KidsDoc Monthly Newsletter from AllForKids

June -2009,Vol -1,Issue-18

By Dr. M.Vijayalakshmi M.D(Peds), M.D(USA), FAAP, DAA
Content Sources: Centers for Disease Prevention and Control(CDC), American Academy of Pediatrics,


Latest from AllForKids

AllForKids has expanded its Allergy Test offering to include most common food allergens.

AllForKids will conduct a complimentary Asthma screening camp in August. Dates and Venue will be announced later.


Triggers of Asthma


Asthma attacks may include coughing, chest tightness, wheezing, and trouble breathing. An asthma attack can occur when you are exposed to things in the environment, such as house dust mites and tobacco smoke. These are called asthma triggers.

What triggers asthma can be very different from those of another person with asthma. Some of the most important triggers are listed below:

Secondhand Smoke

Environmental tobacco smoke is often called secondhand smoke because the smoke created by a smoker is breathed in by a second person nearby. Parents, friends, and relatives of children with asthma should try to stop smoking and should never smoke around a person with asthma. They should only smoke outdoors and not in the home or car. They should not allow others to smoke in the home, and they should make sure their child's school is smoke-free.

Dust Mites

Dust mites are in almost everybody’s homes, but they don’t cause everybody to have asthma attacks. If you have asthma, dust mites may be a trigger for an attack. To help prevent asthma attacks, use mattress covers and pillowcase covers to make a barrier between dust mites and yourself.

Outdoor Air Pollution
Pollution caused by industrial emissions and automobile exhaust can cause an asthma attack.

Cockroach Allergen
Cockroaches and their droppings may trigger an asthma attack. Get rid of cockroaches in your home and keep them from coming back by taking away their food and water. Cockroaches are usually found where food is eaten and crumbs are left behind. Remove as many water and food sources as you can because cockroaches need food and water to survive.

Furry pets like cats  may trigger an asthma attack. When a furry pet is suspected of causing asthma attacks, the simplest solution is to find the pet another home. If pet owners are too attached to their pets or are unable to locate a safe, new home for the pet, they should keep the pet out of the bedroom of the person with asthma.

Inhaling or breathing in mold can cause an asthma attack. Get rid of mold in all parts of your home to help control your asthma attacks. Keep the humidity level in your home between 35% and 50%. In hot, humid climates, you may need to use an air conditioner or a dehumidifier or both. Fix water leaks, which allow mold to grow behind walls and under floors.

Other Triggers
Strenuous physical exercise; some medicines; bad weather, such as thunderstorms, high humidity, or freezing temperatures; and some foods and food additives can trigger an asthma attack.

Strong emotional states can also lead to hyperventilation and an asthma attack.

Learn what triggers asthma attacks so that you can avoid the triggers whenever possible. Be alert for a possible attack when the triggers cannot be avoided.

June is Internet Safety Month


June is National Internet Safety Month in the US. This is the time when lots of awareness activities are conducted to increase awareness about online safety. We thought it will be prudent to use this opportunity to reinforce the importance of keeping your kids safe online to the parents of Kerala.

Here are some tips for parents from National Center for Missing and Exploited Children to improve Internet safety:

  • Clear, simple, easy-to-read house rules should be posted on or near the monitor. 
  • Look into safeguarding programs or options your online service provider might offer. These may include monitoring or filtering capabilities.
  • Always read a web site's privacy policy before giving any personal information. Also make sure that a web site offers a secure connection before giving credit-card information.
  • Web sites for children are not permitted to request personal information without a parent's permission. Talk to children about what personal information is and why you should never give it to people online.
  • If children use chat or e-mail, talk to them about never meeting in person with anyone they first "met" online.
  • Talk to children about not responding to offensive or dangerous e-mail, chat, or other communications. Report any such communication to local law enforcement. Do not delete the offensive or dangerous e-mail; turn off the monitor, and contact local law enforcement.
  • Keep the computer in the family room or another open area of your home.
  • Get informed about computers and the Internet.
  • Let children show you what they can do online, and visit their favorite sites.
  • Have children use child-friendly search engines when completing homework.
  • Know who children are exchanging e-mail with, and only let them use chat areas when you can supervise. NetSmartz recommends limiting chatroom access to child-friendly chat sites.
  • Be aware of any other computers your child may be using.
  • Internet accounts should be in the parent's name with parents having the primary screenname, controlling passwords, and using blocking and/or filtering devices.
  • Children should not complete a profile for a service provider and children's screennames should be nondescript so as not to identify that the user is a child.
  • Talk to children about what to do if they see something that makes them feel scared, uncomfortable, or confused. Show them how to turn off the monitor and emphasize that it's not their fault if they see something upsetting. Remind children to tell a trusted adult if they see something that bothers them online.
  • Consider using filtering or monitoring software for your computer. Filtering products that use whitelisting, which only allows a child access to a preapproved list of sites, are recommended for children in this age group.
  • If you suspect online "stalking" or sexual exploitation of a child, report it to your local law-enforcement agency.

Choking in Children


Physical and developmental factors put children at risk for choking. Children who choke run the risk of death, permanent brain damage caused by lack of oxygen, or other complications associated with airway blockage. Each year a large number of children are getting emergency medical assistance for nonfatal choking episodes. 


The Dangers of Choking

Food or small objects can cause choking when they get caught in the throat and block the airway, preventing oxygen from getting to the lungs and the brain. According to the American Academy of Pediatrics (AAP), when the brain goes without oxygen for more than four minutes, brain damage or even death may occur.
Every child is at risk for choking, says the CDC. Younger children are particularly at risk because of their tendency to place objects in their mouths, poor chewing ability, and narrow airways compared with those of older children and adults.

Inhaled food is drawn into the windpipe (trachea) and travels into one of two bronchial tubes (bronchi), where it can block the flow of air into the lungs. "Depending on the size and shape of the food particle, it can go further to a point where it actually plugs up one of the smaller branches of a bronchial tube and can cause part of the lung to collapse,"

• In the US in the year 2000, 160 children ages 14 years or younger died from an obstruction of the respiratory tract due to inhaled or ingested foreign bodies. Of these, 41% were caused by food items and 59% by nonfood objects .
• For every choking-related death, there are more than 100 visits to U.S. emergency departments. In 2001, an estimated 17,537 children 14 years or younger were treated in U.S. emergency departments for choking episodes.
◦ Sixty percent of nonfatal choking episodes treated in emergency departments were associated with food items; 31% were associated with nonfood objects including coins; and in 9% of the episodes the substance was unknown or unrecorded.

◦ Candy was associated with 19% of all choking-related emergency department visits by children ages 14 years or younger; 65% were related to hard candy; and 12.5% were related to other specified types of candy (chocolate candy, gummy bears, gum, etc.). The type of candy was not specified in the remaining 22.5% of the cases.  Candy was associated with 5% of all choking-related visits for infants less than one year of age; 25% of visits for children ages 1 to 4 years; and 28% of visits for children ages 5 to 14 years.

Coins were involved in 18% of all choking-related emergency department visits for children ages 1 to 4 years.

Tips for Parents
Every child is at risk of choking. To reduce this risk, parents and caregivers can

  • keep a watchful eye on their children when eating and playing;
  • keep dangerous toys, foods, and household items out of reach;and
  • learn how to provide early treatment for children who are choking.

Unsafe Foods for Young Children

The American Academy of Pediatrics recommends keeping the following foods away from children younger than 4:

  • hot dogs
  • nuts and seeds
  • chunks of meat or cheese
  • whole grapes
  • hard, gooey, or sticky candy
  • popcorn
  • chunks of peanut butter
  • raw vegetables
  • raisins
  • chewing gum.

Dangerous Objects for Young Children

The American Academy of Pediatrics advises keeping the following items away from infants and young children to reduce the risk of choking:

  • latex balloons
  • coins
  • marbles
  • toys with small parts
  • toys that can be compressed to fit entirely into a child's mouth
  • small balls
  • pen or marker caps
  • small button-type batteries
  • medicine syringes.

What you can do to prevent choking

  • Learn CPR (cardiopulmonary resuscitation) (basic life support).
  • Be aware that balloons pose a choking risk to children up to 8 years of age.
  • Keep the above foods from children until 4 years of age.
  • Insist that children eat at the table, or at least while sitting down. They should never run, walk, play, or lie down with food in their mouths.
  • Cut food for infants and young children into pieces no larger than one-half inch, and teach them to chew their food well.
  • Supervise mealtime for infants and young children.
  • Be aware of older children's actions. Many choking incidents occur when older brothers or sisters give dangerous foods, toys, or small objects to a younger child.
  • Avoid toys with small parts, and keep other small household items out of the reach of infants and young children.
  • Follow the age recommendations on toy packages. Age guidelines reflect the safety of a toy based on any possible choking hazard as well as the child's physical and mental abilities at various ages.
  • Check under furniture and between cushions for small items that children could find and put in their mouths.
  • Do not let infants and young children play with coins.

Quick Tips – Child Nutrition

Here is the daily Calorie/Nutrition intake requirements for children as recommended by USDA for a balanced diet


Calory Table

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