Modern Mom Experts

Michael A. Schoenwetter, M.D. - "Dr. Mike"
Dr. Mike has been practicing general pediatrics in a suburb of Los Angeles for over 10 years. He is married and has a six year old son and a three year old daughter. He enjoys golf, football and family time. His higher education has all been through the University of California system - Bachelor of Science with honors from UCLA, his MD degree from University of California at Irvine and his pediatric training at UCLA. He is the featured pediatrician in the DVD, Newborn Care 101 – What Parents Need To Know (www.newborncare101.com).

Dr. Mike: Our Resident Pediatrician

Back to School!

Posted by Dr.Mike at 9/2/2010 9:10 AM PDT

As summer break ends, my office starts to get busy. Putting all those kids back together in school a confined place is a perfect way to transmit infection. Here are some recommendations to limit your child’s visits to the doctor this school year.

First, I want to start with some basic, obvious healthcare tips. A good nights' sleep paired with a healthy diet is imperative to good health and peak performance in school. If your child’s diet lacks diversity, add a basic multivitamin. Encourage your children to wash their hands before eating at school. Good hand washing is the easiest and most effective way to control the spread of infection. In addition, remind your kids not to share food and drinks; someone can be contagious without feeling ill.

Gym showers and locker room floors are breeding grounds for tinea pedis, the fungus that causes athletes foot. Make sure your athlete wears shower shoes in the locker room and thoroughly dries his/her feet after showering to help prevent this irritating problem.

Another health tip is to not share hats, combs, or brushes. Lice do not jump or fly, they crawl. So it is close contact, like sleeping in the same bed or sharing the aforementioned objects, that transmits the bugs. Lice can be difficult and frustrating to treat. The over-the-counter remedies are safe and effective, but sometimes a prescription medication needs to be used. Be careful not to mistake dandruff flakes for nits (a louse’s egg casing). If uncertain, come in to the doctor for evaluation.

Vaccinate your children. This year, the flu shot protects against H1N1 as well as seasonal flu, so two different vaccines are not necessary. Also, there is presently a pertussis (whooping cough) epidemic. Make sure your child is up to date on this vaccine. Current recommendations are to receive a booster before kindergarten entrance and then at 11 years.

Obviously, there is not one fail-safe way to keep your children healthy during the school year. But, by discussing and explaining health prevention with them, your children become active members of their health team. This can empower them to make strides toward staying healthy. Just remember, only nine months until June.

All information given is not a substitute for the advice of your pediatrician, primary care provider or trained health professional. Always consult with your pediatrician or health care professional

Comments (0) | Permanent Link

Swimmer's Ear

Posted by Dr.Mike at 7/27/2010 11:45 AM PDT

Pediatricians love the summer. Overall, our offices are much less

chaotic as we are not dealing with the flu and other illnesses that

winter brings. There are some illnesses, though, that are linked with

warmer weather: sunburn, heat stroke, and certain bug bites, to name

a few. A very common summer related illness is swimmer’s ear, and

right now we are seeing at least three a day in my office.

Swimmer’s ear is an infection of the skin lining the ear canal,

usually caused by a bacteria. Normally, ear canals have features

that protect it from infection. There are glands in the canal that

secrete a waxy substance (cerumen) that acts like a water repelling

film. Also, the wax is acidic, making it hard for bacteria to grow.

Lastly, the wax has some proteins in it that are anti-bacterial. When

the ear canal is exposed to a lot of water (swimming!) the wax can

become thin and less acidic, creating an environment that bacteria can

grow easily. Be aware that lake water in the summer can have a high

bacterial count and thus cause swimmer’s ear more easily.

Symptoms usually start with mild itching, but can progress to severe

pain when the ear is touched. Children might also describe a “plugged

up “ feeling and there might also be discharge from the ear.

Luckily, swimmer’s ear is easily treated with ear drops. The drops

have an antibiotic to kill the bacteria and might contain a mild

steroid to decrease the inflammation.

There are some ways to prevent swimmer’s ear. The most effective is

to keep your child’s ear canals as dry as possible. After swimming,

turn his/her head to each side and pull the earlobe in different

directions to help the water run out. Also, as long as you know your

child doesn’t have a perforated ear drum or ear tube in place, you can

put ½ teaspoon of a mixture of one part white vinegar and one part

rubbing alcohol in each ear after swimming. This will not only help

the ear dry, but will help keep the normal acid balance of the canal

intact.

Overall, swimmer’s ear is very common and easily treated. A child

with ear pain, though, should be evaluated by his/her doctor so a

correct diagnosis and treatment plan can be made.

All information given is not a substitute for the advice of your

pediatrician, primary care provider or trained health professional.

Always consult with your pediatrician or health care professional

Comments (0) | Permanent Link

My Pee-Pee Hurts

Posted by Dr.Mike at 6/15/2010 8:33 AM PDT

At least once a day a child comes in to my office complaining of pain with urination. Parents think that their child has a urinary tract infection (UTI). Although a UTI is a common cause of painful peeing, not all urinary pain is infectious in nature.

In babies, pediatricians will look for UTI as a possible cause of a fever or irritability. Babies are screened for these infections by placing a plastic bag in their diaper area and catching a urine sample. If this sample indicates a possible infection, then a cleaner specimen is obtained using a catheter. In children who are potty trained, collecting urine in a cup is adequate and using a catheter is not necessary. Babies diagnosed with a UTI, especially if associated with a fever, usually need further testing to evaluate and possibly eliminate recurrent infections.

School age boys rarely have UTI as their cause of painful peeing. Male anatomy is very protective against these infections, although uncircumcised males do have a slightly greater risk. Sometimes, pain is caused by irritation at the tip of the penis. Sometimes, very concentrated urine might sting, which means the child needs to hydrate themselves better to relieve the discomfort. Even though UTI is rare in school age boys, it is advised to bring your child to the doctor for exam and urine testing if he complains of urinary pain.

Girls are a whole different story. A female’s anatomy makes girls very prone to UTI. But again, not all painful urination is infection. For example, school age girls, and especially newly potty trained 3 and 4 year olds, do not maintain good hygiene in their vaginal areas. This can lead to vaginal irritation and inflammation (vaginitis) and even vaginal infection. Girls need to be constantly reminded to keep their private area clean, making sure to wipe from front to back after urination. Also, bubble baths can irritate sensitive areas and I do not recommend them to girls. During the summer months, chemicals in the pool can be irritating. After swimming, make sure to shower off to decrease exposure to these chemicals. To help with vaginal irritation, I recommend a sitz bath—a clean tub of tepid water with a small amount of baking soda—making sure to wash out the area well.

Remember, if your child complains of pain with urination, the way to diagnose and remedy the problem is to see your doctor for an examination and urine sample.

All information given is not a substitute for the advice of your pediatrician, primary care provider or trained health professional. Always consult with your pediatrician or health care professional

Comments (0) | Permanent Link

Poop Problems?

Posted by Dr.Mike at 5/14/2010 5:13 PM PDT

Poop is a very frequent topic of conversation in my office. It is a rare day when I don’t hear about a child’s poop or even see a poop sample. Is it too hard? Is it too soft? Is the color ok? Bowel habits can be very stressful to parents.

One of the frequent problems I encounter is constipation. Sometimes, if a toddler or small child gets constipated (usually due to dietary issues--such as poor fiber and water intake or too may carbohydrates) and has a painful bowel movement, they might associate pooping with pain. They may become fearful of pooping, and they might try their best to “hold it in”. Normally, as stool is formed, it is stored in the rectum. When the rectum fills up, it stretches and sends a signal to the brain that is time to go to the bathroom. If a child develops a pattern of holding onto their poop, however, over time the rectum can stretch too much. Now it takes more stool than normal for the rectum to fill up. The child may not even feel that he has to go until many days have passed. Then, when they finally feel the need, the stool is huge and hard, reinforcing the painful and fearful association they have with pooping. This leads to a cycle of chronic constipationabdominal pain. and episodes of

The problem is two-fold. Not only do we have to break the association of pain and fear, but the stretched rectum needs to be returned to normal. The best way to do this is to keep the rectum empty by having a daily stool. Sometimes this can be done by dietary means alone, such as increasing fiber, water, and juices and decreasing constipating foods. Frequently, medications are used to soften the stool and facilitate daily pooping.

One of the misconceptions that parents have is that once their child poops, the problem is solved. The patient usually comes to the pediatrician during a crisis of abdominal pain, and measures are taken to clean out the constipation. But, because of the fearful association and the changes is the rectum, the problem reoccurs. Once the patient is on a good regimen and having soft, non-painful regular stools, the rectum returns to its normal size and the fear of pooping goes away.

I try to reinforce to parents not to stop the regimen too quickly. If a toddler has 99 normal stools in a row and then has one hard painful one, you can guess which one he remembers!

Constipation and stool holding can be very stressful for the family, and very uncomfortable for the child. It is also extremely common, so if you suspect the problem, it should be discussed with your pediatrician.

All information given is not a substitute for the advice of your pediatrician, primary care provider or trained health professional. Always consult with your pediatrician or health care professional.

Comments (0) | Permanent Link

Gesundheit - It is Allergy Season

Posted by Dr.Mike at 4/13/2010 1:16 PM PDT

I love spring. Most of the country is finishing their wet winter and the sun is starting to shine.We can look forward to grasses, trees, and flowers blooming. This is beautiful to look at, but for many children it is a sneezy, itchy, watery-eyed nightmare.

Approximately fifty million Americans, or about 1 in 5, have allergies. The majority of these people have pollen allergies and thus suffer more during spring and summer.

There is an interesting fact about allergies that most don’t know: people with allergies have a “clinical threshold”. Once someone’s body passes this threshold is when they develop the common allergy symptoms. You see, what a person is allergic to, called an allergen, is cumulative. This means that you can be exposed to allergen and not feel symptoms until your body crosses your clinical threshold.

For example, you might be allergic to a pet dog or cat all year long but only feel the allergy symptoms when a pollen allergen is added to the pet allergen and the combination is over your clinical threshold. A lot of my patients blame the grass, when actually it is something else in their environment that is causing most of their allergy problem. This is one of the reasons we test for allergies. If we can find an allergen like dust or pet dander, it can be eliminated a lot easier than the gazillion types of pollen producing plants in our environment.

Another important point is there are symptoms other than the typical sneezing and watery eyes that could be related to allergies. Children with asthma and/or eczema sometimes have respiratory or food allergies as part of their underlying problem. Also, kids with recurrent upper respiratory infections and sinus infections could be suffering from allergies.

Testing for allergies has become easier. There is a simple blood test that is a powerful diagnostic tool. Also, allergy specialists can perform skin testing to determine allergies to both respiratory and food based allergens.

There are many treatment options. The best treatment for allergies is to avoid the allergen. In most instances, this is easier said than done. A child with significant pollen allergy still wants to play outdoors. Telling a family to get rid of their household pet is usually met with resistance. There are numerous medications, both over-the-counter and prescription, in the form of oral medications, nasal sprays and eye drops that work well if avoidance is difficult.

With all the diagnostic tests and treatment options available, allergy symptoms are becoming easier to control. Be sure to discuss this with your doctor to see what your child’s best options are if he/she is an allergy sufferer.

All information given is not a substitute for the advice of your pediatrician, primary care provider or trained health professional. Always consult with your pediatrician or health care professional.

Comments (0) | Permanent Link

1 2 3 4 >> Last