As we head in to the Holiday Season, I encourage you to pause and reflect on what it means to be a parent. I recently read a quote of an unknown author, "The days are long, but the years are fast." My interpretation of this as a parent (and a Pediatrician) is that we often get bogged down in the daily "stuff" -- laundry, kid transportation, cleaning, doctor visits, etc -- that our days become so long. I find myself looking forward to bedtime after a full day at the office followed by all the evening chores and kid activities. But here I am with a child ready to graduate from high school and I can't believe I had roughly 6500 days of "stuff" with her, but only 18 very short years. I try often, but not often enough, to just watch her as she studies or competes in her sport. Just watching seems to make the time slow down. I think this satisfies "the living in the moment mantra" we hear so often these days or the "mindfulness mantra." Take time to just watch your kids, whether they are 8 months or 18 years, your day may feel more fulfilled and you will experience a richer 18 years knowing you "watched" your child grow up.
Katrina Hood, MD
Wondering which medications are safe to take while breastfeeding your baby? ã€€
Here are a few guidelines:
1. ã€€ When possible, it's best to avoid taking any medication while breastfeeding. While there is some information available about most medications and compatibility with breastfeeding, often, there's not as much data as we would like. If you have a cold, allergies, or viral illness and are uncomfortable but not truly miserable, the risk of exposing your baby to medications is just probably not worth it.ã€€
2. ã€€Try to treat symptomatically first. For nasal congestion, try saline nasal spray or a neti pot (use distilled water). For cough or sore throat, try warm apple cider, a teaspoon of honey here and there, a humidifier in your bedroom, or a steamy shower. For seasonal allergies, keep all windows in your home closed to decrease exposure. ã€€
3. ã€€If medication is needed, try to treat in the most localized way possible. For example, if you're having allergy eyes, try allergy eye drops, rather than an oral antihistamine. If you're having nasal allergies, try a prescription allergy nasal spray. ã€€
4. ã€€Be sure to tell your doctor that you're breastfeeding. And then double-check the medications you're given with us. Many adult doctors don't have a great deal of experience prescribing medications for breastfeeding mothers, and they may not be sure where to look for accurate information. Sometimes doctors also may not be aware that certain medications can interfere with breastmilk production, even if they don't pose an exposure risk to the baby. ã€€
5. ã€€If your doctor tells you that you need to discontinue breastfeeding or pump-and-dump to take a medication, then definitely double-check with us. Exclusive pumping can decrease your milk production, and it can be emotionally difficult for a baby who is accustomed to exclusive nursing. Sometimes it's a necessity, but sometimes we can recommend alternatives.
6. ã€€Here's a great resource you can check on your own at home: http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT. LactMed, published by the United States National Library of Medicine, is the most up-to-date resource for information about breastfeeding and medications. Just type in the brand or generic name of your medication, and a summary of breastfeeding research and safety will pull up. ã€€
Breastfeeding is important. And the mother's health is important too! ã€€If you're really sick, take care of yourself and see your doctor. Fortunately, if medications are needed, it's usually possible to find ones that don't necessitate any interruption in breastfeeding. Just check with us to be certain if you have questions!
Dr. Michelle Bennett
Allergic rhinitis, sometimes called "hay fever," affects 15-25% of American children and is probably the most common chronic disease in childhood.
Although it’s called "hay fever," allergic rhinitis is not caused by hay, nor is it associated with a fever. Instead, it is an overreaction of the immune system to substances (allergens) that are harmless to most people. The symptoms of allergic rhinitis can be triggered by pollen (especially tree, grass and ragweed), mold spores, dust mites, pet dander and cockroaches. Symptoms include a clear runny nose, nasal congestion, itchiness of the nose, postnasal drip, sneezing and coughing. The eyes may be red, itchy and have clear drainage. Complications of allergic rhinitis include mouth breathing – this can lead to long-term dental and facial bone abnormal growth. Restless sleep can lead to daytime fatigue. The ears can be affected, which can lead to retained fluid in the middle ears, raising the potential for ear infections, hearing problems, and then problems with speech in children.
The tendency to have allergies is often inherited. What a child is allergic to, though, is usually not.Allergic rhinitis is diagnosed by history, physical exam and sometimes by allergy skin testing. Specific allergies may be tested for in children 5 and older by putting diluted samples of suspected allergens on the skin that has been scratched or pricked. Sometimes the allergen samples are injected into the skin. A red, hive-like reaction is usually a positive sign for that particular allergen.
Treatment consists of avoidance, medications and sometimes immunotherapy. During the season, it is recommended to avoid the peak pollen and mold spore time of 5-10 a.m. Staying indoors, using air conditioning and mattress covers, and removing rugs and carpeting may help. Antihistamines by mouth or as nasal sprays, or eye drops in children as young as 6 months may be used. Steroid nasal sprays and oral leukotriene inhibitors can also be effective.If avoidance and medications provide no relief, immunotherapy may be tried. Diluted mixtures of a child’s offending allergens are injected into the skin in slowly increasing concentrations over years. This trains the immune system to eventually become tolerant of (and not react to) these allergens. ï™
Dr. Charles Ison
**This article can also be found in the Lexington Family Magazine. **
As a Pediatrician in Lexington, I see hundreds of patients each year. A new concern I have is how quiet my exam rooms are sometimes. The rooms are so much quieter because the kids, and the parents, are on electronic devices of all sorts. This trend has only recently surfaced in the last 4 to 5 years. If the room is quiet then several things are missing; talking and laughing among families and personal interaction of the human kind. I truly think this will become a big problem for babies. Many times I walk into an exam room and there is a baby in a carseat and a caregiver on the phone texting or playing a game. If this is happening frequently at home as well, then the baby is not hearing language. The first 2 years in a baby’s life is the most critical for learning love and language. I am particularly worried about these children over their young lives if they are not hearing language and missing out on human interaction when they are awake.
I read something recently that makes a great deal of sense; “Make your awake baby a Text Free Zone, just like your car.” So, next time you are with a young child, and particularly an infant, talk to them and put the electronics away.
Katrina Hood, M.D.
Overuse of antibiotics has become a major health problem for children as well as adults. Kentucky has one of the highest rates of antibiotic use in the U.S. There are reasons why antibiotics should not be used for all illnesses. In addition, certain steps can be taken to decrease their overuse.
First of all, antibiotics work only for bacterial infections. Viruses cause a large percentage of the total number of infections, especially in children. Not all bacterial infections need to be treated all of the time, either.
Secondly, antibiotics are not without their side effects. These range from gastrointestinal upset to life-threatening severe allergic reactions such as anaphylaxis. They can also cause the overgrowth of the potentially dangerous bacterium Clostridium dificile that usually lives in the colon (which can cause severe diarrhea). Antibiotic use can also encourage the overgrowth of fungi such as yeast.
Thirdly, overuse of antibiotics can lead to antibiotic resistance in bacteria. The more they are used, the more likely the chance that some types of bacteria will learn to outsmart the antibiotics. They become resistant to them. There are types of bacteria that have become resistant to multiple families of antibiotics. If a person gets an infection with one of them, it could be difficult or impossible to treat.
There are steps that patients can take to decrease the overuse of antibiotics. They should not demand antibiotics if their healthcare providers tell them they do not need them. Since a lot of infections are viral, they may frequently not be needed.
Antibiotics should not be shared with others except in those rare emergencies where a healthcare provider advises it. They also should not be hoarded and used for a subsequent infection: this also means that the initially prescribed dose was probably not finished, which can also lead to antibiotic resistance in bacteria (more resistant bacteria are more likely to survive a shortened course of antibiotics than less resistant bacteria).
Healthcare providers and their patients are not the only ones to blame for antibiotic overuse. They are often used in large amounts to farm animals to keep them healthy. This allows for the development of resistant bacteria on an industrial scale. They can then make their way into the food supply and ultimately into us. There is a lot of blame to go around for our overuse of antibiotics, but also a lot of responsibility to do our part to stop it.
By Charles G. Ison, M.D.
**This article can also be found in the January issue of Lexington Family Magazine. **
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