Tuesday, July 21, 2009

Heat Exhaustion and Heat Stroke

In the sweltering heat of Arizona were the temperatures outside have been climbing in the 110-118F it is no surprise that the incidence of heat exhaustion and heat stroke is on the rise. There comes a time when the body will be unable to maintain normal temperature when exposed to excessive heat. We have normal mechanisms that prevent this from happening. We become very thirsty and we start to sweat to help bring our core temperature down. Sometime people do not notice this especially children because they are having so much fun under the sun.

Signs and Symptoms of Heat Exhaustion

  • mild dehydration

  • core temperature from 100.4 to 104F

  • profuse sweating

  • thirst, nausea, vomiting

  • confusion

  • headaches

  • feels faint or has collapsed

Signs and Symptoms of Heat Stroke

  • usually with severe dehydration

  • core temperature greater than 104F

  • flushed with hot dry skin

  • dizziness, vertigo, fainting, confusion, delirium

  • loss of consciousness

  • may be in shock

First Aid for Heat Exhaustion and Heat Stroke

  • bring child/adult indoors

  • undress

  • have them lie down and elevate the feet slightly

  • put the child is awake place cool bath water or sponge bath the child immediately if outside spray with mist from a garden hose

  • if the child is alert give frequent sips of cool, clear fluids

  • if child is vomiting turn to side to prevent aspiration

  • monitor the child's temperature

  • call the doctor if this is not resolving

Prevention is the best medicine

  • teach children to drink lots of fluids before and after playing outside even it they are not thirsty

  • make sure they wear light-colored loose fitting clothes

  • hats , eye wear for protection

  • only participate in heavy activity before 10 am in the morning and after 6pm

  • tell children to come indoors immediately if they feel overheated

Monday, July 6, 2009


The most common photosensitive reaction in children is acute sunburn and the best treatment for sunburn is prevention.

The sun is one of the most important things that keep our planet alive. We get our vitamin D from the sun from its conversion of cholesterol in our body, this helps absorb calcium for healthier teeth and bones. As we say too much of a good thing is not too good either, it does not take long of sun exposure to cause damage. This can cause skin damage, eye damage, immunosuppression and cancer.

The invisible ultraviolet rays of the sun can cause tanning, burning and other skin damage.

  • Ultraviolet A causes skin aging, wrinkling and skin cancer such as melanoma

  • Ultraviolet B causes sunburns, cataracts and immune system damage, they contribute to cancer

  • Ultraviolet C are most dangerous but fortunately it is totally blocked by the ozone layer

Melanin: Our protection from the Sun

Melanin is our defense from the sun because it absorbs the dangerous UV light before it can cause serious damage resulting in a darker color or a tan but with constant exposure this can still result in a sunburn. Children vary in susceptibility to UV light depending upon their skin tone the lighter they are the less melanin they have.

Sun-reactive Skin Types

Type Demographics Sunburn, Tanning History

I red hair, freckles and Celtic origin Always burns easily with no tanning

II fair skin, fair-haired, blue-eyed and white usually burns with minimal tanning

III darker skinned white sometimes burns, gradual light

brown tan

IV Mediterranean backgrounds minimal to no burning, always tans

V Middle eastern white, Mexican rarely burns, tans profusely dark

Oriental brown

VI Black Never burns, pigmented black

Avoidance is the best Prevention

Avoid the most intense heat of the sun between 10:00am to 4:00pm. Make sure to apply sunscreen if they are exposed to sunlight. Try to avoid exposure of infants to the sun because they burn more easily because of their thinner skins. Make sure you cover-up infants and you may put sunblock on the exposed areas. Make sure you have umbrellas to cover everyone from the sun exposure from time to time.


Select a sunscreen with at least a SPF(Sun protection factor) of 15 or higher to prevent sunburn and tanning. Select one that is broad-spectrum that protects from UVA and UVB rays. If your child have sensitive skin avoid sunscreens with PABA and instead look for one with titanium dioxide as an active ingredient.

  • do not skimp on sunscreen make sure you got good coverage, experts suggest to start of on a lotion as a base and you can use the spray for reapplication every 2-3 hours

  • apply sunscreen 30 minutes before sun exposure

  • apply a waterproof sunscreen and do not forget the eyelids, back of the neck, lips, hands,ears, feet and shoulders

  • need to wear sun-glasses with both UVA and UVB protection

First Aid for Sunburn

  • keep away from the sun into a cool shaded area, additional sun exposure will aggravate the burn

  • have your child take a cool bath

  • apply pure aloe vera gel to any sunburned areas

  • pain reliever (acetaminophen or ibuprofen) do not give aspirin to children and teens this can result in liver problems

  • apply 1% hydrocortisone to inflammed areas (do not use topical benzocaine, this can cause skin irritation or petroleum-based products, they prevent excess heat and sweat from escaping)

Call your pediatrician if:

  • Sunburn is severe resulting in blisters

  • child has unexplained fever of higher than 102F

  • the skin looks infected

  • trouble looking at the light(sunburn in the cornea)

  • fever or chills after sunburn

  • signs of dehydration (increased thirst or dry eyes and mouth)

  • sunburn covering a large area

  • facial swelling from sunburn

Thursday, July 2, 2009

Newborn Care 101

Feeding and Nutrition
Breastmilk or formula should be your baby's major source of nutrition for the first year of life. We usually introduce solids around 4-6 months of age. There will be a period of time that your baby will undergo growth spurts. They will start to nurse and eat more often than usual and they seem to be hungry all the time. Do not worry this just occurs in spurts and they go back to their normal routine. You know you are overfeeding your baby because they will be spitting-up a whole lot. Make sure you burp them often in between feedings.

You are underfeeding your baby if:
  • he has less than 4 wet diapers a day
  • not nursing at least 10 minutes at the breast
  • appears hungry looking for the breast
  • appears more yellow
  • does not seem to be gaining weight

(for the first few weeks of like we expect the babies to be gaining at least 1/2 ounce a day)

Bowel Movement

The initial bowel movement of babies are called the meconium stools . They start of as black and tarry then we see the transition stools which are greenish yellow and the normal seedy mustard looking stools that is slightly watery. Formula fed babies have more formed stools. They can move their bowels everytime they eat to once a week there is a wide variation of normal. They are considered constipated if the stools are rock hard and come out as pellets.

Wet Diapers

We need to know the number of wet diapers a baby has to ensure the baby is taking enough breastmilk or formula. This is usually between 6-8 diapers a day.


Babies can not express themselves very well and they tend to cry for everything. It will take you a few weeks to learn what cry is for what. You can not spoil a baby by carrying and hugging them. Make sure the baby is not hungry or wet. Sometimes they just need cuddling.

According to Dr. Karp think of the 4S

S - swaddle the baby this helps them feel comfortable, remember they were inside the uterus in a tight spot which is a comfort for them

S - Stomach try to lay them across your arms on their stomach they seem to quiet down with this position

S - Shh... silence or darkness can calm them, overstimulated babies are cranky babies

S - swinging not to much just gently, they like monotonous noises like the sound of the blow dryer, the vacuum cleaner


If you do not burp your baby they will become fussy and inconsolable. Try burping in between feeding. you can burp them over your shoulders, across your lap or sitting-up, make sure you pat their backs gently


This is totally normal in newborns. Try to feed them before they get too hungry when they start gulpin the milk down they tend to swallow a lot of air. make sure the nipple airflow is not too fast.

You can never spoil your baby during the first few months of life. This is the perfect time to attend to their needs closely and you will realize that they can communicate to you what they need and want very effectively.