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How To Use a Car Seat Harness Correctly

It’s Child Passenger Safety Awareness Week and I have decided to talk a little about the car seat harness. The car seat harness holds a child down in the car seat so they cannot slide up, forward and out the car seat in the event of a crash.

There are two different types of harnesses; the 5-point and 3-point harness. What this really means is that the harness comes into contact with your child in 5 or 3 points. The 5-point harness has straps over both shouldres, both hips and one between the legs whereas the 3-point harness only has straps over the shoulders and one between the legs. Not only is a 5-point harness more secure but it also allows the forces from an accident to be distributed more evenly across the body.

Using the harness incorrectly is one of the most common mistakes parents make. In this short post I have outlined 3 really simple steps to take to correctly position your child in a car seat. Please remember to always check the manufacturer’s instructions first before using your car seat.

  1. Place your child all the way back in the car seat

Your child must sit snugly in the car seat with the bum and back firmly against the backrest.

  1. Correctly position the shoulder straps

Rear-facing car seats: the shoulder straps should be at or just below shoulder level (+- 2.5 cm)

Forward-facing car seats: the shoulder straps should be at or just above the shoulder level (+- 2.5 cm)

Image: Diono.com

  1. Tighten harness straps snugly

The straps should be tight enough so there is no excess webbing (check this using the pinch test).

Image: Diono.com

The harness should also not be too tight that it pinches your child’s skin or forces them into an unnatural position.

HARNESS RETAINER CLIPS

Image: safekids.org

Car seats made in Europe, Australia and South Africa do not come with harness retainer clips. You will most likely only see these clips if you are in the United States or Canada. These clips are not for added safety and are not designed to keep your child in their car seat in the event of a crash. In fact they are more likely to open up from the impact and slide down the straps. These clips are positioning devices and used to keep the shoulder straps in position pre-crash.

South Africa adheres to European car seat safety standards so you will not find car seats in this country with retainer clips. European regulation requires all car seat harnesses to be released in one motion and therefore a chest clip is simply not allowed. European car seats use other methods to keep the harness in place.

There are many other gadgets and devices available to use together with your harness to provide added comfort or extra protection. These are generally not safe since most of them are not crash tested and therefore can cause serious harm in the event of a motor vehicle accident.

RESOURCES

https://cpsboard.org/cps/wp-content/uploads/2014/01/Technician-Guide_March2014_Module-8.pdf

https://csftl.org/chest-clip-myths-busted/

 

 

Common First Aid Myths

 

I am often surprised by how some of my patients manage their injuries before they come to the emergency room. I think my own mother is also guilty of practising some really strange methods whilst I was growing up. Over the years, medical advice and management has evolved. What may have made sense years ago is now out of date and has been replaced with more sound research and often logic. Here are just a few of the first aid practices and myths that I have seen over the years.

1. BUTTER ON A BURN

The idea behind this myth is not entirely wrong. Butter can help alleviate the initial pain caused by a burn because of its direct cooling effect. This however does not last long because butter, or any greasy substance for that matter, will actually slow down the release of heat from the skin. This means that the trapped heat can continue to burn the skin. Rather run the affected area under cool running tap water for up to 20 minutes immediately after the burn.

2. LEAN YOUR HEAD BACK DURING A NOSEBLEED

This one I see all the time and it is very wrong. If you lean your head back during a nosebleed you will inevitably swallow blood. This blood can irritate the stomach and cause nausea and vomiting. It can also even cause you to choke. Rather pinch the nose closed and lean your head forward.

3. PUT SOMETHING IN SOMEONE’S MOUTH WHEN THEY ARE HAVING A SEIZURE

This is often done to try and prevent someone from biting his or her tongue during a seizure. Tongue biting does happen often, but it very rarely causes any airway obstruction. You are more likely to cause an airway obstruction from whatever you have put in the mouth.

Seizures can look really scary but it’s better to move that person to a flat surface and clear the area around them so that they cannot injure themselves, while waiting for the seizure to end.

4. RUBBING ALCOHOL FOR A FEVER

 Many parents try reduce their little one’s fevers by rubbing alcohol directly on the skin or adding it to a sponge bath. As alcohol evaporates it can significantly cool the skin and potentially help reduce a fever. The problem with this is that rubbing alcohol (isopropyl alcohol) is also quickly absorbed into the skin and the fumes inhaled, which can lead to alcohol poisoning.

5. STAY AWAKE AFTER A BUMP TO THE HEAD

Parents often ask me if their little one is allowed to sleep after taking a knock to the head. It is no longer recommended to keep someone awake after a head injury. The concern was always that if someone with a concussion went to sleep they would not wake up.

If there are no red flags then it is perfectly acceptable to allow your child to sleep. Sleep is actually really important for the brain to heal. You can read more about head injuries here https://www.oneaid.co.za/a-bump-to-the-head-when-should-you-worry/

6. LIFT YOUR ARMS ABOVE YOUR HEAD WHEN YOU ARE COUGHING OR CHOKING

Someone who has a partial airway obstruction will still be able to cough. You should do nothing else but encourage coughing. When I was a child, my mother used to make me lift my arms up above my head. This can actually be dangerous because when you lift your arms, this movement causes the neck to move as well. The object causing the irritation may then slip further down into the airway and cause a complete obstruction.

7. MAKE SOMEONE VOMIT IF THEY HAVE SWALLOWED A POTENTIAL POISON

Do not make your child or anyone vomit by giving Ipecac syrup or even sticking your finger in their throats. This can be very harmful, especially if the poison swallowed is burning or corrosive.

The substance may get breathed into the lungs when vomited up and cause serious damage. The substance may also cause more damage to the lining of the oesophagus when vomited. The best thing to do is to call an ambulance or head straight to your nearest emergency room.

8. IF SOMEONE FEELS FAINT, MAKE THEM SIT WITH THEIR HEAD BETWEEN THEIR KNEES

If you do this and the person bent over does faint, they can fall out of the chair and get injured. Fainting is usually caused by decreased blood to the brain. If you are seated and put your head between your legs you will only slightly increase blood flow to the brain. It is far better to make that person lie down flat on their back and raise their legs. If the person has already fainted you should also lay them on their back and raise their legs.

9. APPLY HEAT TO A SPRAIN, STRAIN OR FRACTURE

Cold is commonly used for acute injuries and heat for more chronic conditions. Heat causes blood vessels to dilate, which increases blood flow, swelling and ultimately pain and cold has the opposite effect. After a sprain, strain or fracture it is better to apply ice to help with the swelling and pain.

Heat is very good for muscle spasms and other inflammatory conditions such as arthritis. Heat reduces muscle tension and causes muscles to relax. The increase in blood flow caused by the heat also helps remove pain-causing inflammatory cells and bring in healing cells.

10. PUT RAW STEAK ON A BLACK EYE

We can probably thank the Looney Tunes for this one! The only benefit you will get from this myth is the effects of the cold. Meat is often full of bacteria so whilst a big piece of raw steak will help with the swelling, it may cause an eye infection in the process. It is much better to apply an ice pack or even a frozen bag of peas.

There are many other myths. Do you have any others you would like to share with me? Can you remember any first aid tips or tricks that your Mother and even your Grandmother used to practice?

How Safe Are Teething Gels?

Every baby is different but common symptoms associated with teething include, mild irritability, drooling, low-grade fever and loss of appetite. If your baby is inconsolable or has a high fever chances are this is not due to teething. Teething should not make your baby very sick but rather very unhappy.

It’s terribly heartbreaking to see our little ones in pain and we would do just about anything to help ease their discomfort. As a result, parents commonly resort to various teething gels. Evidence has shown that some of the ingredients in these teething gels can be dangerous and that teething gels or creams actually offer very little benefit since they get washed out of a baby’s mouth within minutes. In this post I am going to unpack these ingredients and explain why they can be so harmful.

BENZOCAINE AND LIDOCAINE

Both of these ingredients are local anaesthetics and work by numbing the gums to alleviate pain. Whilst there are differences in absorption and duration of action between the two, their side effects are very similar.

One of the most dangerous and thankfully rare side effects is the development of methaemaglobinaemia. This condition basically leads to a reduction in oxygen in the body, which can lead to death. Children younger than two have a higher risk of developing this condition and therefore benzocaine and lidocaine products are not recommended for use in children under this age, unless prescribed by a healthcare provider. 

Another problem with these products is accidental overdose. It is difficult to dose these medications therefore it’s quite possible you can give too much. Inevitably most of the gel you give ends up being swallowed and if too much is swallowed this can lead to seizures, heart problems and even death. Too much of these gels can also numb the back of the throat and inhibit the gag reflex making it easier for young children to choke.

CHOLINE SALICYLATE

Another ingredient found in teething gels is choline salicylate. Teething gels, which contain this ingredient, work by reducing the inflammation and subsequently the pain.

This is the same salicylate found in aspirin and we know that aspirin is not recommended in children under the age of 16 because of the risk of Reye’s syndrome, a rare but fatal disease. Because of the theoretical risk of developing this syndrome from teething gels which contain this ingredient, the United Kingdom has completely banned their use in children younger than 16.

As I have mentioned before, it can be tricky to dose gels correctly so there is also a risk of salicylate toxicity when using gels with this ingredient.

WHAT ABOUT “ALL-NATURAL” TEETHING GELS?

With all the hype around the dangerous ingredients mentioned above there has been an increase in so-called “all-natural” teething gels. The problem with “natural” products is that they do not undergo rigorous scientific testing using clinical trials, which aim to identify any potential side effects. Some natural remedies have been around for years and whilst these herbs may or may not be effective for some, they can be dangerous for others.

The FDA has warned against the use of any homeopathic teething gels. The concern has mainly been over compositions that contain the ingredient belladonna, which is extremely toxic in large amounts. Investigations have found that the amount in the teething products exceeds the amount stated on the label. 

Chamomile and Marshmallow root extract are commonly found in natural teething gels. They are mainly used for their anti-inflammatory properties and do have a relatively low risk of side effects. But since you never really know what you are getting with these herbal products it is recommended you simply avoid them. These products are not tested for safety or effectiveness, and you have no way of knowing if the amount of active ingredient is too small to actually have an effect, or too large to result in serious complications.

SO HOW CAN YOU EASE THE PAIN?

There are a few simpler and safer methods you can try to ease your little one’s teething pain:

  1. Massage your child’s gums with a clean finger.
  2. Give your child a firm rubber teething ring that has been chilled in the fridge and not in the freezer.
  3. Give your child a clean and cooled damp washcloth to chew on.
  4. If you need to resort to medicine use paracetamol or ibuprofen (you can read more about these medicines in a previous blogpost of mine: https://www.oneaid.co.za/medications-for-pain-fever-in-children/ ).

RESOURCES

https://www.aappublications.org/content/35/8/32.1

https://emedicine.medscape.com/article/1009987-overview

https://www.fda.gov/consumers/consumer-updates/safely-soothing-teething-pain-and-sensory-needs-babies-and-older-children

https://www.fda.gov/news-events/press-announcements/fda-warns-against-use-homeopathic-teething-tablets-and-gels

https://www.gov.uk/drug-safety-update/oral-salicylate-gels-not-for-use-in-those-younger-than-age-16-years

https://www.medscape.com/viewarticle/849029_2

https://medsafe.govt.nz/profs/PUArticles/Topical%20oral%20choline%20salicylate%20gels%20-%20safety%20in%20children%20-%20Aug%2009.htm

https://nccih.nih.gov/health/teething

Shouldn’t It Be “Fed Is Best”?

This post is a little different to my others because it is personal. I want to share more of my momlife journey with you so where better to start than at the beginning, with one of the first challenges I had to deal with when becoming a mom.

No one tells you before having kids how difficult breastfeeding really is. The phrase “breast is best” is one I have constantly heard over the years and one that I myself have drummed into my patients. My breastfeeding journey was a time in my life when I have never felt more incompetent. I have spent so much time over the years ‘lecturing’ expectant parents and new moms about the benefits of breastfeeding and even shown some moms how to latch correctly. I would have thought that with all my knowledge I would grasp this breastfeeding skill from the beginning, but I did not.

It took two midwives and three lactation specialists to finally tell me I had flat nipples. Clearly, I have never looked at my breasts properly. With this newfound information I went out to buy a range of different nipple shields thinking this would solve my problem. After 2 weeks of becoming obsessed with breastfeeding I realised my daughter was not gaining any weight and was in fact losing it. So I decided to scrap the shields and embrace my breastpump.

I exclusively pumped for three very long months. I sometimes think that this required even more effort than the breastfeeding. I had to pump at regular intervals throughout the day and night to ensure a good milk supply, since the suction from a pump is not as efficient as the suction from a baby in stimulating milk production. After three months, I went back to work. The pumping was going to be even more difficult and to be honest I was a bit over constantly having to sterilise the parts. And so began my quest to find the best formula.

I remember staring at that formula aisle for a really long time feeling overwhelmed by all the options available. Of course I knew some names like NAN, Isomil and S-26, but there were so many more. I had no idea what the difference between all of them was (they don’t teach us this at med school) so I asked someone for help. You know what I was told? “I am not allowed to tell you anything about formula”. I was now really confused and very angry.

Before the 80’s, women were encouraged to formula feed (obviously to the benefit of the big pharmas). Unfortunately such messages were exploited in underprivaledged communities. This had devastating consequences with rising infant mortality rates in these areas. I won’t go into any detail about the Nestlé formula scandal but it did cause a global uproar and now there is a code in place which restricts the marketing of breast-milk substitutes worldwide in order to protect breastfeeding. South Africa has incorporated this code into legislation and this is why it is so damn hard to get any information about formula. Our former health minister, Dr Aaron Motsoaledi, even suggested formula be banned throughout the world stating it is “no different from skin lightening creams”.  Yes, seriously, this comparison was made.

As if being a mother isn’t hard enough, we now have to find time to do our own research or pay to get this information by going to see our Paediatricians (and I don’t even think they know everything there is to know about formula). If breast is best and if this code is so effective then why are we constantly being bombarded with confusing messages. On one end breastfeeding in public is still very much taboo yet everyone tells us we need to breastfeed. On the other end we should not formula feed our babies yet bottle feeding is easier on the eye and we all need to go out and buy those new self-warming bottles.

Shortly after I stopped pumping I took Eryn to a birthday party. Most of the moms there were successfully breastfeeding either their infants or toddlers. All these women spoke about the entire morning was breastfeeding. I never said a word because I felt ashamed and excluded. In hindsight, I am angry at myself for having felt that way. I was sitting there with a very healthy baby girl on my lap and so what if she was being formula-fed.

I’m sure we can all agree that breast is best but I think we are taking things a little too far. I would like to see the narrative change to “fed is best”. I don’t deny the benefits of breastmilk but this may not work for everyone. The success of breastfeeding is a complex combination of many factors. All it takes is for one wheel to come off and then the whole ride can become very bumpy.

We live in a society where freedom of choice is celebrated. Why then are mothers judged so harshly for the feeding methods they choose? Since becoming a mom I have learnt that mothers are the harshest critics and supreme court judges. We really need to take a step back and start to create a safer all-inclusive space for mothers to exist. A space where single, divorced and widowed moms, breast and formula feeding moms, moms with post-partum depression and anxiety, adoptive and foster moms, working and stay at home moms, biological and stepmoms can all be celebrated as the real mothers they are.

RESOURCES

https://www.who.int/elena/bbc/regulation_breast-milk_substitutes/en/

https://www.news24.com/SouthAfrica/Politics/Ban-infant-formula-Motsoaledi-20100513

Essential Fire Safety Equipment You Need In Your Home

How many of you have smoke detectors installed in your homes? Do you also own a fire extinguisher and if so is it the correct one? In this blog post I want to go into a little more detail on these products and why they are so important to have in your home.

SMOKE AND CARBON MONOXIDE DETECTORS

A smoke detector alarm detects the presence of smoke and possible fire in your home whereas a carbon monoxide (CO) detector alarm alerts you when the levels of CO in your home are dangerously high. Smoke detectors are a must for all homes. You only need a carbon monoxide detector if you use fuel-burning appliances such as gas stovetops, heaters and geysers. CO detectors are also important if your home has a fireplace.

These detectors need to be installed where you can hear them, especially while you are sleeping. It would be pretty pointless to put one in the garage if your bedroom is on the top floor. It is recommended that you have a smoke and carbon monoxide detector either inside or just outside of every bedroom. You also need to make sure there is one on each floor of your house.

Carbon monoxide detectors should also be installed near fuel-burning appliances, just outside the garage and in rooms with wood burning fireplaces. Carbon monoxide is a silent killer. You cannot see or smell the gas and in the early stages CO poisoning will feel more like the flu. You can read more about carbon monoxide and how it affects the body in my previous blog post: https://www.oneaid.co.za/gas-or-wood-how-to-safely-keep-warm-this-winter/

Most of these alarms run on batteries so they need to be tested regularly, at least every month. The batteries should also be replaced once a year.

FIRE EXTINGUISHERS

There are at least four different types of fires that can happen in your home and water is definitely not the safest way to extinguish all of them.

Common causes of house fires:

1.     Class A

These fires involve combustible materials such as wood, textiles, straw, paper etc. These are materials that can combust, i.e. burn in air.

2.     Class B

These fires are caused by the burning of liquids or materials that liquify, such as petrol, paint, alcohol and paraffin.

3. Class F

These fires involve cooking oils and fats in the kitchen.

4.   Electrical appliances (formerly type E)

These are fires caused by electrical appliances

What fire extinguisher do you need?

There are five main types of fire extinguishers; water, foam, dry powder, CO2  and wet chemical. The different types of extinguishers are used to put out different classes of fires. There is not one extinguisher type that works on all classes of fire.

  1. Water fire extinguisher

These extinguishers are used to put out class A fires. The water has a cooling effect, which causes the fire to burn more slowly until all the flames have been extinguished. These extinguishers should not be used on or near electrical appliances.

These are not recommended for class F fires. If you had to use this extinguisher on such a fire in your kitchen, there would be an explosion of steam much larger than the one you see when rinsing a hot pan under water. This explosion would throw hot oils all over your kitchen, which could cause a new fire and most definitely result in thermal burns to your skin and eyes.

2.Foam fire extinguisher

Foam extinguishers are useful against both class A and B fires. Similar to water extinguishers, foam extinguishers have a cooling effect. These should also not be used on or near electrical appliances.

3. Dry powder fire extinguisher

These extinguishers can be used on class A, B, C and electrical fires. They work by forming a barrier on top of the fire so that the burning fuel has no more access to the oxygen it needs to burn.

These extinguishers should not be used in enclosed spaces as the powder that is dispersed can be inhaled. Therefore they are not recommended for home use.

4. CO2 fire extinguisher

CO2 extinguishers are used on class B and electrical fires because CO2 does not conduct electricity. These extinguishers work similar to the dry powder ones whereby they suffocate the fire by removing the oxygen from its surface.

5. Wet chemical extinguisher

These are the extinguishers you would use on a class F fire. They can also be used on class A fires. They work by creating a layer of cooling foam on top of the burning oil or fat and therefore also cut off the oxygen supply.

Before going out to buy a fire extinguisher you need to identify the different fire risks you have in your home, because this will determine which type of extinguishers you need and where you need to keep them. It is probably best to have an expert come and inspect your home and assess your individual needs. They can also guide you on where to install smoke and carbon monoxide detectors.

If you do have a fire extinguisher in your home make sure you know how it works. Read the manual or have someone show you, because in an emergency you really don’t want to be figuring out how the safety pins work.

RESOURCES

https://www.cityfire.co.uk/wp-content/uploads/2018/11/fire-extinguisher-types.pdf

https://www.cpsc.gov/s3fs-public/SmokeAlarmWhyWhereandWhichCPSCPub559RevisedJuly2016PostReview.pdf

https://surreyfire.co.uk/types-of-fire-extinguisher/

Gas or Wood? How To Safely Keep Warm This Winter.

We are now well into winter and definitely feeling the chill! South African homes are not well equipped to withstand the cold and we have to resort to various heating appliances to stay warm during winter. This is why structural fires and carbon monoxide poisoning are so common during the winter months. Below, I outline some safety tips on keeping warm in the home.

WHEN USING A GAS HEATER

  1. Always make sure the gas heater and especially the cylinder is completely turned off before going to bed or leaving the house.

  2. Always keep the room well ventilated to avoid carbon monoxide (CO) build up.

  3. Do not use outdoor gas heaters indoors, as they may produce more CO.

  4. Make sure all components of the heater are well maintained. Ensure the gas bottle is safely secured with no leaks.

  5. Natural gas is odourless. In order to identify leaks more easily manufacturers add chemicals to give it that distinctive rotten eggs smell.  If you smell gas in your home turn off the gas cylinder and do not use an electric fan to try and remove the gas.

  6. When switching your gas heater on always start by first turning on a match or lighter and then opening the gas supply. When switching the heater off always turn the gas cylinder off first.

  7. Never move a gas heater whilst in use.

  8. Do not place anything on or over the heater, such as damp laundry items. This can result in a fire. Do not ever sit on a gas heater either as it could fall over.

  9. Do not use flammable liquids and/or aerosols near a gas heater. Do not use a gas heater in a room that has recently been painted.

  10. Make sure to keep all flammable items a safe one-metre away.

  11. Have smoke and CO detectors installed and test them regularly.

  12. Always keep a fire extinguisher in your home.

 

WHEN USING A FIREPLACE 

  1. Keep a window slightly open.  This will help prevent the room filling up with smelly smoke. It also prevents the build up of carbon monoxide (CO).

  2. Make sure the damper of your chimney is open so that the smoke can leave the house. Only close the damper once the fire is completely extinguished.

  3. Use dry wood and not wet or green wood. Wet and green wood cause more smoke.

  4. Clean out any ash from the previous fire. Thick layers of ash restrict the air supply to the fire and cause more smoke. 

  5. Use smaller pieces of wood because these create less smoke.

  6. Remember to have your chimney cleaned once a year before the winter season. Animal nests and excess soot can block the escape of smoke.

  7. Never leave a fire in the fireplace unattended. Always make sure it is completely extinguished before going to bed and/or leaving the house.

  8. Make sure the area around the fireplace is clear of potentially flammable items such as books, curtains and furniture. Keep a safe one-metre distance.

  9. Keep fireplace tools and accessories such as firelighters, matches and lighters out of a child’s reach.

  10. Use safety screens so your children can’t get burnt by hot flying embers or by touching the hot glass of a closed fireplace.

  11. Have smoke and CO detectors installed in your house and test them regularly.

  12. Always keep a fire extinguisher in your home!

CARBON MONOXIDE POISONING

It may seem counter-productive to keep a window open when you are trying to keep your home warm, but this is extremely important if you are burning a fuel, such as gas, paraffin, coal or wood to generate heat.

Carbon monoxide (CO) is a colourless and odourless gas produced by the incomplete combustion of these carbon-containing fuels. When there is too much CO in the air your body replaces the oxygen attached to red blood cells in the blood, with carbon monoxide. This is because the affinity between haemaglobin (Hb) (in the red blood cells) and carbon monoxide is much stronger than the affinity between Hb and oxygen. This can be extremely dangerous and lead to hypoxia, irreversible brain damage and eventually death.

Symptoms of carbon monoxide poisoning include:

  • Tiredness
  • Shortness of breath
  • Headache
  • Dizziness
  • Nausea or vomiting
  • Weakness
  • Confusion
  • Loss of consciousness

If carbon monoxide poisoning is suspected you need to move the victim into fresh air, either by opening all the doors and windows or getting the person outside. This will allow some oxygen to start displacing the carbon monoxide. Definitive management is however in hospital with high flow 100% oxygen so you need to call an ambulance right away.

ELECTRIC HEATERS

Some of you may have electric heaters in your homes. These are safer than using gas and fire but still not 100% safe. Electric heaters use a lot of electricity so they can easily overload circuits and cause power failures or fires.

You should never plug in more than one electrical device into the same outlet as the heater to prevent overheating and overloading. To prevent electric shocks electric heaters should not be used in rooms where moisture builds up such as bathrooms and kitchens. There is also a fire risk if flammable items such as fabric come into contact with electric heaters that have hot elements and the electric bar heaters pose an additional burn risk.

Whatever heating methods you use this winter none of them are guaranteed safe, so remember to take the necessary precautions. It is important that you teach your children about fire safety from a young age. If your little ones do get thermal burns from poking fires and other heating elements follow the principles of first aid.

To find out more about management of thermal burns you can read my previous post: https://www.oneaid.co.za/baking-with-your-little-ones-safety-and-tips-to-taking-care-of-thermal-burns/. It is also recommended that you develop a fire escape plan and make sure your children know how to safely get out of the house in the event of a fire.

RESOURCES

https://www.betterhealth.vic.gov.au/health/healthyliving/gas-heating-health-and-safety-issues

https://www.healthychildren.org/English/safety-prevention/all-around/Pages/Fire-Safety.aspx

https://www.nhs.uk/conditions/carbon-monoxide-poisoning/ https://riseandshine.childrensnational.org/how-to-protect-children-around-fireplaces/

Is It A Cold Or Is It The Flu?

Winter is here and so are coughs, colds and flu. Common colds and flu are both caused by viruses and share many of the same symptoms however colds are usually milder and do not cause any serious complications. More than 200 viruses can cause a cold whereas the flu is caused by the Influenza virus. This is why there is no vaccine available for the common cold.

WHAT IS THE DIFFERENCE?

Generally colds affect you from the neck up where the flu attacks your entire body. A cold causes a runny or blocked nose and sneezing. There may be a sore throat with a slight headache because of nasal congestion. A cough can develop but this is mostly because of a post-nasal drip. Cold symptoms usually last for about a week. If the symptoms do not improve after a week it is less likely to be a cold and an allergy or sinusitis should be considered.

The flu on the other hand causes more distressing symptoms. These include fever, chills, body aches, cough, weakness and extreme tiredness in addition to all the symptoms of a cold. Most flu symotoms also improve after a week but it is common to still feel a little weak and tired for up to two weeks.

Pneumonia is a complication of the flu, especially in the young, elderly and those with pre-existing chronic diseases. If your child seems to be getting worse, has difficulty breathing, is extremely lethargic or irritable, is refusing to take in enough fluids and/or has a persistently high fever you need to seek medical assistance.

HOW TO REDUCE THE RISK OF CATCHING A COLD OR THE FLU

  1. Vaccinate: make sure everyone in your family gets the seasonal flu vaccine every year. It takes about two weeks for antibodies to develop and offer protection. It is recommended you receive the flu vaccine before the flu season starts but it’s never too late. In South Africa the flu season usually starts around the first week of June but in previous years it has started as early as April.

  2. Hand washing: Make sure you wash your hands frequently and teach your children about good hand washing. Wash with warm soapy water for at least 20 seconds. Cold and flu viruses enter the body through the mucous membranes of the nose, mouth and eyes. This means that every time you touch these parts of your body with hands that have the virus you have a high risk of infecting yourself.

  3. Cover up:  teach your children to sneeze or cough into a tissue or their elbow and NOT into their hands.

TREATING A COLD OR THE FLU

Antibiotics do not work against viruses. Therefore they will not work for a cold or the flu unless a bacterial complication has developed. Often I see that antibiotics are prescribed for viral infections to “treat” the parents rather than the children. This is dangerous and will only lead to the emergence of more antibiotic resistance, which is already a major global problem. Some parents will argue and say that their child started recovering after a few days on antibiotics but this is probably because the viral infection has run its course and is coming to an end instead.  

There are plenty of over the counter (OTC) medicines available for cold and flu symptoms targeting both adults and children. However, these are not recommended for use in children under two years of age. Some experts even suggest avoiding them up to six years. There is very little evidence to prove that these medications work at all and some of them can cause serious side effects in younger children such as hallucinations, irritability, restlessness and abnormal heart rhythms. More importantly codeine, which is an ingredient commonly found in cough, cold and flu medications should not be given to children younger than 18 years of age.

There are some antiviral medicines available for the flu. These are typically prescribed to children at high risk of complications, such as children with asthma. These drugs work best if taken within 48 hours of the onset of symptoms and help by reducing the length and severity of the infection.

Unfortunately, there is no cure for the common cold and flu. It will usually clear up on its own and all you need to do is treat it symptomatically:

Analgesics and antipyretics: you can give your child paracetamol or ibuprofen, NEVER aspirin. To find out more about medicines for pain and fever in children you can read my previous blog: https://www.oneaid.co.za/medications-for-pain-fever-in-children/

Fluids: make sure to give your child lots of fluids to prevent dehydration especially if they have a fever and/or are refusing to eat.

Rest, rest and more rest: allow your child to rest. The body needs rest to recover so keep your child home from school and forget about extra murals for a while.

Nose sprays: the most important nose spray you should use is a saline spray. These help thin the mucus and reduce nasal congestion. There are also other decongestant nose sprays that can be used in older children.

Warm steam and humidifiers: sitting in a steamy bathroom or using a humidifier, which adds moisture to the room, can help loosen mucus in the nose and relieve coughing.

TOP 5 COLD AND FLU MYTHS

  1. Milk and other dairy products make a cold worse
    There is no evidence that dairy products increase mucus production.

  2. “Feed a cold, starve a fever”
    If your child have a fever they need more fluids. Fevers cause dehydration and this happens more rapidly in young children. Provide plenty of fluids when your child is sick and if he or she has an appetite, allow them to eat.

  3. The flu vaccine will give you the flu
    The flu vaccine is made from an inactivated virus so you cannot get the infection. People who do get sick after receiving the vaccine got the infection from another source and were going to get sick anyways. Also, some people develop flu-like symptoms after a vaccine. This is a normal immune response to a vaccine. These symptoms never last as long as the flu would.

  4. You can catch a cold or the flu by going outside in cold weather without a jacket, having wet hair in winter or walking barefoot
    Germs make you sick and not the cold. People make this natural association because the cold and flu season happens during winter. The reason for this is that in colder weather people tend to congregate closer together to keep warm and doors and windows stay closed. This allows viruses to spread more easily.

  5. Chicken soup will make you better
    There are no antiviral properties in chicken soup but it can definitely make one feel better. The warm liquid can soothe a sore throat and keep you hydrated and the steam can help break down nasal congestion and reduce stuffiness.

It’s quite common for children under two to have as many as 8-10 colds a year with prescholars getting around 7-8.  It takes years to develop an immunity to viruses and since there are more than 200 viruses that can cause a cold the high rate of infection in our little ones makes sense. Don’t despair, the cold and flu season does eventually end but for now it’s a great reason to give more healing cuddles and keep our little ones loved up and warm this winter.

RESOURCES

https://www.cdc.gov/flu/symptoms/coldflu.htm

https://www.fda.gov/consumers/consumer-updates/when-give-kids-medicine-coughs-and-colds

https://www.health.harvard.edu/diseases-and-conditions/10-flu-myths

http://www.nicd.ac.za/influenza-season-approaching/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2722603/

When Your Child Eats A Silica Gel Sachet

I’m sure many of you are familiar with those little sachets you find in almost anything these days.  The ones with the massive “DO NOT EAT” all over them. I have seen my fair share of hysterical parents bring their kids into the ER with a history of having swallowed the contents. But are these sachets really that dangerous?

These little sachets contain silica gel, which is silicon dioxide (Si02). The sachet does not actually contain a gel but rather small beads. Silica is a desiccant, which means it absorbs water. It has millions of small pores that hold moisture and can absorb up to 40% of its weight, which is why you find it in products that would otherwise spoil from excess moisture.

IS SILICA TOXIC?

Silica gel is chemically inert and considered to be non-toxic. Silica gel packets contain less than 5g of silica gel. If this tiny amount is ingested, it basically passes through the digestive tract without being absorbed or digested.

While this means that the contents of these sachets are harmless, it would be quite unpleasant if these are handled or swallowed. The mouth, gums and tongue would become parched, and if the contents were swallowed and not spat out, this would result in a few self-limiting side effects. Most notably, dry throat, eyes and mucous membranes in the nose, together with stomach discomfort and depending on the amount swallowed, nausea, vomiting and constipation. If the sachet was opened and the contents handled, it can also dry out and irritate the skin.

FIRST AID FIRST

If you think your child has played with silica gel, practice the principles of first aid. Anywhere the silica has come in contact, will be irritated. Wash whatever parts of the skin have been in contact with the silica and moisturise afterwards. If the eye has been touched, then rinse with running water for up to 15 minutes. If the contents were swallowed the best thing you can do is offer continuous sips of water to relieve the stomach distress. Do not give anything to induce vomiting! You don’t want the silica to be inhaled, because it can cause a very irritating cough and shortness of breath. The symptoms of silica ingestion are self-limiting, meaning that eventually, they will go away on their own.

IF SILICA IS NON-TOXIC WHAT IS THE BIG DEAL?

The biggest concern with these sachets is choking. These tiny beads are a choking hazard for small children. Unfortunately, additives, such as moisture indicators, are also sometimes added to the silica which can then make it toxic.

WHAT ARE MOISTURE INDICATORS?

Some silica gel sachets have moisture indicators. These indicator sachets are available in different colours depending on the type of indicator used. You may also find some sachets which contain a mixture of both indicator and non-indicator beads. The blue “indicator” silica gel is the more common one you may find. The blue comes from either cobalt dioxide, methyl violet or some other toxic substance that gets added to the silica. These substances change colour when wet and therefore are a good indicator of a saturated silica gel sachet. Cobalt dioxide, in particular, is a known carcinogen and also affects fertility. The FDA is busy banning this additive altogether, and thankfully, these indicator sachets are not commonly found in consumer products. If your child does, however, come into contact with one of these, you should seek immediate medical assistance.

Always remember to discard these sachets immediately after opening your products. Given the uncertainty of the composition of some of these silica sachets, practice the principles of first aid and keep an eye out for any unusual signs and symptoms whenever your child comes into contact with silica. If there is any concern, head straight to your nearest emergency room and don’t forget to take the sachet with you so that the contents can be tested.

RESOURCES

https://www.productip.com/uploads/CClip_519_SilicaGel_20130827_v1.pdf

https://www.illinoispoisoncenter.org/my-child-ate-Silica-Gel

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3493316/

Should Your Child Be Using Fluoride Toothpaste?

Untreated tooth decay in children is one of the most common conditions worldwide, which is why many toothpaste manufacturers have a wide range of toothpaste aimed at children, available in a variety of sweet flavours with cartoon characters all over the packaging. I wanted to write this post to give parents a little more information about toothpaste because it’s not really about the cute packaging and the taste test (agreed this does help make brushing teeth a lot easier).

Many parents, unfortunately, do not know the proper guidelines when choosing and using toothpaste in children. Majority of mothers start brushing their children’s teeth late, use adult toothpaste and have no idea about the clinical significance of fluoride. Most moms also use a full length of toothpaste on their children’s brushes.

HOW MUCH FLUORIDE IS ENOUGH?

Your body takes in fluoride by swallowing it in food and water. Fluoride occurs naturally in varying amounts in water sources and to a lesser degree in certain foods and drinks. Some countries also fluoridate their public water supply. Another way to take in fluoride is by topical application (in fluoridated toothpastes and mouthwashes). The fluoride taken in from foods and drink also provides some topical benefits when it becomes mixed with saliva.

We all know that brushing your teeth is vital in preventing tooth decay. It helps remove plaque, and the fluoride in toothpaste makes tooth enamel stronger, and more resistant to cavities. But how do you know which toothpaste to buy for your little ones when the amount of fluoride between brands ranges from zero to as high as that of adult toothpaste?

Fluoride in toothpaste is expressed as parts per million of fluoride (ppmF). According to the UK Department of Health, children under three years of age need to use a toothpaste with 1,000 ppmF. Older kids and adults need to use 1,450 ppmF. Young children need less fluoride to reduce the risk of fluorosis.

WHAT IS FLUOROSIS?

Fluorosis is the change of appearance of permanent teeth where they develop white lines or streaks. This happens when the developing teeth under the gums in younger children are exposed to excess fluoride. Too much fluoride affects the mineralisation of the teeth, and children younger than six years are at highest risk. The severity of Fluorosis is dose-dependent.

Image Source: health2blog.com

Fluorosis is a cosmetic condition and not a disease. It does not increase or decrease the risk of cavities. While the majority of cases of Fluorosis are mild, it can still have a significant psychological effect on your child.

HOW MUCH TOOTHPASTE IS ENOUGH?

It can be challenging to get your child to spit out the toothpaste after brushing without swallowing, especially if the toothpaste tastes like candy. It is therefore essential to use a small amount of toothpaste until your child has learnt to spit after they brush since inevitably your child will end up swallowing about half of what’s on the brush.

To prevent too much fluoride from being swallowed, you have to be vigilant about the amount you put on the brush. It is recommended that children under three years of age use no more fluoride toothpaste than a smear or the size of a grain of rice. For children three to six you should use a pea-sized amount of fluoride toothpaste.

Teach your child from an early age to spit. They don’t need to rinse. It’s also a good idea to not let them eat or drink anything after they have brushed their teeth so that the fluoride can do its job overnight.

KEY POINTS

  • Start brushing your baby’s teeth as soon as you see them come through.
  • Brush your child’s teeth morning and night with an age-appropriate brush.
  • Use fluoride toothpaste with the right amount of fluoride recommended for your child’s age. It is no longer recommended that children start using fluoride toothpaste only after the age of two.
  • Use the correct amount of toothpaste for your child’s age.
  • Children under six years of age should never use a fluoride mouthwash.

Fluoride toothpaste is generally safe and recommended for babies and young children provided you use it correctly. The most important thing you need to worry about is the amount of fluoride in the toothpaste. The next time you go out shopping for toothpaste take a look at the ppmF. You will be quite surprised since many of the “children’s” toothpastes have exactly the same amount of fluoride as adult toothpaste. Therefore it really only boils down to cost and taste and whether or not your little is a fan of Barbie.

How To Make The Medicine Go Down

It’s stressful when your kids are sick and even more stressful when they refuse to take their medicines. Not to mention the icky stickiness that is almost impossible to wash off your skin. In this blog I will share with you some tips I have learnt over the years to help make the medicine go down.

1. Disguise the taste

Many over the counter liquid medications available for kids are flavoured. Look on the bottle to see which flavour you are buying. Some brands have different options for the same drug such as Panado’s strawberry and peppermint flavours. Some brands may have the same flavours but taste different. My daughter prefers the strawberry flavour of Calpol than that of Panado. If the medication needs to be made up by a pharmacist, ask them to flavour the medication if possible.

Unfortunately, some meds just taste awful and not all pharmacies stock flavourings. You’ll need to get creative here. You can mix the liquid with fresh fruit or vegetable juice and even honey (if your child is over one year). You can also try mixing meds with milk or yoghurt but the calcium may interfere with the effects of some medications, particularly with certain antibiotics. Acidic foods may also inactivate some antibiotics. It’s important to ask your pharmacist and read the patient information leaflet before you decide to try this method.

If you are hiding the medication in a food or drink, keep the volume small so that the entire dose can be taken. Don’t mix with a full bottle or cup of juice if your child will not finish this.

2. Equipment

I always use a syringe and squirt the medicine along the inside of the cheeks and not onto the tongue. This way you can bypass the taste buds a little. You can also use a medicine dropper the same way. Slide the syringe or dropper along the cheek towards the back of the mouth and squirt the medicine slowly. Do not aim for the throat as your child will gag and cough and if you aim too far in front of the mouth the medicine will simply be spat out.

Using a syringe also allows you to give correct dosages. In kids it’s vital you give the correct dosage of medication. You can wash and reuse the syringes but after a while you should replace them.

3. Keep it chilled

You can also numb the taste buds beforehand. Your child can suck on a block of ice if he or she is older or you could try an ice-lolly for a younger child. Some medications can also be stored in the fridge, which can make them taste better.

4. Wash it down

Whilst Mary Poppins recommended a spoonful of sugar, I’m not sure many of us moms will be too happy with the after effects of this sugar rush before bedtime.

Have a glass of water or your child’s favourite drink on standby to drink as soon as they swallow just so they can wash their taste buds.

5. Coat the taste buds

You can try giving your child a spoonful of something thick and sweet such as maple syrup or honey to coat the tongue before giving the medicine.

6. Try a tablet instead

Some liquid medicines are available as chewables. If your child is old enough you can try these. Whilst there are some tablets that can be crushed and mixed with food. Speak to your doctor or pharmacist before you do this.

You may also find dissolvable tablets. Dissolve the tablet in a small glass of water and add some fruit juice to hide the taste as these can be extremely bitter.

7. Give your child some control

You will find that your kids will be more willing to take their medicine if they are in control or at least think they are. Allow them to choose when to take their medicine, for example, before or after the bath. They can also choose what flavour medicine they would like when you are buying it for them.

IF IT WORKS, STICK TO IT

You might find that more than one trick is necessary. If you have found a technique that works, stick to it. A while back I tried using one of those fancy medicine syringes I got at my baby shower instead of a simple syringe (I had actually forgotten to replace the ones I had thrown out). These syringe type medicine feeders are quite big and I couldn’t get it far enough to the back of the mouth to bypass the taste buds. My daughter did not like this at all and I ended up wearing most of the medicine!

Do you have any other tricks or tips to get your kids to take medicine? Please share in the comments section below!

If your little one requires medicine on a regular basis, here is a medicine chart to help you organise the days and quantities.

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