SID Syndrome Awareness Month
Several months ago we posted a “Parent Alert” regarding SIDS and early research findings regarding serotonin and its link to this frightening medical quandry.
October is SID Syndrome Awareness Month, so we wanted to do our part to build awareness of the statistics surrounding this unsettling infant health issue, while also reviewing some common questions about SIDS. A campaign begun in 1994 to raise awareness and understanding on the part of adults has positively impacted the SIDS rate, reducing it by 50%.
First Candle, a national not-for-profit organization whose main thrust is making sure infants reach their first birthdays, has a very informative website. Some of the facts regarding SIDS that they share include:
- SIDS is the leading cause of death in children under one year of age (2,300 deaths per year).
- 90% of all SIDS deaths happen when the infant is younger than six months old.
- 60% of SID cases are male; 40% are female
- Prior to their dying, most infants seem to be normal and healthy.
The First Candle site tries to clarify important topics for parents, such as:
- Co-sleeping vs Bed Sharing vs Room Sharing
- Guidelines for Products Intended for Sleeping Babies
- Immunizations and SIDS
- Safe Sleep Saves Lives!
The National Institutes of Health has guidelines for avoiding SIDS that we shared in February and would like to reiterate here:
- Always place your baby on his or her back for sleep whether it’s for naps or at night. Insist all who care for your baby do the same.
- Use a firm sleep surface for your baby, such as a safety-approved mattress and crib.
- Do not place loose toys or bedding in your baby’s sleep area. If a blanket is used, place the baby’s feet at the end of the crib and tuck the blanket under the mattress. Do not allow the blanket to reach any higher than the baby’s chest.
- Do not let your baby get overheated when sleeping. Use light sleep clothing, and keep the room at a temperature comfortable for an adult.
- Do not share sleep space with your baby. Place him or her nearby, but separate.
- Do not allow smoke around your baby. Do not smoke before, during or after pregnancy.
- Provide “tummy time” when your baby is awake and someone is watching. Change the direction that your baby lies in the crib from one week to the next, and avoid too much time in car seats, carriers, and bouncers.
As a case management company that has pediatric care as one of its specialties, we want to urge all parents with infants under one year of age to become very familiar with the information above and encourage them (you) to share that awareness with those who care for your child, as well.
Helping Your Child with Positive Mental Health Growth
So many times when we think about children and their health, our thoughts and attention immediately go to their physical health. Of utmost importance, as well, is the mental health of our youngsters. Very often parents feel less capable and less prepared to deal with mental health issues or don’t know where to begin in preventing problems of mental health. In acknowledgment of the fact that May is Mental Health Month, it might be helpful to be aware of ways in which your child (or someone else’s) can be helped in developing healthy mental health outlooks and attitudes.
- Children look up to and imitate their parents and other adult role models. Be sure that the manner in which you conduct yourself in front of your child is the way in which you would want them to act and grow into an adult.
- Be sure to compliment and praise your child when he or she behaves well, even if you think it may be insignificant. It’s never insignificant for a child to feel proud of himself/herself and feel that parents are proud of him/her, as well!
- We all need and want to be listened to and shown respect; children are no exception. Make sure you are a “safe” place for your child when he/she has issues to discuss, no matter how big or small their concern or fear.
- Limit the amount of time your child spends in front of the TV and computer or video games (even hand held ones). When they are watching, monitor the content for appropriateness, avoiding violence; and don’t use TVs or computers as babysitters. To make this easier, try not to have these items in a child’s bedroom.
- Have family meals together as often as possible, giving your family members time to talk and share the events of the day.
- Strong emotions aren’t just for adults. Children get angry and feel stressed, as well. Using your own actions as examples (see the first tip above), guide your child into ways that are appropriate for expressing and working through these feelings.
- There will be times when you and your child butt heads over things. Rather than letting the situation escalate into yelling or acting out, offer your child options for how things can play out. Explain what it means for there to be consequences for the things he or she does and the choices made at any given point in time… especially when they are opposing something that you are requiring or requesting of them.
- Help your child know that it’s okay to ask for help when they have a problem or difficulties arise. Just as important, be sure to guide them in knowing who they can trust to ask for help and HOW they should ask.
These eight tips are a good place to start, and for further information on mental health issues and children, visit the American Academy of Pediatrics website.
PARENT ALERT: McNeil Recall of OTC Children’s Medicines
This Parent Alert is in reference to a recent announcement by McNeil Consumer Healthcare that they are voluntarily recalling numerous over-the-counter children and infant liquid medicines. The reason behind this recall is the possibility that these medicines may have more of the active drug ingredient than is noted on the bottles or inactive ingredients that may either contain tiny particles or not meet their internal testing requirements.
The products that are covered by this recall include the following OTC medicines, which come in 43 different flavors and sizes:
- Tylenol Infants’ Drops
- Children’s Tylenol Suspensions
- Children’s Tylenol Plus Suspensions
- Motrin Infants’ Drops
- Children’s Motrin Suspensions
- Children’s Motrin Cold Suspensions
- Children’s Zyrtec Liquids in Bottles
- Children’s Benadryl Allergy Liquids in Bottles
McNeil has requested that consumers immediately stop using these products. Important, as well, is that consumers understand this recall is not being done because of any adverse medical reactions.
If your child is sick and needs a medicine that is on the above list, look for generic versions of these products. If there is a question in your mind about what product to use, be sure to call your doctor or pharmacist. The FDA also emphasizes that parents not administer medicines that are adult strength to children.
To find out what lots have been recalled and whether or not you are in possession of any of them, you can check the McNeil website. If you do have any packages, you can contact McNeil for a refund.
If you believe that your child has had an adverse reaction to one of these medicines, it can be reported to the FDA’s MedWatch Program one of three ways: Fax at 1-800-FDA-0178; Mail to MedWatch, FDA, 5600 Fishers Lane, Rockville, MD 20852-9787; Report to the MedWatch website.
Children and Allergies, Part 3
In this, our final post about allergies and children, we’re going to discuss another very common…and often scary…allergy instigator, FOOD!
It’s hard to believe that something as necessary as food could cause allergy reactions, reactions that can sometimes even be fatal if not attended to immediately! Although scientists and doctors don’t as yet know why, food allergies are on the rise and are something you (as a parent) need to be aware of.
Today’s most common food allergies (those responsible for 90% of the allergic problems) are caused by:
- Peanuts
- Tree nuts
- Dairy (milk)
- Eggs
- Soy
- Wheat (Gluten)
- Fish and Shellfish
Food allergies obviously pose an extreme challenge for families, especially when there is only one person among several with the food allergy. Should you totally eliminate the allergy-causing food from your home? If this is your action plan, how will it affect the others in your household? What kind of hardship will it place on them? If you do eliminate the specific food from your own home environment, is your child old enough to know how to deal with the outside world and the possibility of that food being present somewhere else? These are definitely questions to ask yourself and the rest of your family members.
The Food Allergy Initiative has a great website that offers a significant amount of information, including some of these tips for keeping your home safe when one of your children (or other loved one) is suffering from a food allergy:
- You and your family need to know how to read AND DECIPHER food labels
- After each meal is prepared and after it’s eaten, be sure to scrub down the counter tops and tables
- Have a separate set of utensils for handling “safe” and “unsafe” foods.
- Have an assigned place for young children to sit at the table to avoid siblings sharing bites of food from each other.
- Be sure to have a couple of emergency kits that include all the medications and injectables you may need. At the Food Allergy Initiative site, you will find an Emergency Medical Plan form that can be filled out with your doctor to keep with both kits.
These are just a few tips that can be of benefit immediately. Also, follow this link (Food Companies) to find companies who offer food that you can safely buy for food allergy sufferers.
The other place that is sure to be a challenge and worry for you is your child’s school and what happens there. Knowledge is power, so be sure to request a meeting with your child’s teacher, the principal, and the school nurse to discuss the parameters under which your child must be guided while in their care.
There is a law in place to help protect your child’s rights to attend school and participate safely in all activities, including meals in the cafeteria. If the school should be uncooperative, search out information on a “Section 504 Plan” that outlines what the school’s responsibilities are under Section 504 of the Rehabilitation Act of 1973.
It should go without saying, but it’s imperative that you also make other caregivers aware of their responsibilities when looking after your children with allergies. These people include grandparents, aunts, uncles, and babysitters, as well as Sunday school teachers or play date moms who have your children in their homes.
Food allergies are, obviously, not to be taken lightly. With due diligence, serious reactions can be avoided not only from food allergies, but from all the allergens we have discussed over the past few weeks. If you have some tips to offer you have discovered in helping your child with food allergies, please share them with us in the comment section of our blog.
Children and Allergies, Part 2
Last week we talked about outdoor and indoor allergy instigators that are found in nature, such as pollen and mold, as well as those man made, i.e. chemicals and harsh soaps. This week we’re going to discuss other very prevalent…and often difficult to control instigators…pet dander and dust mites.
However, let’s look first at some of the symptoms that those with allergies experience:
- Itching eyes, nose, and throat
- Watering eyes
- Sneezing, along with either a stuffy nose or runny nose
- Conjunctivitis (swollen eyes, crusty eyelids)
- Dark circles under the eyes (sometimes called “allergic shiners”)
If you notice any or all of these symptoms in your child, a trip to your pediatrician is certainly warranted to verify allergies and find out the specific allergen responsible.
Pet dander and dust mites are a very prevalent problem for allergy sufferers. The most common pet dander that causes allergies comes from cats, dogs, and birds. However, on the increase are allergic reactions from other kinds of pets, such as guinea pigs, hamsters, ferrets, etc.
Although many of us have long believed the allergic reaction is caused by the hair of the animals, in fact it is the proteins that are secreted by the animals’ oil glands in their skin, which is shed as dander. There are also proteins in their saliva that sticks to the fur when they clean themselves. Pet urine can also be a source of these allergy-causing proteins. When the urine dries, the proteins are released into the air. Because cats lick themselves more, are sometimes held more, and generally are in the house more, they seem to more often cause allergic reactions.
When it is an impossibility to permanently remove the pet from your home, it can help to keep the pet out of the child’s bedroom and also off the household furniture. If possible, bathe your pet at least once a week. Putting down tile or other floor coverings, in lieu of carpeting, helps, as does vacuuming frequently with a cleaner that has a HEPA filter. Also consider the use of a HEPA filter in your child’s bedroom.
If you decide to part with your pet, a good steam cleaning of the house is in order, along with laundering furniture coverings, bedding, etc. Allergens can remain in the carpet and furniture for several weeks after the pet is gone and in the air within the house for months. Expect that the allergic reactions may take six months or more to subside.
Dust mites eat dead human skin flakes and are not usually airborne. Their home is usually our beds…mattresses and pillows and blankets. To lessen the impact of this “allergen”, you should frequently wash bedding in hot water (blankets, comforters, etc.)…a couple times a month at least. Also wash stuffed animals and other pillows lying on the bed. Here’s a great tip: if you can’t put the animal or pillow in the washer, put them in the freezer for a couple days, then hand wash with soapy water. The dryness of the freezer will kill the dust mites! Allergen covers for bedding is also very important. Dust mites can’t penetrate these covers.
Next week we will discuss one more allergen “group” that is a growing problem for children, and that is food allergies. If you have any helpful hints on ways you help your child deal with pet allergies, we’d love to hear about it!
Children and Allergies, Part 1
Springtime is generally the time of year when allergies and their symptoms become a real problem for those who suffer from them. Children are not exempt from this problem, so being aware of what irritants can cause the allergies and the steps that can be taken to alleviate the problem is important. You should also be aware that if a parent or both parents suffer from allergies, it’s very likely the children will, as well.
Allergy symptoms can be different for different age groups. In children under the age of five, 20% suffer from eczema, which results from the itching that allergies can cause. Itching for infants and young children usually presents itself around the child’s face, the back of the scalp, the trunk of the body, and the arms and legs. All of these are spots the child can easily reach and scratch.
What triggers the irritation and itching? Although pollens and mold spores that circulate in the air contribute and are very wide spread, the most significant triggers tend to be animal dander and dust mites.
If your child is diagnosed with allergies (having the testing done is a very important step), there are things you can do to make them more comfortable and help prevent the recurrence in the future. Hay fever is a challenge, of course, unless you and your child stay indoors during certain seasons. The pollen in the air enters human noses and throats and sets off allergic rhinitis. Because this is so hard to avoid, seeing your pediatrician for this type of allergy can be very beneficial in finding treatment for the symptoms, as well as preventive medications.
Itching and irritation can be brought on by chemicals, certain fabrics (such as wool), harsh soaps, and even getting overheated and sweaty. Obviously, the solution to these instigators of allergy symptoms is not to use them or find milder substitutes.
Mold and mildew within your home or environment is also an issue for some who suffer from allergies. Cleaning these areas with a diluted bleach solution can be helpful or removal of the articles containing the mold, of course, works best, if that’s possible.
In next week’s blog, we’ll discuss more allergy “instigators”, specifically pets and dust mites!
Remember, if your child exhibits signs of allergic reactions (including itching, sneezing, runny nose), your first plan of action should be a visit to the pediatrician to determine what he or she is allergic to so you can go about making changes in your child’s environment, if possible.
Medical Expense Deductions for Your Income Tax Return
We thought it might be helpful to our clients at this time of year to give some insight as to what medical expense deductions can be used when filing your income tax returns. When you have children who have been in the hospital, are home after a serious illness or accident, and with those who have chronic diseases, it is in your best interest to know what you should be keeping track of for tax time each year.
First of all, be aware that the 7.5 % guideline for medical expenses is taken as a percentage of your Adjusted Gross Income, not your total income. Your AGI is your total actual income less appropriate deductions.
Also be aware that your medical expense deductions are not limited to doctor, hospital, and dental bills, plus prescriptions. Medical “items” or equipment can be deducted, especially if it is prescribed by your physician. These items include:
- Wheelchairs
- Crutches
- Artificial Limbs
- Seeing eye dogs
- Telephone and television adaptors for the deaf
- Home improvements to accommodate medical needs
- False teeth
- Braces
- Eyeglasses
- Hearing Aids
- Contact Lenses
According to Deborah Hull, owner of Specialized Bookkeeping Services, Inc., an expense that nearly all people miss on their taxes in relation to medical expenses is the cost of transportation. Keep a log of your medical miles driven during the year, and you can deduct $.24 per mile or (if you prefer not to keep track of your miles) you can deduct the cost of gas and oil consumed. If you don’t use a personal vehicle for your transportation, you can deduct bus and taxi fares. Also deductible are parking fees and tolls.
If you have to be away from home to be near your child while he or she is having medical treatments out of town, you can claim $50 per day for lodging and also deduct your meals.
One deduction that should be of interest to parents with small children is the expense of having lead-based paint removed from your home.
If you haven’t yet filed your income tax returns for 2009, be sure to re-visit what you believed to be medical expense deductions to be sure you haven’t missed one or more of those listed above.
National Poison Prevention Week
“Children Act Fast…So Do Poisons!” That is the theme for National Poison Prevention Week, which is March 14-20 (and March is National Poison Prevention Month). It only takes a minute to turn your back on a child and have them ingest some form of product that is a poisonous substance. Hopefully, the following information will prevent anything happening to your child, grandchild or neighbor in your care.
In emergency rooms around the country, almost 88,000 children are treated for non-fatal poisonings each year, the majority of whom are younger than six years old. In addition, close to 100 kids under the age of 14 die from accidental poisoning every year.
To help prevent poisonings, there are many “rules” adults should be aware of, including the following:
- The Poison Control Number is 800-222-1222. It can be called 24/7. Be sure you have it posted in your home and saved in your cell phone.
- To avoid mimicking, try not to take medicines in front of young children or call it “candy”.
- Be aware of drugs that may be brought into your house by guests and be sure they are careful to put them out of reach of your children.
- Don’t leave children alone with household cleaners or drugs you are taking; if you leave the room, take the child with you.
- Learn about lead poisoning and its prevention.
- Do not transfer medicines, pesticides or household cleaners to different containers that children may relate to foods or drinks.
- Close bottles or containers properly, using the child-resistant packaging. This packaging has been proven to save hundreds of lives since the guidelines were put in place.
- If you are applying pesticides around your house, take children and their toys out of the area; and wait until the chemicals are dry before returning.
Do you know what the signs of poisoning are that you need to look for should you suspect that your child has swallowed something hazardous? The obvious reactions would include vomiting and the youngster acting drowsy in an abnormal way. You should also check in your child’s mouth and around his or her teeth for traces of the substance. There could be burns from certain toxic products on the child’s lips or mouth. You may even be able to smell something coming from the child’s breath. Unfortunately, some products don’t have immediate symptoms. If you suspect the poison product was swallowed, call the Poison Control Number.
Once again, be sure to keep the Poison Control Center’s phone number (800-222-1222) in handy places. There are at least 64 Regional Poison Control Centers in the United States. These centers have the right information for you regarding treatments and toxicity. If they don’t have the answer handy, they know where to find it.
PARENT ALERT: Sudden Infant Death Syndrome (SIDS)
It was announced on February 2, 2010, that preliminary research indicates decreased levels of serotonin in the brain stem are associated with an increased risk for Sudden Infant Death Syndrome (SIDS). Serotonin is the chemical that helps regulate breathing, blood pressure, and heart rate in the brain during sleep. Although it is not known if this could be a single cause or a contributing factor, it appears to be a major breakthrough in helping to identify infants at increased risk.
Here are some SIDS prevention tips, as recommended by the National Institutes of Health:
- Always place your baby on his or her back for sleep whether it’s for naps or at night. Insist all who care for your baby do the same.
- Use a firm sleep surface for your baby, such as a safety-approved mattress and crib
– For more information on crib safety guidelines, contact the Consumer Product Safety Commission online or call 1.800.638.2772
- Do not place soft or loose toys or bedding in your baby’s sleep area. If a blanket is used, place the baby’s feet at the end of the crib and tuck the blanket under the mattress. Do not allow the blanket to reach any higher than the baby’s chest.
- Do not let your baby get overheated when sleeping. Use light sleep clothing, and keep the room at a temperature comfortable for an adult.
- Do not share sleep space with your baby. Place him or her nearby, but separate.
- Do not allow smoke around your baby. Do not smoke before, during or after your pregnancy.
- Provide “tummy time” when your baby is awake and someone is watching. Change the direction that your baby lies in the crib from one week to the next; and avoid too much time in car seats, carriers, and bouncers.
It is unfortunate that most of us, as pediatric nurses, have witnessed the intense pain and suffering a family experiences when their baby dies suddenly from SIDS. People grieve so differently, but ultimately SIDS changes their lives forever. It is encouraging that, as we learn more and more about the causes and prevention of SIDS, parents can rest more comfortably knowing their infants will remain healthy and strong.
As case managers, our goal is to educate and advocate for the prevention of SIDS. If you have experienced such a loss or you know someone who has, be aware that case managers can provide support to assist families through this difficult time.
2010 Immunization Schedule
The most up-to-date immunization schedule (approved by the American Academy of Pediatrics, the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention, and the American Academy of Family Physicians) has been released. There are three levels or categories of the schedule: Children 0-6; Children 7-18; and a schedule should your child get started on immunizations late or fall behind.
Each year it gets more difficult to stay on top of vaccines and the administration of them. With new vaccines being developed each year, the task becomes more and more challenging and complex. In addition to newer vaccines, there are many vaccines that need multiple doses to reach their peak effectiveness or vaccines that need to be repeated whose “powers” wane over time.
For information on what changes there are to last year’s schedule, you can follow this link to the list published at the CDC website (Centers for Disease Control and Prevention).
Included in the description of changes is one regarding the inactivated poliovirus vaccine series. It is now recommended that this vaccine be given after a child’s 4th birthday and at least six months from the previous shot. If all four doses have been given before the child is 4, a fifth dose needs to be administered between the ages of four and six.
Also, be reminded that the National Childhood Vaccine Injury Act requires doctors or staff members to give copies of the Vaccine Information Statements to parents prior to giving their child the vaccination.
Make sure you familiarize yourself with this year’s schedule and check with your pediatrician should you have any further questions.
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Health Management Connect
(formerly Primary Pediatric Management Inc.)
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