Being sure that a child is well enough to go to school can be tough for any parent. It often comes down to whether the child can still participate at school. Having a sore throat, cough, or mild congestion doesn’t always mean kids can’t handle class and other activities.
With flu and respiratory illness season in full swing, health experts ask that kids stay home when they have symptoms like a fever over 100.4°F, diarrhea, vomiting or trouble breathing.
As for other types of infections, chickenpox sores should be dry and crusted over before kids go back to school (usually this takes about 6 days). Kids with strep throat need a dose or two of antibiotics first, which can mean staying home the day after diagnosis (or possibly longer). Other contagious infections — like rubella, whooping cough, mumps, measles, and hepatitis A — have specific guidelines for returning to school. Your pediatrician will help you discern these guidelines.
Lice, scabies, and ringworm shouldn’t keep kids out of school. If the problem is found by the teacher or school nurse, the child should stay in school until the end of the day. Kids who get their first treatment after school should be able to return to the classroom the next morning.
You know your kids best. A child who has the sniffles, but hasn’t slowed down at home is likely well enough for the classroom. However, one who coughed all night and had a hard time getting up in the morning might need to take it easy at home. When in doubt, call your pediatrician for advice.
A: Influenza (also known as the flu) is an infection of the respiratory tract. It is caused by a virus that spreads easily from person to person. It spreads when people cough or sneeze out droplets that are infected with the virus and other people breathe them in. The droplets also can land on things like doorknobs or shopping carts, infecting people who touch these things.
Q: Is flu contagious?
A: The flu is very contagious. People can spread it from a day before they feel sick until their symptoms are gone. This is about one week for adults, but it can be longer for young children.
Q: How will I know if my child has flu and not just a cold?
A: The fall and winter months are cold and flu season. Both the cold and the flu can present similar symptoms, including cough, congestion and runny nose. In general, the flu hits a lot harder and quicker than a cold. When people have the flu, they usually feel worse than they do with a cold. Most people start to feel sick about two days after they come in contact with the flu virus.
Q: What are some symptoms of flu?
A: Common symptoms of the flu include:
Fever or feeling feverish with chills, though not all people with the flu will have a fever
Cough
Sore throat
Runny or stuffy nose
Muscle or body aches
Headaches
Fatigue
Vomiting and diarrhea, which are more common in children
Q: When should we get this season’s flu vaccine?
A: Flu season in the United States is from October to May. Vaccines are provided at most pediatricians’ offices. The American Academy of Pediatrics (AAP) recommends the flu shot for everyone over 6 months old.
Q: What is the treatment for flu?
A: Most children with flu get better at home. In the event a child does get sick, you can help mitigate symptoms. Make sure your child is drinking plenty of fluids. You can give appropriate doses of acetaminophen or ibuprofen to relieve fever and aches, and make sure they are getting plenty of rest.
Q: When should I seek medical treatment for my child if I suspect flu?
A: Bring your child to the doctor if you’re concerned about severe symptoms. Most of the time parents can care for their children with plenty of rest, fluids and extra comfort. Some children are more likely to have problems when they get the flu, including:
children up to the age of 5, especially babies
children and teens whose immune system is weakened from medicines or illnesses
children and teens with chronic (long-term) medical conditions, such as asthma or diabetes
Q: In addition to the flu vaccine, how else can we stay healthy during cold and flu season?
A: The American Academy of Pediatrics (AAP) recommends the flu shot for everyone over 6 months old. Here are some other tips for staying healthy during cold and flu season:
Cover your cough and sneeze
Wash your hands
Clean living and working areas
Avoid crowds
Stay home from work or school if you are sick
Avoid touching your eyes, nose, and mouth
Q: How can we prevent the spread of germs in our house if my child is sick?
A: The flu virus spreads when people cough or sneeze out droplets that are infected with the virus and other people breathe them in. The droplets also can land on things like doorknobs or shopping carts, infecting people who touch these things.
Teaching children the importance of hand washing is the best way to stop germs from causing sickness. It’s especially important after coughing or nose blowing, after using the bathroom and before preparing or eating food.
There’s a right way to wash hands, too. Use warm water and plenty of soap, then rub your hands together vigorously for at least 20 seconds (away from the water). Children can sing a short song — try “Happy Birthday” — during the process to make sure they spend enough time washing. Rinse your hands and finish by drying them well on a clean towel. Hand sanitizer can be a good way for children to kill germs on their hands when soap and water aren’t available.
Cleaning household surfaces well is also important. Wipe down frequently handled objects around the house, such as toys, doorknobs, light switches, sink fixtures, and flushing handles on the toilets.
Soap and water are perfectly fine for cleaning. If you want something stronger, you can try an antibacterial cleanser. It may not kill all the germs that can lead to sickness, but it can reduce the amount of bacteria on an object.
It’s generally safe to use any cleaning agent that’s sold in stores but try to avoid using multiple cleaning agents or chemical sprays on a single object because the mix of chemicals can irritate skin and eyes.
Q: If my child has had flu, when can he return to school, child care, etc.?
A: Children with the flu should stay home from school and childcare until they feel better. They should only go back when they have been fever-free for at least 24 hours without using a fever-reducing medicine. Some children need to stay home longer. Ask the doctor what’s best for your child.
Q: How do I know if my child’s symptoms are flu or COVID-19?
A: The symptoms between these two viral illnesses can be similar, making it difficult to distinguish between the two based on symptoms alone. Diagnostic testing can help determine if you are sick with the flu or COVID-19. A phone call to the child’s pediatrician or primary care provider will help determine next steps regarding testing for flu and/or COVID-19.
Q: Do COVID-19 symptoms develop like flu symptoms?
A: If a person has COVID-19, it could take them longer to develop symptoms than if they had flu. According to the CDC, symptoms may appear two to 14 days after exposure to the virus. People with these symptoms may have COVID-19:
Orthopedic injuries in children are one of the most common visits to the pediatric emergency department (AAP). Courtney Trapp, an orthopedic nurse clinician at Children’s of Alabama, said, “the majority of patients we see come in for injuries related to sports or trampoline parks, especially during the summer months.”
Precautions to take against injury
School being out during the summer months and kids having more free time can lead to unforeseen incidents, including orthopedic injuries. While spending time outdoors is very beneficial for children, the risk of injury increases. Parents can take precautions to prevent their child from being injured.
Teaching kids how to use safety precautions when playing sports and supervising them while they play outside can decrease the risk of injury. Parents should ensure their child is wearing or using proper safety equipment depending on the sport or activity. For instance, if a child is riding a bike, they should wear a helmet. A safety net should always be used on a trampoline. If a younger child is playing with older kids, the younger child is more likely to be injured due to the size difference. Parents should be mindful of who their child plays with to reduce the risk of accidental injury. Implementing vitamin D in a child’s diet is recommended by The American Academy of Pediatrics to help maintain good bone health. Their general recommendation is 600IU (international unit) per day and can typically be found in an over-the-counter multivitamin.
Signs of a broken bone
A broken bone, also called a fracture, is when a break goes through part or all of a bone. Broken bones typically happen from a fall, accident or sports. Fortunately, the healing process is typically faster for kids who break their bone. “Most kids stay in a cast for 4-6 weeks, wear a splint after and then avoid high-contact sports for several weeks,” Trapp said.
The signs of a fracture depend on the type of break and the bone affected. Pain, swelling, bruising and lack of movement all indicate a broken bone. Sometimes, there is a deformity – when the body part looks crooked or different than it did before the injury. Doctors order X-rays if they think a bone is broken and treat the broken bone with a cast, splint or brace. Children wear one of these for several weeks or even months, depending on the injury.
What to do if my child breaks a bone?
In situations when a child’s bone breaks, they should not move the injured extremity. “If splinting materials are available, i.e. pillows or blankets, then the parent should try to stabilize the extremity on the way to get the child evaluated,” Trapp said. If caregivers notice an immediate deformity or swelling in a child’s extremity, they shouldn’t give them anything to eat or drink. If they have to be sedated, it has to be done on an empty stomach. Once arriving to a hospital, the child could go to the operating room or emergency room – depending on the injury. How do you know when to bring your child to the emergency room if their bone breaks? If you see a deformity of the extremity, a child should go to the emergency room. If there is not an obvious deformity, the orthopedic team at Children’s recommends visiting the child’s pediatrician to see if they need to be referred to an orthopedic department.
If safety precautions and supervision are implemented while children are engaging in sports and activity, visits to the emergency room can be avoided.
Fireworks are synonymous with the 4th of July holiday.
The American Academy of Pediatrics (AAP) continues to urge families not to buy fireworks for their own or their children’s use, as thousands of people, most often children and teens, are injured each year while using consumer fireworks.
Sue Rowe, a charge nurse in the Burn Center at Children’s of Alabama, has advice for those who choose to use their own fireworks this 4th of July.
Her number one fireworks safety rule? “Never leave children unattended around fireworks.”
If you are using fireworks on your own, only use them with adult supervision. Keep children at a safe distance from lit fireworks. She also suggests keeping a bucket of water nearby. Store fireworks in a safe place, outside the main living area, such as in a garage or storage area, out of a child’s sight and reach.
And while sparklers may seem like a safe alternative to large, showy displays, they can be just as dangerous. “The tip of a sparkler produces a significant amount of intense heat,” Rowe said. The AAP reports that sparklers can reach above 1,800 degrees Fahrenheit – hot enough to melt some metals.
However, accidents do happen, and Rowe offers tips if your child is burned with a firework. “The first thing is to immediately apply cool water to the burn site.” She cautions against ice packs, though. For home care, “apply a topical antibiotic ointment to the affected area.” If the burn is significant, a trip to the closest emergency department is advised.
The Burn Center at Children’s of Alabama is the only designated pediatric burn center in the state and one of the largest in the southeast. A specially trained team of pediatric surgeons, registered nurses, physical and occupational therapists, social workers, child life therapists, teachers, pastoral care staff, nutritionists and burn technicians work together to form a cohesive team of professionals dedicated to treating children with burn injuries. The Children’s of Alabama Burn Center is a six-bed specialty unit designed to care for the needs of burn patients ages birth to teenagers. For more information, visit www.childrensal.org/BurnCenter.
As you begin assigning chores to your children this summer, there are few things to consider about yard work and lawn mower safety.
“We see quite a few patients in our emergency room during the summer because of lawn mower injuries,” said Lisa Maloney, pediatric emergency medicine. “Most typical are skin lacerations and injuries to extremities, such as their hands and feet. We also see some eye injuries when items like rocks or sticks are picked up and thrown by a lawn mower.”
In general, children should be at least:
12 years old to safely operate a walk-behind power or hand lawn mower
16 years old to safely operate a riding lawn mower
When you decide your child is ready to use a lawn mower, spend some time with them reviewing the equipment’s owner manual in advance and talking about how to do the job safely. The most important thing, said Maloney, is parental supervision.
“Lawn mower injuries can be severe. These types of injuries require many surgeries involving many specialists, especially when the goal involves saving a limb,” Maloney said.
Before mowing:
Inspect the area to be cut, and remove any items that could be picked up and thrown by the lawn mower.
Ensure your lawn equipment is in good working condition.
While mowing:
Use sunscreen, safety glasses or goggles, closed-toe shoes and hearing protection.
Small children should be a safe distance away while the lawn mower is in use.
Never allow children to ride as passengers on a riding lawn mower.
Avoid mowing in reverse.
Push or drive your mower up and down slopes, not across, to prevent mower rollover.
After mowing:
When you turn your mower off, make sure the blades are completely stopped.
Only refuel the mower once the engine has cooled.
A lawn mower is a very powerful tool. It can cause serious injuries, but many of these injuries are preventable. Keep your children safe around lawn mowers this summer. Following these guidelines can help prevent lawn mower injuries.
Children hear about what’s going on in the world through social media, friends, or adults’ conversations. Sometimes the news is uplifting — like kids their age taking a stand on social or environmental issues. Other times, children may worry about current events like the recent school shooting in Texas and need an adult to help make sense of what’s happening.
Help your child understand the news and feel more in control by taking these steps:
Find Out What Your Child Already Knows
Ask your kids questions to see if they know about a current event. For school-age kids and teens, you can ask what they have heard at school or on social media.
Consider your child’s age and development. Younger kids may not grasp the difference between fact and fantasy. Most kids realize the news is real by the time they are 7 or 8 years old.
Follow your child’s lead. If your child doesn’t seem interested in an event or doesn’t want to talk about it at the moment, don’t push.
Answer Questions Honestly and Briefly
Tell the truth, but share only as much as your child needs to know. Try to calm any fears and help kids feel safe. Don’t offer more details than your child is interested in.
Listen carefully. When kids hear about an upsetting event like a school shooting, they may worry, “Could I be next? Could that happen to me?” Older kids may have lots of questions. Focus on what your kids ask so you can help them cope with their fears. An adult’s willingness to listen sends a powerful message.
It’s OK to say you don’t know the answer. If your child asks a question that stumps you, say you’ll find out. Or use age-appropriate websites to spend time together looking for an answer.
Limit how much kids watch online, on TV, and social media about the events. The strong images may be upsetting for kids and teens.
Help Kids Feel in Control
Encourage your child to talk. If your child is afraid about what’s going on, ask about it. Even when kids can’t control an event — like a school shooting or natural disaster — it can help them to share their fears with you.
Urge teens to look beyond a news story. Ask why they think an outlet featured a frightening or disturbing story. Was it to boost ratings and clicks or because the story was truly newsworthy? In this way, a scary story can be turned into a discussion about the role and mission of the news.
Teach your children to be prepared, not panicked. For example, if the news is about a school shooting, talk about the ways schools are keeping kids safe. If it’s about a natural disaster, make a family plan for what you might do. If an illness is spreading, talk about ways to protect yourself and others.
Talk about what you can do to help. After a tragic event, finding ways to help can give kids a sense of control. Look for news stories that highlight what other people are doing. Articles such as School Violence: What Students Can Do may be helpful for older kids and teens.
Put news stories in context. Broaden the discussion from a specific news item about a difficult event to a larger conversation. Use it as a way to talk about helping, cooperation, and the ways that people cope with hardship.
Limit Exposure to the News
Decide what and how much news is appropriate for your child. Think about how old your kids are and how mature they are. Encourage them to take breaks from following the news, especially when the topics are difficult.
Keep tabs on the amount of difficult news your child hears. Notice how often you discuss the news in front of your kids. Turn off the TV so the news is not playing in the background all day.
Set limits. It’s OK to tell your kids that you don’t want them to have constant exposure and to set ground rules on device and social media use.
Watch the news with your child and talk about it. Turn off a story if you think it’s not appropriate for your child.
Keep the Conversation Going
Talk about current events with your child often. Help kids think through stories they hear – good and bad. Ask questions like: “What do you think about these events?” or “How do you think these things happen?” With these types of questions, you can encourage conversation about non-news topics.
Watch for stress. If your child shows changes in behavior (such as not sleeping or eating, not wanting to be around people, or worrying all the time), call your child’s doctor or a behavioral health care provider. They can help your child manage anxiety and feel better able to cope.
Biking is a beneficial summer activity for children because it provides an opportunity to exercise, get outside, play and interact with other children. However, parents should consider these tips as their child engages in bike riding this summer. Children should be efficient in their bike-riding skills and proficient in the rules of the road before embarking on their own biking adventures. Parents should ride alongside their child until they are confident that they can ride on their own.
When riding a bike, always remember to do the following:
Wear a securely-fitted helmet and fasten the chin strap
Follow traffic signs and signals
Ride in the same direction as traffic
Stay in the bike lane whenever possible
Look left, right and left again before entering street or crossing intersection
Use the sidewalk appropriately and be alert of other pedestrians
Never use electronics while riding
Use hand signals when changing directions
Make sure you ride in a straight line and do not swerve around cars – be predictable as you ride
Use lights on your bike and wear bright-colored clothing
Director Think First Alabama, Julie Farmer, said, “Parents should model good behavior and always wear a helmet when riding a bike.” Parents should teach their child how to ride a bike in a safe area, such as an unused parking lot or empty athletic track. Children need to be taught the rules of the road and safety hand signals. A good resource to teach hand signals is provided by the National Highway Traffic Safety Administration at www.nhtsa.gov/sites/nhtsa.gov/files/8009-handsignals.pdf
According to the Consumer Product Safety Commission (CPSC), “A majority of the 80,000 cycling-related head injuries treated in emergency rooms each year are brain injuries.”
According to Safe Kids, “Properly-fitted helmets can reduce the risk of head injuries by at least 45% – yet less than half of children 14 and under usually wear a bike helmet.” The Alabama law for bike helmets states that children under the age of 16 must wear a helmet when riding a bicycle. In cases of violation, the child’s parent or guardian may receive up to a $50 citation.
Parents should always make sure their child has the right size helmet. Your child’s helmet should align with the U.S. Consumer Product Safety Commission’s standards and have a certification stamp on the side – either Ansi or Snell. The fit and certification of a helmet is more important than the cost of the helmet itself. In addition, parents should make sure their child knows how to correctly put on the helmet to ensure their head is protected.
“A helmet should sit on top of the head in a level position, and should not rock forward, backward or side to side. The helmet straps must always be buckled, but not too tightly,” said Farmer.
In addition to helmet fit, proper bike fit is extremely important to ensure a safe ride. If possible, parents should bring their child along with them to the store when shopping for a bike. Be sure your child’s feet can touch the ground when they sit on the bike.
Before your child leaves on a bike ride, make sure:
The reflectors are stable
Brakes work efficiently
Gears shift easily
Tires are properly secured and inflated
Helmet is secured
Your child is not wearing long, loose clothing, flip-flops or sandals
Children should be at least 10 years old before riding a bike without a parent present. There are many factors that contribute to the decision, such as traffic, sidewalks available or where someone lives, but 10 years old is a good choice. At this age, children have the cognitive ability to determine how close the sound or sight of cars are in relation to their current location. To learn more about this or other safety topics, visit our website at childrensal.org.
Hepatologists and infectious disease doctors at Children’s of Alabama and the University of Alabama at Birmingham are investigating several cases of hepatitis found in the state since last fall, and they want to make the public aware of how to stay safe.
The Centers For Disease Control and Prevention (CDC) released the latest data on these cases Friday.
Children’s of Alabama doctors treated nine patients – all children under 10 years old – for hepatitis between October 2021 and February 2022. They say all nine cases were caused by adenovirus – a common virus that often leads to vomiting and diarrhea. Two of the patients needed liver transplants.
Doctors say what’s unique about this situation is that adenovirus typically does not lead to hepatitis in healthy patients. When it does lead to hepatitis, it’s usually in patients who are immunocompromised. When doctors at Children’s and UAB discovered the initial cases in the fall, they alerted the Alabama Department of Public Health (ADPH) and the CDC.
Doctors say the cases initially presented as vomiting and diarrhea. Within a few days, the patients showed signs of jaundice and yellowing of the eyes, which are indications of possible liver failure.
To protect yourself from adenovirus, doctors offer the following recommendations:
Washing hands with soap and water for at least 20 seconds or use alcohol based hand sanitizer
Avoid touching eyes, nose or mouth with unclean hands
Hemophilia is an inherited bleeding disorder where the blood fails to clot. Hemophilia is a lifelong bleeding disorder that currently does not have a cure.
There are low levels of clotting proteins in the blood.
It is seen mostly in boys (rarely in girls).
Very few people have it.
There are about 400 babies with hemophilia born in the U.S. each year.
About one in every 20,000 men in the U.S. have hemophilia.
About 80% of those with hemophilia have hemophilia A (factor 8 deficiency) and 20% have hemophilia B (factor 9 deficiency).
Hemophilia occurs in all races and social groups.
Women may carry the gene that is passed on to her children.
People with hemophilia are born with the disorder.
How can medications help?
They can help prevent or stop bleeding.
By using medicine and visiting a hematologist regularly, a person with hemophilia can expect to live a long and healthy life.
What happens when someone with hemophilia has an injury?
The injured blood vessel gets smaller (vasoconstricts) to let less blood through.
Platelets rush to the site and stick together to form a platelet plug.
Clotting factor proteins in the blood work together to make threads of fibrin (a protein produced by the body). The fibrin weaves itself into a clot over the platelet plug. This makes a strong seal.
How are injuries different when someone has hemophilia?
People with hemophilia can’t make a fibrin clot.
A person with hemophilia has problems when a fibrin clot is needed to stop the bleeding. People with hemophilia don’t have enough of certain clotting factors.
The fibrin clot is not made or is so thin that the bleeding continues.
Someone with hemophilia does not bleed faster than someone without hemophilia. However, the person with hemophilia will bleed longer.
Why is this a problem?
Bleeding inside the body is more of a problem for people with hemophilia than bleeding on the outside from a cut or scrape.
Inside the body, the blood can go into spaces in joints, muscles, and organs.
Over time, this can cause great damage, especially if the bleeding is not treated or happens often.
For educational purposes only. For specific medical advice, diagnosis and treatment, consult your doctor.
One in 10 teenagers will experience some sort of abuse by a dating partner, according to the Children’s Safety Network. Negative short-term or long-term health issues can result from abusive relationships. Parents should be cognizant of warning signs in their teenagers’ relationships.
Dating violence manifests in many different forms, including emotional, physical and sexual abuse. Emotional abuse can be hard to recognize because it typically progresses gradually throughout the relationship. Emotional abuse can include intimidation, manipulation, intense jealousy, threats, controlling behavior, verbal assault and gaslighting. Physical abuse is any means of physical harm, including hitting, kicking or punching. Sexual abuse involves forcing a partner to engage in any type of sexual experience without consent.
“If the perpetrator is more interested in controlling you, then that is a big red flag,” said Debra Schneider, director of the Children’s Hospital Intervention and Prevention Services (CHIPS Center) at Children’s of Alabama.
Teens in an abusive relationship have an increased risk of depression, anxiety, post-traumatic stress disorder, substance abuse, antisocial behaviors, eating disorders, negative body image, sexually transmitted diseases, trust issues, emotional triggers, lying, stealing, cheating and lack of discernment when picking appropriate partners in adulthood.
“Open dialogue about physical and emotional boundaries in relationships should begin when children are young,” Schneider said. “Boundaries and respect are vital to pave the way toward healthy relationships in their teenage years. If parents are modeling a healthy relationship, that’s going to be what teens are used to and what they expect in their own relationships.”
Parents should be mindful of: • Secrecy or withdrawal from friends and family • Onset of anxiety and/or depression • Physical findings (bruises, cuts, headaches, back pain) • Only spending time with partner • Feeling excessive guilt or shame • Avoidance of school or social events with excuses that don’t seem to make any sense
If you observe any warning signs of an unhealthy or abusive relationship in your teen, talk to them about it. It is important to start a conversation with your teen and listen to them. Try to understand and validate their feelings in this situation. Your show of support will increase their trust and your teen will be more comfortable sharing information with you. This open conversation will be crucial in educating your teen about what should be expected in a healthy and safe relationship. A teen who is being abused needs someone to hear and believe them and be reminded that abuse is never deserved.
The CHIPS Center has abuse prevention resources available. For more information, call 205-638-2751 or visit childrensal.org/CHIPS.
Other resources for you or your teen:
• National Dating Abuse Helpline – 1-866-331-9474 or loveisrespect.org to receive immediate, confidential assistance • Birmingham Crisis Center – 205-323-7777 • Birmingham Rape Response – 205-323-7273 • RAINN (Rape Abuse and Incest National Network) – 1-800-656-4673 • If your teen is in immediate danger, call 911.
