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(The Crying Baby) |
| Diarrhea |
Conjugate Vaccine |
of Heat Injury |
Throat Infection |
| Stuttering |
| Vomiting |
Your child was stung by a
honey bee, bumble bee, hornet,
wasp, or yellow jacket. Over 95
percent of bee stings are by
yellow jackets. These stings
cause immediate painful red
bumps. While the pain is usually
better in 2 hours, the swelling
may increase for up to 24 hours.
Multiple stings (more than
10) can cause vomiting,
diarrhea, a headache, and fever.
This is a toxic reaction related
to the amount of venom received.
It is not an allergic reaction,
which would cause difficulty
swallowing, passing out, or
If you see a little black dot
in the bite, the stinger is
still present (this only occurs
with honey bee stings). Remove
it by scraping it off. If only a
small fragment remains, it will
come out on its own. Then rub
each sting for 20 minutes with a
cotton ball soaked in a meat
tenderizer solution. (Avoid in
the area around the eye.) This
will neutralize the venom and
relieve the pain. If meat
tenderizer is not available,
apply a baking soda solution for
20 minutes. For persistent pain,
massage with an ice cube for 10
minutes. Give acetaminophen
immediately for relief of pain
Some bee stings can be
prevented by avoiding gardens
and orchards and by not going
barefoot. Insect repellents are
not effective against these
IMMEDIATELY (AND CALL 911) IF:
|Breathing or swallowing is
DURING OFFICE HOURS IF:
|The swelling continues to
spread after 24 hours. |
|Swelling of the hand (or
foot) spreads past the wrist
(or ankle). |
|You have other questions
|Every human being must make sense
to himself. |
|It is the child’s feeling about
being loved or unloved that affects
how he will develop. |
|Every child seeks a picture of
himself as capable and strong. And
behavior matches the self-image.
|Words are less important than the
judgments that accompany them. |
|Defenses are put up around
|If you live with youngsters so
that you crush self-esteem, you
thwart positive growth; in fact, you
foster warped, defensive
|Low self-esteem is tied to
impossible demands on the self. |
|Children rarely question our
expectations; instead they question
their personal adequacy. |
|The key to inner peace and happy
living is high self-esteem, for it
lies behind successful involvement
with others. |
|Helping children build high
self-esteem is the key to successful
|You nourish from overflow, not
The major killer and crippler of children in the United States is motor vehicle crashes. Approximately 700
children under the age of 5 years are killed each year, and about 60,000 are injured. Proper use of car safety
seats can reduce traffic fatalities by at least 80%. All 50 states have passed laws that require children to ride
in approved child passenger safety seats.
A parent cannot protect a child by holding him or her tightly. In a 30-mile-per-hour crash, the child will
either be crushed between the parent's body and the dashboard or ripped from the parent's arms and possibly
thrown from the car. Car safety seats also help to control a child's misbehavior, prevent motion sickness,
and reduce the number of accidents caused by a child distracting the driver.
CHOOSING A CAR SEAT
1. Government safety standards
Since January 1981, all manufacturers of child safety seats have been required to meet stringent
government safety standards, including crash-testing. Choose a seat that has met Federal Motor Vehicle
Safety Standard 213, with 1981 or later as the year of manufacture. If the seat was manufactured
between 1971 and 1981, it may not meet the government safety standard. When in doubt, contact the
National Highway Traffic Safety Administration hotline (1-800-424-9393) for information. The
American Academy of Pediatrics also publishes a list of infant/child safety seats that is updated yearly.
To obtain this list, write to:
American Academy of Pediatrics Division of Public Education PO Box 927
Elk Grove Village, Illinois 60007
2. Types of car safety seats
There are three types of car safety seats:
Before you buy a car safety seat, look at several different models. Make sure that the car seat will fit in
your car and that your seat belts will work with the seat.
|Infant safety seats are installed in a rear-facing position only and can be used from birth until a child
weighs approximately 20 pounds. |
|Convertible safety seats can be used in both rear-and forward-facing positions.
|Booster safety seats are forward-facing and have a removable shield.
3. Matching car safety seats with your child's weight
|Birth to 20 pounds: Use an infant safety seat until your child is over 20 pounds and able to sit up by
himself. Keep your child facing backward as long as possible, because it protects him from neck
|Over 20 pounds: Use a convertible car seat in the forward-facing position.
|Over 40 pounds and over 40 inches tall: Use a booster safety seat. This will also help your child
see out the window. |
|Over 60 pounds: Use the regular car seat without a booster seat and with a lap belt low across the
hips. When your child is also over 4 feet (48 inches) tall, add a shoulder strap. Using a shoulder
strap before your child is 4 feet tall can cause neck injuries. If the shoulder strap runs across the
neck (rather than the shoulder), put it behind your child. Never put the shoulder belt under both
4. Air bags
Air bags are standard equipment in most new cars. They have saved many lives. However, they are
very hazardous to infants in REAR-facing child safety seats and have caused death from brain injury.
If your car has air bags, take the following precautions:
|Infants riding in REAR-facing child safely seats should NEVER be placed in the front
seat of a car or truck with a passenger-side air bag. They must be in the car's rear seat or not ride in that vehicle.
|Children in FORWARD-facing child safety seats should also ride in a car's rear seat. If the vehicle
does not have a rear seat, children riding in the front seat should be positioned as far back as
possible from the air bag. Move the seat all the way back so that the child is as far as possible from
the dashboard. |
USING A CAR SEAT PROPERLY
If used consistently and properly, your child's car seat can be a lifesaver. Your attitude toward safety belts
and car seats is especially important. If you treat buckling up as a necessary, automatic routine, your child
will follow your lead and also accept car seats and seat belts. To keep your child safe and happy, follow
|ALWAYS FOLLOW THE MANUFACTURER'S DIRECTIONS for installation and use of the car
seat: Improper installation or use will not protect your child. |
|Always use the safety seat. Use the safety seat on the first ride home from the hospital, and continue
using it for every ride. |
|Whenever possible put the safety seat in the back seat of the car, which is much safer than the front seat.
|If the seat belt in your car has a shoulder harness, you will need a seat belt locking clip that keeps the
seat belt from moving when it is used with your child's safely seat. These locks often are sold with the
safely seat. Baby specialty stores also sell them separately. |
|Everyone buckles up! Allow NO exceptions for older kids and adults. If adults ride unprotected, the
child quickly decides that safety is just kid stuff. |
|Give frequent praise for appropriate behavior in the car.
|Remember that a bored child can become disruptive. Keep a supply of favorite soft toys and munchies
on hand. |
|NEVER let a fussy child out of the car seat or safety belt while the car is in motion. If your child needs a
break, STOP the car. Responding to complaints by allowing your child to ride unprotected is a
disastrous decision that will make it harder to keep him or her in the seat on the next ride.
|If a child tries to get out of the seat, stop the car and firmly but calmly explain that you won't start the car
until he or she is again buckled in the car seat. |
|Make a vinyl seat pad more comfortable in hot weather by covering it with a cloth pad or towel.
|When your child travels in another person's car (such as a baby sitter or grandparent), insist that the
driver also use the safely seat. |
|For long-distance trips, plan for frequent stops and try to stop before your child becomes restless.
Cuddle a young child; let an older child snack and run around for 10 to 15 minutes.
Chickenpox (varicella) is a disease affecting most children in the United States before their 10th birthday.
Until recently it could not easily be prevented with a vaccine, only treated. Now, however, parents can
have their children immunized against chickenpox with a new vaccine. Regular medical care includes
vaccinations, which are an important part of your child's total health care.
This brochure discusses chickenpox and why its beneficial to have your child vaccinated against the disease.
The new vaccine can protect your child against chickenpox and prevent the discomfort and possible serious
complications the disease can cause.
What is this disease?
Chickenpox is one of the most common childhood viral diseases. It is usually mild and not life-threatening to
children who are otherwise healthy. The most noticeable sign of chickenpox is a skin rash that develops on
your child's scalp and body, then spreads to the face, arms, and legs over a period of 3 to 4 days. The rash
forms between 250 to 500 itchy blisters that dry up into scabs 2 to 4 days later. School-age children often get a
mild fever for 1 or 2 days before the rash appears. Other symptoms of chickenpox are chills, fussiness, loss of
appetite, and headaches.
Chickenpox is highly contagious and is spread in one of the following ways:
A person who has chickenpox is contagious from 1 to 2 days before the rash starts and for 6 days after you
first see the rash. A child will have to stay home from day care or school until he or she is no longer contagious.
An adult or child who has never had chickenpox is at risk for getting it and may not show symptoms for 10
to 21 days after being exposed to the virus. Within households, 80% to 90% of at-risk persons will develop
chickenpox if they are exposed to a family member who has it.
|by direct contact with an infected person, usually through fluid from broken blisters
|through the air when an infected person coughs or sneezes
|through direct contact with lesions (sores) from a person with shingles
Who gets chickenpox?
There are about 3.9 million cases of chickenpox in the United States each year, with more than 95% of all
people developing the disease. Cases occur most frequently in children from ages 6 to 10.
Chickenpox can occur at any time throughout the year, but its peak times are in the winter and early spring,
especially in moderate climates.
What is the treatment for chickenpox?
You may remember from when you were a child just how itchy chickenpox can be. If your child scratches the
blisters before they are able to heal, they can get infected/ turn into small sores, and possibly leave scars.
Discourage your child from scratching, but keep his or her fingernails trimmed short just in case.
Oatmeal baths can help relieve your child's itching and acetaminophen may help reduce your child's fever.
Do not give your child aspirin or salicylate (a compound found in aspirin) as they have been associated with
Reye's Syndrome, a disease that affects the liver and brain. If your child's fever lasts longer than 4 days or
rises above 102°F, call or see your pediatrician. Also let your pediatrician know if areas of the rash get very
red, warm, or tender; this may mean your child has a bacterial infection and needs other treatment.
Acyclovir, an oral drug, is used for certain patients who are at risk of developing severe chickenpox. These
patients include adolescents and children with skin or lung diseases. To be effective, acyclovir must be given
within the first 24 hours of the onset of the chickenpox rash. You may want to discuss the use of acyclovir
with your pediatrician.
Can chickenpox cause complications?
Most children who are otherwise healthy and get chickenpox won't have any complications from the disease.
However, each year in the United States, about 9,000 people are hospitalized for chickenpox and 90 people
die from the disease.
The most common complication from chickenpox is bacterial infection of the skin. The next most common
problems are viral or bacterial pneumonia and encephalitis. The following groups of people are at higher risk
of developing these problems:
When an adult gets chickenpox, the disease usually lasts longer and is more severe, often developing into
pneumonia. Adults are almost 10 times more likely than children under 14 to need hospitalization from
chickenpox and more than 20 times more likely to die from the disease. If a pregnant woman develops
chickenpox, her unborn baby may have complications.
|people who have weak immune systems |
|infants under 1 year of age |
|adolescents and adults |
|newborns whose mothers had chickenpox around the time of delivery
|premature infants whose mothers have not had chickenpox
|children with eczema and other skin conditions
|children receiving salicylate (a compound found in aspirin) therapy
(Upper Respiratory Infections, or URIs)... ?
|runny or stuffy nose
|usually a fever and sore throat
|sometimes a cough, hoarseness, red eyes, and swollen lymph nodes in the neck.
|Vasomotor rhinitis: Many children and adults have a profusely runny nose in the wintertime when they
are breathing cold air. The nose usually stops running within 15 minutes after a child comes indoors. It
requires no treatment beyond a handkerchief and has nothing to do with infection.
|Chemical rhinitis: Chemical rhinitis is a dry stuffy nose that results from using vasoconstrictor
nose drops too often and too long (longer than 1 week). It will be better a day or two after you stop using
the nose drops. |
A cold or upper respiratory infection is a viral infection of the nose and throat. The cold viruses are spread
from one person to another by hand contact, coughing, and sneezing. Colds are not caused by cold air or
drafts. Because there are up to 200 viruses that cause colds, most healthy children get at least six colds a year.
Usually the fever lasts less than 3 days, and all nose and throat symptoms are gone in a week. A cough may
last 2 to 3 weeks.
Watch for signs of secondary bacterial infections such as earaches, yellow drainage from the eyes, constant
pus from the nose (often indicating a sinus infection), or difficulty breathing (often a sign of pneumonia).
If you have a young infant, make sure that the baby does not get dehydrated. A blocked nose can interfere
so much with the ability to suck that dehydration can occur.
Not much can be done to affect how long a cold lasts. However, we can relieve many of the symptoms.
Keep in mind that the treatment for a runny nose is quite different from the treatment for a stuffy nose.
1. Treatment for a runny nose with a lot of clear discharge: Suctioning or blowing
The best treatment is clearing the nose for a day or two. Sniffing and swallowing the secretions is
probably better than blowing because blowing the nose can force the infection into the ears or sinuses.
For younger babies, use a soft rubber suction bulb to remove the secretions gently.
Put petroleum jelly around the openings of the nose to protect them from irritation.
Nasal discharge is the nose's way of getting rid of viruses.
2. Treatment for a dry or stuffy nose with only a
little discharge: Warm-water nose drops and
Most stuffy noses are blocked by dry mucus. Blowing the nose or suction alone cannot remove most
Nose drops of warm tap water are better than any medicine you can buy for loosening up mucus. If you
prefer normal saline nose drops, mix 1/2 teaspoon of table salt in 8 ounces of water. Make up a fresh
solution every few days and keep it in a clean bottle. Use a clean eyedropper to put drops into the
nose. Water can also be dripped in using a wet cotton ball.
|For the younger child who cannot blow his nose:|
Place three drops of warm water or saline in each nostril. After I minute use a soft rubber suction
bulb to suck out the loosened mucus gently. To remove secretions from the back of the nose, you
will need to seal off both nasal openings completely with the tip of the suction bulb on one side and
your finger closing the other side. If you cause a nosebleed, you are putting the tip of the suction
bulb in too far. You can get a suction bulb at the drugstore for about $2. Try to buy a short, stubby
one with a clear-plastic mucus trap.
|For the older child who can blow his nose:|
Use three drops in each nostril while your child is lying on his back on a bed with
his head hanging
over the side. Wait I minute for the water to soften and loosen the dried mucus. Then have your
child blow his nose. This can be repeated several times for complete clearing of the nasal passages.
|Mistakes in using warm-water
The main errors are not putting enough water in the nose, not waiting long enough for secretions to
loosen up before suctioning or blowing the nose, and not repeating the procedure until the breathing
is easy. The front of the nose can look open while the back of the nose is all gummed up with dried
mucus. Make sure that the nose is suctioned or blown after the warm-water nose drops
are put in.
3. The importance of clearing the nose of a young infant
A child can't breathe through the mouth and suck on something at the same time. If your child is
breast-feeding or bottle-feeding, you must clear his nose out so he can breathe while he's sucking. It is
also important to clear your infant's nose before you put him down to sleep.
4. Treatment for associated symptoms of colds
|Fever: Use acetaminophen or ibuprofen for aches or mild fever (over 102 degrees F, or 38.9 degrees
|Sore throat: Use hard candies and warm chicken broth for children over 4 years old.
|Cough: Use cough drops for children over 4 years old and corn syrup for younger children. Use a
humidifier to make the air in the room less dry. |
|Red eyes: Rinse frequently with wet cotton balls.
|Poor appetite: Encourage drinking fluids by letting the child choose what to drink.
5. Prevention of colds
A cold is caused by direct contact with someone who already has a cold. Over the years we are all
exposed to many colds and develop some immunity to them.
Complications from colds are more common in children during the first year of life. Try to avoid undue
exposure of young babies to other children or adults with colds, day care nurseries, and church
A humidifier prevents dry mucous membranes, which may be more susceptible to infections.
Vitamin C, unfortunately, has not been shown to prevent or shorten colds. Large doses of vitamin C
(for example, 2 grams) cause diarrhea.
6. Common mistakes in treating colds
Most over-the-counter cold remedies or tablets are worthless. Nothing can make a cold last a shorter
time. If the nose is really running, consider using a pure antihistamine (for example, chlorpheniramine
products) if your child also has allergies. Especially avoid drugs that have several ingredients because
there is a greater chance of side effects from these drugs. Avoid oral decongestants if they make your
child jittery or keep him from sleeping at night. Use acetaminophen for a cold only if your child also
has a fever, sore throat, or muscle aches.
Do not give leftover antibiotics for uncomplicated colds because they have no effect on viruses and may
LIVINGSTON PEDIATRICS IMMEDIATELY IF:
|Breathing becomes difficult AND no better after you clear the nose.
|Your child starts acting very sick.
CALL LIVINGSTON PEDIATRICS DURING OFFICE HOURS IF:
|The fever lasts more than 3 days.
|The nasal discharge lasts more than 10 days.
|The eyes develop a yellow discharge.
|You can't unblock the nose enough for your infant to drink enough fluids.
|You think your child may have an earache or sinus pain.
|Your child's throat becomes quite sore (get a throat culture).
|You have other questions or concerns.