Just wanted to give a plug to my friend Tyler from Portland, OR. He is a terrific song writer and has a new CD out. Here is a link to his site where you can listen to and buy his music. One of my favorite songs is “better be us all”. Check it out.
October 20, 2008
Okay, so I spoke too soon on my last post regarding Anna’s sleep habits. Just a few days later after writing that she began waking up again 1-3 times a night. She also shortly there after developed a runny nose, which has progressed to a cough, irritability and sleeplessness. Last night she wouldn’t even stand to be put to bed down in her crib and ended up sleeping with us for most of the night. She was terribly irritable today so I took her into Urgent care to see if she had an ear infection and low in behold the poor little one does.
For those of you with kids out there I am sure you have all dealt with many colds and illness with your little ones. It can be quite troubling seeing them sick and it can be quite tiring for us trying to care for them. (especially when no one is getting sleep). I thought this would be a good idea to bring up the American Academy of Pediatrics current guidelines for treating middle ear infections/otitis media. The literature shows that the majority of these kids get better on their own without antibiotics and that a watchful waiting approach is acceptable in kiddos older than 6 mos old ( who are otherwise healthy). Patients seem to usually want antibiotics for every little cold or sniffle and it is that mind frame that has caused our widespread problems with antibiotic resistance.
American Academy of Pediatrics and American Academy of Family Physicians
Question and Answers on Acute Otitis Media (Posted: March 9, 2004)
The following Frequently Asked Questions” (FAQs) are from the American Academy of Pediatrics (AAP). Feel free to excerpt these FAQs or use them in their entirety for distribution to your families. Please attribute these FAQs to the American Academy of Pediatrics
What are the new guidelines?
The new guidelines define acute otitis media (AOM), or middle ear infections, and outline appropriate diagnosis and treatment standards – including pain management – based on a child’s age and other factors.
Why were these new guidelines developed?
Acute otitis media (AOM) is the most common bacterial illness in children and the one most commonly treated with antibiotics. There has been a significant increase in, and concern about antibacterial resistance of the organisms that cause AOM. These factors suggested the need for a detailed evaluation of AOM and its management.
While the number of office visits for otitis media with effusion – middle ear fluid – (OME) have decreased over the past decade from 25 million in 1990 to just 16 million in 2000, the number of antibiotic prescriptions to treat AOM has remained constant. At the same time, concerns about the rising rate of antibiotic – or antibacterial – use and resistance have emerged.
What do the new guidelines recommend?
- Accurately diagnose AOM and differentiate it from OME, which requires different management.
- Relieve pain, especially in the first 24 hours, with ibuprofen or acetaminophen.
- Minimize antibiotic side effects by giving parents of select children the option of fighting the infection on their own for 48-72 hours, then starting antibiotics if they do not improve.
- Prescribe initial antibiotics for children who are likely to benefit the most from treatment.
- Encourage families to prevent AOM by reducing risk factors. For babies and infants these include breastfeeding for at least six months, avoiding “bottle propping,” and eliminating exposure to passive tobacco smoke.
- If antibiotic treatment is agreed upon, the clinician should prescribe amoxicillin for most children.
Do the guidelines apply to all children?
No. The guidelines apply only to an otherwise healthy child without underlying conditions that may alter the natural course of AOM. These conditions include, but are not limited to, anatomic abnormalities such as cleft palate, genetic conditions such as Down syndrome, immune system disorders, and cochlear implants. Also excluded are children with a clinical recurrence of AOM within 30 days or AOM with underlying chronic OME.
What is acute otitis media?
A diagnosis of acute otitis media requires:
- Recent, usually abrupt, onset of illness.
- The presence of middle ear fluid, or effusion.
- Signs or symptoms of middle ear inflammation.
Over 5 million AOM cases occur annually in US children, resulting in more than 10 million annual antibiotic prescriptions and about 30 million annual visits to doctor’s offices. Fifty percent of antibiotics for preschoolers in the US are prescribed for ear infections. Using an observation option could reduce antibiotic prescriptions annually by up to 3 million and would significantly reduce the prevalence of resistant bacteria.
What are the harmful effects of antibiotics?
Each course of antibiotic given to a child can make future infections more difficult to treat. The result is an increase in the use of a larger range of – and generally more expensive – antibiotics. In addition, the benefit of antibiotics for AOM is small on average, and must be balanced against potential harm of therapy. About 15 percent of children who take antibiotics suffer from diarrhea or vomiting and up to 5 percent have allergic reactions, which can be serious or life threatening. The average preschooler carries around 1 to 2 pounds of bacteria – about 5 percent of his or her body weight. These bacteria have 3.5 billion years of experience in resisting and surviving environmental challenges. Resistant bacteria in a child can be passed to siblings, other family members, neighbors, and peers in group-care or school settings.
When should antibiotics be prescribed?
- For children age 6 months and younger – for certain or suspected AOM.
- Children age 6 months to 2 years – for certain AOM or suspected AOM with severe symptoms; observation is an option for suspected or uncertain AOM if non-severe.
- Children age 2 to 12 years – antibiotic treatment for certain AOM with severe symptoms; observation is an option for suspected or non-severe AOM.
The guideline provides an option to observe select children and only start antibiotic treatment if symptoms have not improved in 48-72 hours. Approximately 80 percent of children with AOM get better without antibiotics. And children whose ear infections are not treated immediately with antibiotics are not likely to develop a serious illness.
What if a child with a middle ear infection is in great pain and discomfort?
The mainstay of pain management for AOM is medications such as acetominophen and ibuprofen, not antibiotics. Most children with AOM have significant ear pain, which may manifest in young children as ear rubbing, sleep disruption, or temper tantrums. Analgesics are most important in the first 24 hours after diagnosis, especially before the child’s bedtime. Fortunately, by 24 hours about 60 percent of children feel better, rising to 80-90 percent within a few days. Antibiotics do not relieve pain in the first 24 hours, and have only a small effect after that.
Is my child at risk for developing other infections if she is not treated with antibiotics?
Published trials of observation, placebo, or non-antibiotic AOM therapy have shown no increased rate of complications, provided that children are followed carefully and receive antibiotics if symptoms persist or worsen. These studies vary in the age of children studied and the severity of illness, factors taken into consideration in determining which children are suitable for the observation option.
Bottled water safety concerns. October 20, 2008
Not only is bottled water a concern for the environment as it is filling up landfills across the world, but it may not be the best choice when it comes to drinking water. It appears as if drinking just plain old filtered tap water from your faucet is healthier than bottled water.
Bottled Water: Buyer Beware
It’s just what we’ve all suspected – pure, “straight from the mountains” bottled water is not so pure after all. Yesterday, EWG released an industry-rattling report that reveals the dirty truth about bottled water.
We tested 10 brands and found an alarming array of contaminants, including cancer-causing byproducts of chlorination, fertilizer residue, industrial solvents and even caffeine.
In light of these disturbing findings, here’s what you can do:
• Drink filtered tap water instead of bottled or unfiltered tap water.
• Mix infant formula with filtered, non-fluoridated water.
• Carry water in safe, reusable containers.
Read the full report or download our handy guide to safe drinking water for more tips.
sleeping through the night? October 12, 2008
I was looking back at previous posts I had written. Back in June I was so darn smitten with myself because Anna had slept through the night at 11 weeks old. I had thought–oh my gosh, she is doing what all the books say a baby will do… yeah! However, that only last 1-2 more night and then it was right back to waking 1-2 times a night. She is now 6.5 mos old and for the first time again since 11 weeks old, is sleeping through the night. We have had 5 nights in a row now. However, the one thing that I have learned about motherhood/parenthood is: the only constant is change. She may sleep through the night but low and behold I know there will be things that are going to sideline this. Things such as an illness, or teething, or maybe even just learning something new that day. None the less, it has been a welcomed pleasure of ours to have some sleep again. ah. Now, I have also learned in my wise old wisdom of being a mom for 6.5 mos now that you have to do what is right for you and your family. No book is going to teach you that. And no book is 100% right about how YOU should parent. I actually got quite stressed out in reading some of those books and eventually through them out the window because they were interfering with my own intuition. In regards to Anna sleeping though the night, I suppose I could have done what one of the book said to do…let her cry it out. I tried it a little and it didn’t feel right. Wwhy should I leave her alone in her crib to cry when I can easily go calm her. I wasnt spoiling her or creating bad sleeping habits. I was being there for her when she needed me. I was instilling trust into our relationship. And look, now she sleeps through the night on her own.
green baby October 9, 2008
For those of you interested in trying to live a more”green” life for both you and your baby here is new website/blog I have found. Worth checking it out.
I have to say I don’t always live the most green life possible but I do try to make better decisions when I have the opportunity. For one, I feel all of us should avoid plastic bags. When we go the grocery store or shopping there is absolutely no need to use plastic. Those bags are not biodegradable nor can you recycle them. If you care about the earth at all and what the earth may look like it 30-40 years for our children and grandchildren, then you should stop using plastic bags. I recommend bringing you own bags that you can use time and time again. What I have found is that you can fit more into these reusable bags, they are easier to carry and they don’t harm the environment. If you forget to bring your own bag, then at least opt for paper which is recycle-able.
