Tuesday, March 28, 2017

Busting Common Pediatric Myths

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(or How to Mess with your Mother-in-Law)

By Michael Weiss, D.O.
October 2008

The contents of this web site are provided as an informational tool.  This is not intended to replace medical advice or care administered by a healthcare professional.  Common sense should always be used when referencing this site.  If, at any time, you feel your child is experiencing a medical emergency, call 911 immediately.

My child’s runny nose has turned green.  This means she has an “infection” and needs antibiotics.  True or False?

In fact, this is most definitely FALSE. This is the most common old wives tale that pediatricians deal with every day. Most uncomplicated colds will progress to a yellow or green runny nose on or about the 4th to 6th day of the cold. This is an indication that the body is sending white blood cells to attack the viral infection. The green or yellow nose usually lasts 2-3 days and then returns to clear before resolving in a 10-12 day period. If the green runny nose is lasting more than 10-12 days, and is accompanied by a wet cough, you should then seek medical attention as your child may have developed a secondary sinus infection.

My child is 3 years old and has bowed legs and toes that are inturning. My mother-in-law said my husband wore orthopedic shoes and braces for this; does my child need the same?

Almost certainly NOT. All children are born with bowed legs and intoeing. This is a normal phenomenon that will improve with age.  When grandma comes to visit for Christmas and mentions the story about dad, just smile and tell her you love her.  Most children will develop straighter legs by 6-7 years of age.  Signs that would indicate you should see your pediatrician include: asymmetric bowing (one side way more than the other), pain, and tripping over the feet when walking normally (not when running).

I always suggest videotaping your child walk if you are concerned. In about 4-6 months, look again and compare to the video. Usually things are getting better. A small percentage of the population continues to intoe. This is actually a competitive advantage. If you look at most professional basketball and football players, they intoe as well, so get ready for that big contract!

I must keep water and cold air our of my child’s ears to prevent ear infections.  True or False?

Absolutely NOT TRUE.  The classic middle ear infection (otitis media) that most children get in the winter when they have a cold is actually located behind the eardrum in the middle ear space. There is no connection between the outer ear and the middle ear unless the child has ear tubes or has perforated an eardrum. You can pour water in the ear and blow an ice-cold fan in there and it will not cause a middle ear infection. The exception is older children who are continuously swimming in the summer and trap water in the ear canal. This can cause a “swimmers ear” or otitis externa. This is easy to recognize because it happens in the summer and is related to swimming AND it hurts to pull on the ear. So, bottom line, get rid of the hats with earflaps and don’t worry if water drips in your child’s ear during bathing.

If I fill my infant up with a big feeding or start cereal before bed he will sleep through the night.  True or False?

Sorry, also false.  This one has been perpetuated for hundreds of years but never substantiated by any data. What that means is that a study done years ago looked at a number of infants fed either water, formula, breast milk, cereal, or nothing before bed. The researchers then reported which infants slept best. There was NO statistical difference in the duration of sleep between groups. The bottom line is that sleep is a learned process like riding a bike. Infants start to cycle through normal sleep by around 4 months of age, so this is when we need to start letting them “work it out” and fuss themselves back to sleep. This can be a challenge, but it is well worth it in the long run.  The classic book, “Solving Your Child’s Sleep Problems”, by Dr. Richard Ferber, is the resource we most commonly recommend.  Try to avoid rocking or feeding your child to sleep after 4-5 months of age because he will then require that same intervention when he wakes every 3-4 hours as he cycles through normal sleep.  Sweet dreams!

Good luck messing with your mother-in laws head! If you have any questions about these subjects, please feel free to contact our office.