How to Treat Newborn Constipation
Dr. Jim Sears demonstrates ways to treat newborn constipation. WATCH...
Pediatrician Dr. Jim Sears says that constipation is common in newborns. “Their stool should be nice and mushy,” he explains.
Switching between breast milk and formula can cause constipation, as well as the introduction of any new milk source. Make sure to give baby lots of fluids, which will increase fluid in the colon and stool.
Signs of Newborn Constipation
- Straining to pass firm stool less than once a day
- Painful, dry, hard stool
- Hard, pebble-sized stool
- Abdominal discomfort
Fever PitchParents inevitably worry how high of a fever is too high and when to take a child to the emergency room because of it.
“We don’t worry as much about the number as how does your child look,” Dr. Travis says. “Are they eating and drinking OK? Are they out playing in the yard? If they’re doing those types of things, normally the kid is doing OK and the fever is benign.”
Dr. Travis warns that a fever becomes dangerous when it rises to 105 to 106 degrees. In newborns, any fever over 100.4 degrees taken rectally can be a sign of a serious infection. Dr. Travis does advise, however, regardless of how high the temperature is, if you ever feel concerned about a fever, take your child to the ER or call your doctor.
Best Fever Medication
"Never give aspirin to children," says pediatrician Dr. Jim Sears, "especially if they have a fever. Acetaminophen and ibuprofen are great, but never aspirin." Naproxen sodium, the active ingredient in Aleve, should only be taken by children over the age of 13. "It's usually used for more serious conditions," Dr. Sears adds.
Taking Your Child’s Temperature
A fever is defined as a core body temperature equal to or higher than 100.4 degrees Fahrenheit or 38 degrees Celsius. Digital thermometers can be used rectally, orally or auxiliary, or under the armpit. Doctors agree that a rectal thermometer is the most accurate way to take a child’s temperature. If your child is under the age of three months, always take his or her temperature rectally.
“Your baby will not remember that you took a rectal temperature!” Dr. Schrieber assures.
Depending on the child, you can take his or her temperature rectally up until the age of two. However, around age 9- to 12-months, most kids are crawling and moving around too much to take a rectal temperature. At this point, the pediatricians suggest switching to an armpit temperature. If you take an armpit temperature, Dr. Schriber suggests adding a degree and a half to the reading.
By the time a child is age five or six, it’s ok to transition to an oral thermometer. Make sure to add a degree to the reading.
Pediatrician Dr. Jim Sears says a new product known as the pacifier thermometer is not as accurate and does not recommend it. Dr. Freishtat is also skeptical of the accuracy of the infrared no-touch thermometer by KidzMed.
When a child has a high fever, it can be alarming. But should you be concerned if the thermometer reads less than normal?
"Most people think that everybody's temperature is 98.6 [degrees Fahrenheit]," Dr. Jim Sears says. "But that's actually just the average. People can normally be a whole degree higher or lower than that. So you could be walking around most of the time at 97-something or 99-something.
"But this brings up another point," Dr. Sears continues. "A low temperature, if it's real, actually can indicate an infection, just like a fever can. If your child is acting ill and they have a low temperature, that could be serious. You definitely need to go to the [emergency room] or call the doctor. But most of the time, if a parent calls me and they say, 'My child's temperature is 95 and they're acting fine,' then most likely, you just didn't take it right."
Dr. Sears demonstrates the proper way to take your child's temperature.
Asthma affects 20 million Americans, 9 million of whom are kids. See what happens during an asthma attack, and learn how to prepare for one.
Thermometer for Kids
Kidz Med 5-in-1 thermometer uses infrared technology to measure a child’s temperature in the temporal artery. Simply hold the thermometer an inch away from the forehead -- and presto! -- you receive an immediate reading, accurate within .4 degrees Fahrenheit of a rectal temperature, which is considered the ideal standard for children.
Body temperature increases at night around dinnertime, regardless of whether you have a fever. When you do have a fever, time in the day can exacerbate the symptoms.
"Kids, especially, have problems at night with croup, ear infections and runny noses, also because they're [lying] horizontally," pediatrician Dr. Jim Sears explains. "It's normal that the fever would go up a little bit at night. Just treat it with the normal fever precautions -- a little Tylenol or Motrin every four to six hours."
Treating a Fever
A cold, fever and chills tend to go hand in hand, but understanding these symptoms and treating them properly can put you on the road to recovery in no time. In most cases, a fever is the body's response to some form of infection.
The hypothalamus is a region in the brain that regulates body temperature, among other functions. Invading or foreign entities trigger the fever response in the hypothalamus, which essentially changes the body's internal thermostat to combat the threat.
Go inside the body and see what happens during a fever.
"Oftentimes, doctors will use acetaminophen or ibuprofen to reset the [body's] thermostat," Dr. Travis says. "Your body is trying to find the temperature that your thermostat is set at, and you don't want to overheat or submerge yourself in cold water."
"A lot of parents ask, ‘What about cool baths?' when their child has a fever," pediatrician Dr. Jim Sears adds. "That's actually the wrong thing to do; that can make the fever even worse. A lukewarm bath, along with a fever-reducing medicine, can get the temperature down pretty quickly."
Excessive VomitingDr. Sears explains that vomiting is the body’s way of ridding itself of something agitating, be it a virus, food poisoning, or a food intolerance. If it’s clearly not a virus, keeping a food journal of what your child ate before the vomiting began can help determine the cause. For example, cow’s milk can cause vomiting in many young children.
Dr. Sears says that it could be also a reflux issue, or perhaps something called cyclic vomiting syndrome (CVS), a condition that often goes misdiagnosed and affects 2 percent of school-aged children.
"CVS [is caused by] both genetic and environmental components, and research is still being done on this syndrome," medical geneticist Dr. Richard Bowles says.
Though there is no clinically proven cause for CVS, it may be due to a mitochondrial deficiency, which hinders the body's ability to metabolize energy. Symptoms include nausea, vomiting, loss of appetite and extreme fatigue, which are also telling of other conditions, such as the stomach flu, leading to frequent misdiagnoses.
If left untreated, chronic vomiting can tear the lower part of the esophagus. However, if properly diagnosed, the condition can be treated with medication.
Croup, an inflammation of the vocal cords, is a respiratory infection often caused by the Parainfluenza virus. It often develops several days after the onset of a cold, and the infection manifests in the bronchial tubes, vocal cords and windpipe.
A croup cough is usually accompanied by a stridor, or wheeze, which sounds like a high-pitched, almost musical sound when a person inhales. Teens, adults and children can all get croup, but it is more common in children. Croup can become dangerous quickly if the vocal cords swell to the point where the child can’t breathe, so make sure to call your physician immediately.
Croup is often treated with steroid medications and home remedies such as a hot, steamy shower and humidifier. “Usually croup is treated with one dose of steroids,” E.R. physician Dr. Travis Stork says. “That’s it.”
How to Prevent Croup:
• Croup is a contagious disease, so if possible, avoid people with cold and cough symptoms.
• Wash hands often to reduce the chance of spreading infection.
• Get prompt treatment for symptoms of respiratory infection.
• Increase the amount of fluids consumed.
• Avoid exposure to respiratory irritants such as smoke.
Diagnosing a Cough
When your child comes down with a cough, how can you tell the difference between a harmless hack and a dangerous wheeze? Dr. Sears demonstrates how to decipher the four most common coughs.
Types of coughs:
Dry: common with the flu or an upper respiratory infection. Dr. Sears suggests that parents let their child cough during the day to get all the mucous and phlegm out, but use humidifiers or cough suppressants at night to help them sleep.
Wet: phlegmy, mucousy and often accompanies bronchitis. Try to avoid cough suppressants, as the lungs are doing their job of expelling the offending germs.
Croup: usually accompanied by a stridor, which sounds like a high-pitched, almost musical sound when the child inhales. Croup can become dangerous quickly if the vocal cords swell to the point where the child can’t breathe, so make sure to call your physician immediately. Croup is usually treated with steroid medications and home remedies such as a hot, steamy shower and humidifier.
Whooping: characterized by uncontrollable deep coughing that causes a person to gasp for breath. Although whooping cough can be treated with antibiotics, it can be fatal, especially in young children, so it is important to get vaccinated.
Signs of a Respiratory Infection
• Shortness of breath
• Coughing when exercising
• Decreased exercise tolerance
• Coughing without phlegm
• Trouble sleeping
If you or your child is suffering from an earache, avoid putting anything, such as your finger or a cotton swab, inside the ear. If the inside of the ear is dry, itchy or has wax buildup, a drop or two of olive oil can help soothe it and loosen excess wax. If you get your ears wet, be sure to dry them.
If wax buildup continues, make a solution of four parts water to one part hydrogen peroxide and place one to two drops in the ear. If you experience pain or fever, see your doctor.
Six-year-old Lucca complains of an earache and after inspecting the boy’s ear, Dr. Sears concludes that Lucca has a middle ear infection, and prescribes an antibiotic.
Middle Ear Infection
Fever, cold symptoms and a bulging ear drum point to a middle ear infection. The most common form of treatment is to observe for a few days to allow the infection to clear on its own, but if a child has a high fever and severe pain, then antibiotics are prescribed.
Outer Ear Infection/ Swimmer’s Ear
If the ear canal is swollen and it hurts to wiggle the tragus -- the prominence in front of the external opening of the ear -- the ailment is most likely an outer ear infection, commonly called swimmer’s ear, which is treated with drops.
Dr. Travis explains that his rule of thumb is: “Colds and middle ear infections go hand in hand, just as swimming pools and swimmer’s ear go hand in hand." More on preventing ear infections.
Ear Infection Test
Ear infections occur more frequently in children because their Eustachian tubes -- the funnels that link the pharynx to the middle ear -- are shorter, narrower and more horizontal than in adults. This particular alignment can impede the flow of air and fluids through the tubes, and as the fluid pools, bacteria grow and cause infection.
Symptoms of a Middle Ear Infection in Children:
• Pulling or rubbing the ears
• Fussiness or irritability
• Fluid leaking from the ear
• Changes in appetite or sleep patterns
• Trouble hearing
Ear infections are the number one reason for emergency room visits for children. Dr. Sears and Dr. Ordon demonstrate how an ear infection forms and how to determine if your child has one.
If children are plagued by frequent ear infections, physicians can surgically drain the Eustachian tubes to alleviate pressure. Learn more about treatments for chronic ear infections.
Pediatrician Dr. Jim Sears shares natural remedies for chest congestion in children.
With school in session, Dr. Jim shares Germ Smarts for kids and parents. He drops in on a preschool classroom and shows the children how to keep germs at bay.
"If you have to cough, then make sure to cough into your elbow, not your hand," he says.
The best way to fend off germs is to make sure to wash hands with good old-fashioned soap and water for at least 20 seconds.
"A great way to have kids wash them for that long is to have them sing their ABC's while they scrub," Dr. Sears suggests, "Or maybe two rounds of the ABC's if they sing fast!"
Symptoms: fatigue, dizziness, sweating has stopped, dry mouth, muscle weakness, low blood pressure, rapid heartbeat, fever, delirium or unconsciousness.
A simple test for dehydration: Pinch the skin on the back of the hand and pull it up. If it doesn’t bounce back, that could be a sign of severe dehydration and fluids are needed immediately.
How to Prevent Dehydration:
- Hydrate your kids before practice or a big event. It’s best to start hydrating the day before a strenuous exercise.
- Avoid playing in extreme heat
- Drinks: Water is good any time, especially while exercising. Drinks with electrolytes are good when you’ve been sweating for an hour or more; just make sure there is no high-fructose corn syrup in it. A six-ounce juice box is OK if it’s 100 percent juice. Parents, keep in mind that one six-ounce juice box should be a child’s total juice intake for one day. One way to cut down on the sugar intake is to dilute the juice.
- Snacks: Fruit like bananas and oranges are great for replenishing your energy, getting your blood sugar up and sustaining it throughout the activity. Stay away from sugary snacks like soda and cookies.
Hylenex, a recombinant-facilitated sub-cutaneous rehydration treatment, is used to treat severely dehydrated pediatric patients. In layman’s terms, fluids are administered in the child’s back, and the procedure cuts the normal rehydration process time in half, from five hours to two-and-a-half.
Babies who spend too much time lying on their backs can develop deformational plagiocephaly, or flat-head syndrome, a flattening of the back of an infant's skull. A study in the journal Pediatrics found that 25 percent of babies with flat-head syndrome had less-developed motor skills, but pediatrician Dr. Jim Sears explains that the delays were mild and temporary.
"It's important to know that it's not the flat head compressing the brain and causing the delays," Dr. Sears says. "It's simply the fact that the babies are probably a little less stimulated because they're lying there ... in the same direction all the time."
Dr. Sears assures that the shape of a baby's skull will even out once he or she is able to sit up unassisted and can sleep in varrying positions. To prevent flat-head syndrome, Dr. Sears recommends shifting a baby's position in a car seat frequently, especially if he or she tends to sleep on one side. You can place a baby on his or her belly if he or she is awake and under adult supervision.
"You don't want the young babies to sleep on their bellies, because then you increase the risk of [sudden infant death syndrome]," Dr. Jim says.
Dr. Sears explains that a young baby’s head is so soft and malleable that any force acting upon it – be it in the womb, or positional sleeping – i.e. sleeping on the back with the head always to one side, can “push” the head into a different shape. Most babies will outgrow the condition on their own, but some infants need correctional intervention.
To correct this, the pediatrician suggests a non-invasive orthotic called a dynamic orthotic cranioplasty, or DOC band; which is essentially a little helmet that Abigail can wear to gently correct her head shape.
Different types of skull irregularities include:
• Plagiocephaly – the head grows oblongly
• Brachycephaly – the head grows outwardly side-to-side
• Scaphocephaly – the head grows front to back
Parents: does your little one have eczema? You’re not alone. Twenty percent of children have this vexatious skin condition. Pediatrician Dr. Jim Sears shares tips to soothe 2-year-old Nyaire’s skin.
What is Eczema?
Eczema is a chronic, recurring skin disorder that interferes with normal skin function and results in easily irritated, dry and itchy skin. Although there isn’t a cure for eczema, practicing daily skin care and avoiding potential irritants can help control the condition.
Who Gets Eczema?
The exact cause of eczema is unknown, but it is commonly found in families with a history of eczema, allergies or asthma.
Tips for Treating Eczema
Eczema flare-ups are often triggered by certain substances or conditions such as stress, abrupt changes in climate, animal dander, and exposure to certain household products like soap or detergent.
• Use moisturizers and ointments to protect the skin’s barrier and lock in moisture
• Use a humidifier
• Keep nails short and avoid scratching the skin
• Always wash new clothes before wearing
• Avoid foods that could cause a flare-up
More on Eczema
Ointments and Moisturizers When skin is raw and irritated, it’s best to use ointments that soothe it. Fragrances, dyes and preservatives can irritate skin, so it’s best to use ointments with as few ingredients as possible, such as Eucerin’s Aquaphor.
Try a soak-and-seal method with your baby. Bathe your baby in lukewarm water for about 10 minutes, and then apply ointment when his or her skin is still damp. This will help retain moisture and keep the skin’s barrier hydrated and protected.
Try oatmeal baths, salt baths or oil baths as well.
Topical steroids, available in different dosages in prescription and non-prescription strength, are the most common medications used to treat eczema. As always, seek the guidance of your pediatrician, dermatologist, or allergist.
“Rashes are simply changes in the color or texture of the skin”, E.R. physician Dr. Travis Stork says.
The most common cause of rashes is contact dermatitis, which is inflammation of the skin through contact with everyday materials. Skin irritation can also be triggered by a particular substance that causes an allergic reaction, which is known as allergic contact dermatitis.
The most common rash-producing allergens are nickel, rubber, preservatives, additives found in hand creams and lotions, as well as urushiol, the oil found in plants like poison ivy, poison oak and poison sumac.
Rashes can also be caused by insect bites and stings as well as medical conditions such as eczema, psoriasis, impetigo, shingles and childhood illnesses such as chickenpox, measles, rubella and scarlet fever.
Hydrocortisone, oatmeal baths and medicated calamine lotion are the most commonly used treatments to relieve the symptoms of rashes, although antibacterial creams and oral antibiotics can also be prescribed. In addition, to help with skin irritation, practice gentle skin care methods, avoid irritating substances and fabrics, and expose the affected areas to air whenever possible.
“In serious scenarios where there is a sign of an underlying, significant infection, you really do need to talk to your doctor”, Dr. Travis advises. In cases where the rash is mild, Dr. Travis demonstrates how a solution of 50 percent olive oil and 50 percent honey will naturally soothe the irritated area.
Sick PlanSchool nurses are a wonderful resource for parents. Robin Fleming, R.N., Ph.D. from the Seattle, Washington Public School District says it's important to put a plan in place should your child fall ill.
Download The Doctors health plan.
The Doctor's Office
Go behind the scenes and see Dr. Jim Sears in action!
Pediatrician Dr. Jim Sears examines three young patients and offers solutions for common ailments in your kids.
Lice are parasitic insects that feed off the blood of human scalps, so you won’t find them nestled in the fur of the family pet. They don’t jump or fly and although they cause irritation and scratching, they don’t carry disease.
A louse (the singular form of lice) goes through several different stages in its very short life span. It starts as a nit and will grow to the size of a sesame seed. An infestation occurs when the adult louse starts to lay eggs, (50 to 150 in all), and each egg will produce 150 more nits.
So Your Child Has Lice, Now What?
Notify the school nurse so he or she can alert other parents and children. Pediatrician Dr. Jim Sears demonstrates how to check for and treat lice. If one person in the family comes home with head lice, the chance of someone else in the family catching it is a whopping 80 percent, so make sure to seek treatment immediately.
Head Lice Rx:
•Avoid sharing hats, brushes, combs, clothing or helmets
•Have several treatments, three to four days apart
•Disinfect combs and brushes
•Machine wash clothing and bedding two days before and after treatment
•Vacuum floor and furniture, but don't fumigate
•Seal stuffed animals in plastic bags for two weeks
Impetigo is a skin infection that oftentimes afflicts the faces of infants and children, causing red, itchy sores around the nose and mouth. If the sores rupture, they ooze fluid and form a yellow-brown crust that resembles dried honey.
To help treat your child's impetigo, Dr. Sears advises keeping the skin clean, and using warm, soapy water to wash his or her face. You can also apply a one-to-one solution of hydrogen peroxide and warm water to the infection, which will help blood flow to the affected area.
"Probably the most important thing you can do for impetigo is use Polysporin ointment," Dr. Sears says. "[Put] a triple antibiotic ointment on there a few times a day. Keep it covered with a Band-Aid, because it's very contagious. Once [the sores are] healed, [the child] is all better and not contagious anymore."
Vitiligo is a condition in which the skin loses its pigment cells. Dr. Pearl Grimes, dermatologist and vitiligo specialist, says that the body essentially becomes allergic to itself, and mistakes its pigment cells, or melanocytes, for foreign cells, and subsequently attacks and destroys them.
The condition is often treated with Protopic ointment, steroids, or UVB light therapy, all of which are very effective for children.
Dr. Grimes performs a narrow-band UVB light treatment on 6-year-old Savion, who has suffered from vitiligo for most of his young life. “Even though you’ve lost your pigment cells in the skin,” Dr. Grimes explains, “You still have a reservoir of melanocytes in the hair follicle. What that light does is stimulate those pigment cells; it wakes them up so that they’ll repopulate the skin.”
As Savion stands in front of the light, Dr. Grimes explains, “For each treatment, we tend to use the light three times a week, and all you have to do is follow the set schedule. Then, on each treatment, you make a step-wise increase until that skin becomes nice and pink, and you would keep that exposure time constant.”
National Biological Corporation provided the Panosol II UVB Ultraviolet Light Panel for the treatment and sent Savion home with one of his very own.