Should my child take sports drinks/ energy drinks after exercise?

The short answer is NO. Plain water is the BEST rehydrating solution for most children doing routine exercises / activities.

For a longer version, read on ...

In India, the fad of sports drinks and energy drinks is fast catching on. For starters, is there any difference between the two?

Yes, Sports drinks contain carbohydrates, minerals, electrolytes, and flavoring, and are intended to replace water and electrolytes lost through sweating during exercise. Although they may be useful for young athletes participating in prolonged, vigorous physical exercise, they tend to be overused and are usually unnecessary. Some brands available in India include Gatorade, Stamina (Amul) and Sofit (Godrej).

Unlike sports drinks, energy drinks contain stimulants including caffeine, guarana, and/or taurine. Rigorous review and analysis of the literature suggest that energy drinks are never appropriate for children or adolescents. Because caffeine has been associated with harmful neurologic (brain) and cardiovascular (heart) effects in children, caffeine-containing beverages, including soda, should be avoided. Energy drinks can make a normal child restless and anxious.The excessive sugar present in these drinks not only adds to the calorie counts, but also acts as a laxative. Energy drink brands available and aggressively marketed in India include Red Bull, XXX & Cloud 9.

For most children engaging in routine physical activity, plain water is the best form of rehydration. Use of sports drinks can increase the risk of obesity and tooth decay, and is not required for routine activity.

Specific AAP (American Academy of Pediatrics) recommendations regarding use of sports drinks and energy drinks in children and adolescents include the following:

• Pediatricians should educate patients and their parents regarding the potential health risks of energy drinks and sports drinks and explain the significant differences between these types of drinks. The terms should not be used interchangeably.
• Energy drinks should never be consumed by children or adolescents, because the stimulants they contain pose potential health risks.
• Children and adolescents should avoid and restrict routine consumption of carbohydrate-containing sports drinks, which can increase the risk for overweight, obesity, and dental erosion.
• For pediatric athletes, sports drinks should be consumed in combination with water during prolonged, vigorous physical activity, when rapid replenishment of carbohydrates and/or electrolytes is needed.
• For children and adolescents, water, not sports drinks, should be the principal source of hydration.

Given the increased awareness and easy availability of these drinks in the Indian Market, pediatricians and parents need to be aware of the potential risks of these drinks.

So what should an active child take if he indulges in vigorous activity?

It's better for children to drink water during and after exercise, and to have the recommended intake of juice and low-fat milk with meals. The recommended intake of juice is 6 oz (~ 180 ml/ 1 small glass) for children 1-2 years, and up to 2 glasses (6-12 oz/ 2 glasses) for older children only.

Suggested reading

http://www.medscape.com/viewarticle/743634?src=mpnews&spon=9 (accessed June 2011)

http://pediatrics.aappublications.org/content/107/5/1210.full (accessed June 2011)

An uncommonly diagnosed common problem in kids - Helping children with voiding dysfunction!

My child wants to go the toilet repeatedly!
She rushes to the toilet, and sometimes passes urine in her underwear!

This is a fairly common complaint in Pediatric Office Practice.

It is the tendency of the Pediatrician & the parent to blame this on a lazy, inattentive child who is simply too busy to stop whatever they are doing. However this can very easily be a sign of voiding dysfunction. Repeated wetting can lead to lower self esteem in a child, so this condition should not be left undiagnosed and untreated.

I am going to use this forum to provide links to some important and helpful articles that are great learning resources for parents & pediatricians.

This is an excellent primer for pediatricians regarding a common problem that we encounter in our practice, voiding dysfunction. Unfortunately we rarely investigate this thoroughly, beyond the usual urine examination, and do not seek specialist consultation, especially in India. This is due to two reasons, first a lack of awareness of the problem of voiding dysfunction, and secondly, since we lack qualified/ interested Pediatric urologist in our country.

Hopefully these articles will educate us regarding this relatively common condition.

"In a study of 7-year-old Swedish schoolchildren, 20% reported needing to get to a bathroom quickly. Additionally, it was reported that 6% of girls and 3.8% of boys continued to have problems with daytime wetting at this age. Upadhyay et al. (2003) found that half of children with dysfunctional voiding symptoms had a history of urinary tract infections."

http://www.medscape.com/viewarticle/507163

http://emedicine.medscape.com/article/1016198-overview

(Please note: Both these articles require free registration)

Dysfunctional voiding refers to an abnormality in either the storage or emptying phase of micturition and is associated with urgency, frequency, incontinence, and UTIs. It is important to distinguish dysfunctional voiding from enuresis. With enuresis, there is normal voiding with complete expulsion of urine at a socially less acceptable time or place. Enuresis occurs more frequently at night (nocturnal), can occur during the day (diurnal), and is usually self-limiting.

Recommended Audience - Pediatrician, Pediatric Urologist, and Family Physicians. While parents can read the article, they may find it technically demanding.

My child is swimming - how do I prevent Swimmer's Ear?

It's summertime, and everyone seems to be hitting the pool.

While swimming is not as prevalent in India, as some of the western countries, it is fast catching up, with the mushrooming societies, wherein a swimming pool is a must. While swimming is a great low impact exercise, it can lead to a few minor medical problems.

Swimmer's ear (also known as otitis externa) is an infection of the outer ear canal that can cause pain and discomfort for swimmers of all ages, more so in children. Symptoms of swimmer’s ear usually appear within a few days of swimming and include Itchiness inside the ear, Redness and swelling of the ear, Pain when the infected ear is tugged or when pressure is placed on the ear, and in advanced cases pus draining from the infected ear. This is not the same thing as a middle ear infection (fluid in the ear).

If you can wiggle/ move the outer ear without pain or discomfort then your ear condition is probably not swimmer's ear.

Swimmer’s ear can occur when water stays in the ear canal for long periods of time, providing the perfect environment for germs to grow and infect the skin. Germs found in pools and at other recreational water venues are one of the most common causes of swimmer’s ear. Swimmer’s ear cannot be spread from one person to another. Swimmer's ear can often be treated with antibiotic ear drops, after consulting your doctor.
Now coming to its prevention,

DO keep your ears as dry as possible.

• Use a bathing cap, ear plugs, or custom-fitted swim molds when swimming to keep water out of your ears.

DO dry your ears thoroughly after swimming or showering.

• Use a towel to dry your ears well.
• Tilt your head to hold each ear facing down to allow water to escape the ear canal.
• Pull your earlobe in different directions while your ear is faced down to help water drain out.
• If you still have water in your ears, consider using a hair dryer to move air within the ear canal.
  • Be sure the hair dryer is on the lowest heat and speed/fan setting.
  • Hold the hair dryer several inches from your ear.

DON’T put objects in your ear canal (including cotton-tip swabs, pencils, paperclips, or fingers).

DON’T try to remove ear wax. Ear wax helps protect your ear canal from infection.

• If you think your ear canal is blocked by ear wax, consult your health care provider rather than trying to remove it yourself.

Source

Suggested reading - Tips for healthy swimming

So have a great time swimming, but follow the above tips for a safe summers!