dried chapped hands

Raw hands- recognize your kid?

Even when it isn’t flu season, we pediatricians wash our hands about sixty times a day, maybe more. This frequent washing, in combination with cold winter air, leads to chapped hands. Here are the hands of a patient. Do your children’s hands look like these?

To prevent dry hands:

Don’t stop washing your hands, but do use a moisturizer afterwards. Also use warm but not hot water. Hot water removes protective oils from skin.
• According to the American Academy of Dermatology, hand sanitizer can prevent the drying that accompanies frequent hand washing. However, we can tell you from experience that once your hands are already chapped and cracked, the alcohol content in the sanitizers stings sensitive skin. So if your child’s hands are already chapped, stick with water and soap.
Wear gloves or mittens as much as possible outside even if the temperature is above freezing. Remember chemistry class—cold air holds less moisture than warm air and therefore is unkind to skin. Gloves will prevent some moisture loss. Having difficulty convincing your child to wear gloves? Point out that refrigerators are kept around 40 degrees Fahrenheit or below. Tell your kids that if they wouldn’t sit inside a refrigerator without layers, then it would be wise to wear gloves.
• Before exposure to any possible irritants such as the chlorine in a swimming pool, protect the hands by layering heavy lotion (e.g. Eucerin cream) or petroleum based product (e.g. Vaseline or Aquaphor) over the skin.

To rescue dry hands:

• Prior to bedtime, smother hands in 1% hydrocortisone ointment. Avoid the cream formulation. Creams tend to sting if there are any open cracks. Take old socks, cut out thumb holes and have your child sleep at night with the sock on his hands. Repeat nightly for up to a week. Alternatively, for mildly chapped hands, use a petroleum oil based product such as Vaseline or Aquaphor in place of the hydrocortisone.
• If your child has underlying eczema, prevent your child from scratching his hands. An antihistamine such as diphenhydramine (Benadryl) or cetirizine (Zyrtec) will take the edge off the itch. Keep his nails trimmed to avoid further damage from scratching.
For extremely raw hands, your child’s doctor may prescribe a stronger cream and if there are signs of a bacterial skin infection, your child’s doctor may prescribe an antibiotic.

Happy moisturizing. Remember smearing glue on your hands and then peeling off the dried glue? It’s not so fun when your skin really is peeling.

Naline Lai, MD and Julie Kardos, MD
© 2009, 2015, 2018 Two Peds in a Pod®

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In light of the recent school shooting in Parkland, Florida, you may be left wondering if, and how, to explain this or other tragedies to your children.

Understand that kids sense your emotions even if you don’t tell them. Not telling them about an event may make them concerned that they are the cause for your worried hushed conversations. Break away from your discussion with adults to say, “ Do you know what we are talking about? We are not talking about you.”

Even though an event may be far away, media makes it seem as if it happened next door, and sooner or later your children will see or hear about it. Tell the facts in a straight forward, age appropriate manner. Answer questions and don’t be afraid to answer with an “I don’t know.” Preschoolers are concrete in their thinking—dragons are real and live under their bed, so don’t put any there that do not exist. For a preschooler a simple “Mom is sad because a lot of people got hurt,” will suffice. Young school age kids will want to know more details. And be prepared to grapple with more high level questions from teens.

Look for the helpers. Mr. Rogers who hosted Mister Roger’s Neighborhood for 30 years, tells this story about seeing scary things on the news: “My mother would say to me, ‘Look for the helpers. You will always find people who are helping.’ To this day, especially in times of ‘disaster,’ I remember my mother’s words, and I am always comforted by realizing that there are still so many helpers-so many caring people in this world.”

What if the kids ask, “Will that happen here?” or “Why did that happen?” Again, reassure in a simple straight forward manner. For instance you can say, “Many people are working hard to prevent something like that here.” Consider answering the question with a question. Asking “What do you think?” will give you an idea of exactly what your child fears. You can also reach out to other family supports for help with answers. Say to your child, ”I wonder what our minister or school counselor has to say about this, let’s ask.”

Routine is reassuring to children, so turn off the background 24 hour television and internet coverage and make dinner, take them to sports activities, and get the homework done.

Give your kids something tangible to do to be helpful. Help them set up a coin donation jar at school or put aside part of their allowance for a donation.

If your child seems overly anxious and fearful, and her worries are interfering with her ability to conduct her daily activities, such as performing at school, sleeping, eating, and maintaining strong relationships with family and friends, then seek professional help.

For more advice on this topic, please see this American Academy of Pediatrics recommendation for parents. Also, the following is a firearms safety message for parents, from the AAP:

• Young children are curious. They are often unable to remember or follow safety rules. Teens are impulsive, and naturally tend to be moody. When combined with access to firearms, the consequences can be tragic and permanent.

• Many homes have guns – which is why you have to ask about guns when your child visits another home. Depending on location, 18 percent to 64 percent of U.S. homes have firearms.

If there is a gun in the home, there’s a good chance a child living there will know where it is. In a recent study, 39 percent of parents erroneously believed their children did not know where their gun is stored, and 22 percent wrongly believed their child never handled a gun.

The safest home for children and teens is one without guns. If you do have a gun, you can greatly reduce the risk of a child being injured or killed by storing the gun unloaded and locked, with the ammunition locked in a separate place.

Parent your children so they feel secure in themselves and secure in the world around them. You may not hold the answers to why a tragedy strikes, but you do hold the ability to comfort and reassure your children.

Naline Lai, MD and Julie Kardos, MD
© 2018 Two Peds in a Pod®, adapted from our 2015 post

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So you just read our post “Does my child have the flu or a cold” and you’ve decided that your child likely has the flu (short for influenza). Now what do you do? When do you call the pediatrician? Does your child need medication?

First take a deep breath. Then, make sure your child is breathing easily. She may be coughing a lot but as long as her breathing is unlabored, and you see no retractions (see 6 second video in our coughing post), her lungs are most likely OK. Kids who are short of breath can become agitated or lethargic. A little tiredness from illness is normal, but extreme lethargy is not.

Think about it. Is your child’s mental state OK? Is she thinking clearly, walking well, talking normally, and consolable? She may be more sleepy than usual but when awake she should be rational and easily engaged.

Hydrate!  A high fever and cough increases a child’s hydration needs.  Make up for lost fluids by aiming to give her at least one and one-half times the amount she usually drinks in a day. For example, if she typically drinks 24 ounces of water or milk per day, try to give at least 36 ounces of fluid per day. Offer your child ANYTHING she wants to drink, including soup, juice, lemonade, electrolyte replenishers (e.g. Gatorade or Pedialyte), decaffeinated tea or a little flat decaffeinated soda. If your child is not eating, avoid hydrating solely with plain water. Kids need salt to keep their blood pressure up and sugar to keep their energy levels up. And yes, milk is great to offer. If milk doesn’t cause your child to make more mucus when she is healthy, then it won’t affect her nose or lungs when she is sick. Even chocolate milk is fine! For infants, give breastmilk or formula—no need to switch. The goal is to produce PEE. Well hydrated kids pee at least every 6-8 hours. Other signs of dehydration include dark urine, dry mouths/lips, the inability to produce tears, sunken eyes, and sunken soft spot (in an infant).

Offer food as well. My grandmother used to say, “Feed a cold, starve a fever.” I loved my grandmother, but she was incorrect about this advice. Food = nutrition = improved germ fighting ability. However, don’t argue with your sick kid about eating if she is not hungry. Just know that drinking extra is a MUST.

Placate pain. She may have muscle aches, a headache, or a sore throat. Relieve her discomfort with ibuprofen (Motrin, Advil) or acetaminophen (Tylenol). Offer some ice pops and a movie on the couch. If she is in severe pain, is unable to move normally, or is inconsolable, call your child’s doctor. Unable to move or inconsolable = very bad.

It’s OK to play and move about. Your child with flu might spend a large portion of her day on the couch or in bed but it’s fine to let her play and have some activity. Some walking around and playtime helps her exercise her lungs. “Moving” her lungs with a cough actually prevents pneumonia by preventing germy mucus from lodging in the lungs. Also, seeing that your child can walk around, despite her aches and discomfort, will reassure you that she is handing her illness.

Does every kid with flu need to see a doctor? No. Some kids have medical problems that predispose them to complications of illness and doctors will want to see those kids more often. Most otherwise healthy kids get through the flu, as long as they drink enough and can be kept comfortable. The fever from flu usually lasts from 4-7 days and can go quite high, but you know from reading our fever post that the number alone is not what you fear. What matters is how your child is acting.

Some reasons your child should see a doctor:
-difficulty breathing
-change in mental state or you cannot console her
-your child is dehydrated
-a new symptom that concerns you
-the fever goes away for a day or two and then returns with a vengeance
-fever goes on more than 4-7 days, but you can certainly call the doctor to check in by day 3-5
-a rash appears during the flu illness (this can be a sign of overwhelming bacterial infection, not the flu)
-new pain (eg. ear pain from an ear infection) or severe pain
-your gut instinct tells you that your child needs to see a doctor

What about Tamiflu (brand name for oseltamivir) ? Some areas of the United States are experiencing a shortage of this anti-flu medicine. Oseltamivir can lesson the severity of flu symptoms and perhaps shorten how long the flu lasts by about a day. Since most people recover in about the same amount of time without the medication, the CDC (Centers for Disease Control) and the AAP (American Academy of Pediatrics) issued treatment guidelines. Kids with certain lung, heart, neurologic, or immune system diseases, kids with diabetes, and kids under the age of two years may be medication candidates.  You can check the exhaustive list here. The other two medications that cover the two main types of flu are not available in oral form.

Better than Tamiflu is the flu vaccine. Remember the saying, “An ounce of prevention is worth a pound of cure?” A 2017 study showed that the flu vaccine prevented kids from dying of the flu. Vaccinated kids who do end up with the flu tend to have less severe illness. The vaccine prevents several types of the flu, so even if your child gets flu and did not receive the flu shot this season, it’s not too late. Take her to get it after her fever is gone. Also put in a reminder to yourself to schedule a flu vaccine appointment for your child next September, in advance of next winter’s flu season.  

Over-the-counter flu medications  do not treat the flu, but they can give side effects. In fact, cough and cold medicines should not be given to children younger than four years, according to the American Academy of Pediatrics. Instead, try these natural remedies:

-If older than one year, you can give honey for her cough and to soothe her throat.
-Run a cool mist humidifier in her bedroom, use saline nose spray or washes, have her take a soothing, steamy shower, and teach her how to blow her nose.
-For infants, help them blow their noses by using a bulb suction. However, be careful, over-zealous suctioning can lead to a torn-up nose and an overlying bacterial infection. Use a bulb suction only a few times a day.

What about black elderberry (sambucus)? Articles abound on social media about the benefits of black elderberry in fighting flu symptoms. However, if you read a credible source such as the National Institute of Health information site about complementary and alternative medicine, you will find, “Although some preliminary research indicates that elderberry may relieve flu symptoms, the evidence is not strong enough to support its use for this purpose.” The research was not conducted with kids, so unfortunately we cannot recommend this unproven treatment for flu.

Take heart. While the groundhog predicted 6 more weeks of winter this year, history shows that the groundhog is usually wrong.

Julie Kardos, MD and Naline Lai, MD
©2018 Two Peds in a Pod®

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photo by Lexi Logan

We are seeing a lot of coughing kids in the office these days. In general we like coughs. Coughs keep nasty germs from lodging in the lungs. It is hard for parents to tell if a cough is from a cold, an asthma flare, pneumonia, allergies, or something else. Regardless of what is causing your child to cough,  even if you think your child has a simple cold, it’s important to recognize when your child is having difficulty breathing. Share this information with all of your child’s caretakers, including teachers. Too often we get a child in our office with labored breathing which started during school hours but was not recognized until parent pick-up time.

Signs of difficulty breathing:
  • Your child is breathing faster than normal.
  • Your child’s nostrils flare with each breath in an effort to extract more oxygen from the air.
  • Your child’s chest or her belly move dramatically while breathing—lift up her shirt to appreciate this.
  • Your child’s ribs stick out with every breath she takes because she is using extra muscles to help her breathe—again, lift up her shirt to appreciate this. We call these movements “retractions.”
  • You hear a grunting sound (a slight pause followed by a forced grunt/whimper) or a wheeze sound at the end of each exhalation.
  • A baby may refuse to breast feed or bottle feed because the effort required to breathe inhibits her ability to eat.
  • An older child might experience difficulty talking.
  • Your child may appear anxious as she becomes “air hungry” or alternatively she might seem very tired, exhausted from the effort to breathe.
  • Your child is pale or blue at the lips.

In this video, the child uses extra chest muscles in order to breathe. He tries so hard to pull air into his lungs that his ribs stick out with each inhalation.  Try inhaling so that your own ribs stick out with every breath- you will notice it takes a lot of effort. 

 For those whose children have sensitive asthma lungs,  review our earlier asthma posts.  Understanding Asthma Part I explains asthma and lists common symptoms of asthma, including cough, and  Asthma Medicine Made Simple tells how to treat asthma, summarizes commonly used asthma medicine, and offers environmental changes to help control asthma symptoms.

Julie Kardos, MD and Naline Lai, MD
©2012, 2014, 2016 Two Peds in a Pod®

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teen hearing loss

photo from pixabay

Dr. Lai’s son practices his saxophone with headphones on, while Dr. Kardos’s son rarely remembers to protect his ears while practicing drums. While admirable that they both practice their instruments, guess which one is more at risk for hearing loss?

Sound is described by decibels (loudness) and by frequency (pitch) measured in hertz. An example of a high frequency sound is a person whispering. A very high frequency noise is the sound of a dog whistle. By thirty years old, almost everyone experiences some hearing loss at frequencies above 15 hertz. If you are this age, this is why everyone now seems to mumble at parties. A few years ago, teens capitalized on this natural hearing loss phenomenon with “mosquito” ringtones– high frequency cell phone rings heard only by younger ears but not by prying adult ears. For kicks, check out your ability to hear high frequencies at this non-scientific site.

Exposure to loud sounds at high decibels hastens the natural progression of high frequency hearing loss. The ringing in the ears after a loud concert or a day of weed-wacking is the “sound” of hearing loss occurring. Damage to the hearing nerve (cochlear nerve) in an ear can occur from a one time exposure to dangerously high decibels or from repetitive exposure over time.

What is the margin of safety?

  • Sounds above 85 decibels cause damage.
  • Those below 75 decibels rarely cause problems.
  • The humming of a refrigerator is 40 decibels.
  • Ordinary conversations are 60 decibels.
  • City traffic registers at 80 decibels.
  • Lawn mowers and hair dryers are around 90 decibels.
  • Firecrackers explode at 120-140 decibels.
  • After two minutes, exposure to rock concerts (which usually register at 110 decibels) may cause damage.
  • For lawn mowing, the permissible exposure time of exposure is some time between 2-4 hours.

This site gives maximum recommended lengths of time for exposure to loud sounds.

When we last published a post on teen hearing loss five years ago, there was concern that amongst teens, high frequency hearing loss was on the rise. Turns out this may not be the case, however, there is still concern that teens are putting themselves at risk for hearing loss from their frequent use of headsets and earbuds. Because of differences in ear buds and how music is recorded, there is no uniform way to regulate the volume reaching your teen’s ears. However, as a general rule of thumb, if you can hear your teen’s music playing when he has ear buds in, it’s too loud. Kids should be able to hear normal conversations even when their devices are on. Frequently asked questions about sound settings for Apple devices can be found at the Apple site. Encourage your kids to protect hearing by turning down the sound, and by using ear plugs or sound blocking headphones when appropriate.

Finally, we should mention signs of “selective hearing loss.” Many parents describe this form of “hearing loss” in the office. In these cases, a child does not hear her mom admonish “Clean your room,” yet hears her mom whisper “Let’s go out for ice cream.”

Even if your teen can hear, he may not listen!

Julie Kardos, MD and Naline Lai, MD
©2018 Two Peds in a Pod®

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flu symptoms

“Now what kind of soup did the doctor recommend? Was that tomato soup? Mushroom Barley?”

Headlines remind us daily that the US is officially in the midst of flu season. We are also in the midst of a really yucky cold season. We have seen numerous kids in our offices with bad colds and others with flu.

Parents ask us every day how they can tell if their child has the flu or just a common cold. While no method is fool proof, here are some typical differences:

The flu, caused by influenza virus, comes on suddenly and makes you feel as if you’ve been hit by a truck. Flu almost always causes fever of 101°F or higher and some respiratory symptoms such as runny nose, cough, or sore throat (many times, all three). Children, more often than adults, sometimes will vomit and have diarrhea along with their respiratory symptoms, but contrary to popular belief, there is no such thing as “stomach flu.” In addition to the usual respiratory symptoms, the flu causes body aches, headaches, and often the sensation of your eyes burning. The fever usually lasts 5-7 days. All symptoms come on at once; there is nothing gradual about coming down with the flu.

Colds, even really yucky ones, start out gradually. Think back to your last cold: first your throat felt scratchy or sore, then the next day your nose got stuffy or then started running profusely, then you developed a cough. Sometimes during a cold you get a fever for a few days. Sometimes you get hoarse and lose your voice. The same gradual progression of symptoms occurs in kids. In addition, kids often feel tired because of interrupted sleep from cough or nasal congestion. This tiredness leads to extra crankiness.

Usually kids still feel well enough to play and attend school with colds. The average length of a cold is 7-10 days although sometimes it takes two weeks or more for all coughing and nasal congestion to resolve.

Important news flash about mucus: the mucus from a cold can be thick, thin, clear, yellow, green, or white, and can change from one to the other, all in the same cold. The color of mucus does NOT tell you if your child needs an antibiotic and will not help you differentiate between a cold and the flu. Here’s a post on sinus infections vs. a cold.

Remember: colds = gradual and annoying. Flu = sudden and miserable.

If your child has a runny nose and cough, but is drinking well, playing well, sleeping well and does not have a fever and the symptoms have been around for a few days, the illness is unlikely to “turn into the flu.”

Fortunately, a vaccine against the flu is available for all kids over 6 months old (unfortunately, the vaccine isn’t effective in younger babies). This flu vaccine can prevent the misery of the flu. In addition, vaccines against influenza save lives by preventing flu-related complications such as pneumonia, encephalitis (brain infection), and severe dehydration. Even though we are starting to see a lot of flu, it is not too late to get the flu vaccine for your child, so please schedule a flu vaccine ASAP if your child has not yet received one for this season. Parents and caregivers should also immunize themselves- we all know how well a household functions when Mom or Dad have the flu… not very well! Sadly there have been 20 children so far this flu season who died from the flu. In past years many flu deaths were in kids who did not receive the flu vaccine, so please vaccinate your children against the flu if you have not already.

Be sure to read our article on ways to prevent colds and flu. As pediatricians, we remind you to WASH HANDS, make sure your child eats healthy, gets enough sleep, and avoid crowds, when possible. As moms, we add that you might want to cook up a pot of good old-fashioned chicken soup to have on hand in case illness strikes your family.

Julie Kardos, MD and Naline Lai, MD

©2018 Two Peds in a Pod®

 

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We wonder: do elephants get big ear infections?

“An ear infection,” we often hear parents say, “how can that be? I am so careful not to get water into her ear.”

Let us reassure you: parents do not cause ear infections. Germs cause infections. So please: no parent guilt!

When we doctors say “ear infections,” we usually refer to middle ear infections. Where exactly is the middle ear? When we look into the ear we peer down a tunnel called the ear canal. This part of the ear is considered the outer ear. At the end of the tunnel is a sealed door called the “ear drum” The medical term for ear drum is “tympanic membrane.” We’ll stick with “ear drum.” Behind the ear drum is the middle ear. As long as the ear drum (the door) leading into the middle ear is closed, water cannot enter the middle ear. Only if a child has ear tubes, or if the ear drum is ruptured, can water from a pool or bath enter the middle ear.

Now picture yourself opening the door and walking through to the middle ear. When you stand in the middle ear you will see tiny bones which help with hearing. The middle ear is the space that fills with fluid and gives you the uncomfortable sensation of pressure when you have a cold. It is the same space that gives you discomfort when you are descending in an airplane.

In the floor you will see a drain. This drain, called the Eustachian tube, helps drain fluid out of the middle ear. “Popping” your ears by swallowing opens this drain when you are descending on a flight. If fluid (usually from congestion from a cold or from allergies) sits long enough in the middle ear, it can become infected and the resulting pus causes pressure and pain. Sometimes the pressure becomes so great that it causes the ear drum to rupture and the painful infection will then drain out of the ear. Parents are often surprised to learn that this rupturing can occur both in untreated AND treated ear infections.

Beyond the middle ear is the inner ear, which houses nerves needed for hearing. Because children do not tend to get infections here, you may never hear about this part of the ear from your pediatrician (pun absolutely intended).

So, why do people talk about preventing ear infections by preventing water from getting into the ear? There is a type of ear infection called “swimmer’s ear,” formally known as “otitis externa,” which occurs in the outer ear. Swimmer’s ear usually results from a bacteria which grows in a damp environment. The water that causes this damp environment typically comes from a swimming pool, but can also come from lake, ocean, or even bath water. Swimmer’s ear can also be a result of anything that causes ear canal irritation such as eczema, hearing aids, or even beach sand. You can read more about this malady and it’s treatment and prevention here.

To summarize:

Ear infection = middle ear infection
Swimmer’s ear = outer ear infection
Cause of ear infections = germs

So, are you to blame for either type of ear infection? No, but there are associated factors which you can modify.

Wash hands to decrease spread of cold viruses.
Limit exposure to second hand smoke.
Give all vaccines on time – pneumococcal bacteria and the flu virus can cause ear infections–we have vaccines against these germs.
If your child suffers from allergies, talk to your child’s doctor about decreasing triggers in the environment and/or taking medications which might prevent middle ear fluid build-up from allergies.

Some kids who contract a lot of ear infection need help to stop further infections. Ear tubes, or “myringotomy” tubes,  promote middle ear fluid drainage before an infection occurs. Ear, nose, throat doctors (also known as ENTs or otolaryngologists) poke a hole in the ear drum leading to the middle ear and place a small tube in the hole. Through the myringotomy tubes, or “ear tubes,” fluid runs from the middle ear out into the outer ear canal before the fluid becomes infected. This drainage prevents middle ear infections from occurring.

To prevent swimmer’s ear, dry your children’s ears with a towel or blow gently with a hairdryer on cool setting after they are done swimming for the day.

We wrote this post because of the many questions we often hear about ear infections and ear anatomy. Hope the information wasn’t too eerie. Or is that EARie?

Naline Lai, MD and Julie Kardos, MD
©2018 Two Peds in a Pod®, updated from 2013

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earring“When can I have her ears pierced?” is a question I hear fairly often in the office. Usually, I hear this question from parents of young girls, so for this post the operative pronoun will be “she.”

There really isn’t one correct medical answer to this question. I have heard pediatricians tell patients to wait until after their babies receive their first tetanus vaccine (at two months of age) but I have never heard of a case of tetanus from ear piercing, at least not in the United States. But, I wouldn’t take a younger-than-two-month-old to the mall where strangers could infect her with germs.

And yes, the mall is where I send my patients for ear piercing. If I pierced 100 ears per day, than I would feel comfortable performing this procedure. If I pierce a set of ears once a month, I am hardly an expert. Just as I would refer your child to an Ear, Nose and Throat specialist for too many ear infections for further evaluation, I refer all ear piercing families to the mall where the experts use sterile technique many times daily and are in fact qualified experts.

That said, some pediatricians do pierce ears and pride themselves on delivering the art, as well as the science, of medicine. If your pediatrician likes to perform ear piercing in the office, then consider it a convenience as well as a safe practice.

So when is the best time to pierce ears? I suggest to parents that they may wish to wait until their daughter is old enough to decide for herself if she wants her ears pierced. Some parents want to pierce earlier. Either way, here are some tips and points to consider:

    • Piercing hurts. Take it from this pediatrician who was twenty-three (in medical school, after a really difficult neuroanatomy exam) when she had her ears pierced. It is fine to pre-medicate with ibuprofen (brand names Advil, Motrin) or acetaminophen (Tylenol). She will still feel the sting of piercing but the pain medicine may help prevent some of the throbbing which occurs afterwards.
    • Some of the same techniques used to help ameliorate the sting of vaccines can also help ameliorate the sting of ear piercing. Keep in mind, after the pain of piercing with the first ear, your child may balk at piercing the second.
    • Follow the instructions for ear cleaning. It takes around 6 weeks for the wounds to heal completely.
    • Avoid dangling earrings. They can get caught on clothing or bedding and also are a choking hazard because babies/toddlers can more easily pull out the earrings and then put them into their mouths. At recess a hoop earring can snag as a child runs.
    • Some kids are allergic to gold as well as nickel. If you notice the skin around the hole becoming red, itchy, or scaly, or swollen, your child is probably having an allergic reaction to metal. The only cure is to remove the earrings.
    • Avoid piercing the cartilage of an ear. Infections occurring in the cartilage tend to be more serious than in the lobe of the ear.

Warning: Pediatricians remove embedded earring backs on an all too frequent basis. Even years after a piercing, the skin on the back of an ear may overgrow.   This malady tends to occur in kids around eight years old or older when parents are no longer taking earrings out for their children. Check your child’s ears frequently to make sure the holes are clean and the earring parts are where they should be:  in the hole in the ear, not embedded in an earlobe. Watch out, an earring can look fine from the front and you may even be able to twirl it around, but the earring back may be burying itself into the skin.

Ear piercing for some families is cultural; for others, cosmetic. Piercing your child’s ears as a baby may lead to some interesting debates later about piercing other body parts. But that’s a topic for another post.

Julie Kardos, MD and Naline Lai, MD
©2018 Two Peds in a Pod®, updated from our prior post.

embedded earring back

Earring embedded in the back of an earlobe.

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new years resolutions

A lot of life’s issues boil down to the essentials…eat, sleep, drink, pee, poop, love and learn… for your child and yourself.  We are here to help you to carry out your parenting New Year’s resolutions in all of these areas.

1- Eat  Resolve to help your picky eater become less picky. Become more patient and creative in helping your children eat new foods.

2- Sleep Resolve to fix your child’s sleep problems. Help create a reasonable bedtime routine for your baby and end night time wakenings, and help your tired teen get better sleep.

3- Drink This year resolve to wean your toddler from the bottle/breast to a cup.

3- Pee Resolve to help your child avoid urine accidents and gain a better understanding of bed-wetting.

4- Poop For parents of newborns: resolve to help your gassy baby. For parents of toddlers: resolve to end the battle of the potty and encourage your child to potty train in a peaceful, non punitive and non-controlling way.  Help solve your child’s tendency to hold onto poop, which leads to constipation.

5- Love and Learn to understand your child’s developmental abilities in order to discipline appropriately and have reasonable expectations. Learn how and when to use “time out.”For your teen, learn how to talk with them. Help your child learn to “go it alone,” and calm test/school work anxiety.

As for us, we resolve to continue to be your source of dependable pediatric advice. We resolve to keep current with pediatric advances, remain honest, and treat your family with respect and care as we help you grow your children into confident, independent adults.

Wishing you health and peace in the New Year,
Drs. Kardos and Lai

©2018 Two Peds in a Pod®

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