Preventing Anaphylaxis in Children

To reduce the risk of food allergy & anaphylaxis, parents have often been told to avoid giving children specific foods at an early age. But is this the right approach? Probably not.

What’s the problem?

Food allergy among children is common, affecting up to 2 out of every 25 kids (8%) younger than 3 years of age. Allergies can be serious or fatal, and anaphylaxis in children seems to be increasing. To reduce the risk, parents have often been told not to give their children foods such as peanut, egg, dairy, etc. at an early age and many schools impose “no sharing” policies.

Reducing Peanut AllergiesPeanuts are the biggest cause of choking

A year ago, doctors did a trial to assess if this avoidance was a good idea. Specifically, they did it with peanuts. They found out that children eating peanut products from an early age were much, much less likely to have allergic reactions. The trial was so convincing that doctors now suggest introducing peanut products before 6 months of age, especially in high risk children.

Reducing Other Food Allergies

OK, so much for peanuts, that’s only one of many foods which can cause problems. What about all those other things – wheat, dairy, egg, etc. Well, the peanut trial was so convincing that another one had to be done. Children between three and six months of age were to be fed 3 rounded teaspoons of smooth peanut butter, one small egg, two portions (40 to 60 g) of cow’s milk yogurt, 3 teaspoons of sesame paste, 25 g of white fish, and two wheat-based cereal biscuits every week. They were compared to babies who just breast-fed at that age. The kids were checked regularly up to the age of three.

So did this reduce food allergies?

Hard to say. Out of every 5 families who tried to do this, only 2 managed. Maybe because it’s challenging to feed a 3 month old all that food. Maybe baby couldn’t eat it. Whatever the reason, that’s not good enough for doctors to say for sure that you should be doing this. But…. In the ‘normal’ families who were breast feeding, about 2 in every 25 kids developed an allergy. Exactly what you’d expect. In the families who managed to feed their kids all the other foods, only 1 in 50 kids developed an allergy. Much lower than would be expected.

Epi-Pen Adult and Epi_pen Jr.

Epi-Pen adult and Junior. “Blue to the sky, orange to the thigh!”

What can I do?

That’s up to you as a parent. It seems like giving kids food early on is a good idea and reduces allergies, but that’s not for sure yet. If you do, take care. At 3-6 months old, they’re not yet very good at chewing. Don’t let them choke on foods to try and reduce allergies! As usual, a balanced approach seems best. If you want to introduce these foods at an early age, be sure to prepare them in ways which are safe for your child. And as always, make sure you have the training to know how to recognise and deal with serious allergies.

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The Dirty Secret about CPR in the Hospital (That Doctors Desperately Want You to Know)

Long, but well worth reading

K.V. Scruggs

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A few things have changed in medicine over the last few decades. Okay, a lot has changed, and most of it good. But along with the improvements in patient care there has been an exponential increase in expectations. We’ve somehow gone from “your loved one has a life threatening illness and we will do what we can to treat it and in the meantime ensure they don’t suffer” to “your loved one has a life threatening illness that we have the capacity to cure, and if we don’t we will have done something wrong.”

The problem is, last I checked, everyone dies. Let me say that again for good measure. Everyone. Dies. The problem is not with that truth alone, but with the fact that patients with terminal illnesses – and their caregivers – rarely understand their mortality. And when patients and families have unrealistic expectations about what their doctors…

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Lawnmowers and Kids don’t mix

Seriously. Find the little people a different job to do for you. Recent (US) research has found about 16 mower-related accidents per state, per year. Most of them (unsurprisingly) in the warm months from April to September. About ¾ of them could have been prevented. If you have (or care for) kids you’ll know they are easily distracted – which can have serious consequences if they’re trying to use a mower at that moment. More than half the reported injuries needed an amputation.

 

Lawnmower Injuries? How?Lawnmower Races

The mower blade often doesn’t seem that sharp, but think about the speed of it traveling. The very tip of a rotating blade is moving faster than a speeding bullet – literally. Which makes “the injuries we see not just lacerations, they’re more like an explosion or blast injury” says Dr Armstrong, the researcher. About half the injuries come from ride-on and half from push mowers. 8 out of 10 happen to boys.

Lawnmower Injury Prevention

There are in fact guidelines to prevent lawnmower injuries in children, which have been around since 2001:

  • No kids under 12 should use a push mower
  • No kids under 16 should use a ride on mower
  • Kids under 6 should be indoors at all times a mower is in use

“children should not operate lawn mowers until they have displayed appropriate levels of judgment, strength, coordination, and maturity necessary for their safe operation.”

Lawnmower Injury Treatment

We are all about first aid after all, so what would you do for a kid with a lawnmower injury? Here are our guidelines – depending on the severity of the injury, of course.

1. Turn off the mower (If you didn’t know “Check for safety” comes first, slap yourself all the way back to the classroom and get some training). Secure it so no one else can come and turn it back on accidentally!

2. Comfort the child. Position appropriately, which may be lying down, depending on blood loss and how faint they feel.

3. Assess the need to call an ambulance – do so if necessary.

3. Apply pressure to stop the bleeding. Don’t apply pressure to any broken bones or if it causes undue pain, but you need to stop the blood flow.

4. Bandage appropriately. If there are broken bones, this may involve stabilising the injury.

5. If there is an amputated body part, wrap it in a sterile dressing, then a towel, then a plastic bag and then ice. (See your book for full details, or remember what we did in class.)

6. Off to hospital, clinic, or further care as appropriate.

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Plant Poisoning in Spring

With all this nice weather, we hope you and your children are getting chance to enjoy your yard, garden or the local parks and wild spaces. Of course, with nice weather comes all the nice flowers. Now, which ones are poisonous and which did your child just eat?

We often get asked about plants in class and no wonder, they are one of the most common causes of poisoning in children. Sadly it’s difficult to remember every species and all their effects. Below is a short list of some plants which cause calls to Poison Control regularly, along with information about them. If you aren’t sure, pick up the phone! (1-800-567-8911 in BC)

Springtime Poisonous Plants

(A combined extract from the BC Poisons Control Springtime Hazards & Plant Awareness.)

Azaleas/Rhododendrons: All parts of these plant species are poisonous. Symptoms include burning in the mouth, salivation, nausea, vomiting and diarrhea  Swallowing large amounts may cause drowsiness and changes to blood pressure and heart rate. Do not induce vomiting. Rinse out mouth and drink a glass of water or milk. Popsicles work well also. Contact the Poison Control Centre. 

rhododendron1

A lovely pink, poisonous rhododendron.

Spring Crocus: Is not toxic. Don’t confuse it with the autumn crocus!

Daffodils/Narcissus: All parts of the plant are poisonous, but especially the bulbs. May cause nausea, vomiting, abdominal pain and diarrhea. Symptoms usually subside within 4 hours but may last up to 24 hours. The bulb also contains calcium oxalate crystals, which can cause irritation to the mouth and throat. 

Iris – All parts of the plant are considered toxic. May cause mouth, stomach or skin irritation.

Mushrooms: Get as much information as you can and call poison control on this one. Could be anything from a yummy meal to deadly.

Prunus species: Includes cherries, plums, apricots, peaches…. Obviously the fruit isn’t a problem, but the seed (pit, stone) contains cyanide. All parts of the cherry tree are toxic except the fruit. Poisoning is not expected when the hard pit is swallowed whole. The body does not digest the pit so it just passes through the gastrointestinal tract and is excreted in the stool. The main concern with young children ingesting the pit would be the choking hazard Swallowing one or two still wouldn’t be a problem.

The Cherry Laurel: All parts of the plant except the cherry fruit contain cyanide. If the cherry & stone are swallowed they usually can’t be digested, so aren’t a problem. 

1 Plant sp. 7 - wetland 2011.08.30.jpg
By Emőke Dénes – WWT London Wetland Centre, CC BY-SA 2.5

Tulips – The bulb is nontoxic but may cause dermatitis (“tulip itch”) most often in people who handle the bulbs frequently such as gardeners or nursery workers. Swallowing the bulb may cause an upset stomach. Tulip bulb dermatitis usually affects the hands and is characterized by redness, swelling, itching, eczema and blisters. Fingernails may become brittle and cracked. See your family doctor if dermatitis develops.

A General “What to do” if your child swallows plants or parts

  • Remove any remaining plant parts from their mouth, or have them spit the stuff out
  • If they are choking or having breathing difficulties, get the ambulance on the way and follow your training for choking, CPR or Anaphylaxis (you have been to class, right?)
  • No breathing problems? Call Poisons Control (1-800-567-8911)
  • If you need to go to the hospital, take the plant or plenty of it with you. One leaf or one berry isn’t enough for good identification.
  • If they tell you to go to the nursery or garden centre for plant identification, go but don’t worry about speeding. You have time. (Find a nursery who can do this for you ahead of time. It may not be your local Canadian Tire.)
  • Knowing the plant name will save you a lot of worry

Hint: Right Now is the best time to go and find out what’s in your yard or neighbourhood.

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