Watchung Pediatrics Messenger
Spring Issue
2017
Walk It or Bike It
Spring into Action!
With the sun back from hibernation, now is the
perfect time to introduce kids to an active lifestyle
by incorporating exercise into their day-to-day life.
Get in the Swim
As summer approaches, kids will be getting
excited about pool parties and beach trips. Water
safety is important all year round, but especially
so in the warmer months. Children can start
developing the skills to keep them safe in water
from infancy. Spring is the perfect time to have
your child take swimming lessons or to take your
infant to parent-child water classes.
Getting kids comfortable in the water as
early as possible gives them an important lifelong
survival skill and introduces them to a fun way to
be active. Swimming is great exercise for the
whole body and has low risk of injury, as long as
your child is a proficient swimmer.
If your neighborhood is safe for pedestrians and
you feel comfortable letting your child walk or bike
to and from school on her own, encourage her to
do so. Not only is this an excellent way to show
kids how activity can be an enjoyable part of their
day, but it also is an opportunity to help your child
develop independence and confidence. Younger
kids will enjoy walking to school with a parent or
older sibling. Practice the walk so you can review
the safest route with your child. It’s a great way to
be a healthy family together. Don’t forget to wear
a helmet when biking (parents, too)!
INSIDE THIS ISSUE
2
Seasonal Sickness: Rotavirus
3
Springtime Sniffles
5
Food Bytes
6
The 4-1-1 on Fluoride
7
Brush Up! Quiz for Parents
8
Kids Corner
Watchung Pediatrics Messenger 1
Seasonal Sickness: Rotavirus
Rotavirus, a virus that causes fever, nausea, vomiting, and diarrhea, occurs
most frequently between December and June. Most kids will get rotavirus
before age three, but your child doesn’t have to be one of them. Here’s what
you need to know about rotavirus:
Infants and toddlers are at highest risk for getting rotavirus
Rotavirus infection is common among young children, in part because the
virus is spread through the fecal-oral route. Infants and toddlers are more
likely to put contaminated fingers, toys or other objects into their mouths than
older children and adults, which means the virus passes easily and quickly in
places, such as daycare, where small children are grouped together.
If your child gets rotavirus, hydration is key
Vomiting and diarrhea cause the body to lose water rapidly, leading to
dehydration that can be severe and even life-threatening in infants and
toddlers. Give sick kids plenty of clear liquids (water or a pediatric electrolyte
drink) to replace lost fluids. If the child can’t keep any fluids down, call our
office right away.
Your child is not immune to rotavirus after one infection
Rotavirus comes in many different strains. For this reason, your child can
become infected with rotavirus more than once. The body does develop
resistance to rotavirus after an infection, but it will only resist the specific
strain that caused that infection.
Although rotavirus spreads easily and quickly, you can take steps to
keep it out of your home
In households with more than one child, rotavirus is likely to pass from
sibling to sibling. Rotavirus can make adults sick, too. You can limit the
spread of rotavirus by teaching your children to properly wash their hands,
especially before eating or preparing food, using the potty, and after school
or daycare. You can also keep your home healthy by sanitizing plastic toys in
a diluted bleach solution (no more than ¼ cup bleach per gallon of water),
wiping down bathroom and changing table surfaces with antiseptic wipes,
and disinfecting touch screens using rubbing alcohol.
The rotavirus vaccine is safe and effective in preventing many rotavirus
infections
The rotavirus oral vaccine is recommended by the American Academy of
Pediatrics and is one of the routine immunizations infants receive at
Watchung Pediatrics. In the ten years since its introduction, the rotavirus
vaccine has significantly reduced rotavirus-related doctor visits,
hospitalizations, and deaths. Rotavirus vaccine is given to infants in two or
three doses: the first dose must be administered before fifteen weeks of age
and the last dose by eight months of age.
Watchung Pediatrics Messenger 2
Springtime Sniffles – Is it Allergies, Cold, or Flu?
Itchy, watery eyes
Itchy, watery eyes are the body’s way of trying to get rid of airborne allergens like pollen and
mold. Since cold and flu are caused by viruses, these infections can cause eye redness and
irritation, but generally do not cause itchy eyes. Eye drops containing the ingredient ketotifen are
effective against allergy eye symptoms and are available over the counter. Call our office if your
child’s eyes are red, painful, or crusted.
Nasal congestion
Congestion can be a symptom of cold, flu, or allergies. Congestion due to
viruses is usually accompanied by symptoms such as a sore throat,
headache, cough, and body aches. For children older than six, nasal
congestion from any cause can be treated with over-the-counter
decongestants or with a combination antihistamine-decongestant. Allergy
nasal sprays containing fluticasone or triamcinolone are safe and effective for treating nasal
congestion caused by seasonal allergies in children over age six.
Sneezing and runny nose
Runny nose and sneezing are classic symptoms of both allergies
and upper respiratory viruses. One way to figure out the cause is to
look at when the symptom occurs. If sneezing and runny nose start
right after walking outside or opening the window, they are likely
allergy-related. Sneezing and runny nose caused by infection can
occur anytime and won’t necessarily get worse or start upon going
outside. Antihistamine medications containing cetirizine, loratadine,
and fexofenadine will treat sneezing and runny nose from any
cause.
Sore throat
While a sore throat is more likely the result of a cold or flu virus, allergies can cause an irritated,
itchy, and even sore throat. For example, post-nasal drip due to allergies
can cause throat pain. While any over-the-counter pain reliever
containing acetaminophen or ibuprofen can relieve a sore throat, if it is
caused by post-nasal drip, decongestants may be more effective.
Watchung Pediatrics Messenger 3
Fever
Allergies do not cause fever. If allergy-like symptoms are
accompanied by fever, they are probably due to a cold or flu
virus. If the symptoms are severe and the fever is persistent or
high, call our office. Fever medicines containing acetaminophen
or ibuprofen are effective for reducing mild fevers from colds. Call
our office before giving fever medicine to infants less than six
months of age.
Cough
Coughing can be associated with allergies, but it is more commonly a symptom of cold or flu.
Since seasonal allergens can worsen asthma symptoms, allergies are more likely to cause
coughing in people who have asthma. Post-nasal drip can also
cause a cough, often worse at night. If your child has asthma, ask
your provider about an asthma treatment plan and prescriptions for
asthma medication.
Fatigue, aches and pain
Fatigue can result from cold, flu, or allergies. However, when
accompanied by body aches and pains, it is much more likely to
be due to cold or flu. Allergies may cause congestion-related headaches, but they won’t cause
muscle aches. Fatigue from allergies will subside with proper treatment of the allergy symptoms,
especially congestion which makes it harder to get a full, restful night’s sleep. The best way to
reduce fatigue caused by cold or flu is to get plenty of rest, stay hydrated, and treat any other
symptoms.
Remember: Over-the-counter cough, cold, and allergy medicines are not recommended
for children under the age of six. Call our office if you think your young child may be
suffering from allergies.
Watchung Pediatrics Messenger 4
Food Bytes
By Sapna Lalla, RD Watchung
Pediatrics’ Dietitian
Up your Game with Good Nutrition
Children need nutritionally balanced meals for healthy growth and
development. For kids involved in athletics, the need is even greater. To
ensure young athletes receives proper nutrition and hydration to fuel their
growing bodies, consider these suggestions:
Quench your thirst
Keeping active kids hydrated can be tricky as they may not recognize or act on their thirst. Remind
athletes to hydrate often and offer frequent water breaks. A reusable sports bottle with a spout keeps
water available. Sports drinks are good for activities lasting more than 90 minutes. Otherwise, water is
adequate to meet hydration needs.
Give your body fuel
Carbohydrates fuel physical activity, so make sure your athlete eats high-quality carbs every day. Whole
grains are better than refined grains. Whole grains are rich in fiber, vitamins and minerals, and they take
longer to digest, which helps kids feel fuller longer and prevents dips in blood sugar during play.
Create balance
A balanced diet for young athletes includes complex carbohydrates, a lean protein source and plenty of
fruits and vegetables. Aim for about 50 percent fruits and vegetables, 25 percent whole grains and 25
percent protein.
Frequent feeding
Young athletes may not take in enough calories to keep energy levels consistent and meet growth and
development needs. Offer three meals and at least two snacks each day. Encourage your athlete to
recognize when she feels hungry and make healthy food choices. Aim for snacks that have a protein and
a grain or fruit, such as cheese and crackers.
Plan and prepare
The key to avoiding the fast food drive-thru pre- or post-game is to plan and prepare in advance.
Food on the go need not be a hot meal. Try packing a healthful meal of peanut butter on whole grain
bread with dried or fresh fruit and cheese sticks.
Perfect timing
Timing and delivery of the right nutrition is important for
young athletes. While some kids can eat right before an
activity and feel fine, others may need at least an hour for
digestion before they play. What's important is that kids not
exercise on an empty stomach. The body needs
replenishment within 20 to 30 minutes after exercise; meet
this need for both calories and hydration with a fruit and
yogurt smoothie or a cup of chocolate milk!
Watchung Pediatrics Messenger 5
The 4-1-1 on Fluoride
Fluoride is a naturally occurring element found in many foods and water sources. It is an ingredient in
some vitamin supplements and many dental care products, including toothpastes, mouthwashes, and
treatments applied by dentists. If your child is under six, he may even have received fluoride varnish in
our office. Here are some frequently asked questions about fluoride that we hear from our patients:
Why is fluoride important?
Fluoride penetrates tooth enamel and increases resistance to bacteria that cause tooth decay. Fluoride
taken orally or applied to the surface of teeth can have this beneficial effect. Oral fluoride is also absorbed
into teeth that have not yet broken through the gums. Both oral fluoride supplementation and topical
fluoride treatments are recommended for children six months to twelve years.
Isn’t there fluoride in my drinking water?
Some towns in the area do have fluoridated water, many others do not. If your town’s water supply
contains fluoride and your child drinks tap water, he may not need an oral fluoride supplement. Your
provider can tell you if your town’s water has adequate fluoride and how much tap water your child needs
to meet the fluoride requirement.
Can my child get too much fluoride?
Fluoride in concentrations found in water, supplements, and topical fluoride varnish has not been shown
to cause illness or disease. Exposure to high concentrations of fluoride can result in fluorosis, a cosmetic
condition in which white spots are visible on teeth. To reduce the risk of fluorosis, follow
recommendations for appropriate toothpaste use (see box) and supervise your child to prevent her from
swallowing toothpaste. Do not allow children under six to use fluoride rinses.
My child sees the dentist every six months and
uses a fluoride toothpaste. Does she need a
multivitamin with fluoride?
Topical fluoride treatments and regular tooth
brushing offer excellent cavity prevention for teeth
that have erupted. Oral intake of fluoride via water
or supplements allows fluoride to reach developing
teeth that have not yet appeared in the mouth. This
provides protection for teeth as soon as they
appear. Once most of the secondary teeth are
present in the mouth around age 12, oral fluoride
supplements are no longer needed. Topical fluoride
is still recommended, however.
How much toothpaste is right?
A regular toothpaste containing fluoride is
appropriate for children of all ages. Here is
correct amount to use:
For infants (from the first tooth to age
three) - use a smear about the size of a
grain of rice.
Over three years - use a pea-sized amount.
Take the “Brush Up” quiz on page 7 to test
your knowledge about keeping your kids’
teeth healthy.
Watchung Pediatrics Messenger 6
Brush Up on Healthy Teeth
A Quiz for Parents About Simple Steps for Kids' Smiles
Learn more about keeping your child's teeth healthy
with this true or false quiz.
1. ____
All children older than 6 months should receive a
fluoride supplement every day.
2. ____ Parents should start cleaning their child's teeth as soon
as the first tooth appears.
3.___ Parents should start brushing their child's teeth with
toothpaste that contains fluoride at age 3.
4.____
Children younger than 6 years should use enough
toothpaste with fluoride to cover the toothbrush.
5. ____ Parents should brush their child's teeth twice a day
until the child can handle the toothbrush alone.
Young children should always use fluoride mouth
rinses after brushing.
1. False. Check with your child's doctor or dentist about your child's specific fluoride needs.
Parents of a child older than 6 months should discuss the need for a fluoride supplement with
the doctor or dentist if drinking water does not have e nough fluoride to help prevent cavities.
2. True. Start brushing as soon as the first tooth appears. Wipe teeth every day with a
clean, damp cloth. Switch to a small, soft toothbrush as more teeth come in.
3. False. Parents should start using toothpaste with fluoride to brush their child’s teeth at age 2.
Toothpaste with fluoride may be used earlier if the child's doctor or dentist recommends it.
4. False. Young children should use only a pea-sized a m ount of fluoride toothpaste. Fluoride is
important for fighting cavities, but if children younger than 6 years swallow too much fluoride,
their permanent teeth may have white spots. Using no more than a pea-sized amount of
toothpaste with fluoride can help keep this from happening.
5. True. Children usually do not have the skill to brush their teeth well until around age 4 or 5.
Parents should brush their young child’s teeth thoroughly twice a day until the child can handle the
toothbrush alone.
6. False. Fluoride mouth rinses have a high
concentration of fluoride. Children younger than 6
years should not use fluoride mouth rinses unless the
child’s doctor or dentist recommends it. Young children
tend to swallow rather than spit, and swallowing too
much fluoride before age 6 may cause the permanent
teeth to have white spots.
Watchung Pediatrics Messenger
7
KIDS KORNER
Spring Crescent Veggie Pizza
Ingredients
- 2 cans (8oz each) Pillsbury refrigerated
crescent dinner rolls or Pillsbury refrigerated
Crescent Dough Sheet
- 1 package (8 oz) cream cheese, softened
- 1/2 cup sour cream
- 1 teaspoon dried dill weed
- 1/8 teaspoon garlic powder
- 1/2 cup small fresh broccoli florets
- 1/3 cup cucumber slices; cut
- 1 plum tomato, seeded, chopped
- 1/4 cup shredded carrots
* vegetables can be substituted for any vegetable
of choice
Directions
- Heat oven to 375°F
- If using crescent rolls: Unroll both cans of
dough; separate dough into 4 long rectangles (or
sheets if using dough sheets). In ungreased
15x10x1-inch pan, place dough; press in bottom
and up sides to form crust.
- Bake 13 to 17 minutes or until golden brown. Cool
completely, about 30 minutes.
- In a small bowl, mix cream cheese, sour cream,
dill and garlic powder until smooth. Spread over
crust. Top with vegetables. Serve immediately, or
cover and refrigerate 1 to 2 hours before serving.
Cut into 8 rows by 4 rows.
Riddles
1. What must be broken before
you can use it?
2. What has a neck but no head?
3. What goes up and doesn’t
come back down?
4. What has a face and two
hands but no arms or legs?
Answers: 1. An egg 2. A bottle 3. Your age
4. A clock
Watchung Pediatrics Messenger 8