My Blog
By Charles H Geneslaw, MD
November 05, 2018
Category: Child Health
Tags: Child Care   Cold   Flu  

Cold Vs. Flu

Is it a cold or the flu? When it comes to your child's health, your pediatrician provides great information and guidance on the most common illnesses plaguing families. If you are wondering about the exact nature of your child's illness and how to treat it, learn the differences between a cold and the flu and how to treat and prevent them.

What is a cold?

A cold is an upper respiratory viral infection lasting 5 to 7 days in both adults and children alike. Generally milder in intensity and shorter in duration than influenza, a cold causes:

  • Coughing
  • Sneezing
  • Watery eyes
  • A runny nose
  • Tiredness
  • Low-grade fever
The Centers for Disease Control states that most healthy children experience 8 to 10 colds by the age of two years.
 
What is the flu?
 
The flu is a much more serious viral infection. Of sudden and intense onset, the flu usually comes with:
  • High fever
  • Body aches
  • Cough
  • Extreme tiredness
  • Severe headache
  • Chills
Also, the flu lasts longer and debilitates sufferers. It carries dangerous complications, particularly with young children, the elderly, asthmatics, diabetics and those with weak immune systems.
 
Treating colds and the flu
 
Treating a cold involves rest, fluids and decongestants as needed. The onset of a cold is gradual, and so is recovery. Typically, your child will not need to visit the pediatrician if he or she has a simple cold. Simple symptom relief works well. However, high and persistent fever merits a call to your child's doctor.
 
Regarding the flu, your pediatrician may do an in-office Rapid Influenza Diagnostic Test (a throat or nasal swab) to confirm the diagnosis. They may prescribe antiviral medication and instruct on how to monitor a young child's symptoms. Keep your youngster well-hydrated, and administer acetaminophen or ibuprofen as directed.
 
If flu symptoms escalate (labored respirations, severe headache, rapid heart rate or anything that seems unusual to you), take your child to the nearest hospital ER for evaluation. Pneumonia is a frequent and life-threatening complication of influenza.
 
Prevention is the best medicine
 
Protect all members of the family with these simple measures:
  1. Eat a healthy diet.
  2. Stay well-hydrated.
  3. Avoid crowds during peak cold and flu season.
  4. Keep your child home from daycare and school if he or she is sick.
  5. Teach your child to cover his or her mouth when coughing or sneezing.
  6. Don't share food or utensils, even with family members.
  7. Vaccinate against the flu. Ask your pediatrician for your child's "shot."
Trust your pediatrician
 
They work hard to prevent acute illnesses such as colds and the flu. The doctor and professional team are great resources for prevention, healing and overall well-being for your children.
By Charles H Geneslaw, MD
October 24, 2018
Category: Uncategorized
Tags: Untagged

Let’s really go back to the very beginning and review some basics of baby formula preparation. Of course, we pediatricians still advise that the best infant nutrition is breastfeeding, but at some point most babies’ diets will likely include some formula. The AAP recommends the following:

  1. Prepare the formula according to the manufacturer’s directions ONLY. DO NOT dilute the formula (to save money) or concentrate it (to increase calorie concentration). Both can cause diarrhea at least and sometimes disruption of blood electrolyte levels like sodium and potassium which can lead to severe problems with normal nerve or heart function.
  2. Make sure the water source is safe. If your home has well water, it’s best to boil the water for 1 minute (“rolling boil”) and then allow 30 minutes to cool before mixing your formula.
  3. Be careful to maintain proper formula temperature. Use a bottle warmer or place the bottle in a container of hot water for 5-10 minutes. It is best not to microwave the bottle. Microwaving can heat the insides of any container in an uneven fashion which can cause burns, and also it can disrupt the nutritional value of some formula ingredients. At any rate, its best to always check the formula temperature on yourself prior to giving it to the baby.
  4. “Cleanliness is next to Gdliness.” Always wash your hands prior to preparing or feeding your baby. Wash all countertops and surfaces carefully. A dishwasher will not clean the inside of a long, thin bottle very well, so wash by hand using a bottle brush for the inside. Bottles and nipples should all be cleaned with hot, soapy water and be sure to rinse all soap off thoroughly. By the way, best to boil nipples for approximately 10 minutes prior to using for the first time. This is not for cleanliness as much as to boil off residue of chemicals used to soften the rubber.
  5. Be aware of proper storage times. All leftover formula should be discarded 1 hour after feeding to the baby. Powder based preparations can be refrigerated for 24 hours; bottles of unused concentrate can be refrigerated for 48 hours prior to usage.

As stated initially, breastfeeding is still best and what I and all pediatricians recommend as the first line nutritional source for your baby’s best health. This seems like a good place for me to give a shout out to Dr. Rose St. Fleur and my colleagues at the Center for Breastfeeding at Jersey Shore Medical Center. They can be reached at 732-776-3329 and are an excellent resource/clearinghouse for questions from nursing mothers. Tell them Dr. G sent you (they won’t care).

By Charles H Geneslaw, MD
October 17, 2018
Category: Pediatric Health
Tags: Sports Injuries  

Even though you try as hard as possible to keep your child safe while they are playing sports, accidents still happen. At these moments, it’s important that you know whether these are injuries that can easily be treated from the comfort of your own home or whether you need to turn to a pediatrician for proper medical attention.

Pediatricians have seen a lot of sports-related injuries over the years and while we also focus as much of our attention on prevention, we know the importance of being able to get immediate and comprehensive care when your child does sustain an injury.

Common sports-related injuries include:

  • Dislocations (particularly in the shoulder)
  • Traumatic injuries (this includes cuts, sprains and strains, and broken bones)
  • Stress fractures
  • Tendinitis (often in the hand or wrist)
  • Concussion

When a dislocation happens many times it is accompanied by an audible popping sound at the moment that the injury occurred. This unnerving sound is often followed by sudden and intense pain. It’s important that you turn to a pediatrician who can put the shoulder or any other area of the body back in place. The joints of a child’s body are looser than adults, so it makes shoulders and other areas more prone to dislocations.

Minor cuts, sprains, and strains can often be handled with at-home care. In most cases, the RICE method is a great way to ensure that your child gets the rest they need to heal properly and to stay off of the injury until it fully heals. Icing and elevating the injured area can also reduce pain and swelling. Of course, if you suspect that your child has a broken bone, this will need to be evaluated by a medical professional right away.

Children who are serious or long-term athletes are more likely to experience overuse injuries. These injuries occur over time rather than suddenly and they are often the result of performing repetitive movements. Overuse injuries include stress fractures and tendinitis. If your child feels pain whenever they move a certain area of the body or if they notice pain or swelling in a certain area it’s important that they get checked out.

Wearing a helmet is crucial for protecting your child’s head while playing sports. Of course, if your child has received a blow to the head and is experiencing dizziness, fatigue, frequent or severe headaches or just seems out of sorts it’s crucial that you bring them in right away to see if they’ve incurred a concussion.

When in doubt, pick up the phone and talk to a pediatrician about your child’s injuries and symptoms. They will be able to determine whether or not they should come in for proper care.

By Charles H Geneslaw, MD
October 01, 2018
Category: Pediatrics
Tags: Child Care   Sports Physical   Sports  

Your child is eager to start the school year so they can participate in sports. That’s great news! Keeping your child active is an important part of a healthy lifestyle and sports can be a great experience for many children; however, it’s also important that your child’s pediatrician performs a yearly sports physical to make sure that they are ready for physical activity.

A sports physical is necessary for every child regardless of their current health. In fact, some schools make it mandatory for children to get an annual sports physical before they participate in any school sports. Regardless of whether this physical is mandatory or not, it’s highly advised that all children get a sports physical once a year.

Your child’s sports physical will involve going through their medical history and conducting a physical examination. The physical examination is pretty self-explanatory. We will check their vitals, as well as their height and weight. We will perform a vision test and evaluate everything from their heart and respiratory system to their musculoskeletal system. The goal of a physical exam is to make sure that your child hasn’t incurred any past injuries or developed any health problems that could be exacerbated by physical activity.

A pediatrician can also answer questions and provide counseling on nutrition, healthy weight loss or gain, and habits that could help your child’s physical health. Remember to bring any questions along with you.

Besides the physical examination, we will also sit down with you and your child and ask questions about their medical history. It’s important to be as detailed as possible. If it’s the first time they are having a sports physical it’s important to bring in a list of any supplements or medications (both over-the-counter or prescription) that they are currently taking.

We will ask a series of questions to find out if there are any serious or chronic health problems that run in the family, if your child has experienced any past injuries, if they’ve ever undergone surgery or been hospitalized, if they have any allergies or if they have any current disorders or illnesses. It’s important to provide as much detailed history as possible so that our pediatric team can perform a thorough and comprehensive physical.

Don’t wait until the last minute to schedule your child’s sports physical. It’s important to get your child on the books before the summer is gone and the doctor’s schedule fills up. You don’t want your child being benched during the season because they didn’t get a sports physical. Call your pediatrician today.

By Charles H Geneslaw, MD
September 26, 2018
Category: Uncategorized
Tags: Untagged

OK, I may make some enemies in our community with what I am about to say, but here goes. There is a growing consensus among health professionals who care for children–including pediatricians like me, neurologists, radiologists, and others–that organized tackle football should be avoided in younger players. Children have larger heads and weaker neck muscles compared to adults, making collisions riskier. Moreover, younger, less experienced players more often utilize poorer tackling technique which also raises the risk threshold. While hard shell helmets do limit skull fractures, the evidence regarding concussion prevention is actually quite poor.

Of course, at these younger ages the brain is still developing. Researchers at Wake Forest Medical School recently followed children 8-13 yrs during football season with MRI scans. None of the boys had developed concussion symptoms during the study period, yet their scans showed subtle but clear disruptions of normal brain metabolism from pre to post season. Related studies done at Boston University Medical School looked at former NFL players and found that those who had started in the sport < 12 years old had a significantly higher incidence of “white matter” brain changes and more frequent difficulties with depression, cognitive impairment and behavioral problems in later life. There are additional studies reporting similar patterns in people playing other contact sports from an early age compared to those who did not.

So where does that leave us? Well, I am certainly NOT “anti-football”(well, maybe anti-NE Patriots, but anyway…). > 1 million boys play high school football. As I spend a good part of my time begging/yelling at my teen patients to get off their darn phones and to be more active, I strongly support this and all high school sports. Presently there are approximately 1.2 million US 9-12 year olds playing youth football (numbers have decreased in the last few years because of these concerns) and those kids sustain approximately 240-585 head hits each season. Note that youth football is a relatively recent phenomenon–when I was growing up in the 1960’s-70’s it hardly existed. Back then, tackle football was something we played on weekends in the park if we could collect enough guys to make 2 teams. There were no non-HS football “leagues”–tackle or otherwise– to speak of.

We need a new paradigm, and I believe this is where flag football comes in. The nonpartisan Aspen Institute recently issued a White Paper advocating for flag only < 14 years. Here in NJ, Assemblywoman Valerie Vainieri-Huttle (D-Bergen) has introduced a bill (A-3760) that would allow flag football but ban tackle statewide < 12 yrs. Given the above, the arguments against–that teaching younger boys proper tackling technique improves safety–are, at best, unconvincing. I believe this bill deserves serious consideration; personally (and professionally) I support it.

Don’t all yell at me at once– but send along questions and comments, and thanks for following.





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