Eva Alessia, D.O.

Seizures can be very scary for parents. About four out of 100 children ages six months to five years can have seizure because of a fever. The most common age range is 12 to 18 months of age. A seizure can happen at any temperature, but the most common temperature is 104°F. The seizure usually lasts less than a minute, but sometimes can last 10 to 15 minutes and then stop without any treatment.

Forty percent of children who have had a fever seizure may have another one to three fever seizures. It is rare for children to go on to have seizures not caused by fevers. Fever seizures do not cause brain damage.

Signs of a fever seizure are:

• stiffening of body
• twitching
• eye rolling
• Unresponsive for a moment – the breathing pattern will be “off” and the child may look a little darker in color.

What to do if your child has a fever seizure:
If your child has a fever seizure, lay him/her on the floor, away from hard or sharp objects. Turn his/her head to the side to let saliva or vomit drain more easily. Clear anything in the mouth with your finger to prevent choking. Undress the child and apply cool towels to body. Do not worry about the tongue; your child will not swallow his/her tongue. Call your child’s doctor and if the seizure does not stop after five minutes, call 911.

Even a couple seconds of a seizure can seem like forever, but try not to worry. Your child will be fine afterwards.

Nicole Keller, D.O.

Hello spring! It is so nice to finally get some nice weather and be able to get outside. I hope you are all enjoying the break in the cold as well. Even so, while the weather is nicer, this brings a whole new slew of seasonal allergies to deal with. I’m going to take this opportunity to help you identify and treat environmental allergies to hopefully keep you and your family sniffle free as the flowers bloom.

Identifying allergies can be tricky – they many times look similar to a cold. Runny nose, congestion and sneezing are common signs as well as eye watering and itching and sometimes even puffy red eyes. Allergies tend to be worse when exposed to the allergen and get better when the exposure is gone. This isn’t so with a virus causing a cold. Also, with a cold, typically your symptoms worsen until peaking at 3 to 5 days into the illness before then improving over the next week. Allergies will many times stay steady with continued exposure to that allergen. In addition, many people with allergies have what we call “allergic shiners” which are dark circles under the eyes from blood vessel congestion. You might also notice your child doing the “allergic salute” where they are constantly rubbing their nose from their constant allergic drip. Some people describe allergic runny nose like a faucet dripping as well. Sneezing and eye watering are common with both allergies and colds but tend to worsen abruptly when exposed to an allergen. Allergies rarely come with fevers which may also clue you in to what is causing your symptoms.

If you think your child might have allergies, there are lots of over the counter remedies. Most are safe for kids two years old and older and some are safe for younger kids as well (ask your pediatrician if your child is younger than two years old). Most of these formulations are not marketed for those under two years old because your body needs several years of exposure to actually develop an allergy – so we really don’t commonly see seasonal allergies until at least two to three years old. Anti-histamines are one way to treat allergies. This helps one component of what is causing allergies. They come in liquid and pill forms – such as benadryl (diphenhydramine), claritin (loratadine), zyrtec (cetirizine), or allegra (fexofenadine). Benadryl can be taken three to four times per day but the other options are usually a daily regimen. This makes them easy to take and typically have little side effect if taken appropriately. Another option for allergy sufferers is a nasal spray. There are nasal saline sprays or saline sinus rinses – these are a good way to cleanse the nasal passages and help relieve congestion. You can also try eye washes to help rinse your eyes free of allergens that may be causing itching and irritation. Additionally, there is a nasal steroid spray that can help relieve nasal symptoms, congestion, and itchy eyes called flonase (fluticasone) that can also be tried. Typically this takes a little longer to kick in (a few days) but has more focused symptom relief. While all of these medications are safe to be sold over the counter, if you have questions or aren’t sure about dosing, please call your pediatrician to make sure you give your child the right medication for the right issue at the right dose.

Beyond taking medications, one of the best things you can do is avoid the allergen you or your kids are reacting to. Sometimes this is hard! Especially when we all want to get outside and enjoy the sunshine! You can follow pollen counts on the news or weather apps on your phone to help you know when you might run into more allergy issues. You can also try to stay inside on windy days when allergens are being blown about more heavily. Keeping windows closed in your house and making sure carpets are cleaned regularly and dust is kept to a minimum is helpful too (easy to say…harder to do!). Indoor allergens can be just as annoying so making sure you have dust mite covers on your bedding and your house is mold free is also important.

Allergies are no fun but they can be dealt with. I hope this information helps you navigate through the weedy season of pollens and enjoy the beauty of spring and summer!

Eva Alessia, D.O.

At some point, every child is going to vomit. Here are some tips to help you and your child at home and help prevent him from getting dehydrated.

Less than 12 months of age and formula fed
Give 5 ml of Pedialyte (preferred) or water every 10 minutes. After one hour, if baby does not vomit, then you can increase to 7.5 ml every 10 minutes. Then,  increase by 2.5 ml every hour. After 8 hours, your baby can return to formula. If your baby is older than 4 to 6 months of age, they also return to cereal, bananas, etc. After 24 to 48 hours with no vomiting, they can return to their regular diet.

Less than 12 months of age and breastfed
After two episodes of vomiting, nurse only on one breast every 1 to 2 hours. If your baby has more than two episode of vomiting, then nurse for 4 to 5 minutes every 30 to 60 minutes. If baby has not vomited in 8 hours, you can return them to their usual breastfeeding pattern.

Older than 12 months of age
Give your child 15 ml Pedialyte, water/ice chips, flat Sierra Mist (or other lemon-lime soda) or Ginger Ale, or popsicles every 10 minutes. Gatorade is not recommended for rehydration of vomiting and diarrhea due to a virus/”stomach flu.” Gatorade is only good for rehydrating after sports/work done in the heat for many hours. If your child is having multiple/severe vomiting, then rest their stomach for an hour before starting to offer liquids. You can increase the amount by 2.5 ml every hour, as long as your child does not vomit. After 8 hours without vomiting, start BRAT (bananas, applesauce, rice, toast) diet. These are essentially bland foods. After 24 to 48 hours with no vomiting, it is ok to return your child to their regular diet.

Sleep is one of the best things any child can do to help resolve vomiting. Try not to give Tylenol, etc; it can make vomiting worse. Do not let child “swig” fluid; they will be more likely to vomit it right back up. Slow and steady wins the race. Vomiting should be over in 24 hours. Sometimes it may last 48 hours. Call your pediatrician if you see any signs of dehydration: decreased urine output, sunken soft spot, inside of mouth/tongue looks “dull”, not shiny or glistening.

Vrinda Kumar, M.D.

I recently read an article about Kristin Cavallari, former reality star, wife of Chicago Bears Jay Cutler, and mother of three adorable kids. She is also anti-vaccine and has written a book with parenting tips (this already is not sounding good to my pediatrician ears). According to her, she chose to put her children on a homemade goat’s milk formula rather than switching to formula, once she depleted her supply of breast milk. (In case you are wondering, it is thought that goat’s milk is slightly most comparable to human milk than cow’s milk). People magazine originally was going to publish her recipe, but then recanted upon the AAP’s (American Academy of Pediatrics) insistence based on the fact that this is potentially harmful advice and that this type of homemade formula is NOT recommended for any child, especially for a child under one year of age. If you are asking yourself “well, why not?”, keep reading…

Current recommendations are to continue your infant on either breastmilk or an iron fortified formula until he/she is one year of age, at which point you can introduce cow’s (or goat’s) milk. I get asked by patients all the time, “why is this?”

Well, the biggest reason is that cow’s milk consumption (or goat’s milk, for that matter) can cause anemia (mostly iron-deficiency anemia, and it can be severe in infants under one year of age!). Children under one year of age need a lot of iron for growth, and cow’s milk can decrease the availability of iron for these tiny growing bodies by the following mechanisms:

1. Cow/goat milk is naturally low in iron, so switching them to this as their main source of milk intake before one year of age deprives them of sufficient iron needed to grow and develop.

2. Small, invisible amounts of blood can be lost through the gut in about 40 percent of children who are introduced to cow’s/goat’s milk before the age of one year. As babies lose blood, they are losing the iron that is in that blood, potentially leading to anemia.

3. Cow/goat milk can inhibit the absorption of iron into the body, specifically by casein and calcium, both of which are present in large quantities in cow/goat milk. The less iron that is absorbed into the body, the less iron there is for the body to use to grow.

I am going to assume the next thought would be, “Why not give cow or goat milk and just supplement with additional iron?” Great thought! But there is still one more danger that has nothing to do with anemia.

The proteins and basic composition of cow/goat milk is very different from human milk and formula. As the waste from the ingestion of milk goes through the body, a lot of it also gets processed through the kidneys to become urine. Cow/goat milk produces a higher solute load going through the kidneys, and the more solute you have in your urine, the more water it is going to draw out of the body with it (remember that from chemistry?). Because of this, your child is at higher risk of dehydration, especially in case of an illness during which he/she will naturally lose more fluid.

There you go! All the reasons to heed the AAP’s advice and not give your infant under one year of age cow/goat milk. Keep in mind that ingesting large amounts of cow’s milk or goat’s milk can potentially lead to anemia, so if you are unsure about safe/recommended amounts of milk for you child (based on their age), please talk to your pediatrician.