Issue link: http://cp.revolio.com/i/329829
44 Fever-reducing medications might not decrease the risk of seizures caused by fever. Furthermore, the best pain relief from vaccines comes from parents connecting with their babies, nursing, and using calming techniques, such as the "5 S strategy" from the book "The Happiest Baby on the Block," by Dr. Harvey Karp. This includes swad- dling, swaying, sucking (nursing, bottle, or pacifier), shooshing and side holding. And finally, many babies recover very quickly from injection discomfort and don't have any notable reactions. Pretreating all infants with acetaminophen would lead to many unnecessary doses of medication. If a baby seems to be in significant discomfort in the hours following an injec- tion despite other comforting measures, I would then consider a dose of acetamino- phen for infants under 6 months old and ibuprofen for those 6 months or older. —Bryan kono, Md Highlands integrative Pediatrics, denver How can I help my children cope with the anxiety and discomfort of shots? As a pediatrician, I know that childhood vac- cines save lives and help keep kids healthy. As a parent of two, I also know shots are no fun. Fortunately, many of today's childhood vaccines are offered as combination vac- cines. Stick to the recommended schedule, keeping the pokes as few as possible. The day of the shots, prepare by com- paring the shot to something that kids understand. You could say: "It will hurt like scraping your knee, but then it will get better." For older children, accept their fears and stay positive: "It's OK to be scared. It will hurt for a few minutes, but it will keep you safe for a long time." During the shots, distract your child. For a baby, sing a favorite song or tell a story. Toddlers and small children love to blow bubbles, and the deep breathing can be calm - ing. An older child can listen to music, tell jokes with a parent, or play on their phone. After the shots, comfort your child. A baby can be rocked, nursed, or given a pacifier. Older children can have a favorite toy from home and lots of hugs and kisses. And always praise all kids, regardless of how brave they were. —alison auster, Md advanced Pediatric associates, stapleton What is the difference between food allergy and food intolerance? The difference comes down to how a food impacts the body. An allergy produces a large amount of IgE (allergic antibody) in a very specific area of the body in response to a food the body thinks is unsafe. The timeframe for an allergic reaction ranges from immediately upon ingestion to up to 120 minutes, although sometimes symp- toms can be delayed up to 24 hours. Typical symptoms include hives, itching, vomiting, diarrhea, abdominal pain, troubling breathing, wheezing or coughing, low blood pressure, cognitive struggling, and tingling or swelling in the throat. People can have any combination of these symptoms that fall anywhere from mild to intense, with severity depend- ing on the level of exposure. If a reaction happens quickly and every time, then it's an allergy, but it's still always a good idea to get tested. In contrast, food intolerance has a more delayed reaction, and the symptoms are more non-specific, including upset stomach, diarrhea, fatigue, brain fog and nasal congestion. It will not show up in an allergy test. —Lora Stewart, Md allergy and asthma care Prevention center, Lone tree My baby spits up all the time. Is this normal? When should I worry? Spitting up is common in the first year of life, particularly in the first three to four months, when the connection between baby's esophagus and stomach is imma- ture, not always closing after feeding. This allows for stomach contents to come back up the esoph- agus and out of the mouth. Some babies will be partic- ularly fussy with burping or spitting up. In these cases, y o u r p e d i a t r i c i a n m i g h t consider a diagnosis of acid reflux, a condition where acid is also coming up from the stomach, leading to the discomfort and fussiness. Medication is often prescribed in these cases. It is also important to distinguish nor- mal spitting up from vomiting. Vomiting is much more forceful, and there is usu- ally increased volume coming up. This can imply a mild illness, such as a stomach virus, but can indicate more concern- ing problems, especially in the first few months. Projectile vomiting, which is very forceful and can literally shoot across the room, should always be evaluated by a doctor. Your pediatrician should also be notified immediately if the vomit is bloody or dark green in color. —Brian Stanga, Md Parker Pediatrics, Parker Spitting up is one of the most common concerns for parents. Gastroesophageal reflux is the passage of stomach contents into the esophagus and is a normal phys- iologic process in healthy infants. Many infants have frequent episodes of spitting up throughout the day, but are other- wise growing and developing well. While frequent spitting up can be stressful for parents, we consider babies "happy spit- ters" as long as the episodes of spitting up are not causing distress to the infant or affecting the infant's growth. Spitting up can be helped by slowing down feeds, frequent burping, and keeping infants upright for 20 to 30 minutes after feeds. Gastroesophageal reflux disease is the passage of stomach contents into the esoph- agus that results in bothersome symptoms or complications for an infant. Signs that spitting up may be causing problems that would require medication include poor growth, difficulty feeding, irritability, arch- ing of back, and grimacing. If your infant is experiencing any of these symptoms, you should contact your doctor to discuss possi- ble need for treatment. —kelly newgent, Md greenwood Pediatrics southwest, Littleton Dr. Alison Auster Dr. Lora Stewart Dr. Brian Stanga Dr. Kelly Newgent