Scary? Yes (and I’m not just talking about the contents of those nappies or diapers!). There are three events that you may experience as a parent that, while harmless, may scare the living daylights out of you. They are:

• Breath holding episodes
• Reflux and choking
• Febrile convulsions

In the next 3 blogs I will address each of these frightening occurrences. Firstly… episodes of breath holding.

A provocative stimulus, such as a fright or unexpected pain, may cause your baby to hold their breath. It will generally go like this:

• Your baby will cry vigorously
• They will expel all of the air from their lungs
• Your baby will hold his/her breath and go blue

And if that isn’t scary enough for you…
• They may lose consciousness and have a short seizure

Sounds dreadful doesn’t it? And if you have experienced one of these episodes with your baby then you’ll agree it’s mighty frightening.

Babies and young children (up to about 4 to 6 years of age) may experience an episode of breath holding and if they hold their breath long enough to pass out it will be frightening and worrying for all. The good news is that any loss of consciousness will immediately cause your baby to stop crying and breathe again. (Phew!)

Can I reassure you that episodes of breath holding are, by and large, harmless and will not result in any long term complications. A panic attack for you, yes, but harmful to your baby, no.

As breath holding more commonly occurs in your presence, you will undoubtedly feel compelled to do something (who wouldn’t?). However, apart from maybe rolling them on to their side, you really need take no specific action. One again, there is nothing to worry about as no baby or child is able to consciously hold their breath long enough to cause any harm.
While I hope you never witness a breath holding episode with your baby, can I reassure you that if you do, your baby will be fine. Always seek medical advice if you are unsure or need reassurance (there’s more good information from the Royal Children’s Hospital here) but remember that breath holding is harmless and will cause not complications (other than your jangled nerves!).

Did you know eczema affects 10 to 20% of children? I see many children in my Pediatric practice who are suffering from its effects. Not only is eczema a common condition, but it’s distressing and prone to complications (such as infection and bleeding). Children with eczema (and their parents) will also know that it is often associated with other difficulties such as poor quality sleep due to constant itching, scratching and bleeding.

These issues make life difficult and I believe both the community and health professionals understate the impact of eczema on children and their families. Affected children often scratch at night and therefore sleep poorly. This in turn can lead to impaired growth, development, concentration, appetite and even learning.

Our management of childhood eczema has been somewhat ‘light on’. We tell each other that he’ll grow out of it or its ok she won’t develop any scars. While this is true, what we should also be doing is working hard to treat the condition effectively, and ensuring that sleep and lifestyle are minimally affected.

We know the following are triggering factors for an eczema flare up:

·         Overheating

·         Dryness

·         An illness, like the common cold or gastro

·         Emotional stress

·         Sleep deprivation

·         Secondary bacterial infection of the skin

·         Irritants (such as soaps or nylon)

·         In some children, exposure to certain allergens

       such as egg, cow’s milk, wheat

All children with eczema respond differently, however I always recommend the following treatment guidelines:

·         Moisturize, moisturize, moisturize…paraffin or sorbelene are good

·        Keep your child cool. Try not to over-clothe them and, where possible,  keep their environment cool

·         Use bath oil rather than soaps

·         Avoid or reduce exposure to allergens if you can

·         Treat secondary bacterial infection aggressively with antibiotics (infection is suggested if the lesions have become weepy)

·         Don’t be afraid to use corticosteroid ointments (rather than creams) prescribed by your doctor. Better to treat the condition aggressively from the outset and then complications and chronic problems less likely to occur. Continue steroid ointments for 3 days after resolution of eczema inflammation.

·         Consider using wet dressings at night to for severely affected areas to reduce inflammation. This will keep the skin cool, moist and protected from scratching

If you are a parent with a child who has eczema you’ll no doubt be familiar with many of these suggestions. Other useful information can be found here. You may even have some of your own strategies that you could share? I’d love to hear.

While the outlook for childhood eczema is variable (children with multiple allergies generally have more severe and longer lasting eczema) the good news is most infants and children grow out of eczema by primary school. Also, long-term complications (such as scarring) are rare indeed. So hang in there everybody, there is light at the end of the eczema tunnel.

By the Chinese Zodiac Calendar, 2009 is the Year of the Ox. Forgive me for thinking it is the year Two thousand and Swine. Turns out we are not only in a global economic meltdown, but also a pandemic of panic. Not a day has passed in recent months that we do not hear updates about Swine Flu. How many new cases, government responses, expert opinions, media sites and the now, sadly, deaths.

In context, H1N1 Influenza 09 (Human Swine Flu) is still a ‘flu in a teacup. Ordinary Influenza A is more dangerous, and always has been. The World Health Organization’s decision to raise the pandemic alert level to Phase 6 is not a response to the severity of illness caused by the virus, but a reflection of its rapid spread.

So what can we do to help? How do we prevent Swine (or any other) flu from reaching our home? Simple measures are the best and no different from any other pandemic or seasonal influenza:

      Wash your hands often and well

      Stay away from sick people and crowded areas if there is an influenza outbreak in your area

      Cough and sneeze into a tissue

      Keep your immune system healthy with lots of sleep, exercise, water, good food and less stress.

Sound familiar? This is probably the same advice given to you by your mother to prevent spreading the latest cold or flu when you were a child!

While the current outbreak of Swine Flu should not be dismissed as unimportant, we need to keep it in perspective. Deaths from Swine Flu are a reality. However they tend to be in those patients with predisposing factors. Chronically ill children (and elderly people), perhaps with ongoing lung or heart problems, are more prone to influenza, swine or otherwise. These vulnerable areas of the population (including those who are pregnant) should be vigilant. Alert but not alarmed, as they say.

 To deal with the panic and inevitable media-hype that surrounds us with Swine Flu:

      Stay informed and link to credible information

      Don’t panic or buy into the fear

      Be sensible and use simple preventative measures

      Be vigilant if you are pregnant or care for vulnerable people

There is no vaccine for Human Swine Influenza as yet. Unfortunately, neither is there one for panic. I am pleased to read in the Medical Journal of Australia that people’s level of anxiety surrounding H1N1 is decreasing and I encourage us all to continue protect ourselves from the contagious nature of both panic and swine flu.

“Autistic people hear everything; the pens clicking, someones shoes scruffing on the floor, the voices,the lights actually hum, So how does it feel to be autistic when you are overstimulated? It feels like: 20 cologne smells… like hundred of kids running around you asking you questions in different languages, like you’re sitting in a chair that is missing one leg and trying to balance it while all that is going on, and lights flickering…too much..” Kris

Do you know somebody who has a child with autism? Heard of Asperger’s Syndrome? Information about the Autism Spectrum Disorder (ASD) abounds and research continues. We are now hearing stories about what it is like to have autism from high function adults such as Kris. ASD, to me, is one of the really fascinating areas that have emerged over the last 20 years in childhood medicine.

We did not know how prevalent Autism and Asperger’s was until recently. Can you believe we used to think of people who have Asperger’s syndrome as troubled individuals, obviously having had inappropriate parenting? Of course Asperger’s is not the fault of parents. It never was.

Thankfully research teaches us more and more about Autism Spectrum Disorder each day. The Journal of the American Academy of Pediatrics has just published an article that explores the connection between Autoimmune Disorders (AD) and Autism Spectrum Disorder (ASD). As a Pediatrician and a parent, this new interests me greatly. Click here to access the abstract of this article. I’d also love to hear your stories.

I wonder what the implications of this new research are for parents of babies and children with ASD? Could it one day be prevented? Let’s hope so, for all children and families in the future.

Vomiting and diarrhoea. Pooing and spewing. Why is it that as soon as we become parents, so much of our lives (and conversations) revolve around the output of our children? It seems as though as soon as we have a crying baby in our arms, what comes out either end of them is both vital and fascinating. There’s entire blogs devoted to the subject squidoo.com/babypoop!

How much has our little one had to eat? Has he pooed today? Did she feed properly? And if that isn’t enough, we begin to panic when more than expected comes up or goes down. Oh no, she has diarrohea. Heavens above, have you seen this nappy?

As both a Pediatrician and a father of four I have my fair share of stories about babies crying and loaded nappies! I’ll bet you do too? However, I won’t ask you to share them (unless you really want to… feel free to tell). Right now I’d like to discuss when vomiting and diarrohea go above and beyond. When your baby has gastro.

Answers to your questions about gastro can be found in the Gastroenteritis – Your Questions Answered article. There’s also great info here. But for now let’s look at one important piece of information… lemonade.

Do you remember as a child being given flat lemonade to drink? The intent of our parents here was good – something tasty and sugary to keep us going when everything else won’t stay down. However, research has shown that undiluted lemonade or juice is too strong and can have an adverse affect. It is vital for the health of your baby that diluted lemonade or fruit juices are used when keeping your baby or child hydrated during a bout of gastro. Keep this in mind next time you are faced with a shirt-front full of baby vomit… and let your mother’s group and friends know. Let’s do the best we can to keep our little ones soothed and safely hydrated when the dreaded gastro hits.