It’s 2 a.m., and the coughing starts again. Anyone who has gotten a baby through cold season knows that sound, and the worry that comes with it. As a pediatrician and a mother of two (soon to be three), I’ve been on both sides of that bedroom door.

Cold and flu season is here, and parents often ask me what to do when their child, especially a baby, catches a cold, gets congested or seems to be coughing too much. The good news is that most colds can be handled at home. The key is knowing what helps, what to avoid, and when to call.

Coughing at night

Coughs often seem worse at night, just when parents are running short on sleep themselves. You may hear your baby coughing, or breathing harder or faster than usual, and wonder if something is wrong.

Since babies can’t tell us how they feel, we have to watch and listen. For the most part, a moderate cough in a baby with a cold is a good thing. It’s how the body clears out congestion.

During the day, gravity is your friend, and mucus drains more easily. When your baby lies down for the night, things can get a little backed up. Even so, always put your baby to sleep flat on their back, alone in the crib, with no pillows, wedges or inclined sleepers. Clearing the nose before bed is the safer way to help.

A typical cold lasts seven to 10 days, and the cough can hang on for two or three weeks after that. That’s normal.

Keep nasal passages clear

Babies breathe mostly through their noses, so a stuffy nose can make eating and sleeping hard. A couple of saline drops in each nostril, followed by gentle suction with a nasal aspirator, can make a big difference. Do it right before feedings and bedtime. A few times a day is plenty, since more than that can irritate the inside of the nose.

A steamy bathroom can also help loosen mucus. Run a hot shower, close the door and sit with your baby in the steam for a few minutes, well away from the hot water.

Skip the cough medicine

I don’t recommend over-the-counter cough and cold medicines. They haven’t been shown to help young children, and they can cause serious side effects.

For children over a year old, a spoonful of honey, alone or in a warm drink with lemon, can soothe a cough or sore throat and may help everyone sleep. Never give honey to a baby under 12 months, not even a taste. It can cause a serious illness called infant botulism.

If you want to be really popular with your toddler or older child, a popsicle soothes a sore throat and helps with fluids (you can make healthy versions yourself).

Keep babies and children hydrated

Many children lose their appetite when they have a cold. That’s okay for a short time, but staying hydrated is critical.

For babies, keep offering the breast or bottle, in smaller amounts more often. Babies under 6 months shouldn’t be given water; breast milk or formula is what they need. Older babies and toddlers can have sips of water throughout the day.

Most babies have about six wet diapers a day. Watch for signs your child isn’t getting enough fluid: fewer wet diapers than usual, a dry or sticky mouth, few or no tears when crying, or a sunken soft spot on top of the head. If your baby hasn’t had a wet diaper in six hours, call your provider.

Other times to call

Children’s breathing is my specialty, so here is what I want parents to watch for. Call your provider right away if your child:

• is breathing fast while resting
• has skin pulling in between or under the ribs with each breath
• has flaring nostrils or makes a grunting sound when breathing
• is too out of breath to eat
• is unusually sleepy, hard to wake, or won’t eat or drink
• has a fever lasting more than three days, or seems to get better and then gets worse

When the nearest emergency room may be a half-hour drive away, your provider’s 24-hour line is a good first call. If you’re worried, it’s always okay to call. I’d much rather see your baby and send you home reassured than have you tough it out. And if you come in, we can show you how to use a nasal aspirator gently and correctly.

When your baby or child gets sick, a little TLC with purpose goes a long way. In my next column, I’ll talk about steps you can take to help keep your child from getting sick in the first place.

A board-certified pediatrician, Dr. Sarah Alexander serves patients in Crawford and Orange counties. She has specialized fellowship training in pediatric pulmonology and brings advanced expertise in children’s respiratory health to her clinical practice in English and Paoli, Indiana.

The post What do you do when your small child gets sick? appeared first on Southern Indiana Community Health Care.

As the end of summer nears, two things happen with great reliability in southern Indiana. The corn gets tall, and my phone starts ringing with parents who need a physical signed by Friday.

I understand completely. The summer gets away from all of us. But if I could give parents one piece of advice before the first bell rings, it would be this: the annual well-child visit deserves a spot on the back-to-school list, right up there with the new backpack, as well as the shoes that fit in June and mysteriously do not fit in August.

Why the well-child visit is important

A yearly physical is more than a signature on a form. It’s a chance to see whether your child is growing and developing the way we’d expect, to make sure vaccinations are current, and to confidentially talk through balanced meals, sleep, exercise, and any worries about learning, behavior, or mood. It’s also when we can knock out those annual forms, the ones that always seem to turn up in a folder the night before they’re due.

As a reminder on vaccines, Indiana requires certain immunizations for school attendance, with additional ones at key grade levels. These include kindergarten, sixth grade, and twelfth grade. That list generally includes DTaP/Tdap, polio, MMR, chickenpox, hepatitis A and B, and the meningococcal vaccine for middle and high school students.

Since they don’t come up every day, that may sound like a lot, and parents oftentimes have questions. This is one of the reasons it’s good to have a direct conversation with a qualified medical provider.

Addressing physical issues that can inhibit learning

Vision and hearing are worth a look, too. In three decades of practicing medicine, I have never once had a child walk in and announce in a voice that only children have, “Doctor, I believe I need corrective lenses.”

What I hear instead comes from parents: “he squints,” “she gets headaches,” or “he asks us to repeat everything,”

The point? Sometimes the difficult issue that seems to come across like a school problem is really an eyeglasses problem.

When you should connect with the school nurse

If your child manages asthma, diabetes, allergies, or seizures, please connect with the school nurse before the year starts. Send updated medication orders, refresh emergency contacts, and check the dates on inhalers and epinephrine auto-injectors. Expired rescue medication in the nurse’s office does nobody any good.

School issues:  simple worry, or attention-sapping anxiety?

Mental health belongs on the list as well. Going back to school brings excitement and, for plenty of kids, a knot in the stomach. Ask how they’re feeling about it. Ask about friendships, about bullying, about what they do when something feels like too much. If you notice changes in sleep, appetite, mood, or behavior that stick around more than a couple of weeks, a one-on-one talk with your provider is a good idea.

The rest is old-fashioned and still true. Think about starting bedtimes and wake-ups a week or two early, because nobody adjusts to a 6:30 alarm overnight. Children ages 6 to 12 need nine to twelve hours of sleep; teenagers need eight to ten. Eat breakfast. Move every day. Put the screens down before bed. Wash hands, cover coughs, skip the shared water bottle, and stay home with a fever or a stomach bug.

And you athletes: drink a lot of water, wear the gear, and tell a coach immediately about any head injury.

Finally, don’t wait. Schedules usually fill fast as summer comes to a close, and the calendar always wins. Call now, and help your child start the year healthy, confident, and ready to learn.

Board-certified in family medicine, Curtis Thill M.D. has seen multiple generations of children at Southern Indiana Community Health Care on their way back to school.

The post If I Could Give Parents One Piece of Advice… appeared first on Southern Indiana Community Health Care.

What should alert a parent or caregiver to the possibility that a child may have ADHD (Attention Deficit Hyperactivity Disorder)? Here are some important answers and considerations based on a recent presentation by Teresa Faulkner and Sasha Newland, both Licensed Clinical Social Workers serving on SICHC’s mental health team.

ADHD symptoms typically include unusual difficulty in sustained concentration, an inability to plan or finish tasks, talking too much, inattention and distraction, impulsive interruptions, a high need to be in constant motion, and other behaviors. To be certain, many children and teenagers occasionally experience these behaviors as a normal part of mental and emotional development. 

Children with ADHD often possess talents like enhanced creativity, resilience or curiosity – all with the capacity to be singular strengths. 

Normal behavior or ADHD?

But when challenging behaviors continuously interfere with schoolwork or life with family or friends, it might be time to have a discussion with a medical provider or mental health professional.

Here’s an important fact: while more than 10% of U.S. teens have been diagnosed with ADHD, many children (and later adults) go through life with an undiagnosed condition. That can affect quality of life, success in school (and careers), and interpersonal relationships within a family, work environment, or even later in a marriage. 

It is very important to understand that if one is in fact diagnosed with ADHD, that is not somehow a “strike” against one’s success in life. Positive navigation of life with ADHD is indeed possible.

Given the uniqueness and complexity of each person, a qualified professional should make an evaluation and subsequent diagnosis of ADHD. “Self-diagnosing” ADHD and possible self-treatment can lead to issues and unwanted consequences. 

Some myths about ADHD can lead people to think that the condition compromises the capacity to lead a happy and fulfilling life. Successful life with ADHD is widely demonstrated, including professionals like Olympic gold medalist Michael Phelps, Harry Potter film actress Emma Watson, NBA basketball legend Michael Jordan,  Olympic gymnast Simone Biles, technology legend Bill Gates, singer Solange Knowles, and many more. 

If one is diagnosed with ADHD, the goal becomes how to manage the condition and fashion personal pathways that lead to success.

Parents and caregivers are important

The role of parents and caregivers in supporting children and teens diagnosed with ADHD is critical. Children need to be supported and actively accompanied on this journey. SICHC professionals directly engage parents and caregivers, providing tools and techniques (including how to manage stress) to help their child develop successful pathways and learn how to manage day-to-day challenges.

SICHC professionals consider a variety of potentially contributing factors when evaluating for ADHD. These include developmental variations, as gifted children can display traditional symptoms of ADHD. SICHC professionals also evaluate potential neurological, neurodevelopmental, behavioral, societal, and medical conditions or patterns. 

Since ADHD in children can affect cognitive, academic, behavioral, emotional and social function, most treatment of ADHD begins with talking with a licensed professional  in cognitive behavioral therapy (CBT). After an evaluation, diagnosis, and initial treatment (including ADHD training for parents), medications may be prescribed.

Education about ADHD critical

Far too many myths – including potential unfounded confusion between ADHD and autism – exist. As all children are unique, educating oneself about what ADHD is and the positive means to deal with it remains critically important in supporting someone with ADHD.

Concerned that your child or loved one may be facing ADHD? There is real hope and support! And it’s never too late to seek help. 

For more information about SICHC professional mental health team, please visit https://sichc.org/mental-health/ or contact a professional at one of our offices (visit https://sichc.org/locations/ for more information).

The key? Don’t struggle alone – help is available for a successful life!

The post What you should know about childhood ADHD appeared first on Southern Indiana Community Health Care.

Besides helping to build a special bond between you and your baby, breastfeeding has been rightly called by physicians and researchers “the clinical gold standard for infant feeding and nutrition.”  Why? Because breast milk is uniquely tailored to meet the complex needs of your growing baby, producing unmatched health benefits for both infant and mother.

Did you know that research shows that infants who are breastfed have reduced risks of developing asthma, obesity, or Type 1 Diabetes? Breastfeeding also reduces the risks of certain kinds of severe respiratory disease, ear infections, infections that produce diarrhea and vomiting, and even Sudden Infant Death Syndrome (SIDS). Here’s an unusual fact: statistical research notes that babies who are breastfed usually later score higher on IQ tests. 

And on top of all of those benefits, breastfeeding helps mothers too. Research shows that mothers who breastfeed can have lower risks of high blood pressure, Type 2 diabetes, and both ovarian and breast cancer.

Why is breastfeeding so good for your baby? From a nutritional standpoint, your breast milk usually gives your baby certain hormones and just the right amount of protein, sugar, fat and most vitamins that your infant needs at this critical time. Your breast milk also includes tailored antibodies that help your baby ward off infection and illness.

Other benefits include the fact that you can breastfeed at any time. You don’t have to prepare or heat up any formula, and there’s no mess to clean up. Plus, the more you breastfeed, the more your body will produce milk, making as much nutritional milk as your baby needs. That’s important, because breast milk usually provides 100% of the food and drink that your baby needs for the first six months.

With all of these benefits, there is still a challenge. While some 83% of babies start out with breastfeeding, that can change rapidly. Statistical research notes that only one in four infants are exclusively breastfed as medically recommended by the time they are six months old.

Questions or concerns? Talk with one of our OB providers at Southern Indiana Community Health Care for more information.

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