Saturday, February 13, 2010

Winter Health Articles

How To Know When Your Baby is Sick
By Margaret Lewin, MD, FACP – Medical Director, Cinergy Health (
            As new parents, you’ve spent nine months emotionally as well as logistically preparing to welcome that magical newborn into your household.  Nevertheless, you may not be prepared to evaluate your infant when he’s ill and to know when you can handle the illness yourself and when to get help.  For infants under the age of six months, the following are some of the signs of illness and general guidelines for when to call the doctor.
·         Fever itself is not an illness, but rather the baby’s response to an illness – most commonly an infection.  Call the doctor if your infant is less than three months old and has a rectal temperature above 100.3F, or if between three and six months has a temperature above 101F.  Even if the temperature is lower than these general guidelines, call the doctor if the baby appears ill with such signs as a rash, irritability, poor feeding, trouble breathing, a stiff neck, persistent vomiting or diarrhea, signs of dehydration or is lethargic or difficult to arouse.
·         Dehydration can happen if the baby is feeding poorly, has a fever, is in too warm an environment, or has persistent vomiting or diarrhea.  You can recognize it if the baby has a dry mouth and gums, wets the diaper less frequently, sheds no tears when crying or the fontanel (the soft spot on the top of the head) appears to sink slightly.  If you think the baby is dehydrated, call the doctor.
·         Diarrhea is common in infants, but call the doctor if there is blood in the stool, the baby has more than 6 watery stools a day, is not taking fluids or shows signs of dehydration.
·         Vomiting (not just ‘spitting up’) may not be serious if it happens only once or twice.  If it happens more frequently, contains blood or is green in color, or if the baby looks dehydrated, call the doctor.
·         Difficulty breathing can be suspected if the baby is breathing much more rapidly than usual, if the tissue between the ribs, above the collar bones, or in the upper abdomen is sucked in when the baby inhales, if the baby grunts while exhaling, if his head is bobbing or if his lips or skin develop a bluish tinge.  The doctor and 911 should be called immediately.
·         Red, oozing or bleeding navel (or umbilical remnant) or penis – call the doctor.
·         Rashes are common in babies, but call the doctor if the rash covers a large area, especially the face, or is accompanied by a fever, if it oozes, bleeds or the area is swollen, or if it looks infected.
·         Colds (upper respiratory infections or “URI”) are caused by a virus and are very common in infants.  They usually last 1 or 2 weeks with an associated runny nose, fever and poor appetite for a few days, and a cough which can last as long as 2 to 3 weeks.  Do call the doctor if the temperature is higher than the guidelines above, if there is a rash, there’s any difficulty in breathing as described above, he is unusually fussy and cries a lot, the cough is severe and almost non-stop or brings up any blood, if he is vomiting, or if the symptoms last more than 2 weeks.
            Finally, under all circumstances, if you’re very worried that the baby looks really ill, trust your instincts and call the doctor!

Health News Digest- Winter Skin

By Margaret Lewin, MD, FACP, Medical Director, Cinergy Health
Even the most perfect skin needs help to remain perfect during the winter months, when cold dry air outside and overly-warm dry air inside leech out natural moisture.
Dry skin can feel uncomfortably tight and itchy.  When drier still, skin feels rough and looks dry and flaky and the normal fine lines become more pronounced – looking like the cracks in fine porcelain. 

As always in healthcare, Step #1 is prevention:
·         Stay comfortably warm:
ü  Greet the cold outdoors by wearing loose layers, with a soft cotton or a wicking fabric next to your skin to protect it from scratchy fabric such as wool.
ü  Use soft glove and sock liners to add an extra layer of warmth to hands and feet as well
ü  When you’re back inside, remove wet garments – which can cause chafing.
·         Wear a moisturizing sunscreen (with an SPF of at least 15) on all skin exposed to the sun – even in the winter, when not only sun but also light reflecting from snow can cause damage.
·         Protect your lips with petroleum jelly.
·         Protect your face from the wind,  using either a scarf or - in extreme weather - a balaklava. (Don’t forget to shield your eyes from sun and wind as well, by wearing a good pair of sunglasses.)
·         Keep  humidifiers running in your office and at home in your lounging area and bedroom .
·         Take quick, in-and-out lukewarm showers rather than soaking in a steamy hot bath – which, while relaxing, is especially drying to delicate skin.  Don’t shower more than once daily – in fact your skin would be most grateful if you replace your shower with a gentle sponge bath every other day.
·         If you use soap or liquid skin cleanser, chose  a mild, unscented brand.
·         After exiting the shower, gently pat your skin with a clean towel and immediately apply a generous amount of moisturizer (see below) to form a seal over your still slightly damp skin.

Products to consider:  Moisturizers – to slow the loss of normal skin moisture and to replace what has been stripped by dry air.  These consist of pure oil or oil suspended in water with the use of emulsifiers.  Humectants (such as glycerine and alpha-hydroxy acids) might be added in order to attract moisture to your skin. 

The moisturizer should feel good on your skin; if it itches or burns, change products.  What works best for your particular skin depends on how dry it is to begin with, and you may need to go through a bit of trial and error to achieve optimal results.

·         Bath oil – when used in the traditional manner, bath oil floats in bath water and leaves a thin deposit on your skin as you arise from the tub; unhappily, this deposit has also trapped the grime you tried to remove by taking the bath in the first place!   It’s better applied directly to the skin as soon as you’ve toweled semi-dry.
·         Lotions – provide a slightly heavier lay of oil on the skin and should be applied immediately after you wash; although fine for summer, this layer may not be sufficient to guard against winter’s harsh, dry air.
·         Creams – are heavier yet and may be what you need for winter.  Aqueous cream is non-greasy and very inexpensive.
·         Ointments – are the heaviest and contain petroleum jelly or paraffin; they should be reserved for especially dry areas such as hands, feet and lips so they don’t clog pores and aggravate acne.
Moisturize frequently (at least three times) during the day, applying the product to all exposed areas.

A bit of prevention can work wonders for providing that  “winter glow”  and avoiding  the dry, cracked, inflamed skin left defenseless from winter’s dry air.

-Courtesy of Dr Margaret Lewin & Cinergy Health

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