Drowning is Not Only a Summertime Problem

By Caren Kirschner, M.D.

As pediatricians, part of our goal is to help prevent injuries and fatalities in our patients. Recently, the American Academy of Pediatrics has highlighted new information on drowning prevention. I think it is important to review some of this information with our families.

Sadly, approximately 900 U.S. children die every year from drowning. Drowning is the single leading cause of injury-related deaths among children aged 1 through 4. It is the third leading cause of injury-related death in children aged 5 through 19. It is deadly because it happens quickly and silently.

Most drowning in babies and toddlers occur in bathtubs and buckets of water. Fifteen to 30% of careful caretakers report leaving their children younger than two for a period of one to five minutes alone in the bathtub. Children can never be unsupervised when in or around bathtubs or buckets even for a second. The caretaker should always be no farther than an arms-length away, and other children like siblings should not be left to supervise. In addition, bath seats and rings are problematic because they can tip over when suction cups fail and cause bodily entrapment which can lead to drowning.

During the toddler years, most drownings occur in swimming pools. All pools, whether inground and above ground, need to be surrounded by a four-sided fence. Barrier fences should not have accessible steps or ladders. Portable inflatable pools are particularly worrisome since they generally do not have fences around them and sometimes are filled with water for weeks at a time.

It is crucially important that all children learn how to swim. It has been demonstrated that children age 2 through 4 are able to acquire the skills for swimming and most children are developmentally ready at age 4.5 years. By age 5 to 6 most, children are capable of swimming front crawl. As you may recall from your child’s well-visit, this is an issue we feel is important to discuss.

When children are playing near water of any type, a “water watcher” should be assigned. This person pays constant attention to the children with absolutely no distractions like cell phones. Adults should take turns being the “water watcher.” Many times, parents overestimate their child’s swimming ability. It is important to note that “floaties” and “swimmies” are unreliable and can impart a false sense of security. They can easily fall off or malfunction. When children are in boats, they should always wear a Coast Guard approved life jacket. These have been proven to decrease the amount of boat related drownings.

Welcome Julie Shubert CRNP, CPNP

For patients and their families who have come to the office since April, they may have met our newest nurse practitioner Julie Shubert.

Julie spent her early childhood in the Midwest but went to high school locally at Council Rock in Newtown, PA.  She has dual undergraduate degrees in Economics and Nursing after attending both the University of Massachusetts and University of Delaware. She has worked in research at the Wistar Institute and the Hospital of the University of Pennsylvania.

For the past seven years, Julie has worked for The Children’s Hospital of Philadelphia. In 2019, she graduated from University of Pennsylvania with her Master’s in Nursing and is a member of the National Association of Pediatric Nurse Practitioners. 

Julie lives in Burlington County, NJ, with her two sons and their dog Wrigley. And, yes they are a baseball family. When not working, Julie enjoys spending time outdoors, traveling, going to the shore, attending Phillies games, and of course, Eagles games!

Tips for Getting Your Child to Wear a Mask

By Yuliya Bilan Yu, MSN, CRNP

Current guidelines recommend that all children ages 2 and older wear a mask at school or daycare, or when indoors in other public places to prevent the spread of COVID-19. As a parent of two young children, I understand that it can sometimes be a challenge to get your little one to put on a mask and consistently keep in on. Fortunately, there are some things we can do to make this process a little easier.

Involve your child in making or selecting their mask and make sure it fits comfortably

Your child might be more likely to wear a mask if it has their favorite color, character, or special interest on it. There are many sites online, such as oldnavy.com and etsy.com that sell children’s masks with different patterns. To make the mask more comfortable, especially when wearing it several hours each day at school, consider getting face mask extenders or ear savers. These put pressure on the back of the head instead of on the back of the ears. Another option is using a headband with buttons that the mask attaches on. When choosing a mask, make sure that it fits snugly around the mouth and nose. Gaiters used to be recommended as a comfortable alternative for kids; however, new research shows that gaiters are not as effective in stopping the spread of disease.

Prepare your child for wearing a mask

Consistently keeping a mask on may take repeated preparation and practice.

Talk to your child why it is important to wear a mask and try to make the explanation positive. For example, you might say “Masks help keep us safe from the virus. When we wear a mask, the virus can’t jump from person to person.” You can also make comparisons to other healthy habits in your daily life that help prevent illness, such as handwashing or wearing weather-appropriate clothes.

Point out to your child how you wear your own mask and watch their reaction. Also note how your child reacts to others wearing a mask. Some children might find strangers wearing a mask a little scary. If this is the case, you can show your child pictures of other people wearing masks and talk about it. This will help them see it as more normal and put them more at ease in different social settings. You can also involve your child’s favorite toys and stuffed animals in wearing a mask. Younger children often appreciate a playful approach to mask wearing.

Once your child is comfortable wearing their mask for a little while, try to extend the time while they are engaged in their favorite activity, such as going for a walk or watching a favorite show. It can take some time to adjust to the longer mask-wearing periods and this is normal. If your child feels anxious or uncomfortable wearing a mask for an extended time, teach them relaxation techniques such as taking deep breaths or relaxing all the muscles in their body. Also encourage them to talk about their feelings and concerns.

Consistency, breaks, and rewards

You might find it helpful to set clear rules for your child about when, where, and why they need to wear a mask. Some children understand this better with visuals, such as pictures or videos. Reviewing the rules each time the family goes out could also work.

Young children often need frequent breaks when wearing a mask. Talking to a child about breaks ahead of time can help them keep the mask on for the expected timeframe. For example, you might say, “We are going to keep our masks on at the store while we get a few grocery items and after that we will go outside and can take off our masks.” Staying well hydrated is also important in preventing illness, so let your child know it is ok to take off their mask to quickly drink some water when feeling thirsty.

For many children, rewards can go a long way in getting them to wear a mask. Let your child know what they can earn for doing a good job in keeping their mask on. You may need to set this up ahead of the outing or bring something with you that could be given as a reward.

For more resources and information on masks, check out:

https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/about-face-coverings.html

https://www.healthychildren.org/English/health-issues/conditions/COVID-19/Pages/Cloth-Face-Coverings-for-Children-During-COVID-19.aspx

Meningitis B Vaccine Recommended for College Students

By Timothy Flynn, M.D.

In the past decade there have been at least 14 outbreaks of a particular bacteria called serotype B Neisseria meningitidis (meningitis B) on college campuses throughout the country.  These outbreaks tend to be relatively small, but young adults who become infected can become critically ill and some suffer long term health consequences or even die. Students who live on campus are most at risk for getting sick. The meningitis B vaccine is required by one local college and recommended by several others in the Philadelphia area. 

It is important to realize that the meningitis B vaccine is different than the meningitis vaccine that children get at ages 11 and 16 years old. The vaccines are different and the childhood vaccine does not protect young adults from the type of bacteria that causes these outbreaks. 

If you have questions about the status of your child’s vaccinations or to schedule a meningitis B vaccine please call our office.