Tips for summertime fun!

Go outside! The warmer months are a wonderful opportunity to explore, play and learn outdoors.

Here are a few tips to stay safe in the sun:

Bright Sun and Healthy Skin
• Keep your skin protected from sun damage to prevent sunburns, skin cancers and wrinkles later in life. Remember that small amounts of sun exposure over time causes most sun damage – It is important to protect yourself every day, not just on long pool days.
• Use sunscreen that is at least SPF 30 or higher, protects from UVA and UVB rays, and is water resistant if you will be spending time in the water. Re-apply every 2 hours and after getting out of the pool!
• Fight heat exhaustion! It can start slowly but become serious quickly.
– Drink plenty of fluids on hot days, especially during time in the sun.
– Be careful about moderate to heavy exercise at midday.
– If overheating, have your child lie down in the shade and seek medical care immediately if concerned.

 

Hiking and Camping
• There is Poison Ivy all around in Eastern Washington and North Idaho. Don’t forget: “leaves of three, let them be”.
• Check for ticks! Lyme disease, which ticks can carry, is not common in Washington. It is still important to examine for ticks and remove them quickly if they are found. Be sure to check behind the ears, scalp, under the arms and groin.
• DEET-containing insect repellent is safe for children older than 2 months old. Use 10-30% and apply one time per day. Do not apply to the face, or to the hands of young children.

 

Water Activities
• Learn about water safety. Swimming is fun and can be a lifelong healthy activity, but it is very important to know how to stay safe around the water. Nearly 1,000 kids drown each year – most in swimming pools.
• Plan to enroll in swimming lessons after the child turns four years old. Even if a child knows how to swim, all children deserve close observation when around water.
• Life vests are very important for kids to wear whenever they are near water.
• Install a fence around a pool if there is one in the home.
• If there is concern for drowning, pull the child out of the water, call for help/911, and if child is not breathing start CPR if you have been trained.

Learn more by asking your pediatrician!

by Marcus Baca, MD – Pediatrician at Valley Clinic

Autism, what is it?

Autism spectrum disorder (ASD) is a complex developmental disability; signs typically appear during early childhood and affect a person’s ability to communicate, and interact with others. Your Pediatrician can start to recognize these symptoms between 1-2 years old and should be testing for concerns. ASD is defined by a certain set of behaviors and there is a wide spectrum as to how it impacts each child’s life.

There is no known single cause of autism, but increased awareness and early diagnosis/intervention and access to appropriate services/supports lead to significantly improved outcomes.

Many of the early signs of Autism deal with difficulties with social interaction. 

The range and severity of symptoms can vary widely. Common symptoms include:

  • difficulty with communication
  • difficulty with social interactions
  • obsessive interests
  • repetitive behaviors
  • difficulty making eye contact
  • poor motor skills’ and sensory sensitivities (overly sensitive to the feel of clothing or texture of foods).

A person with ASD may follow many of these behaviors or just a few, or many others as well. The diagnosis of autism spectrum disorder is applied based on analysis of all behaviors and their severity and how they impact that child life and learning.

Autism is treatable.

Children do not “outgrow” autism, but studies show that early diagnosis and intervention lead to significantly improved outcomes. For more information on developmental milestones, visit the CDC’s “Know the Signs. Act Early” site.

  • Lack of or delay in spoken language
  • Repetitive use of language and/or motor mannerisms (e.g., hand-flapping, twirling objects)
  • Little or no eye contact
  • Lack of interest in peer relationships
  • Lack of spontaneous or make-believe play
  • Persistent fixation on parts of objects

Early recognition, as well as behavioral, educational, and family therapies may reduce symptoms and support development and learning.

Is it a Cold or Seasonal Allergies?

Spring is around the corner and we are all looking forward to longer days and warmer weather. However, this time of year can also bring seasonal allergies for many families and children.

Seasonal allergies, or allergic rhinitis, occur when the immune system reacts to harmless substances including mold, dust mites, pet dander and pollen. In response, the body releases histamine, which can cause nasal drainage, sneezing, coughing, throat irritation, and itchy watery eyes.

 

Allergy symptoms that last throughout the year are often caused by indoor allergens such as pet dander or dust mites. Seasonal allergies are usually related to pollen from weeds, grass and trees. Parents may also notice that their child’s allergy symptoms are worse at certain times of day. A child that is allergic to dust may have symptoms when they first wake up in the morning while a child that has a grass allergy may experience symptoms after they have been playing outside.

 

Because the symptoms of allergic rhinitis are similar to the common cold, it can sometimes be difficult to determine what is causing a child’s symptoms.

 

Questions to Consider:

  • How long has your child had symptoms? The common cold typically resolve within 2 weeks, so if your child has symptoms that last longer than this it may be time to look at allergies as a possible cause.
  • Does your child have a fever? Allergies do not cause a fever, so if your child’s symptoms are accompanied by an elevated temperature it is safe to assume that they have a virus.
  • Does your child have eye symptoms? Allergy symptoms usually include itchy, watery and irritated eyes while the common cold does not. Dark circles under the eyes are also a common sign of allergies in children.
  • Do any of your child’s playmates or siblings have similar symptoms? If you have noticed that other children that your child has been in close contact with have similar symptoms, a virus is the most likely cause.
  • Is there a family history of allergies? Allergies are more common in families with a history of allergies.

 

To diagnose allergies, your child’s provider may order allergy testing through a blood or skin test. Many medications and lifestyle modifications can help control allergy symptoms. See your child’s healthcare provider if you suspect allergies or have any questions or concerns about your child’s symptoms or condition.

Tips for a Healthy Fall

Later, summer.
It’s been real. But, it’s time to welcome back short days, crisp air and colorful leaves of fall time. Time to stow away swimsuits in favor of sweaters for apple picking. Fall is incredible in the PNW; beautiful weather, colorful leaves and fall foliage make it for a great time of year for both exercise and wonderfully fresh seasonal foods. Here are some tips to make your fall a healthy and happy one:

All hail The Great Pumpkin!
Pumpkins are more than just pies and jack-o-lanterns, they are rich with vitamins A and C. Of course pumpkin seeds are a wonderful and healthy fall treat. There are a ton of possibilities with pumpkins. Check some of these healthy recipes out:

12 Healthy Pumpkin Recipes

Get your flu shot and yearly check-up.
This one is pretty simple. You don’t want to be sniffling, aching, coughing and sneezing all winter long. Get your shot, keep the flu away. Schedule your appointment today by calling 509.444.8200

Boost your immune system! Hydrate throughout the day. adequate hydration has a huge impact on your immune system. Water helps all of your body’s systems function at optimum levels. Eat foods that add to your immune system with probiotics and vitamin C such as yogurt, oranges, peppers, garlic, yes even pumpkins can pack vitamin C.

Get outdoors. The bright colorful leaves on the trees add a visual treat to your walks as do the crunching of leaves under foot. What better season to put on a beanie and get active? In addition, outdoor time increases vitamin D levels, which can make you happier and improve concentration according to Harvard Medical School

Keep the treats in check. When you are stuck inside with delicious Halloween candy everywhere, it can be hard to resist eating 10 mini Snickers in a row. Don’t resist entirely, just don’t become a sugar zombie. Also, when it comes to game days make healthier choices by setting out veggies and dip instead of chips. You can also cut some of your favorite unhealthy snacks in to smaller portions.

Spring Allergies- Common Activities to Minimize Symptoms

With the spring season here and pollen in the air, there are a few daily activities you can do to minimize allergy symptoms including:

Eat healthy foods- Improper eating habits aggravate many health problems, including asthma and seasonal allergies. Foods that contain antioxidants such as fruits and vegetables can help battle inflammation which helps with controlling allergies.

Reduce stress– When you are stressed, your body releases stress hormones which sends signals to various parts of your body to prepare for actions. If this is a common occurrence in your body and there is not a physical release, the stress can affect your immune system. In addition, a weakened immune system increases your chances of allergic reactions.

Use your air conditioner– Having windows or doors open is a common way to bring allergens inside your home so instead close your windows and use an air conditioner.

Clean door mats– Cleaning your door mats prevents mites, mold, and fungus- all common allergens, from being tracked into the home.

Spring clean– Dust is a common allergen and cleaning in those tough to reach areas can help minimize allergy symptoms.

These are simple tasks you can do to minimize allergy symptoms, but if you still suffer from symptoms, seek treatment from your health care provider.

 

By Sarah Giomi, Communications Intern and Bill Bomberger, PA-C

Spring Allergies- Symptoms and Treatment

Spring season brings the blooming of many plants and flowers and that means the blooming of spring allergies. What are allergy symptoms and how can you treat them? The most common allergy symptoms to look for are:

  1. Runny nose
  2. Watery eyes
  3. Sneezing
  4. Coughing
  5. Itchy eyes and nose
  6. Dark circles under the eyes

If you experience these symptoms during the spring allergy season, you should visit your primary care provider who can refer you to an allergist for tests. There are two forms of common allergy tests including a skin test, also known as a prick test or a blood test.

The skin test involves either a pricking of the skin with a tiny amount of allergen, or injecting a small sample of a diluted allergen under the skin of your arm and back. If you are allergic to the substance, a small red bump, also known as a hive, will form. The blood test is also another common option for an allergen test.

If the symptoms are caused by an allergy, there are over the counter prescriptions and medications that a provider can prescribe to ease the symptoms.

This is the 3rd part in a 4 part allergy series, be sure to follow for more!

By Sarah Giomi, Communications Intern and Bill Bomberger, PA-C

Spring Allergies- Is it an Allergy or a Cold?

Spring is here and so are allergies but how do you know your child’s runny nose is from allergies instead of a cold?

Colds are caused by a viral infection, while allergies are caused by your immune system overreacting to harmless substances.  Several of the symptoms are the same for colds and allergies, however there are a few differences that may give you a clue to the true culprit.

  1. Length of symptoms. Colds last 1-2 weeks while allergy symptoms can go on for weeks or months.
  2. You will not get a fever, chills, or body aches with allergies, however these are common symptoms of colds.
  3. A common symptom of allergies is itching: itching skin, itching eyes, itching throat, and itchy nose.  This does not occur with a cold.
  4. Colds tend to develop thicker nasal secretions, while allergies tend to have clear watery discharge.

Understanding the differences can help you decide what steps to take to give your child the right treatment they need!

This is the 2nd part in a 4 part allergy series, be sure to follow for more!

By Sarah Giomi, Communications Intern and Bill Bomberger, PA-C

Too sick for school?

Flu season is officially here! Over the next few months, many parents of ill children will be faced with the decision whether or not to send their child to school. The most important thing for parents to consider when making this decision is if the child will be able to learn and participate in school activities. We also don’t want to unnecessarily expose other children to illness causing germs. However, we all want to minimize missed school and work days for both students and their parents. Below are a few guidelines that can help parents make this often tricky call.

Fever

A fever is body’s way of fighting off infection and is the most common reason parents keep their children home from school. The definition of a fever is a temperature of 100.4 or higher, though some schools and daycare centers will have their own rules. The general rule of thumb is to keep your child home until they have been fever free for 24 hours.

Upper respiratory Infections

Most children will have several different cold viruses each winter. A child with typical cold symptoms including a runny nose, sore throat, and cough can usually participate in school without any restrictions. Coughs may linger for several weeks after the other symptoms have resolved. It is important to go over the importance of coughing or sneezing into an elbow or a tissue and proper hand washing techniques with your sick child to limit the spread of these germs.

It may be necessary to keep a child home if they have more severe symptoms, such as extreme fatigue, loss of appetite, or anything else that will keep them from learning and participating at school. If a child has influenza (the “flu”), they should be kept home from school until their symptoms have resolved. The flu is similar to a cold but is accompanied by high fevers and body aches. We recommend an annual influenza vaccine to help lower the risk of this illness.

If your child has an ear, sinus, or strep throat infection it is recommended that they stay home from school until at least 24 hours after antibiotic treatment has been started. Conjunctivitis (also known as “pink eye”) can be caused by allergies or a virus, but when it’s caused by bacteria it is very contagious and needs antibiotic treatment before the child returns to school.

Vomiting and Diarrhea

Children with vomiting and diarrhea should also be kept home until their symptoms have resolved. If there are no other symptoms, older children with mild diarrhea that are able to use the toilet and wash their hands on their own may go to school if they don’t have any other symptoms.

Skin

Most childhood rashes are caused by viruses and most are not cause for concern. Certain rashes, such as chicken pox are more severe and highly contagious. If a rash is accompanied by a fever, the child should not attend school. If you are unsure what is causing a child’s rash, it’s a good idea for them be seen by their healthcare provider to find out what the rash is and any precautions that should be taken.

Lice is another common reason for children to miss school. In the past, many schools had a “no nits” policy. Experts now agree that these absences are unnecessary and children can return to school as soon as they have had one lice treatment.
Illnesses are a normal part childhood. We can’t keep our children home for every sniffle and sneeze, but we do want to minimize the spread of germs and make sure that our children go to school ready to learn. If you have any questions about whether or not to send your child to school, talk to your child’s healthcare provider.

Autumn Barbero, Pediatric Nurse Practitioner

Gestational Diabetes: Do I HAVE to drink that?

 

Short Answer:  Yes.

Long Answer:  You actually don’t HAVE to do anything you don’t want to do.  We won’t MAKE you do anything you don’t want to do.  This concept supports your autonomy as a patient.

However, you trust us to be the lifeguard of your pregnancy.  Throughout your pregnancy, we will monitor your blood work, vital signs, and the baby’s growth and development by using ultrasound, drawing your blood, listening to your baby’s heartbeat, and measuring the size of the uterus.  Trust us when we say that the second trimester glucose screen is very important to the health of both you and your baby.  We might even recommend it earlier in the first trimester if we are concerned about impaired glucose tolerance.

One complication of pregnancy that we screen for and treat is called gestational diabetes.  Gestational diabetes can occur in women of any size, even without a personal history of family history of diabetes.  Insulin is a hormone produced by the pancreas, and the body uses insulin to help transport blood glucose (sugar) from the bloodstream into the cells of the body.  The hormones of pregnancy can cause you to be resistant to insulin.  If you become resistant to insulin, your blood glucose levels become elevated and the glucose easily transports across the placenta to your baby.  This can cause the baby to grow very large, and at the same time it impairs the development of the baby’s lungs.  You can end up with a very large baby who, at the same time, has very immature lungs and needs help breathing after birth.

Maternal Complications of Gestational Diabetes:

  • You have a 70% chance of developing Type 2 Diabetes within 10 years
  • You are at a higher risk of high blood pressure or preeclampsia in pregnancy
  • You might require medication to help manage your blood glucose
  • You are at higher risk of miscarriage or stillbirth

 

Fetal Complications of Gestational Diabetes:

  • Your baby can grow very large
  • Your baby might experience a shoulder dystocia at delivery, which is an emergency situation where the head delivers but the large body is stuck behind your pelvic bones.  We might have to break the baby’s collar bone to help your baby deliver.
  • Your baby might require assistance breathing at delivery or in the first few days
  • Your baby might need to be observed or treated in the special care nursery for low blood glucose.

What happens if your one hour glucose screen comes back elevated? 

We will ask you to take a three hour glucose screen.  If the three hour glucose screen comes back elevated, you will have the diagnosis of Gestational Diabetes.  At that time, we will send you for a consultation with a Maternal Fetal Medicine physician called a Perinatologist.  These physicians are specially trained in high-risk pregnancy and obstetric ultrasound.  They can help us monitor the growth of your baby.  In addition, a diabetic educator will teach you how to test your blood glucose daily.  They will also teach you how to eat well to keep your blood glucose as stable as possible.  You will also be asked to increase your daily exercise, which will help your body be more sensitive to insulin and help you regular your blood glucose.

 

The glucose screen is usually done at the 24-28 week visit.  We ask that you eat normally that day, with good protein and not a heavy carbohydrate load.  Plan for the visit to take at least an hour because we have to draw your blood one hour after you finish drinking the liquid.  Pack a healthy snack with protein for the ride home.

 

So… yes.  Your midwives are aware that the glucose screen can cause nausea and discomfort.  You may not like the taste of the drink.  However, it is an important screening test that can help us provide the very best care for you and your baby.

 

For more information:

http://www.diabetes.org/diabetes-basics/gestational/

http://www2c.cdc.gov/podcasts/player.asp?f=11504&loc=WhatIsGestational

By: Kirsten Johnson | Certified Nurse Midwife