 ©Nemours Health Foundation Ear infections happen when infected fluid builds up in the space behind the ear drum (or tympanic membrane), called the middle ear. Fluid in the middle ear usually drains out the eustachian tubes, which connect the middle ear to the back of the nose. These tubes are soft tubes (like a sock with the toes cut off) rather than a hard tube (like a straw). Eustachian tubes open and let fluid drain from the middle ear when you move your jaw around talking or chewing, when you yawn, or when you hold your nose blow to “pop” your ears. If there is swelling or mucus around the opening of the eustachian tubes, like from allergies or a cold, the fluid can’t drain and will build up in the inner ear. If you have ever had a cold and felt like your ears were “stuffy” or your hearing was muffled, this is probably what was going on. Kids tend to get more fluid behind their ears than adults, because kids’ eustachian tubes are more horizontal. As people get older, their eustachian tubes get more vertical, which makes it easier for the fluid to drain.
A study was recently published in the Journal of the American Medical Association (JAMA) looking at unnecessary antibiotic prescription practices in different medical settings: doctors’ offices, emergency rooms, urgent care centers, and retail based clinics (clinics inside of stores like Walmart or CVS). Antibiotics are used to treat bacterial infections. The study found that nearly half (46%) of people seeking treatment in urgent care centers for viral illnesses like colds, flu, bronchitis/bronhiolitis, ear infections without pus behind the ear drum, and viral pneumonia and for things like asthma and allergies were prescribed antibiotics. That is nearly 3 times the rate of inappropriate prescription in medical offices (17%) and twice as high as emergency departments. Retail clinics actually had the lowest rate of inappropriate antibiotic prescriptions at 14%.
Have you seen headlines recently about a study showing that feeding babies at 3 months helps them sleep better at night? I have. The nonmedical press is not very good at reporting on medical studies and tends to put out sensational headlines with very little data. I was curious about this study, because this directly contradicts the recommendation to exclusively breastfeed for the first six months with no other foods introduced. I took a look at the original study, and here’s what I found.
It's that time of year again. School is out, so you have time to get your kids in for their check-ups and sports physicals. You have probably seen ads for sports physicals at urgent care clinics or group physicals run by local doctors offices. They seem convenient (and cheap!), but are they really the best thing for your kid?
Vitamin D regulates the amount of calcium and phosphorus in the blood and bones and is important for bone health. It’s also important in immune function and the regulation of inflammation. While it is found naturally in a few foods (like fatty fish), added to some foods (like milk), and available as a supplement, it is also made in the body through a process that’s triggered when sunlight strikes the skin. Because of the shallow angle of the sun in northern latitudes, we receive less sunlight here in Oregon to be able to make as much vitamin D naturally, especially in the months between November and April. Clothing and sunscreen use also decrease how much sunlight reaches the skin.
It’s summer again, so it’s a good time to talk about sunscreen. Kids and adults should be wearing sunscreen whenever they are outside. Choose a sunscreen that is at least SPF 30, is water resistant, and is labeled “broad spectrum” so it covers UVA rays (cause tanning, skin aging, and wrinkles) and UVB rays (cause sunburns and skin cancer). It takes about 15 minutes for sunscreen to absorb into the skin, so you should apply it before going outside to make sure the skin is protected as soon as it is exposed to the sun. I see lots of kids with sunscreen ON their skin but not rubbed INTO their skin. The sunscreen needs to be absorbed by the skin in order to do its job. Make sure you use enough! Most adults need about as much sunscreen as you can hold in the palm of your hand to cover their bodies. Decrease the amount accordingly for kids. Make sure you cover all exposed areas, including ears, the back of the neck, the hands, and the tops of the feet (I’ve had that sunburn before…ouch!). Lips can be protected by lip balm with at least SPF 15. Remember to reapply sunscreen every 2 hours when out in the sun, after swimming, and after sweating. Sunscreen can be used on babies as young as 6 months (don’t forget that bald, little head!). Younger babies should be protected from the sun with clothing and shade. Eyes can be protected with a hat or sunglasses.
I have seen a few interesting things online recently about online media. First was an article in the Washington Post about the problem of gaming addiction in kids, a problem estimated to occur in 5% of teens. The article discusses one family's struggle and talks about available resources. The best way to help kids with gaming is to help them learn to set limits. Keep screens (computers, TVs, game systems) out of bedrooms and in public areas of the house, so kids can be supervised while they play. Establish time limits in advance and keep them. Set a timer if you need one. Be firm. Be consistent. Your child might not like it, but you are helping them learn self-regulation.
Family meal (as many family members as possible sitting down to eat together with no screens on) are a frequent recommendation to parents. They benefit kids of all ages for different reasons, but they can be a challenge as kids get older.
The history of autism is a fascinating story told in Steven Silberman's book Neurotribes. While investigating things like the relationship between autism and Nazis, the history of autism parent groups, and the autism self-advocacy movement, he explores autism research and diagnoses and our understand of the cause of autism as these things have changed over the course of the 20th century and into the 21st century. Check out the book. Check out the TedTalk. Having a baby requires new parents to make a lot of decisions. For parents of baby boys, one of the first decisions is often whether or not to have your baby circumcised. Circumcision is an optional procedure where the foreskin of the penis is removed. When this is done in the newborn period, it is a much more minor and much less traumatic procedure than when it is done later in childhood or in adulthood. But is it necessary for penises to be circumcised at all?
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About the blogA look at some topics in breastfeeding, medicine, and kids health. Archives
December 2019
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