Children's

Partners in Kids Health – Asthma

Partners in Kids Health – Asthma

Asthma can be a scary diagnosis for a child and their parents. It’s a disease that makes it hard to breathe. This happens because airways in the lungs get swollen, smaller and filled with mucus. According to the Centers for Disease Control and Prevention, one in 13 people have asthma. Molly Bolton is the Asthma Program Nurse Practitioner at Children’s of Alabama. She says the common symptoms of asthma include coughing, especially at night time, as well as chest pain or chest tightness, and difficulty breathing or a wheezing, whistling sound when breathing.

Asthma Symptoms

  • Cough
  • Chest pain
  • Wheezing

There’s no cure for asthma, but it can be managed to prevent flare-ups. Bolton says, “Our goal is that children with asthma can run and play and do the things any other child can do.” There are multiple treatment measures that can be used in the management of asthma. These include quick relief medicines that help relieve asthma symptoms within minutes and controller medicines that manage asthma by preventing flare-ups. Controller medicine is taken every day, even when a child feels well.

Treatment of Asthma

  • Quick relief medicine
  • Controller medicine

If you’re concerned your child might have asthma, make a note of the symptoms and any “triggers” that are causing the symptoms and share with your child’s pediatrician. Notice if flare-ups occur inside or outside, or are they exercise-induced? Bolton advises, “Talk to your pediatrician about the symptoms that are concerning to you. Try to let them know what makes the symptoms worse or better.” It may help to keep a journal initially to record these observations.

Bolton says if your child is diagnosed with asthma, a pediatrician will probably recommend seeing your child every three to six months. “Asthma is chronic, long-term and may change over time,” she says. By partnering with your child’s pediatrician and following their recommendations for management of asthma and avoiding triggers, your child should be able to stay healthy and breathe well.

Children's

Scoliosis Screening in Grades 5-9

What is scoliosis?

Scoliosis, a condition estimated to affect 2 to 3 percent of the population, is a side-to-side curvature of the spine that can look like an “S” or a “C.” Scoliosis occurs when the vertebrae in the spine form a curved line instead of being straight. The vertebrae can also twist like a corkscrew.

Scoliosis curves are measured in degrees:

  • A mild curve is less than 20 degrees
  • A moderate curve is between 25 and 40 degrees
  • A severe curve is more than 50 degrees

Who should be screened?

Scoliosis can occur in people of all ages, but symptoms typically present in early adolescence, around age 10. While some cases of scoliosis present serious symptoms such as a protruding shoulder blade or an uneven rib cage visible when bending forward, scoliosis often goes undetected because of its painless onset.

Why is it important to be checked?

When detected early, treatment with a brace may prevent the progression of the curve and in turn prevent the need for surgery. Untreated cases of scoliosis may affect the function of other parts of the body, including the heart and the lungs.

Prevention and treatment

Schools play a vital role in early scoliosis detection and can help prevent permanent spinal deformity by offering a wide variety of screening programs. Alabama public schools offer free yearly scoliosis screening for students in the 5th through 9th grades (ages 11-14). Beginning in the 2019-2020 school year, students must return a signed parent permission slip to be screened.

Screening is performed by observing the uncovered spine, viewing the student from the back, side and front with the student bending forward. If a spinal problem is suspected, the child will be rechecked at a second screening. Parents of students found to have signs of a possible spinal abnormality will be asked to see their own physicians for further evaluation. Girls and boys are screened separately for privacy.

While there is no cure for scoliosis, early detection and treatment can prevent deformities that may lead to back pain and impaired posture. Ensure that your child is screened for scoliosis by signing the permission slip provided to your child.

Children's

Children’s Doctor Using Herpes Virus To Fight Brain Tumors

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Each year more than 300 children and young adults in Alabama are treated for brain or central nervous system cancer at Children’s of Alabama.

May is Brian Tumor Awareness Month, and it’s particularly exciting that patients treated for brain tumors at Children’s are benefiting from a breakthrough in cancer treatment.

The process is known as viral immunotherapy, and it uses the herpes virus called G207, the same one responsible for the common cold sore, to treat brain tumors.

University of Alabama at Birmingham (UAB) and Children’s are the only places in the world where this type of virus has ever been used to help pediatric brain cancer patients.

Dr. Gregory Friedman, an associate professor, Pediatric Hematology-Oncology and director of Developmental Therapeutics at UAB who treats patients at Children’s, says it’s still early in the study, but it’s already showing major promise. Friedman’s team has treated 10 patients from across the U.S., and some internationally with promising preliminary results.

“We do get a lot of looks when we say we’re going to be using the herpes virus,” Dr. Friedman says, “but what we’ve learned is that we can engineer these viruses so that they’re safe and can actually be directed, targeted therapy to kill cancer cells.”

Here’s how it works.

Once a biopsy is done to confirm a recurrent tumor is present, doctors place catheters directly into the tumor. Then the catheters are externalized out through the patient’s scalp similar to an IV.

“Then the following day, the virus is infused over six hours through the catheters,” he says.

Doctors then remove the catheters, the patient is monitored for a few days in the hospital, and then followed intermittently in the outpatient clinic.

This one-time treatment is shown to not only kill cancer cells but also to stimulate the patient’s immune system.

Friedman noted that the primary purpose of this initial study is to demonstrate safety and thus far the virus has been safe and tolerable in children with progressive malignant brain tumors.

The following is a Q and A with Dr. Friedman about the study.

Q: What is pediatric virotherapy/immunotherapy as it relates to your research of recurrent brain tumors?

A: Virotherapy is a type of immunotherapy that utilizes a virus to kill cancer cells and to stimulate the child’s immune system to attack the tumor, providing a “one-two punch” at attacking the tumor. There are many different viruses that are being studied as possible cancer treatments. Some of the viruses do not typically produce disease in humans, and others, like the cold-sore virus that we are researching, have to be altered so that the virus cannot harm normal cells but can kill cancer cells. We think the cold-sore virus is an ideal virotherapy/immunotherapy agent for a number of reasons. It can infect and kill cancer cells while stimulating a robust immune response against the tumor. The virus has been studied extensively so that the essential and nonessential genes have been identified. Nonessential genes can be replaced with foreign human genes. As the virus replicates, the foreign gene can result in the production of substances that enhance the immune response against the tumor. Lastly, unlike other viruses, there are drugs available to treat infection in the unlikely event that the altered virus causes problems.

Q: Describe the attributes of children who are generally diagnosed with malignant brain tumors.

A: When a child is diagnosed with a brain tumor, the symptoms can vary depending on the location of the tumor. Commonly children will experience headache, nausea, vomiting, and difficulty with balance. Occasionally, a tumor can cause seizures, weakness, numbness, vision changes, or difficulty with speech or swallowing.

Q: What is a typical treatment plan for a child with malignant brain tumors?

A: The treatment depends on the type of tumor and location of the tumor, but in general, malignant brain tumors in children are treated with a combination of surgery, chemotherapy, and radiation. These therapies are very damaging to a child’s developing brain and can result in lifelong disability in survivors. Unfortunately, many children do not survive a malignant brain tumor. This is why novel, targeted therapies are greatly needed to improve outcomes and lessen toxic side effects of current therapies.

Q: What is the prognosis of someone with malignant brain tumors?

A: The prognosis depends on the type of malignant tumor, the location, and the molecular genetics of the tumor. Some tumor types, like brainstem gliomas and glioblastoma, have very poor outcomes with survival rates of 0–10%. Survival rates for medulloblastoma, the most common malignant brain tumor in children, range from 50–80%. Overall, malignant brain tumors are the leading cause of death from cancer in children.

Q: What happens when a patient relapses?

A: When a patient relapses with a malignant brain tumor, there are very few effective treatment options. If it is possible for the neurosurgeon to remove the recurrent tumor, surgery may be performed. If it has been a long enough interval from the initial course of radiation, another course of radiation may be used. There are a few traditional chemotherapy agents that can be used as a second line of treatment as well. Unfortunately, these type of treatments tend to only temporarily control the disease; recurrent malignant tumors are very rarely curable and almost always fatal over time.

Q: How has treatment for pediatric malignant brain tumors changed in the last 30 years?

A: The main changes to standard therapies have been improvements in surgical techniques, new strategies for delivering radiation, and a few new traditional chemotherapy agents. More recently, there has been a scientific boom in understanding the molecular characteristics of tumors, which has helped to define tumor behavior and provide new targeted avenues for treatment. This has led to the development of many different types of therapies, including antibodies, small molecule inhibitors, and immunotherapies.

Q: Why did you choose to research malignant brain tumors?

A: While overall survival rates for childhood cancers have improved greatly, unfortunately, outcomes for malignant pediatric brain tumors have lagged behind other types of cancer. Also, those that survive often suffer long-term disability from the treatments and the disease itself. There is an incredibly great need for new, targeted, less-toxic agents for this vulnerable population of patients, and that need is really what attracted me to research in this area.

Q: Are there any current research projects that are promising? If so, can you provide high-level/layperson details of the research?

A: To me, the most exciting and promising research projects currently are immunotherapies. Immunotherapies harness the patient’s own immune system to attack the tumor. There are many different approaches being tested, including antibodies to block proteins that tumors use to evade the immune system attack, tumor vaccinations, immune cellular therapies such as chimeric antigen receptor (CAR) T cells or natural killer cells, and virotherapy. Likely a combination of these approaches will be most effective. The first step is to get the child’s immune system to recognize the tumor as abnormal and to begin to attack it. Then the goal is to increase and maintain the attack on the tumor. Even if the immune system can just keep the tumor in check and keep it from growing, this would provide significant benefit for the patient.

Q: In lay terms, describe your research and the potential outcomes.

A: My overarching goal is to improve outcomes for children with brain tumors by developing and improving novel, targeted immunotherapies in the lab and then translating these therapies to clinical trials. We are currently studying a cold-sore virus that has been genetically altered so that it cannot harm normal brain cells but can infect and kill tumor cells while stimulating the patient’s own immune system to attack the tumor. Our first-generation virus is currently in a Phase 1 clinical trial for children with brain tumors and has shown great promise thus far. It has been safe and tolerable in all patients with evidence of efficacy in many, including a patient over two years out from the treatment without any additional therapy. We are taking what we are learning from the current clinical trial back to the lab (bedside-to-bench) to improve the therapy further by developing newer viruses, unique routes of delivering the virus, and unique combination therapies with the virus to maximize the anti-tumor response from the immune system. We will then take our discoveries from the lab back to the clinic (bench-to-bedside) to conduct new clinical trials to hopefully improve outcomes and lessen side effects for children in desperate need of better therapies.

Q: What have you learned from the patients with malignant brain tumors you have treated?

A: I have learned something from every patient I have treated. These lessons have ranged from how to handle adversity to communicating more effectively with children and families to managing unexpected side effects to considering and offering new treatment approaches. My goal is to treat each patient and family like I would want my own child and family members treated.

Q: Is there one child or family in particular about whom you could share a story of the way they impacted your passion to continue your research?

A: One of the first children with a brain tumor I took care of was a 3-year-old with a highly aggressive ependymoma. The tumor wrapped around the brainstem, and during the surgery to remove the tumor, the child suffered a brain injury and was in the ICU for months. The child lost the ability to talk and walk, and we were not certain if any recovery was possible. Against all odds, the child made a miraculous recovery, and through hard work and determination of the child and family, the child returned to walking, talking and playing. Unfortunately, the disease was a really bad disease, and the tumor returned. When it did, we lacked effective treatment options, and ultimately, the disease took the child’s life. This was incredibly difficult for everyone involved—to watch the child courageously fight back only to lose the battle against the disease. This definitely heightened my passion to fight for these children and their families and develop improved, targeted therapies.

Children's

100 Deadliest Days of Summer: Teen Driving

Summer is a liberating time for children and teens alike. Classes are finished, the sun is out and it’s their time to relax and have fun. But did you know that the time between Memorial Day and Labor Day is considered the 100 deadliest days for teens?

An average of 260 teens are killed in car crashes each month during the summer, a 26% increase compared to other months in the year*. However, there are safety precautions teens can take to stay safe and vigilant behind the wheel.

7 Ways to Stay Safe Behind the Wheel

1. Buckle up: every person, every time

More than half of teens involved in fatal car crashes were not wearing a seat belt. Make sure your teen is buckled up every time they get into the car: every time, every distance, no exceptions.

2. Don’t text and drive

Texting and driving takes your eyes off the road for 5 seconds at a time, on average. If your teen is driving at 55 mph, this is the equivalent of driving the length of a football field blindfolded. Set strict guidelines against texting and driving, and set a good example by not using your phone while driving.

3. Speak up when any person is driving unsafely

Half of teen passengers report feeling unsafe while riding with a driver who isn’t alert, but most of them don’t speak up. Why? Because they are afraid of what their friends might say. Encourage your child to speak up if they feel they are riding with an unsafe driver, and provide them with an alternative way home.

4. Limit the number of passengers in the car

When two or more teens ride together in the car, the risk of a fatal crash can double or even triple. Alabama follows the Graduated Driver’s License Law, which restricts teen drivers from having more than one non-family member in the car with them for the first six months after getting their license. Enforcing this law at home will ensure than your teen isn’t distracted by friends behind the wheel. 

5. Don’t drink and drive

15 percent of drivers aged 15-19 who were killed in fatal crashed had a Blood Alcohol Content (BAC) of .08 or higher. Remind your teen that drinking and driving is never okay, and poses serious legal and potentially lethal consequences.

6. Driving when it’s dark

The risk of a fatal crash at night can be three times higher for teens than for adults. Make sure your teen gets plenty of practice driving at night when they still have their permit and a trusted adult like you in the car.

7. Follow the speed limit

More than 33% of teens killed in fatal crashes were speeding. Make sure your teen is following posted speed limit signs at all times.

Remember that children and teens learn by example. Modeling good behavior behind the wheel will teach your child what is and what isn’t acceptable. Additionally, creating a contract or pledge for you and your teen to sign will set clear guidelines for your expectations. Use this contract to address consequences for speeding, texting, drinking or having too many passengers in the car.

*statistic courtesy of wesavelives.org

Children's, Health and Safety

Safe Sleep

SIDS or Sudden Infant Death Syndrome is the number one cause of death in babies under 12 months. SIDS is the sudden and unexplained death of a baby and often occurs during sleep.

SIDS is very frightening for new parents, but there are things you can do to keep your baby safe and help prevent SIDS. Dr. Candice Dye is an Associate Professor of Pediatrics at Children’s of Alabama and UAB. She says parents and caregivers of babies should remember the ABCs of Sleep. “Alone, on their back, in a crib. It’s that simple,” she says.

ABCs of Sleep
•Alone
•On their Back
•In a Crib

Dr. Dye explains each point:

ALONE- “Items in the crib pose a huge suffocation risk,” she says. “No bumper pads, no stuffed animals, no loose blankets. Nothing else in the crib. A boring crib equals a healthy baby.”

On their BACK- “This is different from when our grandparents or parents were doing this, but babies should be laid down on their back,” Dr. Dye says. “This ensures that the baby can breathe and they are not getting trapped face down unable to breathe.”
In their CRIB- “It’s really easy for parents to be tired and want to keep the baby in their bed with them, but an adult mattress is not the same as an infant crib mattress and there is the risk of the adult rolling onto the baby while sleeping,” she says.
Who is at risk?

All babies are at risk for SIDS. There is no single cause. However, SIDS is more common in black and Native American infants than in Caucasian infants. More boys than girls fall victim to SIDS.
Other risk factors include:
•Smoking, drinking or drug use during pregnancy and after birth
•Poor prenatal care
•Prematurity or low birth weight
•Family history of SIDS
•Mothers younger than 20
•Exposure to secondhand smoke
•Overheating

Dr. Dye strongly recommends that parents make grandparents and caregivers aware about the risk of SIDS and that they follow the ABCs of sleep when caring for the baby. She also cautions parents not to rely on store-bought devices or gadgets that may claim to help prevent SIDS.
Once babies consistently roll over from back to front on their own, they are less at risk of developing SIDS and can sleep in the position they choose. Until then, a parent can greatly reduce the risk of their child dying by SIDS by following the ABCs of sleep.

Allergies

Springtime Allergies

Springtime brings warmer temperatures and flowers in bloom, but it also can bring dreaded allergy symptoms like itchy watery eyes, runny nose and sneezing.

Dr. Amy CaJacob is an Allergist at Children’s of Alabama.  She says spring allergies are due to tree pollen.  Tree pollen is carried by the wind, so the allergens are in the air we breathe.  In the south especially, tree pollen is evidenced by a blanket of yellow dust covering everything outside. 

Dr. CaJacob says spring allergies usually begin around Valentine’s Day.  She advises parents whose children suffer from allergy symptoms in the spring to begin treatment at that time.  However, Dr. CaJacob, says it’s not necessary for everyone to seek treatment.

“If it’s just here and there, drippy nose, itchy eyes and it’s not bothering the child then it’s probably not anything to worry about,” she says.  “But when you get concerned is when it is impacting their quality of life, if they’re not paying attention in school, if they’re stuffy and snotty all the time, itching their eyes, eyes that are bloodshot and tearing then you probably want to seek treatment.”

For children who suffer from asthma, springtime allergies can be especially concerning. Dr. CaJacob advises, “Typically children with asthma are already using a rescue inhaler a couple of times a week, if they’re doing it more than that then they really need to see their pediatrician or an asthma specialist to step up their regimen during pollen season.”

It can be tough to avoid pollen exposure in the springtime, other than staying indoors.

Dr. CaJacob usually advises patients to minimize exposure and limit opening windows and doors during this time of year. Parents can also be aware of the daily pollen reporter given by the local weather forecast.

If you think your child suffers from seasonal allergies, keep a diary of symptoms and possible triggers and discuss with their pediatrician.  They may recommend allergy testing. 

Children's, Nutrition

Nutrition for Picky Eaters

By: Rainie Robinson, MS, RD, LD, CDE

Looking for a simple way to make sure your child’s plate is balanced? Try filling half of their plate with non-starchy vegetables like cucumbers, broccoli and green beans. Use your child’s fist to help measure a starch like mashed potatoes or pasta. Their fist is also a good measure for protein portion size. Protein can be a tricky addition, especially for younger kids who tend to be a little pickier. Some outside of the box protein ideas are  frozen Greek yogurt, trail mix with almonds or peanuts, string cheese or cubed cheese, or even use hummus for dip. Consider plating your child’s meal on a colorful plate with dividers, or cutting vegetables into interesting shapes to make meal time more fun.

MyPlateA great way to encourage children to make healthier choices is to incorporate a family dinner time. Studies have shown that kids who eat with their parents tend to make better grades, have a lower risk for becoming overweight, usually make healthier food choices, and typically engage in fewer risky behaviors as they grow older. If you’re feeling crunched for time, try starting with one family meal per week.

Children’s of Alabama has 24 registered dietitians ready to help your child thrive. March is National Nutrition Month and a great time to learn more about how dietitians can help your family. We are here to help guide your child as they continue to grow and develop. From the NICU through adulthood, each specialty service has its own dietitian that has become an expert in what your child needs. Our goal is to provide you with the nutrition education and tools you need to help your family live well.

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For more information on National Nutrition Month, healthy eating tips, and resources, visit https://www.childrensal.org/clinical-nutrition.

Children's, Health and Safety

Antibiotic Resistance

Your child has a cold and feels miserable. You take him or her to the pediatrician expecting an antibiotic as treatment. Unfortunately, this mindset has lead to more and more children becoming dangerously resistant to antibiotics.

 

Dr. Shannon Ross is with Infectious Diseases at Children’s of Alabama. She says antibiotic overuse is leading to children becoming very sick and harder to treat. “We see children every day who five to 10 years ago, we could have treated with an oral antibiotic. But because there are not many options, we are having to admit them and give them an IV antibiotic,” she says.

Most illnesses are caused by a virus. However, antibiotics don’t treat viruses. They treat bacterial infections. “A bacterial infection would be something like pneumonia or an ear infection,” Dr. Ross says. “And antibiotics are necessary to treat those infections.” Antibiotics can even be life-saving when used to treat a bacterial infection. But if a child receives antibiotics when it’s not needed, this overuse can lead to the child being resistant over time. “We are seeing, over the past decade or so, increasing resistance,” Dr. Ross says. “Common infections, pneumonias, bladder infections we used to treat easily are now resistant to common antibiotics.”

Antibiotic resistance is a widespread problem. The Centers for Disease Control and Prevention (CDC) calls it “one of the world’s most pressing public health problems.” Dr. Ross says parents can play an essential role in preventing antibiotic resistance. “When taking your child to the pediatrician, talk to your pediatrician about the diagnosis.If he or she prescribes an antibiotic, it’s OK to ask what the antibiotic is for and if it’s necessary.” She also advises that parents don’t pressure pediatricians to prescribe medicine their child doesn’t need.

If the pediatrician does prescribe an antibiotic. Remember these safety tips:

  • Take antibiotic exactly as prescribed
  • Don’t skip a dose
  • Finish the course of treatment
  • Never share antibiotics with anyone else

Parents can also help fight antibiotic resistance by encouraging their children to take simple steps to prevent the spread of infections. Encourage hand-washing and make sure your child is up to date on their immunizations. Also, remember if your child has a cold the best thing to do is “ride it out.” Help keep them hydrated and make sure they get plenty of rest. This will help their immune system to fight off the virus on its own.

Children's

Common Calls to the Regional Poison Control Center

The Regional Poison Control Center (RPCC) at Children’s of Alabama gets a variety of calls every day. The RPCC takes a variety of steps to ensure you and your child’s safety and keep you out of the emergency room, best of all its free and entirely confidential.

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The majority of calls the RPCC receives are about pediatric exposures. The most common 

exposure for children is household cleaning supplies. Many of your household cleaning supplies can look similar to edible substances for children. When making a call to the RPCC for this circumstance, they recommend you bring the product that your child was exposed to with you to the phone so ingredients can be verified off the label.

The following are other questions that a poison control specialist will ask you:

  1. Age, weight, allergies, current medication and prior diagnosis?
  2. How long ago did the exposure happen?
  3. What are the current symptoms?
  4. How much was ingested, inhaled or got on the skin or in the eye?
  5. Any first aid measures that you have already administered.

In this type of circumstance, the RPCC recommends that you do not try to induce vomiting after an ingestion because this could worsen the symptoms.

The poison control specialist will analyze all of the data and possible outcomes then decide whether it is treatable at home or whether the patient needs to go to the emergency department.

Last year, the RPCC was able to keep 9 out of 10 children under six years of age from going to the emergency department, which can be a costly experience. It only takes 3-5 minutes for a poison specialist to make an evaluation.

Thirty- four percent of RPCC exposures pertain to adult exposures. The number one poisoning in adults are analgesics, which is very common in terms of medication errors. The poison specialists, who are nurses and pharmacists, evaluate each case individually.

These are the questions that the specialist will ask:

  1. What was the exposure? What type of exposure – ingestions, inhalation, dermally, or ocular?
  2. How much?
  3. Age, weight, allergies, current medication and prior diagnosis?
  4. What are the current symptoms?
  5. Any first aid measures that you have already administered.

From this information, the specialist looks at the amount ingested per body weight and will help the patient decide whether it is necessary to go to the emergency department.

In 2018, the RPCC handled 100,801 calls, both incoming calls and follow up calls. The majority of the RPCC come from the lay public (705), while 30% of calls came from doctors, nurses, pharmacists, paramedics and other health care professionals. The RPCC is available to all ages. Within the past year, they handled patients that ranged from 1 day to 99 years old.

The Regional Poison Control Center at Children’s of Alabama is open 24 hours a day, seven days a week, including holidays, for questions or emergencies regarding poisons. One national number, 1-800-222-1222, will connect you to your local poison center. Be sure to program this number into your cell phone and keep it visible in the home and workplace.

Children's, Health and Safety

When to Visit the Emergency Department

Your child doesn’t feel well, but should you take them to the emergency department? Sometimes it can be hard to tell when a child requires urgent medical treatment or if the concern can wait.

Dr. Sam Strachan is a pediatric emergency fellow.  He says the emergency department at Children’s of Alabama alone receives approximately 80,000 visits each year.  That’s an average of 219 patients each day!

Dr. Strachan says the emergency department will never turn anyone away, but a child may be better served and have a shorter wait time by seeing their pediatrician instead.  “Every child should have a pediatrician,” he says.  “If a child isn’t feeling well, even in the middle of the night, you can always call your pediatrician’s on-call number for advice.”

You should always take your child to the emergency department in a true emergency.  These signs include:

Go to Emergency Department

  • serious injury
  • trouble breathing
  • not drinking enough, not urinating enough
  • unusual sleepiness or confusion
  • a head injury and is vomiting
  • an eye injury
  • a serious burn

Call 911 if your child

  • isn’t breathing or is turning blue
  • is unconscious after a fall
  • is having a seizure
  • has a serious allergic reaction
  • has broken a bone that sticks out through the skin
  • is choking
  • has a large cut that is bleeding uncontrollably

A high fever can be scary for a parent to see, however, Dr. Strachan says it’s the body’s natural defense mechanism against infection.  “A lot of parents are concerned with a fever of 104 or 105 in their child,” he says.  “However children can deal with high fevers better than adults can.”  Babies are the exception.  “Any baby under two months old should be seen right away for any fever greater than or equal to 100.4,” he says.

Dr. Strachan offers these tips to help decide if a child needs to go to the emergency department in the event of a fever:

  • If feverish, try Motrin or Tylenol, depending on the age of the child
  • If the child feels well between fever, wait to see pediatrician until the next day

If it’s not a true emergency, it’s always best to wait to see your child’s pediatrician. “On the front end you’re taking away resources from children who really need it,” Dr. Strachan says. There’s another benefit to seeing the pediatrician.

“They know your child, they know your child’s history,” Dr. Strachan says.

Through an established relationship with a pediatrician, a child can receive better long term care.