Just as adults need to see their physician at least once a year for a wellness visit, so do children. You wouldn’t hesitate to take them if they are sick, but it’s just as beneficial to take them when they are not. It’s a way to be sure your child is developing according to certain benchmarks and that there are no medical or developmental issues. If this is news to you, here is what to expect during your child’s well-child visit.

Continue reading “What To Expect During Your Child’s Well-Child Visit” →

Eruption Charts

Teeth vary in size, shape and their location in the jaws. These differences enable teeth to work together to help you chew, speak and smile. They also help give your face its shape and form. At birth people usually have 20 primary (baby) teeth, which often erupt about 6 months of age. They are then shed at various times throughout childhood. By age 21, all 32 of the permanent teeth have usually erupted.

View the following eruption charts:

• Primary Teeth Eruption Charts
• Dental Advice and Care Guide

Baby Teeth

A child’s primary teeth, sometimes called “baby teeth,” are as important as the permanent adult teeth.

When Do Baby Teeth Come In?
A baby’s 20 primary teeth are already present in the jaws at birth and typically begin to appear when a baby is between 6 months and 1 year.

Check out this baby teeth eruption chart to see the order in which teeth break through and at what ages you can expect specific teeth to appear.

When teeth first come in, some babies may have sore or tender gums. Gently rubbing your child’s gums with a clean finger, a small, cool spoon or a wet gauze pad can be soothing. You can also give the baby a clean teething ring to chew on. If your child is still cranky and in pain, consult your dentist or physician. Most children have a full set of 20 primary teeth by the time they are 3.

Why Baby Teeth Matter
Not only do primary teeth help children chew and speak, they also hold space in the jaws for permanent teeth that are growing under the gums. When a baby tooth is lost too early, the permanent teeth can drift into the empty space and make it difficult for other adult teeth to find room when they come in. This can make teeth crooked or crowded. That’s why starting infants off with good oral care can help protect their teeth for decades to come.

When Should I Start Taking My Child to the Dentist?
The ADA recommends that a dentist examine a child within six months after the first tooth comes in and no later than the first birthday. A dental visit at an early age is a “well-baby checkup” for the teeth. Besides checking for tooth decay and other problems, the dentist can show you how to clean the child’s teeth properly and how to evaluate any adverse habits such as thumbsucking.

How to Care for Your Child’s Teeth
It’s important to care for your baby’s teeth from the start. Here’s what to do:

Begin cleaning your baby’s mouth during the first few days after birth by wiping the gums with a clean, moist gauze pad or washcloth. As soon as teeth appear, decay can occur. A baby’s front four teeth usually push through the gums at about 6 months of age, although some children don’t have their first tooth until 12 or 14 months.
For children younger than 3 years, caregivers should begin brushing children’s teeth as soon as they begin to come into the mouth by using fluoride toothpaste in an amount no more than a smear or the size of a grain of rice. Brush teeth thoroughly twice per day (morning and night) or as directed by a dentist or physician. Supervise children’s brushing to ensure that they use of the appropriate amount of toothpaste.
For children 3 to 6 years of age, use a pea-sized amount of fluoride toothpaste. Brush teeth thoroughly twice per day (morning and night) or as directed by a dentist or physician. Supervise children’s brushing and remind them not to swallow the toothpaste.
Until you’re comfortable that your child can brush on his or her own, continue to brush your child’s teeth twice a day with a child-size toothbrush and a pea-sized amount of fluoride toothpaste. When your child has two teeth that touch, you should begin flossing their teeth daily.

Holiday Safety & Mental Health Tips

The holidays are an exciting time of year for kids, and to help ensure they have a safe holiday season, here are some tips from the American Academy of Pediatrics (AAP).

TREES
When purchasing an artificial tree, look for the label “Fire Resistant.”
When purchasing a live tree, check for freshness. A fresh tree is green, needles are hard to pull from branches and needles do not break when bent between your fingers. The trunk butt of a fresh tree is sticky with resin, and when tapped on the ground, the tree should not lose many needles.
When setting up a tree at home, place it away from fireplaces, radiators or portable heaters. Place the tree out of the way of traffic and do not block doorways.
Cut a few inches off the trunk of your tree to expose the fresh wood. This allows for better water absorption and will help keep your tree from drying out and becoming a fire hazard.
Be sure to keep the stand filled with water, because heated rooms can dry live trees out rapidly.
LIGHTS
Check all tree lights (even if you’ve just purchased them) before hanging them on your tree. Make sure all the bulbs work and that there are no frayed wires, broken sockets or loose connections.
Never use electric lights on a metallic tree. The tree can become charged with electricity from faulty lights, and a person touching a branch could be electrocuted.
Some light stands may contain lead in the bulb sockets and wire coating, sometimes in high amounts. Make sure your lights are out of reach of young children who might try to mouth them, and wash your hands after handling them.
Before using lights outdoors, check labels to be sure they have been certified for outdoor use. To hold lights in place, string them through hooks or insulated staples, not nails or tacks. Never pull or tug lights to remove them.
Plug all outdoor electric decorations into circuits with ground fault circuit interrupters to avoid potential shocks.
Turn off all lights when you go to bed or leave the house. The lights could short out and start a fire.
DECORATIONS
Use only non-combustible or flame-resistant materials to trim a tree. Choose tinsel or artificial icicles of plastic or nonleaded metals.
Never use lighted candles on a tree or near other evergreens. Always use non-flammable holders, and place candles where they will not be knocked over.
In homes with small children, take special care to avoid decorations that are sharp or breakable. Keep trimmings with small removable parts out of the reach of children to prevent them from swallowing or inhaling small pieces. Avoid trimmings that resemble candy or food that may tempt a young child to eat them.
Wear gloves to avoid eye and skin irritation while decorating with spun glass “angel hair.” Follow container directions carefully to avoid lung irritation while decorating with artificial snow sprays.
Remove all wrapping papers, bags, paper, ribbons and bows from tree and fireplace areas after gifts are opened. These items can pose suffocation and choking hazards to a small child or can cause a fire if near flame.
Keep potentially poisonous holiday plant decorations, including mistletoe berries, Jerusalem cherry, and holly berry, away from children.
TOY SAFETY
Select toys to suit the age, abilities, skills and interest level of the intended child. Toys too advanced may pose safety hazards for younger children.
Before buying a toy or allowing your child to play with a toy that he has received as a gift, read the instructions carefully.
To prevent both burns and electrical shocks, don’t give young children (under age 10) a toy that must be plugged into an electrical outlet. Instead, buy toys that are battery-operated.
Young children can choke on small parts contained in toys or games. Government regulations specify that toys for children under age three cannot have parts less than 1 1/4 inches in diameter and 2 1/4 inches long.
Children can have serious stomach and intestinal problems – including death — after swallowing button batteries or magnets. In addition to toys, button batteries are often found in musical greeting cards, remote controls, hearing aids and other small electronics. Small, powerful magnets are present in many homes as part of building toy sets. Keep button batteries and magnets away from young children and call your health care provider immediately if your child swallows one.
Children can choke or suffocate on uninflated or broken balloons; do not allow children under age 8 to play with them.
Remove tags, strings, and ribbons from toys before giving them to young children.
Watch for pull toys with strings that are more than 12 inches in length. They could be a strangulation hazard for babies.
Parents should store toys in a designated location, such as on a shelf or in a toy chest, and keep older kids’ toys away from young children.
FOOD SAFETY
Bacteria are often present in raw foods. Fully cook meats and poultry, and thoroughly wash raw vegetables and fruits.
Be sure to keep hot liquids and food away from the edges of counters and tables, where they can be easily knocked over by a young child’s exploring hands. Be sure that young children cannot access microwave ovens.
Wash your hands frequently, and make sure your children do the same.
Never put a spoon used to taste food back into food without washing it.
Always keep raw foods and cooked foods separately, and use separate utensils when preparing them.
Always thaw meat in the refrigerator, never on the countertop.
Foods that require refrigeration should never be left at room temperature for more than two hours.
HAPPY VISITING
Clean up immediately after a holiday party. A toddler could rise early and choke on leftover food or come in contact with alcohol or tobacco.
Remember that the homes you visit may not be childproofed. Keep an eye out for danger spots like unlocked cabinets, unattended purses, accessible cleaning or laundry products, stairways, or hot radiators.
Keep a list with all of the important phone numbers you or a baby-sitter are likely to need in case of an emergency. Include the police and fire department, your pediatrician and the national Poison Help Line, 1-800-222-1222. Laminating the list will prevent it from being torn or damaged by accidental spills.
Always make sure your child rides in an appropriate car seat, booster seat, or seat belt. In cold weather, children in car seats should wear thin layers with a blanket over the top of the harness straps if needed, not a thick coat or snowsuit. Adults should buckle up too, and drivers should never be under the influence of alcohol or drugs.
Traveling, visiting family members, getting presents, shopping, etc., can all increase yourchild’s stress levels. Trying to stick to your child’s usual routines, including sleep schedules and timing of naps, can help you and your child enjoy the holidays and reduce stress.
FIREPLACES
Before lighting any fire, remove all greens, boughs, papers, and other decorations from fireplace area. Check to see that the flue is open.
Use care with “fire salts,” which produce colored flames when thrown on wood fires. They contain heavy metals that can cause intense gastrointestinal irritation and vomiting if eaten. Keep them away from children.
Do not burn gift wrap paper in the fireplace. A flash fire may result as wrappings ignite suddenly and burn intensely.
If a glass-fronted gas fireplace is used, keep children and others well away from it with a screen or gate. The glass doors can get hot enough to cause serious burns and stay hot long after the fire is out.
HOLIDAY MENTAL HEALTH TIPS
Take care of yourself both mentally and physically. Children and adolescents are affected by the emotional well-being of their parent or caregivers. Coping with stress successfully can help children learn how to handle stress better, too.
Make a plan to focus on one thing at a time. Try a few ideas from “mindfulness” as a strategy to balance the hustle and bustle of things like shopping, cooking, and family get-togethers during the holidays: Stop and pay attention to what is happening at the moment, focus your attention on one thing about it ,and notice how you are feeling at the time. Withhold immediate judgment, and instead be curious about the experience.
Give to others by making it an annual holiday tradition to share your time and talents with people who have less than you do. For example, if your child is old enough, encourage him or her to join you in volunteering to serve a holiday meal at your local food bank or shelter or sing at a local nursing home. Help your child write a letter to members of the armed forces stationed abroad who can’t be home with their own family during the holidays.
Remember that many children and adults experience a sense of loss, sadness or isolation during the holidays. It is important to be sensitive to these feelings and ask for help for you, your children, family members or friends if needed.
Try to keep household routines the same. Stick to your child’s usual sleep and mealtime schedules when you can, which may reduce stress and help your family enjoy the holidays.
Kids still need to brush their teeth twice a day!
Don’t feel pressured to “over-spend on gifts.” Consider making one or two gifts. Help your child make a gift for his or her other parent, grandparents, or other important adults and friends. Chances are, those gifts will be the most treasured ones and will teach your child many important lessons.
Most important of all, enjoy the holidays for what they are — time to enjoy with your family. So, be a family, do things together like sledding or playing board games, and spend time visiting with relatives, neighbors, and friends.
Published
11/17/2015 12:00 AM

FROM HEALTHYCHILDREN.ORG

Your child’s reaction to a bite or sting will depend on her sensitivity to the particular insect’s venom. While most children have only mild reactions, those who are allergic to certain insect venom can have severe symptoms that require emergency treatment.

In general, bites are usually not a serious problem, but in some cases, stings may be. While it is true that most stings (from yellow jackets, wasps, and fire ants, for example) may cause pain and localized swelling, severe anaphylactic reactions are possible, although uncommon.

If your child is having a severe reaction to an insect bite or sting, call for medical help immediately.  If your child is experiencing moderate pain or itching for a prolonged period of time, call (805) 845-1221 to schedule an appointment at Petite Pediatrics today. Our highly trained pediatrician, Dr. Charish Barry, can treat the bite or sting and test for allergies if deemed necessary.

Treatment

Although insect bites can be irritating, they usually begin to disappear by the next day and do not require a doctor’s treatment. To relieve the itchiness that accompanies bites by mosquitoes, flies, fleas, and bedbugs, apply a cool compress and/or calamine lotion freely on any part of your child’s body except the areas around her eyes and genitals. If your child is stung by a wasp or bee, soak a cloth in cold water and press it over the area of the sting to reduce pain and swelling. Call your pediatrician before using any other treatment, including creams or lotions containing antihistamines or home remedies. If the itching is severe, the doctor may prescribe oral antihistamines.

If your child disturbs a beehive, get him away from it as quickly as possible. The base of a honeybee’s sting emits an alarm pheromone (hormone) that makes other bees more likely to sting as well.

It is very important to remove a bee stinger quickly and completely from the skin. The quick removal of a bee stinger will prevent a large amount of venom from being pumped into the skin. If the stinger is visible, remove it by gently scraping it off horizontally with a credit card or your fingernail. Avoid squeezing the stinger with a pair of tweezers; doing this may release more venom into the skin. The skin may be more swollen on the second or third day after a bee sting or mosquito bite.

Keep your child’s fingernails short and clean to minimize the risk of infection from scratching. If infection does occur, the bite will become redder, larger, and more swollen. In some cases you may notice red streaks or yellowish fluid near the bite or your child may get a fever. Have your pediatrician examine any infected bite right away, because it may need to be treated with antibiotics.

Call for medical help immediately if your child has any of these other symptoms after being bitten or stung:

• Sudden difficulty in breathing
• Weakness, collapse, or unconsciousness
• Hives or itching all over the body
• Extreme swelling near the eyes, lips, or penis that makes it difficult for the child to see, eat, or urinate
• Prevention
• Some children with no other known allergies may have severe reactions to insect stings. But if you suspect that your child is allergy-prone, discuss the situation with your doctor. He may recommend a series of shots (hyposensitization injections) to decrease your child’s reaction to future insect stings (but not bites). In addition, he will prescribe a special auto-injection kit containing epinephrine for you to keep on hand for use if your child is stung.

It is impossible to prevent all insect bites, but you can minimize the number your child receives by following these guidelines.

Avoid areas where insects nest or congregate, such as garbage cans, stagnant pools of water, uncovered foods and sweets, and orchards and gardens where flowers are in bloom.
When you know your child will be exposed to insects, dress her in long pants and a lightweight longsleeved shirt.
Avoid dressing your child in clothing with bright colors or flowery prints, because they seem to attract insects.
Don’t use scented soaps, perfumes, or hair sprays on your child, because they also are inviting to insects.
Insect repellents are generally available without a prescription, but they should be used sparingly on infants and young children. In fact, the most common insecticides include DEET (N, N-diethyl-m-toluamide), which is a chemical not recommended for use in children under two months of age. Do not apply DEET-containing repellents more than once a day on older children.

The concentrations of DEET vary significantly from product to product—ranging from less than 10 percent to over 30 percent—so read the label of any product you purchase. Some products have concentrations much higher than 30 percent, and the higher the concentration of DEET, the longer the duration of action. Its effectiveness peaks at a concentration of 30 percent, however, which is also the maximum concentration currently recommended for children. The safety of DEET does not appear to be related to its level of concentration; therefore, a prudent approach is to select the lowest effective concentration for the amount of time your child spends outdoors. You should avoid products that include DEET plus a sunscreen, because sunscreen needs to be applied frequently while DEET should be applied only once a day. If you apply DEET more frequently, it may be associated with toxicity. Also be sure to wash off the DEET with soap and water at the end of the day.

An alternative to DEET is a product called picaridin (KBR 3023). While it has had wider use in Europe, picaridin has more recently become available in the US. It is a generally pleasant- smelling product without the oil residue associated with DEET, and is available in concentrations of 5 to 10 percent.

The American Academy of Pediatrics recommends that repellents used in children over six months of age have 30 percent DEET or 5 to 10 percent picaridin repellent, applied once before going outdoors. These repellents are effective in preventing bites by mosquitoes, ticks, fleas, chiggers, and biting flies, but have virtually no effect on stinging insects such as bees, hornets, and wasps. Contrary to popular belief, giving antihistamines continuously throughout the insect season does not appear to prevent reactions to bites.

Insect Bites and Stings

Mosquitoes
Water (pools, lakes, birdbaths)
Stinging sensation followed by small, red, itchy mound with tiny puncture mark at center.
Mosquitoes are attracted by bright colors and sweat.

Flies
Food, garbage, animal waste
Painful, itchy bumps; may turn into small blisters.
Bites often disappear in a day but may last longer.

Fleas
Cracks in floor, rugs, pet fur
Multiple small bumps clustered together; often where clothes fit tightly (waist, buttocks).
Fleas are most likely to be a problem in homes with pets.

Bedbugs
Cracks of walls, floors, crevices of furniture, bedding
Itchy red bumps occasionally topped by a blister; usually 2–3 in a row.
Bedbugs are most likely to bite at night and are less active in cold weather.

Fire ants
Mounds in pastures, meadows, lawns, and parks in southern states
Immediate pain and burning; swelling up to 1⁄2 inch (1.2 cm); cloudy fluid in area of bite.
Fire ants usually attack intruders.

Bees and wasps
Flowers, shrubs, picnic areas, beaches
Immediate pain and rapid swelling.
A few children have severe reactions, such as difficulty breathing and hives/swelling all over the body.

Ticks
Wooded areas
May not be noticeable; hidden on hair or on skin.
Don’t remove ticks with matches, lighted cigarettes, or nail polish remover; grasp the tick firmly with tweezers near the head; gently pull the tick straight out.

https://www.healthychildren.org/English/safety-prevention/at-play/Pages/Choosing-the-Right-Size-Bicycle.aspx

Choosing the Right Size Bicycle

A bicycle of the wrong size may cause your child to lose control and be injured. Any bike must be the correct size for the child for whom it is bought. To keep your child safe, the American Academy of Pediatrics recommends the following:

Do not push your child to ride a 2-wheeled bike until he or she is ready, at about age 5.
Take your child with you when you shop for the bike, so that he or she can try it out. The value of a properly fitting bike far outweighs the value of surprising your child with a new bike.
Buy a bike that is the right size, not one your child has to “grow into.” Oversized bikes are especially dangerous.
How to test any style of bike for proper fit
Sitting on the seat with hands on the handlebar, your child must be able to place the balls of both feet on the ground.
Straddling the center bar, your child should be able to stand with both feet flat on the ground with about a 1-inch clearance between the crotch and the bar.
When buying a bike with hand brakes for an older child, make sure that the child can comfortably grasp the brakes and apply sufficient pressure to stop the bike.
A helmet should be standard equipment. Whenever buying a bike, be sure you have a Consumer Product Safety Commission (CPSC)-approved helmet for your child.
Consider the child’s coordination and desire to learn to ride. Stick with coaster brakes until your child is older and more experienced.
Last Updated
5/11/2015
Source
TIPP: The Injury Prevention Program (Copyright © 1994 American Academy of Pediatrics, Updated 9/2005)

https://www.healthychildren.org/English/safety-prevention/at-play/Pages/Sun-Safety.aspx

Sun Safety: Information for Parents

About Sunburn & Sunscreen

It’s good for children and adults to spend time playing and exercising outdoors, and it’s important to do so safely.

Simple Rules to Protect your Family from Sunburns
Keep babies younger than 6 months out of direct sunlight. Find shade under a tree, an umbrella, or the stroller canopy.
When possible, dress yourself and your children in cool, comfortable clothing that covers the body, such as lightweight cotton pants, long-sleeved shirts, and hats.
Select clothes made with a tight weave; they protect better than clothes with a looser weave. If you’re not sure how tight a fabric’s weave is, hold it up to see how much light shines through. The less light, the better. Or you can look for protective clothing labeled with an Ultraviolet Protection Factor (UPF).
Wear a hat with an all-around 3-inch brim to shield the face, ears, and back of the neck.
Limit your sun exposure between 10:00 am and 4:00 pm when UV rays are strongest.
Wear sunglasses with at least 99% UV protection. Look for child-sized sunglasses with UV protection for your child.
Use sunscreen.
Make sure everyone in your family knows how to protect his or her skin and eyes. Remember to set a good example by practicing sun safety yourself.
Sunscreen
Sunscreen can help protect the skin from sunburn and some skin cancers but only if used correctly. Keep in mind that sunscreen should be used for sun protection, not as a reason to stay in the sun longer.

How to Pick Sunscreen
Use a sunscreen that says “broad-spectrum” on the label; that means it will screen out both UVB and UVA rays.
Use a broad-spectrum sunscreen with a sun protection factor (SPF) of at least 15 (up to SPF 50). An SPF of 15 or 30 should be fine for most people. More research studies are needed to test if sunscreen with more than SPF 50 offers any extra protection.
If possible, avoid the sunscreen ingredient oxybenzone because of concerns about mild hormonal properties. Remember, though, that it’s important to take steps to prevent sunburn, so using any sunscreen is better than not using sunscreen at all.
For sensitive areas of the body, such as the nose, cheeks, tops of the ears, and shoulders, choose a sunscreen with zinc oxide or titanium dioxide. These products may stay visible on the skin even after you rub them in, and some come in fun colors that children enjoy.
How to Apply Sunscreen
Use enough sunscreen to cover all exposed areas, especially the face, nose, ears, feet, hands, and even backs of the knees. Rub it in well.
Put sunscreen on 15 to 30 minutes before going outdoors. It needs time to absorb into the skin.
Use sunscreen any time you or your child spend time outdoors. Remember that you can get sunburn even on cloudy days because up to 80% of the sun’s UV rays can get through the clouds. Also, UV rays can bounce back from water, sand, snow, and concrete, so make sure you’re protected.
Reapply sunscreen every 2 hours and after swimming, sweating, or drying off with a towel. Because most people use too little sunscreen, make sure to apply a generous amount.
Sunscreen for Babies
For babies younger than 6 months: Use sunscreen on small areas of the body, such as the face, if protective clothing and shade are not available.
For babies older than 6 months: Apply to all areas of the body, but be careful around the eyes. If your baby rubs sunscreen into her eyes, wipe her eyes and hands clean with a damp cloth. If the sunscreen irritates her skin, try a different brand or sunscreen with titanium dioxide or zinc oxide. If a rash develops, talk with your child’s doctor.
Sunburns
When to Call the Doctor
If your baby is younger than 1 year and gets sunburn, call your baby’s doctor right away. For older children, call your child’s doctor if there is blistering, pain, or fever.

How to Soothe Sunburn
Here are 5 ways to relieve discomfort from mild sunburn:

Give your child water or 100% fruit juice to replace lost fluids.
Use cool water to help your child’s skin feel better.
Give your child pain medicine to relieve painful sunburns. (For a baby 6 months or younger, give acetaminophen. For a child older than 6 months, give either acetaminophen or ibuprofen.)
Only use medicated lotions if your child’s doctor says it is OK.
Keep your child out of the sun until the sunburn is fully healed.​

Last Updated 5/11/2015
Source Fun in the Sun: Keep Your Family Safe (Copyright ? 2008 American Academy of Pediatrics, Updated 4/2014)