Friday, November 28, 2008

After Thanksgiving

Kids throw up, they just do, sometimes only once and sometimes for a few days. After your child throws up, their stomach is irritated, so although they are thirsty don't give them anything to drink or eat for an hour, then give them small amounts of fluid frequently. For example; a sip or 1/2-1 tsp every 5-10 minutes, after they keep that down for a hour, then give them 2 tsp every 5-10 minutes for an hour. After 2 hours of the small amounts of fluid frequently, they can have normal amounts of fluid. If you let them drink normally too soon after they throw up, they are just going to throw up again. It's your job as a parent to be amazingly annoying and say, " Here take a sip, here take a sip". Good signs that they are getting enough fluid are at least 2-3 wet diapers a day, making tears when they cry and when you look in their mouth it is pink and moist.

I am fine with children drinking whatever they would like during the first few days of illness. That can be in frozen form like popsicles or in solid form like jello. We use popsicles a great deal in the clinic to get a child who is otherwise not taking fluid to take something. There is nothing magic about pedialyte, it won't make the vomiting stop. It has some electrolytes in it and is good to treat acute dehydration, but that is about the extent of it.

Good reasons to take your child to the doctor:

You've tried the small amounts of fluid frequently and they continue to throw up

They are having blood in the vomiting.

They have vomiting for more then one day without diarrhea.

Vomiting without diarrhea is accompanied with a high fever.

They seem to be dehydrated.

Sunday, November 23, 2008

Don't freak out because your kid has a fever

I see a lot of people who come in because their child has a fever.  There are a lot of reasons kids have fever.  Most of the time it's not anything to get too excited about, simple infections like viral, ear infections, strep, gastroenteritis (stomach flu).  Sometimes we don't know why they have fever.  

This is my fever talk:  
As long as we know why they have it, Fever in and of itself is not necessarily a bad thing.  Your body puts your temperature up on purpose to help fight off infection.  You're not at risk of having brain damage unless you have a fever of 108.  As long as your brain is functionally normally, your body isn't going to allow that to happen.  Some people are predisposed to febrile seizure, we don't know who they are until they deiced to have one.  Even then it's scary to watch, it doesn't cause brain damage.  

If a kid's runny around with a fever of 101 or 102, but is otherwise doing well, that's OK in fact actually a good situation.  When  your child has a high  temperature and fells miserable, that is the best time to given them an antipyretic.  You want to make sure you give your child an adequate dose of Tylenol or ibuprofen and stick with the one they respond to better.  Even if their fever doesn't come all the way down to normal, that's ok as long as they are feeling better.  If they have at temp of 104 that is not responding to Tylenol or ibuprofen, then they should be seen.  Anyone who has a fever for more then 5 days should be seen and any child who has headache, fever and neck pain should be seen immediately.  Kids who are sick usually don't want to eat a whole lot, and that's alright as long as they are getting adequate fluids.  What your mother told you about pushing fluids is true.  There is nothing I can do to make your child eat when they don't want to.   Any child who is not responding to you needs to be seen immediately.  But you don't need to wake a sick child to give them fever medication, let them sleep.

Ode to my Husband

I thought I'd write a bit about Dr. Valentine, not me and not Mark, the other Dr. Valentine.  He is an excellent husband and father.    He makes pancakes on Sunday with eggs in the middle.  He takes a very long time to fix all kinds of electronic things, but once he does it works really well and does things you didn't even know you wanted it to do.  He motivates the kids to pick up by making it fun.  He arranges his work schedule so that he can be home with the children when I go to work.  He is not jealous when I go to the ballet with my "boyfriend".   He brings Mila so she can nurse when I'm at work sometimes several times in a shift the whole time carting around  a baby bag that looks like a large purse.  He makes beds for the kids and paints walls in several different layer of very good faux.    He thinks I'm interested in what Mac is coming out with now and tells me all of his plans for his business.  He talks more then any man I know.  He's a good man that Dr. Valentine of mine

Sunday, November 2, 2008

Working out with children

So the other morning I'm trying to do a mother baby yoga/pilates video. Imogen, my now 4 year was watching me. I had to stop shortly after starting to feed the baby. While I'm nursing Immy tries to immitate the yoga on my mat.

Finally I turn the video back on. Immy decides she wants to do it too. First she needs a mat, so I go out to the car to get my spare mat. 2 mintues later she needs her "baby". I go up to her room and get her doll. 2 mintues later she needs a blanket for her baby. Then she needs a toy for her baby. Then she decides she likes the color purple of my mat better then her mat ( they are both purple), and we need to switch mats. Next she decides that it would be best if we both were on the same mat.

One hour later, it's time for Millie's nap. Thus concludes my excercise for the morning.