Bottles, Pacifiers & Thumbsucking

That bedtime bottle may soothe your baby tonight, but the milk or juice inside it could lead to major dental problems tomorrow.

Sucking is a normal, natural reflex for infants. Besides the fact that without this reflex a baby couldn't be fed, it also offers relaxation and comfort, which is exactly why so many babies and toddlers continue sucking well after they need to do so for nourishment. The concern that a lot of parents have is that thumbsucking and pacifier use can cause damage to children's teeth that can only be repaired through orthodontics.

Pediatric dentist Dr. David Kenney says with young children neither thumbsucking nor use of a pacifier is harmful, although most dentists prefer to see a child use a soother. "We actually recommend soothers and the reason we do, is that a child who starts out with a soother will be more apt to give that soother up than if they start out with their thumb. With a thumb you have a friend and constant companion well into the time when the permanent teeth erupt."

Dr. Kenney feels that parents shouldn't really expect two and a half or three year olds to stop sucking their thumb, but that "by five, or five and a half years of age, if the habit hasn't stopped by then there is some risk of damage which may need to be repaired orthidontically later on."

If there is one concern that over-rides all others, specifically when it comes to children and dental health, is the use of juice or milk bottles at bedtime says Kenney, "because at that time the amount of saliva is decreased and the amount of swallowing is reduced. I know that what they do is suck a little bit, then hold it in their mouth, swallow it, then suck a little more, then hold it and swallow. This keeps supplying, constantly, sugar to the bacteria. I see children with rampant decay of their primary teeth from these causes."

The result is what dentists call Nursing Bottle Decay, and according to pediatric dentist Dr. Richard Kramer, it's becoming more common. "Interestingly enough, although decay rates have generally gone down for children, for very young children decay rates have increased due to nursing bottle decay."

The final word is, if your child has to have a bedtime bottle, the only safe thing to fill it with is water.

Teething

Is your child suffering from teething pain and discomfort? Or is teething pain just an old-time medical myth?

Sometime between four and six months of age, most babies get their first tooth, and they'll keep getting a new tooth until all of their primaries are in place by the age of two and a half years.

Any parent that has watched their baby cry in discomfort during the teething years would be hard pressed to say their child isn’t in some pain. But can it lead to illness? For many years people believed teething and illness were synonymous. In fact, as little as one hundred years ago teething was blamed for many infant deaths. So what’s the reality? More than likely it’s somewhere between the two explains Dr. Allan Green, author of From First Kicks to First Steps. "Good studies have shown that some babies experience significant discomfort, low grade fevers and diarrhea with teething", explains Dr. Greene.

But pediatrician Dr. William Feldman says that it also happens that between four months and two and a half years of age children are exposed to many viruses and bacteria, and it’s unwise to automatically blame illness on teething. His concern is that if parents simply chalk up their child’s fever to teething, a more serious illness can be missed. "If there is a fever which accompanies this, it's usually caused by a virus that just happens to be there at the same time," explains Feldman.

If your child is in discomfort from teething, the temptation is to soothe the gums with one of the many over-the-counter topical gels available at the pharmacy. But Dr. Greene does not recommend these. "The topical gels, I'm not a very big fan of. Many kids don't seem to like them very much. They leave the mouth feeling numb and swollen like you've just been to the dentist, they wear off very quickly, and they can decrease the gag reflex in some kids."

Instead Dr. Greene recommends "a variety of solutions for babies who are experiencing difficulty with teething. Massaging of the gums can be very helpful with a clean finger. There are some homeopathic teething gels that are quite gentle and many parents report great success with those."

Over all, while it is hard to see your child suffering from teething pain, remember that in the long run this is relatively short-lived period in your child’s life. Teething rings and massage can be helpful. And if your child becomes ill, don’t automatically assume that teething is to blame. Instead have your child seen by a physician to rule out any other health concerns.

S.I.D.S.

Just the words 'Sudden Infant Death Syndrome' evoke fear. Fortunately more and more is being learned about prevention of this terrible tragedy.

SIDS or Sudden Infant Death Syndrome is, as the name implies, the sudden and unexpected death of an infant for no known cause. It's the largest killer of babies in the first year of life. Although the exact cause of SIDS is still unknown, research is pointing more and more to certain factors which can put our babies at risk. Research now shows a correlation between SIDS and babies who are laid down to sleep on their stomachs. Although this research doesn't state that the prone position causes SIDS, it appears to be a major factor in SIDS related deaths.

Because of this pediatrician Dr. John Kattwinkel recommends that "if there is no other reason to do otherwise, if the baby is healthy, born at term and not a baby who spits up a great deal or has abnormalities of the airway, then perhaps the parents ought to place their babies down to sleep on their side or on their back rather than on their stomach. "

Dr. Kattwinkel also stresses that parents should avoid laying their babies on soft pillows, lambskins and water beds. And he adds that although SIDS is often unavoidable there are things that parents can do to decrease the risks. "We used to think that SIDS was a sporadic problem which couldn't be avoided and could hit anyone, explains Kattwinkel. "That's still true to an extent, but there are ways to decrease the risk. Babies of mothers who don't smoke, don't use drugs, and who do breast feed and place their babies on back or sides are at a low risk of having SIDS."

One in 500 babies die each years from SIDS, with the majority of those deaths occurring in infants between two and four months of age. While the cause of SIDS is still mysterious, the more we know, the more ways we have to prevent this terrible tragedy from occurring. 

Sore Throats

Does your child's sore throat mean a dose of antibiotics? Only if it's a proven case of strep say the experts.

Does your child have a sore throat? While viruses cause most sore throats, the streptococcus bacteria, otherwise know as strep, usually cause those that are accompanied by headache and fever. Thankfully, in this day and age of antibiotics, strep throat is not nearly the dreaded illness that it once was, says pediatrician, Dr. Diane Sacks. "In the past, 50 or 60 years ago, it was a very serious infection that was feared because it led to serious heart problems, rheumatic fever or problems in the kidney. Fortunately, penicillin came along and it killed strep very effectively."

Dr. Sacks adds that strep can still lead to scarlet and rheumatic fever if left untreated, so if your child has a very severe sore throat and swollen glands, the doctor needs to take a throat swab, and if it turns out positive, medicine must be taken for its full coarse of treatment to prevent some of the secondary side effects."

Still, don't assume that your child will be prescribed antibiotics even when it appears to be strep. Overuse of antibiotics has been blamed for the development of some strains of antibiotic resistant bacteria. Therefore, most doctors won't prescribe them unless the signs of strep are very clear and the swab is positive, says pediatrician Dr. William Feldman, editor of "The 3AM Handbook". He adds "people are developing guidelines that predict strep throat a little better. Now if the child with a sore throat, has a runny nose, no fever and there's nothing to see in the throat, then the chances of this being strep throat are quite remote."

So when should you suspect strep? "If the child just has a sore throat and has a high fever and swollen glands then it's likely that this is strep and that the child should be seen," explains Feldman who adds that if your child is covered in a rash, he may have scarlet fever. "Scarlet fever is simply a strep throat with a toxin that is released into the bloodstream and causes a rash. But it's not at all serious, it's just a strep throat with a rash and will get better with penicillin."

Headaches

While headaches are common occurrences in childhood, certain types of headaches can signal something more ominous.

Headaches are something we usually associate with adulthood, but they can and do show up in children, and for many reasons. The child may have a viral illness, be fatigued, or even stressed out. Fortunately, headaches rarely signal anything ominous like a brain tumor, explains pediatrician Dr. Paul Theissen. "If we look at the overall picture of headaches in childhood, only a small percentage actually have anything physically wrong inside their head. The vast majority of headaches in younger children will not be related to any mass that needs to be treated in any specific way. (However) I think headaches in any child under 5 years of age should be seen and addressed by a physician."

You may be surprised to learn that, according to statistics, 40% of children have had a headache by age seven, and by age fifteen 75% have coped with headaches, with 4% of those being migraine sufferers. According to Dr. Theissen "the signs of a headache that might be a migraine include headaches that are associated with vomiting, where it's severe and concentrated over one half of the head, and it might be associated with transitory visual loss or complaints of some sort. These are indications that your child might be suffering from a migraine headache." It1s recommended that, for children who suffer from migraines, the pain be treated with acetaminophen as soon as they complain of a headache. Waiting too long can just make the headache worse and more difficult to treat.

No matter what type of headache your child is suffering from it's important that you don't dismiss it, says pediatrician Dr. Marvin Ghans. "It isn't fair to a child to deny the fact they have a headache. Instead we should be sympathetic and help reassure them that the headache will go away shortly."

Finally, headaches that show up in the early morning and are accompanied by vomiting should be seen by a doctor to determine whether or not your child has a more serious problem, adds Dr. Ghans. "If your child is having persistent headaches, or prolonged headaches or if they interfere with their daily life, or affect their balance and gait, then it is time to see a doctor."

Fevers

Does your child have a fever? While fever may be a sign of illness, it may also be a part of the cure.

If your child has a fever, do you automatically reach for the medicine cabinet? Well, you may want to rethink this. Now, many in the medical profession feel that there's good evidence to suggest that fevers don't necessarily need to be brought under control with medications such as acetaminophen. In fact, fevers may actually help to kick-start the immune system into fighting off viral and bacterial infections, explains pediatrician, Dr. Paul Theissen. "The more we learn about fever over the years the more we learn that fever is an important adaptation of the body to fighting infection. We have become much more conservative about fighting fever as an objective in itself. So fever should be treated if it's making the child uncomfortable and really unwell. But I don't think that fever should be fought and brought down at any cost."

A fever is defined as a body temperature that is above normal. A child is thought to have a fever when their temperature reads higher than 37.5°C (99.5°F) in the mouth, more than 37.2°C (99°F) under the arm, or above 38°C (100.4°F) when measured rectally. While fever in itself isn't dangerous, sometimes the illness that accompanies it is. So, if your child has a fever and other symptoms such as listlessness, uncontrollable crying, a stiff neck, trouble breathing, and/or confusion, seek immediate medical attention.

The age of a child also plays a role as to when a physician must see him or her. First, a doctor should see a child of any age if the fever lasts for 3 or more days. Secondly, if your child is under two and the fever lasts for more than a day, call your doctor. Finally, if you have a newborn with a fever, seek immediate attention. According to Dr. Theissen, "a child under 3 months of age who gets a high fever of 39 to 40 degrees should be seen by a physician fairly urgently - that day. Certainly a child under one month of age should be seen immediately. A high fever should never be dismissed in a young infant. The likelihood of it being a bacterial infection is quite high."

Finally, it's always best to err on the side of caution. If you're concerned about your child's fever, always have it checked out by a qualified health professional.

Chicken Pox

There's no mistaking chicken pox. This is one childhood illness that's easy to spot!

Unless your child is vaccinated against chicken pox, it's almost guaranteed that at some point he or she will come down with this common childhood illness. Fortunately, chicken pox (or varicella) is short lived, lasting about a week. Chicken pox is spread through airborne droplets and is extremely contagious, occurring in about 85% of children under twelve. The good news is that while it is extremely contagious, once children have chicken pox they are immune for life.

How do you know your child has chicken pox? "The first thing the parent sees is the rash," explains infectious diseases specialist, Dr. Ron Gold. "The rash often starts on the face or body and then may spread out onto the arms or legs. It's a very typical rash that doesn't look like anything else. It's a little blister with redness around the base of it. Unfortunately for the child it bothers them more than other rashes because it's very itchy." Other symptoms include fever, runny nose, fatigue, and decreased appetite.

Acetaminophen may help a child feel more comfortable and reduce the fever. But never give a child A-S-A, such as aspirin, as there is a link between it and the sometimes fatal, Reye's syndrome. Dr. Gold suggests that baths can be of great help and that "some children prefer cool water to relieve the itching with starch in it. Some prefer it to be hot so it's worth experimenting."

As for complications, Gold says, "in young children, the most common complication is an infection from scratching the pox. You can't usually stop young ones from scratching, but you can keep their fingernails short so that they don't cause any damage."

Although rare, chicken pox can have more serious complications such as pneumonia and encephalitis. If you're concerned that your child's illness is taking a turn for the worse, contact your child's doctor, but do so by phone so as to avoid exposing those children and adults with low immune systems to the virus. And if your child is an adolescent when exposed contact your doctor, as serious illness is more common in older children and adults.

Finally, although not widely used, there is a chicken pox vaccine now available. For more information about it, talk to your child's doctor.

Croup

When it comes to croup, this is one childhood illness in which the bark is usually worse than the bite.

Croup is one of those illnesses that all children seem to end up with sometime in their young lives. A virus that generally strikes between the months of November and March, croup usually affects children between the ages of six months and five years. As an illness of the upper airway, croup's main symptom is a deep, bark-like cough that sounds much like a seal. When you hear the croup cough, it may set off alarm bells and bring images to mind of hospitalization and oxygen tents. However, in reality, croup is rarely serious explains pediatrician and editor of "The 3am Handbook", Dr. William Feldman. "Croup is an interesting condition which is virtually always accompanied by a fever. A child will wake up with a low-grade fever and a barking cough. Most of the time it goes away on it's own."

Treatment for most cases of croup is simple. It's an illness that requires no medication, unless specifically recommended or prescribed by your child's physician, explains pediatrician Dr. William James. "When you get your child awakening in the night (with croup), don't go running to the medicine cabinet and use one of those over-the-counter cough and cold remedies. They are dangerous in this circumstance because they dry out the mucous membranes, and you make the croup worse." Instead, Dr. James recommends that "if the child wakens in the middle of the night with this barky, hacky cough, turn on the shower, and steam up the bathroom really well. It will help to loosen things a bit." Some doctors even recommend bundling children up in a blanket and standing outside where they can breath in the cool, moist air which helps reduce airway inflammation.

And while croup is generally self-limiting, Dr. James adds that there are still instances when a child's croup takes a serious turn. "If the child starts to have some in-drawing, by that I mean that the child is sitting there at rest and has difficulty breathing, and the chest muscles are drawing and sucking in, then I think that's an indication to head to the nearest emergency department." There a child may be treated with medication to help reduce inflammation and relieve the breathing difficulties.

Ear Infections

Children suffering from ear infections should be seen by their physician, and for good reason!

If your child complains of ear pain and has a fever, chances are she's suffering from a common childhood ailment, otitis media, otherwise known as an ear infection. Ear infections require medical attention for many reasons; they can be extremely painful, and without treatment can lead to complications such as meningitis. Some research points out that recurrent ear infections lead to hearing loss and in turn, delay in speech development. Fortunately prompt treatment with antibiotics usually clears up an ear infection within a few days. Still, even once your child is on antibiotics, it's important to monitor her progress says pediatrician Dr. Mickey Lester. "If the doctor puts the child on antibiotics, the parents should monitor the situation to be sure the symptoms and the fever disappear within a couple of days. If not, they should report to the doctor. They should also return to the doctor after a couple of weeks to be sure that the infection is completely cleared. "

For those with stubborn ear infections, a doctor may suggest keeping a child on a low dose of antibiotics for many months, adds Dr. Lester. "Prophylactic antibiotics, which are administered in small doses once a day, for three to four months will hopefully clear up the infection. It gives nature time to heal the middle ear and return to normal so it will not be prone to further infections." Even with this, some children continue to have recurrent ear infections in which case a common and safe operation called tube surgery may be suggested. This is when ventilating tubes are inserted through the eardrum and into the middle ear to drain fluid.

Ear infections are most common in young children under three because the tube between their ear and throat is immature and not quite developed. Because many young children aren't yet verbal, parents need to be attuned to the signs of a child with an ear infection says pediatric ear, nose and throat specialist, Dr. Lesley Salkeld. "Young children may be fussy or irritable or may appear to be in a lot of pain that makes sleeping or eating difficult."

Is an ear infection ever a medical emergency? Most physicians would agree that the older child suffering from an ear infection could usually be treated with acetaminophen to reduce the pain, and then be seen by a physician within 24 hours. But Dr. Salkeld warns, "if a young child has a high fever, I consider it a medical emergency for which a diagnosis and treatment should be immediately commenced."

Common Eye Infections - Signs and Treatment

Is your child in daycare? Then it's probably just a matter of time before she comes home with a case of the highly contagious, pink eye.

If your child comes home from school or daycare with an itchy, red eye, then beware. She likely has the common, and very contagious eye infection, conjunctivitis. Also known as pink eye, it is usually accompanied by a thick, yellow discharge, often crusting the eyes shut in the morning. Pink eye can be viral or bacterial in nature. Viral infections are self-limiting and need to run their course, whereas bacterial infections require antibiotic eye-drops. The only way to know for certain whether your child's eye infection is bacterial or viral is to have her seen by her doctor.

The good news is that while pink eye is uncomfortable, it is rarely serious. Pediatric ophthalmologist Dr. Roy Cline elaborates. "Conjunctivitis is an infection of the eye surface. Normally it should be nice and white. But if it's red and swollen with discharge, it's usually caused by the same type of virus that causes an upper-respiratory condition. And when it comes in that combination then you have pink eye."

If your child has pink eye then you may want to keep your child away from school or daycare until the infection has cleared, so as not to pass it around to other children. Also it's advisable to avoid sharing towels, and avoid touching the eye area. As Dr. Cline explains "it's a very contagious disorder and really requires children to be meticulous about hand-washing. It's spread by tear drops so you don't want a child touching back and forth."

Overall, it is wise to have any problems with eyes or vision assessed by a doctor. Finally, if your child's eye infection is accompanied by a fever, swelling and a general sense of malaise, do have your child seen by a physician immediately, as this may require prompt treatment.

Antibiotics - Misuse and Overuse

With the emergence of super bugs, there's good argument for being judicious in our use of antibiotics.

It's hard to believe that around a half a century ago, before antibiotics became widely used, just the thought of a bacterial infection such as strep throat could put the fear of death into parents. Fortunately antibiotics have virtually wiped out many of those illnesses that at one time were considered deadly. But that is not to say that antibiotics are the answer to every fever, cough and cold. As pediatrician Dr. Alan Goldbloom explains, antibiotics are only useful when bacteria cause your child's illness. "Probably 90% plus of all the infections young children get are caused by viruses for which antibiotics don't work. The number of infections for which antibiotics work is still relatively small. They are used for ear, bladder and some throat infections, particularly strep throat. For all the others, the flues, colds, etc., antibiotics won't do anything at all."

Unfortunately, we've become so accustomed to using antibiotics that they have often been either over-used or misused. Pediatrician Dr. Paul Theissen says that because of this overuse "we're seeing the emergence of serious bacteria which are resistant to antibiotics. This is the biggest concern about antibiotic abuse - the emergence of strains of very nasty bacteria for which we have no antibiotics with which to treat them."

Besides the advent of super bugs, there are other reasons why you should use antibiotics judiciously. "The reason you don't want to take an antibiotic if you don't need it, is to prevent the side effects to yourself or your child," explains Dr. Theissen. "Side effects include diarrhea, rashes, vomiting and sometimes a serious inflammation of the bowel. So there are very good reasons as to why you don't want to take an antibiotic unless you need to."

When a child's illness is due to a bacterial infection, antibiotics do play an important role in treatment. Still, proper use of those antibiotics is vital says Dr. Goldbloom. "What's really important is to complete the course of treatment. This is very difficult for a lot of parents, because the children seem to get better after three days of treatment. But often the bacteria lie around longer than the symptoms do. Therefore, for things like strep throat it often takes longer to eradicate the bacteria then it does for children to get better."

Asthma - Signs and Treatment

Is your child's cough hanging on longer than normal? Then you may want to have him checked for asthma.

Most of us associate asthma with attacks that leave children wheezing and having difficulty breathing. But asthma can often be detected before it gets to this state. One sign of asthma in a child is a cough that goes on long after a cold is over, explains pediatrician and asthma specialist Dr. Barry Zimmerman. "Asthma is a bit like an iceberg. Once a child wheezes, that's the tip of the iceberg, and everybody can make the diagnosis. But really what a parent should think about is, every time a child gets a cold does it get into their chest and leave them coughing for a few weeks? One out of five children gets a cold that hangs around, and in theses cases asthma should be considered."

In most cases, asthma symptoms develop before age five. Once asthma is diagnosed, most physicians will prescribe medication to open airways and decrease inflammation. Dr. Zimmerman stresses that it's important that these medications are used at the first sign of an attack. "You fight asthma like a fire, when it's a few sparks and not an inferno. There should be none of the sudden, acute attacks. If a child requires the use of the bronchodilator a lot and has sudden episodes, then the inflammation and asthma are not being controlled."

Pediatric respiratory specialist Dr. Stephen Kent adds that while medication is vital, it's also important to be aware of what triggers your child's asthma attacks such as dust mites, pollen or animal dander. "The important first for parents is to control the environment as best as they can, including controlling the humidity so it doesn't go above 50% which is conducive to the growth of mold and dust mites, removing dust catchers, pets in the child's room and second hand smoke altogether."

If you suspect your child has asthma, have him or her seen by a physician. Asthma can be a serious condition if left untreated.

Sun Safety - Preventing Painful Sunburns

The sun may seem like a summertime friend, but without the right protection it can also be our children's enemy.

With our depleted ozone layer, in many ways the sun has become more of a danger than a pleasure. Gone are the days of basking in the sun with little or no protection. Now we're told that blistering sunburns double the chance of developing malignant melanoma (skin cancer) later in life. So if we want to protect our children from the sun's damage then we need to use more than just sunscreen, explains dermatologist Dr. G. Daniel Schacter. "Sunscreens are important, but when trying to protect a child remember they need a hat with a wide brim and we need to cover their skin with as much clothing as possible. Whatever isn't covered you should cover with sunscreen."

Babies under a year of age should not be put in direct sunlight. And Dr. Schacter says there are times when it's best for all children to avoid the sun altogether. "From 11 to 3, or 11 to 4, the exposure to sun is greatest and if possible children should play indoors as long as possible. If they have to play outdoors, protect them."

Many doctors recommend finding a sunscreen with Parsol 1789 in it, as this is a very good UVA block. And when it comes to the strength of the sunscreen Dr. Schacter says look for a higher SPF. "SPF stands for sun protection factor. Sunscreens are rated from two to fifty. The higher the rating, the greater the protection. If it's a SPF of fifteen it means they can play fifteen times as long in the sun without burning. That's a guide. You shouldn't spend fifteen times as long in the sun."

If you've misjudged how long your child can be in the sun or when the sunscreen needs to be reapplied, then a sunburn may occur. So how do you treat it? Dermatologist Dr. Thomas Christianson says "the age old methods of keeping the skin comfortable are the same as always such as the use of cold compresses and bland cream. If they get to the point of erosion and sores on the skin, at that point they may want to seek a medical opinion to make sure that there's nothing that can be done."

Foods Allergies - Signs and Symptoms

If your child has trouble breathing or gets hives after eating, then she may have a life threatening food allergy.

In children, particularly young ones, intolerance to certain foods is fairly common. But actual food allergies, when the body's immune system reacts to certain foods, are rare, effecting only one to three percent of the population. Nonetheless, food allergies can be dangerous and even life threatening.

Allergist Dr. John Dean explains some of the signs of a true food allergy. "Possible signs of a food allergy are severe eczema, swelling around the mouth, in the mouth, vomiting, maybe coughing & wheezing. (It occurs) often with certain foods particularly peanuts, raw eggs, sometimes milk, soya, shellfish and nuts, when these children ingest the food."

If your child has a food allergy, there are two main concerns. First and foremost is that the child avoids the food that he or she is allergic to. The second concern is that parents work closely with a specialist to ensure that their child has an adequate diet explains allergy specialist, Dr. Edward Hein. "For children with food allergies, it's a very good idea to work with a physician and to also talk to a dietitian or nutritionist in order to make sure that the diet is adequate so that the child will grow and develop normally."

Once your child has been tested and the food allergy is confirmed, then it's vital that he or she is well informed of what food he or she is allergic to and that this food is avoided without exception says Dr. Dean. "If your child has been identified as having a specific food allergy, it's absolute avoidance. You cannot smuggle food, so any food that contains that food product such as milk solids in a hot dog has to be avoided."

Dr. Dean hastens to add that it's imperative anyone in regular contact with your child such as teachers and caregivers know just what to do if your child ingests the wrong stuff. Part of that game plan may include adrenalin. "If anyone has any major problem in their throat, difficulty swallowing or speaking, adrenalin is the only safe drug to use, and obviously you go straight to hospital," says Dean. It's recommended that children with food allergies carry a special emergency kit that contains a shot of adrenalin.

If you suspect your child has a true food allergy, then have her seen by a physician so testing can be arranged. Food allergies can be life threatening and therefore, must be taken seriously.

Food Poisoning - How to Prevent Hamburger Disease

Every year people die from food poisoning. However it's easy to avoid with a little care and a lot of cooking.

If your child eats food contaminated by bacteria, food poisoning can occur causing abdominal cramps, nausea, vomiting, diarrhea and fever. Several types of bacteria can lead to food poisoning including, among others, salmonella, which is most commonly found in uncooked meat and poultry, eggs, and un-pasteurized milk. Botulism can be a deadly food poisoning caused by bacteria often found in improperly canned food and sometimes, honey. Other bacteria that cause food poisoning are staphylococcus-aureus and clostridium-perfringens usually transferred by a food handler, making hand washing vital to healthy food preparation.

E-coli bacteria cause one of the most serious forms of food poisoning. Often referred to as 'hamburger disease', it can cause "the more serious form of gastroenteritis", explains pediatrician Dr. Aliza Lipson. Generally a child will ingest e-coli "typically from undercooked hamburger meat, but it can come from other sources as well." Hamburger disease can be deadly, so if your child is vomiting and has bloody stool, Dr. Lipson stresses you must immediately call a physician. "Children can die from it, and the other side of the coin is that they can completely recover and never look back. The dangerous part is that sometimes the kidneys get involved and children can go into renal failure. There's other systems that can be involved but it's usually the renal problems that are the long lasting ones."

Infectious disease specialist, Dr. Ron Gold says prevention of hamburger disease is quite simple. First don't let raw hamburger come into contact with any other uncooked food such as salads. Second, wash your hands well before and after preparing raw hamburger, and wash all utensils and countertops with hot, soapy water after they've come into contact with the raw meat. And make sure you store ground beef properly. Dr. Gold says "the problem with meat is that if the meat isn't refrigerated or stored properly the bacteria can multiply so that you can get a lot of the toxins released, and then if the meat isn't cooked properly you can get sick. We have to get out of the habit of eating rare hamburger. To be safe it should not be pink at all."

Treatment for food poisoning can include antibiotics. But the best bet is prevention through cleanliness and thorough cooking. Finally, when you're finished cooking, be sure to store those leftovers immediately, and when you go to reuse them ensure that they are thoroughly reheated before serving.

Care of a Baby's First Teeth

Those pearly whites. From teething to the first visit with a dentist, here is a look at the do's and don'ts of caring for your child's first teeth.

If you have a child around four to six months of age, then chances are her first tooth is erupting, and she'll continue getting about one tooth a month until she's approximately two and a half years of age. For generations we've referred to this as teething, and have blamed the process of teething on everything from crankiness to serious illness. However according to pediatrician Dr. Alan Goldbloom, "teething is not a disease. It's as normal a process as the hair growing on your head, or any other part of growth and development."

Today, most physicians and dentists agree that the eruption of baby teeth causes very little discomfort. In fact, Dr. Goldbloom says if your child seems really upset or uncomfortable then it's important to have your child seen by her physician in order to rule out a serious illness. However Goldbloom adds "teething may produce a little bit of discomfort. The gums may be a little swollen, the baby may drool a little more, the baby may be a little fussy. If you wanted to give them something cold such as a teething ring, or anything hard to chew on that they can't swallow, that's fine."

Caring for those first pearly whites is important. Avoiding sugar, bottles of juice or milk at bedtime and brushing the new teeth with a soft cloth or brush is part of that care. So is the first visit to a dentist. But when is the right time to begin taking your child to the dentist? Pediatric dentist Dr. Richard Kramer recommends parents bring their children in for a check up at around their first birthday. "It used to be that 3 years of age was the magic number, but in recent years they've reduced the age for a kid to go to a dentist down to approximately one year of age. If you go to a pediatric dentist's office they may ask to see him at that age with the rational being if you see a child that young, you may be able to prevent problems before they occur. (It's also) an opportunity to review procedures at home, in order to reduce the potential for decay."

Colds and Cold Medications

When your child suffers from a cold do you automatically reach for the cold medications? Doctors tell us, you may want to rethink this idea.

The common cold is called common for a good reason. In fact, it turns out that cold viruses are so common, most school aged and adolescent children get an average of three to five colds, or upper respiratory infections each year. And those same sniffles and sneezes hit preschoolers at well over double the rate, as pediatrician Dr. Paul Theissen explains. "The average child in the first five years of life will get somewhere between 20 and 50 infections, so clearly the body needs to cope with a fair bit of infection. Only a small percentage of those are bacterial and where antibiotics are actually required."

While acetaminophen medication such as Tylenol may provide some relief for a child fighting a cold, Dr. Theissen says it’s a different story with over-the-counter cold medications. "There is no evidence that across-the-counter cold remedies actually benefit children less than five years of age. There are several well controlled studies where there has been no difference shown between children given medication and those who have not, although children given a cold remedy sometimes sleep a little better because antihistamines are sedative drugs."

Pediatrician Dr. William Feldman agrees and adds that the other downside of having cough and cold medicines in a home is that they can taste good to children and that in itself can be dangerous. "Children can get into them and take a whole bunch of it, much more than they should have. If you overdose on it, you can have rather nasty side effects, not fatal, but serious enough to warrant a visit to a poison control center of the hospital to have the stomach pumped, or to swallow some nasty stuff to get rid of the cough medicine, explains Dr. Feldman.

But what about for the child over five years of age? Dr. Feldman says, "If you have older children, some of the studies would suggest that it helps some kids. But as it does cause some side effects you have to ask if it's worth having. If you're going to keep it because you have experience that it does work with your over five year old, make sure it's under lock and key and that it's in a place where your younger child won't get at it."

Finally, the best way to treat a cold is still the old fashioned way "by ensuring an adequate intake of fluids and giving some Tylenol for headaches or fever", concludes Dr. Theissen.

Flus and Flu Vaccine

Is your child’s cold or flu virus taking a turn for the worst? Here’s when you’ll need to have your child’s illness further assessed by a doctor.

At this time of the year we hear a lot about the flu season. Or is it the cold season? Sometimes it’s difficult to discern the difference between the two, after all both are caused by a virus and some of the symptoms are the same. Pediatrician Dr. William James agrees that while there are some similarities between the two, there are also significant differences. "The common cold is basically when you feel a little achy, have a runny nose and a general feeling of malaise. Usually with a common cold you get a low grade fever, whereas with the flu, kids are usually much more ill, they ache all over, they may not have a runny nose but every part of their body aches."

If it is the flu, Dr. James recommends bed rest, fluids, and giving your child "a little Ibuprophen. It works well by taking away the aches and pains and works on the fever."

Whether it’s a cold or flu, secondary infections can sometimes set in such as pneumonia or bronchitis, and in that case you’ll want to have your child further assessed. "If a youngster is getting worse, if their sense of well being is getting worse, they have an uncontrolled fever, are hallucinating, these are some of the signs that suggest that there may be something more than just the flu going on," explains James. "They should be seen by their physician or emergency department. Sometimes you don't realize that they may have a touch of pneumonia or other serious infections and will need a little more aggressive work up."

Physician, Dr. Marjorie Keymer agrees that "if your child has the symptoms of the flu, seems to be getting better then suddenly takes a turn for the worse, spiking a higher fever, getting a more productive cough, generally looking sicker, your child may have developed one of the complications of the flu. The most common complication is pneumonia and the second most common complication is kidney disease. The one you're most apt to recognize is the pneumonia with a much more productive cough and a higher fever."

What about preventing all of this with the flu vaccine? Generally, it’s felt that because most children deal with the flu without any complications, the flu vaccine is unnecessary. However as each jurisdiction’s recommendations vary, it’s best to consult with your child’s doctor.

Finally, if your child is in a high-risk group, then the flu vaccine is highly recommended. Dr. Keymer explains, "children who are in the high risk group are children who have chronic diseases; chronic heart disease, chronic lung disease, chronic rheumatic disease, cancers, leukemia, severe anemias, any child who's immune response may be reduced. These children are at higher risk for the complications of the influenza and therefore would require and benefit from flu vaccine."

The ABC's of Healthy Eating

Dietitians of Canada have chosen this year’s national Nutrition Month theme - “The ABC’s of Healthy Eating”. The ABC’s stand for Antioxidants, B vitamins, Calcium and other related bone health nutrients. The general information and tips below can help you add the ABC’s of healthy eating to your family’s diet.

A - Antioxidants

Vitamins C, E, beta-carotene (the plant form of vitamin A), carotenoids (pigments that give colour to fruits and vegetables) and the mineral selenium are called antioxidants. Studies are showing that antioxidants may protect against heart disease, cancer, and cataracts, as well as reduce some of the effects of aging. Fruits and vegetables have the highest amounts of antioxidants. Other food sources are fish, meat, nuts, sunflower seeds, and whole grain products.

Ways to add antioxidants to your family’s diet:

• Offer at least 5 to 10 portions of fruits and vegetables in meals and snacks throughout each day.
• Try offering a new fresh, dried, canned, or frozen fruit or vegetable each week. Seasonal fruits and vegetables are cheaper.
• Prepare ready-to-eat fruits and vegetables as quick healthy snacks.
• Fruit shakes can be eaten at breakfast, snack time or used as a refreshing dessert. View this recipe onwww.dietitians.ca/english/kitchen/recipes/recipe1.html

B – B vitamins

Thiamin, riboflavin, niacin, vitamin B6, vitamin B12, folate, pantothenic acid and biotin make up the B vitamins -- all of which have important functions in the body. Eat enriched and whole grain products, fish, meats, liver, nuts, beans, lentils, dairy products, eggs and green leafy vegetables for sources of B vitamins. There are some groups of people who require B vitamin supplements; a folic acid supplement is essential for women of childbearing age. Others may require supplements of B vitamins; a vitamin B12 supplement is recommended for people who follow a strict vegan diet (i.e., eat no animal products) or those over the age of 50. Ask your doctor, pharmacist or registered dietitian if you have questions about supplements.

Ways to add B vitamins to your family’s diet:

• Serve vitamin B rich foods more often.
• Encourage your family to eat the minimum servings as outlined in Canada’s Food Guide to Healthy Eating: 5 to 12 servings of grain products; 5-10 servings of vegetables and fruits; 2-4 servings of milk products; 2-3 servings of meat and alternatives.
• Post a copy of Canada’s Food Guide to Healthy Eating on your refrigerator as a reminder to everyone.
• Using fridge magnets or stickers, track the number of servings your family members eat each day 
• Help your family explore different foods by involving them in buying food, and planning and preparing meals.

C - Calcium and other nutrients related to bone health

Calcium is needed to form strong bones and teeth. Other important nutrients are vitamin D, phosphorus, magnesium and fluoride. The amount of calcium and vitamin D your child gets during childhood and adolescence is the key to strong healthy bones and teeth for a lifetime. Food sources of calcium and other nutrients for bone health include milk, dairy products, calcium-fortified soy or rice beverages and calcium- fortified orange juice. Calcium-enriched tofu, canned fish with bones and green leafy vegetables are other sources. 

Ways to promote strong bones and teeth:

• Offer 2-4 servings of milk products per day in meals and snacks. Different age groups need different numbers of servings. Refer to Canada’s Food Guide to Healthy Eating for recommendations.
• Use creative ideas. Top a mini-bagel or baked potato with broccoli and cheese, or offer baby carrots with a tofu dip. Check out recipe books at your local library. 
• Check your child’s calcium intake using the Calcium Calculator R at www.bcdf.org 
• Weight-bearing activity (e.g., walking, skipping, badminton) is also important for building bone mass in childhood and adolescence, and helps to maintain peak bone mass in adulthood.

Limit the amount of beverages that have caffeine (e.g., colas, ice teas). Caffeine can rob calcium from bones.

In a fast-paced world, it can be difficult to meet your family’s nutrient needs. Following some of the tips above can help add the ABC’s of healthy eating to your family’s diet. 

For more information, nutritious tips, recipes and access to a Registered Dietitian,
visit these websites or call Dial-a-Dietitian at            1-800-667-3438      (DIET)

Dietitians of Canada www.dietitians.ca
Dial-A-Dietitian www.dialadietitian.org
Canadian Health Network www.canadian-health-network.ca

References used:

1. Dietitians of Canada www.dietitians.ca
2. Dietitians of Canada’s 2002 National Nutrition Month Resource Manual for Health Professionals
3. BC Dairy Foundation www.bcdf.org

Music & Young Children

One of the greatest gifts we can give our children is the love of music. Fortunately it doesn't require expensive lessons and instruments to do this.

Singing, even speaking in a sing-song voice to children is a natural for most parents. Something deep inside us tells us that music elicits joy and happiness and even calms our little ones. Charlotte Diamond, former teacher and now an award-winning children's performer elaborates on how easy it is to bring music into children's lives. "Young children love music and rhythm. Parents can rock their children and sing to them as a part of a regular routine each night before bed. It's not necessary to have a great voice, because children are simply happy to hear their parents voice and how they express themselves."

Whether or not you've studied music formally has nothing to do with sharing music with your child. 'I don't think a parent should ever be concerned about their own weakness musically", says Diamond. "Hearing someone sing with their own voice is great, it's part of who they are and part of their personality."

As for what you should sing to your child, the answer can be found in the songs and lullabies of your own childhood. It's not so much how perfectly sung they are explains Diamond. "What's being communicated is your love for your child, that you'll take care of them and that they are secure."

Diamond feels that the more young children are exposed to music, the more likely they will be to develop their musical abilities. "Music is everywhere. If parents have music playing in the home, on tapes in the car, and have fun singing songs with them, then music is just a part of everyday life and children will grow to be musical."

So rather than reserving music for your child's formal lessons, bring music into their lives on a regular basis. Sing songs at bedtime or find a favorite tape or CD to play in the car or at home. Diamond says parents should "make a point of listening to music together and sharing feelings with them about music. If you love something and tell them, then they might be encouraged to feel the same way."

Tips for Choosing Child Care

Finding good childcare requires patience, persistence and a few detective skills. Here's what to look for in a qualified day-care center.

For most of us, returning to work and finding alternative care for our child is a fact of life. For many, licensed day-care centers offer the answer. The question is, what makes a good day-care center?

Every day-care center provides, as the name implies, all day care including snacks, lunch and naptime. Generally the caregivers at licensed day-care centers must be fully trained in Early Childhood Education, or its equivalent. Beyond that, the signs of a good day-care center is how adult caregivers interact with children, says Nadia Hall of Mothercraft. "Look at the way care-giving routines are handled such as eating. Is it a time to socialize, to have a warm conversation so as to develop language skills and to allow the child to feel special? Look to see that children's self esteem is being built and that each child is known intimately well by the care-giver."

Hall believes one of the benefits of good day-care is socialization, even for babies as young as ten months. "Children form peer groups at nine and ten months and they know when someone is away. By the time they are toddlers they have formed a very solid peer group and that's the time care-givers are teaching them social skills such as sharing, empathy and learning how to do things as a group."

Finally, Hall says that as good as a day-care center may be, it may still not be the answer for your own child. "If the child is shy, slow to warm up to large groups of children or bothered by the noise level then perhaps a better option is family day care at private homes where there are smaller numbers with one nurturing mother figure."

While leaving young children behind in care is inevitable for many working parents, it's still a difficult adjustment. But by finding the most appropriate childcare arrangement from the onset, this back-to-work transition can be eased for both child and parent.

Camping Fun and Safety

When you take your kids camping in the great outdoors, there are a few things you must keep in mind, for safety's sake.

Camping during summer holidays is one of the best ways of experiencing a little one-on-one time with your children and with mother nature. While kids love the freedom of the great outdoors, so do many parents. After all, there are no clocks to watch, and no television or computers to divide attention. There's just you and the kids, making fires, roasting marshmallows, hiking and swimming.

Of course, camping can pose hazards. However, by exercising a little caution these hazards can be avoided. Fires must be supervised, as do all water activities. And because every year we hear or read of a child who has been lost in the woods, we need to keep a close eye on our little ones explains safety expert, Laurie LeClair. "If you are going to take your children on a camping weekend or a week, the key is to keep them as well supervised as possible. If your child does wander off, coach the child that if you wander off, stay put. If you lose us stay where you are, because we will find you. If you keep wandering around, we're all going to wander in circles and we're not going to find one another." LeClair also suggests that parents pin a whistle to their child's shirt or jacket as a safety measure. That way, if a child does get lost, he can stay in one place and blow his whistle to attract attention.

LeClair adds that accidents happen anywhere, including in campgrounds. Whether it's a scraped knee or something more serious, parents should be trained in basic CPR and first aid, and must bring along a first aid kit.

Finally, LeClair reminds us that "other hazards include wild animals, depending on where you're camping. Find out in advance what kind of animals are in the area from the camping authorities at that campground. Don't let your children feed the animals. It encourages them. It brings forth animals that may be congenial when they're being fed, but turn nasty if the food runs out."

All in all, camping is a wonderful family activity that teaches children appreciation of nature and provides quality time together for everyone. And with just a little common sense and a few precautions, camping can be a safe and fun summer vacation.