Constipation

In continuing our discussion of poop I thought I would address constipation. This is a common problem that I seem to be seeing a lot more of in the past few years.  By definition constipation is infrequent stooling. Once past infancy most children stool 1-2 times a day.  If it is less freqent, hard, or painful then they are constipated. 

So, what causes constipation?  Most commonly it occurs because someone does not have enough fiber and water in their diet.  In young children there can also be a behavioral part as well.  If a child is scared to stool in the toilet or they have 1 or 2 painful stools then they start holding their stool in. Then of course it hurts to stool so they continue to hold it in.

How to treat constipation?
1. Increase fiber in the diet.  We are supposed to eat 5-7 servings of fruits and veggies a day.  (juice doesn't count!)  You can also get extra fiber in beans, bran cereals, whole grain bread, and products that have fiber added such as the brands Fiber One and Fiber Plus.  To see if something has fiber read the side of the box that has the nutrition information.  The line that says fiber should say 5 grams or higher for cereals and granola bars and 3 grams or higher for bread.
2. Drink more water.  If your body doesn't have enough fluid it steals it from your intestines and dries your stool out.
3.Take time to poop.  I know this sounds funny but in today's fast paced society many children do not want to stop playing or watching TV to sit on the toilet long enough to stool.  Keep magazines or books (not small toys unless you want to go fishing for them!) by the toilet and encourage your child to sit on the toilet for about 10 minutes after eating.
4. Use a step stool. If your child's feet do not reach the floor when sitting on the toilet then get a step stool for them to put their feet on.  It is harder to stool if your legs are dangling.
5.  Give mineral oil.  If your child is older than 12 months of age you can give 1 Tbsp of mineral oil once daily to help keep their stool soft.

If these things don't help then it is time to come and see us.

The Poop on Poop

I don't know of any other profession that spends as much time talking about poop as pediatricians do so I thought I would do a series of posts about the subject. (If anyone is worried I will NOT be posting any pictures with these posts!)  The subject of poop brings about brings about such varied reactions in our office.  The new parent is anxious and worried about it, the school age child bursts out in peals of laughter when discussed and the teenager has the "Really, do we have to talk about this" response.

Let's start off talking about baby poop.

Newborns start off life with the tarry dark stools called meconium. These last for about 2-3 days.  Breast fed babies may then have 1-2 days of no stool while mom's milk is coming in.  Once her milk is in the baby's stool then should be loose, seedy, and watery.  If you are changing more diapers than you can count it means your baby is getting plenty of breast milk.  Formula fed babies have more variation in their stool.  Some babies may go many loose stools a day like a breastfed baby while others will have a formed stool every other day.  The color of the stool can be yellow, green, brown, tan, dark.  Quite frankly we really don't care!  So when to call us?  Please call if you are seeing blood or mucous in the stool, the stools are white for more than a couple of days, or if your baby is going more than 2-3 days without stooling.  (As always, if your child is acting sick then call)

As babies get older often times their stooling patterns change and they stool less often.  Breast fed babies can sometimes go 1 week without stooling.  (This really freaks parents out!)  When cereal and baby food are introduced parents notice that stools can change in color, frequency, and consistency.  This is normal as well.

That's enough poop for today.  Stay tuned for my next post on constipation.

Encouraging Your Child's Creativity

I wanted to take a moment to talk about creativity. It is a valuable trait that can easily get lost if not fostered.  So what is creativity?   By definition it the use of the imagination or original ideas.  Some parents might think that since their child is not going to be an artist they don't need to be creative.  This is not true, creativity is useful in most professions.  Such as leaders and business professionals who develop new ideas or engineers who design better products.

So how to encourage your child to be creative?  Here are a few suggestions:

1. Allow time for play.  In our fast paced society often times our days are full of structured and planned activities and time to play is lost.

2. Provide materials.  These include craft materials, Play Doh, boxes.

3. Provide opportunities for movement and music.  These activities can be things such as playing with streamers, banging pots with spoons, dancing to different types of music, or making an obstacle course.

4. Limit electronic toys.  They can be restrictive in how they can be used.  Toys that can used in unique ways or involve the imagination encourage creativity. Some suggestions include blocks, Legos, and dress up clothes.  I discovered with my kids that the electronic toys seemed to be popular but then they only would play with them for a short while.  The non electronic toys were the ones played with over and over again.

5. Provide a variety of children's book selections.  Reading to your child stimulates use of their imagination.  The library is a great place to find books to interest your child.

6. Limit screen time.  (here is where Dr. Krieg gets up on her soapbox!)  Computer, tv and video games all have little opportunity to use creativity.

I hope you find these suggestions helpful and that you and your child have fun doing creative activities together!

Scorpion Stings

This is the time of year that we see more scorpions so I thought I would blog about scorpion stings.  Just to be clear scorpions STING not bite!

So.. what's all the fuss about scorpion stings.  Well, they sting you with a neurotoxin  (that means it is a chemical that is toxic to your nervous system).   Scorpion stings are rarely fatal and do not have long lasting effects but are quite unpleasant.  One feels immediate pain and burning.  The area where the sting occurs also can be sensitive to touch and can have numbness and tingling.  Less common side effects include blurry vision, muscle twitching, eye roving movements, drooling, and restlessness.

What should you do if you get stung?  First wash the area with soap and water.  Then apply a cool compress or ice.  If you are stung on an arm or leg elevate it. Next, I would recommend calling poison control (800-222-1222).  They are a wonderful resource and they can give you advice as to whether or not you need to go to the ER.  Most people do not need to go to the ER.  If you do they will likely give you medication to make you more comfortable and may give you antivenin if your symptoms are severe.

New Infant Tylenol Dosing

Studies have found that many parents are confused about how much fever reducer to give their child and thus many children are given too much or too little medication.  To help decrease overdoses Tylenol and other manufacturers of acetaminophen (generic name for Tylenol) have reformulated their infant suspension.  The strength of the infant is now the same as the children's suspension (160mg/5mL).

So... what dose to give?  The children's liquid has dosing on the side of the box.  Give the dose based on your child's weight not their age.  For an infant check the last handout our office gave you.  Up until age 5 the dosing is listed at the top under your child's height and weight.  Still uncertain of the dose?  Then call our office.  We would rather you call us than given an incorrect dose.

A general rule of thumb is that if a medication comes with a medicine dropper then that is what you should use.  Don't use that dropper for any other medication.  If you want to use a dropper or syringe for the children's liquid (which comes with a cup) then use a dropper with the same dosing markings.  For example if your child's dose is 1 tsp in the cup then use a dropper with a 1 tsp mark on it.

Still confused?  Then bring the product you have to your child's next visit and ask us to help you out.  We are always happy to help you!