Being Well 1204: Kids/Pediatrics


[music playing]
Lori:They’re the ones who raise the bar. The ones dedicated to providing care in the
most demanding of circumstances. The ones that understand the healing benefits
of kindness and compassion. They’re the people of Sarah Bush Lincoln,
and they set the bar high. Sarah Bush Lincoln, trusted, compassionate
care, right here, close to home. Male Voice:Carle is redefining healthcare
around you. Innovating new solutions, and offering all
levels of care, when and where you need it. Investing in technology and research to optimize
healthcare, Carle with Health Alliance, is always at the forefront to help you thrive. Rameen:
Meeting the ever changing in healthcare needs of our communities. Paris Community Hospital/Family Medical Center
is now Horizon Health, with the same ownership, management, providers and employees. Horizon Health provides patient care and promotes
wellness to the communities of East Central Illinois. Jeff:
At HSHS St. Anthony’s Memorial Hospital we are at work transforming heart care, rebuilding
knees and hips, delivering new generations, and focused on providing healthcare to you. We are HSHS St. Anthony’s Memorial Hospital. Ke’an:
Hi, I’m Ke’an Armstrong, your host for Being Well. I’d like to thank you for tuning in today. We’ve got a really interesting topic today. We’re talking all about kids and pediatrics. Today I have Dr. Mary Harvey with Sarah Bush
Lincoln. She’s a pediatrician. Thank you so much for joining me today. Mary:
Thanks. Thanks for having me. Ke’an:
Yeah, I’m really interested in this. It’s a great time of year to talk about kids. I mean, when isn’t, but especially summertime. So first of all, I’d like to ask you, how
did you get interested in pediatrics, and then we may go into some summer safety here. Mary:
Sure. Well, in medical school, your third year of
medical school, you go through different rotations. Pediatrics happened to be my last one and
I thought I was going to go into family practice, but I just enjoyed the pediatric rotation
so much that it convinced me, why wouldn’t I want to just do this for the rest of my
life? Ke’an:
Yeah, well lots of people out there turn to pediatricians for all kinds of answers and
hopefully that’s what we’re going to give our viewers today. Let’s talk about some summer safety, some
sun and pool safety and things like that. What are some helpful advice that you can
help us keep in the forefront of our minds when it comes to summer safety for kids? Mary:
Well, water safety is very important around pools, especially home pools, which may not
be as supervised as a public pool with lifeguards. It’s important to make sure that children,
and toddlers especially, are safeguarded and away from it, and if they’re ever at the pool,
they’re in protective wear. And it’s a very important skill for everyone,
especially children and babies to start getting comfortable with water and learn to swim,
so swim lessons are really important things for children to learn. Other summer topics, sun, sun burns. Sun protection with sunscreen and shading
is important not only to protect against burns, but for a lifetime of skin health. Damage to our skin actually builds up our
whole lives, so protecting children’s skin with sunscreen, and a SPF of 15 is fine, is
really important because whatever exposure and damage is happening to the melanin cells
are actually building up and building up and it’s a additive effect. It’s also important to reapply the sunscreen
every hour and a half to two hours. That’s more important than the SPF actually. Ke’an:
Really? Because I was going to ask you about that. There’s all kinds of numbers, like 15 to 50,
75, whatever it is. How do you know what to choose? So, 15 is okay just as long as you keep reapplying? Mary:
Right. The increment of protection you get, say between
15 and 30, 30 to 55, is really not that much. It kind of decreases just exponentially, but
water, handling, playing, all of that wears it off the skin, so reapplying it is actually
more important than going up on a SPF. You could go to a 60, but leaving it on for
three hours, you could still get a burn. If you had a SPF of 15 and you put it on an
hour later again, going to be better protected that way. Ke’an:
Well, and also when they’re in the pool or playing on any kind of water equipment or
outside water parks, different things like that, you just want to make sure you keep
applying it so it doesn’t wash off. Even if it does say waterproof, it’s probably
better to be sure, to put it on. Mary:
Exactly. Yep. It can come off with rubbing against toys,
and kids are wrestling and it comes off on hands, so yeah, it does need to go back on. Ke’an:
And probably also think about, I’m thinking, maybe hats or sunglasses, different things
like that, so not just sunscreen is important. Mary:
Right, right. Eyes are important, protect the retina, and
the hats are really good for shading. Years and years ago, there were some sunscreens
that contained a chemical that could have been absorbed into babies’ skin and was dangerous. That isn’t in products anymore. That was outlawed, so it’s actually safe to
apply sunscreen to a baby who is less than six months old. So that’s kind of gone by the wayside that
you shouldn’t apply sunscreen to babies six months and younger, but they’re still very
sensitive to the sun, so the best thing is keeping them shaded and out of the sun altogether. Ke’an:
Okay. Mary:
Hats, under a roof, umbrella- Ke’an:
Or those rash guards, like the shirts that they can swim in now too. Mary:
Yeah, yeah. Ke’an:
Hey, you brought up something just a minute ago when you were talking about chemicals
in sunscreen. What about protecting kids from bug bites
and things like that? Give us some tips on maybe how to protect
kids from insects. Mary:
Well, there are sprays and that’s probably the most effective as far as keeping bugs
from biting. Some people just happen to be more naturally
prone to attracting insect bites than others. Ke’an:
And those darn mosquitoes. Mary:
Yeah, so really the avoidance. The best thing would be a spray, unfortunately,
and you hate to think of putting chemicals on, but you got to weight your- Ke’an:
Right, yeah, I understand. Mary:
… advantages, disadvantages. Most of the time, insect bites are harmless
and just annoying, but sometimes they can get infected, especially if they’re particularly
itchy and get scratched with a dirty finger and open up a wound where a germ can get in. It can seed an infection. So when there are insect bites, it’s important
for parents and caretakers to look at the bite regularly, make sure they’re not noticing
any pus or increasing redness over the course of days. Ke’an:
Okay. What about a bee sting or wasp sting? What’s the best thing for an adult to do if
a child gets stung? What’s something they should do first? Mary:
The first thing to do if a child’s not allergic to that, because there are people who have
anaphylactic reactions to those sort of things, but if it’s just a local reaction, sometimes
just ice to soothe it, or a cool washcloth can be helpful. Ke’an:
Okay, and then just let time take its course? Mary:
Yeah. Yeah. I wish there was more that you could just
do to erase the pain, but yeah. It’s usually acute severe pain and then it
gets better with a little bit of time, sometimes quicker than actually a pain reliever like
a ibuprofen or acetaminophen could do. So it’s not always worth treating them. If a child is anaphylactic, and does have
reactions, it’s, of course, always important to have an EpiPen available. So to travel with a child, and sometimes that’s
hard to remember in the summer, because they’re not in their structured school environment
where it might be at the school office or whatever, so we should- Ke’an:
Right. I don’t go anywhere without a first aid kit. I think it’s important because a lot of times
if you’re at the playground or somewhere where there’s kids who are playing and having activities
that someone’s going to get scratched or hurt or something, and it’s just good to keep on
hand, I think. Mary:
Yeah. Yeah. And if there is a insect bite or a scratch
or a scrape, cleaning the wound is a good first step too. So clean it, make sure that there isn’t any
dirt or germs that are going to get into it, and then after that, maybe an antiseptic cream
and cooling it off. Well, topically. Ke’an:
All right. Hey, during the spring and fall, there’s a
lot of times where kids have allergies and different things like that. How do you know if it’s something that’s triggering
an allergy versus a cold or a virus or something going on? Give us some tips on that one. Mary:
Well, I think of having a fever is a differentiating symptom. With allergies, you shouldn’t have a fever. A lot of the other symptoms can be the same:
congestion, runny nose, runny eyes, cough even. And those things are annoying, but they’re
not dangerous. And even if a child has a fever with all of
that, it may just be a viral infection, which again, is not dangerous, but sometimes it’s
worth getting checked out to make sure it didn’t seed any deeper and lead to an ear
infection or worse, say a pneumonia or something like that. But a fever is probably the point at which
I would consider it a illness rather than a allergy, like a more contagious illness. Ke’an:
Okay. People you hear sometimes are, I don’t know,
hesitant sometimes to give medications to children or you hear a lot about vaccinations
and things like that these days. What do you tell parents about antibiotics
or over-the-counter medicines or vaccinations? Let’s cover some of that a little bit. Mary:
Sure. Well, over-the-counter medications, there
aren’t a lot of over-counter medications that are very useful for kids. Cough and cold medications really sometimes
can actually make kids feel worse than they do better. For adults, sometimes they can mask symptoms
enough so that it’s easier to go to work and not sound stuffy or … But for kids, that’s
probably not as bad as maybe the jitteriness they might get or stomachache they might get
from cough and cold medicine, so I’m not a big proponent of those. Acetaminophen, ibuprofen, those are pain and
fever reducers, and I think it’s fine to use those when needed, whether there’s a fever
or pain. A fever itself isn’t dangerous, but it’s important
to note because it is a symptom to kind of add on to other symptoms when taking an illness
into consideration. However, anybody who’s got a fever, whether
it’s a child or adult, is going to feel crummy, so bringing the fever down is nice so that
they feel a little bit better- Ke’an:
Right. You don’t want to feel like that. Mary:
… and you want them to drink fluids and stay hydrated- Ke’an:
That’s important. Mary:
… so it’s easier to do that if you’re not feverish. As far as the antibiotics go, there has been
a tendency for antibiotic overuse over the last many decades. Antibiotics are good when they’re needed and
bad when they’re not, so it’s important that they’re prescribed appropriately. Antibiotics won’t work on all illnesses. Viruses do not respond to antibiotics because
they’re not bacteria. Antibiotics specifically kill bacteria, and
not all antibiotics work on all bacteria, so it’s important to be aware of that and
know that if a physician’s prescribing an antibiotic, it should be for something real
specific, which would be like a bacterial illness, whether it’s strep or pneumonia that
we would suspect as being caused by a bacteria. Ke’an:
All right. What about vaccinations and maybe school readiness
too? Can you talk about what needs to be done,
what parents need to keep in mind, either at the ages that kids need them or also what
they need to prepare if their child’s getting ready for school? Mary:
Sure. As far as school, before kindergarten, there’s
some vaccines that are required by the state, and prior to that, infant vaccines would have
brought them up to date where there might be a couple of years before the child’s had
immunizations. Although we do recommend even for babies,
six months old and older, that they get flu shots every year. Those are very important. Vaccines are safe and there are vaccines given
at kindergarten. As far as the next round of required vaccinations
by the state, it doesn’t come around until sixth grade, so there’s a pretty big gap in
there of when the required immunizations come around. And again, that’s not including the flu shot. That’s every year. At sixth grade there are some, even in kindergarten
and earlier, there are some immunizations that are available that aren’t required. That doesn’t mean that it’s not a good idea
to do them. Immunizations are very safe, and if you could
protect your child from an illness, why wouldn’t you? I mean, before kindergarten we offer Hepatitis
A vaccine. That’s not required by state or government
officials and may never be, I don’t know if that’s coming down the pipeline as far as
legislation. Once girls and boys get to be 11 years old,
we offer an HPV vaccine, which is not required. Again, it’s a very, very great vaccine, as
it protects against a lot of cancers. Why wouldn’t one want to protect your child? Ke’an:
Right. Right. Think ahead. Mary:
Yeah. Ke’an:
So let me ask you, you’re talking about different guidelines and things like this, kids are
on the screen so many hours, it seems like, if you don’t monitor that. What is the guidelines for screen time versus
physical activity, and summertime versus school time and things like that? How do you balance all of that? What’s your tips? Mary:
Well, that’s a good question. The American Academy of Pediatrics just recently,
I think a couple months ago, published some pretty clear-cut guidelines. Really, six months and younger shouldn’t have
any screen time. And as far as up to 18 months, really, it
should very, very specifically educational, and not more than a half hour. Ke’an:
Okay. And why is that, I guess? Explain why that is. Why do they have these guidelines in place? Is there things that affect the child if they
have too much screen time? Mary:
Yeah, they basically are not interacting. They’re not using back-and-forth communication. They’re not physically active during that
time. It’s sort of just occupying them without using
any skills that they need to develop, like reading, or when they’re playing outside or
playing in the house, they’re manipulating, say, toys or blocks, and developing skills. And those are windows of opportunity lost
if they are wasting time just staring at a screen. Ke’an:
Right. It can be helpful. Here we are, a PBS station, and we offer PBS
Kids and educational activities, but we always say, “Watch it and then turn it off and do
something about what you just watched. Read a book, do an activity so you’re not
having too much screen time.” Mary:
Absolutely. And then, even younger than middle school,
a lot of schoolwork requires online investigation, studying, reading something related to a video
or a search. So we can’t say that you can erase all screen
time because that’s not realistic, but there is a difference in the quality of screen time. I mean, social media doesn’t offer much, and
there’ve been studies to show that it’s actually kind of a negative impact on middle school
and high school kids. But there are a lot of academic things online
that, and even on the phone that can help and are useful for school too. Ke’an:
Right. Mary:
But going more than a couple hours a day probably is going beyond what is useful. Ke’an:
Yeah, just kind of limit the time, make sure that you’re keeping mindful of the time, and
it’s best probably for adults to stay off their phone a little bit more too. Mary:
Right. Ke’an:
Right. Yup. Mary:
Yup, and keeping the quality high. Ke’an:
There you go. There you go. Hey, a topic that I think of often because
my son is a very picky eater, what do you suggest for some of these kids that maybe
don’t want to eat meat, or they’re like, “Ew, I don’t like the texture of that. I’m not eating anything with sauce.” Give us some helpful information on how to
help our kids have a balanced diet. Mary:
That’s a good question, very broad. I guess I would start when children are very
young and starting to eat, it’s important to offer a lot of different flavors and textures
so that children are more exposed to different types of food, and it’s not something new
and they’ve already maybe established some likes. So at an early age through toddlerhood, offering
wide variety of options is good. It’s important to know that kids aren’t always
hungry when we’re hungry. As adults, we tend to be hungry more often
and we’ll eat three full meals a day, sometimes with snacks in between, whereas children and
toddlers especially may just snack. So, it’s important to make sure that the food
that’s being offered during those snacks is healthy food. Don’t give in and say, “Oh, oh, she’ll take
a cookie.” I wouldn’t go there. Just offer fresh fruits, vegetables, cheese. If those are going to be the snacks … I
mean, if there’s going to be snacks, make sure that the snacks are what you would want
the meal to be. Ke’an:
Okay. What about drinks and soda drinks, juices,
things like that? What do you … Mary:
That’s a good question too. Really, water is super important. It’s the healthiest thing we can drink. The sugar that’s in juices or in sodas is
not good. It’s just not nutritionally valuable. So surprisingly, juices don’t offer much,
and skipping them altogether isn’t a bad idea. Toddlers shouldn’t have more than 24 ounces
of milk in a day because sometimes that can lead to problems. But other than milk and water, there really
isn’t anything else that’s really healthy to drink. Ke’an:
All right. Stay hydrated. Mary:
Yeah, stay hydrated, drink enough water, and every now and then for a little treat, juice
is okay, or a soda occasionally. But as far as mainstay of staying hydrated,
water is the best option. Ke’an:
Limit the sugar. Mary:
Yes. Ke’an:
Yeah. Well, not only for hyperactivity, but also
to do their body good. Mary:
Yeah, free sugar just really hasn’t been proven to help us with anything nutritionally except
for in cases of emergency. But yeah, the more complicated the carbohydrate
is the healthier it is, and sugar is about the least. Ke’an:
Right, yeah, for all of us. Mary:
Yeah. Ke’an:
Hey, you hear about kids getting ear tubes a lot lately. A lot, I guess, because I mean, I don’t know
if it’s just colds and things that lead to it and ear infections, if it’s allergies. What can you tell us about ear tubes, how
to know when it’s just a minor ear infection, when to take them to the doctor, what to do
about ear issues? Mary:
Well, ear tubes are a surgical procedure where a tiny tube’s inserted into ear drum itself,
way deep inside the ear. Now, what that does is it just creates an
air flow between the back of our throat and the external ear so that fluid can’t build
in the middle ear. Ear infections come from when there’s fluid
building in the middle ear, which is really deep inside of our ear, behind the eardrum,
and it’s trapped in there. And it’s a wet, warm place, whether it’s mucus
from a cold that starts it. What happens is the bacteria can get in there,
white blood cells get in there, and it basically turns into an abscess. We try to treat that with antibiotics, but
sometimes it doesn’t work. If it goes on for weeks and weeks and we’ve
switched up antibiotics, that might be an appropriate time to go to the surgical route
and have a tube placed. More often it’s recurrent ear infections where
a child may have, say, three or four in one season, we think about tubes at that point,
or six in a year. Those are sort of the guidelines we use of
when a surgical tube placement might be appropriate, which in that case we would refer the child
to an ear, nose and throat doctor to do that. Ke’an:
Okay. So if they are having recurrent ear infections,
that’s more often the time to look into? Mary:
Yes. Yep. And there are specific number guidelines on
how often and when, so during one season if it’s three ear infections, or if it’s one
year and it’s six ear infections or more, that’s usually the recommended guideline to
follow. Ke’an:
Yeah, and you don’t want your child to suffer. That’s painful. They don’t feel good, things like that. Mary:
Yeah. Ke’an:
Good to keep in mind if they do have ear tubes, what about being in the water, in the pool,
and things like that? Mary:
That’s a good question, and actually there it’s a controversial thing whether water should
be in there or not. Some ear, nose and throat physicians will
recommend plugs, others don’t. Ke’an:
Okay. Mary:
So that’s a difficult one to answer. I’d say just follow the guidelines that your
specific ENT gives you. Ke’an:
All right. All right, well, hey, we have covered so many
topics today. I’m sure there’s lots more to cover when it
comes to kids and you get asked all kinds of things in the office, but it’s been very
informative, very helpful. I want to thank you so much for being on today’s
episode. Mary:
Well, thanks for having me on. Ke’an:
Absolutely. So once again, we had Dr. Mary Harvey with
Sarah Bush Lincoln, a pediatrician. Lots of helpful tips today. We want to thank you for watching, and we’ll
see you next week. Jeff:
At HSHS St. Anthony’s Memorial Hospital we are at work transforming heart care, rebuilding
knees and hips, delivering new generations, and focused on providing healthcare to you. We are HSHS St. Anthony’s Memorial Hospital. Rameen:
Meeting the ever changing in healthcare needs of our communities. Paris Community Hospital/Family Medical Center
is now Horizon Health, with the same ownership, management, providers and employees. Horizon Health provides patient care and promotes
wellness to the communities of East Central Illinois. Male Voice:Carle is redefining healthcare
around you. Innovating new solutions, and offering all
levels of care, when and where you need it. Investing in technology and research to optimize
healthcare, Carle with Health Alliance, is always at the forefront to help you thrive. Lori:They’re the ones who raise the bar. The ones dedicated to providing care in the
most demanding of circumstances. The ones that understand the healing benefits
of kindness and compassion. They’re the people of Sarah Bush Lincoln,
and they set the bar high. Sarah Bush Lincoln, trusted, compassionate
care, right here, close to home. [music playing]

1 thought on “Being Well 1204: Kids/Pediatrics

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