Asthma Awareness in Children by Dr. Patricia Avila, Pediatrician

“Asthma in children is one of the most common long term (chronic) diseases. It is estimated to affect 1 in every 10 children in the US. If your child has Asthma one of the most important things you must do is to learn as much as you can about Asthma. Being educated about your child’s Asthma will help you work together with your child’s doctor to control their Asthma and have the absolute best outcome.”

Dr. Patty Avila, Pediatrician

What is Asthma?

  1. It is a disease of the lungs that causes the airways or tubes that bring air into the lungs to become swollen and inflamed. The muscles around the airways become tight and it makes it hard to breath. This leads to episodes of coughing, wheezing, feeling breathless, chest pain/chest tightness, and feeling more tired than usual.
  2. It is more common in children where there is a parent or sibling or close relative with Asthma, Allergies, and/or Eczema. Children with Asthma often develop Allergies or Eczema as well. These are sometimes present before they develop Asthma.
  3. There is no cure for Asthma. There are medications and things you as a parent/caregiver can do to help control it. Know what the signs/symptoms of Asthma are, how to avoid triggers, and follow your doctor’s treatment plan. This is especially important to prevent and decrease the damage to your child’s lungs. It will also help avoid your child needing emergency medical treatment.

What causes an Asthma Attack?

  • An Asthma attack happens when your child is exposed to “triggers” things that cause your child’s Asthma to get worse.
  • An Asthma attack also happens when a child does not take their medications as prescribed.

Common triggers include:

  • Allergens – including outdoor allergens like pollen, animal dander, dust mites, mold, and cockroaches.
  • Infections – including the common cold, the flu, sinus infections, and pneumonias.
  • Irritants – including cigarette smoke or other smoke, pollution, strong odors like perfumes or scented candles, and cleaning products.
  • Changes in weather – cold and dry, very humid, or extremely hot weather.
  • Exercise.
  • Stress and strong emotions.

How can you help control your child’s Asthma and how is it treated? Avoid triggers. It may not be possible to completely avoid all possible triggers, but there are some changes you can make that will help.

  • Allergens. Have your child take their allergy medications during allergy season. Keep windows and doors shut during allergy season. Avoid outdoor activities when pollen counts are high.
  • Dust mites. Use mattresses and pillow covers. Vacuum and dust regularly. Wash bedding once a week. Limit and wash stuffed animals.
  • Furry pets. Keep pets out of your child’s bedroom. Wash pets more often.
  • Use HEPA filters.
  • Fix any water leaks that could lead to mold.
  • Infections. Make sure your child and family receive their yearly Flu vaccine. Having Asthma increases your child’s risk for severe Flu illness that can trigger an Asthma attack.
  • Use good hand hygiene.
  • Irritants. Do NOT allow anyone to smoke in your home or car. Avoid public places where smoking is allowed. Avoid use of perfumes, scented candles, incense, paints, and cleaning supplies that can irritate your child’s lungs. Check your local forecast for air quality and keep your child indoors when the pollution is bad.
  • Weather. Avoid outdoor activities in extreme weather conditions.
  • Exercise. If your child’s Asthma is triggered by exercise have your child take his/her Albuterol 15-30 minutes prior to activity to prevent these symptoms. Encourage your child to exercise and participate in sports. Know what medications help control his/her Asthma so that they can continue to be active.
  • Medications. Includes inhaled medications in the form of MDIs also known as inhalers or “pumps” and nebulizers that are given by a machine. Rescue or quick relief medications like Albuterol help during an Asthma attack. They help open the airways or tubes that bring air to the lungs. Long term controller medications like inhaled corticosteroids help improve the inflammation of the lungs. When these medications are used daily your child is less likely to have an Asthma attack.

Develop an Asthma Action Plan.

This plan is made with the help of your child’s doctor. It will help you and your child know what medications to use and when. It will also help you and your child know what to do in the case of an emergency. Share this plan with the school as well. It is important, because your child spends a good amount of time there and the school will know exactly what to do to help your child.

By becoming knowledgeable about your child’s Asthma, avoiding triggers, and following a good Asthma Action Plan you are taking important steps in keeping your child healthy. Have your child see his/her doctor at least 2 times per year to make sure their Asthma is under control. Do not forget to make sure your child and family receive a yearly Flu vaccine. Your child should be able to enjoy everyday activities and participate in sports without any problems breathing if their Asthma is under control.

Adverse Childhood Experiences and Child’s Brain Development by Dr. Patricia Avila, Pediatrician

Did you know that suffering a potentially traumatic event during childhood also known as ACE or Adverse Childhood Experience can have long lasting negative effects on a child’s health, brain development, and life potential? 

Adverse Childhood Experiences can include experiencing violence, abuse, neglect, witnessing violence in the home, loosing a family member, mental health issues in a parent, substance/alcohol abuse by a parent, or instability from divorce or having a parent become incarcerated. 

These events lead to what is called toxic stress. Research shows that this toxic stress negatively changes a child’s brain and body by affecting the child’s brain development, hormonal system and immune system. These changes can persist for years and can lead to long term behavioral, mental, physical health problems.

The toxic stress from ACEs on brain development can impact a child’s potential to: 

  • Develop normally – leading to delays in development.
  • Focus and learn – leading to learning disabilities, dropping out of school, lack of future job opportunities.
  • Make decisions – leading to increase risk taking behaviors such as involvement in drugs and unprotected sex, unwanted or teen pregnancy.
  • Develop mental illness – leading to increase depression, anxiety, and rates of suicide.
  • Form healthy, stable relationships – leading to continuing this cycle of toxic stress in their children and families.

Research also shows that toxic stress from Adverse Childhood Experiences negatively affects a child’s body and can lead to chronic health problems like: 

  1. Obesity.
  2. Cancer.
  3. Heart disease.
  4. Autoimmune problems.
  5. Asthma and chronic lung disease.
  6. Headaches.
  7. Early death from general poor health.

The more of these events a child has suffered, the higher the risk of developing these long-term problems.

The GOOD NEWS is that we can do something about this! Research also shows that we can PREVENT and UNDO the harm done and the future harm on a child’s brain and body. There are some simple things that parents/caregivers can do at home to help regulate a child’s stress response and change the negative impacts of the stress hormones to keep them healthy and on track with brain development.

These include providing our children with: 

1. Supportive and nurturing relationships.
a. Tell them and show them how loved, special, and important they are.
b. Spend quality time doing activities that they enjoy. Simple activities like making art, dancing, cooking, playing games, reading, and singing together are excellent choices.
c. Keep connections outside the home with friends and family members.
2. Regular physical activity. Recommendation for 1 hour of physical activity which does not have to be all at the same time. These can include sports, dance parties, hula hooping contests, hiking, playing tag, chasing the family dog, or anything you can think of to get your child physically active.
3. Healthy meals.
a. Avoid high sugar foods/drinks. Avoid high fat foods or foods/snacks high in carbohydrates.
b. Include fruits and vegetables with every meal. 5-9 servings of fruits/veggies per day are recommended. Fruits and veggies provide nutrients that no other foods can provide.
c. Include foods rich in healthy Omega 3 fatty acids such as fish, nuts, avocados, flax seeds.
4. Restful sleep.
a. Keep a routine with a regular bedtime.
b. Make sure the bedroom is quiet, calm and free of distractions.
c. Avoid all electronics including cell phone, tablet, computer, and TV 1-2 hours prior to bedtime.
5. Getting mental health care for yourself as parent/caregiver and for your child.
6. Practicing mindfulness.
a. This can include meditation, breathing exercises, and prayer.
b. Talk with your child about how they are feeling physically and emotionally.
c. Practice talking about, writing down, or drawing what you are grateful for each day with your child.

All of these will build connections in their brains to help them succeed in school, behave in ways you would expect and become happier, healthier, and more successful.
When parents and caregivers manage stress in positive ways as well, your brain also changes in ways to make you happier and healthier.

Learn ways to manage your stress as a parent/caregiver:

  1. Know what is stressing you out. When you know what exactly it is, you can better deal with it.
  2. Ask yourself “can I do something about this?” If the answer is no, then let it go and focus on something else. If the answer is yes, break it down to small steps so that it is not overwhelming.
  3. Have faith. Think of other times you have overcome challenges. It has been proven that people who attend church, pray or practice other forms of spirituality have less stress.
  4. Relax. Use breathing exercises, meditation, listen to music, or take a nap.
  5. Form healthy habits for yourself by getting good sleep, exercising, and eating well.
  6. Take time for yourself like reading a book, picking up a hobby, or spending time with friends.
  7. Make connections with others. Have a support network that includes friends and family. Don’t be afraid to ask for help.
  8. You are never alone. Your child’s Pediatrician or Family Doctor can also be a great resource and support person for you. They can help give you ideas, resources, and help connect you with others who can help.

Additional resources:
Crisis Text Line Text HOME to 741-741 to connect with a Crisis Counselor. It is Free and is available 24/7.
National Domestic Violence Hotline 1-800-799-SAFE (7233) or text LOVEIS to 22522. Available 24/7.
Childhelp National Child Abuse Hotline 1-800-4-A-CHILD, 1-800-422-4453 or chat/text at www.childhelphotline.org. Available 24/7.

Amazing Brain Series of booklets to help parents/caregivers:
http://preventchildabuse.org/wp-content/uploads/2016/02/ABSapps.pdf
preventchildabuse.org/wp-content/uploads/2016/02/ABSwhateveryparent.pdfpreventchildabuse.org/wp-content/uploads/2016/02/ABStrauma.pdfpreventchildabuse.org/wp-content/uploads/2016/02/ABSteen.pdf

Other websites with great ideas for parents/caregivers:
https://childdevelopmentinfo.com/family-building/everyday-practices-to-make-your-child-feel-loved/#gs.4csgtk
https://childdevelopmentinfo.com/family-building/family-life-is-important-for-kids-mental-health-and-adjustment-to-life/#gs.4csmks

Know the Facts about Children and Diabetes by Dr. Jain, Pediatrician and Brandon Bolton, RDN

The Defeat Diabetes Foundation (DDF) has named April Defeat Diabetes Month. Defeat Diabetes Month is a time to raise awareness about diabetes prevention, management, and treatment throughout our communities. At NOAH, we are here to help you through all aspects of defeating diabetes, from awareness through treatment.

There are multiple forms of diabetes, but the two most common forms are called type 1 and type 2 diabetes mellitus. Both forms can occur at any age, but a child is typically more likely to be diagnosed with type 1 diabetes. However, with childhood obesity rates on the rise, the number of children diagnosed with type 2 diabetes or who are at risk of developing type 2 diabetes later in life is also increasing. According to the DDF, 1 in 3 US children is overweight or obese. 75% of these children will become overweight or obese adults, and 87.5% of adults diagnosed with type 2 diabetes in the US are overweight or obese.

The DDF has created three different steps to help win the fight to defeat diabetes. The three steps include awareness, action, and prevention.

  • Awareness – creating awareness of the risk factors, warning signs, and complications.

Diabetes is a chronic disease that is characterized by high levels of glucose (sugar) in the blood. Insulin is needed to help lower the levels of sugar and maintain normal blood sugar levels. Diabetes occurs when insulin is not produced in sufficient amounts or the cells of the body are unable to use the insulin properly. Over time, high blood sugar levels may lead to serious complications such as diseases of the eyes (retinopathy), kidneys (nephropathy), nerves (diabetic neuropathy), and blood vessels (that can eventually lead to poor circulation in the extremities). Diet and lifestyle changes can help decrease the risk of these complications.

Type 1 diabetes is a chronic disease that is almost exclusively based on genetics, and it cannot be prevented. With type 1, the pancreas produces very little or no insulin, leading to high blood sugars. Symptoms include increased urination, excessive thirst, increased appetite, and weight loss.

Type 2 diabetes is highly preventable and can be characterized by insulin resistance, decreased insulin production, or a combination of both. Some of the modifiable risk factors for type 2 diabetes include diet, physical activity, and weight management.

  • Action – taking action and providing individuals with the information they need to make the right dietary, lifestyle, and treatment choices to ensure their optimal health.

It’s important to talk with your child’s doctor to find the best treatment plan. Your child’s doctor will talk you through the importance of lifestyle, diet, and medication in order to keep your child’s blood sugar under control. Eating healthy and maintaining an active lifestyle can help manage BOTH type 1 and type 2 diabetes. As mentioned, Type 2 diabetes is highly preventable, so it is even more important to start creating healthy nutrition and lifestyle habits at a young age.

Children who are at risk or are diagnosed with diabetes can live a happy, healthy life through self-management and with an integrative team approach with various medical professionals. An integrated approach with your child’s doctor, a registered dietitian, and a behavioral health specialist can help develop a nutrition, physical activity, and medication plan that can help.

Here are some healthy nutrition tips from The American Academy of Pediatrics:

  • Eat at least 5 servings of fruits and vegetables each day.
  • Stick with water, avoiding juices and other drinks high in sugars.
  • Include high-fiber, whole-grain foods such as brown rice, whole-grain pasta, corns, peas, and breads and cereals at meals. Sweet potatoes are also a good choice.
  • Choose lower-fat or fat-free toppings like grated low-fat Parmesan cheese, salsa, herbed cottage cheese, nonfat/low-fat gravy, low-fat sour cream, low-fat salad dressing, or yogurt.
  • Select lean meats such as skinless chicken and turkey, fish, lean beef cuts (round, sirloin, chuck, loin, lean ground beef—no more than 15% fat content), and lean pork cuts (tenderloin, chops, ham). Trim off all visible fat. Remove skin from cooked poultry before eating.
  • Include healthy oils such as canola or olive oil in your diet. Choose margarine and vegetable oils without trans fats made from canola, corn, sunflower, soybean, or olive oils.
  • Use nonstick vegetable sprays when cooking.
  • Use fat-free cooking methods such as baking, broiling, grilling, poaching, or steaming when cooking meat, poultry, or fish.
  • Serve vegetable and broth-based soups or soups that use nonfat (skim) or low-fat (1%) milk or evaporated skim milk when making cream soups.
  • Use the Nutrition Facts label on food packages to find foods with less saturated fat per serving. Pay attention to the serving size as you make choices. Remember that the percent daily values on food labels are based on portion sizes and calorie levels for adults.
  • Prevention – take a personal pledge to prevent diabetes in your family and your community.

Feel free to reach out to one of your NOAH Health Centers with any questions you may have. NOAH offers a full range of primary and preventable health services for all ages!

To learn more about the DDF and the prevention and management of diabetes, visit their website at https://defeatdiabetes.org/

To read more about Type 1 Diabetes in children visit https://www.healthychildren.org/English/health-issues/conditions/chronic/Pages/Diabetes.aspx

To learn more about type 2 diabetes and tips for healthy living check out https://www.healthychildren.org/English/health-issues/conditions/chronic/Pages/Type-2-Diabetes-A-Manageable-Epidemic.aspx

7 Tips to Improve Your Child’s Sleep Hygiene by Dr. Amit Jain, Pediatrician

Do you wonder if your children are getting enough sleep? Are they going to bed early enough? It is well known that in today’s hustle and bustle of daily life, sleep tends to get compromised for everyone, children and adults alike. Sleep is essential to good health and has many benefits from allowing one’s brain to process and store in memory what was experienced and learned that day to rejuvenating so that they may be ready for the day ahead with full mental functionality. Without enough sleep, one may suffer consequences of sleep deprivation including difficulty concentrating, inattention, headaches, poor behaviors / irritability, obesity, and depression. With enough sleep, children may be able to better concentrate, have more energy, thus decreasing the risk for obesity, have better mental health, and even a healthier immune system.

As your children grow, their sleep needs will vary. The American Academy of Sleep Medicine has provided some helpful guidelines regarding how much sleep a child needs as they grow through various stages of their development.

This chart includes any naps a younger child may take during the day, as it is a total within a 24-hour period:

Is your child getting enough sleep? Our NOAH family wants to ensure your children are sleeping well, as it is an important component of their overall health. Below are some tips on improving your child’s sleep hygiene, so they may get a good night’s rest and stay healthy:

  • Keep a daily routine, including sleep and wake times, mealtimes, nap times, and play times. This can help the brain get into sleep mode when it is time for a nap or bedtime, as it helps with a smooth transition to sleeping. The disruption to this schedule should be kept to a minimum over the weekend and breaks as well.
  • Establish a good routine of daily physical activity, including getting fresh air and participating in age-appropriate sports.
  • Keep an eye on that screen time! The American Academy of Pediatrics (AAP) recommends no more than 2 hours of screen time per day. This includes computers, phones, TVs, tablets, etc.
  • Along the same lines, all screens should be turned off at a minimum of one to two hours before bedtime as the blue light emitted from screens can prevent the brain from being able to fall asleep, or prevent the brain from getting to deeper stages of sleep until later in the night.
  • Limit your child’s bed as a place to sleep, and only for sleep. Any playtime or homework should be done in a different environment, as a simple cue of getting into bed can help trigger the brain to start falling asleep.
  • Avoid any sugary beverages such as juices and sodas just before bedtime. This includes a bottle of milk, formula, or juice (only water if needed), as these beverages at bedtime can cause or increase the speed of baby bottle tooth decay.
  •  Regarding bedtime routine, the AAP recommends the 4 B’s of Bedtime: 
  1. Bathing: having this as a part of the normal sleep routine is a hygienic and soothing way to separate evening activities and dinnertime from bedtime and can help the brain get into bedtime mode if used as a part of a routine.
  2. Brushing: Getting in the habit of brushing their teeth before bedtime can not only help prevent cavities and tooth decay, but also can help the brain transition into bedtime mode.
  3. Books: This can stimulate excellent brain activity and it can also help cue the brain for bedtime if used as part of a daily routine.
  4. Bedtime: To reiterate, none of the above are more important than enforcing a reasonable bedtime and encouraging your child to sleep at the same time every night.

If your child has trouble falling asleep or getting enough sleep, please reach out to your NOAH provider for further recommendations. We are happy to help promote this important concept in good health.

For additional information, visit the American Academy of Pediatrics website healthychildren.org.
(https://www.healthychildren.org/English/healthy-living/sleep/Pages/Healthy-Sleep-Habits-How-Many-Hours-Does-Your-Child-Need.aspx)

Healthy Smile Tips by Dr. Lou Sarrosa, Dental Director

During the month of February, thousands of dedicated professionals, healthcare providers, and educators come together to support National Children’s Dental Health Month. The goal is to promote the benefits of good oral health to children, their caregivers and members of the community. At NOAH we believe in educating our little community members on the importance of having a healthy smile. We do this by partnering with local school districts, hosting free dental health screenings and providing oral health education to all attendees. We also attend various events in the community where we offer the same services while encouraging families in need of a dentist to come see us at one of our dental offices. At NOAH, we take oral health education a step further by providing these free community screening events all year long. With your help, and just a few simple tips from our dental pro’s, you and your child can have a healthy smile that is bright and cheerful.

HEALTHY SMILE TIPS

  • Brush your teeth twice a day with a fluoride toothpaste.
  • Clean between your teeth daily.
  • Eat a healthy diet that limits sugary beverages and snacks.
  • See your dentist regularly for prevention and treatment of oral disease.

Tis’ the Season – When is a Cold Not a Cold?

By Dr. Patty Avila, Pediatrician

It is that time of year again!  The busy time of year when everyone is preparing for the holidays is also when children are getting more colds and other respiratory illnesses.  These are the most common type of illness that children will see their doctor for, and it is important to recognize when to worry or not.  Most of these will be simple colds and resolve on their own, but there are some that can be serious.

The Common Cold; also called an Upper Respiratory Infection.

The common cold is caused by several different viruses and is the most common of all the respiratory illnesses. In the 1st 2 years most children will have about 3 to 5 colds per year. Older school age children and children in daycare can get sick even more often, because they are exposed to others.  Fortunately, most of these are just colds and will go away on their own and not lead to anything worse. 

Symptoms of the Common Cold:

  • Low fevers (101-102 degrees F).
  • Runny nose, nasal congestion comma and sneezing.
  • Sore throat.
  • Cough.
  • Not eating well.
  • Fussiness.

Most children will be better after 7 to 10 days of illness, but some may take up to 10 to 14 days to get better.

When to worry with the common cold:

Most children will not need to see their doctor with a common cold or upper respiratory infection. Infants younger than 3 months should see their pediatrician because they are at higher risk of getting very sick. 

See your doctor immediately if your child or infant is having:

  • Trouble breathing or fast breathing – using their muscles in between their ribs to breathe or the openings of the nose get larger with every breath.
  • Nails or lips turn blue.
  • The symptoms are lasting longer than 10 to 14 days.
  • Dehydration or not drinking well and not urinating well.
  • Child/infant is too sleepy or very fussy and not consolable.
  • Ear pain or any other concerns for child/infant not improving or getting worse.

Antibiotics do not treat the common cold since it is caused by a virus. 

Supportive care includes:

  • Increased fluids.
  • Use of pain/fever medication such as acetaminophen or ibuprofen.
  • Nasal saline with suctioning for congestion.
  • Honey for cough in a child OLDER than 1 year (NEVER given an infant <1 year of age honey).
  • Use of a humidifier may provide relief. 

The Flu; sometimes called Influenza.

The flu is also caused by respiratory viruses called influenza and can present very similar to the common cold.  Children with the flu feel much worse and are sicker than with the common cold.  The flu can have very serious complications including need for hospitalization and sometimes death.   

Symptoms of the Flu:

  • Rapid onset of high Fevers (above 101 degrees F), chills.
  • Headaches, body aches.
  • Runny nose, nasal congestion.
  • Chest pain and cough.
  • Sore throat.
  • Poor appetite.
  • Feeling tired and weak.

Most children will get better after 2 weeks. Fevers from the flu can last up to 5 to 7 days. 

See your doctor immediately if your child or infant is having:

  • Trouble breathing or fast breathing – using their muscles in between their ribs to breathe or the openings of the nose get larger with every breath.
  • Nails or lips turn blue. 
  • Dehydration or not drinking well and not urinating well.
  • Child/infant is too sleepy or very fussy and not consolable.
  • Ear pain or any other concerns for child/infant not improving or getting worse.

Young children and infants as well as children with high-risk medical conditions should see their pediatrician as soon as possible. These high-risk medical conditions include:

  • Heart defects.
  • Chronic lung issues.
  • Asthma.
  • Low immune system.
  • Diabetes.
  • Cancers. 

Supportive care includes:

  • Increased fluids.
  • Use of pain/fever medication such as acetaminophen or ibuprofen.
  • Nasal saline with suctioning for congestion.
  • Honey for cough in a child OLDER than 1 year (NEVER given an infant <1 year of age honey).
  • Use of humidifier may provide relief. 

Outside of supportive care, there is an antiviral medication called Tamiflu which may be indicated and started if the flu is diagnosed within the first one to 2 days.

Bronchiolitis.

Bronchiolitis is another respiratory illness that can be commonly seen during the winter months.  There are several viruses that can cause this illness but RSV, also known as Respiratory Syncytial Virus, is the most common.  RSV is an infection that will affect almost all children at least once before they turn 2 years old.  It usually starts as a cold and is followed by lower respiratory symptoms around 3 to 5 days of the illness.  For some children the illness can be severe, especially younger infants, preemies, and those with heart or lung defects.   

Symptoms of Bronchiolitis:

  • Cold symptoms with fevers, runny nose, nasal congestion, and cough.
  • Fussiness.
  • Poor Feeding.
  • Wheezing.
  • Difficulty breathing.

See your doctor immediately if your child or infant is having:

  • Trouble breathing or fast breathing – using their muscles in between their ribs to breathe or the openings of the nose get larger with every breath.
  • Nails or lips turn blue. 
  • Dehydration or not drinking well and not urinating well.
  • Child/infant is too sleepy or very fussy and not consolable.
  • Ear pain or any other concerns for child/infant not improving or getting worse.

Supportive care includes:

  • Increase fluids.
  • Use of pain/fever medication such as acetaminophen or ibuprofen.
  • Nasal saline with suctioning for congestion.
  • Honey for cough in a child OLDER than 1 year (NEVER given an infant <1 year of age honey).
  • Use of humidifier may provide relief. 

For infants who are high risk there is an injection that is given monthly during the winter months called Synagis that can decrease the risk of severe RSV infection. 

Croup.

Croup is a common respiratory illness during the Fall and Winter months and is usually seen in infants and young children – children younger than 5 year of age.  It is caused by several different viruses including the flu virus and some cold viruses.  The illness is characterized by swelling of the upper airways including the voice box (larynx) and the windpipe (trachea). Symptoms from Croup are usually worse at the beginning of the illness. 

Symptoms of Croup:

  • Fevers which can be low grade or high.
  • Cold symptoms with runny nose and nasal congestion.
  • Hoarseness of voice.
  • Barky or “seal like” cough.
  • Noisy breathing when breathing in – stridor.

The swelling of the airway can sometimes be severe and need immediate medical attention.

See your doctor immediately if your child or infant is having:

  • Trouble breathing – struggles to catch their breath.
  • Noisy breathing that is getting louder and child/infant appears to struggle to breathe.
  • Cannot talk because of difficulty breathing.
  • Lips/mouth or nails turn blue.
  • Drooling and not able to swallow saliva.
  • Dehydration or not drinking well and not urinating well.
  • Child/infant is too sleepy or very fussy and not consolable.

Steroids can decrease the swelling and can be given by mouth, injection, or in a breathing treatment.  If given early can help decrease the need for hospitalization and improve breathing.  There are breathing treatments with epinephrine that can be given as well in severe cases, but these will require careful observation in the Emergency Department or Hospital setting.

Use of cold moist air can help improve mild symptoms as well and can be used at home with a cool mist humidifier.

PREVENTION TIPS

  • For all respiratory infections, the best form of prevention is to avoid exposing infants/young children to people who are sick or crowded situations. 
  • Breastfeeding infants as long as possible (at least 6-12 months) is also an important way to help prevent and fight infections because breastmilk provides antibodies. 
  • Practicing and teaching children good hand hygiene is key.
  • Use soap and water and scrub for at least 20 seconds (singing the ABCs).  Another option is the use of an alcohol-based hand rub if hands are not visibly soiled. 
  • Teach children to cover their coughs and sneezes properly by using a tissue or coughing in their arm rather their hands. 
  • Keep children home from daycare or school when they are sick to avoid spreading the illness. 
  • Eating a healthy balanced diet high in fruits and vegetables can help boost the immune system and help decrease the chances of getting sick.   

At NOAH, we’re here for you. If you have any questions for your child’s pediatrician, give us a call at 480-882-4545. You can also send a message to your pediatrician via your child’s MyChart account.

Tips to Treat Nosebleeds in Children by Dr. Debbie Bauer, Pediatrician

“Nosebleeds are very common in children, especially during these winter months,” says Debbie Bauer, Pediatrician. The dry air from outside combined with the dry air from heaters inside can make the skin inside the nose more fragile and sensitive. This is one of the most common reasons children get nosebleeds. Some children also get nosebleeds from picking their nose, from sniffling too much from allergies/colds, or of course from being hit in the nose.

Learn what to do if your child has a nosebleed and when to get help from a doctor below. Also, check out our tips on how to prevent nosebleeds from coming back!

What should you do if your child has a nosebleed?

– First, don’t panic! Nosebleeds are rarely serious. Your child will have an easier time following your instructions if you remain calm.

– Have your child sit down and put their head slightly forward, NEVER have them tilt their head backwards.

– Put firm pressure on either side of their nose with your fingers and hold it there for 10 minutes.

– After 10 minutes, check to see if the bleeding stopped. If it hasn’t, hold firm pressure again for 10 more minutes.

– When bleeding has stopped, gently clean blood off their face with water but do not put anything in their nose or have them forcefully blow their nose.

When should you get help from a doctor?

– If your child has a nosebleed for more than 20 minutes without stopping.

– If your child looks very pale, weak or sweaty.

– If you see blood in your child’s urine or stool.

– If your child has strange, unexplained bruises.

– If frequent nosebleeds are concerning you.

How can you prevent nosebleeds?

– You can use a saline nasal spray to keep their nose from getting dry.

– You can use a humidifier in their room.

– You can apply a small amount of Vaseline inside their nose carefully with a Q-tip.

– If your child picks their nose, keep their fingernails trimmed short.

At NOAH, we’re here for you. If you have any questions for your child’s pediatrician, give us a call at 480-882-4545. You can also send a message to your pediatrician via your child’s MyChart account.

Skin Care Tips for Teens by Dr. Debbie Bauer, Pediatrician

“Adolescence can be a tough time – especially on your teen’s skin! Almost 8 out of 10 teenagers will have acne at some point,” says Dr. Debbie Bauer, Pediatrician. This is because the changing hormones cause an increase in oil production and can lead to clogged pores. This can happen all over your child’s body, not just their face. And while acne isn’t dangerous for their health, it can cause scars and decrease their self-esteem.

Here are a few pointers for home care of your teen’s skin:

  • Keep it clean: They should wash their face with warm water and a gentle cleanser twice per day. CeraVe, Cetaphil and Dove make reasonably-priced and effective cleansers.
  • Be gentle: Harsh scrubbing or rough washcloths are not recommended. Your teen should be using just their hands to gently rub in the cleanser and rinse off.  Very hot water or very cold water should not be used.
  • Stick to the routine: Oily skin and acne can last for months or years, so it’s important to have a good skin routine to minimize the effects. Remind your teen to always remove make-up before sleeping.  And change sheets and pillowcases frequently.
  • Don’t pop pimples: Although it’s tempting, squeezing pimples will only make things worse. Not only will they introduce more oil onto their skin from their hands, but this will probably push the oil deeper into the skin and cause inflammation and swelling.
  • Keep moisturizing: Drying out their face can actually lead to more acne because their body will try to produce even more oils to keep their face from being so dry. Make sure the moisturizer bottle says “oil free” or “noncomedogenic” on it so it doesn’t clog their pores more.
  • Use sun block: This is important for every child, but especially for those with acne. The sun’s rays can irritate skin and make acne and scars much, much worse. Make sure the sunscreen is at least SPF 15.

Some kids even need prescription medication to help manage acne, and our NOAH Pediatricians are here to help with that too!

For more information about taking care of your skin, visit the American Academy of Dermatology: www.aad.org.

October is Dental Hygiene Month!

“Don’t be tricked on Halloween, choose the right treats that may help your children steer clear of the Mouth Monsters (also known as tooth decay) like Ginger Bite-Us and Tartar the Terrible. Instead, choose Tooth D.K. Dark chocolates and sugar-free gum which are better for the teeth compared to gummies, caramel, sour candy or bubble gum,” says our friends at The American Academy of Pediatric Dentists. They’re less likely to get stuck in the tiny grooves and crevices of your teeth. If you prefer chocolate, try to encourage your kids to eat dark chocolate. This tasty treat is packed with antioxidants that can stop bacteria from sticking to teeth, which may help fight gum infections and has less sugar in most cases than milk chocolate with may help reduce tooth decay! Don’t forget to rinse your mouth with water anytime you consume sweet treats and make sure to brush before bed! Have a safe and Happy Halloween from our NOAH family to yours!

For more information, go to: https://mouthmonsters.mychildrensteeth.org/aapds-guide-to-a-tooth-friendly-halloween/

Halloween Safety Tips by Amit Jain, MD, FAAP, MBA

It’s that time of year again! Halloween is right around the corner. With it comes lots of fun, elaborate costumes, tricks, and treats! Have your children thought of the costume they’d like to wear this year? We here at NOAH want to make sure they stay safe while out trick or treating this year. With assistance from the American Academy of Pediatrics, have provided some great safety tips below to keep them safe while they’re out.

Fun / elaborate costumes can be an exciting part of Halloween. One of the most effective but most easily forgotten ways to help make your child’s Halloween a safe one is with costume safety.

Here are some great safety tips:

  • As most of the trick or treating happens after dusk, make sure costumes are bright and colorful and / or have some reflective surfaces that can be easily seen by drivers and others. You can even consider adding some reflective tape or striping to the costumes and trick-or-treat bags with such tape. It can even help for a cool effect the children would love.
  • Make sure the costumes are short enough to prevent tripping, and are clearly labeled as flame-resistant.
  • Along with this, make sure your children have shoes that fit well and are comfortable for walking long distances.
  • Masks can obscure a child’s vision, especially to the sides (peripheral vision) as the mask moves around their face. Consider non-toxic makeup and decorative hats as fun and safe alternatives to masks.
  • Any swords or other sticks / canes that are a part of the costume should not be sharp or too long that they could hurt your child if they trip and stumble over these objects.
  • Make sure all children and their escorts have flashlights with a fresh set of batteries.
  • Before leaving for trick or treating, make sure your children know how to call 9-1-1 or their local police department in case they get lost or separated or in an emergency. Have a safety plan in place for the chance that a child gets separated from the group, which should include having the child stay where they are in a safe location if they do get separated from the group. The non-emergency number for the Phoenix Police Department is: 602-262-6151.
  • Also, make sure they have a good meal prior to going trick or treating, and bring a water bottle for each child and the children’s escorts to stay hydrated while out.
  • A parent or responsible adult should be with and watching children at all times while out. Instruct children to always stay in a group and close to the parent / responsible adult. Also instruct them to remain on well-lit streets, always use the sidewalks (or as close to the edge of the road as safe if no sidewalk is available, facing traffic), and use designated crosswalks to cross the street.  Don’t assume you have the right of way – it is much more difficult to see the road and pedestrians at night! While out trick-or-treating, only go to homes with a porch light that is on. Remember to never enter homes or cars for a treat.
  • If your older children are going alone, plan and review a route that is acceptable to you beforehand – and ensure they will stay on that route. Plan and agree upon a time that they should arrive home by. Remember curfews – Phoenix juvenile curfew hours are 10 p.m. for children 15 and younger and midnight for 16- and 17-year-old children. If possible, give them a cell phone for emergency contact use.
  • Finally, after the fun night of trick-or-treating, sort and check all treats before the child eats any of them (including ones they eat while still out trick-or-treating). Throw away any spoiled, unwrapped, or suspicious looking treats. Ration out treats for the weeks and months following Halloween. They should not eat any of these treats immediately before bedtime. Along with this, remind your children that the rules don’t change from a normal day – remember to have your children brush their teeth before bedtime to get all of that stuck-on candy out of their teeth.
  • Also, don’t forget to have regular check-ups with our wonderful Pediatric Dentists here at NOAH!

Please check the American Academy of Pediatrics website for some more awesome safety tips here:

https://www.aap.org/en-us/about-the-aap/aap-press-room/news-features-and-safety-tips/Pages/Halloween-Safety-Tips.aspx

Have a fun, safe, and Happy Halloween from your friends at NOAH!