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Spiders and Bees and Bugs, Oh My! Treating insect bites and stings

Another beautiful Seattle summer is just around the corner.  As we stare out windows and wait for our long days of sunshine to begin, know this – the bugs are doing the same thing!  Any day now all our biting, stinging, and pinching friends will begin to appear.  Make sure you prevent bites with insect repellants.  The American Academy of Pediatrics recommends using repellants containing 30% or less of DEET for all children older than 2 months of age.  But if a bite happens, arm yourself (and your medicine cabinet) with a treatment plan to get your kids back outside ASAP.
 
Treatment for ...

When do kids need antibiotics?

Winter can seem like one long continuous “sick day” for families - kids pick up frequent infections at school or daycare and pass them around to everyone at home.  Often it feels like by the time the illness has worked its way through the household, a new one has started!  Even for physicians, it can sometimes be difficult to distinguish between viral and bacterial infections.  Since antibiotics cannot treat viruses, they are often over-prescribed - which can lead to significant side effects in children and also contributes bacteria becoming resistant to existing medications.  In November 2013, the American Academy of Pediatrics released an updated guidance regarding antibiotic treatment, helping answer the frequently asked question about when kids need antibiotics.

Here's what you should know about antibiotics in these situations:

  • Ear infections ...

FDA finally defines gluten free

On August 5th, 2013, the U.S. Food and Drug Administration (FDA) at long last published a formal rule regulating the use of the term "gluten free" on foods and beverages.  Even though this came with a big sigh of relief to the millions of people with celiac disease living in the US, consumers should be aware that the law gives manufacturers one year to be in full compliance (and goes into effect August 5, 2014).

As we head into the final months before the law’s final compliance date, I thought I’d highlight a few other key points about this brand new law:

1. No symbols needed.  The law does not require or recommend manufacturers use any particular symbol or food label, but if a label should include any of the following phrases, compliance must be ensured:
    •    “Gluten-free”
    •    “Free of gluten”
    •    “No gluten”
    •    “Without gluten”

2.  It’s voluntary.  A manufacturer may produce gluten-free foods, but just choose not to label them as such.   

3.  “Gluten-free” does not mean “zero gluten”. The new law defines "gluten-free" to mean that a food contains less than 20 parts per million (20 ppm) of gluten.  (This tiny amount can be visualized as less than a tenth of a grain of salt on a slice of bread, and is acceptable as the standard for people with celiac disease).

4.  As with any rule, there are exceptions.  Although ...

Jaundice in newborn babies

As a new parent, you’re understandably eager and excited to leave the hospital and settle into your new routine with your baby. Sometimes, that routine is delayed due to the baby’s blood test confirming hyperbilirubinemia, also known as jaundice.

Jaundice in newborns is caused by an excess of red blood cells. Jaundice is seen as a yellow color to the skin, appearing first at the head (skin and sclera – or “whites of the eyes”) then progressing to the feet. As it decreases, it lessens in reverse. Before birth, the placenta removes bilirubin from the baby’s system; after birth, the baby’s liver takes over. In breast-fed babies, an imbalance between mother’s milk supply and baby’s feeding can lead to a higher-than-expected bili level. In addition to ensuring the baby is feeding well and having enough wet/stool diapers, phototherapy or “bili lights” may be needed. Bili lights help speed up the process by breaking down the bilirubin in the skin.

For phototherapy, your baby will be ...

Tips for kids with Inflammatory Bowel Disease (IBD)

Working as a CMA (certified medical assistant) in Swedish Pediatric Gastroenterology, I have the responsibility and honor of taking care of children diagnosed with a variety of gastrointestinal problems, one of the most serious being Inflammatory Bowel Disease (IBD).  IBD is an autoimmune disease that causes chronic intestinal inflammation.  Crohn’s disease and Ulcerative Colitis are the two main types of IBD, depending on the location and depth of inflammation in the gut. 

As I work with the families of children diagnosed with IBD, I am constantly amazed at what a complicated job they have, balancing life between a chronic illness and the challenges of “normal childhood”. 

As the school year gets off to a start, seeing how hectic life can become for most kids, I wanted to write down a few ways children with IBD might better empower themselves to gain control over their chronic disease:

Signs of Hearing Loss for Babies and Children

Early identification and intervention of childhood hearing loss is linked to improved outcomes in communication and learning. Most newborns receive a hearing screening before being discharged from the hospital. However, some children may experience hearing loss sometime after that initial screening. Childhood hearing loss can be caused by a number of factors including family history, health problems at birth, syndromes, persistent middle ear fluid, chronic ear infections, and exposure to loud noise or head trauma. Children with normal hearing typically demonstrate similar listening and vocalization behaviors. If your child does not display these behaviors, it may be a sign of possible hearing loss or other problems.

Does your baby…

 

Birth – 3 months

  • Wake or startle in response to a sudden noise?
  • Seem to be soothed by your voice?

4-6 months

  • Move ...

Food allergies and emergency epinephrine in Washington State schools

Food allergies have been on the rise in recent years.  Studies suggest that up to 1 in 13 children are affected by a food allergy.  Egg and cow’s milk are the most common food allergies for infants and toddlers.  Fortunately, most children will lose a milk or egg allergy by the time they enter school.  Peanut and tree nut allergies are also becoming more common.  Unfortunately, only 10-20% of children will ever outgrow a nut allergy.

Currently there is no cure for food allergies.  Instead, doctors rely on an accurate diagnosis, avoiding food triggers, and being prepared in the event of a severe reaction.  Making the situation more challenging, nearly half of children with a food allergy may be at risk for a potentially life-threatening reaction called anaphylaxis. 

Symptoms of anaphylaxis may include:

  • hives or itchy welts
  • swelling
  • vomiting or diarrhea
  • difficulty breathing (cough, wheeze or shortness of breath)
  • dizziness or passing out

During a severe food allergy reaction, epinephrine (“adrenaline”) can be a life-saving medication. Epinephrine is typically injected into a thigh muscle with an “auto-injector” device like EpiPen® or Auvi-Q™.  Oral antihistamines like Benadryl, Allegra, or Zyrtec can help with some anaphylaxis symptoms, but are not considered life-saving treatment.

Emergency Epinephrine in Schools

Until recently, only certain students in Washington State could receive a life-saving epinephrine injection while at school.  They needed to be diagnosed with a food allergy and already have an epinephrine injector in the health room.  However, some students may not have an injector at school, or they have their first serious allergic reaction while at school.  In that case, the school could only call 911 and hope they arrived in time to save a life.

In January 2013...

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