Friday, April 29, 2005

In the summertime: Nosebleeds

Summertime brings about quite a few problems in kids; however not many appear as threatening (but are generally harmless) as nosebleeds. It is a common sight for a busy pediatrician to be confronted with panicky parents carrying a bloodstained handkerchief and a crying child.
The good news is that almost all cases of nosebleeds in an otherwise healthy child are medically not serious.
So why does my child get a nose bleed?
The nose has a thin lining (mucosa) that covers blood vessels lying inside the nose. This can often break if a child digs his nose, puts some foreign object in the nose, has cold or allergy or sneezes heavily, or suffers an injury to the nose. Another common reason is dry air that leads to the nasal mucosa getting crusted and bleeding.
Why does this happen in the summers?
As mentioned above, dry weather (either summers or winters) can cause nasal bleed.
Are there any serious causes of nasal bleeds?
Rarely, a nose bleed may suggest something amiss with the body's blood clotting ability. You may find the child having easy bruisability over the rest of the body in this case. Also any nasal bleeds after trauma need to be seen by an ENT specialist. Rarely, high blood pressure can cause nose bleeds.
How do I manage nose bleeds in my child?
Ask the child to lean forward and spit out the blood.
Apply pressure to the soft part of the nose and pinch it for 10 minutes.
If after 10 minutes there is till persisting bleeding, insert a gauze piece covered with vasocontrictor nasal drops (like nasivion/ otrivin etc.) and press for another 10 minutes.
If the bleed still persists go to a doctor, while still keeping the nose pinched.
DO NOT press on the bony part of the nose;
DO NOT apply a cold washcloth on the forehead;
DO NOT pack the nose (as when trying to remove the pack the bleeding invariably restarts).
How can i prevent recurrent nosebleeds?
Apply some amount of petroleum jelly on the center wall inside the nose with a cotton applicator an ear bud will do just fine)
HUMIDIFY your room, a lot of AC and/or dry weather can cause recurrent nosebleeds. A desert cooler is a much better option in the summers.
Put saline drops / warm water in the nose before blowing, and continue saline drops for a few days after an episode of nasal bleed.
Get any nasal allergies treated.
Never blow your nose with excessive force.
Sometimes taking Vit C/ Zinc supplements may help in reducing recurrent nasal bleeds.

Friday, April 08, 2005

Masturbation in Preschool children!

I recently had a 3 year old child from Canada. The parents that thier child had possibly a recurrent pinworm infection (as stated by their health care provider). On detailed questioning it was found that the child enjoyed rubbing her genitals againt any surface, as opposed to scratching with her fingers. This suggested a diagnosis of masturbation.
The following information is by Dr. Barton Schmitt, and taken from the Virtual hospital website. This may come as a shock, but it is estimated that almost 30% of toddlers and preschoolers masturbate. Masturbation is self-stimulation of the genitals for pleasure and self-comfort. It is a normal, healthy activity at any age. During masturbation, children usually rub themselves with their hands. Girls may rock against an object such as a stuffed animal or pillow. Children usually appear dazed, flushed, and preoccupied while they are masturbating. These children have discovered masturbation during normal exploration of their bodies and it continues because it feels good. Masturbation becomes frequent only if the child is pressured to stop. That invites a power struggle.
Try these approaches instead:
• First, set realistic goals. It's impossible to eliminate masturbation. All that you can control is where it occurs. Accept it in the bedroom or bathroom or at nap time.
• Second, ignore masturbation at naptime or at bedtime. Don't check on your child at these times.
• Third, distract your child from masturbation at other times. Try a toy or a new activity. If this fails, send your child to his room. You can't ignore it, or your child will feel he can masturbate anywhere. Your child will catch on to privacy and modesty somewhere between the ages of four and six.
• Fourth, be sure no one punishes your child for this. It's counterproductive.
• Finally, if you're having trouble accepting this normal behavior, talk with your child's doctor.
My suggestion:
Please remember that there is no sexual element in preschooler masturbation, it is just a pleasurable sensation generated by self-exploration, do not let your guilt, feeling about sex influence your atitude towards the child. Try to be nonchalant about the whole thing, and inform the child that it is inappropriate to carry out this activity in public. In a way, it would be equivalent to thumb-sucking or any similar activity that the child indulges in while he is bored or alone.
You can get more information about common pediatric disease at Charak Clinics