Influenza Updates

If you watch the news or follow health news online you are aware that this is a bad flu year, worldwide. Here on the West Coast we tend to have a longer window of time to immunize and prepare as the flu works its way across the country starting from the East Coast and the South. Here are the high points of what you should know:

  1. It's not too late to get a flu vaccine, and it will still help. This year's vaccine is not as good of a match for the circulating strains as previous years. However, even partial immunity gives you a lower chance of experiencing severe disease or complications from influenza. Getting your flu vaccine every single year exposes your immune system to a wide variety of flu strains and may help improve your body's response to those strains in the future.
  2. Just like last year, there is no nasal flu vaccine ("FluMist"); all flu vaccine is given by injection and is a killed virus. The vaccine is recommended for everyone six months and older but is especially important for infants, children, health care workers, the elderly, and those with chronic diseases.
  3. While there are tests for flu, the diagnosis is overall made based on the symptoms. If you have fever, cough, cold symptoms, misery, sore throat, body aches... flu is a strong possibility. Flu hits hard: a child with influenza usually will not play or want to eat. 
  4. What about antivirals? We get a lot of questions this time of year about Tamiflu. Tamiflu (oseltamivir) is approved for treatment of influenza in children and adults. It's a tool in our toolbox but not a great one. If started in a case of flu within the first 72 hours it has been shown to decrease the duration of the illness an average of 24 hours, and it may or may not decrease the frequency of complications such as pneumonia. It does have side effects (most commonly nausea and vomiting, but rarely can cause hallucinations), is not always covered by insurance, and can be expensive. In a bad flu year there are often regional or national shortages of Tamiflu and when that happens it really needs to be reserved for the very highest-risk patients. The bottom line is that each decision about whether or not to use Tamiflu is one that is made carefully by our clinicians, and if your child is sick enough/high risk enough to be considered to be a possible candidate then we really need to see your child in the office.
  5. The most common complications of flu are ear infections and pneumonia. Persistent ear pain and/or worsening productive cough mean your child needs to be checked by us.
  6. Most flu responds to the time-honored treatments: rest, fluids, and OTC fever medications. Stay home if you suspect that you have it, or any other illness with cough and fever.

 

Tips on brushing teeth of young children

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It is important that parents help with brushing teeth until at least age 8. Before this, children do not have the dexterity to brush well.

It can be easier to brush if you have your child lie down with their head in your lap. Then you can see into their mouth and see what you are brushing.

Consider moving tooth-brushing activities out of the bathroom into a common area like the kitchen. Then, your children can brush as a group while you monitor. This helps you to make sure they are brushing instead of just playing.

Set a timer for 2 minutes, to make sure that brushing happens for an appropriate length of time.

For the independent child, allow them to brush first and then you can brush. This practice allows them to develop their skill.

If your child cries with brushing, don’t give up! Continue to work on this habit daily and usually children become used to the routine.

Start when children are very young. It is easier to get a child used to tooth brushing if you begin the habit from the very moment they have their first tooth – usually between 6-12 months of age.

Ask another adult to help you. If your child really struggles, it can be useful to have one parent hold the child in his lap while the other parent brushes the teeth.

For children who really fight brushing, it is important to eliminate all sugary foods and beverages and see a dentist regularly. Brushing is the best way to prevent cavities. If you are not able to brush well, or at all, it becomes more important to use these other ways to prevent decay.

Allow your child to hold a comfort item, like a prized blanket or a favorite toy, while you are brushing.

Children with autism often benefit from a specially designed three-sided toothbrush head. The design allows the child to chew on the brush rather than brushing, which can result in increased removal of plaque over a one-sided toothbrush. One brand is the Den-Trust 3-sided toothbrush.

Here is a great article with some more tips https://parenting.blogs.nytimes.com/2014/10/20/for-some-children-with-autism-even-a-toothbrush-is-a-challenge/?mcubz=1. Also HealthyChildren.org tips.