Laughter is Good Medicine

There are few things in life better than hearing a child laugh. The sound is food for the soul – and often adults can’t help but to join in and laugh along.   And that’s wonderful, because laughter is good for children and adults alike.

Whether a simple chuckle or a rumble from deep in the belly, research shows that laughing has numerous health benefits:

  • Laughter enhances the intake of oxygen-rich air and increases the endorphins that are released by the brain. This makes kids feel good and may even reduce pain.
  • Laughter reduces stress and aggression. When children are stressed, upset or lashing out, a good laugh can divert them and provide an outlet for their aggression or anxiety.
  • A good laugh can improve mental alertness and help children be more creative.
  • Laughter may improve your immune system. Positive thoughts can release neuropeptides that help fight stress and potentially more-serious illnesses.*
  • Laughter helps us feel closer and connect with one another. When we laugh together, we feel a common bond.
  • Laughter promotes a more restful nights’ sleep.
  • Laughter is contagious. It’s hard to keep a straight face when someone near you is “cracking up”.

If you aren’t naturally finding things to laugh about, buy a joke book, watch a funny movie or a cartoon — or make funny faces. Whether you laugh a little or a laugh a lot, it’s fun, it’s free and it’s good for you!

 

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Ways to Build Strong Bones:

It’s easy to take our bones for granted. After all, they do all their work behind the scenes. But when a bone breaks, it’s a big deal. Bones take time to heal, even for kids.

Having strong bones in childhood lays a foundation for bone health throughout life. We build almost all our bone density when we’re children and teens. The bone-building process is mostly finished around age 20. As adults, we still replace old bone with new bone, but more slowly. Over time, our bones get weaker.

Kids with strong bones have a better chance of avoiding bone weakness later in life. As a parent, you can help by making sure kids get the three key ingredients for healthy bones: calcium, vitamin D, and exercise.

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1. Give Kids High-Calcium Foods

Calcium is a mineral that’s known for building healthy bones. It’s found in dairy products, beans, some nuts and seeds, and leafy green vegetables. It’s also often added to foods like orange juice or cereal.

What You Can Do

Encourage your kids to eat high-calcium foods:

  • If your child eats dairy, your doctor or dietitian can tell you how much to serve based on age. Younger kids may need 2–3 servings of low-fat dairy each day, while older kids may need 4 servings.
  • Look to replace common foods with high-calcium versions. Buy almond butter instead of peanut butter or calcium-fortified orange juice instead of regular juice.

2. Give Kids a Vitamin D Supplement

Vitamin D (sometimes labeled vitamin D3) helps the body absorb calcium. But most kids don’t eat many foods that contain vitamin D. Because vitamin D is so important, health care providers recommend all kids take a vitamin D supplement if they don’t get enough in their diet. Even babies need to take vitamin D unless they’re drinking at least 32 ounces of formula per day.

What You Can Do

Ask your doctor, nurse practitioner, physician assistant, or a dietitian how much vitamin D your child needs and the best way to get it.

3. Encourage Kids to Exercise

Our muscles get stronger the more we use them. The same is true for bones.

Weight-bearing activities like walking, running, jumping, and climbing are especially good for building bone. They use the force of our muscles and gravity to put pressure on our bones. The pressure makes the body build up stronger bone.

Activities like riding a bike and swimming don’t create this weight-bearing pressure. They are great for overall body health, but kids also need to do some kind of weight-bearing exercise.

What You Can Do

Make sure your child gets at least an hour of physical activity each day, including weight-bearing exercises.

Everyone needs to get enough calcium, vitamin D, and exercise. But these are really important for kids — especially when they’re growing during the preteen and teen years. Vitamin D and calcium also can be useful as part of a medical treatment. Health care providers often prescribe them when kids are recovering from fractures or orthopedic surgeries, such as spinal fusion for scoliosis.

Strep Test: Throat Culture

What It Is

A throat culture or strep test is performed by using a throat swab to detect the presence of group A streptococcusbacteria, the most common cause of strep throat. These bacteria also can cause other infections, including scarlet fever, abscesses, and pneumonia.

A sample swabbed from the back of the throat is put on a special plate (culture) that enables bacteria to grow in the lab. The specific type of infection is determined using chemical tests. If bacteria don’t grow, the culture is negative and the person doesn’t have a strep throat infection.

Strep throat is a bacterial infection that affects the back of the throat and the tonsils, which become irritated and swell, causing a sore throat that’s especially painful when swallowing. White or yellow spots or a coating on the throat and tonsils also might be present, and the lymph nodes along the sides of the neck may swell.

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Strep throat is most common among school-age children. The infection may cause headaches, stomachaches, nausea, vomiting, and listlessness. Strep throat infections don’t usually include cold symptoms (such as sneezing, coughing, or a runny or stuffy nose).

While symptoms of strep throat can go away within a few days without direct treatment, doctors will prescribe antibiotics to help prevent related complications that can be serious, such as rheumatic fever. Taking antibiotics reduces the length of time a person is contagious.

Why It’s Done

The throat culture test can help find the cause of a sore throat. Often, a sore throat is caused by a virus, but a throat culture will see if it’s definitely caused by strep bacteria, helping doctors decide on the proper treatment.

Preparation

Encourage your child to stay still during the procedure. Be sure to tell the doctor if your child has taken any antibiotics recently, and try to have your child avoid antiseptic mouthwash before the test as this could affect test results.

The Procedure

A health professional will ask your child to tilt his or her head back and open his or her mouth as wide as possible. If the back of the throat cannot be seen clearly, the tongue will be pressed down with a flat stick (tongue depressor) to provide a better view. A clean, soft cotton swab will be lightly brushed over the back of the throat, over the tonsils, and over any red or sore areas to collect a sample.

You may wish to hold your child on your lap during the procedure to prevent movement that could make it difficult for the health professional to obtain an adequate sample.

throat_swab_illustration

What to Expect

Your child may have some gagging when the swab touches the back of the throat. If your child’s throat is sore, the swabbing may cause brief discomfort.

Getting the Results

Throat culture test results are generally ready in 2 days.

Risks

Throat swabbing can be uncomfortable, but no risks are associated with a throat culture test.

Helping Your Child

Explaining the test in terms your child can understand might help ease any fear. During the test, encourage your child to relax and stay still so the health professional can adequately swab the throat and tonsils.

If You Have Questions

If you have questions about the throat culture strep test, speak with your doctor.

How to Take Your Child’s Pulse:

A person’s pulse, or heart rate, is the number of times the heart beats per minute. Taking someone’s pulse can tell doctors important things about his or her health.

Heart rate can vary depending on things like a person’s age and level of stress or activity at the time the pulse is taken. It’s normal for a heart rate to be irregular — meaning that the heart will slow down or speed up from time to time. But when it beats faster than what’s considered normal for an extended length of time, it could signal a problem.

What’s a Normal Heart Rate?

A child’s hearts normally beat faster than an adult’s. A healthy adult heart rate can range from 60 to 100 beats per minute during rest.

Kids’ heart rates can be as low as 60 beats per minute during sleep and as high as 220 beats per minute during strenuous physical activity. It’s normal for athletic kids to have slower resting heart rates, often in the 40s or 50s.

Before taking your child’s pulse, check with your doctor to see what range is considered normal for your child.

4 years 2.0

When to Take a Child’s Pulse

Usually, there’s no need to take your child’s pulse. Your doctor will check your child’s heart rate at well checkups.

But if your child has a medical condition that requires you to monitor his or her heart rate, your doctor may have told you when to take a pulse. You might need to do it regularly, or only on occasion. If you’re not sure, ask your doctor.

You also should take a pulse if your child ever complains of a “racing” heart or palpitations — when it feels like the heart is “skipping” a beat. Some kids say this feels like a buzzing, beeping, vibrating, or fluttering feeling in their chest. (Oftentimes, though, these feelings are nothing serious and sometimes not even related to the heart. Muscles in the neck or chest can sometimes twinge or spasm, making someone think it’s the heart skipping or racing.)

Other times to check a pulse include if your child:

  • faints
  • has chest pain
  • has trouble breathing that is not caused by asthma
  • has skin that suddenly turns pale or grey, or has lips that are blue

If your child has any of the symptoms above, begin taking the pulse right away. Make note of the activity that caused the symptoms and be sure to tell the doctor.

How Do I Take a Pulse?

To take your child’s pulse, you will need a watch with a minute hand, or a stopwatch with the minutes and seconds displayed (this is usually easier to use). Find a quiet place where your child can sit or lie comfortably.

If your child has just been active (running, jumping, crying, etc.), wait at least 5 minutes to allow the heart time to slow down and return to a normal beat.

To feel a pulse, you press two fingers — your index (“pointer”) and middle fingers — onto a major artery in the body. Press gently. Never press with your thumb, as it has a pulse all its own and can throw off a reading. When you’ve located the pulse, you will feel a throbbing sensation.

There are several areas on the body to read a pulse, but in kids these are generally the easiest places:

  • On the neck (carotid artery pulse). The carotid artery runs along either side of the throat (windpipe). Run your fingers about halfway down the neck and press gently to the left or right side of the windpipe (carefully avoiding the Adam’s apple in teen boys). Press gently. You should feel the pulse. If not, try again or on the other side.
  • On the wrist (radial pulse). This is the spot where most adults have their pulse taken. It can work well in kids, too. To find the right spot, place a finger at the base of your child’s thumb and slide it straight down to the wrist. On the wrist, press gently to feel for the pulse. This works best if your child’s hand is lying flat or bent slightly backward.
  • In the armpit (axillary pulse). Press your fingertips into the armpit, feeling around for the arm bone. When you feel the arm bone beneath your fingers, you should also feel the pulse. This method works well for infants.
  • In the crease of the elbow (brachial pulse). This location works best for infants. Place your infant on his or her back with one arm flat along the baby’s side (elbow crease facing up). In the crease of the elbow, gently place your fingers on the inside of the arm (the pinky side). Feel around for a pulse.

Once you’ve located the pulse (feeling a “throbbing” or “beating” sensation on your fingers), begin counting the beats within a 30-second timeframe. After 30 seconds, stop. Take the number of beats (for example, 45 beats in a 30-second period) and double it. So:

  • 45 x 2 = 90 beats per minute. The heart rate for your child would be 90, which is within the normal range for most kids. (This is just an example; your child’s heart rate may be different.)

If you don’t feel comfortable taking a pulse this way, or have difficulty, there is another option. Many smartphone apps can give pulse readings simply by pressing a finger over the camera lens. For a good reading, your child needs to be very still, so this method works best in older kids who are more cooperative. Before using one of these, ask your doctor if it’s a good idea or if he or she recommends a particular heart rate app.

When to Call the Doctor

If your child’s heart rate is within the normal range, you don’t need to call the doctor (unless your doctor asked you to call with the reading, in which case you should call to report that it’s normal). There’s also no need to call if the heart rate slowed down or sped up while you were taking the pulse. Some variation in speed is normal.

If your child’s heart rate is above the normal range, or too fast to count, wait a little while and recheck it. It may return to a normal rate. If it’s still too high, call your doctor. If your child is having other symptoms in addition to a high heart rate, call 911 or drive your child to the nearest ER.

If you have any other questions about taking a child’s pulse, call your doctor.

http://kidshealth.org/en/parents/take-pulse.html?WT.ac=ctg

Obstructive Sleep Apnea:

What Is Sleep Apnea?

Brief pauses in breathing during sleep are normal. But when breathing stops often or for longer periods, it’s called sleep apnea. When someone has sleep apnea, oxygen levels in the body may fall and sleep can be disrupted.

It’s more common in older people, but kids and teens can have sleep apnea too.

What Happens During Sleep Apnea?

Sleep apnea happens when a person stops breathing during sleep. It is usually caused by something obstructing, or blocking, the upper airway. This is known as obstructive sleep apnea (OSA).

OSA is a common, serious condition that can make kids miss out on healthy, restful sleep. If it’s not treated, OSA can lead to learning, behavior, growth, and heart problems. In very rare cases, it can even be life-threatening.

Child-sleeping

What Causes Obstructive Sleep Apnea?

When we sleep, our muscles relax. This includes the muscles in the back of the throat that help keep the airway open. In obstructive sleep apnea, these muscles can relax too much and collapse the airway, making it hard to breathe.

This is especially true if someone has enlarged tonsils or adenoids(germ-fighting tissues at the back of the nasal cavity), which can block the airway during sleep. In fact, enlarged tonsils and adenoids are the most common cause of OSA in kids.

Risk factors for the development of OSA include:

  • a family history of obstructive sleep apnea
  • being overweight
  • medical conditions such as Down syndrome or cerebral palsy
  • defects in the structures of the mouth, jaw, or throat that can narrow the airway
  • a large neck (17 inches or more in circumference for men; 16 inches for women)
  • a large tongue, which can fall back and block the airway during sleep

Less commonly, sleep apnea can happen when someone doesn’t get enough oxygen during sleep because the brain doesn’t send signals to the muscles that control breathing. This is called central sleep apnea. Head injuries and other conditions that affect the brain increase the risk for this type of apnea, which mostly affects older adults.

What Are the Signs & Symptoms of Sleep Apnea?

When breathing stops, oxygen levels in the body drop. This usually triggers the brain to briefly wake us up so that the airway reopens. Most of the time, this happens quickly and we go right back to sleep without knowing we woke up.

ut with sleep apnea, this pattern repeats itself all night. So people who have it don’t reach a deeper, more restful level of sleep.

Signs of OSA in kids include:

  • snoring, often associated with pauses, snorts, or gasps
  • heavy breathing while sleeping
  • very restless sleep and sleeping in unusual positions
  • bedwetting (especially if a child previously stayed dry at night)
  • daytime sleepiness or behavioral problems

Because OSA makes it hard to get a good night’s sleep, kids might:

  • have a hard time waking in the morning
  • be tired throughout the day
  • have attention or other behavior problems

As a result, sleep apnea can hurt school performance. Teachers and others may think a child has attention deficit hyperactivity disorder (ADHD) or learning problems.

How Is Sleep Apnea Diagnosed?

If your child snores regularly, is a restless sleeper, is very sleepy during the day, or has other signs of sleep apnea, talk to your doctor. Your doctor might refer you to a sleep specialist or recommend a sleep study.

A sleep study (also called a polysomnogram) lets doctors check for OSA and record a variety of body functions while a child sleeps. Sleep studies also can help doctors diagnose central sleep apnea and other sleep disorders.

In a sleep study, sensors are placed at a few spots on the child’s body with a mild adhesive or tape. The sensors are wired to a computer to provide information while the child sleeps. Sleep studies are painless and risk-free, but patients usually need to spend the night in a hospital or sleep center.

During a sleep study, doctors monitor:

  • eye movements
  • heart rate
  • breathing pattern
  • brain waves
  • blood oxygen level
  • snoring and other noises
  • body movements and sleep positions

How Is Sleep Apnea Treated?

If enlarged tonsils or adenoids are thought to be causing the apnea, the doctor will refer your child to an ear, nose, and throat doctor (ENT). The ENT might decide that an operation called an adenotonsillectomy is needed to remove the tonsils and adenoids. This often is an effective treatment for OSA.

If tonsils and adenoids are not the cause of OSA or if symptoms of OSA remain after adenotonsillectomy, a doctor may recommend continuous positive airway pressure (CPAP) therapy. In CPAP therapy, a person wears a mask that covers the nose and mouth during sleep. The mask is connected to a machine that continuously pumps air into it to open the airways.

When excess weight is a factor in OSA, it’s important to work with a doctor on diet changes, exercise, and other safe weight-loss methods. In mild cases of OSA, doctors may monitor a child for a while to see if symptoms improve before deciding on treatment.

http://kidshealth.org/en/parents/apnea.html?WT.ac=ctg

What Are Night Terrors?

Most parents have comforted their child after the occasional nightmare. But if your child has ever had what’s known as a night terror (or sleep terror), his or her fear was likely inconsolable, no matter what you tried.

A night terror is a sleep disruption that seems similar to a nightmare, but is far more dramatic. Though night terrors can be alarming for parents who witness them, they’re not usually cause for concern or a sign of a deeper medical issue.

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What Are the Signs and Symptoms of Night Terrors?

During a night terror, a child might:

  • suddenly sit upright in bed
  • shout out or scream in distress
  • have faster breathing and a quicker heartbeat
  • be sweating
  • thrash around
  • act upset and scared

After a few minutes, or sometimes longer, the child simply calms down and returns to sleep.

Unlike nightmares, which kids often remember, kids won’t have any memory of a night terror the next day because they were in deep sleep when it happened — and there are no mental images to recall.

What Causes Night Terrors?

Night terrors are caused by over-arousal of the central nervous system (CNS) during sleep.

Sleep happens in several stages. We have dreams — including nightmares — during the rapid eye movement (REM) stage. Night terrors happen during deep non-REM sleep. A night terror is not technically a dream, but more like a sudden reaction of fear that happens during the transition from one sleep stage to another.

Night terrors usually happen about 2 or 3 hours after a child falls asleep, when sleep moves from the deepest stage of non-REM sleep to lighter REM sleep. Usually this transition is a smooth one. But sometimes, a child becomes upset and frightened — and that fear reaction is a night terror.

Who Gets Night Terrors?

Night terrors have been noted in kids who are:

  • overtired, ill, or stressed
  • taking a new medicine
  • sleeping in a new environment or away from home
  • not getting enough sleep
  • having too much caffeine

Night terrors are relatively rare — they happen in only 3%–6% of kids, while almost every child will have a nightmare occasionally. Night terrors usually happen in kids between 4 and 12 years old, but have been reported in babies as young as 18 months. They seem to be a little more common among boys.

Some kids may inherit a tendency for night terrors — about 80% who have them have a family member who also had them or sleepwalking(a similar type of sleep disturbance).

A child might have a single night terror or several before they stop. Most of the time, night terrors simply disappear on their own as the nervous system matures.

How Can I Help My Child?

Night terrors can be very upsetting for parents, who might feel helpless when they can’t comfort their child. The best way to handle a night terror is to wait it out patiently and make sure your child doesn’t get hurt if thrashing around. Kids usually will settle down and return to sleep on their own in a few minutes.

It’s best not to try to wake kids during a night terror. This usually doesn’t work, and kids who do wake are likely to be disoriented and confused, and may take longer to settle down and go back to sleep.

There’s no treatment for night terrors, but you can help prevent them. Try to:

  • reduce your child’s stress
  • create a bedtime routine that’s simple and relaxing
  • make sure your child gets enough rest
  • help your child from becoming overtired
  • don’t let your child stay up too late

If your child has a night terror around the same time every night, you can try waking him or her up about 15–30 minutes before then to see if that helps prevent it.

Understanding night terrors can ease your worry — and help you get a good night’s sleep yourself. But if night terrors happen repeatedly, talk to your doctor about whether a referral to a sleep specialist is needed.

http://kidshealth.org/en/parents/terrors.html?WT.ac=ctg

Broken Bones:

The harder kids play, the harder they fall. The fact is, broken bones, or fractures, are common in childhood and often happen when kids are playing or participating in sports.

Most fractures affect the upper extremities: the wrist, the forearm, and above the elbow. Why? When kids fall, it’s a natural reflex for them to throw their hands out in an attempt to stop the fall.

Many kids will have a broken bone at some point. Most aren’t too big of a deal, but fractures can be scary for kids and parents alike. Here’s what to expect.

Broken hand 2

How Do I Know if It’s Broken?

Falls are a common part of childhood, but not every fall results in a broken bone. The classic signs of a fracture are pain, swelling, and deformity (which looks like a bump or change in shape of the bone). However, if a break is non-displaced (when the pieces on either side are straight in line with one another), it may be harder to tell.

Some telltale signs that a bone is broken are:

  • You or your child heard a snap or a grinding noise during the injury.
  • There’s swelling, bruising, or tenderness around the injured part.
  • It’s painful for your child to move it, touch it, or press on it; if the leg is injured, it’s painful to bear weight on it.
  • The injured part looks deformed. In severe breaks, the broken bone might poke through the skin.

What Do I Do?

If you suspect that your child has a fracture, you should seek medical care immediately.

If your child has either of the following, do not move your child and call 911 for emergency care:

  • your child may have seriously injured the head, neck, or back
  • the broken bone comes through the skin. Apply constant pressure with a clean gauze pad or thick cloth, and keep your child lying down until help arrives. Don’t wash the wound or push in any part of the bone that’s sticking out.

For less serious injuries, try to stabilize the injury as soon as it happens by taking these quick steps:

  1. Remove clothing from around the injured part. Don’t force a limb out of the clothing, though. You may need to cut clothing off with scissors to prevent your child from having unnecessary added pain.
  2. Apply a cold compress or ice pack wrapped in cloth. Do not put ice directly on the skin.
  3. Place a makeshift splint on the injured part by:
    • keeping the injured limb in the position you find it
    • placing soft padding around the injured part
    • placing something firm (like a board or rolled-up newspapers) next to the injured part, making sure it’s long enough to go past the joints above and below the injury
    • keeping the splint loosely in place with first-aid tape or a wraparound bandage
  4. Get medical care right away, and don’t allow the child to eat, in case surgery is needed.

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