Hey parents, stop bugging your kids with antiquated notions about keeping healthy outdoors in wintertime. True, practically none of you still hang garlic around your kids’ necks, or place slices of onion in their socks, or force-feed them cod liver oil, all to ward off cold germs. But let’s face it; some old wives’ tales are slow to fade away. And new old wives’ tales are popping up, some based on that mysterious super force, our immune system. Here is some sense to replace the “non-sense.
1. Blame our forefathers for confusing “cold” as in weather with “cold” as in illness. Understandably, they linked the two; cold and colds occurred concurrently while microorganisms were yet unknown. And, in fact, the two are linked, but indirectly, and especially concerning kids. Cold weather forces kids indoors, often into crowded daycare centers and schools, with windows shut and the heat turned up. This dries out the air and lowers humidity, conditions which allow viruses to travel farther through the air and stay viable longer. Also, low humidity dries out nasal membranes, making them more fertile ground for viruses to take hold and multiply.
2. Neither rain nor snow nor the gloom of night increases the risk of catching colds. Nor does wet hair, drafts, wearing winter clothes indoors or, within reason, being “run down” or lack of sleep. There is no need to keep kids indoors when they already have colds; doing so does not make them less susceptible to the next cold.
3. Exposure to cold does not significantly lower the body’s immune system. We’re talking about appropriately dressed kids playing in the snow or skiing/ice skating with adults checking on them from time to time. Only extreme and prolonged exposure to cold and wetness, hypothermia, causes the body’s internal (core) temperature to tumble significantly and increase susceptibility to infection.
4. Giving kids vitamins and other “immune system boosters” helps parents to feel better. Even less than optimal diets suffice to keep the immune system functioning adequately. The value of zinc and Echinacea and other health food remedies is mostly unproven. Ditto for using room humidifiers, serving foods rich in antioxidants, honey and gargling with warm water.
5. Keeping kids dry outdoors is more important than keeping them warm. Modern fabrics are so efficient in retaining heat and repelling rain/snow that perspiration through the skin can produce a pint of water in a few hours. Wearing clothing wet from perspiration or the elements is like standing naked in the cold. As perspiration increases, remove layers of clothing, open ventilation zippers, take off head coverings, unbutton jackets and take sleeves out of gloves.
6. Warm drinks have negligible effects on warming up the body. Encourage kids to drink outdoors, even when they aren’t thirsty. This compensates for fluids lost by perspiration under heavy clothing and deeper breathing. If kids like hot cocoa, fine. If they don’t, let them drink whatever else is appropriate, hot or cold. Milk does not increase mucus production. Positive effects, if any, from warm beverages are psychological.
7. Treatments for colds can be worse than the cold. Cough and cold remedies, mostly antihistamines and, dextromethorphans, are no longer recommended for children because of occasional serious side effects. (Some remedies may help adults.) Use acetaminophen and ibuprophen to reduce fever and relieve aches, but understand these do not shorten the duration of colds. The old saying, “feed colds and starve fevers” is nonsense. For young children who are playing outdoors or are involved in non-competitive sports, let them eat as they wish. With almost no exceptions, there are no poor/picky eaters. Cold weather increases the need for calories, but it increases appetite appropriately.
8. Young children in daycare/school may have cold-like symptoms much of the winter. Hundreds of cold viruses exist. Newborns have little protection against colds; immunity is acquired by infection, one virus at a time. Fortunately, many viruses cause no symptoms. In daycare/school, kids are crowded together, practice poor hygiene, and shed viruses for many days after symptoms have disappeared, longer than adults do. Illness from a single cold may last two or three weeks. In that time kids may have contracted additional viruses, extending the period of illness for a month or more. Cold viruses do not “ping-pong” back and forth within a family. A second round of colds is generally due to a new virus.
9. Kids who come inside with runny noses are not necessarily ill. The nose warms and humidifies dry inhaled air by secreting moisture. Some of this moisture reaches the cold tip of the nose and condenses into a watery discharge.
10. Flu (influenza) vaccines do not protect against colds. Flu is a specific cold-like disease but causes more severe symptoms and may lead to complications. Rarely, young children with flu require hospitalization. All children at six months of age should be vaccinated against the flu. There are no known adverse reactions to the vaccine.
Forget lousy food, airports delays, and turbulence. One of air travelers’ biggest nightmare is sitting near a cute, cuddly little baby that suddenly morphs into a nonstop, noise machine emitting high decibel, ear-piercing, headache-producing, sleep-preventing terror. An even worse nightmare: it’s your child. Here’ what you should know:
An Australian airline settled a lawsuit by a passenger who said a screaming child caused her to lose some of her hearing. The incidence occurred before the aircraft left the ground.
To misquote Shakespeare: To sedate or not to sedate infants for air travel, that is an oft-raised question. Is it truly nobler to spurn sedatives, risk an unruly child, and bravely suffer the scorn of outraged fellow passengers? Or is it more virtuous to sedate infants, perchance they’ll sleep, but endure the thousand humiliations that parental guilt is capable of self-inflicting?
A flight attendant allegedly secretly added Xanax, an anti-depressant, to juice and told the mother that it will make her screaming infant sleep. It is unclear if the infant drank the juice; no side effects occurred. Later, the mother noticed that the juice was foamy, contained blue specks, and tasted bitter. She submitted the juice to authorities. Analysis revealed Xanax. The FBI charged the flight attendant with assault, charges he denied. He was fired. The outcome of the charges is unknown.
Sky Nannies to the rescue. Two large international airlines – Etihad and Gulf, both based in the Middle East – employ Sky Nannies on their long haul flights. “Nannies are trained to provide a wide range of on-the-ground, boarding and disembarking, and in-flight services to assure that children will receive the best care every step of the way. Nannies give parents that much needed break during long flights and provide a watchful eye on the little ones.” Check the airlines’ websites for services provided.
Infant car safety seats are life savers when correctly used, reducing traffic-related fatalities by about 70%.* But the seats are responsible for numerous problems and, rarely, deaths when inappropriately used away from cars. Moreover, car seat plus baby is heavy. Improper carrying can cause you, the carrier, needless aches and pains.
1. In the US, about 10,000 infants suffer car seat-related injuries away from cars. Most of the injuries occur in infants less than 4 months of age. Head injuries are most common, followed by broken arms and legs. Of the injuries, 85% are related to falls: 65% with the infant falling out of the car seat and 15% with seat and infant falling from elevated surfaces such as shopping carts, tables, and counters.
2. Car seats are unstable when standing alone. Sometimes they are accidentally tipped over by adults or older children. Older infants can wiggle sufficiently – even when properly strapped in – to topple the seat over. Some parents neglect to strap infants in when seats are not in cars. If young infants turn seats over onto couches they may land with their mouths on soft fabric and have difficulty breathing.
3. Never place seats atop washing machines and dryers. These locations are convenient while you do the laundry; the rhythmic noise tends to lull infants to sleep. However, the vibration of the machines can move the seats towards and over the edge.
4. The least dangerous place for seats is the floor or ground. When you must put the seat down, (to open the car door, for example), check the area for unfriendly animals and make sure the seat is visible to other drivers. Never place car seats on the hood or roof of the car.
5. Carrying car seats incorrectly can cause you pain. Don’t carry seats in the fold of your elbow; this may cause shoulder/neck pain or pain in your hand due to compression of the nerves in your elbow (nerves that lead to your hand). Also, carrying the seat in one hand places the seat at hip level, forcing you to bend your hip for balance and twisting your lower spine, causing lower back pain.
6. Carry seats in front of you at waist height and use both hands on the handle bar. Or carry the empty seat in one hand and the baby on your shoulder with the other hand. Or use a sling carrier. Plan ahead for the shortest distance to carry. Car seats that pop into strollers are an ideal solution.
7. Car seats and shopping carts are a hazardous mix. Shopping carts have their own safety issues, injuring thousands of infants each year. Placing car seats on top of shopping carts is fraught with danger. Some shopping carts have attachments for car seats. If you use such carts, make sure that you correctly buckle the seat into the cart. A safer method is to place the seat inside the shopping cart, if it fits. (However, this leaves little room for groceries.)
8. Ideally, infants should not sleep in car seats. They should sleep on their backs on firm mattresses, greatly reducing the risk of SIDS (Sudden Infant Death Syndrome). But most infants sleep well in moving cars. Fortunately, cases of SIDS related to car seats have virtually disappeared. Present day seats prevent infants’ heads from flopping forward and compromising the infants’ airways. Transfer sleeping infants to a proper sleeping surface at your destination, even if doing so will wake them up.
9. Stay in touch with your car seat manufacturer. Make sure that your car seat is registered with them and that they can get in touch with you, especially if you move. Recalls of seats for safety reasons occur. Some manufacturers send out helpful safety tips and other useful information.
10. * Installing car seats properly is complicated. Three out of four parents purchase less than optimal models or install seats incorrectly. Consider consulting professionals. To find a car seat inspection center near you, go to http://www.safercar.gov/cpsApp/cps/map/findfitting.htm?q. In most cases there is no charge for the inspection.
No single answer fits all infants nor all situations. Moreover, the answer changes based on new findings – like the one that just came to light: apparently, very rarely, parents may accidently suffocate infants sitting on the parent’s lap.
Here is what is known:
No government agency regulates the age at which newborns may fly. Each airline has its own policy. Lower age restriction on major US and international airlines vary from no restrictions to 2 days, 7 days and 14 days. Some airlines allow infants younger than the airline’s stated cutoff age to fly if parents carry a letter from a doctor. Airlines’ policies are posted on each airline’s website. No reasons are given for rulings. Recommendations are not based on flight lengths.
Overall, air travel for infants is extremely safe. Millions travel each year; only an infinitesimal percentage experience recognizable health issues. Some restrictions date from the early days of aviation when aircraft were poorly pressurized, oxygen was sometimes required, and little was known about newborn physiology.
Some infants should have medical clearance before flying. Infants born with significant medical issues (prematurity or heart and lung problems, for example), even if they appear totally healthy at home, may have difficulty compensating for lower cabin oxygen concentrations at cruising altitudes. Clearance is essential until age 12 months.
Infants may suffocate when held on a parent’s lap. (Journal of Pediatric Critical Care Medicine, September 2014.) A small number of infants with no known medical issues have died during flights, with deaths more common among infants held on laps than those in their own safety seats. Possibly, the adult holding the infant fell asleep and their bodies rested on the infant’s face, blocking the infant’s airways. Some of the deaths showed similarities with SIDS (Sudden Infant Death Syndrome), infants suffocating while sleeping on their stomachs. Infants should sleep on their backs and on firm surfaces.
Infants may contract infectious diseases in flight. Air circulates in aircraft cabins from ceiling to floor, not through the entire cabin. Air is replaced every few minutes. Therefore, infants’ (and other passengers’) exposure to disease-causing organisms exhaled by passengers is limited to those sitting in nearby seats, not from the entire aircraft.
An infant’s immunity to contagious disease varies. Infants inherit some immunity from their mothers but its effectiveness depends on innumerable factors and this immunity wanes over the first few months of life. Infants begin receiving immunizations at two months, but optimum immunity requires several doses of a vaccine over many months. Immunizations against other diseases (measles, for example) begin at twelve months. This leaves “windows” during the first year in which infants are vulnerable to infections. Moreover, there are no immunizations against cold-like contagious diseases. Yet very few infants are known to have become infected in-flight.
Is Ebola a threat to infants traveling by air? Probably not. In Africa, the virus shows no predilection for infecting children. Moreover, Ebola spreads by skin contact with body fluids from infected individuals, not through the air, and spreads only after the victim shows signs of illness. People ill with most other infectious diseases spread the disease-causing organisms before they themselves are ill, greatly abetting the spread of the disease.
Be safety conscious. Avoid aisle seats when holding an infant on your lap. Aisle seat-related accidents include: infants’ dangling arms and legs into the aisle and being struck by food carts; burns from hot beverages spilled by flight attendants or other passengers; and luggage falling from overhead bins. Also, walk carefully in aisles while holding an infant. He or she blocks your view, sometimes resulting in you stumbling over feet protruding into the aisle.
Miscellaneous. There is no evidence that air travel damages infants’ ears – though it may cause ear pain… Use disinfectant cloths to clean seat trays and other objects that infants may touch. Some disease-causing organisms survive for days on inanimate objects. Wash infants’ hands often. Aircraft toilets (door handles and sink surfaces, for example) are likely sources of organisms… Opt for the first flight of the day, when possible. Aircraft are thoroughly cleaned during the night. During the day only trash is removed.
Are you, the mother, fit to fly? Many obstetricians recommend delaying air travel for one to two weeks after routine vaginal deliveries and three weeks after caesarian sections. Post-delivery issues that may arise include blood clotting, bleeding and infection. For both mothers and infants, check if there are competent medical facilities at your destination.
If you are planning to travel with your children, in this country or abroad, there is presently no reason to change your plans due to the Ebola outbreak – even though this is a deadly illness with travel playing an important role in in its spread, says the Centers for Disease Control (CDC). The CDC does advise against visiting the countries in West Africa where the disease is currently endemic. These countries are among the poorest in the world and are rarely visited by travelers.
Here is what you should know:
Ebola is one of the deadliest infectious diseases known to man. It generally causes severe pain, internal bleeding, kidney and liver failure, shock, coma, and other life-threatening conditions.
A travel history should be part of every medical examination. If medical personnel fail to ask you where your family has traveled recently, tell them. Numerous illnesses have strong geographical links. Flu-like symptoms, for example, can be Ebola, malaria – or, most of the time, the flu. Even within the United States, there are illnesses found in the Southwest that are rarely seen in the Northeast.
Children are no more susceptible to Ebola than adults. In fact, in previous outbreaks in Africa, children were less affected (CDC: Journal of Emerging Diseases, October 2014). This may be because children had less contact with infected adults or for unknown reasons. It is not unusual for diseases to have a predilection for individuals of certain ages. (In Africa, one very sad consequence of the Ebola outbreak is the large number of children left orphaned.)
Ebola does not spread through the air. People become infected with Ebola from direct contact with virus-containing blood, sputum or other body fluids of infected individuals, or by touching objects such as needles that have been contaminated with infected fluids. The virus then enters uninfected individuals through broken skin or membranes in the mouth or eyes. Family members and healthcare workers caring for the ill individual are at greatest risk. Frequent and thorough hand washing may help prevent infection.
Infected individuals do not spread the virus until they show symptoms of being ill. This is contrary to most childhood infections, which start spreading several days before symptoms surface – while children are still attending daycare and school, greatly abetting the spread of the disease.
Animals appear to be the reservoir of the virus. People in Africa become ill from close contact with animals harboring the virus. Suspect animals include chimpanzees, gorillas, monkeys, forest antelope, pigs, porcupines and fruit bats. In the poor countries where Ebola exists, people live in close contact with the animals.
Early symptoms are vague. Symptoms include fever, headache, joint and muscle aches, weakness, tiredness, sore throat and chills. As the disease progresses, other symptoms begin appearing: bleeding inside and outside of the body, nausea and vomiting, diarrhea (often bloody), bruising and other skin rashes, and difficulty breathing and swallowing.
Prompt diagnosis and isolation are vital to help prevent spread. Often, only a good travel history will raise the suspicion of the presence of a serious disease. Medical personnel must wear proper protective gear. Various blood tests and viral studies help make the diagnosis. Ebola can appear from 2 to 21 days after someone has been exposed to the virus. Most people’s symptoms begin 8-10 days after exposure.
There is as yet no specific treatment for Ebola. Experimental drugs and vaccines have been used recently but it is too early to evaluate the results. Presently, treatment consists of replacing blood lost by bleeding, maintaining vital signs, supplying oxygen, and treating complications as they appear. Currently about 50% of victims die.
Backpacks here. Backpacks there. Backpacks practically everywhere. Toddlers wear them for the sake of wearing them, often empty and in the shape of cartoon characters. Elementary school-age kids pile everything they have into them. High school kids use them as fashion statements; it doesn’t matter what’s in them.
But for parents, there are health and safety issues to consider.
1. Loads on backs should not exceed 20% of the child’s body weight. Lesser loads, 10 to 15%, are recommended for backpack beginners, long trips, going uphill, climbing stairs, walking on tough terrain, and in hot weather.
2. Backpacks that are too heavy or worn incorrectly may cause back problems. (However, there is no evidence that these problems cause permanent deformities.) In the US, more than 7,000 backpack-related injuries are seen in emergency rooms each year, with many more seen in doctors’ offices. Approximately half of the cases are in children. Upper and lower back pain and shoulder pain, sometimes severe, are the most common symptoms.
3. Choose function before fashion. Opt for backpacks with shoulder straps that are wide, contoured, and padded to prevent straps from digging into the shoulders. Straps should be adjustable so that the backpack rests snuggly against the back, can be put on and taken off easily, and doesn’t interfere with arm movement.
4. Waist straps help keep backpacks in place. When straps are too loose, backpacks dangle uncomfortably. Ideally, the backpack should rest two inches above the waist. Padding in the backpack protects wearers from objects inside. The lighter the backpack, the more weight can safely be placed in it.
5. Discourage children from wearing backpacks on one shoulder. This fad is now in vogue – and even young children are surprisingly fashion-conscious. Weight should be distributed equally. Numerous compartments simplify weight distribution. Place heavier objects at the bottom, near the center, and up against the back.
6. Tuck in straps. Some backpacks, especially ones designed for small children, have long straps to fit children of various sizes. Long straps may cause tripping, become entangled in branches or get caught in doors.
7. Watch your child for backpack “dysfunction.” The aches and pains resulting from wearing new backpacks is not a necessary adjustment period. Discomforts ought to be investigated before they become worse. Investigate red marks on kids’ shoulders or complaints of tingling or numbness in their arms. Backpacks are too heavy when children have difficulty putting them on, lean to one side while wearing them, or bend forward with their heads down to balance them. This can cause children to topple over, especially on stairs.
8. Consider rolling backpacks. Wheels allow children to roll backpacks where feasible. Handles on wheeled backpacks should be sufficiently long so that children can stand fully upright when pulling them. Some schools have banned wheeled backpacks as being dangerous on stairs and not fitting into lockers.
9. Put backpacks on correctly. Children should bend at the knees, not at the waist, while keeping the trunk of the body straight and stable. They should push up using their leg muscles and keep the backpack close to the body. Excessive twisting and turning may indicate that the backpack is too heavy or the wrong model. Some children find it advantageous to place backpacks on a chair or table (depending on the child’s height), before placing them on their backs.
10. Avoid backpack-related injuries to others. Fully loaded backpacks protrude more than a foot. Bystanders, in the aisles of school buses or on airplanes, for example, have been knocked over when a backpack wearer suddenly turns around. People at airports trip over backpacks carelessly left on the floor.