in the heat:

 

• Limit your outdoor activity to morning and evening hours.  It is suggested to change your outside times at your program so that most children go outside between 7am and noon.

 

• Cut down on exercise.  If you must exercise, drink two to four glasses of cool, nonalcoholic fluids each hour.  A sports beverage can replace the salt and minerals you lose in sweat.  Warning: If you are on a low-salt diet, talk with your doctor before drinking a sports beverage. Remember the warning in the first “tip” (above), too.

 

• Try to rest often in shady areas.

 

• Protect yourself from the sun by wearing a wide-brimmed hat (also keeps you cooler) and sunglasses and by putting on sunscreen of SPF-15 or higher (the most effective products say “broad spectrum” or “UVA/UVB protection” on their labels).

 

Heat Exhaustion

 

Heat exhaustion is a milder form of heat-related illness that can develop after several days of exposure to high temperatures and inadequate or unbalanced replacement of fluids.  Those most prone to heat exhaustion are elderly people, people with high blood pressure, and people working or exercising in a hot environment.

 

Recognizing Heat Exhaustion

 

Warning signs of heat exhaustion include the following:

• Heavy sweating                         ·    Muscle Cramps
• Headache                                  ·    Tiredness
• Nausea or vomiting                   ·    Weakness
• Fainting                                    ·    Dizziness
• Paleness 

 

The skin may be cool and moist.  The victim's pulse rate will be fast and weak, and breathing will be fast and shallow.  If heat exhaustion is untreated, it may progress to heat stroke.  Seek medical attention immediately if any of the following occurs:

 

• Symptoms are severe.
• The victim has heart problems or high blood pressure.

 

Otherwise, help the victim to cool off, and seek medical attention if symptoms worsen or last longer than 1 hour.

 

What to Do

 

Cooling measures that may be effective include the following:

• Cool, nonalcoholic beverages, as directed by your physician
• Rest
• Cool shower, bath, or sponge bath
• An air-conditioned environment
• Lightweight clothing

 

Heat Stroke

 

Heat stroke occurs when the body is unable to regulate its temperature.  The body's temperature rises rapidly, the sweating mechanism fails, and the body is unable to cool down.  Body temperature may rise to 106°F or higher within 10 to 15 minutes.  Heat stroke can cause death or permanent disability if emergency treatment is not provided.

 

Recognizing Heat Stroke

 

Warning signs of heat stroke vary but may include the following:

• An extremely high body temperature (above 103°F, orally)
• Red, hot, and dry skin (no sweating)
• Rapid, strong pulse
• Throbbing headache
• Dizziness
• Nausea
• Confusion
• Unconsciousness

 

What to Do

 

If you see any of these signs, you may be dealing with a life-threatening emergency.  Have someone call for immediate medical assistance while you begin cooling the victim.   Do the following:

 

• Get the victim to a shady area.
• Cool the victim rapidly using whatever methods you can. For example, immerse the victim in a tub of cool water; place the victim in a cool shower; spray the victim with cool water from a garden hose; sponge the victim with cool water; if the humidity is low, wrap the victim in a cool, wet sheet and fan him or her vigorously.
• Monitor body temperature, and continue cooling efforts until the body temperature drops to 101-102°F.
• If emergency medical personnel are delayed, call the hospital emergency room for further instructions.
• Do not give the victim alcohol to drink.
• Get medical assistance as soon as possible.

 

Sometimes a victim's muscles will begin to twitch uncontrollably as a result of heat stroke.  If this happens, keep the victim from injuring himself, but do not place any object in his mouth and do not give fluids.  If there is vomiting, make sure the airway remains open by turning the victim on his or her side.

 

 

Sunburn

 

Sunburn should be avoided because it damages the skin.  Although the discomfort is usually minor and healing often occurs in about a week, more severe sunburns may require medical attention.

 

Recognizing Sunburn

 

Symptoms of sunburn are well known: skin becomes red, painful, and abnormally warm after sun exposure.

 

What to Do

 

Consult a doctor if the sunburn affects an infant younger than 1 year of age or if these symptoms are present:

 

• Fever
• Fluid-filled blisters
• Severe pain

 

Also, remember these tips when treating sunburn:

• Avoid repeated sun exposure.
• Apply cold compresses or immerse the sunburned area in cool water.
• Apply moisturizing lotion to affected areas.  Do not use salve, butter, or ointment.
• Do not break blisters.

 

 

 

 

 

Heat Rash

 

Heat rash is a skin irritation caused by excessive sweating during hot, humid weather.  It can occur at any age but is most common in young children.

 

Recognizing Heat Rash

 

Heat rash looks like a red cluster of pimples or small blisters.  It is more likely to occur on the neck and upper chest, in the groin, under the breasts, and in elbow creases.

 

What to Do

 

The best treatment for heat rash is to provide a cooler, less humid environment.  Keep the affected area dry.  Dusting powder may be used to increase comfort, but avoid using ointments or creams -- they keep the skin warm and moist and may make the condition worse.

 

Treating heat rash is simple and usually does not require medical assistance. Other heat-related problems can be much more severe.

 

 

Heat Cramps

 

Heat cramps usually affect people who sweat a lot during strenuous activity. This sweating depletes the body's salt and moisture.  The low salt level in the muscles causes painful cramps.  Heat cramps may also be a symptom of heat exhaustion.

 

Recognizing Heat Cramps

 

Heat cramps are muscle pains or spasms -- usually in the abdomen, arms, or legs -- that may occur in association with strenuous activity.  If you have heart problems or are on a low-sodium diet, get medical attention for heat cramps.

 

 

 

What to Do

 

If medical attention is not necessary, take these steps:

• Stop all activity, and sit quietly in a cool place.
• Drink clear juice or a sports beverage.
• Do not return to strenuous activity for a few hours after the cramps subside, because further exertion may lead to heat exhaustion or heat stroke.
• Seek medical attention for heat cramps if they do not subside in 1 hour.

 

Be aware of allergies such as bee stings and other insects.  Be aware of ragweed, pollen, ECT.