Staying Healthy in the Fall by Victoria McEvoy, M.D., Contributing Blogger

By now all the children are back at school. Unfortunately, the viruses are back too!

Not that the viruses ever went away, but warm weather and outdoor play leads to fewer viral infections over the summer. Cool temperatures (many respiratory viruses do better in cool temperatures) and closer contact between children cause the cough, sneeze, vomit, fever cycles to gear up again.

What can you do to ensure your child’s health during the Fall?

As always, good hand washing is essential. While some of the hand sanitizers do not actually kill some of the viruses, good hygiene certainly cuts down on infection.

Be sure your child gets enough sleep. Inadequate sleep lowers the immune system’s resistance to infection. Children vary in the number of hours of sleep they require, but parents usually know what their children require. The “whining index” is one measure.

Stress also can lower resistance to infection. Having a stable, predictable schedule without too many activities allows your child to settle into the post-summer routine. Try to shield your child from some of the stresses that you may be feeling as a parent- there is plenty of time for them to experience their own adult dramas later.

A good diet with all the essential food groups will also help the immune system to do its job. If you don’t buy junk food and only offer healthy choices, your child will eventually get hungry enough to eat the foods you offer. If they know that they can hold out for goldfish, then they will!

If your child is ill, keep him home even if you know he got his illness at school or day care. Have a back-up plan for school sick days if you both work because there will be many days when your child will be better off at home.

And, don’t forget to have your child get a flu shot!

So have a good healthy start to the school year and enjoy the remaining warm days.

Dr. McEvoy is the author of “The 24/7 Baby Doctor: a Harvard Pediatrician Answers All Your 
 Questions From Birth to One Year.” 

CONTRIBUTING EXPERT - View from the Pediatrician's Office by Victoria McEvoy, M.D.

Summer is here. Children are released from the pressures of school. Play and exercise take place outdoors. Colds and stomach bugs are pushed to the back burner. Families may get to spend more time together. But summer brings a new set of hazards. Poison ivy, sunburn, bug bites, athletic injuries, and animal bites can bring a new set of hazards to children.

What can you do to keep your child safe during the summer months?

1) What should I use for sunblock for my baby?

New guidelines have been introduced by the FDA to abort misleading advertising in the sunscreen world.

* Babies under 6 months of age should be covered up and shielded from the sun. Sunscreen is not recommended for infants under 6 months of age.

* Sunscreen should offer at least SPF (sun protection factor) of 30. Over 50 is not incrementally better.

* Universal protection, meaning protection against both UVA and UVB should be listed on the sunblock. UVA rays cause aging of the skin as well as skin cancer. UVB causes sunburn and skin cancer.

* Umbrella and other sun shielding devices do not offer total protection from sun. Sunscreen should still be applied.

* Sunscreen listed as water proof is inaccurate; water resistance is the best that some sunblocks can offer.

* Most sunblocks need to be reapplied every 40 to 80 minutes.

* Check on the sunblock tube to be sure you apply adequate amounts of sunblock.

* Sprays are not thought to be as effective as creams or lotions.

2) Why does my baby have big red welts on his arm or leg when he gets a bug bite- is he allergic or are these bites infected?

* We all develop some degree of a wheal and flare reaction-i.e. redness and swelling- at the site of a bug bite. Young children seem to have a more dramatic reaction to simple insect bite. The wheal and flare reaction is an allergic response. Cold packs and/or Benadryl if itchy can suffice. Occasionally bug bites do get infected if a child picks and itches at the bite.

3) My child has eczema but he loves to swim- what should I do about the chlorine?

* It is wonderful for children to swim in the summer. Once he gets out of the pool, be sure to thoroughly rinse and wipe off the chlorinated water. Then apply a moisturizer after showering.

* Avoid having your child sit around in a wet diaper or bathing suit if he has sensitive especially on hot, humid days.

4) How can I prevent Lyme disease; I am worried sick about ticks?

* Children should play outside if safety precautions are observed. If he is in a woodsy are, have him wear long pants and shirt if you live in an endemic tick area.

* Do tick checks every night before bed after bath- go over all parts of the body including the scalp to look for feasting ticks.

* If you find a tick and it has been attached for less than 36 hours, it is unlikely to transmit Lyme Disease.

Victoria McEvoy, M.D., is the author of “The 24/7 Baby Doctor, a Harvard Pediatrician Answers All Your Questions From Birth to One Year," Lyons Press.

GUEST BLOG POST: Getting Your Life Back - by Victoria McEvoy, M.D.

One of the chapters in our newly published book for new parents is about finding that accomplished woman you left behind when this new little baby tyrant entered your household.

It is not that you regret letting this new little person into your life, but at some point you may wistfully wonder why your old friends are not enjoying your tales about the miracle baby, or why you have not regained that toned pre-baby shape that you worked so hard for, or why your life seems to revolve around pumping breast milk, washing those little outfits, feeding, changing diapers, and trying to catch some shut eye between feeds. Not only does your partner not find you so interesting, but you are a little bored with yourself. But, how do you regain that edge when going for a walk with the baby seems to be a major undertaking requiring huge organizational skills and time management expertise?

First of all, take that sacred post-partum period- whether it be three months or six months -and let your body recover, try to catch up on the sleep deficit that may have started in the last trimester and seems to be skating out of control with each passing day, and eat a healthy diet with lots of fluids. Let your hormones settle down. Childbirth often starts with euphoria followed by moodiness, with tears and emotional fragility soon to follow. Sleep deprivation doesn’t help matters. Ask for help; sometimes your partner may want to help but does not know how. Be specific-“please empty the dishwasher” rather than “I seem to be doing everything!”

Once the household seems to be getting back on an even keel, make some time for yourself. Spontaneous “mommy” .time is not an option ; free time requires planning. Decide what it is that will make you feel whole again and arrange for a babysitter or a partner to take the baby. You may want to go to the gym, work with a personal trainer, have lunch with a friend, get back on track with work, or just be alone to read. It is a good idea to get out of the house. Don’t forget after the first week or so, unless there are extreme weather conditions, your baby can get out for a walk with you in a snuggly and later in a stroller.

New mothers often feel isolated so making connections with others is important. Be sensitive to old friends who don’t have children. They may not find you r tales from the crib as scintillating as you do. Finding other new mothers on line or at the gym or park can be lots of fun because they do want to talk about breast feeding, car seats, and vaccinations.

And don’t forget to laugh. The worry and responsibility of caring for another human being can be so overwhelming that new parents forget how to have fun. Have a date night with your partner, go to a movie, or just relax and let it go for a few minutes- at least until that soft whimpering next door turns into a full-blown wail.

Victoria McEvoy, M.D., is the author of  “The 24/7 Baby Doctor: a Harvard Pediatrician Answers All Your Questions From Birth to One Year.” She grew up in New York, and after attaining the rank of #3 in the USLTA tennis rankings for women in the U.S., left tennis to pursue a career in medicine. She graduated in 1975 from Harvard Medical School and trained at Boston City Hospital, New England Medical Center, Children’s Hospital, and Mass General Hospital. She has been a practicing pediatrician in the greater Boston area for over thirty years. She celebrates her thirty-eighth wedding anniversary this year with husband Earl, and together they raised four children. Dr. McEvoy is a senior pediatrician on the staff at Mass General Hospital today and has attained the rank of Assistant Professor of Pediatrics at Harvard Medical School. She currently divides her time as the Medical Director and Chief of Pediatrics of Mass General West Medical Group between clinical practice and administration. She had a column called “The Exam Room” in the Boston Globe and has written extensively for various publications. She is the former Associate Editor of the “Harvard Medical School Family Health Guide”. 

A Family That Poops Together

I am so thrilled and proud to annnouce...and just in the knick of time....Seth is now regularly pooping in the potty. And, not a moment too soon!!

This past week, we have all taken turns running to our respective bathrooms. Luckily, we have two, and Marc isn't home during the day.

We got hit with the most nasty stomach virus. You've probably either heard of it, or experienced it by now. It's taking families by storm, and hits you like a ton of bricks if you get it.

I was actually laid up in bed one day last week and wound up cancelling a gym apppointment, which I hate to do. I must admit, this is one way to start a diet, since you can barely eat. But, who wants to be sick to lose weight.

Tonight we ventured out to the diner, thinking we were all relatively on the mend. If we ate lightly, we'd be okay, we presumed. Well, it hit me like a tons of bricks yet again, once we got home.

Thankfully, we have plenty of saltines, ginger ale and Gatorade in the house, from last week, so we're well stocked. But, when is this going to be over? Seth's pediatrician warned that even if you think it's done, it might not be. She's seen alot of relapses....terrific!!

Crossing my fingers this will be a better week.

I don't know about you....but this winter has been so sickly for our family. Nothing serious to speak of, but still, it's quite the challenge to keep us all well.

Hope your family is having better luck. And, if not, at least you know you're not alone.

Sick Days

Seth's pre-K called yesterday. I know whenever the phone rings, and it's the school nurse, that it's not good news. Seth had a 101 fever she said, and was very uncomfortable. I had to come pick him up right away.

I have to admit...I lost it at that moment. In my time of frustration, I said to her, "You know...this isn't mom's taxi service. I'm in the middle of some things now. I will get there as soon as I can."

Well...she didn't seem to like that response, and the next call I got was from the school social worker. I explained that I would definitely get there within the hour. That I don't live around the corner, and I work part time from home, and can't just drop everything and run over there this very second. She seemed to understand a bit more, though really, she wanted me there pronto too.

Now...I could see if Seth had, G-d forbid, some awful, contagious disease. And, believe me, I understand that you don't want whatever it is to spread throughout the entire school. That said, I drove him directly to the doctor who squeezed us in before the after school rush. Turns out he has some kind of virus, which you don't treat with medication. I more or less suspected this, but since he had a chesty sounding cough too, I wanted to be safe.

Did you know they can diagnose the flu in a child immediately by popping a cotton swab in their nose and testing it on the spot? Takes about 10 minutes for results. Unreal. Luckily it wasn't the flu. I waited anxiously to hear, since I did not get the flu shot and have never been keen on it. When I was little I recall getting the measles vaccine and wound up with a case of the measles from it. To this day, that left me a bit vaccine phobic, at least for myself.

I asked the pediatrician for a doctor's note for the school, and he looked at me funny. I explained it wasn't because they think Seth might be playing hookie, but rather, more to document to the school that Seth has been seen by a physician.

So, Seth was home sick today. He seems improved, and no fever. Monday is a holiday, so we have a long weekend ahead, with some cold weather coming, so Seth will need to be somewehat housebound to get fully well. This means mommy may go a bit stir crazy too, but Tuesday is another day. And, hopefully a healthier one...and crossing my fingers that Marc & I don't catch this from Seth. We've both had more than our share of awful colds already this season.

The Whites of Seth's Eyes

Over the summer, due to all the swimming in our community pool, Seth's eyes often got irritated due to the chlorine. Since then he's been fine, until yesterday.

Sunday morning, he awoke with two red eyes. Out of the blue. We quickly called the doctor....getting a doctor on a Sunday is no easy feat. She said it's probably an allergy. He should take Benadryl and use Visine. What does he sleep with, she asked?

His favorite teddy is always by his side, along with a host of other animals....subject to change on any given day. Piggy, bunny, woofy dog, etc. She said they could be carrying irritants. Teddy, a dust mite culprit?! Beloved teddy?? I guess it's not entirely shocking since teddy seldom gets a bath. Frankly, it slips my mind to do it, but it does make sense.

That said, we gave teddy a good soaking. But, Seth's left eye was still quite red today. We kept him home from school and made a doctor's appointment. Luckily he wasn't symptomatic, so he didn't have discomfort. He was just restless all day, missing his friends in pre-K.

We had to wait all day til our doctor appointment, and then sat restlessly an hour in his waiting room. I just kept thinking what a germ factory this is. No wonder kids get sick so much. A mere trip to the doctor's office for one thing can expose you to a host of other unwelcome viruses, etc. I now carry Purell with me wherever I go and often spring it on Seth.

I hope this isn't the start of a challenging winter for Seth healthwise. It was just two weeks ago that I took him to the doctor for a flu shot. No offense to the pediatrician, who I happen to like a lot, but I'm not looking to be a regular in his office.

Seth was thrilled not to get a shot this time...and he made out well in the end, with his usual lollipop.

We're keeping him home again tomorrow, and he's now on prescription eye drops. It's like torture to give them to him, but hopefully it will do the trick.