KidsDoc Monthly Newsletter from AllForKids

May -2009,Vol -1,Issue-17

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


Growing pains in children


Your 5 year-old son wakes up crying in the night complaining that his legs are paining and you try to comfort  him as much as you can, but you are not sure about whether to give him any medicine or take him to the doctor.
Your child is probably experiencing growing pains, a normal occurrence in about 25% to 40% of children. They generally occur in early childhood, among 3 to 5-year-olds, and later on, in 8  to 12-year-olds.


What causes growing pains?


There is no conclusive evidence to show that the growth of bones causes pain. The most likely known causes are the aches resulting from the jumping, climbing, and running that kids do during the day. The pains can occur after a child has had a particularly active day.


Growing pains always concentrate in muscles, rather than the joints. Most kids report pains in the front of their thighs, in the calves, or behind the knees. Whereas joints affected by more serious diseases are swollen, red, tender, or warm, the joints of kids experiencing growing pains appear normal.

Although growing pains often strike in late afternoon or early evening before bed, pain can sometimes wake a slumbering child. The intensity of the pain varies from child to child, and most kids don't experience the pains every day.

How to diagnose growing pain

One symptom that doctors find very helpful in making a diagnosis of growing pains is how the child responds to touch while in pain. Kids who have pain from a serious medical condition does not like to be handled because movement tends to increase the pain. But those with growing pains respond differently — they feel better when they're held and massaged.

Helping your child through growing pain

Some things that may help alleviate the pain include:

  1. massaging the area
  2. stretching
  3. placing a heating pad on the area
  4. giving Paracetamol

When to call the doctor or take him to a hospital

Call your doctor if any of the following symptoms occur with your child's pain:

  1. persistent pain, pain in the morning, or swelling or redness in one particular area or joint
  2. pain associated with a particular injury
  3. fever
  4. limping
  5. unusual rashes
  6. weakness / tiredness

These signs are not due to growing pains and should be evaluated by the doctor.

Back to school issues – illnesses


It is very common for children who start school/daycare to get 6-8 infections in one year . Most of them are viral colds/diarrheas.

One way the incidence of illnesses can be reduced is to by teaching your children proper hand washing habits. It is most important to wash hands, especially after coughing and sneezing, before preparing foods or eating, and after using the toilets. Everyone should wash their hands for 20 seconds (about the length of a little tune) to remove germs.

Another important way you can prevent serious illnesses is to make sure that your child is up-to-date on vaccinations before the start of the school year.

Avoid sending your child to school till they have recovered to stop the spread to the whole class.

Make sure that your child eats a balanced diet including enough vegetables and fruits. A balanced diet improves the overall immunity and well being and reduces the chances of illnesses.

Febrile seizures

Febrile seizures are seizures triggered by a fever.

Febrile seizures occur in about 2% of children younger than 6 years. Febrile seizures tend to run in families. Most children who have a febrile seizure have only one ever, and most seizures last less than 15 minutes.

Febrile seizures may be simple or complex.

Simple: The entire body shakes for less than 15 minutes.

Complex: The entire body shakes for more than 15 minutes, only one side of the body shakes or seizures occur at least twice within 24 hours. Children who have complex febrile seizures are slightly more likely to develop a seizure disorder later in life.

Febrile seizures usually result from the fever itself. Most often, the fever is caused by an otherwise minor infection such as a viral infection. In such cases, the infection and the seizure are harmless. However, life-threatening brain infections such as meningitis or encephalitis also sometimes cause seizures. Because parents cannot identify whether children have such a brain infection, children who have a fever and who have a seizure for the first time or are very sick should be taken to the doctor for checkup. Doctors examine the children and sometimes do tests to check for these conditions.

Treatment :

Usually, seizures last less than 15 minutes, and no treatment is given other than drugs to reduce the fever. If seizures last 15 minutes or more, drugs may be given by the doctor.

Children who have had only a few simple febrile seizures are usually not given drugs to prevent additional seizures. Children who have had several febrile seizures or seizures lasting a long time may be given drugs to prevent seizures.

Disease Focus –Swine Flu (H1N1 Flu)


Novel influenza A (H1N1) is a new flu virus of swine (pig) origin that was first detected in April, 2009. Originally detected in Mexico the virus is infecting people and is spreading from person-to-person, sparking a growing outbreak of illness in the United States. An increasing number of cases are being reported internationally as well.

It’s thought that novel influenza A (H1N1) flu spreads in the same way that regular seasonal influenza (flu) viruses spread; mainly through the coughs and sneezes of people who are sick with the virus.

Because this is a new virus, most people will not have immunity to it, and illness may be more severe and widespread as a result. In addition, currently there is no vaccine to protect against this novel H1N1 virus.

In children, emergency warning signs that need urgent medical attention include:

  1. Fast breathing or trouble breathing
  2. Bluish or gray skin color
  3. Not drinking enough fluids
  4. Severe or persistent vomiting
  5. Not waking up or not interacting
  6. Being so irritable that the child does not want to be held
  7. Flu-like symptoms improve but then return with fever and worse cough

In adults, emergency warning signs that need urgent medical attention include:

  1. Difficulty breathing or shortness of breath
  2. Pain or pressure in the chest or abdomen
  3. Sudden dizziness
  4. Confusion
  5. Severe or persistent vomiting
  6. Flu-like symptoms improve but then return with fever and worse cough

Take these everyday steps to protect your health:

  1. Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
  2. Wash your hands often with soap and water, especially after you cough or sneeze.
  3. Avoid touching your eyes, nose or mouth when not needed. Germs spread this way.
  4. Try to avoid close contact with sick people.
  5. Stay home if you are sick for a few days after your symptoms begin or until you have been symptom-free for 24 hours, whichever is longer. This is to keep from infecting others and spreading the virus further.

Tips to handle a ‘Picky Eater’

Many mothers complain about their children being ‘picky eaters’, here are some tips to handle the ‘picky eaters’:

  1. Know the meal timings. Stop juice, snacks etc. at least one hour before meals. If your child comes to the table hungry, he or she may be more motivated to eat.
  2. Don’t get angry. If your child senses that you're unhappy with his or her eating habits, it may become a battle of wills. Threats and punishments only reinforce the power struggle.
  3. Don't expect the child to eat too much. After age 2, slower growth often reduces a child's appetite. A few bites may be all it takes for your child to feel full.
  4. Respect your child's hunger — or lack thereof. If your child is not hungry, don't force a meal or snack.
  5. Limit liquid food intake as the child grow. If your child fills up on milk or juice, he or she may have no room for meals or snacks.
  6. Start in small portions and offer variety. Offer several foods in small portions. Let your child choose what he or she eats.
  7. Be very patient with new foods. Young children often touch or smell new foods, and may even put tiny bits in their mouths and then take them back out again. Most children may need repeated exposure a number of times to a new food before he or she start liking it.
  8. Involve you child in shopping and cooking. At the super market, ask your child to help you select fruits, vegetables and other healthy foods. Don't buy anything that you don't want your child to eat. At home, encourage your child to help you wash vegetables, stir or set the table.
  9. Set a good example for the child. If you eat a variety of healthy foods, your child is more likely to follow your example
  10. Stick to the routine as much as possible. Serve meals and snacks at about the same times every day. If the kitchen is closed at other times, your child may be more likely to eat what's served for meals and snacks.
  11. Minimize distractions at meal times. Turn off the television during meals, and don't allow books or toys at the meal table.
  12. Don't offer chocolate or candy or sweets as a reward for finishing their meals. Or redefine dessert as fruit, yogurt or other healthy choices.
  13. Everyone has food preferences. Don't expect your child to like everything. Expect some food preferences to stick. As kids mature, they tend to become less picky about food.
  14. Know when to seek help from a doctor. If your child is energetic and growing, he or she is probably doing fine.




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