Pediatrics

Preventing an illness is better than trying to treat it once it has begun. For some diseases there aren’t any good treatment available, including many illnesses caused by viruses. The childhood immunization schedule recommends vaccines at most of the well check visits in the first two years of a child’s life. Depending on which vaccines your doctor uses, the schedule can include anywhere from one to four vaccines per visit, and a total of 27 doses of 10 different vaccines. Nobody likes the pain of shots — so whenever possible combination vaccines are recommended. This will cut down on the number of shots your baby will receive, while making sure they’re well protected against all of those infectious diseases. It would be a great idea to give all immunizations in one shot, and whenever possible they are combined, but not all vaccines work well when combined.

Infants have frequent checkups to follow growth and development in the first two years of life. Giving immunizations at these visits makes it likely that they will get all their vaccines on time. But the most important reason to give these vaccines then is because the first two years are when children are at highest risk of getting very ill from these infections. For example, Pertussis (Whooping Cough) occurs frequently in adults and teenagers. It is a long and difficult illness, but is usually not serious. In babies it can lead to severe illness and death. Other illnesses, like Hib Meningitis or Pneumococcal infections, occur at any age but are more frequent and serious in babies under 2.

Many different viruses cause upper respiratory infections or the “common cold.” Children can get 8 to 10 colds per year, mostly in winter. With each cold lasting one to two weeks, that means two to four months of continuous illness! Many children have one cold right after another, which can make it seem like they have a cold that lasts for months. This often happens to young children in daycare or preschool. Older children have built up some resistance to common viruses, and get well more quickly.

It can be hard to tell the difference between allergies and recurrent colds. There are clues that your child’s runny nose is allergies. These are: no fever, sneezing, itchy eyes or nose, and clear mucus that stays clear instead of following the usual pattern for a cold: clear mucus that becomes yellow or green and then clear again. A typical cold will follow this pattern over the course of a week or two. Allergies are more common in Spring and Fall, when pollens are being blown around, and usually last for longer.

Many parents worry that their children, especially toddlers and preschoolers, are not eating enough. It is normal for a child’s appetite to vary – sometimes they eat, and sometimes they don’t. You may notice that when your child is going through a growth spurt, their appetite goes up to provide the calories they need to grow. By the same token, when they aren’t growing very much, their appetite goes down.

Children learn eating habits early. It’s important that you let your child decide how much to eat, and you decide what they eat. They may prefer sweets or snack foods, but should learn to like healthy foods, eat when they are hungry, and stop when they are full. This is why it’s important to focus on what your child eats – it’s better for them to eat a small amount of a healthy food than a lot of a sugary cereal or salty crackers. If they are filling up on crunchy snacks or milk, they won’t be hungry when it’s mealtime. Make sure to limit those, as well as sugary treats. Offer your child a variety of foods, including cereal, rice, pasta and bread, milk, yogurt, cheese, meat, chicken, fish, beans, eggs and lots of fruits and vegetables. Make sure they have regular meal and snack times every day. They will eat as much as they need, even if sometimes it doesn’t seem that way.

Babies over six months who are mostly breastfed and are not eating iron fortified baby cereal every day should take a multivitamin with iron until they begin eating different foods that are high in iron. Breastfed babies also need a good source of Vitamin D in their diet. Vitamin D can be given in a multivitamin, or through sensible sun exposure for mom and baby – this is about half an hour, in the middle of the day, two to three days a week. You should have some skin exposed – arms and legs are best, and no sunscreen until after your “Vitamin D session” is over.

Older children can get all of the vitamins and minerals they need from their diet if there is variety in what they eat, including fruits and vegetables. Vitamins are not a bad idea, but they are no substitute for a balanced and varied diet.