A:  Common warts are generally found on the hands but can occur anywhere.  They often start as just a small bump but can quickly increase in size.  They are generally firm with a rough surface and may have black pinpoint spots.  Plantar warts occur on the feet.  They are usually flat and resemble a callous. Both types can be painful if irritated.  A diagnosis by your pediatrician is recommended.

Q:  What causes warts, and are they contagious?

A:  Warts, both common and plantar, are caused by a virus.  Because of this, they can be spread directly from person to person or indirectly by touching a towel or piece of clothing that an infected person used.

Q:  How are warts treated?

A:  Warts will sometimes resolve without treatment. However, if they are spreading or cosmetically are an issue, treatment can be considered. Plantar warts can be more difficult to treat as they can extend up deep into the skin.  Many home remedies and over-the-counter treatments are available.  For common warts, duct tape can be applied over the wart for a week.  After a week, the tape should be reomved and the wart should be thoroughly soaked in warm water. After soaking, the surface should be scraped with an emery board, and then the tape can be reapplied.  This method can be used until the wart resolves. If you try an over-the-counter method, look for one the contains 17% salycilic acid. When using these products, make sure only the wart is treated, or chemical burns can occur on the healthy skin surrounding the wart.  Also, soak and scrape the warts before each treatment.  If at any time, the wart becomes painful or inflammed, treatment should stop until the symptoms resolve. 

If home or OTC methods are not successful or the warts reoccur, more intensive treatment is available at your pediatrician’s office.

Q:  How can I stop warts from spreading?

A:  If you have warts, don’t pick at them. If they are around the nails, don’t bite your fingernails or use the same nail clippers on nails with warts and healthy nails.

If you don’t have warts, wear flip flops in public showers.

The most likely cause of these common symptoms is a viral gastroenteritis, a virus affecting the stomach and GI tract. This is a viral illness that is often seen in children and adults at any time of the year.

Is this the illness that is prevented by the flu shot?

No, it is a common misconception that the “stomach flu” is the same as the seasonal influenza that we can get vaccinated against.

What are other common symptoms seen with viral gastroenteritis?

This illness will usually cause vomiting, diarrhea, nausea, abdominal pain and sometimes fevers. Some children will also experience headaches, lethargy, dizziness, and poor appetite.

How long should I expect this to last?

Viral gastroenteritis can last anywhere from 24 hours to 1 week.

How is this treated?

There are currently no medications that can successfully treat this illness. The goal in treating gastroenteritis is to effectively treat the symptoms involved. The most important thing to do is make sure you child drinks plenty of clear fluids and stay hydrated. A bland diet (sometimes referred to as the BRAT diet) should be followed until symptoms resolve. Good foods to offer your child while they are sick are toast, crackers, bananas, rice, jello, etc. You may also give you child the recommended dose of acetaminophen or ibuprofen for any fevers, headaches, or body aches. Foods to avoid are dairy products, sugary drinks, spicy and greasy foods.

When should we seek medical attention?

It is important to take your child to his or her pediatrician if there are any signs or symptoms of dehydration. A child may be dehydrated if they have a decrease in urinary output, dry mouth or lips, and/or dizziness. If there are any signs of dehydration or the symptoms are lasting longer than a few days then it’s a good idea to seek medical attention.

Frostbite occurs when there is an injury to the skin and underlying tissue that has been exposed to the cold for too long.

The most common areas include the hands, feet, nose, cheeks and ears. The symptoms of frostbite can include white and cold skin, numbness, a prickly sensation, stiffness, and possibly pain in the affected area. However, frostbite can also occur without any symptoms.

The best way to treat frostbite is to prevent it from happening. Tips for this include:

• Wear several layers of loose, warm clothing rather than one heavy tight garment. The best bottom layer is one that wicks moisture away from the skin.
• Wear a face mask and ear muffs.
• Wear mittens instead of gloves.
• Stay dry!
• Use the buddy system when in severe cold. Check each others faces for evidence of frostbite.
• Warm up frequently indoors.

If frostbite is suspected, rewarm the area gradually in warm water or with warm soaks for 20 minutes or until the area is unfrozen. Never use dry heat such as a fireplace or oven, and do not rub the area. Expect burning or prickly sensations which may require acetaminophen. If blisters, bruising, or swelling occur after rewarming, contact your pediatrician.

Have fun in the snow, and stay warm and dry!

Misconceptions about the dangers of fever are very common. Fever is a sign that the body is fighting an infection and is one of the body’s protective mechanisms. How high a fever is does not help the doctor to decide whether an infection is mild or severe or whether an infection is from a bacterial or viral illness. Here are some myths and facts regarding fever:

Myth:    If the fever is high, the cause is serious.

Fact:      If the fever is high, the cause may or may not be serious. If the child looks well but has a high temperature, for example, it is less concerning than a child who only has a mild fever but who appears sick or unresponsive. Some viral infections may have high fevers associated with them, and some serious bacterial infections may be associated with an abnormally low body temperature.

Myth:    Fevers cause brain damage, or fevers above 104 F are dangerous.

Fact:      Most fevers associated with infections are less than 108 F (42 C) yes, 108! These fevers do not cause brain damage.

Myth:    Low grade fevers are between 99 F and 100 F.

Fact:      These are normal variations.  An actual low grade fever is above 100 F to 102 F (>37.8-39 C).

Myth:    Anyone can have a seizure triggered by fever, and these seizures are harmful.

Fact:      Only 4 out of 100 kids can have a febrile seizure. They cause no permanent harm. Children who had febrile seizures do not have a greater risk for developmental delays, learning disabilities, or seizures without a fever.

Myth:    All fevers need to be treated with fever medicine, and without treatment, fevers will keep going higher.

Fact:      Fevers only need to be treated if your child is uncomfortable. Usually fevers don’t cause any discomfort until they go above 102 F. Fevers from infection usually top out at 103-104 F rarely going to 105-106 F, these are high fevers but again may be harmless ones.

Myth:    With treatment, fever should come down to normal, and if it doesn’t (if you “can’t break the fever”), the cause is serious.

Fact:      Fevers that don’t respond to fever medicine can be caused by viruses or bacteria. It doesn’t relate to the seriousness of the infection. With treatment, fevers usually come down 2 or 3 degrees.

Important points:

• If your child is less than 3 months old or your child is looking or acting very sick, your child needs immediate evaluation regardless how high the fever is.
• Fever is usually a sign that the body is fighting an infection.
• Your child’s exact temperature is less important than how your child looks and acts.
• To keep your child comfortable, keep your child lightly dressed, give extra fluids, and give acetaminophen or ibuprofen.
• To confirm that your child has a fever, use a thermometer to measure your child’s body temperature.
• Teething does not cause high fevers.

1. Always dress them appropriately for the colder weather. Children should always be wearing hats and gloves when outside in winter. Do not let your children outside to play or go sledding in extreme cold or snow for long periods of time.

2. Encourage your children to wash their hands frequently, especially when out shopping in stores and around family and friends during holiday get togethers. Washing hands will prevent germs from spreading and keep them from catching common illnesses.

3. Get your children vaccinated! Keep your kids free from the influenza by getting them the flu vaccine this winter.

4. Keep your fragile ornaments and decorations out of reach of children to prevent them from breaking and causing lacerations, burns, and other injuries.

5. Keep burning candles out of reach of children in order to prevent fires. All cords and holiday lights should be protected so that children cannot trip on them or cause electrical damage to themselves or the home. Lastly, keep space heaters away from blankets or other objects that may set on fire and keep children from accidently burning themselves on heaters.

6. Always keep the home at a warm and comfortable temperature in winter. It’s also a good idea to keep a humidifier running in your child’s room at night. Dry air will often cause bloody noses, nasal congestion, coughs, and other symptoms, which can be prevented if rooms are kept humidified.

7. Always keep driveways and sidewalks shoveled and salted to remove ice and prevent unnecessary falls and injuries.

8. Make sure your children aren’t overeating sweets, candies, junk food, etc. during the holiday time. Proper nutrition will help prevent illness and keep your child’s stomach from feeling upset.

9. Get plenty of rest! The holiday time can get very busy and children often don’t get as much sleep as usual, but it is important to try and get the proper amount of sleep in order to keep your children healthy during the busiest time of the year.

10. Make sure furnaces have been checked and carbon monoxide detectors are functioning properly. Many unnecessary deaths occur in winter from carbon monoxide poisoning.

Actually, this depends on both the parent and the child.  Parents need to plan on having extra time and attention to focus on the skill.  Half-hearted attempts produce half-hearted results.  So wait until you’re ready to give it your full attention!  As far as the age of your child, look for some or all of these signs to see if, developmentally, your child is able to successfully give up their diapers!

-          Is your child bothered by a wet or dirty diaper, and do they let you know when it needs to be changed?

-          Does your child show an interest in the potty chair or toilet?  Having one in each bathroom to let them explore and observe can help.

-          Is your child dry for longer than 2 hours at a time or wake up dry from a nap?

-          Can your child follow basic instructions?

-          Can they pull up and down pants and underwear?

Some of these signs are usually beginning between 18-24 months, but it is not uncommon for a child not to show interest in toilet training until 2 ½ – 3 years.

How do I start the task?

If, developmentally, your child seems ready, get rid of the diapers except for nighttime, and begin using underwear.  Plan to put them on the toilet several times a day and especially if they are squirming or giving other signs that they may need to go. You may also want to try after a meal or right after a nap when they should need to go.  Take time to sit with your child and read a book while you are expecting them to sit. Small rewards such as M & M’s or stickers after a success can go a long way in encouraging them.  Plan on accidents, and don’t make a big deal out of them.  Stay home for several days to allow for consistency.  If you try for 1-2 weeks and it’s not working, quit for several months and try again.  Remember, to my knowledge, no child goes to kindergarten in diapers so eventually it will happen!  Good Luck!

Children have been in school for a few weeks by the time this article is posted to our website. Some of the parents may have already have had calls, letters, and meetings with their child’s school as the child may be struggling to learn in school and possibly at home as well. Although the causes of learning difficulty/disability are numerous, the recent buzz is about Attention Deficit Disorder/Attention Deficit Hyperactivity Disorder.

ADD/ADHD is one of the most common neurobehavioral disorders of childhood. It is usually first diagnosed in childhood and often lasts into adulthood. Children with ADHD have trouble paying attention, controlling impulsive behaviors (may act without thinking about what the result will be), and in some cases, are overly active. It is normal for children to have trouble focusing and behaving at one or other times; but in children with ADHD, symptoms continue and can cause difficulty at school, at home, or with friends.

The cause(s) and risk factors for ADHD are largely unknown, but current research shows that genetics and family history play a strong role. Other known risk factors are brain injury, lead exposure, alcohol and tobacco use during pregnancy, premature birth, and low birth weight. Research does not support the popularly held views that ADHD is caused by eating too much sugar, watching too much television, parenting, or social and environmental factors such as poverty or family chaos. However, if present, all of the above might make symptoms worse, especially in certain children.

Deciding if a child has ADHD is a several step process. There is no single test to diagnose ADHD; and many other problems like anxiety, depression, and certain types of learning disabilities can have similar symptoms. One step of the process involves having a medical exam, including hearing and vision tests, to rule out other problems with symptoms like ADHD. An important part of the process also includes a checklist for rating ADHD symptoms and taking a history of the child from parents, teachers, and sometimes the child.

In most cases, ADHD is best treated with a combination of medication and behavior therapy. No single treatment is the answer for every child, and good treatment plans will include close monitoring and follow-ups. Some organizations that may provide information are CHADD and the National Institute of ADD. If families have questions about where to seek help, they should contact their child’s healthcare provider for further advice.

by Katie M. Bell, RPA-C

Q: How can I tell if my child is dealing with a case of head lice?

A: It is often very difficult to figure out if your child is affected by head lice but there are a few signs or symptoms that may let you know. Often, a child will complain that their head itches and you can actually see the tiny nits in the childs hair. When a case has been reported in your child’s classroom the school nurse will often do a full head check on all children to make sure it hasn’t spread to anyone else.

Q: Once I know my child has head lice how do I safely treat it?

A: The first and most important thing to do is get all nits removed from the childs head by carefully combing through their hair and removing what is there. There are several over the counter and prescription head lice shampoos but direction should be give by your doctor before using them on your child. Each member of the family should be carefully checked with a clean comb to find out which members of the family may need to be treated.

Q: What do I need to do in my house to prevent spread to others?

A: Any part of the home or school which has been in contact with head lice should be carefully cleaned to prevent spread to others. Vacuuming is the safest and best way to ensure removal of lice and fallen hairs with attached nits on furniture, rugs, etc. All bedding, linens, clothing, stuffed animals may also be placed in a drier for 30 minutes to ensure lice death.

Q: How can I prevent my child from getting head lice from another child at school?

A: Teaching your child not to share things which go around their head or hair is the most important way to prevent the spread of head lice. Children should not share hats, headbands, headphones, etc. Regular screening of children at home and in school helps detect any cases which will prevent the unknown spread of head lice.

Summer is finally here. Children are out of school and having fun, but soon it will be time to go back to school. Summer is also a time to catch up on your child’s immunizations.

When the issue is as important as the health of your loved ones, don’t be misled by unreliable sources in the media. The American Academy of Pediatrics and the Centers for Disease Control and Prevention agree that vaccines are safe and that they save lives.

Recent media attention that focused on unfounded claims of harm have caused parents to delay or skip vaccinations, and serious diseases including mumps, pertussis (whooping cough), and the measles have begun to re-emerge with deadly results. Vaccines have the most sophisticated safety tracking system in the world, and decades of research support the fact that vaccinations have been proven safe with no link to autism.

Vaccinations are extremely important in building and strengthening a child’s immune system. As of mid-June, more than 150 cases of measles have been reported from more than 25 states. Most cases have been linked to unvaccinated U.S. citizens traveling abroad, unvaccinated visitors in the United States, or unvaccinated children exposed to cases of diseases and then developing the disease themselves as they do not have the protection.

Summer is the perfect time to vaccinate children before the back-to-school rush begins. Vaccines that are needed and indicated for children school age and older are listed below:

•  Boosters of children 4 years and older – MMR, CHICKEN POX, POLIO, DTaP
• Catch up and immunizations for adolescents 11 years and older – Tdap, CHICKEN POX booster (if the child has not already received 2 doses), HPV, and Meningitis vaccine

Specific information about vaccination schedules and different vaccine indications can be found at the CDC and American Academy of Pediatrics web sites. Also, your child’s primary care provider is your local source for further information about these issues.

Finally, do not wait until the last minute to vaccinate to help you avoid the rush at clinics and doctor’s offices. It is even more important to re-focus as parents and as a nation to vaccinate and keep our children healthy and safe from vaccine preventable diseases that are re-emerging again.