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Kid Health

Tummy troubles Is your child suffering from a stomachache or some other kind of abdominal pain? It can be due to any number of maladies. By Dr. Mitchell KatzPublished: October, 2008

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Stomachaches are very common in children. So, what causes them? Constipation is a frequent culprit. It can generate discomfort and irritability due to cramps and hard contractions. Milk products, such as ice cream, cheese and cocoa, sometimes cause bloating, too.     Gastrointestinal infections, caused by viruses, bacteria and parasites, can cause vomiting, fever and diarrhea.     Another frequent cause of abdominal pain is gastroesophageal reflux, usually felt in the upper abdomen. A less common cause is a urinary tract infection, usually followed by pain and burning when urinating.     Appendicitis, a more serious cause, results from inflammation of the appendix. Often, children feel the pain near the navel, and then it radiates to the right side of the abdomen. Treatment options Usually after resting and drinking plenty of fluids, most stomachaches go away. However, symptoms that may indicate that your child needs medical attention are severe pain, which comes on suddenly; persistent vomiting; stools that are black or have blood in them; abdominal distention; dehydration; or persistent high fever.     Prevention is key. Encourage physical activity and a healthy diet. Give your child sufficient fiber and plenty of fluids.     Most importantly, closely observe your child’s symptoms. You know your child best and will be able to tell if he is unusually worn out or ill. If the pain persists or the symptoms get worse, consult your child’s doctor immediately. n Dr. Mitchell Katz is the medical director of the CHOC Gastroenterology & Nutrition Program. To find a CHOC physician, visit choc.org. Teens and blood pressure Adolescents who have blood-pressure readings higher than 120/80 often develop hypertension (high blood pressure) within a relatively short period of time, according to a new study in the medical journal Pediatrics.     Researchers compared blood-pressure readings for 8,535 teens ages 13 to 15 with repeated blood-pressure measurements two and four years later. Of the 1,470 teenagers who had a single blood-pressure reading in the pre-hypertensive range, 14 percent of boys and 12 percent of girls progressed to blood-pressure levels that were considered hypertensive two years later.     Why? A high body-mass index contributed to the problem. Researchers suggest that teens identified with pre-hypertension would benefit from exercising more and eating a healthier diet. Keep an eye on this program California does not require preventive vision care for children. Yet, according to The National Eye Institute (NEI), the most widespread disabling childhood conditions are visions disorders, including amblyopia, strabismus and significant refractive errors.     The key to detecting these disorders and preventing future vision impairment? Early detection. And the See Better and Read More campaign hopes to do just that.     This novel program is a joint effort with Timeless Learning Inc., Kiwanis clubs, Barry Ackerman and Dr. Stuart Eriksen. The program will first target preschool-aged children.     Approximately 8,000 to 10,000 children will be screened in the first year of the program, and the numbers may rise to 25,000 children per year. Re-hydrating sick kids Flat, carbonated drinks should not be used as an alternative to “oral-rehydration solution” to prevent dehydration in children with acute vomiting and diarrhea, according to a report published in a recent issue of Archives of Disease in Childhood.     Oral-rehydration solution is a liquid containing a balance of salts and sugars for avoiding dehydration in people with gastroenteritis who are losing fluids, salts and sugars through diarrhea and vomiting.     It is commonly believed that “flat” carbonated drinks are an effective alternative to these solutions, particularly for children who don’t like the taste of the solutions.     But carbonated drinks were found to contain too much sugar and not enough salts. They provide inadequate fluid and electrolyte replacement and cannot be recommended, the report concludes. Who watches violent movies? A nationwide survey has documented widespread exposure of pre-teens and young teens to movies with extreme graphic violence.     Researchers from Dartmouth Medical School in Hanover, N.H., surveyed 6,522 adolescents ages 10 to 14 from all regions of the U.S to determine what percentage had seen 534 recent movies.     They reported the survey results for 40 movies that were rated “R” for violence by the Motion Picture Association of America. These movies, on average, were seen by 12.5 percent of the teens surveyed.     The most popular movie, “Scary Movie,” was seen by 48.1 percent of kids. And 12.2 percent had seen “Gangs of New York,” in which a character is beaten and tortured with a branding iron. Violent-movie exposure was associated with a TV in the child’s room and the child being allowed to watch R-rated movies. Black henna tattoos for Halloween? Dermatologists warn that harmless-looking henna tattoos sold everywhere could contain a harmful chemical known as paraphenylenediamine (PPD), associated with major skin problems.     The U.S. Food and Drug Administration prohibits the direct application of PPD to the skin because of known health risks. But since the henna-tattoo industry isn’t regulated, people are still getting them.     The most alarming issue with black henna tattoos is the number of kids – as young as 4 – who are getting them and experiencing skin reactions. There have been hundreds of reports of allergic contact dermatitis from black henna tattoos, from mild eczema and blistering to permanent scarring.     If you do allow your child to have a henna tattoo, make sure only vegetable henna is used, not PPD-adulterated henna. DOC TALK With Dr. Daphne Wong Q: How will I know when my daughter is ready to move from the crib to a regular bed? Lori, 34, of Fountain Valley A: The big switch is usually made between 18 months and 3 years. Every child is different, so watch for readiness clues: if she’s too big to sleep comfortably in the crib or can climb out of it, if the crib railing is at her nipple line or below when she stands up, or if she’s potty-trained and needs to get to the bathroom during the night. Help your child prepare for this milestone. Let her know she’s moving to a “big girl” bed. For safety reasons, choose a bed that is low to the ground. If space permits, don’t remove the crib from her room until she’s accustomed to the new bed. Q: My 5-year-old wets the bed at least once a week. Should I be concerned?  – Jenna, 39, of Anaheim A: Occasional bed-wetting is normal. Twenty percent of kids wet the bed at 5 years of age, and 10 percent at 6 years, decreasing by about 15 percent each year. Most kids who experience nighttime wetting are physically and emotionally normal. The goal is to cure bed-wetting, but it’s also crucial to protect the child’s self-esteem. Treatment for bladder and behavioral training includes: >     Putting a night-light in the bathroom >     Not drinking fluids two hours before bedtime >     Reminding your child to go to the bathroom before bedtime >     Waking your child to urinate before you go to bed >     Including your child in cleaning if there’s an accident     In kids 7 years or older, an alarm combined with the above techniques is one of the most effective treatments. n Dr. Daphne Wong is on staff at Children’s Hospital of Orange County (CHOC). Beyond Meds Other ways to help ADHD kids Some ADHD kids are not helped – or not helped enough – by a combination of medication and behavior-management therapies. So which alternative treatments can be trusted? One alternative therapy shown to help some ADHD kids is dietary intervention. Elimination diets (including the highly-publicized Feingold Diet) claim that children are sensitive to artificially added colors, flavors and preservatives in foods. Eliminating these is believed to improve learning and behavioral problems. It has not been shown that all ADHD kids benefit, however. Nutritional supplements attempt to add to the missing diet elements. There is a long list of supplements, including omega-3 and omega-6 fatty acids, glyconutritional supplementation, single-vitamin megadoses and herbal treatments. The National Resource Center on ADHD reports that none of these have proven to help ADHD symptoms, and that megadoses “have been demonstrated to be probably ineffective and possibly dangerous.”     Interactive metronome training is a promising treatment in which individuals attempt to match the beat of a computerized metronome with hand or foot tapping. Improvements in matching are thought to increase motor planning and timing skills – one of the key benefits of ADHD stimulant medications.     Many other alternative treatments exist, such as sensory integration training, cerebellar training, antimotion sickness medication, candida yeast management, neurofeedback, chiropractic, optometric vision training, and thyroid and lead treatments. These are described and evaluated in great detail at help4adhd.org. The site also includes a must-read checklist for ways to spot unproven remedies. Elisabeth Handley is a regular contributor to OC Family magazine.

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