The medicine cabinet inside your kitchen

You may not think of your kitchen as a convenient pharmacy, but parents used common kitchen items successfully to treat various maladies long before CVS and Walgreens were invented. 

Crisco– may not be healthy to eat, but smeared on skin, it’s an old fashioned but effective treatment for eczema or dry skin.

Oatmeal– crush and put into the end of a hosiery sock. Float in the bathtub for a natural way to moisturize skin.

Olive Oil– a couple drops into the ear three times a day will loosen ear wax (don’t put in if your child has a hole in their ear drum eg. myringotomy tubes). For cradle cap, rub into your baby’s scalp and use your fingernail or a soft brush to loosen the greasy flakes. Use to kill lice through suffocation.  Work the oil through the scalp, tuck hair into a shower cap and wash off in the morning. Although studies are unclear on how well this method works on lice, it certainly is worth a try.

White vinegar– dilute vinegar in water and soak feet to stop athlete’s foot. If swimmer’s ear is suspected, mix rubbing alcohol one to one with vinegar and drop a couple drops in the ear to stop the swimmer’s ear from progressing.

Ginger– boil ginger to make a tea to take the edge off nausea

Honey– shown to soothe coughs-give a teaspoon of dark (buckwheat, for example) honey three times a day. However, NEVER give honey to a child who is younger than one year of age because it may cause infant botulism

Lemon– an old singer’s trick—combine with honey in tea to alleviate hoarseness

 

Baking soda: Mix with water to make a paste to help soothe itchy skin, from maladies such as poison ivy . Can also be mixed with water to make toothpaste if you run out of your usual minty whitener.

 

Sugar: mix into weak tea (or your ginger tea from above) and give small amounts frequently to soothe your older child’s nausea and help rehydrate after vomiting.

 

Kitchen sink: excellent place to wash any cut, scrape, or bleeding wound under running water with soap. Also immediately after a burn, rinse the burned skin under cold water for several minutes to limit the extent of the heat injury. Contrary to popular lore, DO NOT put butter on a burn. You may, however, put butter on your toast. In small amounts.

 

Naline Lai, MD and Julie Kardos, MD

©2011 Two Peds in a Pod®

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February 15, 2011 by

How long do germs live?

I spent all day doing laundry. All right, maybe it wasn’t all day but it sure felt like it. Cleaning up after a vomiting child can be tough in the winter time. Unfortunately, it’s too cold to rinse off any sour curds outside. As I scraped off the sheets into the kitchen sink, I wondered how long the germs could live. I turned to my Disease Prevention Manager, Clare Edelmayer  at Doylestown Hospital, PA to find the answer.

She says depending on the germ and the surface it lands on, a germ can live for hours to days and sometimes months.

Most bacteria and viruses die within hours if they are outside the body. Surprisingly, survival does not depend on how deadly the germ is. For example, HIV virus in blood will die as soon as the blood dries outside the body.  However, some strains of flu viruses can survive 24-48 hours on non-porous surfaces such as your kitchen counter or on the handle of a plastic spoon and 2-8  hours on porous surfaces such as your toddler’s sleeve or on paper tissues. 

Methicillin Resistant Staphylococcal Aureus (MRSA), a bacteria which can cause skin infections filled with pus, stays alive for several hours to several days on surfaces.  Hepatitis B virus, a cause of liver disease, can stay viable on surfaces for 2 weeks or more, and the bloody-diarrhea producing Clostridium Difficile can live on surfaces up to 5 months. 

In other words, most germs die within hours, but don’t count on germs dying before they have a chance to enter your unsuspecting child’s mouth or nose. A dilute bleach solution works well to clean surfaces outside the body and of course, have your children frequently wash their hands.

The next time one of my kids throws up this winter, I’m tempted just to bury the sheets under the snow out back and fetch them in the spring.

Naline Lai, MD with Julie Kardos, MD
©2011 Two Peds in a Pod®

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February 9, 2011 by

When your child’s bedtime seems too late, or, will I ever get a late night alone with my spouse again?

A mom recently wrote to us about her grade school aged child’s bedtime creeping later while her wake up time stayed the same. She wondered how to reclaim the earlier bedtime.

Many parents notice as their kids get older, they seem to take longer to fall asleep at night or push their parents for a later bedtime. This trend is largely biological— the older kids get, the less sleep they need. Also as kids age, their body clocks naturally signal them to stay up later at night and sleep later in the morning. Sometimes children are worried about something and this stress prevents them from falling asleep. Parents should ask their kids what they think about while lying in bed at night. However, many times the child is just fine emotionally but begins shifting sleep patterns anyway.

According to sleep experts, adults function best on 7-8 or more hours of sleep per night. In kids and teens, a wide variation exists for how much sleep is sufficient for any individual. In general, if your child is easy to awaken in the morning, cheerful, able to concentrate during the day, easily completes school work and homework and is not having emotional outbursts, then she is sleeping enough. So, when your grade school child transitions from getting 11-12 hours of sleep per night to getting 10, if her days are still rosy, then this sleep shift is okay. Some people just don’t need very much sleep.

If your child needs more sleep, it’s tough to simply move his bedtime up earlier. To him, the sudden change will feel like he flew from California to New York. A gradual approach works best. Put your child to bed first very near the time that he is already falling asleep, even if that seems inappropriately late.

For instance, if your child won’t fall asleep until 11:00 pm, establish a soothing night time routine that ends with reading in bed or listening to soothing music for a few minutes, and turn out the lights out at 10:45 pm. Avoid television within an hour of sleep time because this can interfere with falling asleep. No matter how late he fell asleep, even on weekends, make sure he wakes up at the same time every morning. Once he falls asleep consistently within a few minutes of lights out, move the bedtime another fifteen minutes earlier.  Continue to do this until the daytime sleep-deprivation symptoms have resolved. A child may still need an alarm to wake up in the morning but if he is well rested, he should wake easily.

Be sure to limit or avoid caffeine (found in soda, tea, coffee, some sports drinks, and chocolate) because caffeine stays in the body 24 hours and hinders falling asleep. Also, make weekend sleep routines, including wake up times, as similar to weekdays as possible. If you allow a child to sleep until noon on Saturday and Sunday, he will never be able to fall asleep early on Sunday night and he will start the school week sleep deprived.

Time to end this post. I’ve got to go put my kids to bed. Sweet dreams.

Julie Kardos, MD and Naline Lai, MD
©2011 Two Peds in a Pod®

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February 5, 2011 by

Winter reminder: shovel well to avoid carbon monoxide poisoning

While much of the US is getting pummeled by the latest snow storm, we want to remind everyone to shovel out space around your home’s furnace vent. While some furnaces vent out of a home’s chimney, other vents are located just two feet off the ground on the side of the house. If these vents become blocked with snow, deadly carbon monoxide levels can build up inside the home.  Aim for three feet of snow clearance around the vents.


We thank Dr. Lai’s sister Melisa Lai, MD, toxicologist and emergency room physician in Boston who has treated patients with carbon monoxide poisoning, for reminding us of this winter storm hazard. For more about keeping safe from carbon monoxide, please see our earlier post on this subject.

Naline Lai, MD and Julie Kardos, MD
©2011 Two Peds in a Pod®

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February 2, 2011 by

Get moving: increasing your teen’s activity level

Have a teenage couch potato from January through March?  We all tend to decrease our activity level in the winter months. Physical Therapist Deb Stack gives us ideas to keep teens active.


Let’s face it, it’s hard to move when it’s cold and it’s freezing at my home.  I believe today’s high is 20 degrees Fahrenheit.  Now while this may not deter younger children from bundling up and going sledding, teen couch potatoes are busy whining that it’s “too cold.”  So there they sit.

 

What’s the secret to keeping them active in the winter months?  Have them schedule an activity, and be an example yourself.  Ideas for teens (and you) to do when it’s cold outside:

 

Have a 15-minute dance party

Have a Wii contest

Try swimming (indoors please!)

Dust off the treadmill or stationary bike in the basement and GET ON IT

Play ping-pong

Do a few chores

Jump rope

Jog during T.V. commercials

Pull out some “little kid games” such as hopscotch, hula-hoop or Twister

Let each child in your house choose an activity for everyone to try

 

Teens, like everyone else, need exercise to stay healthy.  Staff from the Mayo Clinic recommend kids ages 6-17 years should have one hour of moderate exercise each day.  Exercise can help improve mood (through the release of endorphins), improve sleep and therefore attention (critical with finals coming up), and improve cardiovascular endurance. Those spring sports really ARE just around the corner. 

 

Here are some numbers to get the kids moving:  All activities are based on 20 minutes and a teen who weighs 110 pounds.  The number of calories burned depends on weight.  If your teen weighs more, he will burn a few more calories, if he weighs less, he’ll burn a few less.  Below the table are links to some free and quick calorie calculators on the web so your teen can check it out for him self.  For those attached to their phones, there are web apps too.

 

ACTIVITY

CALORIES USED

Shooting Basketballs

75

Pickup Basketball game/practice

100

Biking on stationary bike

116

Dancing

75

Hopscotch

67

Ice Skating

116

Jogging in place

133

Juggling

67

Jumping Rope

166

Ping Pong

67

Rock Climbing

183

Running at 5 mph

133

Sledding

116

Treadmill at 4 mph

67

Vacuuming

58

 

 

What’s the worst that can happen?  You’ll have a more fit, better rested, and happier teen!  Or at least you’ll have a cleaner home!

 

Try these activity calculators:

 

http://primusweb.com/fitnesspartner/calculat.htm

www.caloriesperhour.com/index_burn.php

http://www.caloriecontrol.org/healthy-weight-tool-kit/lighten-up-and-get-moving

 

References:

www.mayoclinic.com/health/fitness/FL00030.   
www.caloriesperhour.com/index.burn.php

Deborah Stack, PT, DPT, PCS


Dr. Stack has been a physical therapist for over 15 years and heads The Pediatric Therapy Center of Bucks County in Pennsylvania www.buckscountypeds.com. She holds both masters and doctoral degrees in physical therapy from Thomas Jefferson University.

© 2011 Two Peds in a Pod®

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January 26, 2011 by

Waxing philosophically: ear wax and eew

Babies are gooey. Spew tends to dribble out of every orifice and the ear is no exception. Devin’s mother tipped her four month old baby’s head sideways in the office the other day and asked me what to do about the oily, yellow wax smeared around the opening of his ear canal.


 


Some say wax evolved to help keep bugs and other debris from reaching deep into our ear canals. Case in point: one of my least favorite memories during residency was when I picked out pieces of a cockroach entrapped in the wax of a child’s ear. The amount of wax you see on the outside is not indicative of the actual amount inside the ear canal. Chances are, the wax is not hard and does not block the ear drum.  Even if there is a large amount of wax, it is unlikely to greatly affect a baby’s hearing. Equally normal is that some babies and children don’t seem to produce any ear wax. If you are concerned about your child’s ear wax, have your pediatrician take a peek with a light. 


 


Despite the copious amount of wax on the outside, Devin’s ear canals were clear. “But the wax is simply disgusting,” said Devin’s mom, “Can I clean his ears? “


 


“Yes”, I answered. “Wipe off what you see, doesn’t matter if you use a wash cloth or cotton swab.  The special shaped cotton swabs with the safety tips are unnecessary. Anything you see is fair game.  Rest assured, you will not go too deeply into the ear canal if you only scrape off what is visible.” Dr. Kardos goes one step further and tells her patients: if you can get the wax with a wash cloth, it’s fair game. Otherwise, leave it alone.


 


Now suppose your pediatrician does say the wax should be removed. Place an over-the-counter solution such as Debrox in the ears (children and adults can use the same formulation) – three to four drops one or two times a day (during sleep is easiest for babies and toddlers) for a few days. The solution softens wax.  For maintenance, mineral oil and olive oil are favorite remedies. Place one drop daily in ears. In the office some pediatricians can use a water irrigation system (like a water squirter in your ear) to wash out the wax. The worst side effect is that the child’s shirt sometimes gets wet. Irrigation is a very effective for removing wax  in a school-aged or teenaged child who complains of difficulty hearing.


 


If you find you are constantly cleaning your baby’s waxy ears, take heart. At least there won’t be any roaches “bugging” them.


 


Naline Lai, MD with Julie Kardos, MD


©2011 Two Peds in a Pod®

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January 20, 2011 by

What? That’s not what we said: Real Simple Magazine

Take a look at the February 2011 issue of Real Simple magazine. We are two of the experts cited on page 124. The good news is that some of our thoughts on the essentials of a medicine cabinet were integrated into a photo-essay piece. The bad news is that children’s cough medicine is listed as a component of the medical cabinet.  While the other contributors to the piece may encourage use of over-the-counter cold and cough medications, we discourage use.

Of concern, safety and effectiveness of cough and cold medicine has never been fully demonstrated in children.  In fact, in 2007 an advisory panel including American Academy of Pediatrics physicians, Poison Control representatives, and Baltimore Department of Public Health representatives recommended to the U.S. Food and Drug Administration (FDA) to stop use of cold and cough medications under six years of age.

Thousands of  children under twelve years of age go to emergency rooms each year after over dosing on cough and cold medicines according to a 2008 study in Pediatrics . Having these medicines around the house increases the chances of accidental overdosing. Cold medications do not kill germs and will not help your child get better faster. Between 1985 and 2007, six studies showed cold medications didn’t have significant effect over placebo.  

So why are children’s cough and cold medicines still around? A year after the advisory panel published their recommendations, FDA advised  against using these medications in children younger than two years but data about these medications in older children is still rolling in.   FDA continues to advise caution with these medications. The producers of cold medicines said at that point they would launch new studies on the safety of medication for those two to twelve years of age. In the meantime pharmaceutical companies stopped manufacturing cold medicine products for those under two years of age and changed the labels to read “for four years old and above.”

Yes, watching your child suffer from a cold is tough. But why give something that doesn’t help her get better and has potential side effects?  There is plenty to do besides reach for cold medicine.  Give honey for her cough  if she is over one year of age. Run a cool mist humidifier in her bedroom, use saline nose spray or washes, have her take a shower with you, and teach her how to blow her nose. Break up that mucous by hydrating her well- give her a bit more than she normally drinks.

If you have young children and want to make your medicine cabinet truly “real simple” then take out the over the counter cough and cold medication. 

 

Naline Lai, MD and Julie Kardos, MD
©2011 Two Peds in a Pod®

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January 17, 2011 by

Closure: there is no link between the MMR vaccine and autism

It’s confirmed. Dr. Wakefield was a fraud. Recently, on January 5, 2011, reporter Brian Deer published a report in the British Medical Journal   exposing more flaws in the Wakefield study- the study which proposed a link between Measles, Mumps, and Rubella vaccine (MMR vaccine) and autism. Of note:

  • Lawyers who were trying to win a law suit for parents who believed that the MMR caused their children’s autism paid Wakefield to do the study.
  • Wakefield falsified his findings. The medical records of all 12 children in the study were inconsistent with Wakefields’s data.
  • Almost half of the children in the study already showed signs of developmental abnormalities before they received the MMR vaccine. Therefore, the MMR vaccine did not cause their disabilities.
  • Rather than randomly choosing the children for the study, Wakefield obtained most of his subjects through an anti-MMR campaign group.
  • Ten out of twelve other authors of Wakefield’s paper have withdrawn their support of the paper.

To read about the original study and the controversy around it, please see our earlier post, “Do vaccines cause autism?” For more information about how vaccines work, please read “How vaccines work.”  To learn signs of early communication delays in your infant, please see “How do I know if my baby has autism?”

Too bad it’s too late for some children. Since Wakefield published his paper, measles cases have steadily risen in the UK. Hopefully the damage caused by Wakefield’s 1998 paper will be mitigated by more parents who vaccinate their children.

Julie Kardos, MD with Naline Lai, MD

©2011 Two Peds in a Pod℠

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January 11, 2011 by