kids

<body topmargin=0 leftmargin=0 marginheight=0 marginwidth=0> <table cellpadding=0 cellspacing=0 border=0 height="100%"><tr> <td valign="top" width=200 BGCOLOR="#FFFFFF" TEXT="#080000" bgproperties="fixed" background="112f2f02egerdp.jpg"> <div> <A HREF="index.htm" TARGET="_top" TITLE="_"><U><B><U>HOME</U></B></U></A></div> <div> <TABLE BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="137" BORDERCOLORLIGHT="#C0C0C0" BORDERCOLORDARK="#808080" FRAME="BOX" RULES="ALL" HSPACE="0" VSPACE="0" > <tR> <tD VALIGN=TOP BGCOLOR=#66FFFF HEIGHT= 19 ><NOBR><div> <A HREF="id91.htm" TARGET="_top" TITLE="BRUCE ROSEMAN, M.D. 140 WEST 86th Stree"><U>CONTACT ME</U></A></div> </NOBR></tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FFCC99 HEIGHT= 19 WIDTH="137"><div> <A HREF="id17.htm" TARGET="_top" TITLE="office info"><U>OFFICE INFO</U></A></div> </tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FFFF99 HEIGHT= 19 WIDTH="137"><div> <A HREF="http://www.nlm.nih.gov/medlineplus/druginformation.html" TARGET="_top" 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IMAGING"><U>RADIOLOGY</U></A></div> </tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FF99FF HEIGHT= 19 WIDTH="137"><div> <A HREF="id47.htm" TARGET="_top" TITLE="HANDOUTS "><U>HANDOUTS </U></A></div> </tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FFCC99 HEIGHT= 19 ><NOBR><div> <A HREF="id53.htm" TARGET="_top" TITLE=" ANATOMY"><U>ILLUSTRATIONS</U></A></div> </NOBR></tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#33FFFF HEIGHT= 19 ><NOBR><div> <A HREF="id22.htm" TARGET="_top" TITLE="PHARMACIES"><U>PHARMACIES</U></A></div> </NOBR></tD> </tR> <tR> <tD VALIGN=TOP HEIGHT= 38 WIDTH="137"><bR> <bR> </tD> </tR> </TABLE></div> <DIV ALIGN="LEFT"></DIV> <div>  </div> </td> <td valign="top" BGCOLOR="#FFFFFF" TEXT="#080000" bgproperties="fixed" background="115f0f03.jpg"> <div> <TABLE BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="1034" BORDERCOLORLIGHT="#C0C0C0" BORDERCOLORDARK="#808080" FRAME="BOX" RULES="ALL" HSPACE="0" VSPACE="0" BGCOLOR=#660099 > <tR> <tD VALIGN=TOP BGCOLOR=#660099 HEIGHT= 92 ><NOBR><div> BRUCE ROSEMAN, M.D.</div> </NOBR></tD> <tD VALIGN=TOP BGCOLOR=#660099 WIDTH="618"><div> <IMG SRC="1a543460.jpg" border=0 width="67" height="70" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></div> </tD> </tR> </TABLE></div> <div> <U> <TABLE BORDER="2" CELLPADDING="2" CELLSPACING="1" WIDTH="884" BORDERCOLORLIGHT="#C0C0C0" BORDERCOLORDARK="#808080" FRAME="BOX" RULES="ALL" HSPACE="0" VSPACE="0" > <tR> <tD VALIGN=TOP HEIGHT= 1431 WIDTH="318"><div> <B><U>NEW BABIES</U></B></div> <div> <A HREF="#looking_at_your_newborn_what_s_normal" TITLE="kids"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">WHATS NORMAL IN A NEWBORN</U></A></div> <div> <A HREF="http://www.kidshealth.org/parent/pregnancy_newborn/pregnancy/first_day.html" TARGET="_top" TITLE="http://www.kidshealth.org/parent/pregnan"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">THE FIRST DAY OF LIFE</U></A></div> <div> <A HREF="#a_guide_for_first_time_parents" TITLE="kids"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">A GUIDE FOR FIRST TIME PARENTS</U></A></div> <div> <A HREF="#the_strep_in_expectant_moms" TITLE="kids"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">The Test Expectant Moms Shouldn't Skip</U></A></div> <div> <A HREF="#circumcision" TITLE="kids"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">CIRCUMCISION</U></A></div> <div> <A HREF="http://www.emohel.com/index.htm" TARGET="_top" TITLE="http://www.emohel.com/index.htm"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">MOEL</U></A></div> <div> <A HREF="#study_circumcision_protects_against" TITLE="kids"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Study: Circumcision Protects Against AIDS </U></A> </div> <div> <A HREF="#bringing_your_baby_home_april_18_2003" TITLE="kids"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Bringing Your Baby Home</U></A></div> <div> <A HREF="#recovering_from_delivery" TITLE="kids"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Recovering From Delivery</U></A></div> <div> <A HREF="http://www.kidshealth.org/parent/growth/sleep/sleepnewborn.html" TARGET="_top" TITLE="http://www.kidshealth.org/parent/growth/"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">SLEEP AND THE NEWBORN</U></A></div> <div> <A HREF="http://www.kidshealth.org/parent/medical/genetic/newborn_screening_tests.html" TARGET="_top" TITLE="http://www.kidshealth.org/parent/medical"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">NEWBORN SCREENING TESTS</U></A></div> <div> <A HREF="http://www.medem.com/medlb/article_detaillb.cfm?article_ID=ZZZIQ4ONQ2D&sub_cat=57" TARGET="_top" TITLE="http://www.medem.com/medlb/article_detai"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">INFANT NUTRITION</U></A></div> <div> <A HREF="http://www.motherisk.org/" TARGET="_top" TITLE="http://www.motherisk.org/"><U><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Motherisk</U></U></A><A HREF="http://www.motherisk.org/" TARGET="_top" TITLE="http://www.motherisk.org/"><U> on-line - Your source for evidence-based information about the safety or risk of drugs, chemicals and disease during pregnancy and lactation. </U></A></div> <div> <IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Pacifier Use in the Early Weeks of Life May Interfere with Duration of Breastfeeding</div> <div> <IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Taking Folic Acid During Pregnancy May Protect Kids From Childhood Leukemia</div> <div> <A HREF="#fda_warns_against_codeine_for_mothers" TITLE="kids"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">FDA Warns Against Codeine for Mothers of Nursing Infants</U></A></div> <div> <B><U>NORMAL KID STUFF</U></B></div> <div> <A HREF="id37_immunization_information.htm" TARGET="_top" TITLE="VACCINATION INFORMATION"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">VACCINATION INFO</U></A> </div> <div> <A HREF="id37_american_academy_of_family_physicians.htm" TARGET="_top" TITLE="VACCINATION INFORMATION"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Recommended Childhood Immunization </U></A><A HREF="http://www.aafp.org/x7666.xml" TARGET="_top" TITLE="http://www.aafp.org/x7666.xml"><U>Schedule </U></A></div> <div> <A HREF="http://www.kidshealth.org/parent/firstaid_safe/home/take_temp.html" TARGET="_top" TITLE="http://www.kidshealth.org/parent/firstai"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">TAKING YOUR CHILDS TEMPERATURE</U></A></div> <div> <A HREF="http://www.emory.edu/PEDS/NEONATOLOGY/DCP/mileston.htm" TARGET="_top" TITLE="http://www.emory.edu/PEDS/NEONATOLOGY/DC"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">DEVELOPMENTAL MILESTONES</U></A></div> <div> <A HREF="http://www.nidcd.nih.gov/health/parents/speechandlanguage.htm#mychild" TARGET="_top" TITLE="http://www.nidcd.nih.gov/health/parents/"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Developmental Milestones Language:</U></A></div> <div> <A HREF="http://www.kidshealth.org/parent/general/body/growth_charts.html" TARGET="_top" TITLE="http://www.kidshealth.org/parent/general"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">GROWTH CHARTS</U></A></div> <div> <A HREF="http://health.excite.com/height_predict" TARGET="_top" TITLE="http://health.excite.com/height_predict"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Kid's Height Predictor</U></A></div> <div> <A HREF="http://www.cdc.gov/epo/mmwr/preview/mmwrhtml/rr4907a2.htm" TARGET="_top" TITLE="http://www.cdc.gov/epo/mmwr/preview/mmwr"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Meningitis and College Students</U></A></div> <div> <A HREF="http://olin.msu.edu/menomune.htm" TARGET="_top" TITLE="http://olin.msu.edu/menomune.htm"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">meningitis vaccine</U></A></div> <div> <A HREF="http://www.kidshealth.org/parent/medical/body_basics/mouth_teeth.html" TARGET="_top" TITLE="http://www.kidshealth.org/parent/medical"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">MOUTH AND TEETH</U></A></div> <div> <A HREF="#keeping_your_child_s_teeth_healthy" TITLE="kids"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Keeping Your Child's Teeth Healthy</U></A></div> <div> <A HREF="http://www.emedicine.com/splash/etools_xml.pl?file=1pediatric_vital_signs&prog=edtable" TARGET="_top" TITLE="http://www.emedicine.com/splash/etools_x"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">PEDIATRIC VITAL SIGNS</U></A></div> <div> <A HREF="http://kidshealth.org/kid/stay_healthy/fit/no_sports.html" TARGET="_top" TITLE="http://kidshealth.org/kid/stay_healthy/f"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">KEEPING FIT IF YOU DON'T LIKE SPORTS</U></A></div> <div> <A HREF="http://www.kidshealth.org/parent/positive/family/backpack.html" TARGET="_top" TITLE="http://www.kidshealth.org/parent/positiv"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Backpack Burdens</U></A></div> <div> <A HREF="#child_behavior_what_parents_can_do_to" TITLE="kids"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Child Behavior: What parents can do to cha</U></A><A HREF="#child_behavior_what_parents_can_do_to" TITLE="kids"><U>nge their child's behavior</U></A><A HREF="#child_behavior_what_parents_can_do_to" TITLE="kids"><U> </U></A></div> <div> <A HREF="http://www.kidshealth.org/parent/growth/sleep/positional_plagiocephaly.html" TARGET="_top" TITLE="http://www.kidshealth.org/parent/growth/"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">FLAT HEADS</U></A></div> <div> <IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Y<A HREF="http://www.kidshealth.org/parent/system/medical/vision.html" TARGET="_top" TITLE="http://www.kidshealth.org/parent/system/"><U>OUR CHILDS VISION</U></A></div> <div> <A HREF="http://www.kidshealth.org/parent/emotions/feelings/homesickness.html" TARGET="_top" TITLE="http://www.kidshealth.org/parent/emotion"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">HOMESICKNESS</U></A></div> <div> <A HREF="http://www.nhlbi.nih.gov/health/public/sleep/starslp/parents/parents.htm" TARGET="_top" TITLE="http://www.nhlbi.nih.gov/health/public/s"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">KIDS SLEEP IQ QUIZ</U></A></div> <div> <A HREF="http://www.nhlbi.nih.gov/health/public/sleep/starslp/missionz/missionz.htm" TARGET="_top" TITLE="http://www.nhlbi.nih.gov/health/public/s"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">KIDS SLEEPING GAME</U></A></div> <div> <A HREF="#flu_shots_for_all_tots" TITLE="kids"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Flu Shots For All Tots</U></A></div> <div> <A HREF="#two_year_olds_mimic_parents__who_smoke" TITLE="kids"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">2 year olds Mimic Parents' who smoke and drink</U></A></div> <div> <B><U>NUTRITION</U></B></div> <div> <A HREF="http://www.nlm.nih.gov/medlineplus/breastfeeding.html" TARGET="_top" TITLE="http://www.nlm.nih.gov/medlineplus/breas"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">BREASTFEEDING</U></A></div> <div> <A HREF="http://www.bcm.tmc.edu/cnrc/Facts%20and%20Answers/factsanswers.htm#bodycomposition" TARGET="_top" TITLE="http://www.bcm.tmc.edu/cnrc/Facts%20and%"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">CHILDREN'S NUTRITION: FACTS AND ANSWERS</U></A></div> <div> <A HREF="http://www.bcm.tmc.edu/cnrc/skimmilk.htm" TARGET="_top" TITLE="http://www.bcm.tmc.edu/cnrc/skimmilk.htm"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">SKIM MILK VS REGULAR MILK</U></A></div> <div> <A HREF="http://www.bcm.tmc.edu/cnrc/solidfoods.htm" TARGET="_top" TITLE="http://www.bcm.tmc.edu/cnrc/solidfoods.h"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">INTRODUCING SOLID FOODS</U></A></div> <div> <A HREF="#formula_imitates_breast_milk" TITLE="kids"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">NEW FORMULA  Imitates Breast Milk</U></A></div> <div> <A HREF="http://www.bcm.tmc.edu/cnrc/h20.htm" TARGET="_top" TITLE="http://www.bcm.tmc.edu/cnrc/h20.htm"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">KIDS NEED FLUIDS</U></A></div> <div> <A HREF="id18_obese_kids_heart_disease_link_found.htm" TARGET="_top" TITLE=" MEDICAL NEW"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Obese Kids, Heart Disease Link Found</U></A> </div> <div> <A HREF="http://www.kidshealth.org//breaking_news/fruit_juice.html" TARGET="_top" TITLE="http://www.kidshealth.org//breaking_news"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Too Much Fruit Juice Not a Good Thing</U></A></div> <div> <A HREF="http://kidshealth.org/kid/stay_healthy/food/protein_carb_fat_p2.html" TARGET="_top" TITLE="http://kidshealth.org/kid/stay_healthy/f"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">LEARN ABOUT carbohydrates, fats, protein etc.</U></A></div> <div> <A HREF="#splash_of_iodine_prevents_early" TITLE="kids"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Splash of Iodine Prevents Early Childhood Cavities</U></A><A HREF="#splash_of_iodine_prevents_early" TITLE="kids"><U> </U></A></div> <div> <A HREF="id100_overweight_kids_and_diabetes_risk.htm" TARGET="_top" TITLE="diabetes"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Overweight Kids and Diabetes Risk</U></A></div> <div> <A HREF="#excess_belly_fat_linked_to_insulin" TITLE="kids"><U><IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Excess Belly Fat Linked to Insulin Resistance in Kids</U></A></div> <div> <A HREF="id129_some_breakfast_foods_may_keep_kids_full.htm" TARGET="_top" TITLE="GLYCEMIC INDEX"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Some Breakfast Foods May Keep Kids Full Longer</U></A></div> <div> <A HREF="id137_hydrolyzed_casein_or_whey_formula_may.htm" TARGET="_top" TITLE="ALLERGY"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Babies at Risk for Allergies may be helped by certain formulas </U></A></div> <div> <B><U>WEBSITES</U></B></div> <div> <A HREF="http://kidshealth.org/" TARGET="_top" TITLE="http://kidshealth.org/"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">KIDS HEALTH WEBSITE</U></A></div> <div> <A HREF="http://www.intelihealth.com/IH/ihtIH/EMIHC000/3324/3324.html" TARGET="_top" TITLE="http://www.intelihealth.com/IH/ihtIH/EMI"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">BABY'S HEALTH WEBSITE</U></A></div> <div> <A HREF="http://65.193.9.198/index.jsp" TARGET="_top" TITLE="http://65.193.9.198/index.jsp"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">CHILD MAGAZINE.COM</U></A></div> <div> <B><U>WEBSITES FOR KIDS ONLY</U></B></div> <div> <A 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WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">EMERGENCIES AND FIRST AID</U></A></div> <div> <A HREF="#if_you_have_a_poison_emergency_or_a" TITLE="kids"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">POISEN CONTROL CENTER</U></A></div> <div> <A HREF="http://www.kidshealth.org/parent/firstaid_safe/home/healthin.html" TARGET="_top" TITLE="http://www.kidshealth.org/parent/firstai"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">WHAT YOU NEED TO KNOW IN AN EMERGENCY</U></A></div> <div> <A HREF="http://www.kidshealth.org/parent/firstaid_safe/home/fire.html" TARGET="_top" TITLE="http://www.kidshealth.org/parent/firstai"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">FIRE SAFETY</U></A></div> <div> <A HREF="http://www.aap.org/family/famshop.htm" TARGET="_top" 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SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Sacral dimples</U></A></div> <div> <A HREF="http://archpedi.ama-assn.org/issues/v155n7/abs/poa00578.html" TARGET="_top" TITLE="http://archpedi.ama-assn.org/issues/v155"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">SCHOOL ALLERGIC REATIONS</U></A></div> <div> <A HREF="http://www.kidshealth.org/parent/infections/skin/scabies.html" TARGET="_top" TITLE="http://www.kidshealth.org/parent/infecti"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">SCABIES</U></A></div> <div> <A HREF="id102_using_lindane.htm" TARGET="_top" TITLE="skin"><U><IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">directions for using lindane</U></A></div> <div> <A HREF="http://www.kidshealth.org/parent/infections/bacterial_viral/scarlet_fever.html" TARGET="_top" TITLE="http://www.kidshealth.org/parent/infecti"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">SCARLET FEVER</U></A></div> <div> <A HREF="#sinusitis_can_strike_kids_too" TITLE="kids"><U><IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Sinusitis Can Strike Kids, Too</U></A></div> <div> <A HREF="http://www.immunizationinfo.org/newsbriefs/newsbriefDetail.cfm?id=6331" TARGET="_top" TITLE="http://www.immunizationinfo.org/newsbrie"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">SMALLPOX VACCINE NEWS</U></A></div> <div> <A HREF="http://kidshealth.org/kid/ill_injure/aches/swimmers_ear.html" TARGET="_top" TITLE="http://kidshealth.org/kid/ill_injure/ach"><U><IMG BORDER="0" 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<div> <A HREF="http://www.kidshealth.org/parent/medical/brain/tourette.html" TARGET="_top" TITLE="http://www.kidshealth.org/parent/medical"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">TOURETTE'S</U></A></div> <div> <A HREF="http://www.kidshealth.org/parent/pregnancy_newborn/common/crypto.html" TARGET="_top" TITLE="http://www.kidshealth.org/parent/pregnan"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">UNDESCENDED TESTICLES</U></A></div> <div> <A HREF="http://www.immunizationinfo.org/database/index.cfm" TARGET="_top" TITLE="http://www.immunizationinfo.org/database"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">VACCINE INFO DATABASE</U></A></div> <div> <A HREF="http://kidshealth.org/kid/ill_injure/aches/warts_p2.html" TARGET="_top" TITLE="http://kidshealth.org/kid/ill_injure/ach"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">WARTS</U></A></div> <div> <A HREF="http://kidshealth.org/kid/ill_injure/aches/west_nile.html" TARGET="_top" TITLE="http://kidshealth.org/kid/ill_injure/ach"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">WEST NILE VIRUS</U></A></div> <div> <A HREF="#whooping_cough__pertussis_" TITLE="kids"><U><IMG BORDER="0" SRC="Symb075c00b700dc99006600.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">WHOOPING COUGH</U></A></div> <div> <IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Sinusitis Can Strike Kids, Too</div> <bR> <bR> <bR> <bR> <bR> <bR> </tD> </tR> </TABLE></U></div> <bR> <div> <B><U> <A NAME="excess_belly_fat_linked_to_insulin"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></U></B><B><U>Excess Belly Fat Linked to Insulin Resistance in Kids</U></B></div> <bR> <div> Insulin resistance occurs when the body doesn't respond as well to insulin. Insulin, a hormone, is made by the pancreas and allows the body to process glucose, the main type of sugar in the blood. When a person has insulin resistance, glucose is less able to enter the cells and supply energy to the body. Insulin resistance is a problem because it has been linked to the development of type 2 diabetes, as well as a number of other health problems including high blood pressure and heart disease.</div> <bR> <div> In adults, having a lot of fat in the abdomen and a large waist size has been linked to insulin resistance. To help understand the risk of insulin resistance in kids, researchers from the University of Buenos Aires in Argentina studied 84 6- to 13-year-olds. The kids were weighed and had their heights and waist sizes measured. In addition, each child underwent blood tests, blood pressure measurements, and tests to measure the body's ability to process glucose.</div> <div> Forty of the children in the study were overweight (in the 95th percentile or above in weight for height); 28 of the children in the study were at risk for overweight (between the 85th and 94th percentile in weight for height); and 16 of the children in the study were not overweight or at risk for overweight.</div> <bR> <div> Kids who had larger waistlines tended to have:</div> <bR> <div>     * higher blood pressure measurements</div> <div>     * abnormal cholesterol levels</div> <div>     * higher levels of triglycerides, another type of blood fat linked to heart disease</div> <div>     * a higher risk of insulin resistance</div> <bR> <div> Even after the researchers took into account a kid's height and weight, children with larger waistlines still had a higher risk of insulin resistance.</div> <bR> <div> What This Means to You: Insulin resistance has been linked to the development of type 2 diabetes and heart disease. According to the results of this study, waist measurements could help to identify kids at greater risk for developing insulin resistance.</div> <bR> <div> Children who have insulin resistance are often overweight and may not get much physical activity, but the good news is that eating healthy foods and portion sizes, engaging in regular physical activity, and getting to a healthy weight may help some kids reverse their insulin resistance. If you have questions about your child's weight or insulin resistance, talk to your child's doctor. He or she may recommend that you talk to a registered dietitian if your child needs help managing his or her weight.</div> <div> <B><U> <A NAME="teaching_your_child_how_to_use_911"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></U></B><B><U>Teaching Your Child How to Use 911</U></B></div> <div> One of the challenges you have as a parent is to help your child acquire the skills to work through whatever obstacles life presents. Teaching your child how to use 911 in an emergency could be one of the simplest - and most important - lessons you'll ever share.</div> <div> <B>Talking About 911 With Your Child</B></div> <div> Not that many years ago, there was a separate telephone number for each type of emergency agency. For a fire, you called the fire department number. For a crime, you called the police. For a medical situation, you phoned the ambulance or doctor.</div> <div> In 1968, the U.S. government worked with the phone company to establish 911 as a central number for all types of emergencies. An emergency dispatch operator quickly takes information from the caller and puts the caller in direct contact with whatever emergency personnel are needed, thus making response time quicker.</div> <div> According to the National Emergency Number Association, 911 covers nearly all of the population of the United States. Check your phone book to ensure that 911 is the emergency number you should use in your area.</div> <div> Everyone needs to know about calling 911 in an emergency. But children in particular need specifics about what an emergency is. Asking your child, "What would you do if we had a fire in our house?" or "What would you do if you saw someone trying to break in?" gives you a chance to discuss what constitutes an emergency and what should be done if one occurs. Role playing is an especially good way to address various emergency scenarios and give your child the confidence he or she will need to handle them.</div> <div> For younger children, it might also help to talk about who the emergency workers are in your community - police officers, firefighters, paramedics, doctors, nurses, and so on - and what kinds of things they do to help people who are in trouble. This will paint a clear picture for your little one of not only what types of emergencies can occur, but also who can help.</div> <bR> <div> <B>When to Call 911</B></div> <div> Learning what is an emergency goes hand in hand with learning what isn't. A fire, an intruder in the home, an unconscious family member - these are all things that would require a call to 911. A skinned knee, a stolen bicycle, or a lost pet wouldn't. Still, teach your child that if ever in doubt and there's no adult around to ask to always make the call. It's much better to be safe than sorry.</div> <div> Make sure your child understands that calling 911 as a joke is a crime in many places. In some cities, officials estimate that as much as 75% of the calls made to 911 are nonemergency calls. These are not all pranks. Some people accidentally push the emergency button on their cell phones. Others don't realize that 911 is for true emergencies only. That means it's not for such things as a flat tire or even about a theft that occurred the week before.</div> <div> Stress to your child that whenever an unnecessary call is made to 911, it can delay a response to someone who actually needs it. Most areas now have what is called enhanced 911, which enables a call to be traced to the location from which it was made. So if someone dials 911 as a prank, emergency personnel could be dispatched directly to that location. Not only could this mean life or death for someone having a real emergency on the other side of town, it also means that it's very likely the prank caller will be caught and punished.</div> <div> <B>How to Use 911</B></div> <div> Although most 911 calls are now traced, it's still important for your child to have your street address and phone number memorized. Your child will need to give that information to the operator as a confirmation so time isn't lost sending emergency workers to the wrong address.</div> <div> Make sure your child knows that even though he or she shouldn't give personal information to strangers, it's OK to trust the 911 operator. Walk him or her through some of the questions the operator will ask, including:</div> <div> <IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Where are you calling from? (Where do you live?) </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">What type of emergency is this? </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Who needs help? </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Is the person awake and breathing? </div> <div> Explain to your child that it's OK to be frightened in an emergency, but that it's important to stay calm, speak slowly and clearly, and give as much detail to the 911 operator as possible. If your child is old enough to understand, also explain that the emergency dispatcher may give first-aid instructions before emergency workers arrive at the scene.</div> <div> Make it clear that your child should <B>not</B> hang up until the person on the other end says it's OK, otherwise important instructions or information could be missed.</div> <div> <B>More Safety Tips</B></div> <div> Here are some additional safety tips to keep in mind:</div> <div> <IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Always refer to the emergency number as "nine-one-one" not "nine-eleven." In an emergency, your child may not know how to dial the number correctly because of trying to find the "eleven" button on the phone. </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Make sure your house number is clearly visible from the street so that police, fire, or ambulance workers can easily locate your address. </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">If you live in an apartment building, make sure your child knows the apartment number and floor you live on. </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Keep a list of emergency phone numbers handy near each phone for your children or babysitter. This should include police, fire, and medical numbers (this is particularly important if you live in one of the few areas where 911 is not in effect), as well as a number where you can be reached, such as your cell phone, pager, or work number. In the confusion of an emergency, calling from a printed list is simpler than looking in the phone book or figuring out which is the correct speed-dial number. The list should also include known allergies, especially to any medication, medical conditions, and insurance information. </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">If you have special circumstances in your house, such as an elderly grandparent or a person with a heart condition, epilepsy, or diabetes living in your home, prepare your child by discussing specific emergencies that could occur and how to spot them. </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f099006600.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Keep a first-aid kit handy and make sure your child and babysitters know where to find it. When your child is old enough, teach him or her basic first aid.</div> <bR> <bR> <bR> <div> <B><U> <TABLE BORDER="0" CELLPADDING="1" CELLSPACING="1" WIDTH="328" BORDERCOLORLIGHT="#C0C0C0" BORDERCOLORDARK="#808080" FRAME="VOID" RULES="NONE" HSPACE="0" VSPACE="0" > <tR> <tD VALIGN=BOTTOM HEIGHT= 29 ><NOBR><div>  <A NAME="whooping_cough__pertussis_"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A><FONT SIZE="2" COLOR="#660099" FACE="Verdana" ><B><U>Whooping cough (pertussis)<IMG SRC="2ec02020.png" border=0 width="2" height="2" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></U></B></FONT></div> </NOBR></tD> </tR> </TABLE></U></B></div> <div> <B>Reviewed by</B> <FONT SIZE="2" COLOR="#0000FF" FACE="Verdana" ><A HREF="http://www.netdoctor.co.uk/whoisnd.htm" TARGET="_top" TITLE="http://www.netdoctor.co.uk/whoisnd.htm"><U><U>Dr John Pilinger</U></U></A></FONT>, GP</div> <bR> <div> <TABLE BORDER="0" CELLPADDING="1" CELLSPACING="1" WIDTH="632" BORDERCOLORLIGHT="#C0C0C0" BORDERCOLORDARK="#808080" FRAME="VOID" RULES="NONE" HSPACE="0" VSPACE="0" > <tR> <tD VALIGN=TOP HEIGHT= 1773 WIDTH="628"><div> <B>What is whooping cough? </B></div> <div> Whooping cough (pertussis) is still a very serious disease when it occurs in children under the age of one year old. But thanks to an effective vaccine and prevention against infection, it is now quite rare. </div> <div> <TABLE BORDER="0" CELLPADDING="1" CELLSPACING="1" WIDTH="197" BORDERCOLORLIGHT="#C0C0C0" BORDERCOLORDARK="#808080" FRAME="VOID" RULES="NONE" ALIGN="LEFT" HSPACE="0" VSPACE="0" > <tR> <tD VALIGN=CENTER HEIGHT= 229 WIDTH="16"><div> <IMG SRC="2ec02020.png" border=0 width="2" height="2" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></div> </tD> <tD VALIGN=CENTER><NOBR><div> <TABLE BORDER="0" CELLPADDING="1" CELLSPACING="1" WIDTH="174" BORDERCOLORLIGHT="#C0C0C0" BORDERCOLORDARK="#808080" FRAME="VOID" RULES="NONE" HSPACE="0" VSPACE="0" > <tR> <tD VALIGN=CENTER HEIGHT= 89 ><NOBR><div> <IMG SRC="2f17f530.jpg" border=0 width="127" height="83" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></div> </NOBR></tD> </tR> <tR> <tD VALIGN=CENTER HEIGHT= 89 WIDTH="170"><div> Whooping cough is a very serious disease when it occurs in children aged under one year.</div> </tD> </tR> <tR> <tD VALIGN=CENTER HEIGHT= 18 WIDTH="170"><div> <IMG SRC="2ec02020.png" border=0 width="2" height="2" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></div> </tD> </tR> </TABLE></div> <bR> </NOBR></tD> </tR> </TABLE></div> <div> Before the vaccination against whooping cough was introduced, three out of four children caught the disease and some died every year. Today only a few get whooping cough. </div> <div> <B>What causes whooping cough? </B></div> <div> Whooping cough is caused by a <FONT SIZE="2" COLOR="#0000FF" FACE="Verdana" ><A HREF="mhtml:mid:/health_advice/facts/virusbacteria.htm" TARGET="_top" TITLE="mhtml:mid:/health_advice/facts/virusbact"><U><U>bacteria</U></U></A></FONT> (Bordetella pertussis) and is one of the most contagious bacterial infections. If one child in a group of siblings gets it, the other children are extremely likely to become infected if they have not already had the disease or been vaccinated. </div> <div> This also includes babies. Although infants who are <FONT SIZE="2" COLOR="#0000FF" FACE="Verdana" ><A HREF="mhtml:mid:/health_advice/facts/breastfeeding.htm" TARGET="_top" TITLE="mhtml:mid:/health_advice/facts/breastfee"><U><U>breastfed</U></U></A></FONT> are usually protected against most common childhood infections, they receive no protection against whooping cough. This is why early <FONT SIZE="2" COLOR="#0000FF" FACE="Verdana" ><A HREF="mhtml:mid:/health_advice/facts/childhoodvaccinations.htm" TARGET="_top" TITLE="mhtml:mid:/health_advice/facts/childhood"><U><U>vaccination</U></U></A></FONT> is recommended. </div> <div> Children with a <FONT SIZE="2" COLOR="#0000FF" FACE="Verdana" ><A HREF="mhtml:mid:/diseases/facts/colds.htm" TARGET="_top" TITLE="mhtml:mid:/diseases/facts/colds.htm"><U><U>cold</U></U></A></FONT> or <FONT SIZE="2" COLOR="#0000FF" FACE="Verdana" ><A HREF="mhtml:mid:/health_advice/facts/cough.htm" TARGET="_top" TITLE="mhtml:mid:/health_advice/facts/cough.htm"><U><U>cough</U></U></A></FONT> should be kept away from non-vaccinated children as well as women in labour and newborn babies. </div> <div> <B>How is whooping cough contracted? </B></div> <div> The infection is transferred through airborne droplets when an infected person coughs. Anyone who has not been vaccinated is highly likely to contract the disease just by spending time in the same room as an infected person. </div> <div> Anyone who has been vaccinated or has suffered from whooping cough will have a degree of immunity to the disease. They may contract a mild case some years later but this will not develop into a full-blown attack.</div> <div> The incubation period - the time between contracting the infection and the appearance of the main symptoms - can vary from 5 to 15 days or even longer. </div> <div> Whooping cough is infectious from the first sneezes and throughout the course of the disease, which can last for up to eight weeks. This is a much longer period than with other children's diseases. </div> <div> <B>What are the symptoms of whooping cough? </B></div> <div> The disease begins with a cold and a mild cough. After this, the typical coughing bouts set in. The coughing continues until no air is left in the lungs. After this comes a deep intake of breath that produces a heaving, 'whooping' sound when the air passes the larynx (windpipe) that gives rise to the name of the disease. </div> <div> The patient will eventually cough up some phlegm and these attacks may well be followed by <FONT SIZE="2" COLOR="#0000FF" FACE="Verdana" ><A HREF="mhtml:mid:/diseases/facts/childrenvomiting.htm" TARGET="_top" TITLE="mhtml:mid:/diseases/facts/childrenvomiti"><U><U>vomiting</U></U></A></FONT>. The child's temperature is likely to remain normal. </div> <div> A bout of whooping cough can be very distressing for both the child and the parents who feel unable to help.</div> <div> Coughing attacks may occur up to 40 times a day and the disease can last for up to eight weeks. </div> <div> <B>How does the doctor make the diagnosis? </B><FONT SIZE="2" COLOR="#000000" FACE="Verdana" >The diagnosis is usually made from the symptoms and the history of contact with a person suffering from whooping cough. In case of doubt, the doctor can take swabs from the nose and throat for analysis and have the results in about five days.</FONT></div> <div> <FONT SIZE="2" COLOR="#800000" FACE="Verdana" ><B>Complications </B></FONT>While whooping cough is very unpleasant, there may also be other complications, such as <FONT SIZE="2" COLOR="#0000FF" FACE="Verdana" ><A HREF="mhtml:mid:/diseases/facts/acutebronchitis.htm" TARGET="_top" TITLE="mhtml:mid:/diseases/facts/acutebronchiti"><U><U>bronchitis</U></U></A></FONT>, <FONT SIZE="2" COLOR="#0000FF" FACE="Verdana" ><A HREF="mhtml:mid:/diseases/facts/pneumonia.htm" TARGET="_top" TITLE="mhtml:mid:/diseases/facts/pneumonia.htm"><U><U>pneumonia</U></U></A></FONT> and <FONT SIZE="2" COLOR="#0000FF" FACE="Verdana" ><A HREF="mhtml:mid:/diseases/facts/inflammationofthemiddleear.htm" TARGET="_top" TITLE="mhtml:mid:/diseases/facts/inflammationof"><U><U>ear infections</U></U></A></FONT>. These complications may cause a <FONT SIZE="2" COLOR="#0000FF" FACE="Verdana" ><A HREF="mhtml:mid:/health_advice/facts/childrenfever.htm" TARGET="_top" TITLE="mhtml:mid:/health_advice/facts/childrenf"><U><U>high temperature</U></U></A></FONT>, and change the course of the disease. If one or more of these problems occur, they will usually be treated with antibiotics.</div> <div> <FONT SIZE="2" COLOR="#800000" FACE="Verdana" ><B>How is whooping cough treated? </B></FONT>Most cases of whooping cough require no specific treatment. Infants and small children with other conditions such as <FONT SIZE="2" COLOR="#0000FF" FACE="Verdana" ><A HREF="mhtml:mid:/diseases/facts/asthmachildren.htm" TARGET="_top" TITLE="mhtml:mid:/diseases/facts/asthmachildren"><U><U>asthma</U></U></A></FONT> require constant monitoring which, at least for a while, is best done in a hospital. The effect of <FONT SIZE="2" COLOR="#0000FF" FACE="Verdana" ><A HREF="http://www.netdoctor.co.uk/medicines/subindex.asp?id=19" TARGET="_top" TITLE="http://www.netdoctor.co.uk/medicines/sub"><U><U>antibiotics</U></U></A></FONT> is uncertain but they are sometimes used in the early period of the disease.</div> <div> Vaccination is recommended.</div> <div> <B>How does one prevent the infection?</B><FONT SIZE="2" COLOR="#000000" FACE="Verdana" >Just as important as the vaccination, is the necessity to prevent the infection spreading especially to small children. This is especially important for children in nursery school.</FONT></div> <div> If there are infected children in childcare, other infants under the age of one year should not be admitted unless they have had whooping cough or have been vaccinated against it twice, with a period of four weeks between vaccinations. </div> <div> If the children are more than one year old they may be admitted even if they have not had the disease themselves or been vaccinated. But the parents must be informed of the danger of infection.</div> <div> If whooping cough occurs at home, no special measures are necessary. </div> <div> <FONT SIZE="2" COLOR="#800000" FACE="Verdana" ><B>Which medicine can be used?</B></FONT>There is no medical treatment against whooping cough as such. However, the infectious period may be reduced by giving certain antibiotics (eg <FONT SIZE="2" COLOR="#0000FF" FACE="Verdana" ><A HREF="http://www.netdoctor.co.uk/medicines/showpreparation.asp?id=953" TARGET="_top" TITLE="http://www.netdoctor.co.uk/medicines/sho"><U><U>erythromycin</U></U></A></FONT>).</div> <div> <FONT SIZE="2" COLOR="#800000" FACE="Verdana" ><B>Who should be vaccinated?</B></FONT>The vaccination takes place at the age of two, three and four months as part of the 'triple' <FONT SIZE="2" COLOR="#0000FF" FACE="Verdana" ><A HREF="http://www.netdoctor.co.uk/medicines/showpreparation.asp?id=3043" TARGET="_top" TITLE="http://www.netdoctor.co.uk/medicines/sho"><U><U>Diphtheria-Tetanus-Pertussis (DTP) immunisation</U></U></A></FONT>. After the first two vaccinations protection is almost 100 per cent. (DTP is now routinely combined with vaccination against Haemophilus influenzae in the UK.)</div> <div> It is advisable that all children should be vaccinated against whooping cough, as it is important to prevent this dangerous disease. </div> </tD> </tR> </TABLE></div> <div> <B>Based on a text by</B> Dr Hanne Korsholm</div> <bR> <div> <B>Last updated</B> 01.02.2002</div> <div> <TABLE BORDER="0" CELLPADDING="1" CELLSPACING="1" WIDTH="626" BORDERCOLORLIGHT="#C0C0C0" BORDERCOLORDARK="#808080" FRAME="VOID" RULES="NONE" HSPACE="0" VSPACE="0" > <tR> <tD VALIGN=CENTER HEIGHT= 531 WIDTH="622"><bR> <bR> <div>  <A NAME="fda_warns_against_codeine_for_mothers"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A>FDA Warns Against Codeine for Mothers of Nursing Infants</div> <div> <B>Emma Hitt, PhD</B> </div> <div> Medscape Medical News 2007. © 2007 Medscape </div> <div> August 17, 2007 — Medications containing codeine given to breast-feeding mothers who rapidly metabolize codeine into morphine may cause adverse effects in their infants, according to an alert sent today from MedWatch, the US Food and Drug Administration (FDA) adverse event and reporting program. </div> <div> Codeine is generally considered safe for use in nursing mothers; however, last year, a healthy 13-day-old breast-fed infant died from very high levels of morphine received through breast milk.<FONT SIZE="1" COLOR="#660099" FACE="Arial" > </FONT>The mother was taking codeine at a dose lower than that usually prescribed for episiotomy pain, but genetic testing revealed that the infant's mother was an ultrarapid metabolizer of codeine.</div> <div> According to the FDA, depending on ethnicity, approximately anywhere from 1 to 28 per 100 individuals rapidly metabolize codeine. Genetic testing is the only way to determine whether someone is a rapid metabolizer; an FDA-cleared test for determining a patient's CYP2D6 genotype is available, but there is limited information about using this test to characterize codeine metabolism. In addition, the test result is insufficient in predicting whether too much morphine will be passed along in a mother breast-feeding an infant.</div> <div> The FDA recommends that patients be made aware of the signs of morphine overdose. Patients should be told to contact their clinician if a baby shows signs of increased sleepiness (ie, sleeping for more than 4 hours at a time), limpness, or difficulty nursing or breathing. </div> <div> Healthcare professionals and nursing mothers should report adverse effects that occur while using codeine to the FDA's MedWatch adverse event reporting program by phone at 1-800-332-1088.</div> <bR> </tD> </tR> </TABLE></div> <bR> <bR> <div> <B><U> <A NAME="circumcision"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></U></B><B><U>Circumcision</U></B></div> <bR> <div> Whether you're expecting a baby boy or have just welcomed your new little guy into the world, you have an important decision to make before you take your son home: whether to circumcise him.</div> <bR> <div> For some families, the choice is simple because it's based on cultural or religious beliefs. But for others, the right option isn't as clear-cut. Before you make a circumcision decision, it's important to talk to your child's doctor and consider some of the issues.</div> <bR> <div> What Is Circumcision?</div> <div> Boys are born with a hood of skin, called the foreskin, covering the head (also called the glans) of the penis. In circumcision, the foreskin is surgically removed, exposing the end of the penis.</div> <bR> <div> Approximately 65% of all newborn boys - about 1.2 million babies - are circumcised in the United States each year. The procedure is much more widespread in the United States, Canada, and the Middle East than in Asia, South America, Central America, and most of Europe, where it's uncommon.</div> <bR> <div> Parents who choose circumcision often do so based on religious beliefs, concerns about hygiene, or cultural or social reasons, such as the wish to have their son look like other men in the family.</div> <bR> <div> If you do opt for circumcision, it's best to perform the operation within the first 2 to 3 weeks after birth, as it can become more complicated as a child gets older. But the procedure is usually performed during the first 10 days (often within the first 48 hours), either in the hospital or, for some religious ritual circumcisions, at home. If you decide to have your son circumcised at the hospital, your pediatrician, family doctor, or obstetrician will perform the procedure before you bring your baby home. The doctor should prepare you by telling you about the procedure he or she will use and the possible risks.</div> <bR> <div> In some instances, doctors may decide to delay the procedure or forgo it altogether. Premature babies or those who have special medical concerns may not be circumcised until they're ready to leave the hospital. And babies born with physical abnormalities of the penis that need to be corrected surgically often aren't circumcised at all because the foreskin may eventually be used as part of a reconstructive operation.</div> <bR> <div> The Pros and Cons</div> <div> On the plus side, studies indicate that circumcised infants are less likely to contract a urinary tract infection (UTI) in the first year of life. About one out of every 1,000 circumcised boys has a UTI in the first year, whereas the rate is one in 100 (at most) for uncircumcised infants.</div> <bR> <div> Circumcised men may also be at lower risk for penile cancer, although the disease is rare in both circumcised and uncircumcised males. Although some studies indicate that the procedure might offer an additional line of defense against sexually transmitted diseases (STDs), particularly HIV, the results of studies in this area are conflicting and difficult to interpret.</div> <bR> <div> It's also easier to keep a circumcised penis clean, although uncircumcised boys can learn how to clean beneath the foreskin once the foreskin becomes retractable (usually some time before age 5). However, some uncircumcised boys can end up with infected foreskins as the result of poor hygiene.</div> <bR> <div> Some people also claim that circumcision either lessens or heightens the sensitivity of the tip of the penis, decreasing or increasing sexual pleasure later in life. But neither of these subjective findings has been proven to be true.</div> <bR> <div> Although circumcision appears to have some medical benefits, it also carries potential risks - as does any surgical procedure. These risks are small, but you should be aware of both the possible advantages and the problems that can be associated with the procedure before you make your decision. Complications of newborn circumcision are uncommon, occurring in between 0.2% to 3% of cases. Of these, the most frequent are minor bleeding and local infection, both of which can be easily treated by your child's doctor.</div> <bR> <div> Perhaps one of the hardest parts of the decision to circumcise is accepting that the procedure can be painful. In the past, it wasn't commonplace to provide pain relief for babies being circumcised, but because studies have indicated that it benefits the infant to receive anesthesia, most doctors will now provide it. Also, the American Academy of Pediatrics (AAP) recommends the use of pain relief measures for circumcision. Even up until recently, though, anesthesia hasn't been universally used, so it's important to ask your doctor ahead of time what, if any, pain relief will be utilized with your son.</div> <bR> <div> Two primary forms of local anesthetic are used to make the operation less painful for your baby:</div> <bR> <div>     * a topical cream (a cream put on the penis) that requires at least 20 to 40 minutes to take its full effect</div> <div>     * an injectable anesthetic that requires less time to take effect and may provide a slightly longer period of anesthesia</div> <bR> <div> Besides anesthesia, giving a pacifier dipped in sugar water can help reduce your baby's level of stress (and yours). Used together, these methods can decrease your baby's discomfort by more than 50%.</div> <bR> <div> Caring for a Circumcised Penis</div> <div> Whether you choose circumcision or not, it's important to keep your son's penis clean. It should be washed with soap and warm water every time you bathe him. And you don't need to use cotton swabs, astringents, or any special bath products.</div> <bR> <div> There are also no special washing precautions with newly circumcised babies, other than to be gentle, as your baby may have some mild discomfort after the circumcision. If your son has a bandage on his incision, you might need to apply a new one whenever you change his diaper for a day or 2 after the procedure (put petroleum jelly on the bandage so it won't stick to his skin). Doctors often also recommend putting a dab of petroleum jelly on the baby's penis or on the front of the diaper to alleviate any potential discomfort caused by friction against the diaper.</div> <bR> <div> How you take care of your baby's penis may also vary depending on the type of circumcision procedure your child's doctor performs. Be sure to talk to him or her about what aftercare will be needed.</div> <bR> <div> It usually takes between 7 to 10 days for a penis to heal. Until it does, the tip may seem raw or yellowish in color. Although this is normal, certain other symptoms are not. Call your child's doctor right away if you notice any of the following:</div> <bR> <div>     * persistent</div> <div>     * bleeding redness around the tip of the penis that gets worse after 3 days</div> <div>     *</div> <div>     * fever signs of infection, such as the presence of pus-filled blisters</div> <div>     * not urinating normally within 6 to 8 hours after the circumcision</div> <bR> <div> However, with quick intervention, almost all circumcision-related problems are easily treated.</div> <bR> <div> Caring for an Uncircumcised Penis</div> <div> As with a penis that's circumcised, an uncircumcised one should be kept clean. Also, no cotton swabs, astringents, or any special bath products are needed - simple soap and warm water every time you bathe your baby will suffice.</div> <bR> <div> However, you should never forcibly pull back the foreskin to clean beneath it. Instead, gently tense it against the tip of the penis and wash off any smegma (the whitish "beads" of dead skin cells mixed with the body's natural oil). Over time, the foreskin will retract on its own so that it can be pulled away from the glans toward the abdomen. This happens at different times for different children, but most boys can retract their foreskins by the time they're 5 years old.</div> <bR> <div> As your son grows up, teach him to wash beneath the foreskin by gently pulling it back from the glans, rinsing the glans and the inside of the foreskin with soap and warm water, then pulling the foreskin back over the head of the penis.</div> <bR> <div> Making a Circumcision Decision</div> <div> In addition to the medical issues discussed, religious and cultural beliefs often figure into the equation. Of course, if these are important to you, they deserve to be seriously considered.</div> <bR> <div> Despite the possible benefits and risks, circumcision is neither essential nor detrimental to a boy's health. The AAP and the American Academy of Family Physicians (AAFP) do not endorse the procedure as a way to prevent any of the medical conditions mentioned previously. The AAP also does not find sufficient evidence to medically recommend circumcision or argue against it.</div> <bR> <div> Talk to your child's doctor about the pros and cons of circumcision to help you make the choice that's right for your son.</div> <bR> <div> Updated and reviewed by: Barbara P. Homeier, MD</div> <div> Date reviewed: January 2005</div> <div> Originally reviewed by: Steven Dowshen, MD</div> <div> <B><U> <A NAME="study_circumcision_protects_against"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></U></B><B><U>Study: Circumcision Protects Against AIDS  </U></B>  </div> <div> Fri Mar 26, 3:28 PM ET    By ROBERT BARR, Associated Press Writer </div> <bR> <div> LONDON - A new study found that uncircumcised men were nearly seven times more likely to get the AIDS (news - web sites) virus, giving further support to findings that circumcision .    </div> <bR> <div> The study by Robert C. Bollinger and colleagues from Johns Hopkins University Medical School and the National AIDS Research Institute in Pune, India, was published Friday as a "research letter" in The Lancet medical journal. </div> <bR> <div> "It is now about the ninth study which followed men who are HIV (news - web sites)-negative over a period of months or years. It is the ninth study in a row which has found that the effect (of circumcision) is significant," said Robert C. Bailey, professor of epidemiology and biostatistics at the University of Illinois at Chicago, who was not connected with Bollinger's study. </div> <bR> <div> "The fact that they found no behavioral differences between the two groups is all the more compelling, and indicates that there is a biological factor," Bailey said in a telephone interview. </div> <bR> <div> Bailey, like the authors of the Lancet study, believe that cells in the foreskin may be particularly susceptible to infection. </div> <bR> <div> The association between circumcision and a reduced risk of HIV was noted as early as 1987, when Dr. William Cameron of the University of Manitoba in Canada reported findings from a study in Kenya. </div> <bR> <div> The research published in The Lancet tracked 2,298 men who were being treated at three clinics in Pune, and who were confirmed to be HIV-negative at the start of the study. </div> <bR> <div> The study also found that circumcised men were as much at risk of gonorrhea, herpes simplex and syphilis as the uncircumcised. </div> <bR> <div> The nine studies have all tried to control for variables in behavior, Bailey said. "A randomized control trial is what is necessary now to really nail this down," he said. </div> <bR> <bR> <bR> <div> <B><U> <A NAME="two_year_olds_mimic_parents__who_smoke"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></U></B><B><U>Two-Year-Olds Mimic Parents' who smoke and drink</U></B></div> <div>    </div> <div> TUESDAY, Sept. 6 (HealthDay News) -- Parents, your children are watching: A new study finds that even 2-year-olds are more likely to "smoke" and "drink" during pretend play if their parents smoke and drink regularly.</div> <bR> <div> Toddlers were also more like to mimic these dangerous adult activities if they were regularly exposed to PG-13 or R-rated movies, the researchers found.</div> <bR> <div> It's not news that parental habits can influence their offspring's smoking and drinking habits, said lead researcher Madeline Dalton, director of the Hood Center for Children and Family Community Health Research Program at Dartmouth Medical School, Lebanon, N.H.</div> <bR> <div> "What is new in this study is really the age," she said.</div> <bR> <div> "Lots of people have looked at the social influences of tobacco and alcohol use. Parental smoking and alcohol use are potent predictors of kids' use," she said, noting that that's been long known for teens. "What we wanted to do was to start looking at younger children."</div> <bR> <div> Reporting in the September issue of the Archives of Pediatrics and Adolescent Medicine, Dalton's team observed 120 children, aged 3 to 6, playing with two dolls. The child was asked to pretend to be one of the dolls while the researcher pretended to be the other doll.</div> <bR> <div> The child was told to pretend he or she was the host and had invited the other doll over to watch a movie and have something to eat.</div> <bR> <div> When the researcher-friend said there was nothing to eat, the child was invited to shop at a doll grocery store as researchers recorded the purchases.</div> <bR> <div> For experiments involving 2-year-olds, the child was simply given one doll and told to take her shopping.</div> <bR> <div> In all, 28 percent of the children bought cigarettes while 61 percent bought alcohol on these "shopping trips." The researchers then compared those buying habits with information they had gathered on the parents' smoking, drinking and movie-viewing habits.</div> <bR> <div> They found that children were nearly four times as likely to buy cigarettes if their parents smoked, and three times as likely to choose wine or beer if their parents drank alcohol at least once a month.</div> <bR> <div> Kids who were allowed to view PG-13 or R-rated movies were five times as likely to choose wine or beer while shopping than kids restricted to watching G-rated movies. According to the researchers, images of drinking adults seen in adult-rated films may be influencing these pro-alcohol "buying" decisions in youngsters.</div> <bR> <div> The study is the first to show that preschoolers have what Dalton calls "social cognitive scripts" of adult social life -- behaviors perceived to be appropriate.</div> <bR> <div> Some of the children even recognized specific brand names of cigarettes, the researchers found, because of the brands their parents smoked. Others role-played the lighting of cigarettes or pouring drinks.</div> <bR> <div> The study findings don't surprise Danny McGoldrick, research director of the Campaign for Tobacco-Free Kids.</div> <bR> <div> "It's an interesting study," he said. "I think it really just points to the social environment that kids grow up in. You see these ads that say 'Talk to Your Kids' [about not smoking]. But the best thing parents can do is not smoke themselves. Smoking has a huge impact on kids, not just with secondhand smoke but with role modeling."</div> <bR> <div> If parents can't quit, McGoldrick said, they should, "at least make the home smoke-free."</div> <bR> <div> The research was an eye-opener for Dalton on a professional and personal level. "It's never too early to talk to your kids about alcohol and cigarettes," she said.</div> <bR> <div> "Certainly there are many instances where it is socially appropriate to use alcohol," she said, "but we need to counterbalance that with a clear message about not misusing it."</div> <bR> <div> Dalton said she realized her habit of offering guests wine or beer when they arrive at her home was giving the wrong message to her young children. "Now, when I have guests, I ask, 'Can I get you something? We have water, we have juice, milk, soda, beer or wine.' Just so [her kids know] it's socially appropriate to choose something else."</div> <bR> <bR> <div> <B><U> <A NAME="sinusitis_can_strike_kids_too"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></U></B><B><U>Sinusitis Can Strike Kids, Too</U></B></div> <bR> <div> It could be the common chronic problem of sinusitis, a condition that is usually associated with adults.</div> <bR> <bR> <div> "It is as common in children as in adults, and when sinus problems get worse, asthma and bronchial problems get worse," says Dr. Jordan Josephson, a New York City otolaryngologic surgeon who specializes in pediatric care.</div> <bR> <bR> <div> Kids can be particularly susceptible to sinus problems because their sinuses aren't fully formed until age 12, and their sinuses are narrower than an adult's.</div> <bR> <bR> <div> If you factor in any allergies a child might have -- as well as environmental triggers like secondhand smoke, air pollution and exposure to bacteria -- that child's susceptibility to sinusitis increases, Josephson says.</div> <bR> <bR> <div> Telltale signs of possible sinusitis in a child include a frequent runny nose with yellow mucus, pain near the cheeks or eye areas, and difficulty staying awake in school, Josephson says.</div> <bR> <bR> <div> Sinusitis in children -- as well as adults -- can also produce emotional troubles like irritability and a general unhappiness. But a child is often unable to convey this sense of discomfort to a doctor, says Dr. Alexander Chester, an internist at Georgetown University Medical Center.</div> <bR> <bR> <div> "It can be really tough for kids who feel poorly but whose illness is not validated by doctors or parents," he says. "A doctor looks at a kid with a runny nose and listlessness and basically tells him to shape up."</div> <bR> <bR> <div> Sinusitis is characterized by inflammation of the nasal passages. It can be caused by any number of problems, from a cold to allergies to an infection, doctors say. The inflammation narrows the nasal passages so mucus can't drain properly, causing discomfort and sometimes infection.</div> <bR> <bR> <div> Left untreated, sinusitis can become chronic, lasting for anywhere from three to eight weeks, to months or even years, according to the National Institute of Allergies and Infectious Diseases.</div> <bR> <bR> <div> Statistics on the prevalence of sinusitis in children are hard to come by. But the National Center for Health Statistics reports that the condition affects about 32 million American adults a year, or approximately 16 percent of the adult population.</div> <bR> <bR> <div> Parents should be alert to potential sinusitis symptoms in their children and get them to the doctor.</div> <bR> <bR> <div> "If a cold lasts for 72 hours or less, it's nothing to worry about," says Josephson. "But if a child has a runny nose all the time and is home sick once a month, if he's falling asleep in school, getting bad grades or taking his hand and rubbing it up his nose because he can't get relief, you shouldn't dismiss these symptoms."</div> <bR> <bR> <div> A pediatrician can prescribe a nasal spray and/or antibiotics if there is a bacterial infection, Josephson says.</div> <bR> <bR> <div> "If after two to four weeks the child isn't better, he or she needs to see a specialist," he adds.</div> <bR> <bR> <div> An otolaryngologist will examine the child in the same way an adult is examined, using CAT scans and maybe an endoscopy. This is a procedure where the doctor, using a slim tube with a camera at the end, can look directly at the sinus passages. Pediatric otolaryngologists have a smaller pediatric endoscope for this purpose, Josephson says. These tests allow the doctor to check for polyps, which can block the nasal passages, or anatomical abnormalities that constrict the natural flow of mucus.</div> <bR> <bR> <div> While surgery is rarely performed on children, specialists typically recommend a longer course of antibiotic treatment, usually for a three- to eight-week period, Josephson says.</div> <bR> <div>    </div> <bR> <bR> <bR> <div> "Parents are resistant to the idea of an antibiotic for a long period of time," he says. "They often don't want to give kids antibiotics for more than 10 days. But living with an infection for a year isn't good, either. There could be polyp formation and long-term effects of doing poorly in school."</div> <bR> <bR> <bR> <bR> <div> <B><U> <A NAME="growing_pains"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></U></B><B><U>Growing Pains</U></B></div> <div> Your 8-year-old son wakes up crying in the night complaining that his legs are throbbing. You rub them, and soothe him as much as you can, but are uncertain about whether to give him any medication or take him to the doctor. Sound familiar? Your child is probably experiencing <B>growing pains</B>, a normal occurrence in about 25% of children. Read below to find out more about this common problem.</div> <div> <B>Diagnosis</B></div> <div> Growing pains generally strike during two periods: in early childhood among 3- to 5-year-olds and later on in 8- to 12-year-olds. They are what doctors call a <B>diagnosis of exclusion</B>. This means that other conditions should be ruled out before a diagnosis of growing pains is made. A thorough <FONT SIZE="3" COLOR="#0000FF" FACE="Arial" ><U> <A NAME="link0_1"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></U><U>history</U></FONT> and physical examination by your child's doctor can usually accomplish this. In rare instances, blood and X-ray studies may be required before a final diagnosis of growing pains is made.</div> <div>  <A NAME="link1_1"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></div> <div> <B>Causes</B></div> <div> No firm evidence exists to show that growth of bones causes pain. The most likely causes of growing pains, therefore, are the aches and discomforts resulting from jumping, climbing, and running pursued by active children during the day. The pains can occur after a child has had a particularly athletic day.</div> <div> <B>Signs and Symptoms</B></div> <div> Although growing pains often strike in late afternoon or early evening before bed, there are occasions when pain can wake a slumbering child. The intensity of the pain varies from child to child, and most kids don't experience the pains every day. "Growing pains are often intermittent, coming once a week or even more infrequently," says Dr. James White, a family practitioner.</div> <div> Growing pains always concentrate in the muscles, rather than the joints. Most children report pains in the front of their thighs, in the calves, or behind the knee. While joints affected by more serious diseases are swollen, red, tender, or warm, the joints of children experiencing growing pains appear normal.</div> <div> One symptom that doctors find most helpful in making a diagnosis of growing pains is how the child responds to touch while in pain. Children who have pain for a serious medical disease do not like to be handled, since movement tends to increase the pain. Children with growing pains respond differently; they feel better when they are held, massaged, and cuddled.</div> <div> <B>Treatment</B></div> <div> Massage, stretching, heat, acetaminophen (Tylenol) or ibuprofen (Advil) may help to relieve the pain. Although the pains point to no serious illness, they can be upsetting to a child (or a parent!). Because a child seems completely cured of her aches in the morning, parents sometimes suspect that the child faked the pains. However, this usually is not the case. Support and reassurance that growing pains will pass as children grow up can help them relax.</div> <div>  <A NAME="call_doc"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></div> <div> <B>When to Call Your Child's Doctor</B></div> <div> Your child's doctor should be alerted if any of the following symptoms occur with your child's pain: persistent pain, swelling, or redness in one particular area or joint; <FONT SIZE="3" COLOR="#0000FF" FACE="Arial" ><U>fever</U></FONT>; limping; unusual rashes; loss of appetite; weakness; tiredness; or uncharacteristic behavior. These signs do not accompany growing pains and may be an indication of a medical problem that needs attention. Pains or symptoms localized to the shoulders, arms, wrists, hands, fingers, neck, or back, or pain associated with a particular injury are not due to growing pains, and should be evaluated by a <FONT SIZE="3" COLOR="#0000FF" FACE="Arial" ><U>child's doctor</U></FONT>. </div> <div> Updated and reviewed by: <FONT SIZE="3" COLOR="#0000FF" FACE="Arial" ><U>Kim Rutherford, MD</U></FONT></div> <div> Date reviewed: June 2001</div> <div> Originally reviewed by: <FONT SIZE="3" COLOR="#0000FF" FACE="Arial" ><U>Steven Dowshen, MD, and Robert Cooper, MD</U></FONT></div> <bR> <bR> <div> <U> <A NAME="dehydration"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></U><U>dehydration</U></div> <div> <U><IMG SRC="2999c1c0.png" border=0 width="412" height="28" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></U></div> <div> Following a drinking schedule ensures that your children drink enough to stay hydrated without overdrinking.<FONT SIZE="1" COLOR="#660099" FACE="Arial" >6</FONT> Kids should be well hydrated. For kids less than 90 lbs., it will help to drink 3-6 oz. of fluid one hour before activity. For kids more than 90 lbs., it will help to drink 6-12 oz. one hour before activity. For kids less than 90 lbs., drink 3-5 oz. every 20 minutes.</div> <div> For kids more than 90 lbs., drink 6-9 oz. every 20 minutes. Drink to make up for any remaining fluid loss if a body weight deficit exists. In general, kids weighing less than 90 lbs. may need to drink up to 8 oz. per 1/2 lb. of weight loss and kids more than 90 lbs. may need 12 oz. per 1/2 lb. of weight loss in the first hour after activity. Learn to drink for individual needs. One kid-size gulp equals about 1/2 oz. of fluid. </div> <bR> <div> When the body is low in fluids because a person is not drinking enough to replace what is lost through sweat.</div> <bR> <div> Common warning signs of dehydration include: </div> <div> <IMG BORDER="0" SRC="Symb075c00b700c899000000.png" HEIGHT="13" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">thirst, </div> <div> <IMG BORDER="0" SRC="Symb075c00b700c899000000.png" HEIGHT="13" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">headache, </div> <div> <IMG BORDER="0" SRC="Symb075c00b700c899000000.png" HEIGHT="13" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">dizziness, </div> <div> <IMG BORDER="0" SRC="Symb075c00b700c899000000.png" HEIGHT="13" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">weakness,</div> <div> <IMG BORDER="0" SRC="Symb075c00b700c899000000.png" HEIGHT="13" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0"> irritability,</div> <div> <IMG BORDER="0" SRC="Symb075c00b700c899000000.png" HEIGHT="13" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0"> fatigue</div> <div> <IMG BORDER="0" SRC="Symb075c00b700c899000000.png" HEIGHT="13" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">nausea. </div> <div>     </div> <div>  Children who are in the “tween” years can lose up to a quart of sweat during two hours of activity on a hot day.1,2  </div> <div>  </div> <div>  Children are more susceptible to heat illness than adults when active in hot weather.3 Why? </div> <div>  </div> <div>   – Children produce more metabolic heat per pound of body weight during exercise. They also have a reduced sweating capacity, which lessens their ability to lose heat through sweat evaporation.3  </div> <div>   – Like adults, children frequently do not have the physiological drive to drink enough water to replenish fluid loss during prolonged exercise.4 </div> <div>     </div> <div>  Think of fluids as essential safety equipment for sports, like a bike helmet or shin guards—always pack a squeeze bottle for your child’s practice or game.  </div> <div>  </div> <div>  Leading health professional organizations recommend kids drink at regular intervals, not just when thirsty. By the time thirst kicks in, they’re likely already dehydrated. </div> <div>   </div> <div>  Following a drinking schedule ensures that your children drink enough to stay hydrated without overdrinking.6  </div> <div>   </div> <div>   Kids should be well hydrated. For kids less than 90 lbs., it will help to drink 3-6 oz. of fluid one hour before activity. For kids more than 90 lbs., it will help to drink 6-12 oz. one hour before activity.  </div> <div>    </div> <div>  For kids less than 90 lbs., drink 3-5 oz. every 20 minutes.</div> <div> For kids more than 90 lbs., drink 6-9 oz. every 20 minutes.  </div> <div>    </div> <div>  Drink to make up for any remaining fluid loss if a body weight deficit exists. In general, kids weighing less than 90 lbs. may need to drink up to 8 oz. per 1/2 lb. of weight loss and kids more than 90 lbs. may need 12 oz. per 1/2 lb. of weight loss in the first hour after activity. Learn to drink for individual needs. One kid-size gulp equals about 1/2 oz. of fluid.   </div> <div>         </div> <div> A study that offered active kids (ages 9-12) plain water, flavored water and a sports drink showed that they drank 90% more of the sports drink and stayed better hydrated than when drinking plain water.7</div> <div> <U><IMG SRC="29589de0.png" border=0 width="393" height="222" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></U></div> <div> 1 Iuliano, S. et al. Evaluation of the self-selected fluid intake practices by junior athletes during a simulated duathlon event. Int J Sports Nutr 8:10-23, 1998. </div> <div> 2 Meyer, F. et al. Sweat electrolyte loss during exercise in the heat: effects of gender and maturation. Med Sci Sports Exerc 24:776-781, 1992. </div> <div> 3 Bar-Or, O. Temperature regulation during exercise in children and adolescents. In: Gisolfi C, Lamb DR, eds. Perspectives in Exercise and Sports Medicine, II. Youth, Exercise and Sport. Indianapolis, IN: Benchmark Press; 1989, 335-367. </div> <div> 4 Rivera-Brown A., et al. Drink composition, voluntary drinking and fluid balance in exercising, trained, heat-acclimatized boys. J Appl Phys 86: 78-84, 1999. </div> <div> 5 Adapted from the 2000 National Athletic Trainers’ Association Position Statement: Fluid Replacement for Athletes, J Athletic Training 35(2): 212-224, 2000. </div> <div> 6 Adapted from the American Academy of Pediatrics Position Statement, Pediatrics 106: 158-159, 2000. </div> <div> 7 Wilk B. and Bar-Or, O. Effect of drink flavor and NaCl on voluntary drinking and hydration in boys exercising in the heat. J Appl Physiol, 80: 1112-1117, 1996. </div> <div> 8 Passe, D. et al. Impact of beverage acceptability on fluid intake during exercise. Appetite 35:219-225, 2000. </div> <div> 9 Epstein, Y. Exertional Heatstroke: Lessons we tend to forget. Am J Med Sports 2: 143-152, 2000.  </div> <div> 10 Watts, S. Prevention and treatment of dehydration in athletes. Am J Med Sports 3:286-293, 2001. </div> <div> *  Scientifically formulated sports drink: a sports drink containing 5-8% carbohydrates (14g per 8oz.), at least 100mg sodium, at least 28mg potassium, no carbonation and no caffeine. (Maughan & Murray Sports Drink. Basic Science And Practical Aspects. Boca Raton: CRC PRESS, 2001, pp. 197-224.) </div> <div> ©2003 S-VC, Inc. </div> <div>  </div> <div> While water is readily available to most kids, research shows active kids don’t always drink enough water to stay fully hydrated.7</div> <div>  </div> <div>  </div> <div>  Juices have too many carbohydrates, so it takes longer for the fluid to be absorbed into the body. </div> <div>  </div> <div>  A scientifically formulated sports drink* helps kids stay better hydrated7 because it: </div> <div>  </div> <div>  - Replaces electrolytes active children lose through sweat, helping to maintain the right balance of fluids in the body;2 </div> <div>  </div> <div>  - Contains flavor and sodium to encourage drinking when active.7,8 </div> <div>  </div> <bR> <div> This e-mail was sent to BRUCE@ROSEMAN.COM. When you signed up online</div> <div> as an eteamz.com member you requested a free subscription to our monthly email newsletter</div> <div> and promotions. If you would like to unsubscribe from future newsletter mailings</div> <div> send a blank email to: leave-eteamz-gatorade-7872881Q@newsletters.active.com</div> <bR> <div> <B><U> <A NAME="the_strep_in_expectant_moms"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></U></B><B><U>The Test Expectant Moms Shouldn't Skip</U></B></div> <div> Fri Jul 11, 7:02 PM ET    By Kathleen Doheny</div> <bR> <div> FRIDAY, July 11 (HealthDayNews) -- When women visit Dr. William Frumovitz late in their pregnancy, they're probably thinking about bassinettes, baby clothes and breast-feeding.</div> <bR> <div> So the California obstetrician makes it a point to tell them about a very important test they need between their 35th and 37th week of pregnancy -- one that will tell them whether they have a bacterium called Group B streptococcus, which can threaten the life of their newborn.</div> <bR> <div> Also known as GBS, or Group B strep, it is the most common cause of sepsis and meningitis in newborns, according to the U.S. Centers for Disease Control and Prevention (news - web sites) (CDC). Just last year, the CDC revised its 1996 guidelines for GBS testing and now recommends universal screening of all pregnant women at 35 to 37 weeks of pregnancy. In addition, the National Institutes of Health (news - web sites) has declared July as National Group B Strep Awareness Month.</div> <bR> <div> Before the screening guidelines were strengthened, about 8,000 infants in the United States got Group B strep every year, and one of every 20 infected babies died. Those who survive often have long-term problems with hearing, vision and learning.</div> <bR> <div> Problems related to Group B strep, which usually is found around the vagina and rectum, can occur a few hours after birth. Sepsis, meningitis and pneumonia are the most common, the CDC says. But diseases related to Group B strep can also crop up months after birth.</div> <bR> <div> In the past, Frumovitz says, doctors had a choice: Screen at 35 to 37 weeks of pregnancy and decide on a course of action based on the result, or follow a "risk-based" method. That meant identifying women who would be likely to need intravenous antibiotics during labor -- the treatment to prevent transmission -- by their individual risks. These could include delivery before 37 weeks or a fever just before labor.</div> <bR> <div> Like most doctors, Frumovitz has switched to routine screening. The test itself is relatively inexpensive, about $25. And the benefits of catching the bacterium early are immense, says Frumovitz, who is also an assistant visiting professor at University of California Los Angeles' David Geffen School of Medicine.</div> <bR> <div> While not all women who have the bacterium will pass it on to their babies, if they do it can be a life-threatening problem, he says. And treating it is fairly simple.</div> <bR> <div> Awareness about the dangers of Group B strep for newborns is growing, says Dr. Laura Riley, an assistant professor of obstetrics and gynecology at Harvard Medical School (news - web sites) who chairs the committee on obstetric practice for the American College of Obstetricians and Gynecologists. The college also now recommends universal screening of all pregnant women.</div> <bR> <div> While many women have known about the dangers of Group B strep, Riley says, some may not be aware that the guidelines for detecting it have changed. </div> <bR> <div> "Until last year, doctors could culture at 35 to 37 weeks and treat those with a positive culture, or not culture anyone and during labor if risk factors arose those women would get antibiotics," she says.</div> <bR> <div> "Now, we culture all pregnant women between 35 and 37 weeks," says Riley, a specialist in infectious diseases. All women should expect their doctor to give them this test. If they don't, women are encouraged to ask about it.</div> <bR> <div> Riley also tells pregnant women to follow up with their doctor about test results. Don't assume you're fine, she says. Be sure to get the results. Then, if they're positive, you will be advised about getting antibiotics during labor.</div> <bR> <div> "The antibiotics a mom gets during labor decreases the Group B strep in the vagina and the amount the baby comes into contact with," Riley explains.</div> <bR> <div> While the prospect of Group B strep sounds scary, Riley add, it's also important to put it in perspective.</div> <bR> <div> "Twenty to 40 percent of pregnant women will have a positive culture. Of those, a teeny percentage will go on to have a baby who is infected," she says.</div> <bR> <div>    More information</div> <bR> <div> For more on Group B strep screening, visit the American College of Obstetricians and Gynecologists. For information on Group B strep and newborns, check out the U.S. Centers for Disease Control and Prevention.</div> <bR> <bR> <div> <U> <A NAME="recovering_from_delivery"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></U><U>Recovering From Delivery</U></div> <bR> <div> Your baby's finally here, and you're thrilled - but you're also exhausted, uncomfortable, on an emotional roller coaster, and wondering whether you'll ever fit into your jeans again. Childbirth classes helped prepare you for giving birth, but not for this.</div> <bR> <div> What to Expect in the First Few Weeks</div> <div> After your baby arrives, you'll notice you've changed somewhat - both physically and emotionally. Physically, you might experience the following:</div> <bR> <div> sore breasts - Your breasts may be painfully engorged when your milk comes in, and your nipples may be sore. </div> <div> constipation - The first postpartum bowel movement is typically delayed to the third or fourth day after delivery, and sensitive hemorrhoids and sore muscles may make bowel movements painful. </div> <div> episiotomy - If your perineum (the area of skin between the vagina and the anus) was cut by your doctor or if it was torn during the birth, the stitches may make it painful to sit or walk for a little while during healing. </div> <div> hemorrhoids - Although common, hemorrhoids (swollen anal tissues) are frequently unexpected and initially unnoticed. </div> <div> hot and cold flashes - Your body's adjustment to new hormone and blood flow levels can wreak havoc on your internal thermostat. </div> <div> urinary or fecal incontinence - The stretching of your muscles during delivery can cause you to inadvertently pass urine when you cough, laugh, or strain or may make it difficult to control your bowel movements, especially if a lengthy labor preceded a vaginal delivery. </div> <div> "after pains" - The shrinking of your uterus can cause contractions that worsen when your baby nurses or when you take medication to reduce bleeding. </div> <div> vaginal discharge (lochia) - Heavier than your period and often containing clots (sometimes golf-ball sized), vaginal discharge gradually fades to white or yellow and stops within 2 months. </div> <div> weight - Your postpartum weight will probably be about 10 pounds (the weight of the baby, placenta, and amniotic fluid) below your full-term weight, before additional water weight drops off within the first week as your body regains its sodium balance.</div> <div> Emotionally, you may be feeling:</div> <bR> <div> "baby blues" - About 80% of new moms experience irritability, sadness, crying, or anxiety, beginning within days or weeks postpartum. Like the more severe associated syndromes of postpartum depression and postpartum psychosis, these baby blues result from hormonal changes, exhaustion, unexpected birth experiences, adjustments to changing roles, and a sense of lack of control over your altered life as you adjust to your new baby. </div> <div> postpartum depression (PPD) - More serious than the baby blues, this condition is evident in 10% to 20% of new moms and may cause mood swings, anxiety, guilt, and persistent sadness. Your baby may be several months old before PPD strikes, and it's more common in women with a family history of depression. </div> <div> postpartum psychosis - Postpartum psychosis is a severe and fairly rare condition that makes it difficult to think clearly or function and may become life-threatening to you or your baby. It's common for women with postpartum psychosis to have thoughts about harming themselves or their babies. If you experience any such feelings, call your doctor immediately.</div> <div> In addition, when it comes to sexual relations, you and your partner may be on completely different pages. He may be ready to pick up where you left off before baby's arrival, whereas you may not feel comfortable enough - physically or emotionally - and may be craving nothing more than a good night's sleep. </div> <bR> <div> The Healing Process</div> <div> It took your body months to prepare to give birth, and it takes time to recover. If you've had a cesarean section, it can take even longer because this major surgery requires a longer healing time. If unexpected, it may have also raised emotional issues. Pain is greatest the day after the surgery and should gradually subside. Take sponge baths for several days, and don't scratch the incision. If the incision becomes red and swollen, have your doctor check for an infection. Begin gentle exercises as soon as possible (abdominal tightening, bending and straightening your knees, walking - with assistance at first) to speed recovery and help avoid constipation. Drink eight to ten glasses of water daily. Expect vaginal discharge. Avoid stairs and lifting until you've healed, and don't drive until you can make sudden movements and wear a safety belt properly without discomfort.</div> <bR> <div> Some other things to consider during the healing process include:</div> <bR> <div> birth control - You can become pregnant again before your first postpartum period. If you are exclusively breast-feeding (day and night, no solids, at least every 6 hours), have not had a period, and your baby is younger than 6 months old, you have about 98% protection. If you're not breast-feeding exclusively or want additional protection, discuss your options with your doctor. Many recommend starting low-dose oral contraceptives or injections about 6 weeks postpartum. These methods shouldn't affect milk production or your baby. Barrier methods (condoms, diaphragms, spermicidal jellies, and foams) affect breast-feeding less, but are also less effective than pills or shots. </div> <div> breast-feeding - You need adequate sleep, fluids, and nutrition. Drink a glass of water whenever your baby nurses. Until your milk supply is well established, avoid caffeine, which causes loss of fluid through urine and sometimes makes babies wakeful and fussy. Your clinic or hospital lactation specialist can advise you on how to deal with any breast-feeding problems. Relieve painful, clogged milk ducts with breast massage, frequent nursing, and warm moist packs applied throughout the day. If you develop a fever and your breast becomes tender and red, you may have an infection (mastitis) and need antibiotics. Continue nursing from both breasts. Drink plenty of fluids. </div> <div> engorged breasts - They resolve as your breast-feeding pattern becomes established or, if you can't or don't choose to breast-feed, when your body stops producing milk - usually within 3 days. </div> <div> episiotomy care - Continue sitz baths (sitting in just a few inches of warm water and covering the buttocks, up to the hips, in the bathtub). Squeeze the cheeks of your bottom together when you sit to avoid pulling painfully on the stitches. Use a squirt bottle to wash the area with water when your urinate; pat dry. After a bowel movement, wipe from front to back to avoid infection. Reduce swelling with ice packs. </div> <div> exercise - Resume as soon as possible to help restore your strength and prepregnancy body, increase your energy and sense of well-being, and reduce constipation. Begin slowly and increase gradually. Walking and swimming are excellent choices. </div> <div> hemorrhoids and constipation - Alternating warm sitz baths and cold packs help. Ask your doctor about a stool softener. Don't use laxatives, suppositories, or enemas without your doctor's approval. Increase your intake of fluids and fiber-rich fruits and vegetables. </div> <div> sexual relations - Your body needs time to heal. Doctors usually recommend waiting 4 to 6 weeks to reduce the risk of infection or increased bleeding. Fewer than 20% of couples resume sexual activity in the first month, but 90% do so by 4 months. Begin slowly, with kissing, cuddling, and other intimate activities. You'll probably notice reduced vaginal lubrication (this is due to hormones and usually temporary), so a water-based lubricant might be useful. Try to find positions that put less pressure on sore areas and are most comfortable for you. Tell your partner if you're sore or frightened about pain during sexual activity - talking it over can help both of you to feel less anxious and more secure about resuming your sex life. </div> <div> urinary or fecal incontinence - This usually resolves gradually as your body returns to its normal prepregnancy state. Encourage the process with Kegel exercises, which help strengthen the pelvic floor muscles. To find the correct muscles, pretend you're trying to stop urinating. Squeeze those muscles for a few seconds, then relax (your doctor can check to be sure you're doing them correctly). Wear a sanitary pad for protection. If the problem doesn't resolve in several months, tell your doctor.</div> <div> What Else You Can Do to Help Yourself</div> <div> You'll enjoy your new role - and it will be much easier - if you care for both yourself and your new baby. For example:</div> <bR> <div> When your baby sleeps, take a nap. Get some extra rest for yourself! </div> <div> Set aside time each day to relax with a book or listen to music. </div> <div> Shower daily. </div> <div> Get plenty of exercise and fresh air - either with or without your baby, if you have someone who can babysit. </div> <div> Schedule regular time - even just 15 minutes a day - for you and your partner to be alone and talk. </div> <div> Make time each day to enjoy your baby, and encourage your partner to do so, too. </div> <div> Lower your housekeeping and gourmet meal standards - there's time for that later. If visitors stress you, restrict them temporarily. </div> <div> Talk with other new moms (perhaps from your birthing class) and create your own informal support group.</div> <div> Getting Help From Others</div> <div> Remember, Wonder Woman is fiction. Ask your partner, friends, and family for help. Jot down small, helpful things people can do as they occur to you. When people offer to help, check the list. For example:</div> <bR> <div> Ask friends or relatives to stop by and hold your baby while you take a walk or a bath. </div> <div> Hire a neighborhood teen - or a cleaning service - to clean once a week, if possible. </div> <div> Investigate hiring a doula, a supportive companion professionally trained to provide postpartum care.</div> <div> When to Call Your Doctor</div> <div> There are times when you should call your doctor about your postpartum health. Be sure to call if you:</div> <bR> <div> experience an unexplained fever of 100.4 degrees Fahrenheit (38 degrees Celsius) or above in the first 2 weeks </div> <div> soak more than one sanitary napkin an hour or if the bleeding level increases </div> <div> had a C-section or episiotomy and the incision becomes more red or swollen or drains pus </div> <div> have new pain, swelling, or tenderness in your legs </div> <div> have hot-to-the-touch, significantly reddened, sore breasts or any cracking or bleeding from the nipple or areola (the dark-colored area of the breast) </div> <div> find your vaginal discharge has become foul-smelling </div> <div> have painful urination or a sudden urge to urinate or inability to control urination </div> <div> have increasing pain in the vaginal area </div> <div> develop a cough or chest pain, nausea, or vomiting </div> <div> become depressed or experience hallucinations, suicidal thoughts, or any thoughts of harming your baby</div> <div> Reviewed by: Serdar Ural, MD</div> <div> Date reviewed: August 2001</div> <div>  </div> <bR> <div>  </div> <div> <U> </U></div> <bR> <bR> <bR> <div> <B><U> <A NAME="looking_at_your_newborn_what_s_normal"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></U></B><B><U>Looking at Your Newborn: What's Normal</U></B></div> <div> In delivery room scenes on TV and in the movies, the mother-to-be, often a famous actress in full makeup and with every hair in place, "delivers" a baby after a few token grunts and groans. Seconds later, the doctor presents the glowing parents with a picture-perfect, neatly combed and scrubbed, cooing several-month-old infant, who, if he were any older, probably could walk out of the delivery room on his own.</div> <bR> <div> Contrast that picture with how a baby really looks just after emerging from the womb: bluish, waterlogged, covered with blood and cream-cheesy glop, and battered as though he has just been in a fistfight - and lost. Not a pretty sight.</div> <bR> <div> The fact that your newborn doesn't resemble one of those Hollywood "stand-ins" shouldn't come as a great surprise. Remember that the fetus develops immersed in fluid, folded up in an increasingly cramped space inside the uterus. The whole process usually culminates with the baby being pushed forcibly through a narrow, bone-walled birth canal, sometimes requiring the assistance of metal forceps or suction devices. </div> <bR> <div> Still, it helps to remember two things: (1) usually, the features that may make a normal newborn look strange are temporary, and (2) in the eyes of the adoring parent, every infant looks like the "Gerber baby" anyway.</div> <bR> <div> General Appearance of Newborns</div> <div> When you first get to see, touch, and inspect your newborn may depend on the type of delivery, your condition, and the condition of your baby. Following an uncomplicated vaginal delivery, you should have the opportunity to hold your baby within minutes after the birth. In most cases, infants seem to be in a state of quiet alertness during the first hour or so after delivery. It's a great time for you and your newborn to get acquainted and begin the bonding process. But don't despair if circumstances prevent you from meeting your infant right away. You'll have plenty of quality time together soon, and there's no scientific evidence that the delay will affect your infant's health, behavior, or relationship with you over the long run. </div> <bR> <div> During the first several weeks, you'll notice that much of the time your baby will tend to keep her fists clenched, her elbows bent, her hips and knees flexed, and her arms and legs held close to the front of her body. This position is similar to the fetal position during the last months of pregnancy. Infants who are born prematurely may display several differences in their posture, appearance, activity, and behavior compared with full-term newborns.</div> <bR> <div> Infants are born with a number of instinctual responses to stimuli, such as light or touch, known as primitive reflexes, which gradually disappear as the baby matures. Primitive reflexes include: the sucking reflex, which triggers an infant to forcibly suck on any object put in the mouth; the grasp reflex, which causes an infant to tightly close the fingers when pressure is applied to the inside of the infant's hand by a finger or other object; and the Moro reflex or startle response, which causes an infant to suddenly throw the arms out to the sides and then quickly bring them back toward the middle of the body whenever the infant has been startled by a loud noise, bright light, strong smell, sudden movement, or other stimulus.</div> <bR> <div> Also, due to the immaturity of their developing nervous systems, young infants' arms, legs, and chins may tremble or shake, particularly when they are crying or agitated.</div> <bR> <div> In the first weeks, infants usually spend most of their time sleeping. This may be even more exaggerated during the first day or two of life in newborns whose mothers received certain types of pain medications or anesthesia during the labor or delivery. </div> <bR> <div> Frequently, new parents become concerned about their newborn's breathing pattern, particularly with the increased attention that sudden infant death syndrome (SIDS) has received in recent years. It's normal for young infants to breathe irregularly. They commonly will have periods during which they stop breathing for about 5 to 10 seconds and then start up again on their own. These are known as apneic spells, and they are more likely to occur during sleep. When she's awake, an infant's breathing rate may vary widely, sometimes exceeding 60 breaths per minute, particularly when the baby is excited or following a bout of crying.</div> <bR> <div> Although she won't be talking until later, your newborn will produce a symphony of noises - grunts, moans, high-pitched squeaks - in addition to the obligatory crying. Sneezing and hiccups occur very frequently and don't indicate infection, allergies, or digestive problems in newborns.</div> <bR> <div> Skin</div> <div> There's little doubt about the origin of the expression "still wet behind the ears," used to describe someone new or inexperienced. Newborns are covered with various fluids at delivery, including amniotic fluid and often some blood (the mother's, not the baby's). Nurses or other personnel attending the birth will promptly begin drying the infant to avoid a drop in the baby's body temperature that will occur if moisture on the skin evaporates rapidly. Newborns are also coated with a thick, pasty, white material called vernix caseosa (made up of the fetus' shed skin cells and skin gland secretions), most of which will be washed off during the baby's first bath. </div> <bR> <div> The hue and color patterns of a young infant's skin may be startling to some parents. Mottling of the skin, a lacy pattern of small reddish and pale areas, is common because of the normal instability of the blood circulation at the skin's surface. For similar reasons, acrocyanosis, or blueness of the skin of the hands and feet and the area surrounding the lips, is often present, especially if the infant is in a cool environment. When she bears down to cry or have a bowel movement, a young infant's skin temporarily may appear beet-red or bluish-purple. Red marks, scratches, bruises, and petechiae (tiny specks of blood that have leaked from small blood vessels in the skin) are all common on the face and other body parts and are caused by the trauma of squeezing through the birth canal or by the pressure from obstetrical forceps used during the delivery. These will heal and disappear during the first week or two of life.</div> <bR> <div> Fine, soft hair, called lanugo, may be present on a newborn's face, shoulders, and back. Most of the lanugo is usually shed in the uterus before the baby is delivered; for this reason, lanugo is more frequently seen on babies born prematurely. In any case, this hair will disappear in a few weeks.</div> <bR> <div> Mongolian spots, flat patches of slate-blue or blue-green color that resemble ink stains on the back, buttocks, or elsewhere on the skin, are found in more than half of black, Native American, and Asian infants and less often in white babies. These spots are of no significance and almost always fade or disappear within a few years. </div> <bR> <div> The top layer of a newborn's skin will peel off during the first week or two. This is normal and expected and does not require any special skin care. Peeling skin may be present at birth in some infants, particularly those who are born past their due date.</div> <bR> <div> Despite what the name says, not all babies come with a birthmark. However, pink or red areas, sometimes called salmon patches, are common. Most frequently found on the back of the neck or on the bridge of the nose, eyelids, or brow (hence the fanciful nicknames "stork bite" and "angel kiss"), they can occur anywhere on the skin, especially in light-skinned infants. They generally disappear within the first year. </div> <bR> <div> Strawberry or capillary hemangiomas are raised red marks caused by collections of widened blood vessels in the skin. These birthmarks may appear pale at birth and then typically become red and enlarge during the first months of life. They then usually shrink and disappear without treatment during the first few years. </div> <bR> <div> Port-wine stains, which are large, flat, reddish-purple birthmarks, will not disappear on their own, and concerns about cosmetic appearance may require the attention of a dermatologist as the child gets older. </div> <bR> <div> Cafe-au-lait spots, so called because of their "coffee with milk" light-brown color, are present on the skin of many infants. These may deepen in color (or may first appear) as the child grows older. They are usually of no concern unless they are large or there are six or more spots on the body, which may indicate the presence of certain medical conditions. Common brown or black moles, known as pigmented nevi, may be present at birth or appear or deepen in color as the child gets older. Larger moles or those with an unusual appearance should be brought to a doctor's attention because some may require removal. </div> <bR> <div> Several benign skin rashes and conditions may be present at birth or appear during the first few weeks. Tiny, flat, yellow or white spots on the nose and chin, called milia, are caused by the collection of secretions in skin glands and will disappear within the first few weeks. </div> <bR> <div> Miliaria - small, raised, red bumps that often have a white or yellow "head" - is sometimes called infant acne because of its appearance. Although miliaria often occurs on the face and may be present on large areas of the body, it's a harmless condition that will go away within the first several weeks with normal skin care. </div> <bR> <div> Despite the frightening sound of its medical name, erythema toxicum is also a harmless newborn rash consisting of red blotches with pale or yellowish bumps at the center, which give the rash a hive-like appearance. This rash usually blossoms during the first day or two after birth and disappears within a week. </div> <bR> <div> Pustular melanosis, a rash present at birth mainly in black infants, is characterized by dark brown bumps or blisters scattered over the neck, back, arms, legs, and palms, which disappear without treatment. Because the fetus can suck while still in the uterus, it's not unusual to see infants born with sucking blisters on the fingers, hands, or arms.</div> <bR> <div> Newborn jaundice, a yellowish discoloration of the skin and white parts of the eyes, is a common condition that normally doesn't appear until the second or third day of life and disappears within 1 to 2 weeks. Jaundice is caused by the accumulation of bilirubin (a waste product produced by the normal breakdown of red blood cells) in the blood, skin, and other tissues due to the temporary inability of the newborn's immature liver to clear this substance from the body effectively.</div> <bR> <div> Head</div> <div> Because the infant's head is usually the first part through the birth canal, it can be affected by the delivery process. The newborn's skull is made up of several separate bones that will eventually fuse together. This situation permits the large head of the infant to be squeezed through the narrow, rigid-walled birth canal without injury to mother or baby. The heads of infants born by vaginal delivery often show some degree of molding, which is when the skull bones shift and overlap, making the top of the infant's head look elongated, stretched out, or even pointed at birth. This sometimes bizarre appearance will go away over the next several days as the skull bones move into a more rounded configuration. The heads of babies born by Cesarean section or breech (buttocks or feet first) delivery usually will not show molding.</div> <bR> <div> Because of the separation of your newborn's skull bones, you'll be able to feel (go ahead, you won't harm anything) two fontanels, or soft spots, on the top of the head. The larger one, located toward the front of the head, is diamond-shaped and usually about 1 to 3 inches wide. A smaller, triangle-shaped fontanel is found farther back on the head, where a beanie might be worn. Don't be alarmed if you see the fontanels bulge out when the infant cries or strains, or if they seem to move up and down in time with the baby's heartbeat. This is perfectly normal. The fontanels will eventually disappear as the skull bones close together - usually in about 12 to 18 months for the front fontanel and in about 6 months for the one in back.</div> <bR> <div> In addition to looking elongated, a newborn's head may have a lump or two as a result of the trauma of delivery. Caput succedaneum is a circular swelling and bruising of the scalp usually seen on top of the head toward the back, which is the part of the scalp most often leading the way through the birth canal. This will fade over a few days. </div> <bR> <div> A cephalohematoma is a collection of blood that has seeped under the outer covering membrane of one of the skull bones; it usually is caused by the pressure of the head against the mother's pelvic bones during birth. The lump is confined to one side of the top of the baby's head and, in contrast to caput, may take a week or two to disappear. The breakdown of the blood collected in a cephalohematoma may cause these infants to become somewhat more jaundiced than others during the first week of life. It's important to remember that both caput and cephalohematoma occur due to trauma outside of the skull - neither indicates that there has been any injury to the infant's brain. </div> <bR> <div> Face</div> <div> A newborn's face may look quite puffy due to fluid accumulation and the rough trip through the birth canal. The infant's facial appearance often changes significantly during the first few days as the baby gets rid of the extra fluid and the trauma of delivery subsides. That's why the photos you take of your baby later on at home usually look a lot different than those "new arrival" nursery shots. In some cases, a newborn's facial features can be quite distorted as a result of positioning in the uterus and the squeeze through the birth canal. Not to worry - that folded ear, flattened nose, or crooked jaw usually comes back into place over time.</div> <bR> <div> Eyes</div> <div> A few minutes after birth, most infants open their eyes and start to look around at their environment. Newborns have good vision, but they probably don't focus well at first, which is why their eyes may seem out of line or crossed at times during the first 2 to 3 months. Because of the puffiness of their eyelids, some infants may not be able to open their eyes wide right away. When holding your newborn, you can encourage eye opening by taking advantage of your baby's "doll's eye" reflex, which is a tendency to open the eyes more when held in an upright position.</div> <bR> <div> Parents are sometimes startled to see that the white part of one or both of their newborn's eyes appears blood-red. Called subconjunctival hemorrhage, this occurs when blood leaks under the covering of the eyeball due to the trauma of delivery. It's a harmless conditi