Earlier this year, a four year old girl was hospitalized for a suspected case of dry drowning. Her case understandably sparked frightening warnings to parents. With pool season approaching, many parents asked: is it still OK for my child to play in the water?

If you have questions about dry drowning and what it means for your family, then this blog is for you:

Dry Drowning: What It Is

“Dry drowning” is a non-medical term used to describe certain symptoms experienced after being submerged in a body of water. Dry drowning is one type of post-immersion syndrome, along with near drowning and secondary drowning. Post-immersion syndromes are notably different than a standard drowning case, where a child tragically passes away due to submersion in and inhalation of water.

In so-called dry drowning cases, large amounts of water never reaches the lungs. Instead, breathing in a small bit of water by mistake triggers spasms of the vocal cords and the airways, making them narrower and even closing them off. This happens because the body is trying to keep the water from entering the child’s lungs. However, the spasms and closing of the airway can make it difficult for a child to breathe, resulting in a “dry drowning” case.  This chain reaction takes place quite quickly, and dry drowning sets in less than an hour after inhalation.

Dry Drowning: How Common Is It?

It’s important for parents to know that this condition is very rare! According to news reports, the Centers for Disease Control and Prevention estimates that of the approximately 4,000 drowning or near drowning incidents that occur in the United States annually, post-immersion syndromes account for 1% - 5% in total. So while frightening, the risk of dry drowning is low. 

Dry Drowning: What Are The Symptoms?

The symptoms of dry drowning develop within an hour of a child leaving the water:

• Primarily, coughing and difficulty breathing or speaking
• Vomiting
• Chest pain due to pressure building on their lungs
• Headaches
• Change in behavior, such as sleepiness or agitation

Dry Drowning: Treatment

Dry drowning symptoms will develop within an hour of a child exiting the water. If you do see any symptoms, dial 911 for emergency medical assistance. While waiting for help, try to help your child stay calm, so that their panic does not contribute to their muscle tightness.

Paramedics will be able to administer treatment on the scene and will take your child to the hospital for observation and possible further treatment.

Dry Drowning: Prevention

In addition to monitoring children after they spend any time in water, you can take action to help to prevent dry drowning:

• Children under the age of 4 should always be supervised when in water, even if they're just in the bathtub.
• Consider investing in swimming lessons to ensure that children learn how to swim safely early on.
• Never let children swim in a pool or in the ocean unless a lifeguard is present.
• Teenagers are more likely to have drowning incidents while under the influence of drugs or alcohol. Discuss these risks with your teens.
• Discourage rough play in and around water.
• Ensure pools are properly guarded.
• Always wear life jackets while boating.

A Final Note From Our Doctors

Knowing how to address dry drowning in case of an emergency is very helpful. However, it’s worth remembering that these cases are very uncommon. And basic water safety can go a long way in preventing this rare but possibly tragic phenomenon!

If you are seeking additional advice on how to safely enjoy the summer, please contact your Capital Area Pediatrics physician. Our team can individually assess your children’s health and safety needs, and provide specific advice for your child. To schedule an appointment with a pediatrician, find your nearest location and contact us today!

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While summer is almost here and the school year is coming to an end, you and your child may already be looking at various sports for them to participate in during the upcoming school year. Allowing your child to play a sport is a fun way for them to socialize with other children and keep them healthy and active. Before the season starts, however, it is important for your child to visit their pediatrician and get a sports physical exam.

A sports physical exam, also known as a preparticipation physical evaluation (PPE), helps determine whether or not a student athlete is healthy enough to participate in a sport. In the state of Virginia, sports physicals are required by individual schools and by the Virginia High School League prior to participation in a sport. Even if a sports physical isn’t required by your child’s school, it’s still recommended that your child gets one as a safety precaution.

There are two parts of a sports physical: the medical history portion and the physical examination. The medical history portion includes questions related to family history, past illnesses, recent injuries, allergies, and current medications. During the physical exam, the pediatrician will record your child’s height, weight, pulse and blood pressure; check their ears, nose, throat, heart, lungs, and abdomen; and evaluate their flexibility and strength.

Sports physicals are important because they ensure that your child is healthy enough to participate in the sport that they choose. The exam can help uncover current health problems that you and your child need to address prior to participating in the sport. It can also help recognize potential health problems that could affect your child in the future and determine solutions for preventative care.

A sports physical also gives you and your child the opportunity to voice your concerns about particular sports and ask the pediatrician about risk factors associated with them. Your child’s pediatrician knows your child and their health history better than anyone else, making them the best option for your child’s physical.

Start the summer off right by scheduling a physical exam for your child before they begin their sport! We would also be happy to complete your sports form at the time of your visit. At Capital Area Pediatrics, our team can help you and your child address any health issues and give you both the go-ahead for the upcoming season. To schedule an appointment with one of our pediatricians, find your nearest location and give our staff a call today.

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Did you know that just a handful of serious sunburns can increase your child’s risk of skin cancer later in life?

Or that experts estimate that we get between 50% and 75% of our lifetime sun exposure before we turn 18 years old?

Or that even on a cool day with light cloud cover, UV radiation can cause skin damage?

These facts are exactly why good skin care and protection must begin at an early age. That means minimizing our children’s exposure to the sun’s harmful ultraviolet (UV) rays. And during the spring and summer, it’s particularly important for families to practice good skin care habits. While cooler weather drives us indoors during the fall and winter, warmer weather encourages families to visit sunny beaches, play sports, or just enjoy an afternoon in the backyard.

We’re not saying that you can’t enjoy these seasonal staples! Just that it’s important for families to remember the following skin care tips:

• Apply sunscreen. It’s not a secret that sunscreen is a must when it comes to skin care and protection from the sun. The Centers for Disease Control and Prevention recommends that families use sunscreen every time your child goes outside. The CDC currently recommends using sunscreens with a SPF (sun protection factor) of at least 15, as well as UVA and UVB (broad spectrum) protection. That said, it’s best to go for a higher SPF if you can! An SPF 15 sunscreen blocks 93 percent of UVB radiation, while an SPF 30 sunscreen blocks nearly 97 percent. Additionally, for the best protection, it’s best to apply sunscreen 30 minutes before going outdoors. Be sure to reapply it throughout the day! And don’t rely on sunscreen alone, as it’s meant to be combined with other healthy habits for maximum effectiveness.
• Stick to the shade. No matter how enticing the sunlight is, all experts recommend avoiding it if you can - especially from 10 a.m. and 4 p.m. This is when the sun’s rays are the most damaging. If you can’t plan an indoor activity for your family during this block of time, seek out a tree, open an umbrella, or set up a pop-up tent to help keep those UV rays from reaching your children’s skin.
• Cover up. Another thing you can do to protect your and your children’s skin is to cover it with longer shirts and pants. Clothes made from tightly woven fabric offer the best protection. This tip gets harder to abide by as it warms up, but it’s still worth remembering and following to the best of your abilities.
• Invest in a good hat. Hats are a wonderful way to keep the sun from reaching our face and eyes, both of which can be easily damaged by the sun. However, the best hats also provide shade for our ears and neck. Children are more likely to wear baseball caps, which do not cover these areas. Always remember to use sunscreen to protect any areas a hat doesn’t cover.
• Love the shades. Sunglasses are not just an accessory for the vain. They protect your child’s eyes from UV rays, which can lead to cataracts later in life. Always buy sunglasses that have a sticker certifying that they block 100% of both UVA and UVB rays!

Following these tips will go a long way in helping your children enjoy themselves while taking healthy precautions. Of course, depending on your child’s age or even their current state of health, you may need to take additional steps to ensure they avoid sun damage. If you think you need additional advice on keeping your family healthy, please contact your Capital Area Pediatrics physician. Our team can individually assess your children’s health and safety needs, and provide specific advice for your child’s health and skin care needs. To schedule an appointment with a pediatrician, find your nearest location - and know that our staff will be happy to assist you!

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As of March 20th, spring has sprung! And as the weather warms and we begin to head outside, our winter habits need to be updated accordingly, to ensure that our families stay safe and healthy. In addition to adhering to any specific plans established for your family, we generally advise parents to be particularly observant of the following spring health tips:

• Lyme disease prevention. As the weather warms, ticks begin flourishing. With the increase in tick activity comes a risk of contracting Lyme disease - an inflammatory illness caused by the bacteria in some tick's bites. Fortunately, Lyme disease is preventable. Avoiding tall grass and wooded areas while outdoors can help you avoid ticks. Keeping your own yard's grass and shrubbery trimmed will also cut down on potential exposure. While outdoors, consider using insect repellants known to work on ticks, and remember to dress appropriately. That means light colored clothing - so you can spot ticks - and tucking pant legs into your socks and boots, as well as shirts into your pants! Finally, make tick checks part of your routine any time you family spends time outdoors - even in your own yard. (To learn more about all of these tips, and about the symptoms of a tick bite, just click here.)
• Allergy and asthma care. While these two conditions often occur together, it’s important to note that they are not the same. An allergy refers to when our body's immune system overreacts to specific substances - such as pollen or animal dander. Asthma, on the other hand, is a respiratory condition - often resulting from an allergy - that makes it difficult for a sufferer to breathe. If your child has allergies, it’s important to monitor their triggers and to work with your doctor to safely learn how severe the allergy is. If your child has asthma, be sure to help them avoid common triggers that make it difficult for them to breathe. Additionally, you should meet with your Capital Area Pediatrics provider to review any allergy or asthma care and response plans - this will ensure they are up to date for the 2018 spring season.
• Sunlight protection. Warmer weather means we’ll be spending more time outdoors - and that means potential sun damage. Sun damage from UV rays is linked to skin cancer, and is cumulative. That means a bad burn now can increase your child’s risk of cancer later in life. To help protect your child, it’s important to stay in the shade whenever possible; to cover up with clothes as much as possible; to wear hats, preferably ones that shade the face, scalp, ears, and neck; to wear sunglasses that block as close to 100% of both UVA and UVB rays as possible; and to use sunscreen with at least SPF 30 and UVA and UVB (broad spectrum) protection every time your child goes outside.

These general guidelines can go a long way in making the new season a safer one! If you have any outstanding questions about your family’s care needs, please contact your Capital Area Pediatrics physician. Our team can individually assess your children’s health and safety needs, and ensure they are ready for spring. To schedule an appointment with a pediatrician, find your nearest location and our staff will be happy to assist you!

 We all get a fever now and again - but for parents, few things are as stressful as a sick child. With a nasty flu virus going around this season, a rising temperature can be particularly worrisome. And it begs the question: what should be done when a child begins to feel sick? 

Understanding Fevers

A fever is defined as a temperature over 100.4 F (38.0 C). Normally, our bodies rest at about 98.6 F (37 C). The keyword here is “about” - it’s normal for our temperature to fluctuate throughout the day. Your temperature is also influenced by your age, the activities you’re participating in, and other factors.

While the magic number is 100.4 F, there are still other things to consider when evaluating a fever. In fact, most fevers usually don't indicate anything serious! Fevers are a natural response to the presence of germs that may make us sick. And fevers alone do not always provide a good indication of how serious the problem is; some major infections only cause a mild fever, while simple colds can cause a high one.

For otherwise healthy children, the majority of fevers will not need much more than home remedies and rest. For young children or children with pre-existing health issues, it’s important to discuss a plan with your doctor in advance, so that you know when to report a spiking temperature.

Guidelines For Parents

The following guidelines can help you determine if a doctor’s visit is necessary for a fever:

• If a fever lasts less than a few days and your child is behaving fairly normally, there is no need to visit a doctor. Normal behavior includes being able to drink, eat, and enjoy some easygoing activities while at home. Exhaustion is normal as a child recovers from a fever.
• While it’s tough, try not to worry if temperatures of up to 102.5 F affect a child that is 3 months to 3 years of age. Even fevers up to 103 F in older children are considered common. They key here, again, is to make sure these children are eating and drinking normally, have a normal skin color, and feel comfortable.
• Some children will lose their appetite while fighting a fever. This is also a common side effect. Being able to drink and use the bathroom normally is a good indicator of whether or not the loss of appetite is serious.
• If other symptoms develop or your child's overall condition deteriorates, contact your doctor regardless of temperature. Additionally, contact a doctor if a child’s temperature rises above the guidelines for their age group.

Helping Children Recover

While not all fevers need to be treated, there are things you can do to help older children feel more comfortable if need be:

• You can give acetaminophen or ibuprofen based on the package recommendations for your children’s age or weight group. Never give aspirin to a child unless instructed otherwise. Additionally, infants younger than 2 months old should not be given any medicine for fever without being checked by a doctor. If your child has any medical problems, you should work with your doctor to determine which medicine is best to use.
• Ensure that your thermostat is set to an average temperature that’s not too warm or too cold. Additionally, your child should wear lightweight clothing and use a light sheet or blanket if needed - overdressing can trap body heat and contribute to a higher temperature.
• While they’re sick, it’s important for children to rest and drink extra fluids so they don’t become dehydrated. Water, soup, and ice pops are all good choices. Avoid caffeinated beverages, however, as they are diuretics.

Dr. Susan Kohn, of our Sleepy Hollow offices, recommends the following as parents help their children recover:

'Please give your child the appropriate fever reducer if he or she is uncomfortable, including before being seen in our office. The fever itself may be contributing to pain, rapid breathing, rapid heart rate, irritability, low energy and sleepiness so giving these medications will make your child feel better and more comfortable during our exam and at home. We will also be better able to determine how sick he or she is by observing behavior in the office when the fever is down, in addition to discussing what you have seen at home and examining your child. Please feel free to call us for advice if you are not sure if you need an appointment or for more information.'

When To Call A Doctor

Not all fevers can be managed at home. In addition to calling with questions, as mentioned by Dr. Kohn, it’s important to call a doctor if the following occurs:

• An infant younger than 3 months of age develops a fever
• Your child’s fever lasts more than 24 hours (in kids younger than 2 years old) or 72 hours (in kids 2 years or older)
• Your child’s fever is higher than 104 F (> 40 C).
• Your child’s fever does not come down with fever reducing medicine
• Your child has trouble breathing or develops belly pain
• Your child is not drinking or eating
• Your child has lasting diarrhea or repeated vomiting
• Your child’s mood changes (i.e. if they are extremely irritable or fussy)
• Your child is extremely sluggish and has trouble waking up
• Your baby is not wetting at least four diapers per day
• Your child has a chronic medical condition
• Your child has a rash
• Your child has blue lips, tongue, or nails
• Your child was recently immunized and has a temperature above 102º F, or a fever that lasts more than 48 hours.
• You are concerned. If anything feels off, there is no shame in calling your doctor to make sure everything is OK!

Keep Calm And Try To Carry On

We’re willing to bet that even reading about the complications associated with a fever was a little scary. Illness and discomfort are two of the worst things we can watch our children deal with. Knowing how to monitor for extreme temperatures and other major symptoms will help you and your child both recover as quickly as possible after a fever spikes.

If at any point you need a medical opinion or feel concerned about your child’s behavior or symptoms, Capital Area Pediatrics can help. To schedule an appointment with or to contact a pediatrician, find your nearest location and our staff will be happy to assist you and your family!

Image courtesy of Pixabay.com

These days it’s impossible to turn left or right without coming across a screen. Television, smartphones, tablets, and gaming consoles ensure that we are almost constantly immersed in a digital bubble. It’s hard enough to unplug from that bubble as an adult - so what does that mean for our children?

The answer to this is surprisingly complicated, because the world today is very different than the one many parents grew up in! It used to be that addressing screen exposure was as simple as limiting a child’s time in front of the TV. Experts recommended no more than two hours in front of the TV for kids over age 2.

But today, that is just not practical. Children and adolescents are now able to consume content via traditional broadcasting, streaming services, video games, social media, and apps. Some of that content is purely for fun, while some of it can supplement educational activities. And because of technology’s use and prevalence in our lives, the average amount of time children spend in front of a screen and consuming media increases as they age. This is why it’s more important than ever for parents to engage with their children about their media habits.

So How Much Is Too Much?

In today’s world, the best thing parents can do is learn when digital tech use crosses from normal and healthy into what we call “pixel addiction” territory. According to the American Academy of Pediatrics, “Problems begin when media use displaces physical activity, hands-on exploration and face-to-face social interaction in the real world, which is critical to learning. Too much screen time can also harm the amount and quality of sleep.”

To fight back against the negative effects of screen exposure and media use, experts recommend controlling and monitoring the use of media outside of education related screen time. Encouraging children to make time for their physical health and for social interactions can help them develop a healthy balance with their screen and tech. However, it’s important to note that having a cut-off time for screen use is also important. Since screen-light can ruin our ability to sleep, unplugging at least two hours before going to bed is a great rule to set for your family.

Age Matters

To help children learn how to balance and control their digital lives, the American Academy of Pediatrics recommends that families develop a media plan that considers the health, education, and entertainment needs of every child and family member in a household. As is so often the case with children, their media needs will evolve over time! A few key milestone recommendations from the American Academy of Pediatrics include the following:

• “For children younger than 18 months, avoid use of screen media other than video-chatting. Parents of children 18 to 24 months of age who want to introduce digital media should choose high-quality programming, and watch it with their children to help them understand what they're seeing.
• For children ages 2 to 5 years, limit screen use to 1 hour per day of high-quality programs. Parents should co-view media with children to help them understand what they are seeing and apply it to the world around them.
• For children ages 6 and older, place consistent limits on the time spent using media, and the types of media, and make sure media does not take the place of adequate sleep, physical activity and other behaviors essential to health.
• Designate media-free times together, such as dinner or driving, as well as media-free locations at home, such as bedrooms.
• Have ongoing communication about online citizenship and safety, including treating others with respect online and offline.”

We would also add a guideline of monitoring your children for signs of children becoming overstimulated or negatively affected by their screen use. This guided quiz from PsychologyToday.com can help you identify some signs of distress due to overuse of screens and devices.

Now What?

While these guidelines can feel ambiguous, the good news is that these open-ended recommendations give your family power and control over your own screen use. Boundaries can and should be navigated by families together to ensure that screen time and media use don’t interfere with a child’s physical health, mental health, education, or general livelihood. They may change from year to year or even season to season, all depending on your family’s schedules, goals, and expectations. 

Not sure how to get started? HealthyChildren.org, run by the American Academy of Pediatrics, offers a Family Media Plan tool that can help your family create media use goals and stick to them. And once you’ve established those goals and written out a plan, consider having the family sign a contract and holding them to their promises!

Still feeling overwhelmed? Capital Area Pediatrics can help! Our team can address any of your questions or concerns about screen use and its impact on your family as individuals. To schedule an appointment with a pediatrician, find your nearest location and our staff will be happy to assist you!