Tis’ the Season – When is a Cold Not a Cold?

By Dr. Patty Avila, Pediatrician

It is that time of year again!  The busy time of year when everyone is preparing for the holidays is also when children are getting more colds and other respiratory illnesses.  These are the most common type of illness that children will see their doctor for, and it is important to recognize when to worry or not.  Most of these will be simple colds and resolve on their own, but there are some that can be serious.

The Common Cold; also called an Upper Respiratory Infection.

The common cold is caused by several different viruses and is the most common of all the respiratory illnesses. In the 1st 2 years most children will have about 3 to 5 colds per year. Older school age children and children in daycare can get sick even more often, because they are exposed to others.  Fortunately, most of these are just colds and will go away on their own and not lead to anything worse. 

Symptoms of the Common Cold:

  • Low fevers (101-102 degrees F).
  • Runny nose, nasal congestion comma and sneezing.
  • Sore throat.
  • Cough.
  • Not eating well.
  • Fussiness.

Most children will be better after 7 to 10 days of illness, but some may take up to 10 to 14 days to get better.

When to worry with the common cold:

Most children will not need to see their doctor with a common cold or upper respiratory infection. Infants younger than 3 months should see their pediatrician because they are at higher risk of getting very sick. 

See your doctor immediately if your child or infant is having:

  • Trouble breathing or fast breathing – using their muscles in between their ribs to breathe or the openings of the nose get larger with every breath.
  • Nails or lips turn blue.
  • The symptoms are lasting longer than 10 to 14 days.
  • Dehydration or not drinking well and not urinating well.
  • Child/infant is too sleepy or very fussy and not consolable.
  • Ear pain or any other concerns for child/infant not improving or getting worse.

Antibiotics do not treat the common cold since it is caused by a virus. 

Supportive care includes:

  • Increased fluids.
  • Use of pain/fever medication such as acetaminophen or ibuprofen.
  • Nasal saline with suctioning for congestion.
  • Honey for cough in a child OLDER than 1 year (NEVER given an infant <1 year of age honey).
  • Use of a humidifier may provide relief. 

The Flu; sometimes called Influenza.

The flu is also caused by respiratory viruses called influenza and can present very similar to the common cold.  Children with the flu feel much worse and are sicker than with the common cold.  The flu can have very serious complications including need for hospitalization and sometimes death.   

Symptoms of the Flu:

  • Rapid onset of high Fevers (above 101 degrees F), chills.
  • Headaches, body aches.
  • Runny nose, nasal congestion.
  • Chest pain and cough.
  • Sore throat.
  • Poor appetite.
  • Feeling tired and weak.

Most children will get better after 2 weeks. Fevers from the flu can last up to 5 to 7 days. 

See your doctor immediately if your child or infant is having:

  • Trouble breathing or fast breathing – using their muscles in between their ribs to breathe or the openings of the nose get larger with every breath.
  • Nails or lips turn blue. 
  • Dehydration or not drinking well and not urinating well.
  • Child/infant is too sleepy or very fussy and not consolable.
  • Ear pain or any other concerns for child/infant not improving or getting worse.

Young children and infants as well as children with high-risk medical conditions should see their pediatrician as soon as possible. These high-risk medical conditions include:

  • Heart defects.
  • Chronic lung issues.
  • Asthma.
  • Low immune system.
  • Diabetes.
  • Cancers. 

Supportive care includes:

  • Increased fluids.
  • Use of pain/fever medication such as acetaminophen or ibuprofen.
  • Nasal saline with suctioning for congestion.
  • Honey for cough in a child OLDER than 1 year (NEVER given an infant <1 year of age honey).
  • Use of humidifier may provide relief. 

Outside of supportive care, there is an antiviral medication called Tamiflu which may be indicated and started if the flu is diagnosed within the first one to 2 days.

Bronchiolitis.

Bronchiolitis is another respiratory illness that can be commonly seen during the winter months.  There are several viruses that can cause this illness but RSV, also known as Respiratory Syncytial Virus, is the most common.  RSV is an infection that will affect almost all children at least once before they turn 2 years old.  It usually starts as a cold and is followed by lower respiratory symptoms around 3 to 5 days of the illness.  For some children the illness can be severe, especially younger infants, preemies, and those with heart or lung defects.   

Symptoms of Bronchiolitis:

  • Cold symptoms with fevers, runny nose, nasal congestion, and cough.
  • Fussiness.
  • Poor Feeding.
  • Wheezing.
  • Difficulty breathing.

See your doctor immediately if your child or infant is having:

  • Trouble breathing or fast breathing – using their muscles in between their ribs to breathe or the openings of the nose get larger with every breath.
  • Nails or lips turn blue. 
  • Dehydration or not drinking well and not urinating well.
  • Child/infant is too sleepy or very fussy and not consolable.
  • Ear pain or any other concerns for child/infant not improving or getting worse.

Supportive care includes:

  • Increase fluids.
  • Use of pain/fever medication such as acetaminophen or ibuprofen.
  • Nasal saline with suctioning for congestion.
  • Honey for cough in a child OLDER than 1 year (NEVER given an infant <1 year of age honey).
  • Use of humidifier may provide relief. 

For infants who are high risk there is an injection that is given monthly during the winter months called Synagis that can decrease the risk of severe RSV infection. 

Croup.

Croup is a common respiratory illness during the Fall and Winter months and is usually seen in infants and young children – children younger than 5 year of age.  It is caused by several different viruses including the flu virus and some cold viruses.  The illness is characterized by swelling of the upper airways including the voice box (larynx) and the windpipe (trachea). Symptoms from Croup are usually worse at the beginning of the illness. 

Symptoms of Croup:

  • Fevers which can be low grade or high.
  • Cold symptoms with runny nose and nasal congestion.
  • Hoarseness of voice.
  • Barky or “seal like” cough.
  • Noisy breathing when breathing in – stridor.

The swelling of the airway can sometimes be severe and need immediate medical attention.

See your doctor immediately if your child or infant is having:

  • Trouble breathing – struggles to catch their breath.
  • Noisy breathing that is getting louder and child/infant appears to struggle to breathe.
  • Cannot talk because of difficulty breathing.
  • Lips/mouth or nails turn blue.
  • Drooling and not able to swallow saliva.
  • Dehydration or not drinking well and not urinating well.
  • Child/infant is too sleepy or very fussy and not consolable.

Steroids can decrease the swelling and can be given by mouth, injection, or in a breathing treatment.  If given early can help decrease the need for hospitalization and improve breathing.  There are breathing treatments with epinephrine that can be given as well in severe cases, but these will require careful observation in the Emergency Department or Hospital setting.

Use of cold moist air can help improve mild symptoms as well and can be used at home with a cool mist humidifier.

PREVENTION TIPS

  • For all respiratory infections, the best form of prevention is to avoid exposing infants/young children to people who are sick or crowded situations. 
  • Breastfeeding infants as long as possible (at least 6-12 months) is also an important way to help prevent and fight infections because breastmilk provides antibodies. 
  • Practicing and teaching children good hand hygiene is key.
  • Use soap and water and scrub for at least 20 seconds (singing the ABCs).  Another option is the use of an alcohol-based hand rub if hands are not visibly soiled. 
  • Teach children to cover their coughs and sneezes properly by using a tissue or coughing in their arm rather their hands. 
  • Keep children home from daycare or school when they are sick to avoid spreading the illness. 
  • Eating a healthy balanced diet high in fruits and vegetables can help boost the immune system and help decrease the chances of getting sick.   

At NOAH, we’re here for you. If you have any questions for your child’s pediatrician, give us a call at 480-882-4545. You can also send a message to your pediatrician via your child’s MyChart account.

Skin Care Tips for Teens

By Dr. Deborah Bauer, MD

“Adolescence can be a tough time – especially on your teen’s skin! Almost 8 out of 10 teenagers will have acne at some point,” says Dr. Deborah Bauer, Pediatrician. This is because the changing hormones cause an increase in oil production and can lead to clogged pores. This can happen all over your child’s body, not just their face. And while acne isn’t dangerous for their health, it can cause scars and decrease their self-esteem.

Here are a few pointers for home care of your teen’s skin:

  • Keep it clean: They should wash their face with warm water and a gentle cleanser twice per day. CeraVe, Cetaphil and Dove make reasonably-priced and effective cleansers.
  • Be gentle: Harsh scrubbing or rough washcloths are not recommended. Your teen should be using just their hands to gently rub in the cleanser and rinse off.  Very hot water or very cold water should not be used.
  • Stick to the routine: Oily skin and acne can last for months or years, so it’s important to have a good skin routine to minimize the effects. Remind your teen to always remove make-up before sleeping.  And change sheets and pillowcases frequently.
  • Don’t pop pimples: Although it’s tempting, squeezing pimples will only make things worse. Not only will they introduce more oil onto their skin from their hands, but this will probably push the oil deeper into the skin and cause inflammation and swelling.
  • Keep moisturizing: Drying out their face can actually lead to more acne because their body will try to produce even more oils to keep their face from being so dry. Make sure the moisturizer bottle says “oil free” or “noncomedogenic” on it so it doesn’t clog their pores more.
  • Use sun block: This is important for every child, but especially for those with acne. The sun’s rays can irritate skin and make acne and scars much, much worse. Make sure the sunscreen is at least SPF 15.

Some kids even need prescription medication to help manage acne, and our NOAH Pediatricians are here to help with that too!

For more information about taking care of your skin, visit the American Academy of Dermatology: www.aad.org.

Tips to Treat Nosebleeds in Children by Dr. Debbie Bauer, Pediatrician

“Nosebleeds are very common in children, especially during these winter months,” says Debbie Bauer, Pediatrician. The dry air from outside combined with the dry air from heaters inside can make the skin inside the nose more fragile and sensitive. This is one of the most common reasons children get nosebleeds. Some children also get nosebleeds from picking their nose, from sniffling too much from allergies/colds, or of course from being hit in the nose.

Learn what to do if your child has a nosebleed and when to get help from a doctor below. Also, check out our tips on how to prevent nosebleeds from coming back!

What should you do if your child has a nosebleed?

– First, don’t panic! Nosebleeds are rarely serious. Your child will have an easier time following your instructions if you remain calm.

– Have your child sit down and put their head slightly forward, NEVER have them tilt their head backwards.

– Put firm pressure on either side of their nose with your fingers and hold it there for 10 minutes.

– After 10 minutes, check to see if the bleeding stopped. If it hasn’t, hold firm pressure again for 10 more minutes.

– When bleeding has stopped, gently clean blood off their face with water but do not put anything in their nose or have them forcefully blow their nose.

When should you get help from a doctor?

– If your child has a nosebleed for more than 20 minutes without stopping.

– If your child looks very pale, weak or sweaty.

– If you see blood in your child’s urine or stool.

– If your child has strange, unexplained bruises.

– If frequent nosebleeds are concerning you.

How can you prevent nosebleeds?

– You can use a saline nasal spray to keep their nose from getting dry.

– You can use a humidifier in their room.

– You can apply a small amount of Vaseline inside their nose carefully with a Q-tip.

– If your child picks their nose, keep their fingernails trimmed short.

At NOAH, we’re here for you. If you have any questions for your child’s pediatrician, give us a call at 480-882-4545. You can also send a message to your pediatrician via your child’s MyChart account.

Tricks to Keep Those Treats from Harming Your Teeth!

Don’t let the sugar in those treats trick you and harm those precious pearly whites! Our dental experts have a few tips to help you sort through all that yummy candy on halloween night so that you reduce your risk of getting cavities.
Read more

October is Dental Hygiene Month!

What could be more spine-chilling than Halloween? Neglecting National Dental Hygiene Month! According to the American Academy for Oral Systemic Health, there exists a connection between oral health and broader health issues like heart disease, diabetes, stroke, and more. In honor of National Dental Hygiene Month, here are four straightforward tips to safeguard your well-being.

Brush

Brushing your teeth is a fundamental aspect of good oral health. By scrubbing tooth surfaces daily, you can help prevent cavities. Stimulating your gums and removing plaque along the gum line can also help prevent gum disease.

Floss

Even the most thorough brushing leaves bacteria in the tight spaces between each tooth and under the gum line. To remove plaque, food particles, and bacteria from these areas, be sure to floss once a day.

Use Mouth Rinse for Extra Protection

Your teeth account for less than half of the surfaces in your mouth, so rinsing is important to remove biofilm and bacteria that brushing and flossing leave behind. Mouth rinse isn’t a substitute for either, but it can supplement your other dental hygiene efforts to reduce the chance of tooth decay and infection.

See Your Dentist

At-home oral care is vital for good overall dental hygiene, but you also need regular trips to the dentist. Professional cleanings, exams, and X-rays keep your teeth and gums healthy and help you catch problems when they’re still easy to treat.

While the idea of dental issues might seem scarier than any haunted house, the good news is that with simple yet consistent practices, we can protect our oral health. For more dental tips, schedule an appointment with your NOAH dental provider today.

National Youth Suicide Prevention Week

Did you know suicide is the second leading cause of death for individuals ages 10-24? Youth suicide statistics cannot be ignored as they have greatly increased over the last decade. Ten teenagers out of 100,000 decide to commit suicide. Females attempt suicide at a rate of nearly 3-times that of males. However, males die by suicide at a rate of nearly 3-times that of females. Suicide prevention is a critical health topic for young people in the U.S.

Who is at high risk for suicide?

Adverse Childhood Experiences (also known as ACES) can include neglect, abuse, experiencing violence, substance abuse, divorce, incarceration of a family member, or poverty. Experiencing ACES has been shown to negatively affect physical and mental health over time and can occur across generations. This is particularly troublesome for youth who have had limited access to healthcare. Youth who have one or more ACES are at higher risk for suicide. Populations at a higher risk of experiencing ACES include minority groups, low socio-economic groups, and LGBT groups. Native Americans and Alaskan Indians have the highest rates of suicide by ethnic group.

What are the warning signs?

It is not always possible to recognize the warning signs in those thinking about suicide. Some common signs to watch for include: 

  • Talking or writing about death
  • Expressing hopelessness about the future
  • Withdrawing from family or friends
  • Increased drug/alcohol use
  • Giving away personal possessions
  • Engaging in self-harming behaviors
  • Participating in dangerous activities
  • Significant change in mood or behavior

How to support someone who is experiencing suicidal thoughts:

  1. Talk with them about their suicidal thoughts as it can help them process their emotions. 
  2. Try to acknowledge their feelings, fears, sadness, or pain.
  3. Provide reassurance but do not dismiss the problem. You may ask if they are thinking about hurting themselves or taking their own life, and if they have a plan.
  4. Be sure the person does not have access to any lethal weapons or medications and immediately inform adults or caregivers. 
  5. Try to avoid panicking or offering too much advice. 
  6. Provide contact information for the crisis line(s) and assist them to call if necessary. 

Professionals like the counselors or psychiatrists at NOAH are great resources for ongoing support and safety planning.

If you or someone you know is experiencing a crisis, reach out to one of the following resources for help:

  • National Suicide Prevention Lifeline: Call, text, or chat: 988
  • Crisis Text Line: text HOME to 741741
  • Maricopa County Crisis Line: 800-631-1314
  • Teen Life Line: Call or text 602-248-TEEN (8336)

Sun and Summer Safety Tips – Part 2

By Amit Jain, MD FAAP MBA | Pediatrician

Summer has arrived, offering the perfect opportunity to enjoy the sun and water. Dive into these water safety tips for a fun and safe experience!

Water Safety Tips

Swimming is a great way to beat the summer heat here in Arizona and is a fun, healthy way to enjoy summer. However, water safety and drowning prevention are critical. Drowning is a very common cause of accidental, injury related deaths. Kids between 1 and 4 are at the highest risk.

General Pool Safety Tips

  • Never leave children alone – even for a moment – in or near pool areas or other bodies of water (lakes, beaches, and even bathtubs or buckets of water!)
  • If an unexperienced swimmer is near the pool, make sure there is a designated adult for supervision. This adult should not be under the influence of alcohol or anything else, should not have any distractions (cell phone turned off or handed to another adult), and preferably knows how to swim and perform CPR.

Home Pool Safety Tips

  • Talk to your pool operator to make sure your pool / spa and its drains are compliant with the pool and spa safety act.
  • Install a fence at least 4 feet tall around the pool, which should ideally surround the pool on all sides and completely separate the pool from your home and yard. It should not have any gaps that a small child could slip over, under, or through.
  • The gate should be a self-closing and self-latching gate that cannot be opened / reached by a small child.
  • Newer technology offers alarms, both for the gate and the pool that alerts you to anyone around the pool.
  • Keep rescue equipment such as a shepherd’s hook and a life preserver to reach / throw for rescues.
  • Avoid inflatable swim aids such as floaties, as they are not a substitution for proper life-preserving equipment such as life jackets.

Swimming Lessons

  • Start swimming lessons early! Consider lessons for your child around age 1, but definitely by age 4. It may reduce the risk of drowning. Some neighborhoods that have pools have frequent swim classes for all ages.
  • Infant swim lessons are not advised because there is no evidence that swim lessons reduce a child’s risk of drowning under age 1 year old.

 Lastly, your NOAH pediatric team wishes you a safe and relaxing remainder of your summer!

Sun and Summer Safety Tips – Part 1

By Amit Jain, MD FAAP MBA | Pediatrician

Summer is here and many of us will be out with our kids to enjoy the sun. NOAH’s Pediatric team has a few summer safety tips for safe fun in the sun!

The sun brings many great things, but it also brings harmful UV (ultraviolet) light. UV light can cause melanoma, a deadly form of skin cancer more common in people who have had bad sunburns when they were young. The sun can also cause other health risks and skin damage. Here are some precautions you can take to protect yourself all summer long.

Proper clothing and lots of shade

  • Limit your time in the sun between 10 a.m. and 4 p.m. (the most intense time).
  • Take frequent shade breaks if staying in the sun for long periods of time.
  • Cotton clothing is best – it’s protective against the sun and keeps moisture low so you stay cool outside. Tightly woven fabrics are best.
  • Wear a hat: wide brimmed is best to protect your child’s entire face, including the nose, cheeks, chin, ears, and back of the neck.

UV protection

  • Kids sunglasses should have UV protection. They aren’t expensive and are sold everywhere, but make sure they’re labeled with UV protection.
  • Use SPF 15 (or higher) sunscreen on any skin not protected by clothing. Don’t forget the ears, back of the neck, arms, and legs. Carefully apply around the eyes, avoiding eyelids.
  • Choose a sunscreen that has the words “Broad Spectrum” on it – that will cover both UVA and UVB rays.
  • Before applying sunscreen for the first time, test a small amount on your child’s back for an allergic reaction.
  • Apply sunscreen at least 30 minutes before sun exposure, because it takes this long to start working.
  • Reapply sunscreen at least every 1 hour.
  • If playing in the water, reapply sunscreen every half an hour, and use a waterproof sunscreen.

Babies under 6 months need more sun protection

  • Avoid direct sun exposure. Keep them in shade with a canopy or under a tree.
  • Use wide brimmed hats to cover their face, ears, and neck.
  • Dress babies in lightweight clothing that covers their arms and legs.
  • If a young baby is in the sun, apply small amounts of sunscreen SPF 15 or more to your baby’s face, hands, and legs.
  • Don’t forget to use sun protection even on cloudy days, as the harmful UV rays come through clouds.

Looking for more summer sun safety tips? Talk with your NOAH pediatrician today.

Get a Sports Physical for School

The beginning of the school year means new opportunities. If your child is starting a sport for the first time, changing sports, or deciding to try a new physical activity outside of class, then it’s time for them to have a sports physical so a medical professional can make sure they are healthy enough to play their new sport or activity safely.

What is a sports physical?

  • Screening for safe and healthy participation in sports and activities.
  • Checking that your child’s body is ready for the physical demands of the activity.

Does my child need a sports physical?

  • Yes. In Arizona it is state law that a student gets a sports physical if they are playing a team or club sport at school.
  • And where it isn’t required, it is highly recommended because almost all kids are active in some way! This exam looks at the physical and mental demands of their sport or activity and can address any concerns related to their health.
  • To make life easier and to have less appointments, the American Academy of Pediatrics recommends scheduling a sports physical with your child’s next routine well-child visit.

What happens during the appointment?

  • Bring your child’s completed Pre-Participation Physical Evaluation form with you. Write down any important medical information like past surgeries, injuries, or illnesses, and any family history of heart disease should be reviewed. Write down any questions you may have to discuss with the doctor.
  • At the appointment, the doctor will check your child’s:
    • Vitals: height, weight, pulse, and blood pressure
    • Eyes: if your child may need corrective lenses or a new prescription
    • Medical history
    • Fitness: heart, lungs, abdomen, joints, flexibility, strength, and reflexes             
  • This is also a good time to talk with your child’s doctor about any concerns for your child’s new or ongoing activity or sport, such as:
    • Concussions
    • Special needs or disabilities       
  • Your NOAH provider may also request lab work for your child or refer them to a specialist for further evaluation. If needed, your NOAH Care Team will help set up the next steps for this, and most children are able to play after this extra clearance.

Safe and healthy participation in sports and physical activities is the goal, so get your child’s physical scheduled with your NOAH provider and enjoy watching them play and have fun.

Summer Fun – Pool Safety Tips

By Amit Jain, MD FAAP MBA | Pediatrician

Swimming is a great way to beat the summer heat here in Arizona and is a fun activity for children to pass the summer by. Drowning is the third most common cause of unintentional – injury related deaths. Among children aged 1-4, drowning stands as the leading cause of unintentional deaths, placing them at the greatest risk. As such, we here at NOAH wanted to share some important water safety tips!

  • Never leave children alone, even for a moment, in or near pool areas or other bodies of water (lakes, beaches, and even bathtubs or buckets of water)!
  • Install a fence at least 4 feet tall around the pool, which should ideally surround the pool on all 4 sides and completely separated the pool from your home and yard. It should not have any gaps that a small child could slip over, under, or through. The gate should be a self-closing and self-latching gate that cannot be opened / reached by a small child.
  • Newer technology offers alarms, both for the gate and within the pool, that can alert you to anyone around the pool.
  • When any inexperienced swimmer is around the pool area, make sure there is a designated adult for supervision. This adult should not be under the influence, should not have any distractions (cell phone turned off or handed off to another adult), and preferably knows how to swim and perform CPR.
  • Keep rescue equipment such as a shepherd’s hook and a life preserver to reach / throw for rescues.
  • Avoid inflatable swim aids such as floaties, as they are not a substitution for proper life-preserving equipment such as life jackets.
  • Consider swim lessons for your child if over the age of 1, as it may reduce the risk of drowning. Talk to your NOAH Pediatrician about your child’s developmental readiness to take swim lessons.
  • Talk to your pool operator to make sure your pool / spa and its drains are compliant with the pool and spa safety act.

At NOAH, we want to make sure that you have the proper tools, education and resources to protect you and your family while swimming. Most importantly, we hope you have a safe and fun-filled summer!