The San Luis Obispo Children's Museum wants your Questions about children's health to be answered by an expert!
I've been reading a lot lately about the negative effects of
fluoride when taken internally. Should I opt my kids out of taking flouride
drops if we are on city water? Is there anything specific I should be
concerned about with fluoride for kids?
This is a great question, and unfortunately may not have a perfect answer.
While many concerns have been raised about fluoridation of drinking water,
overall this has had a huge public health benefit. We know that fluoride
strengthens teeth, preventing and perhaps reversing decay. The benefit is
especially pronounced for kids who don't have access to good dental care.
From your question, it seems you are concerned about any negative health
effects of fluoride. This has been studied extensively, and when the
studies are analyzed, the only consistent problem seems to be dental
fluorosis, tiny white stains on the teeth. These are usually so small that
they go unnoticed. The American Academy of Pediatrics universally
recommends fluoride for kids over 6 months of age.
The more complicated question is how much fluoride a particular child is
getting, and whether getting more would provide additional benefit. Each
city in SLO County has a different amount of fluoride in its water (and in
some cities it varies from one block to the next). Each child drinks a
different amount of water. Some kids drink bottled water, and some are on
well water - both of which can also have fluoride. Some families have
reverse osmosis filters on their drinking water, which effectively remove
all fluoride.
I tend to take a fairly practical approach to this question. First, is the
child at high risk - do they eat a lot of sweets, do they lack the resources
to get good dental care, or is there a family history of early cavities? If
so, I am more likely to promote supplemental fluoride, since it's more
likely to benefit that particular child. Second, do I see any evidence of
decay on exam? Not only would that prompt a dental referral, but I would
also then prescribe fluoride.
The bottom line - your dentist and/or pediatrician can help assess risk, and
it makes sense to supplement if the risk of cavities outweighs the very
small risk of fluorosis.
Is it too late in the season to get my children flu shots?
No, it's not too late at all. In fact, it looks like we're having a "late" flu season this winter - meaning that we haven't seen widespread flu yet, so the season will likely peak in February or even March. Check with your pediatrician to see whether they still have any of the vaccine left. If not, the Public Health Department is a good backup.
I understand my eleven year old needs a whooping cough vaccine in order to start school. Is this vaccine proven safe? Can I opt out? - Sarah
The TDaP vannine covers tetanus, diptheria and pertussis (whooping cough). Most children have had several doses of the vaccine (also know as DTaP) as infants and before starting Kindergarten. Unfortunately, the immunity does not last for a lifetime, so periodic boosters are needed to keep up the immune response.
Many parents have received notices from their kids' schools requiring proof of the TDaP vaccine for school entry. This booster is recommended at age 10-11 and every 10 years thereafter. The vaccine is extremely safe and has been available to the public for many years. Typically, pre-teen patients might have mild soreness or a small bump at the injection site; other reactions are exceedingly rate.
We are so concerned about whooping cough for a few reasons. First, it is highly contagious. Second, it often look like a typical viral cold for the first couple of weeks, during which time the infected individual can spread it to close contacts. Third, treatment merely stops the spread - the affected person will continue to have severe cough, often for a few months. There have been many cases of kids and adults who have coughed so hard that they have broken ribs!
Lastly, and most importantly, this vaccine is important because of the potential for harm to very young infants, especially those who are too young to be vaccinated. The infection causes suppression of breathing, blue spells during which the oxygen level falls dangerously low and can lead to death if the infant is not hospitalized quickly.
For these reasons, I highly recommend the vaccine to my pre-teen patients.
My two year old is tugging at her ear and unusually fussy. Could this be an earache? Does she need to be seen by a pediatrician?
-Georgia
Absolutely, ear tugging and fussiness can be related to an ear infection. The first question is whether your child has a history of frequent ear
infections in the past. If so, it's always best to err on the side of
caution and get her checked by her doctor.
A typical ear infection will start with a viral cold; the congestion in the
nose leads to buildup of fluid in the middle ear, which can develop into a
true ear infection.
Most kids will also have fever with their ear
infections (though I have seen many exceptions to this rule). So I would
recommend that she be seen if she has had a recent cold, especially if she's
had a fever as well.
What else can cause these symptoms? The most common would be teething - it
sounds like she's the right age for her two-year molars to be coming in. Check for gum swelling and redness behind her first set of molars. You will
have a good sense for how she's responded to teething in the past; if this
is a more severe reaction, it's best to have her seen.
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