Is it a cold or allergy?

SHE’S SNEEZING. HER EYES ARE

SCRATCHY AND WATERING. HIS

NOSE KEEPS RUNNING. YOUR

CHILD IS MISERABLE. STEVE SUTTON, MDpractices with Allergy and

Asthma Associates, Inc.,

in Cincinnati

allergies vs coldsK N O W I N G T H E S I G N S

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“� e hallmark of an allergic reaction is itching or sneezing, usually within minutes of exposure,” says allergist Steve Sutton, MD. So if your child has bouts of sneezing and runny nose that seem to come on suddenly, review what he was doing just before the symptoms started. Was he playing with the cat, or running around outside just a� er you’d mowed the lawn? Does the condition improve when your child is away from the cat, or the grass?

On the other hand, if it’s a cold, your child will continue to have symptoms, whether she’s with the cat or not. And in addition to sneezing and a runny nose, she might complain of a sore throat, feel achy, and even run a fever. A cold won’t be helped much by medication, Sutton says, whereas your child will probably get relief from an antihistamine if the problem is an allergic one.

If that’s not enough to help you decide, consider your child’s age and

the time of year. “Colds tend to peak in the fall and

winter. Allergies are more likely to occur in spring and early fall,” Sutton says. He adds that runny noses and other respiratory symptoms in infants and children under the age of three are more likely to be colds.

“Although eczema, asthma and food allergies can be seen early in life, most symptoms related to nasal allergies don’t begin until a� er age 2 or 3,” Sutton says. “We see allergies peaking in school age kids.”

If your child is bothered by chronic upper respiratory problems, ask your pediatrician to take a look. � e doctor can determine if the problems are caused by a cold, a blockage (such as enlarged adenoids) or an allergic reaction – and can refer you to an allergy specialist or an ENT (ear, nose and throat specialist) for further care, if necessary.

All allergies (food, skin and respiratory) are the result of a problem with your immune system. The immune system reacts to substances that are harmless to most people and mistakenly creates antibodies to that substance. Thereafter, when you are exposed to the substance through your mouth, nose or skin, your immune system detects it and creates an infl ammatory response, which is what you recognize as your allergy symptoms.

Allergies are often, but not always, hereditary. And kids who are allergic early in life can experience what doctors term the “allergic march,” so a child might have eczema as an infant, a food allergy as a toddler, then develop environmental allergies or asthma in later childhood.

what causes an allergy?

p e d i a t r i c i a nASK THE NICK DEBLASIO, MD

Division of General and Community Pediatrics

Pediatric Primary Care Clinic at Cincinnati Children’s

President, Cincinnati Pediatric Society

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THE FAMILY RESOURCE CENTER

The center helps families,

community providers

and agencies fi nd health

information, community

resources and support.

Call 513-636-7606 for

assistance.

SPECIAL NEEDS RESOURCE DIRECTORY Use this directory to fi nd

information, resources and

advocacy strategies at

www.cincinnatichildrens.org/

special-needs.

JOIN SPECIAL CONNECTIONSOur new online community

connects with others

parenting a child with

special healthcare needs:

www.cincinnatichildrens.

inspire.com.

advocateFOR YOUR CHILD’S HEALTH

My 11-year-old son has started complaining of headaches. Should I be concerned, and what should I give him for them?

A lot of pediatric patients have headaches. e vast majority of headaches are nothing to worry about. But if your child’s headaches are frequent or severe, it’s best to have him evaluated by your pediatrician.

ABOUT THIS ISSUE SPRING 2014 | VOL27 ISSUE1

YOUNG AND HEALTHY is a quarterly publication from Cincinnati Children's Hospital Medical Center. For more health news and patient stories, subscribe to our monthly eNewsletter online at www.cincinnatichildrens.org/subscribe

© 2014 Cincinnati Children's Hospital Medical Center

3

PRODUCED BY

The Department of Marketing & CommunicationsCincinnati Children's Hospital Medical Center3333 Burnet Ave., MLC 9012, Cincinnati, OH 45229-3026Phone: 513-636-4420

Advisers: Chris Peltier, MD, and Zeina Samaan, MDEditorial Consultant: Nick DeBlasio, MDEditorial Staff: Mary Silva/managing editorPhotography: Tine Hofmann, tm photographyDesign: Christina Ullman & Alix Nothrup, Ullman Design

RESEARCHSTUDYJ O I N A

Researchers at Cincinnati Children’s conduct hundreds of studies each year to fi gure out why people get sick and what treatments might help them. Discoveries researchers make in the lab can lead to even better treatments and ways to prevent diseases from happening in the fi rst place. Did you know you could be part of the process of helping our scientists solve medical mysteries? You can participate by joining a research study. Here’s what we’re recruiting volunteers for now.

PRESCHOOL CHILDREN WITH SELF-CONTROL DIFFICULTIES

What: A research study to develop and test an intervention that teaches self-control, memory and the ability to concentrate and focus to preschoolers and their parents.Who: Preschool children 3 and 4 years old who have self-control problems may be eligible to participate.Pay: $100 for their time.Contact: preschoolstudy@cchmc.org • 513-803-1345.

If you have a question for the pediatrician, email youngandhealthy@cchmc.orgHAVE QUESTIONS?

FOOD CHALLENGE RESEARCH STUDY

Has your child been tested at an allergist’s o� ce for a milk, egg or peanut food allergy?What: We want to study a blood test that looks at the speci� c proteins found in food so we can possibly give more accurate results regarding food allergies. Who: Infants, children and teens up to 18 years old who have a milk, egg or peanut allergy based on an oral food challenge may be eligible to participate. An oral food challenge is a test done where an individual is exposed to a certain food in the physician’s o� ce to determine if that food will trigger a reaction in the body.Pay: $10 gi� card for this one study visit where they will have one blood draw.Contact: Kelly ornton at kelly.thornton@cchmc.org • 513-636-0604

facebook.com/cincinnatichildrensfans youtube.com/cincinnatichildrens cincinnatichildrensblog.org@cincychildrens

concernedW H E N T O B E M O R E

Does your child wake up in the morning or in the middle of the night with a headache? Does the headache cause vomiting?

These symptoms require a little more investigation. Your pediatrician would perform a physical exam and decide what, if any, tests need to be done. Brain MRIs and CT scans are rarely needed.

If your doctor thinks the headaches are migraines, your child might be referred to a neurologist who is familiar with medications to prevent the headaches or methods to treat them more effectively.

Here are some possible causes of occasional headaches:

■ INADEQUATE HYDRATIONOne of the big reasons for headaches is inadequate hydration – not taking in enough � uid. is is especially true as the weather gets warmer and kids become more active outside and lose � uid through sweating. If your child has become more active and begins to complain of headaches, the cure might be as simple as having him drink more water.

■ BLOOD PRESSUREElevated blood pressure can cause headaches.

■ VISION PROBLEMSYour child might be getting headaches from straining to see the board at the front of the classroom.

■ FAMILY HISTORYDo you have a family history of headaches? Many times, if a parent gets headaches, a child might as well.

■ LIFESTYLEDoes your child eat a healthy diet (plenty of fresh fruits and veggies and breakfast each morning) and get exercise? Does he drink a lot of ca� einated sodas or other beverages? Certain foods and ca� eine can trigger headaches.

Lack of sleep can cause headaches. Kids in middle and high school typically need at least 10 to 12 hours a night. Fewer than 10 hours of sleep each night is not really enough for kids of that age.

Is your child under a lot of stress or pressure at school? Have things changed at home recently, such as a divorce or a move or other big changes in your life?

FOCuS: AN INVESTIGATIONAL MEDICATION RESEARCH STUDY

Has your child or teen had a moderate to severe head injury? Do they have trouble with concentration or staying focused?What: We want to learn more about how a medication that helps with attention problems can help children who have had a moderate to severe head injury.Who: Children ages 6 to 17 years old who have had a moderate to severe head injury (6 months to 4 years ago) and now have attention di� culties may be eligible for participation.Pay: $125 for time and travelContact: Jessica King at jessica.king1@cchmc.org • 513-636-9631

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Snoring isn't just the funny noise that grandpa makes when he takes a nap. It can be a troublesome sign, especially in kids.

Snore?DOES YOUR CHILD

s l e e p m e d i c i n eFOCUS ON identifying problems

(left) PATRICIA NORTON, RN, MSNProgram Manager, Upper Airway Center

(right) STACEY ISHMAN, MD, MPHPediatric Otolaryngologist at Cincinnati Children’s

“Snoring in kids is not normal,” says Stacey Ishman, MD, MPH, a pediatric otolaryngologist at Cincinnati Children’s who is also certi� ed in Sleep Medicine. “About 10 to 20 percent of children snore. And we know there are decreases in school and learning performance in children who snore versus those who don’t.”

T H E S N O R I N G - B E H A V I O R L I N KA number of studies have been published about

the harm that sleep-related breathing problems can cause – from poor memory and lower IQ scores to behavioral problems and hyperactivity. Experts believe that the problems stem from the poor quality of sleep experienced by children who snore.

ere are a number of possible causes, but the number one reason for troubled breathing and snoring in kids, says Ishman, is enlarged tonsils or adenoids.

If you hear your child snoring, or if he develops otherwise unexplainable problems with school or behavior changes and you suspect it might be because he is losing sleep, it’s best to get to the bottom of it – and soon.

Cincinnati Children’s offers this screening for children with Down syndrome by referral from your primary care physician: Upper Airway Center, 513-636-3730 or upperairwaycenter@cchmc.org.

S N O R I N G A N D D O W N S Y N D R O M E

The American Academy of Pediatrics recommends every child with Down syndrome have a sleep study between 3 and 5 years of age. Children with Down syndrome are at greater risk of sleep disorders and sleep apnea.

screening

5

(right) Data   om a sleep study is essential to diagnosing sleep apnea, says Dr. Stacey Ishman

Sleep-related breathing problems can cause poor

memory , lower IQ scores, behavioral problems and hyperactivity.

W H A T T O D 0“ e � rst step is to talk with your pediatrician,”

Ishman says. “ e most important thing is to � gure out if it’s snoring or sleep apnea.”

In sleep apnea, breathing is brie� y and repeatedly interrupted during sleep. Le� untreated, it can have long-term health consequences. But it’s not easy to identify in children. So the best approach to start may be “watchful waiting,” Ishman says.

“Kids’ tonsils and adenoids grow between the ages of 2 and 6. So I would likely say to the parent of a 7-year-old, ‘Your child’s tonsils might get smaller over the next 6 months, so let’s just watch.’ A study in the last year reported that nearly 40 percent of mild sleep apnea in kids resolves with just waiting.”

If the problem doesn’t improve with time, a sleep study in a special pediatric sleep laboratory is the only way to determine whether or not your child has apnea, Ishman says. Some sleep apnea and snoring can be managed with medications. If the problem is caused by enlarged tonsils and adenoids, surgery might be recommended.

I M P R O V E M E N T A F T E R S U R G E R YRegardless of the cause, seeking help for your

child’s snoring is important, because it can be � xed. “And a number of studies have shown that the problems associated with children’s snoring are reversible,” says Ishman.

American Heart Association: www.heart.org

Sudden Cardiac Arrest Association: www.suddencardiacarrest.org

Sudden Cardiac Arrest Foundation: www.sca-aware.org

Parent Heart Watch: www.parentheartwatch.org

online

SCA is the number one cause of death in the United States. It claims the lives of 359,400 Americans each year – including as many as 7,000 children. SCA is the number one cause of death in young athletes. Every three days, a competitive stu-dent athlete suffers a sudden cardiac arrest without warning.

National primary and secondary prevention programs are in place to save more young lives from SCA. Primary prevention consists of screening young athletes prior to sports participation to detect pre-existing conditions that may lead to SCA. Secondary prevention includes widespread heart health awareness and CPR/AED training.

F A C T S A B O U T S U D D E N C A R D I A C A R R E S T ( S C A )

SCA is the number one cause of

F A C T S A B O U T S U D D E N C A R D I A C A R R E S T ( S C A )

When CPR and an AED are used within the first three to five minutes of collapse, it can triple the chance of survival.

Sudden cardiac arrest (SCA) is a life threatening condition in which the heart’s electrical system malfunctions and the heart can no longer pump oxygen-rich blood to the brain and vital organs. SCA can happen to children as well as adults. � ere are many causes, including underlying heart disease, a blow to the chest, asthma, drowning, electrocution, diabetes, and allergic reaction.When sudden cardiac arrest occurs, every second counts. Knowing how and when to administer cardiopulmonary resuscitation (CPR) and use an automated external de� brillator (AED) can make all the di� erence. When CPR and an AED are used within the � rst three to � ve minutes of collapse, it can triple the chance of survival. CPR pumps oxygen-rich blood to the brain and major organs to sustain life; an AED can deliver a lifesaving shock to the heart and get it beating e� ectively again.

EV E RY PA R E N T S H O U L D K N OW

Th i s Li fe s av i ng S kil lIf your child’s heart stops, would you know what to do?

ANGIE JACKSON, RRTCincinnati Children’s Center for

Professional Excellence/Education

CPR

five minutes of collapse, it can triple the chance of survival.

well as adults. � ere are many causes, including underlying well as adults. � ere are many causes, including underlying

When sudden cardiac arrest occurs, every second counts. When sudden cardiac arrest occurs, every second counts. Knowing how and when to administer cardiopulmonary Knowing how and when to administer cardiopulmonary

minutes of collapse, it can triple the chance of survival. CPR minutes of collapse, it can triple the chance of survival. CPR pumps oxygen-rich blood to the brain and major organs to sustain life; an AED can deliver a lifesaving shock to the

emergenciesB E I N G P R E P A R E D

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Cincinnati Children’s provides CPR classes on a regular basis. Call 513-636-1096 for a schedule of classes.

C P R C L A S S E S

s a fe t y t i p sTRAVEL

In the excitement of planning a trip, many people don’t think about what’s important to make it safer and healthier,

says Mary Allen Staat, MD, MPH, Director of the International Travel Clinic at Cincinnati Children's. e clinic specializes in preparing adults and children for international travel.

“One of the most important things is to learn about where you will be visiting,” Staat says, “and know the associated risks. By preparing, there are lots of things you can do to minimize those risks.”

e Travel Clinic is familiar with most of the risks, and how to prepare for them.

trav el t ip sP R E P A R AT I O N S A N D

P R E C A U T I O N S

American Heart Association: www.heart.org

Sudden Cardiac Arrest Association: www.suddencardiacarrest.org

Sudden Cardiac Arrest Foundation: www.sca-aware.org

Parent Heart Watch: www.parentheartwatch.org

7

� e Travel Clinic team includes (   om le� ) Robin Gordon,

Mary Allen Staat, MD, MPH, and Kelly Hicks, CNS, RN.

Extra socks. Camera batteries. A travel adaptor plug. Immunizations. Medication for travelers’ diarrhea. Wait… those last two items weren’t on your trip planning to-do list? ey should be, if you plan to travel overseas with your kids – particularly if you are traveling to less developed areas.

Traveling Overseas?STAY SAFE AND HEALTHY

■ DON’T GET BUGGEDInsect-borne diseases are a major risk in many regions. Use bed netting if there are no screens on windows or doors to avoid illnesses carried by insects. Be aware of ticks if hiking is in your travel plans.

Also beware of animals, no matter how cute they might be. Dog and monkey bites can cause rabies or infection.

■ MEDICAL GUIDANCEmake an appointment with your doctor or the Travel Clinic in advance of your trip. A little preparation goes a long way toward creating the trip of a lifetime.

make an appointment Contact the Travel Clinic at 513-636-2152.

■ BE CAREFUL WITH FOOD AND WATER Avoid tap water, even for brushing teeth; steer clear of ice cubes. Use common sense in food choices: avoid raw fi sh, undercooked meats and food from street vendors. Use bottled water and juice.

Despite the best efforts, travelers’ diarrhea is a common travel affl iction. The Travel Clinic prescribes medication to take along in case. But seek care from a medical facility if you have bloody diarrhea or high fever.

■ CAR SEATS AND TRAFFICIf traveling with young children, take a car seat along. Be especially alert to unusual driving and traffi c patterns when crossing streets.

■ GET YOUR IMMUNIZATIONS UP TO DATE Do this well in advance of your trip - at least a month or more, since some shots must be taken in a series. Some vaccinations can be accelerated for a trip, says Staat, depending on age. And there are some immunizations needed just for travel.

S L E E P P R O B L E M SSnoring is not normal.

How it affects your child, and what you can do.

insideTHIS ISSUE C O L D O R A L L E R G Y

Learn about the differences in symptoms to determine the best

course of action

3333 Burnet Avenue, MLC 9012Cincinnati, Ohio 45229-3026

Cincinnati Children’s has renovated and updated our Mason, Ohio, location to better meet your family’s needs. Services o� ered at Mason include:■ Urgent Care ■ Laboratory and X-ray■ More than 20 pediatric medical and surgical specialties

Our renovation created space for new services, including:■ Perlman Center, for children with cerebral palsy and other physical challenges■ Dermatology■ Ophthalmology

S P R I N G 2 0 1 4

VOL27 ISSUE1

Maintain your child's health through preparation and education.keeping your child protected

A guide to your child’s good health

healthyyoungand

R E N O VAT E D M A S O N C A M P U SVisit our newly

Our Mason Campus is located at: 9560 Children's Drive, Mason, OH 45040vwww.cincinnatichildrens.org/mason

No appointments needed for lab, X-ray or urgent care visits.