Mosquitoes bite infants and children more than any other insect.

Mosquitoes can transmit dangerous blood-borne illnesses including West Nile Virus, malaria, encephalitis and many other diseases.

Only female mosquitoes bite. They need a blood meal to acquire the protein they need to produce eggs.

The irritation from a mosquito bite comes from a reaction to the saliva, which includes digestive enzymes and anticoagulants.

Sensitivity to mosquito bites varies greatly. Some kids become less sensitive to the bite with age; others become increasingly allergic.

Taking a non-sedating antihistamine such as Claritin (loratadine) or Zyrtec can help lessen the effect of a bite if taken beforehand or lessen the severity of the reaction if taken after a bite.

The most effective bug repellant compounds contain DEET, picaridin and oil of lemon eucalyptus. Consumer Reports created a top five list of the most effective insect repellants, which were shown to prevent bites from ticks and at least two types of mosquitoes for at least eight hours.

• Off Deep Woods Sportsmen II (DEET 30%)
• Cutter Backwoods Unscented (DEET 23%)
• Off FamilyCare Smooth and Dry (DEET 15%)
• 3M Ultrathon Insect Repellant 8 (DEET 25%)
• Repel (Plant Based Lemon Eucalyptus)

 
The maximum concentration of DEET recommended for infants and children is 30 percent. DEET products should not be used on children under 2 months of age.

Repellant should be applied over the clothes, and avoid using it on the parts of the hands that might come in contact with your eyes or mouth.

Mosquitoes care what you wear. Avoid bright, floral colors in clothing as well as fragrances in soaps, shampoos and lotions.

Mosquitoes tend to bite between dusk and dawn, and they tend to hang out near water. When it’s hot and humid, expect more pests.

Females lay their eggs in standing water, so be aware of potential breeding areas such as:

• Bird baths
• Outdoor pet dishes
• Flower pot saucers
• Ponds
• Gutters
• Wheelbarrows and buckets
• Wading pools and swimming pools
• Trashcans, recycling bins and trash lids
• Puddles and ditches in your yard or driveway

Many of the regulations that allow dairy products to carry the label “certified organic” revolve around farming practices. In general, organic milk should come from cows that eat only organic food and are not enhanced with hormones, antibiotics or other chemicals.

In February 2010, the USDA tightened its definition of organic milk to include stricter regulations about the pasture access. The new guidelines define organic milk as milk from a cow that grazes on pasture at least four months out of each year, with at least 30 percent of the feed coming from grazing. The old rules simply stated that animals had to have “access to pasture.” Ranchers must also have a plan to protect soil and water quality.

When breastfeeding women rely on organic milk vs. regular milk, their babies benefit from up to 36% higher levels of the heart-healthy essential fatty acid CLA (conjugated linoleic acid)¹.

Conventional milk contains an average of 2.5 pesticides, according to a USDA study of 788 milk samples in 2005.

The Organic Milk Suppliers Cooperative sponsored an independent study that found that organic milk contained an average of almost 70 percent more heart-healthy Omega 3 essential fatty acids than conventional milk. Other studies have revealed higher levels of other nutrients as well, such as vitamin E and beta-carotene.

Another study showed that the incidence of eczema in young children was reduced by 36 percent when children consumed organic dairy products.

The benefits of buying organic dairy products go beyond nutrition. More than 200 million acres of farmland in the US are dedicated to growing feed for livestock. Choosing organic dairy products creates a market for farms that avoid pesticides and other farm toxins.

If you need or want to avoid dairy products, organic soy milk, yogurt and other soy products are nice alternatives that allow you to reap the benefits of milk’s best nutrients while still choosing organic.

Most of us spend the vast majority of each day indoors, where air quality can be 2-5 times worse than outside. Indoor air quality issues revolve around environmental contaminants such as allergens and airborne chemicals.

• Chemicals that release fumes, called volatile organic compounds (VOCs), are in solvents, cleaning products, air fresheners, polishes, adhesives, paints, new carpeting and furniture. One study found that young kids in homes with high VOC levels were four times as likely to develop asthma.
• Dust mites and other indoor allergens love pillows and mattresses, and we often hear the statistic that up to 10 percent of the weight of a two-year-old pillow is made up of dust mites, living and dead, and their droppings. Enclosing mattresses and pillows in allergen-proof covers can keep the mites at bay, as can washing sheets and blankets in hot water weekly. Dust mite populations can also be controlled by reducing indoor humidity to below 60 percent and removing carpets from the bedroom.
• Stoves or heaters that burn gas, propane, kerosene, wood or charcoal produce carbon monoxide, and the gas can accumulate in poorly ventilated areas. Another dangerous source is from gasoline motors (such as cars or lawn mowers) that are running in enclosed spaces. Carbon monoxide is second only to heroin as a cause of death by poisoning in the US. A carbon monoxide detector is a simple tool that will give you peace of mind.
• One six-inch houseplant per 100 square feet of living area can filter VOCs and vastly improve your indoor air quality. Bamboo palms, Chinese evergreens and English ivies are the three best in removing formaldehyde, benzene and carbon monoxide from indoor air.
• Opening your windows to let polluted air out and fresh air in can noticeably improve indoor air quality.
• Household chores can help with air quality: dust often, keep your ducts clean and forego chemical cleaning products and air fresheners. Also, use a HEPA-filtered vacuum at least twice a week (plus a HEPA air purifier in a the bedroom of a child with asthma), and keep your plumbing in good repair to avoid mold growth.
• Keep the chemicals outside by taking your shoes off at the door to avoid tracking of contaminants, hanging dry-cleaned clothes outside before they make it to the closet and never smoking inside (better yet – take the pledge to never smoke!).

The opposite of antibiotics are probiotics – a term coined in 1965 to describe substances that favor the growth of beneficial microorganisms in the body.

Two species of probiotics, Bifidobacterium and Lactobacillus, have been studied the most.

Bacteria that produce the enzyme lactase help reduce lactose intolerance. Probiotics can treat other enzyme deficiencies (e.g. sucrase maltase deficiency) as well.

In a placebo-controlled study, Lactobacillus was given to children along with antibiotics, resulting in fewer cases of diarrhea and milder diarrhea for those who did get it.

Active-culture foods are somewhat effective at preventing and treating bacterial diarrhea, including Clostridium Shigella, Salmonella, and the dreaded E. Coli 0157:H7.

Lactobacillus is most effective at preventing and treating rotavirus and other viral infections.This suggests that probiotics are not just friendly placeholders in the gut, but active immune enhancers.

By reducing inflammation, probiotics appear to be useful in treating a variety of gastrointestinal problems including inflammatory bowel disease (such as Crohn’s disease or ulcerative colitis), ulcers, and irritable bowel syndrome. Flatulence and non-specific tummy aches can also be decreased.

Food allergies are caused by the production of antibodies (IgE) against something in the diet. Normally, a substance in our bodies called interleukin (IL-12) prevents this. A recent study showed that consuming Lactobacillus can increase IL-12, decrease IgE antibodies, and thus help prevent and treat food allergies.

Many children with eczema have flare-ups triggered by what they eat or drink. In one fascinating study, a group of children who received Lactobacillus had significant improvement of their eczema within one month!

One of the most startling recent studies of Lactobacillus indicated a “marked, long-term” protective effect on the heart, preventing and decreasing damage from lack of oxygen to the heart muscle. The effect was attributed to the demonstrated changes in inflammation and the immune system.

One double-blind, placebo controlled trial found that some strains of active-culture yogurt, eaten over 8 weeks, help lower LDL cholesterol and normalize blood pressure.Serum triglycerides were also lowered in a controlled animal study.

Because probiotics can decrease the presence of carcinogens in the intestines in several ways, they may prove helpful for preventing cancer. One important study suggests that in the soy-rich Japanese diet that seems to prevent breast cancer, it is the abundance of the probiotic Bifidobacterium in some soy products that is at least partly responsible for the powerful preventive effect.

While active-culture yogurt has proven helpful in many areas, and seems to be helpful in many others, it appears to do nothing to combat vaginal yeast infections. It has been recommended both orally and topically, but when evaluated no benefit is found. Perhaps this is because the normal population of Lactobacillus continues to thrive in the vagina even during a yeast infection.

Lactobacillus can help prevent yeast in the GI tract, diaper area and in the mouth. Probiotics can also help to prevent urinary tract infections.

A fasting blood sugar at or above 126 mg/dL or a random blood sugar at or above 200 mg/dL is diagnostic of diabetes, according to the official American Diabetes Association definition.

A fasting blood sugar of 100 to 125 mg/dL or a random blood sugar between 140 to 199 mg/dL is diagnostic of prediabetes, according to this same definition.

Prediabetes occurs when a person’s blood glucose levels are higher than normal but not high enough to be diagnosed with type 2 diabetes.

The name, diabetes mellitus, comes from the Greek words for “to flow through” and “sweet.” The Greek physicians used to diagnose the condition by actually tasting the urine. (That’s dedication!)

Normally, a hormone called insulin pushes sugar from the blood into the body’s cells where it can be used for fuel. The concentration of sugar in the blood remains within a fairly narrow range. If the body stops making insulin (type 1 diabetes), then adequate sugar doesn’t get into the cells.

Until June 23, 1997, type 1 diabetes was also called insulin-dependent diabetes mellitus (IDDM).

Without insulin, muscle and fat begin to be burned for fuel (evidence of this — ketones — shows up in the urine). The person feels hungry all the time, but loses weight in spite of increased eating. Without replacement insulin, the person would eventually starve to death. Meanwhile, the concentration of sugar in the blood begins to increase. When the level reaches around 180 mg/dL, the sugar begins to spill over into the urine. This causes the person to make more urine and then to get thirstier, creating an accelerating cycle.

The classic symptoms of type 1 diabetes are increased urination (polyuria), increased thirst (polydipsia), increased eating (polyphagia) and weight loss. Anyone with the classic symptoms should have a blood sugar test as well as a urine test.

Occasionally people also report fatigue, blurred vision, vomiting, abdominal pain, or frequent skin infections.

If the disease remains undiagnosed, symptoms progress to include labored breathing, coma, and death.

People who get type 1 diabetes were born with a genetic predisposition to it. Not everyone born with this predisposition gets diabetes, however. In fact, if an identical twin has diabetes, the other twin gets it only about half the time.

Along the way, some of the predisposed individuals are exposed to something in the environment that triggers the diabetes. This is usually a viral infection. The virus misleads the body’s immune system into making antibodies against its own pancreas cells that make insulin. (This is why type 1 diabetes is now also called immune-mediated diabetes.) The insulin-producing cells of the pancreas are gradually destroyed over time. When 90% of them have been destroyed, the person suddenly begins to develop symptoms.

Immune-mediated or type 1 diabetes most often strikes young people, especially between the ages of 5 and 7 (when viruses run through the schools), or at the time of puberty (when so many hormones change). For this reason, it used to be called juvenile-onset diabetes.

About 0.4% of the general public (or one out of 250) will eventually develop type 1 diabetes.

According to the National Diabetes Information Clearinghouse, just over 175,000 children under age 20 in the United States have diabetes.

About 800,000 people in the United States now have type 1 diabetes.

About 30,000 people develop type 1 diabetes each year.

Type 2 diabetes is caused, not by the absence of insulin, but by insulin’s not working properly. It is much more frequent in overweight adults over the age of 45, but can occur at any age and weight. There are often no symptoms.

The National Institutes of Health estimates that more than 7 million adults in the United States have undiagnosed type 2 diabetes.

As obesity becomes more common among children, the number of children with prediabetes and with type 2 diabetes has been rising dramatically in recent years.

Rotaviruses are the leading cause of both routine vomiting and diarrheal illnesses and of severe, life-threatening diarrhea in every country in the world. Click here to read more about rotaviruses.

• About 50,000 children are hospitalized in the United States each year for rotavirus infections (JAMA 1998;279:1371-6).
• Rotaviruses cause about 1 in 78 children in the United States to be hospitalized before they enter kindergarten.
• They are the leading cause of both routine vomiting and diarrheal illnesses and of severe, life-threatening diarrhea in every country in the world.
• Almost every child on the planet becomes infected by age 5 (Pediatrics 1996;97:7-13).
• 900,000 young children around the world die each year from rotaviruses (New England Journal of Medicine 1996;335:1022-28). Most of these deaths occur in developing countries.
• In the US, rotaviruses are responsible for more than 3.5 million diarrheal illnesses, half a million physician visits, 50,000 hospitalizations, and 20 tragic deaths each year (JAMA 1998;279:1371-6). Those who are admitted to the hospital stay for an average of four days.
• The extreme dehydration that can be caused by rotaviruses is second only to the dehydration caused by cholera.
• Rotaviruses are extremely contagious. They originate in the stool, but are found throughout the environment wherever young children spend much time, especially during the winter months.
• Rotavirus particles remain active on human hands for at least 4 hours, on hard dry surfaces for 10 days, and on wet areas for weeks.
• There is a fairly rapid test for rotavirus diarrhea. The direct-antigen test can give results in 24 hours.
• In February 2006, the FDA approved a new rotavirus vaccine called “RotaTeq.” It is given orally to children at 2 months, 4 months, and 6 months of age. This vaccine has been shown to significantly reduce severe and life-threatening cases of rotavirus.

Psoriasis is often not even considered in children because the average age of onset is 28 years.

Roughly 80 million people suffer from psoriasis.

According to the National Psoriasis Foundation, between 150,000 and 260,000 new cases are identified each year in the United States.

5% to 10% of people with psoriasis also experience the swollen hands and feet of psoriatic arthritis.

Each year, about 400 people in the United States die from complications of psoriasis.

In the United States, between $1.6 billion and $3.2 billion is spent on psoriasis every year.

For children whose psoriasis is triggered by throat infections, or made worse following strep or impetigo, tonsillectomy and adenoidectomy may be an option.

People who bathe in the salt water of the Dead Sea in natural sunlight have been noted to have dramatic improvement of their psoriasis.

“Huffing,” or inhaling volatile substances, is becoming increasingly popular among children, especially among 12- to 14-year-olds (Archives of Pediatric and Adolescent Medicine, 1998;152(8):781–786).

Alarmingly, about 20% of eighth-graders report having done it (International Journal of Addiction, 1993;28:1613–1621).

Besides sudden cardiac arrest (the most common cause of death from inhalants), huffing can kill quickly in a number of other ways. Motor vehicle accidents, falls, and other traumatic injuries are common and horrible. Others die from suffocation, burns, suicide (from the depression that can follow the high), and from choking–on their own vomit.

Huffing can kill the very first time children experiment with it. About 22% of those who die from huffing do so the first time they try it (Human Toxicology, 1989;8:261–269).

When huffing doesn’t kill quickly, it damages the body each time–especially the brain. Huffing can cause memory loss, impaired concentration, hearing loss, loss of coordination, and permanent brain damage. Chronic use can cause permanent heart, lung, liver, and kidney damage as well.

Solvents (found in glues, paints, and polishes), fuels (such as butane), nitrites (found in deodorizers), and almost any kind of aerosol spray can be responsible.

Most huffing takes place with friends (although kids who sniff correction fluid in class when their teachers turn away are not uncommon). Be observant of your child and his or her friends.

Inhalants gradually leave the body for 2 weeks following huffing–mostly through exhaling. The characteristic odor is the biggest clue. Be on the lookout for breath or clothing that smells like chemicals. Look for clothing stains. Watch for spots or sores around the mouth.

Nausea, lack of appetite, weight loss, nervousness, restlessness, and outbursts of anger can all be signs of inhalant abuse. A drunk, dazed, or glassy-eyed appearance might mean your child is abusing inhalants right now.

If you suspect or discover that you child is huffing, get professional help. Treating inhalant abuse is very difficult and requires expert intervention. Withdrawal symptoms may last for weeks. The relapse rate without a long-term (2-year) program is very high.

Preventing huffing is far better than trying to treat an inhalant addiction. Talking with your child about it is more powerful than anything else (NIDA Research Monograph, 1988;85:8–29).

Start talking with your child about it now. Although huffing peaks between the ages of 12 and 15 years, it often starts “innocently” in children only 6 to 8 years old (Pediatrics, 1996;97:3).

Literally thousands of easily available substances can be inhaled, so you can’t keep your child away from them. You can, however, educate and inspire.

For more information on huffing, I recommend visiting www.inhalant.org.

SIDS, or Sudden Infant Death Syndrome, is defined as the sudden, unexpected and unexplained death of any infant or young child.

SIDS accounts for about half of the deaths that occur between one month and one year of age.

Genetics plays a large role. SIDS is more common in boys than in girls, and it is more common in some population groups (Black, Native American, Hawaiian, Filipino, Maori).

Most of the affected infants have damaged or immature brainstems, making it difficult for them to wake up when they are in trouble. A recent series of autopsies has demonstrated visible brain abnormalities in over 70 percent of the SIDS babies examined (Pediatric Neurology, Jul 1998).

While parents often feel horribly responsible after SIDS, sometimes there is nothing they could have done to prevent it.

Almost 35,000 healthy babies in Italy had EKGs performed in the first week of life. They were then followed for a year. Most of those who ended up dying of SIDS had an abnormality on their original EKGs (a prolonged QTc interval). Those with this abnormality were more than 40 times more likely than their peers to die from SIDS (New England Journal of Medicine, Jun 11, 1998).

Anything that causes less oxygen to get to the baby in the uterus will increase his or her risk. On average, smoking during pregnancy doubles the chances, and the odds increase with each cigarette. Other drugs of abuse such as cocaine or heroine increase the risk by as many as thirty times.

The media often focus on “crack babies,” but tobacco use continues in approximately 25% of all pregnancies in the United States (J Pharmacol Exp Ther, Jun 1998). Nicotine exposure is responsible for many more SIDS deaths than any other drug of abuse, including cocaine. Stopping smoking during pregnancy is the most immediate step we can take to save infants’ lives.

Minimizing caffeine use during pregnancy is another way to protect your child. Those babies whose mothers drank 4 or more cups of coffee per day could have up to twice the risk of SIDS (Arch Dis Child, Jan 1998).

SIDS is more common in babies who sleep in warm environments, who are over-bundled, who sleep in rooms with space heaters, who are exposed to cigarette smoke, who sleep on soft surfaces, who do not use pacifiers, and those who sleep face down or in a prone position.

The rate of SIDS is higher in those babies who do not receive timely well-child care and immunizations.

Putting children to sleep on their backs lowers the risk of SIDS by about three times. Use firm bedding in a slightly cool room.

Breastfeeding may also reduce the risk of SIDS, but the studies remain inconclusive.

The SIDS rate has dropped by more than half in the last few years to 0.7 per one thousand live births in the United States. Changes in sleeping positions are being credited for the reductions (AAP News, Jan 98).

The peak period for SIDS is between two and four months old. It is very rare before one month of age, and at least 95% of all the cases have occurred before children reach six months old.

Pertussis is commonly known as whooping cough.

Pertussis is caused by bacteria that attach themselves to the cilia (little hairs) that line the respiratory tract. These bacteria produce a potent toxin that inflames the respiratory tract and that prevents the cilia from functioning properly.

The disease can be serious or fatal in infants and unimmunized children. It is much milder in teens, adults, and in immunized children – but still can be a real nuisance.

People with pertussis go through four stages:

Incubation. For 5 to 21 days after exposure (usually 7 to 10 days) there are no symptoms at all while the bacteria multiply.

Prodrome. For the next 1 to 2 weeks, pertussis is not unlike a cold. People have runny noses, sneezing, and perhaps a low-grade fever. A mild cough begins that gradually worsens.

Paroxysms. The worst part of the illness lasts from 1 to 6 weeks. Spasms or attacks of coughing may come up to 15 times per day. Sometimes, especially in children, the cough is followed by a “whoop” noise as they breathe in rapidly, attempting to get air. Even so, young infants will often turn blue with the spells from lack of oxygen. The mucus is often thick and sticky. Gagging, choking, and vomiting are common. Sometimes young infants will stop breathing for varying lengths of time. This stage of pertussis is much milder in adults, teens, older children, and immunized children.

Convalescence. As if this disease were not already long enough, the cough continues for another 2 to 4 weeks, but gradually becomes less severe and less frequent. Even after the cough seems finally over, the spasms often recur briefly for the next several months – especially during colds and during exertion.

Current lab tests to detect pertussis are either slow, cumbersome, not readily available, or often fail to pick up the disease.

According to the Centers for Disease Control and Prevention people are considered to have pertussis if they have a cough lasting for at least 14 days (with no other confirmed cause) and any one of the following symptoms (even if they have been immunized): Coughing spasms or fits (coughs comes in clusters), a whooping noise while breathing in, or vomiting caused by the cough.

The case is called confirmed pertussis if there is a positive lab test or if there has been exposure to someone with a positive lab test.

During a pertussis outbreak, anyone who has a cough lasting at least 14 days (with no other known cause) probably has pertussis, even in the absence of other specific symptoms.

Pertussis is treated with an antibiotic (Biaxin, erythromycin, Septra, or Zithromax). The antibiotic doesn’t much affect the length of the illness, but is very effective at stopping its spread.

People with pertussis are highly contagious for up to 5 days after starting the antibiotic.

You or your child have been exposed if you spend a total of 5 hours in the same room with someone with the disease (over a week), or if you sit next to someone with pertussis for any length of time, or if you have any contact at all with infected mucus or saliva.

Between 70 and 100 percent of susceptible people will catch pertussis if they are exposed.

Currently, most adults and teens are susceptible because the protective effect of their childhood pertussis immunizations has waned. To address this problem, it is now recommended that all teens receive a booster vaccine at 11-18 years of age (preferably between 11-12 years).

Between 60 and 80 percent of infants are protected after the first 3 doses of vaccine, but this protection begins to disappear when they are toddlers. After the 4th immunization at 18 months old, 80 percent are protected for the next 3 to 4 years. The 5th dose, at kindergarten entry, protects them for another few years. A booster dose is recommended during the teen years to bolster immunity to pertussis.

People who have been exposed to probable or confirmed pertussis should either receive a course of preventative antibiotics (and I say this as someone strongly opposed to the overuse of antibiotics), or be kept home from daycare, school, or work for at least 3 weeks. If the exposed individual develops symptoms, they should receive antibiotics to prevent further spread of pertussis to others.

Children under age 7 who have been exposed should receive a pertussis vaccine, unless they have already had 4 doses of pertussis vaccine (and the last dose within 3 years), or unless there is a compelling reason not to immunize them. Exposed teens 11-18 years old who have not already received a booster vaccine should receive one.