Note: This information is intended as an overview and provides typical advice for common medical concerns. As all children and situations are different, please call your doctor or seek medical care if you are concerned that your child may have a serious condition.
In order to have a food allergy, you must first come into contact with the food. This can be by direct skin contact, eating or drinking the food, or inhaling small particles of it. The American Academy of Allergy, Asthma and Immunology (AAAAI) defines a food allergy as “an adverse health effect arising from a specific immune response that occurs reproducibly (more than once) on exposure to a given food”. This means that a food allergy happens when the immune system responds inappropriately to a specific food, and it occurs consistently with repeat exposure to the same food.
Symptoms can vary and affect several areas of the body:
- Skin: hives, swelling, eczema
- Gastrointestinal tract: abdominal pain, vomiting, diarrhea
- Respiratory system: nasal congestion, cough, wheezing, difficulty breathing
- Cardiovascular system: low blood pressure (which can cause lethargy or fainting)
If your child has any of these symptoms please let your doctor or nurse practitioner know. Anaphylaxis is a severe life-threatening reaction in which multiple body systems are involved; call 911 immediately if your child develops difficulty breathing, facial swelling or significant lethargy shortly after coming into contact with a food.
Common food allergies include milk/ dairy products, eggs, peanuts and other tree nuts, fish, shellfish, soy and wheat. Allergies to milk, eggs, wheat and soy are often outgrown, while an allergy to peanuts, tree nuts or seafood is usually not outgrown. Your child’s doctor can help you determine when it is safe to reintroduce a food. The AAAAI does not recommend that a mother restrict her diet during pregnancy or when breastfeeding as a way to prevent food allergies from developing in her child. There is no conclusive evidence showing that delaying the introduction of solid foods after 4 to 6 months of age prevents allergies from developing.
If your child is diagnosed with food allergies, it is important to make sure the diet is still nutritionally adequate. Our clinic providers can help you with this, and dieticians are available via referral as an additional resource.
A hemangioma is an abnormal collection of blood vessels. The basic types are:
Expected course for hemangiomas:
Make an appointment to have your child’s provider to check the hemangioma if any of the following are noticed:
The US Public Health Service considers vaccines to be one of the most important medical advances in the past century. Immunizations are an important part of well child care and disease prevention. Routine child vaccines save lives, keep children healthy, and are the most cost effective way to prevent many diseases. Before we had measles vaccination, measles infected more than 500,000 children each year in the United States with 450 associated deaths. We still have outbreaks of vaccine-preventable diseases in the United States, including pertussis (whooping cough), tetanus (lock jaw), Haemophilus influenzae type b (Hib), pneumococcal bacteria (Streptococcus pneumoniae), hepatitis A & B, influenza, measles, mumps, rubella (German measles), and varicella (chicken pox). If you have any questions about vaccines, ask your child’s provider for more information.
Concerns: Some parents are concerned about an association between autism and vaccines. No scientific studies or reviews have found any relationship between vaccines and autism, and many studies have disproven this theory. In addition, the original study that suggested a link between the MMR vaccine and autism has been retracted by the publisher. Several experts and professional organizations, including the American Academy of Pediatrics (AAP) and the Institute of Medicine (IOM), also agree that vaccines are not responsible for the number of children now recognized to have autism.Thimerosal is a mercury-containing compound that was routinely used as a vaccine preservative. There is no scientific evidence that children have been harmed by thimerosal in vaccines. Because of public concern, however, as a precaution in 2001, all routinely recommended childhood vaccines were changed to single-dose packaging so they wouldn’t require thimerosal. Today, influenza is the only childhood vaccine licensed for use in the U.S. that contains more than a trace of thimerosal, and it is considered safe for children. Thimerosal-free influenza vaccines are sometimes available for young children.
What can you do if your child has fever and/or discomfort after vaccines?
Information from the CDC regarding vaccines (including Vaccine Information Sheets specific to each vaccine) can be accessed at http://www.cdc.gov/vaccines.
Good Nutrition for Kids
Children have many things to accomplish as they grow, and good nutrition is essential for normal growth and development. It is always better to use food to supply minerals and nutrients rather than vitamins or supplements, because the body is designed to get nutrients by eating.
Here are some basic requirements your child needs:
Calcium: 4-8 years: 800 mg
9-18 years: 1300 mg
Fiber: Boys need 25-38 grams a day
Girls need 25-26 grams a day
Calories: 4-6 years: 1800 calories a day
7-10ears: 2000 calories a day
A good breakfast is important! If your kids can’t get ready in time for breakfast then pack them something to take with them. Some ideas are yogurt, a sandwich on whole grain bread, peanut butter or cheese on toast, or an english muffin and scrambled egg sandwich. Try to give them breakfast food that has protein in it such as milk, cheese, peanut butter, or egg. This will help keep their blood sugar normal and help them last until lunchtime.
Our schools are trying to feed children healthy meals, but many schools see that food discarded in favor of fast food offerings. Encourage your schools to limit the amount of fried or fast foods available and talk to them about making good choices.
Finally, set a good example by eating healthy foods as a family. Don’t use food as a reward or bribe. Focus on family time instead of making meals a battle. Children need to be exposed to new foods many times before they will accept them. Don’t give up!
It is very common for toddlers to become very picky about what they will and will not eat, and it may seem like your child is living on macaroni and cheese or chicken nuggets. This is a very normal stage of development. What a child chooses to eat is one of the few areas in their lives they can control. It can be very frustrating to deal with this as a parent. Here are some recommendations on how to handle this stage in your child’s life.
If you are very worried that your child’s diet may be affecting their growth or energy level, please schedule an appointment to see your pediatric provider to discuss your concerns.
Community Associated Methicillin-Resistant Staphylococcus Aureus (CA-MRSA) is an emerging infectious disease. MRSA is different from normal Staph aureus because it is resistant to the usual antibiotics. Americans visit the doctor approximately 12 million times each year to get checked for suspected Staph or MRSA skin infection. CA-MRSA affects all ages and is commonly seen as a skin or soft tissue infection, which may be mistaken for a “spider bite”. It is transmitted by direct contact with an infected person or by sharing personal items, such as towels or razors that have touched infected skin. MRSA is prevented by good hand washing and covering skin infections. More information about MRSA can be found at the CDC website at www.cdc.gov/mrsa. If anyone in your family appears to have an MRSA infection, cover the area with a bandage and contact your healthcare professional.
Pityriasis alba is a skin condition where areas of lighter skin color occur in patches. It typically occurs on the face, but other areas of the body can also be affected. The borders of these patches usually show a gradual skin color change from normal to lighter. This skin condition is common among children.
The cause is unknown, but most likely it is secondary to dry skin or contact with chemicals that cause skin dryness. This condition usually improves in winter and worsens during the summer. These changes are most likely due to seasonal variation in sun exposure.
Treatment is not required, but can help speed up recovery to make the lighter skin patches less noticeable. The treatment involves applying a hypoallergenic moisturizer 2-3 times per day and using sunscreen (SPF 35 or higher) prior to sun exposure. To prevent or lessen the return of this skin condition, continue to use the moisturizers and sunscreen on a daily basis.
Call your provider if the skin becomes red and irritated, the light patches don’t return to normal after several months, or you have other concerns.
Most children will get their first tooth between 6-12 months of age. However, some children are born with teeth and others don’t get their first tooth until after 12 months. Increased drooling and mouthing behavior at 3-4 months of age is a normal developmental milestone, and is not usually due to teething.
Most children sail through the teething process with no problems. There are many myths about teething, including that teething causes runny nose, cough, vomiting, diarrhea, and fever. These symptoms are typically caused by viruses rather than teething. Here in the Pediatric Clinics we say that teething causes teeth...period! The most dangerous myth is that teething causes fever. If your child has a fever (>100.4 deg F), it’s being caused by infection or inflammation, not teething.
However, teething can cause discomfort. It’s okay to treat teething if you have already checked for everything else that might be making your baby fussy, and if you can see a tooth erupting. Pain relievers such as acetaminophen (i.e. Tylenol, click here for the dosing chart) are often more effective for pain management than gels applied to the gum. Refrigerated teething rings may also help, but avoid frozen teething rings as they have caused frostbite of the gums.
Pertussis (Whooping Cough)
Pertussis is a highly contagious disease that is spread by coughs and sneezes. Pertussis is caused by a bacteria called Bordetella pertussis. Althoughthe infection can occur in all ages, infants less than 12 months are at highest risk for severe disease and death. According to the California Department of Public Health, there were 9,120 cases of pertussis reported in California in 2010. This is the most cases reported in over 60 years. 804 of these patients were hospitalized with about 75% of those being <6 months of age. Unfortunately, a few of these infants died from the infection.There is no good treatment for pertussis once the symptoms are fully developed, so prevention via immunization is essential. DTaP and Tdap are the vaccines that protect us against pertussis infection. The Centers for Disease Control and Prevention (CDC) and the American Academy of Pediatrics recommend that all children receive 5 doses of DTaP by kindergarten and a booster dose of Tdap at age 11. The CDC now also recommends Tdap for all adult caregivers of infants (including parents!) and adults age 65 years and older. By being vaccinated, adults in close contact with infants create a protective “cocoon” for infants who are too young to be vaccinated or have not completed their initial vaccine series. Studies have indicated that approximately 75% of infant pertussis cases with a known source were caused by a household member, and about 55% of these infants got pertussis from a parent.
How can we protect our children?1. Ensure all children and adults around children get DTaP and Tdap vaccines on time.2. Ensure new parents get the Tdap vaccine before their child’s birth (or just after birth).3. Ensure grandparents and caregivers of infants receive the Tdap vaccine.
4. Call your child’s clinic if he/ she was directly exposed to a person with a pertussis infection, especially if your child has not yet received at least 3 DTaP vaccines (the first 3 doses are given at 2, 4 and 6 months of age). In these cases, an antibiotic course is often given to prevent serious illness from pertussis.5. Keep infants away from people who have frequent coughing.Infant and children with persistent cough which is not improving should contact their primary care manager (PCM) for medical advice and/ or evaluation. Additional online information from the CDC can be accessed at www.cdc.gov/pertussis/.