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The best way to check temperature in infants is rectally (You won’t hurt them. Their poop is bigger than the thermometer!). In older children, oral is best.
Fever is not the enemy! It is our body’s defense mechanism to fight infection. Therefore, you do not need to treat fever in most cases. If your child is very uncomfortable or in pain, then it is appropriate to treat.

You may treat fever with ibuprofen (Advil, Motrin) or acetaminophen (Tylenol). Dosing for acetaminophen every 4-6hrs. Dosing for ibuprofen is every 6-8hrs. Please follow the dosing amount and instructions on the medication label and call the office if you have any questions regarding dosage. To avoid dosing errors and toxicity, it is best to use one fever reducer rather than alternating between acetaminophen and ibuprofen.

Fever will not cause brain damage. Our body raises our temperature to fight infection, not itself. Brain damage and hyperthermia occur when outside forces, such as being left in a hot car, overwhelm our body’s ability to regulate its own temperature.

High fever does not cause seizures. Rapidly rising temperatures can. If your child has a high fever, he/she has likely already missed the window when a seizure typically occurs.

You do not need to wake your child up to check for or treat fever. Let your child rest! They need the fever and rest to help them get better.

Generally you do not need to take your child to the ER or clinic immediately when they start with fever. The most likely cause for fever is a viral illness and it should pass in 3-5 days. Exceptions are for fever in infants <3months old, children with focal complaints such as ear pain or sore throat, or children with lethargy, inconsolable irritability, dehydration, trouble breathing or other serious symptoms.

I am on a roasted veggie kick these days. Beets, sweet potatoes, Brussels sprouts, carrots, broccoli. You name it, it can probably be roasted. All you need is olive oil, salt, pepper, garlic, and lemon or spices depending on the vegetable. Throw it in on a baking sheet in the oven at 400 degrees for 20-30 minutes and you’re good to go. This is a great cooking method for working parents or families on the go with little time on their hands to prepare dinner. I love the ease of preparation and the flavors that develop in the food. Even my picky 5 and 2 year old sons have enjoyed eating their roasted veggies. I would have never thought my son would be cheering for roasted beets!

As a pediatrician, and health conscious mother, I am continually trying to discover ways for kids to eat their veggies and hopefully enjoy them. It is important to consider not only the variety of vegetables offered but also the various ways of serving them. Some like certain veggies cooked, others raw. If you want to cook them, you have several options – Steam, boil, roast, grill, sauté. Each cooking method gives the food a different flavor and texture. Try to experiment with what other flavors you can bring to the vegetables through seasoning. Options include lemon, cinnamon, nutmeg, garlic, paprika, salt, pepper, and various herbs. Check out Epicurious or other on-line recipe databases for lots of options.

There are other ways to make veggies more palatable. To boost flavor, consider cutting your vegetables into smaller pieces. This allows for a better seasoning to veggie ratio plus it looks less daunting to the apprehensive veggie eater. Kids get more excited about food when they actively participate in choosing, growing, and preparing it. Consider taking your family to a farmers market, my family loves the one at the Pearl, or growing your own vegetables in a home garden.

Finally, approach vegetables as a positive part of the meal instead of singling them out as an adversary to be conquered. Have fun in the kitchen experimenting with different flavors and cooking methods and you are bound to find at least one veggie your child may actually enjoy!

Golden Rules:
1) Do not rely solely on sunscreen to protect your child’s skin.
2) Children younger than 6 months should NOT be in direct sunlight.  Keep them under a canopy or UV sun shield/tent and not outside during the sun’s peak hours especially from 10 am to 4 pm.
3) Wear protective clothing when possible.  Loose clothing with a tight weave that blocks sunlight or UV rated swimwear is a great option.
4) Wear hats with wide brims to shield your face and neck.
5) Limit time spent in the sun mid day when the sun peaks especially from 10 am to 4 pm.
6) Wear sunglasses with a minimum of 99% UV protection.  They do make these in kid sizes, but they can be hard to find.
7) Wear sunscreen.  See below for details.

Sunscreens:
1) Use a “broad-spectrum” sunscreen that protects against both UVA (ultraviolet A) and UVB (ultraviolet B) light both of which can cause skin cancer, skin damage and premature aging.
2) Your sunscreen should have a minimum of a SPF (sun protection factor) 15.  SPF denotes the level of protection against UVB light.  UVB light is primarily responsible for sunburns.
3) Your sunscreen should have UVA light protection.  UVA light is deep penetrating and is the light responsible for tanning.  There has been a movement by the FDA to denote the amount of UVA protection in sunscreen via a star rating system.  As of April 2011 sunscreen manufacturers have still not included this on their product labels.
4) For sensitive areas like your child’s face, use a “blocking” product that contains zinc or titanium dioxide.  These are often opaque white, but many companies are now making a clear version.

Application:
1) Make sure your child is not allergic to new sunscreen by applying the new product to a small area prior to his/her first full day out in the sun.
2) Apply liberally all over your child’s body.  Do not miss his/her ears, face, neck, backs of knees, hands etc
3) Rub it in well.
4) Apply sunscreen 30 minutes prior to going outside.
5) Reapply sunscreen a minimum of every 2 hours and more frequently (every  hour) if swimming or sweating.

Resources:  What’s the best way to protect my child in the sun?  www.healthychildren.org

RSV is a virus that typically causes symptoms resembling the common cold,   including fever, runny nose, congestion, and cough. Children <2yrs old are at a higher risk of the infection causing bronchiolitis which involves wheezing and trouble breathing. The infection is easily spread from person to person from nasal or mouth secretions. The illness can last several days with the peak of symptoms commonly occurring around day 4.

Your child  should be seen by the doctor if he/she is

-showing signs of trouble breathing (grunting, using rib or abdominal muscles to breathe, nasal flaring, or fast breathing)

-fever in a child less than 3 months,

-or has signs of dehydration (dry mouth, decreased urine output, lethargy).

Because RSV is a virus, antibiotics are not helpful in treating the infection. The best treatments for RSV symptoms are nasal saline spray and suction, humidifier, and time. You can help prevent the spread of infection by good hand washing and proper disposal of tissues.

To learn more about RSV, visit http://www.healthychildren.org/English/health-issues/conditions/chest-lungs/Pages/Respiratory-Syncytial-Virus-RSV.aspx

The Way They Are
Children may have difficulty with learning and behavior for many reasons. However, the most common reason for children to underachieve and have difficult behavior is the presence of the developmental condition called Attention Deficit Hyperactivity Disorder or ADHD.

Children with ADHD demonstrate varying degrees of short attention span, impulsiveness, disorganization, and physical hyperactivity. These behaviors can interfere with the child’s academic achievement as well as his or her social adjustment.

Three primary developmental patterns define ADHD (or ADD). These are:

Disordered Attention Control
Disordered Impulse Control
Disordered Activity Control

A Common Thread
Common to all of these disruptive symptoms is a lack of organization and control. It is as if a traffic light at a very busy intersection has gone awry, jumbling the traffic into bizarre and disorganized patterns. In fact, something like this is what is happening in the mind of the child with ADHD

Underlying the inadequate control of activity, attention, and impulse is a dysfunction of the interior of the brain resulting in decreased mental organization. That part of the brain responsible for organizing, sequencing, and controlling mental activity is simply not working on a level appropriate for the child’s age. This underlying disorganization leads to a general inefficient approach to tasks. It is important to note that these difficulties have a physical basis; they are not simply the result of an emotional adjustment problem.

Functional Implications
All children with ADHD are not the same. Some have only focus problems but little problem with hyperactivity or impulsiveness. Others draw attention to themselves right away because of their high level of activity. All involved children do not experience the same problems when confronted with a task, but any given child will likely demonstrate some combination of the following difficulties:

short attention span,
distraction,
slow reaction time,
delayed motor speed,
difficulty in interpreting and responding to cues from other
people and the environment
slower response to reinforcement (i.e., discipline),
rapid mood changes with poor control of feelings,
poor self monitoring (they are not able to stop, look, listen or to anticipate
the consequences of their actions),
difficulty in sequencing: putting tasks, things, numbers, letters, etc., in order.

What Can I Do To Help?

Much Can Be Done
Can anything be done to help my child?
This is the question of most concern to parents. It is certainly the most important question. Fortunately, ADHD is not a desperate or hopeless situation. Much can be done to help the child function in a more healthy way at home and at school.
If you and or your child’s teacher have concerns regarding ADHD, the first step is to consult with your child’s pediatrician. A preliminary assessment can be made and a plan for evaluation and treatment can be made.

For further information on the diagnosis and management of ADHD, go to Dr. Grant’s website at http://adhdstrategiesunlimited.com/.