Posts for tag: Hand Washing
8 Simple Rules for Raising a Healthy Kid
1. Offer lots of fruits and vegetables. Eating five servings every day is good for your heart and helps protect against cancer and prevent obesity. Unfortunately, kids facing, say, broccoli won't be particularly persuaded by a reference to the scientific literature. They often need to be taught to like fruits and veggies. When kids reject a food, it's often due to unfamiliarity, not true dislike. So offer the same food many times. While babies eagerly try new foods, older kids may need as many as 15 tries before they'll like or tolerate them.
2. Teach hand-washing. When I became a pediatrician, I was always sick. I assumed that exposure to kids' illnesses was part of the job. Although I washed my hands frequently, I eventually realized that I was inadvertently transferring germs from my computer keyboard to my mouth when I snacked between seeing patients. I stopped eating at my computer and I haven't had a stomach virus since! A group of researchers in London called the International Scientific Forum on Home Hygiene (IFH) tracked germ transmission through homes and found that people's hands are the number-one source for spreading infection. We may blame our pets, sneezing kids, and dirty shoes, but they're not the real cause. We transfer germs from our hands into our body when we touch our eyes, mouth, or nose. And young kids touch their face a lot: One study found that it's as often as 50 times an hour. The goal, then, is to reduce the number of germs on their hands. Certainly, door handles and toys are germ reservoirs, so wipe those down frequently. Other hot spots are the bathroom and the kitchen, which the IFH found to contain some of the most contaminated surfaces in the home.
3. Vaccinate on time. Children get up to 24 shots by age 2. With that number, it's no wonder some parents may be tempted to delay certain vaccines. I actually postponed my daughter's HPV (human papillomavirus) vaccine because we were too busy to schedule visits for all three shots, and protecting her from an adult disease when she was in 7th grade just didn't seem that critical. But after researching my decision, I was reminded that the vaccine schedule is meticulously designed to give immunizations when they are most effective. Babies and toddlers need to get their vaccines in the critical window that begins when their immune system is developed enough to respond but before they are at highest risk from the most dangerous diseases. Deviating from the schedule won't guarantee effectiveness, and delays may also contribute to more side effects. For example, measles-containing vaccines are twice as likely to cause a febrile seizure when given late, shows research from University of Washington in Seattle. Needless to say, we got my daughter back on schedule, and she finished her HPV series before she turned 13.
4. Brush teeth with fluoride. Even mild tooth decay can affect kids' health by causing pain, poor eating, and interrupted sleep. In one extreme case, I had an 11-year-old patient who spent a week in the hospital for a dental infection. Fortunately, simply brushing protects teeth—if you use f luoride. That's what builds and maintains the protective enamel on teeth. They need to "bathe" in fluoride for its magic to work. So as soon as your child has teeth, brush them with fluoride toothpaste at least twice a day. So-called "training" toothpaste doesn't contain fluoride.
5. Enforce a regular bedtime (starting in toddlerhood). I have to confess, I've often delayed my kids' bedtime just to spend a little more time with them. But I'm not doing them any favors. Children who don't get enough sleep can become hyperactive, and their school performance suffers, according to a Pediatrics study. Sleep deprivation in kids may also impact the hormone leptin, which signals us to stop eating, and kids who don't get enough zzz's may be more likely to be overweight or obese than those who do. Make sure your child is going to bed early enough too. Research found that kids who regularly turned in after 9 p.m. also displayed more behavior problems. The good news is that the behavioral consequences of poor sleep are reversible once a kid switches to a regular, appropriate bedtime, no matter how old he is. Kids need far more sleep than many parents realize. Toddlers need 11 to 14 hours (including naps), preschoolers need ten to 13 hours, and after kindergarten, kids need nine to 11 hours. So set a regular bedtime routine and stick to it. If you read a book, cuddle, and tuck them in at roughly the same time each night (before 9 p.m.!), kids will find their natural rhythm and sleep the right number of hours.
6. Insist on a helmet. We keep a dented helmet on a shelf in our pediatric E.R. with a note from a 13-year-old bike rider that reads, "This helmet saved my life when my head dented the hood of a car." It's a reminder that wearing a helmet can prevent serious injuries—yet less than half of kids wear one, and more than a third wear them incorrectly, according to Safe Kids Worldwide. Your attitude has the greatest influence on your kids' helmet use. So insist that your children wear helmets when they ride anything with wheels—and always wear one yourself. Kids often complain that a helmet is uncomfortable. Here's how to know it fits properly: It should rest two-fingers' width above the eyebrows and not slide around. Tighten the chin strap until it's snug; no more than one finger should fit under the strap. When your child opens her mouth wide, the helmet should pull down on her head. Adjust it so that the left and right straps form a Y below her ears.
7. Apply sunscreen, all year long. While sun exposure wreaks havoc on skin at any age, sunburn during childhood is particularly risky. The earlier in a child's life that skin cells become damaged, the greater his chance of developing skin cancer over his lifetime. Kids are especially sensitive to the harmful effects of ultraviolet radiationbecause their skin has a thinner outer protective layer than an adult's does. For kids over 6 months, apply sunscreen any time they're exposed to the sun. (Keep younger babies out of direct sunlight altogether.) In addition to sunscreen, protect kids with clothes that minimize exposure, a wide-brimmed hat, UV-protective sunglasses, and by keeping them in the shade as much as possible.
8. Use safety straps. The National Highway Traffic Safety Administration reports that three out of four kids aren't restrained properly in vehicles. Make sure you carefully follow the instructions on your child's car seat, booster seat, or seat belt so he is safe.
Some Things Old and Some Things New & Some Things Never Change
Let’s repeat the basics. Most Winter illness is viral and spreads through body fluid contact. What fluid is this, you might ask? I speak of air-borne (and hand-borne) small droplets of saliva and mucus that sprays from our mouths and noses when we sneeze or cough. This means when one has a cold and/or sore throat, no matter how young or how old we are or how sick we feel, we will ALWAYS be contagious to others.
So one of life’s lessons we want to teach our children is how NOT TO SHARE these body fluids, when they are ill. Now here’s a fact most people don’t know:
Viruses commonly live in our noses and mouths intermittently and episodically even when one is completely well__without symptoms of illness at all. This is called viral shedding and it happens frequently, and we have no clue that we are contagious! Yes, you can be infectious to others even when you are completely well. Who knew!?
So another life lesson that we should teach our kids is not to share saliva or mucus with others even when one is well. If you think we don’t do this all the time, think again. Kids and adults share gum, pizza, cookies, cupcakes, drinks, utensils, toys, etc without a second thought when they are well, and often when they are ill. This is a behavior that can be altered more easily when one is sick, but occurs unconsciously when we are well. I am not saying we should make our kids phobic, over-anxious or compulsive about germs, or ourselves, for that matter, but that good hygiene habits of behavior are in the best interest of everyone.
Since it is fairly obvious that saliva sharing is a fact of life__like frequently touching our faces with our hands unconsciously every day__teaching our kids and ourselves how to contend with this reality is another life lesson to learn. It’s called handwashing and the use of hand sanitizers safely. Sounds like a simple thing to teach our kids, but it is not. As parents we want handwashing to become an automatic behavior, not just something the kids do when we are watching and ask them to do it. We want them to do it at school, when they are out with their friends, and at home before sitting down to a meal, for example.
Believe it or not, it’s never too late to learn this behavior [https://www.youtube.com/watch?v=zxlQn7KaCNU].
Handsanitizers [https://www.livestrong.com/article/88193-hand-sanitizer-kill-bacteria/] with greater than or equal to 60% alcohol are effective hand-hygiene products but they should not be licked off the hands. So allowing young children under 5 years old to use them independently without supervision is not safe, since hands often end up in mouths. As soon as the hands are dry (after waving them in the air for a few seconds) there is no danger. Of course the sanitizing benefit of these products are short term since hands rapidly touch the world and end up in mouth not long after. But you have to start somewhere. Choosing time and place to use an alcohol-based hand sanitizer is a good idea. You can’t do it every 5 minutes through the day but certain situations, like the petting zoo, necessitate applying sanitizer frequently. After visiting a public restroom, even if you’ve washed your hands, is another good time to use sanitizer. Remember to use it when visiting the mall or taking your seat at a movie theater (or leaving the theater), and after using an escalator in the mall or airport. What these places have in common is that they are all public, meaning the world has touched all the areas you and your children are touching as you go through the day.
Sanitizer hand wipes are OK, but my guess is they are used less effectively than the gels which can be rubbed into tiny spaces on cuticles and between fingers by you and your children very easily. And there is no tissue to dispose of afterwards.
I don’t have anything against against hand washing. It’s great if you have the time to do it, but when you don’t hand sanitizers come to your rescue.
So that’s hand care. What about cough and sneeze hygiene? Not complicated. Most grown ups were taught to cover their mouths with their hands when they were kids. No question this is polite, but think about it..... totally ineffective in preventing the spread of body fluid (saliva and runny nose juice) between people since our hands then go on to touch other people and objects.
Today, kids in preschool and nursery school are being taught correctly, the 21st century way, the Elbow Cough-Cover. It’s quick and readily accessible and in itself NOT impolite to whip your elbow to your face and cover your mouth and nose with your elbow. Sure, no question, you will have germs on your elbow, but NOT YOUR HANDS! You can teach this to your children of all ages. You can role model it as well.
A cute story I like to tell kids this time of year (with parent permission if Santa comes to their house) goes like this: Santa doesn’t visit a home by himself. It’s a lot of work to deliver presents to good children all over the world, so he brings some of his helpers along in the sled. All the helpers want to go with him. (Remember the movie “Elf”. Good thing all the elves aren’t the size of Will Ferrell.) Some of the elves have colds, coughs and runny noses. So they have to know how to cover their face properly when they cough and sneeze. Santa doesn’t want elf germs to get on everyone’s gifts. So Santa’s helpers who can cover their faces with their elbows get to go, but the helpers who don’t know how, stay at the North Pole with Mrs. Clause practicing the Elbow-Cough-Cover so they can go with Santa next year. The punchline: Santa likes it when kids cover their faces with their elbows too when they cough and sneeze. I guess you can always add that the elves have to take and use their hand sanitizer every time before they go down the chimney with Santa to help deliver the presents.
If you like this parable, feel free to use it. No copyright on it as far as I know, since I made it up.
One more thing about our hands, we use them almost always to greet others__hand to hand shake. It’s social and appropriate and certain to transmit illness back and forth with every greeting. So why not greet one another with an elbow-bump or a fist-bump through the Winter virus season? Seems like such an easy solution, if we could only make it the social norm [https://www.youtube.com/watch?v=eYtLQc0YaMo]. If we could just get our media-TV physician personalities, like Dr. Oz and Dr. Gupta and Dr. Snyderman, to endorse the social greeting elbow-bump, this greeting could sweep the nation. Well, we do what we can, us parents and physicians. Maybe our preschool and school teachers could teach this greeting, just as they teach the elbow-cough-cover technique. Bring it up at your next PTA meeting.
One More Time About Influenza Vaccine
I can administer the appropriate influenza vaccine to your children, yourselves and close family, sitters, nannies, etc. who share time with your family. These vaccines can be offered through Winter and early Spring to enhance protection against the Flu and Pertussis among all persons over the age of 6 months. Unfortunately, there is no Flu vaccine as of yet for infants under the age of 6 months.
We should also be aware that when we immunize, we are not just protecting ourselves and our families. We are also helping those in our community who cannot get immunized because of weakened immunity from advancing age, illness disease, cancer or chemotherapy. They depend upon the rest of us to do what we can to protect them from these diseases by keeping our vaccines current. If you believe that we are our brothers’ keepers and have an obligation not to make others seriously ill through immunization apathy, please give this issue serious thought and consider staying current with your vaccines even if you have never had the flu and don’t think that Whooping Cough will make you very sick.
Please call Shelly (404-654-0426) or me or shoot us a text message and I will get back to you to schedule a house visit for the vaccine(s) you request:
Fluzone® Influenza Virus Vaccine, Contains No Preservative: Pediatric Dose Children 6-35 months of age (Single-dose, prefilled syringe, without needle, 0.25 mL) also available for over 35 months of age through adult years.
You can learn more about this and all vaccines at www.immunize.org.
If my Influenza vaccine supplies run out, you should still be able to find the vaccine at your local neighborhood pharmacies for a while longer yet.