Kids Corner with Dr. S 

 

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Welcome to my blog! I am Dr. Lauretta Stombaugh (Dr. S) and I have been part of the Hendersonville Pediatrics family for over 8 years. I have decided to share this blog because I feel that it is vital for parents and caregivers to be well-informed as well as have access to solid, accurate medical information. Your children are our children and we take pride in the excellent care we provide here at Hendersonville Pediatrics. Please join me monthly (or every two weeks if my four kids allow me time to write!) and I will in turn provide interesting, helpful and maybe even comical blogs. Please share a link to my blog! Ready, set, go!!

 

 This is one of the most common questions pediatricians are asked each day in practice (along with “how can i get my kiddo to sleep through the night?”).  School absences can be difficult for caregivers due to childcare issues and missed workdays, troubling for school officials and can cause children to fall behind in extreme cases.  My advice to my patients sometimes includes, “use your mommy or daddy judgement” because you know your child better than anyone. Other times, it is streamlined alongside the recommendations of our infectious disease colleagues. 

 The Common Cold

-no fever for 24 hours  provided your child is acting normally and is not having difficulty breathing

-it is OK to go to school with cold symptoms such as runny nose, nasal congestion, cough, sore throat unless you feel like your child needs to rest (or snuggle)

 -tidbit: yellow and/or green and/or glowing yellow-green nasal drainage does not always mean an antibiotic is necessary, our decision to prescribe an antibiotic (to treat only bacterial infections) is based more on length of symptoms and/or worsening symptoms

 Pink Eye 

-need to be on antibiotics for 24 hours (remember that not all eyes that are red = “pink eye” so always have your child examined by a physician), pink eye can be caused by viruses, bacteria, allergies or chemicals, it does not always require antibiotics (only the bacterial kind)

 Strep Pharyngitis or Strep Tonsillitis

 -free of fever AND on antibiotics for at least 24 hours (although there have been some recent articles suggesting less than 24 hours may be sufficient, no official change to the recommendation as of yet)

Lice

 -despite the “no nit” policies at many schools, the recommendation is to stay out of school just until all live lice are gone (always recheck for at least 1 week for newly hatched lice, retreat if necessary)

 Scabies

 -once treatment has started even if itching and lesions are still present

 Ringworm

 -once treatment has started, keep lesions covered with a bandaid

 Chickenpox

 -return to school after all lesions have crusted over AND there are no new lesions for 48 hours

 Fever

-always consider what the fever is from and how your child feels, but the general rule is fever free for 24 hours

 \Vomiting and/or diarrhea

 -if fever is present? no fever for 24 hours

-vomiting?  no vomit for 24 hours

-diarrhea? no diarrhea for 24 hours

Hand Foot Mouth (Coxsackie Virus)

-no fever and when blisters are dried up

-feeling well enough and drinking enough to be at school for a given time

 

-tidbit: fever = 100.4, your temperature varies throughout the day and so 99 degrees in a child who is usually 98 degrees does not constitute a fever because it is likely a normal variation

-tidbit: fever is caused by infection. if you treat it with Ibuprofen (Motrin) or Acetaminophen (Tylenol), it will likely return if the infection itself is not treated / if the infection is still active in one’s body. 

 

So the magic number is 24, however, the most important thing to remember is to listen to your child, decipher what is reality and what is drama and have a low threshold for bringing them in to see us. Similar to well check ups, while we examine your child we are looking for specific findings to rule out (or rule in) certain dieases, some of which can have lasting effects if not treated.

 Please come in and get your kids vaccinated against the flu this September! Watch our website and our new facebook page “Hendersonville Pediatrics” for announcements.

 

Stay tuned for my next blogs on bullying and common rashes! 

Dr.S

 

 

 

Dr.S

 

 

As long as it is an open conversation, it really doesn’t matter who begins it. Often times I am the one who delicately brings up “the talk” at tween/teen well checkups. I understand that it can be an uncomfortable topic for parents and kids, but I do think that the more we move away from it, the more our children will develop a shameful attitude towards their bodies. My 8 year old asked me how she got her blue eyes. I answered something along the lines of love and beauty.  “Whew, dodged that one” or so I thought. She followed with, “but how did the genes actually get together?” Glaring up at me waiting for the answer, I could see her curiosity beaming. I had a decision to make… repeat myself using other words that mean the same thing or have “the talk” (or tell her to go ask daddy). Then I had to decide how much of the talk to have. What words do I use? How much do I tell her? Is she too young? What if her friends explain things to her before I do? These are common questions we all have as parents. In the very beginning we see our babies exploring their bodies, our toddlers running around naked, our preschool kids asking questions or playing doctor, our school age kids wondering about where babies come from. This blog is for you - the parent who may be uncomfortable, confused or just needs a little guidance to approach these topics in a healthy and helpful way.

 

 

Babies touch their genitals as early as in the womb. They explore their bodies as infants and toddlers. As if having a toddler is not challenging enough, we now have to talk about poop, pee and body parts in addition to poop, pee and why we don’t eat erasers. When they reach toddlerhood, they often prefer to be unclothed which is a healthy part of development. Allowing them to do this at home is ok. Just teach them about “privates” and not being naked in public or around anyone else except immediate family. When approaching the topic of nudity or other areas of sexuality, be casual. Take it seriously, but remain lighthearted. Never laugh at your child when they ask questions about their bodies. Never get angry with them.  Use the proper words for body parts. The kids often change these up so don’t be surprised if they yell something about their “jyna” in a public place. 

 

Here’s an scenario: your 3 year old just got out of the bath and is watching cartoons on the couch. He/she is naked and starts touching their private area. Do you bring attention to it or do you ignore it? At that age I would probably just casually redirect them. An older child? I would explain that it is ok to touch their body, but only in the privacy of their room or bathroom. This is a good time to explain how no one else is to touch their bodies unless parents are helping to clean them or a doctor is checking them (always with a parent present). 

 

Another scenario: you walk into the playroom to find your young child and her male friend playing doctor. Should you yell? Should you send the friend home? Ignore it? I would recommend that you calmly explain that it is normal to be curious about the opposite sex. Then tell them it is not ok to touch or look at someone else’s privates. Don’t make it a big deal. Don’t act too surprised. If you are really brave, ask them if they have any questions. Then simply move on to the next uncomfortable moment.

 

Third scenario: your 10 yo asks you where babies come from (or in my case my 8 yo asks about her genes).  Your 10 yo does not have period yet and has just recently started puberty. Do you …

 

tell her to go ask the other parent :) tell her to google it explain sex in a calm, nurturing, simple way tell her she’s too young to know

 

When in doubt, pick C! It is OK to have this conversation anytime depending on your child’s emotional and physical maturity. I personally  believe that if a female has a period then they should know that they can become pregnant and how. (i have encountered some teens who have no idea why they get a period other than “I’m becoming a woman”) Be honest. If they get too anxious you can always explain it over time. You know your child better than anyone. You will know when “the talk” needs to occur.

 

Scenario: Your 16 yo son has recently started a relationship with a friend in school. You find condoms in his closet while you are “cleaning”. Which of the following is a healthy way to approach this situation?

 

punish him by taking away his car taking him to his favorite restaurant and casually discussing risky behaviors, respecting others and himself, safe sex call the girl’s parents research monasteries

 

It’s not always C…this time it is B. Keep it simple, positive and informative. Let him know that you are available for questions and support. Remember that your pediatrician can also help you navigate these conversations. We do it all. day. long. For me, it’s never presented in the same exact way twice. My drawings vary:) My approach is tailored towards the age of the patient, the maturity of the patient and the wishes of the parent(s). But we are helping you to raise strong adults and this is an important part of it.

 

Dr. S

I'm writing this blog because my firstborn used to eat butter under the dining room table in secret. Leaving me chunks of butter with teeny teethmarks. My second child thinks that three PB & Js make up a balanced meal. My third is a carb addict who uses vegetables as a way to eat his ketchup. My fourth kiddo eats like a grown man and eats your leftovers when you aren't looking. They have all been picky at some point. Some for a brief time and others for a very, long, exhausting two years. So I feel for you when you say, " my kiddo eats nothing." That is exactly how it feels at times. 

I'm in the " mom of four" club. It's an unspoken club where parents understand the level of chaos and joy in their families of four. There's a club for every family. We look at families of one with envy. "Wow. They only have one car seat!" We look at families of two and think, " wow. They only bathe two kids at night." Three? "Wow. They only have three! They are so smart." Then we look at our family of fours and say, "you are nuts! Oh wait, so am I."

As pediatricians we examine many ears in a day’s work. I can’t say i like it very much even after 11 years in pediatrics. Newborns are easier to examine, however, you can’t see very much. Infants sometimes beat me up. Toddlers, well, they are toddlers. Enough said. They put all kinds of things in there, but then they don’t want us to shine a light in there for 3 seconds. Younger children are usually fine with an ear check and don’t put objects in there which makes me happy ( I am starting a collection of “things I have removed from ears and noses”). Teenagers usually stay still for the ear exam, but are always self- conscious about ear wax (necessary for a healthy ear!).