kids health

My niece asked me if she should consider using DHA-fortified milk when her daughter turns a year old in a few months. It seems this was a popular topic at a one year old friend’s birthday party recently.

DHA (docosahexaenoic acid) is an Omega-3 fatty acid (a good thing). DHA occurs in large amounts in breast milk and now all infant formulas are supplemented with DHA, recognizing the critical role of DHA in infant nutrition. DHA is an important nutrient for developing brain and nerve tissue in infants and children and contributes to brain, eye and heart health in adults as well.

Unfortunately, your child loses his or her main source of DHA once breast milk or formula is replaced with cow’s milk, which is low in DHA. DHA is found primarily in fatty fish, but the typical toddler just doesn’t eat much salmon and tuna. Ditto the vegetarian sources like spinach and soybeans-not exactly hot items on a kid’s menu.

The good news? Now you can find milk fortified with DHA. In 2007 Horizon Organic Dairy became the first U.S. company to supplement milk with DHA. Check out Horizon’s interactive site for a fun and easy way to learn more about kids and DHA.

So what did I tell my niece? I told her I thought DHA-fortified milk would be a good idea when she introduces cow’s milk. See if your pediatrician agrees…

My interest in research and development of skincare products stemmed from having a child with eczema. I am always looking for the latest information in better understanding eczema, its causes and potential cures. Could there be a link between hard-water and eczema? Professor Hywel Williams and his research team are going to find out.

The independent trial run by clinicians at The University of Nottingham has received funding of nearly £1million from the Department of Health’s National Institute for Health Research (NIHR) Health Technology Assessment (HTA) program. The study will focus on hard water areas in Nottingham and Leicester, Cambridge, London and the Isle of Wight.

The aim of the Soft Water Eczema Trial (SWET) is to discover whether eczema can be improved by deliberately softening all water used in the home - except at one tap in the kitchen which will supply mains water for drinking.

Families of eczema sufferers and some doctors have said that living in a hard water area may make eczema worse.

Recently a team of researchers at The University of Nottingham found that eczema is more common in primary school children living in hard water areas in the UK compared with children living in soft water areas. No one really knows why, but it could be because hard water contains high levels of calcium and magnesium, leading to increased use of soaps which can act as skin irritants.

Professor Hywel Williams and his research team at the Centre of Evidence Based Dermatology are running the trial. Professor Williams said: “I have wanted to do this study for many years as patients keep telling me that water softeners help their skin, but other people aren’t so sure. Carrying out a proper randomized controlled trial will help us find the answer. If ion-exchange water softeners are found to improve the symptoms of eczema, this will be an extremely important finding for both patients and doctors. Many patients worry about the possible side effects of the usual treatments for eczema, so this would be a welcome addition to their treatment options.”

The study is in the process of recruiting 310 children between the ages of 6 months and 16 years who have moderate to severe eczema.

Up to one fifth of all children of school age have eczema, along with about one in twelve of the adult population. The severity of the disease can vary. In mild forms the skin is dry, red and itchy, whist in more severe forms the skin can become broken, raw and bleeding. Eczema is not contagious and with treatment the inflammation of eczema can be reduced, though the skin will always be sensitive to flare-ups and need extra care and protection against dryness.

The water softener industry (through their representative body, the UK Water Treatment Association) - is closely involved in the development of the trial and a generic water softener has been specially produced for the study. The industry is meeting the costs of producing and installing water softener units. The study findings will be quite independent from any industry influence.

The trial will run until the end of next year and the results won’t be known until the end of 2009 when all the information has been analyzed.

Noodle & Boo’s ultimate ointment was developed especially for sufferers of eczema. It is an excellent alternative to steroid-based medications.

Beware of the sun even in winter months; tender skin can burn before you know it! Even at this time of year, exposure of more than 20 minutes risks damage to your little ones’ sensitive skin.

Here are a few tips for winter sun safety…

• Your child needs sunscreen outside in all weather. Even on overcast days, 80% of the sun’s damaging rays filter through the haze.

• Plan ahead. Apply sunscreen 15 to 30 minutes before going outside. Sunscreen won’t work well unless it has had time to be absorbed. Better yet, use sunscreen on your child’s face and exposed skin each morning; now you can be smart and spontaneous when your toddler wants to play outside. A school age child needs sunscreen every morning year round.

• Sunscreen is absorbed better by dry skin, so don’t wash your child’s face right before applying. When sunscreen is absorbed better, it protects better.

• Bring your sunscreen along on winter vacations. You might not think of packing sunscreen when it is 35 degrees outside, but snow increases exposure. Reflected rays from the sun increase by 80% in snow. The risk of burn goes up even more at high altitude. (And don’t forget the sun goggles in snow country.)

These are a few important features in a sunscreen…

• Sun Protection Factor. There is just a small increase in protection beyond SPF 30, but there is a lot more sensitivity. I see more contact dermatitis with gels of SPF 45 to 50 and higher, so I tell parents to avoid them and choose a water-resistant lotion with SPF 15 to 30 for young children.

• Broad spectrum. The two types of harmful rays in sunlight are UVA and UVB. They are both dangerous, but UVB is the major cause of sunburn and skin cancer. A broad spectrum sunscreen protects against both types of harmful rays.

• Hypoallergenic. When using sunscreen on a young infant, always test on a small area to watch for redness or irritation. You and your older child will benefit from the same mild formula you use on your infant.

Question: Who makes a hypoallergenic, broad spectrum lotion with an SPF 30 that is safe enough for babies? Answer: Noodle and Boo, of course. Play-Day is the perfect sunscreen for sensitive skin of all ages. Don’t leave home without it!

Want to know more? The American Academy of Dermatology is a great resource; read Facts About Sunscreens or take a sun-smart survey called RAYS: Your Grade!

Pearls?…these are some of my pediatric “tricks of the trade.” Time tested, parent tested, and pediatrician approved from over twenty years of baby and child care…

Most people know to avoid diaper rash by keeping those little bottoms dry. But too much cleaning can be a problem too.

Newborns and very young infants are especially sensitive to wetness, and that includes over cleaning. A newborn may need to be changed 12 or more times a day; that’s a lot of wetness and wiping on such sensitive skin. Most diapers wick wetness away quickly, so when changing a wet diaper in a newborn, simply switch it for a dry one. Save the cleaning for a soiled diaper (which may still end up being almost every change!)

When there is any soiling, cleanse with gentle wiping, without rubbing or pressure. And after the bottom seems clean, use another fresh wipe to be sure. Any trace of stool left behind (no pun intended) can trigger irritation and rash.

Older babies and toddlers do not urinate as frequently as newborns, so a quick wipe with every change is better to freshen them.

Which wipe to use? Choose Noodle and Boo’s Ultimate Cleansing Cloths for soft, gentle pampering of your baby’s sensitive skin.

They are just what the doctor ordered.

J.K. Rowling knows what it’s like to need help, and now that she’s in a position to give back, she does so in a big way. In 2005, she used her success from the Harry Potter series and created the Children’s High Level Group, an organization dedicated to improving “the welfare of vulnerable children across Europe … ” by focusing on health, education, and welfare.

She recently auctioned off one of just seven handwritten copies of a “secret” Harry Potter book, The Tales of Beetle the Bard at Sotheby’s. For those of you who didn’t run out and buy the seventh and final installment of the Harry Potter series the moment it went on sale and don’t know what this is, The Tales of Beetle the Bard is the book Albus Dumbledore gave to Hermione Granger in Harry Potter and the Deathly Hallows (and if you don’t know who Dumbledore and Hermione are, you are missing out, my friend).

So what? She auctioned off one book. Big deal, right?

That one book raised over $3.9 million dollars. So, yes, it is a big deal. The money will help the Children’s High Level Group charity, through The Children’s Voice campaign, to improve the lives of thousands of children in need.

Thank you, J.K. Rowling, for bringing some real magic into the world.

Photo Veritaserum.com

Holiday parties, shopping until the wee hours, frantic dashes to my home office to wrap gifts in between homework and other family fun…everything is going along as planned, until BAM!- misbehavior from my little one. As adults, we can more easily go with the flow during this hectic time of year (and sometimes even the best of us struggle with this one!), but through the eyes of a three year old, the whole season can be a little daunting. So, what is a mommy to do?

Three quick fixes for our little ones:

• Attempt to keep the family routine as normal as possible. Try to stagger events and evenings out, and most importantly, keep bedtimes and bedtime rituals the same. Consistency calms children and makes them feel safe.
• Announce activities or events in advance. Just like you, children want to know what the evening will be like before leaving the house in the morning. Have a children’s calendar posted in a clearly visible spot where you explain the events of the day, and preferably the events of the week, far enough in advance so that there is plenty of time for plans to sink in. Surprises are meant for birthdays, not for who is picking up from preschool.
• Create a few family traditions at a time. Too many activities can have an adverse effect, thus creating some negative behaviors. Also keep in mind that the anticipation of an event is often just as exciting as the actual event, so give your children plenty of time to look forward to special family happenings. You may want to limit participation according to your children’s ages. For example, the older kids go to the Nutcracker Ballet while the younger ones stay home with a trusted babysitter.

Remember, if mom and dad take a minute to breathe, the whole family will relax and enjoy the magical moments of the season. Its not how much you do, but how much fun you have doing it.

There has been a ton of controversy lately about some books written to get your kids to eat a more well-rounded diet. I have some very definite opinions about the theories in these books (hint: I don’t like them), but that’s for another post. Today, I’d like to share with you the books that I recommend for encouraging a love of food in your child. These aren’t cookbooks; rather, they are story and picture books that are all about food.

Little Pea This is an adorable book targeted to three- and four-year olds. Little Pea has a great life with his Pea family, but hates eating dinner! Every night, he must eat five pieces of yucky candy in order to get a giant bowl of his favorite dessert; spinach!!My daughter loved this book when she was that age (she is now six) - it made her laugh everytime we read it, and it’s a fun way to get across the message that it’s important to eat healthy foods.

The Pigeon Finds a Hot Dog! If you haven’t experienced the brilliance that is Mo Willems, you are going to love me. His writing is hysterical, and little kids (two- and three-year olds especially) totally take a shine to his prose and characters. In this book, Pigeon finds a hot dog on the street and is subsequently accosted by a very curious (and hungry) little duckling.

My Food / Mi Comida You don’t get much simpler than this little board book, but sometimes simple is all that a little kid needs. This book covers colors, foods, English and Spanish. My daughter loved it when she was two, and now my son is totally digging it. The best page according to both of them? The one with a beautiful chocolate ice cream cone!

The Very Hungry Caterpillar This classic favorite by Eric Carle is a great way to get even the littlest book lovers excited about food. I love the way Carle combines the healthy (plums! apples!) with the decadent (chocolate cake and pickles!)

Two Old Potatoes and Me A girl finds two old potatoes in her kitchen and she and her dad cut them up and plant them in the garden. The book (with great prose and charming illustrations) takes the reader through the entire planting and growing process and finishes with a mashed potato recipe. I love that this is a story about a daughter and her father (there aren’t many out there). It’s also a nice book for kids with divorced parents, as it does a good job of addressing the issues that are faced by kids with two homes.

I Will Never Not Ever Eat a Tomato Fans of the Disney Channel will recognize this Charlie and Lola title. Older brother Charlie helps ease his picky little sister Lola into adventurous eating by weaving fantastical tales about all of the food in their refrigerator.

Do YOU have any favorite children’s books about food? Please share them in the comments!

Winter is on its way…brisk days and pink cheeks, hot cider and gingerbread, shopping for December holidays…and what else? Flu shots!

As a pediatrician, I am often asked if flu shots are a good idea for kids…and the answer is YES! For many, a flu shot can be life-saving.

Even so, some people wonder if it isn’t better to get the illness to boost our immunity “the old-fashioned way”. The answer is definitely no! For the very young and very old, flu can be very serious. Even the strongest of us wilt after days of high fever, chills, muscle aches, cough and congestion (yuk!).

The flu vaccine is a great idea for all of us, and it is especially important for children between 6 months and age 5. For babies less than 6 months old, make sure all family members and caretakers have had the flu vaccine to help protect the infant until he or she is old enough for the vaccine.

Some parents worry that the flu shot will cause the flu, but there is no risk at all of getting the illness from the flu shot. The shot is a “killed” vaccine, which means that the influenza virus is inactivated and cannot cause an infection. Side effects, such as soreness or mild fever, sometimes occur but usually disappear within 24 to 48 hours. The nasal spray, FluMist, is a live vaccine, so it is possible to have mild symptoms like a cold as a reaction to this vaccine. FluMist is not approved for children younger than age 2.

Since it is already December, is it too late to get a flu vaccine? Not at all. Earlier is better, since the flu season can start in late November, and last through March or April. The vaccine is effective within about two weeks, and immunity should last at least six months or more. So don’t delay!

This is the first in a series of “Winter Health Tips”. Next week…”Why Doesn’t the Doctor Get Sick?” I am eager to hear from you, so please share your comments and questions!