Winter Wise
Compliments of ProHealth Physicians – Somerset Pediatrics
Carbon Monoxide Detectors
Carbon monoxide detectors trigger an alarm based on an accumulation of
carbon monoxide over time. Carbon monoxide can harm you if you are
exposed to high levels of carbon monoxide in a short period of time, or to lower
levels of carbon monoxide over a long period of time. Carbon monoxide
detectors require a continuous power supply, so if the power cuts off then the
alarm becomes ineffective. Models are available that offer back up battery
power. Do not place the detector right next to or over a fireplace or flameproducing heat appliance. Keep the detector out of the way of pets and
children. Each floor needs a separate detector. If you are getting a single
carbon monoxide detector, place it near the sleeping area and make certain the
alarm is loud enough to wake you up.
Frostbite
Frostbite happens when the skin and outer tissues become frozen. This
condition tends to happen on the extremities, fingers, toes, ears and nose.
They may become pale. At the same time, the child may complain the skin
burns or has become numb. Set reasonable time limits on outdoor play. Have
children come inside periodically to warm up. If frostbite occurs, bring the
child indoors and place the frostbitten parts of her body in warm (not hot)
water. Warm washcloths may be applied to frostbitten nose, ears and lips. Do
not rub the frozen areas.
Eczema
Eczema (dry, sensitive skin) worsens in the winter. Moisturizer may need to be
applied two or three times a day in winter to keep the skin smooth. Applying
moisturizer to moist skin within three minutes after bathing is very important.
Excellent cleansing agents are Dove for sensitive skin and Cetaphil cleanser.
We recommend white, unscented, creams such as Cetaphil cream, Eucerin
cream and Vanicream. Aquaphor ointment is also recommended.
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Nosebleeds
If your child suffers from winter nosebleeds, try using a cool air humidifier in
the child’s room at night. Also, gently put a small amount of petroleum jelly in
the nose every night before bed.
Winter Sport Safety
Sledding feet first or sitting up is safer then lying down headfirst on a sled.
Use steerable sleds, not snow disks or inner tubes. The American Academy of
Pediatrics recommends that children under age 7 not snowboard. Skiers
should have their safety bindings adjusted yearly. Helmets for skiing and
snowboarding are important.
Runny Nose – “the common cold”
Runny noses are a normal part of winter. Most young children have an
average of six colds each winter. Children in daycare for the first time may
have a new runny nose every two weeks. Viruses (there are hundreds) cause
the common cold. Most colds last at least ten days from beginning to end.
Fever is usually present the first two to three days of illness. Runny nose, poor
appetite, and fatigue increase for four to five days and then slowly decrease for
four to five days. As mucus in the nose increases it becomes thicker and green
or yellow in color. This does not mean an antibiotic is necessary. Cough is
usually part of a cold and the last symptom to go away. Treatment of a cold
means keeping your child as comfortable as possible. For infants, elevate the
head of the mattress, suction noses (especially before feeds), and use saline
drops to loosen mucus if it is thick.
Appetites are normally decreased with a cold. It is important to have children
drink more than usual while they are ill and especially when they have a fever.
Milk may be given during a cold if no vomiting is present.
Cough and cold preparations have been in the news recently. “Infant” cough
and cold preparations were withdrawn from the market in October 2007. This
voluntary withdrawal was done due to rare parental errors in administration
leading to overdose, particularly in infants. Our office recommends the
following guidelines:
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Do not give cough and cold preparations to children under 6 years of age
UNLESS given specific directions from the doctor.
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Preparations should not be given routinely to children with colds.
Children over 6 years of age should only be given this medication if a
beneficial result is seen.
If your child’s cold has not improved any after ten days, there may be an ear or
sinus infection present. An appointment is necessary to determine this.
Medications
Remember to keep the enclosed dosage chart handy at home and refer to it as
your child grows. Dosage is based on weight – not age. The correct dosage
must be given to provide the most comfort. A kitchen teaspoon or tablespoon
is not an appropriate measuring device. Use a dosing syringe, cup or spoon
that is marked for medication.
Helpful Books
The American Academy of Pediatrics has published three books for parents
that provide excellent information on illness, eating, sleeping, and
development. Many of your questions will be answered in these books. Caring
for Your Baby and Young Child: Birth to Age 5; Caring for Your School Age
Child: Ages 5-12; and Caring for Your Teenager may be purchased in most
bookstores.
Phone Advice
Every pediatric office receives many phone calls. The number of phone calls
increase greatly during Fall and Winter as illness increases. Calls for medical
advice are triaged by our telephone advice nurses and returned in order of
priority. You can help us be more efficient by stating your child’s full name
and date of birth, spelling the last name, and telling us your child’s problem
and how long they have been ill. Please also leave your home/work number
and cell phone number. Two phone numbers greatly help us access you. We
will attempt to contact you three times.
If you have questions for the nurse that are not illness related, i.e. toilet
training, behavior, date of last tetanus shot, we suggest you call in the
afternoon. This will allow the advice nurses to focus on illness related
questions early in the day.
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Motion Sickness
Motion sickness occurs when the parts of the inner ear that help control
balance are stimulated too much, as can occur when motion is excessive.
Motion sickness commonly occurs during boat travel, when the boat rolls and
rocks. It may also occur in a moving car, amusement park rides, or other
moving vehicles. Some people are move susceptible than others.
Prevention and Treatment Measures Include the Following:
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Using visual fixation (for example, watching the distant horizon on a
rocking boat; sitting in the driver’s seat and looking ahead)
Choosing a seat where motion is felt least (such as the front seat of a car
– if over 13 years of age, a seat over the wings of an airplane, or the
forward or middle cabin or upper deck of a ship).
Keeping the head and body as still as possible
Sitting face forward and in a reclining position
Not reading
Getting fresh air by opening a window, opening an air vent, or going to a
ship’s top deck.
Eating small amounts of low-fat, starchy foods and not eating strongsmelling or strong-tasting foods
Avoiding food and drink on short airplane trips, especially on small
airplanes
Over the Counter Medications:
1. Dramamine® (dimenhydrinate) should be taken ½ to 1 hour before
starting activity. Dramamine® will cause drowsiness, and some younger
children may be agitated from it.
children 12 years and over: 1 to 2 chewable tablets every 4-6 hours; do
not take more than 8 tablets in 24 hours, or as directed by a doctor
children 6 to under 12 years: ½ to 1 chewable tablet every 6-8 hours; do
not take more than 3 tablets in 24 hours, or as directed by a doctor
children 2 to under 6 years: ½ chewable tablet every 6-8 hours; do not
take more than 1-½ tablets in 24 hours, or as directed by a doctor
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2. Regular Strength Bonine® and Dramamine® Less Drowsy (meclizine) should
be taken one hour before starting activity. They may be less sedating.
children 12 years and over: 1 to 2 tablets once daily
Bonine for Kids
children 6 years of age and older: chew 1 tablet thoroughly every 6 to 8
hours. Do not exceed 3 tablets in 24 hours unless directed by a doctor.
Prescription Medication:
Scopalomine (Transderm Scop), a drug that comes as a patch may be used if
your child is 12 years or ≈ 90 pounds.
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