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In many ways, the eyes are the windows of the body. When children have itchy eyes, it can disrupt their days – and nights. Itchy eyes often distract kids and decrease their ability to learn new material. If this weren’t bad enough, they can cause kids to sleep less well. For some kids, the difference in sleep can make them moody and hungry. Hangry is not what any parent, teacher or child wants.

Why Do Kids Get Itchy Eyes?

The human body is armed with an amazing immune system that includes an array of protection devices. The respiratory system tightens up when foreign particles are introduced. The nose secretes a flow of mucus to wash out potentially harmful agents. The eyes water and release histamines in an effort to protect against harmful particles landing on the surface of the eyes.

Typically, when a child has itchy eyes, it’s an allergic reaction (an overreaction) to pollen, dust mites or animal dander. Sorting out what started the reaction can help you move toward eliminating or reducing the trigger in the future.

This might mean using HEPA air filters in the home and keeping car and home windows shut during peak pollen seasons. For those with dust might allergies, this might mean adopting a dust prevention strategy. Or avoiding being indoors with Aunt Jennifer’s cat.

Note: It’s great for kids to play outdoors, but during pollen season, this can trigger allergies including itchy eyes.

  • If practical have kids shed their outer layer of clothing before coming inside.
  • A shower after playing outdoors is wise. Be sure to rinse the hair and face well.
  • Even if a child hasn’t spent much time outdoors, a shower before bed can help reduce overnight exposure thus the total amount of time a child is exposed to pollen.

But it’s not always practical to avoid the offending agent.

When You Can’t Avoid Triggers, How Can You Treat Itchy Eyes?

When trigger particles land on the surface of the eye, mast cells in the outer layer activate and release histamine and other signal molecules. These dilate the blood vessels in the surface of the eye, make the blood vessels leakier, and produce itching, swelling, and/or a watery discharge.

  • The first thing to do is NOT rub the eye. The itching is a signal to get away from the particles if possible, and to take action to flush the particles away – but rubbing the eyes can mechanically trigger more histamine release from the mast cells and make the itchy eyes worse.
  • The second thing to do is to help the watery discharge wash away the offending pollen, mites, or dander, etc. Saline eye drops (artificial tears) help to flush the eyes. (Saline drops are not the same as the eye drops that are advertised to “get the red out.”). They can be used several times a day to dilute and remove allergens. Note: these particles can also stick to contact lenses. Best not to use contact lenses with itchy eyes.
  • Cool compresses can be very soothing and help reduce itching and swelling of the eyelids or around the eyes.
  • Over-the-counter or prescription antihistamines and/or mast cell stabilizer medications are sometimes appropriate.
  • I prefer prevention and the gentlest methods for additional treatment, such as compresses boosted with herbs and other plants including
  • Cucumber to soothe puffy skin and cool burning sensations
  • Chamomile to alleviate discomfort and inflammation
  • Eyebright (Euphrasia) to help calm allergies
Where Can You Find Gentle, Herbal Treatment for Itchy Eyes?

For decades I’ve looked for remedies that use the herbs I’d love to see in children’s remedies. The remedies need to be pure, organic, the appropriate strength for children, produced in a humane way, and easy for parents to use. I simply haven’t found anything that fits the criteria.

I’m now helping Bambini Furtuna to create these remedies. They aren’t available just yet but will be soon. Please sign-up here to be notified when the Itchy Eye Solution is available. In the meantime, I hope the other tips I’ve shared here will be helpful. Or perhaps try soaking chilled cucumber slices in chamomile tea to make a cold compress.

The post Itchy Eyes: Allergies are Crying Out for Attention appeared first on DrGreene.com.

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Claims that the MMR vaccine might cause inflammatory bowel disease or autism continue to haunt parents. I’m asked about the connection every week. The group that began the controversy, researchers from the Royal Free Hospital in London, have since done further research vindicating the MMR. But the fears continue.

Another team of researchers has completed a large study of the MMR and its potential problems. The results are published in the March 2019 Annals of Internal Medicine. The authors conclude, “The study strongly supports that MMR vaccination does not increase the risk for autism, does not trigger autism in susceptible children, and is not associated with clustering of autism cases after vaccination. It adds to previous studies through significant additional statistical power and by addressing hypotheses of susceptible subgroups and clustering of cases.”

This study followed 657,461 children born in Denmark from 1999 through 31 December 2010, with follow-up from 1 year of age and through 31 August 2013.

Another team of researchers completed an exhaustive review of all scientific studies of the MMR and its potential problems in 2001. The results are published in the September 2001 issue of the Archives of Disease in Childhood. Those authors concluded, “While the final decision rests with the parents, the evidence of the safety and efficacy of MMR  vaccine is so overwhelmingly conclusive that health professionals should have no hesitation recommending its use.”

I agree that the claims that MMR causes autism or IBD are now completely unjustified. And it is far safer to give our children the MMR vaccine than to leave them unprotected from these diseases.

The post Fear, Measles, and Protecting our Kids appeared first on DrGreene.com.

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Kids are not small adults. That may seem like something so obvious that it goes without saying. Yet for decades the doses for many medicines, including over the counter cough and cold medicines were set by just starting with adult doses and reducing them according to children’s smaller size. It turns out, this often does not work.

Before puberty, the hormonal environment within children’s bodies is significantly different than the hormonal environment in adults. Children’s bodies are set in the “rapid growth and development mode”. Young adults are in the “maintain and reproduce mode”. Medicines that work well, or are harmful, for one group may not be for the other.

None of us want to see children feel miserable – for their sakes or for ours. We want remedies when they feel sick.

No Place for Decongestants for Babies or Toddlers

You can clean out the medicine cabinet of decongestants for your baby. There is no evidence that they reduce congestion, runny nose, or sneezing in young children. But they can cause side effects that affect both the health of the baby and the environment.

The American College of Chest Physicians has advised health care professionals against using chemical cough suppressants young children because of actual deaths documented with their use. These deaths were related to dosages high above the recommended amount, but nevertheless, these products present a risk with little if any benefit.

Children deserve treatments where their benefit and safety has been carefully considered – remedies that are mild yet effective. Here are my stuffy nose and cough remedies for kids.

For Stuffy Nose and Cough Remedies I Recommend

Saline Nose Drops (a simple saltwater solution) will loosen mucus so it is easily removed with a bulb syringe. They also have a gentle decongestant and antiviral effect.

Gravity too plays a sound role in treating congestion. You’ve probably felt the way sinus congestion eases when you sit up after lying down for a while. Your baby will gain the same benefit if you keep his head a bit higher than his heart.

Vaporizer or Humidifier can help thin thick mucus. The mucus will become thinner as it pulls in the moisture from the air, allowing it to discharge more easily. (Keep in mind, though, that if the air stays too moist too long, it can encourage mold growth.)

Herbal and Food-Based Remedies made with elderberry, lemon, spearmint and other ingredients known to ease congestion, calm coughing or support the immune system.

I’ve been unsatisfied with the remedies available for children. I feel so strongly about the need for them that I’m helping to formulate a line of remedies that are safe, mild and effective. The products aren’t available yet, but you can sign-up here to be notified when this product (and other natural remedies for kids) become available.

The post Stuffy Nose and Cough Remedies for Kids appeared first on DrGreene.com.

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When the wildfires hit Northern California, I knew it would be only a matter of time before the smoke drifted into the Bay Area and the air quality worsened. Predictably, children with asthma would be showing up in emergency rooms and urgent care centers to get breathing treatments for their increased wheezing.

And three weeks later there would be an increase in cases of pneumonia and lower respiratory tract infections*.

Smoke and Asthma Treatment

Let’s address why humans wheeze in the first place. Wheezing is an adaptive, protective mechanism. It’s a cool feature of the human body. When we encounter something toxic in the air (historically, most often smoke from fires, but now also toxic fumes from chemicals) the muscles around breathing tubes tighten to decrease air flow to the delicate tissues of the lung. Mucus production in the breathing tubes increases to trap particles on the way in. The lining becomes inflamed to destroy those particles. All of this combines to narrow the caliber of the breathing tubes and create the wheezing sound you hear.

Normal wheezing protects the lungs. Asthma is what we call it when people wheeze repeatedly when they don’t need to for protection.

When the smoke arrives, many kids with asthma will be getting extra breathing treatments to open up their lungs, according to the guidelines. But it’s great to avoid that if practical!

Treating Kids with Asthma Exposed to Poor Air Quality

Wouldn’t it be better if kids with asthma avoided exposure?

  • Stay home from school while the air quality was at its worst
  • Stay indoors with an air filter on if possible.
  • Don’t exercise during brief episodes of poor air quality
  • Enjoy a game or movie day instead (and, of course, keep up with homework!)

I’ve seen it work. We protected kids’ lungs from increased exposure to harsh toxins and none of them needed extra breathing treatments. And they weren’t part of the observed spike in infections afterward.

Simple and powerful. Working with the body, not against it.

References:

Short-term Elevation of Fine Particulate Matter Air Pollution and Acute Lower Respiratory Infection. Horne BD, et al. Am J Respir Crit Care Med. 2018 Apr 13. — Link accessed Feb. 1, 2019

*Each short-term increase of 10 micrograms per cubic meter in PM2.5 is associated with a 15 to 23 percent increase in serious respiratory infections

There is another way.

The post Where there’s Fire, there’s Smoke: Poor air quality and asthma treatment appeared first on DrGreene.com.

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Maternal and infant mortality is a huge issue, world-wide. When I met Arlene Saman, the founder of One Heart Worldwide I was excited by the results they were seeing and I had ideas for ways to make the work even stronger. It was my pleasure to join the board of directors in 2015 and watch the work grow. Until this year, I’ve only watched from afar, but in 2018 my wife (@MsGreene) and I had the pleasure of joining Arlene and 14 other people to see the work first hand.

Over the next few weeks, we will be releasing our audio journal of the trip. We hope you will join us on this amazing journey.

Click here for more information about One Heart Worldwide and their amazing work for mothers and babies.

The post Saving Lives in Nepal with One Heart Worldwide appeared first on DrGreene.com.

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Ear infections can hurt! Topical drops can ease the pain while watching to see if antibiotics are necessary. And if antibiotics are needed, while waiting for antibiotics to take effect.

A study in the Archives of Pediatrics and Adolescent Medicine evaluated prescription anesthetic ear drops versus an herbal product from Israel. Otikon Otic Solution in olive oil augmented by herbal extracts including garlic, mullein, and St. John’s wort. In this study of about 100 children, the herbal drops worked as well as the prescription drops. This is great news, except the study is from July 2001 and Otikon Otic Solution is no longer available, or at least not in the United States.

From my perspective, eardrops of some type should play a large role in the management of ear infections. My favorite would be to use garlic oil for ear infections, in a potent high-quality extra virgin olive oil as a base. They would include mullein and other key organic and wild foraged herbs.

Many ear infections can be safely managed without antibiotics if children are given pain relief while their bodies fight off the infections. Those infections that do require antibiotics generally cause enough pain that pain-relief drops should be used as well.

Most children do not get eardrops. I believe they should be used at least as often as antibiotics — but usually not for longer than 48 hours or so. By then the pain should be decreasing. If not, an antibiotic, a stronger antibiotic, or a re-evaluation is probably needed.

NOTE: I feel so strongly about the need for great drops that I’m working on such a product. You can sign-up here to be notified when this product (and other natural remedies for kids) become available.

The post Garlic Oil for Ear Infection Pain appeared first on DrGreene.com.

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Maternal and infant mortality is a huge issue, world-wide. When I met Arlene Saman, the founder of One Heart World-Wide I was excited by the results they were seeing and I had ideas for ways to make the work even stronger. It was my pleasure to join the board of directors in 2015 and watch the work grow. Until this year, I’ve only watched from afar, but in 2018 my wife (@MsGreene) and I had the pleasure of joining Arlene and 14 other people to see the work first hand.

Over the next few weeks, we will be releasing our audio journal of the trip. We hope you will join us on this amazing journey.

The post Saving Lives in Nepal with One Heart World-Wide appeared first on DrGreene.com.

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Many processes in our bodies are orchestrated on a ~24 hour schedule called the circadian rhythm. Body temperature, heart rate, blood pressure, the immune system, melatonin and other hormones, alertness and sleepiness, and much more, rise and fall over the course of a day timed by our internal clock.

When we travel between time zones faster than our internal clock can adjust, we experience jet lag. Our internal clock is out of sync with local time. We notice this with difficulty being alert during the day and difficulty sleeping at night. We might not notice it, but our physical and mental performance may be impaired as well.

Fellow Travelers

We carry within our gut about 38 or 39 trillion bacteria each with their own internal clocks. The composition and function of this microbiome community changes predictably over the course of the day. Normally, these bacteria, our immune system, and our internal clock all communicate with each other and sync up.

When we travel rapidly between time zones, our bacterial schedule can be in disarray. Just like the rest of us.

Traveler’s Diarrhea: It’s Not Just Contaminated Food or Water

Getting exposed to bacteria like Salmonella is more likely to cause infection at certain times of day. Experts in the circadian rhythm now think that disrupting the circadian rhythm, whether by jet lag, shift work, or blue light in the evening, can make people more susceptible to gut infections.

Several times I’ve gotten traveler’s diarrhea after a long red-eye flight. This is not unusual. Sanitation and hygiene are not the whole story with traveler’s diarrhea.

Mother Nature’s Solution to Traveler’s Diarrhea

In babies, breast milk and colostrum are among the most effective ways to prevent and treat diarrhea. Both colostrum and breast milk contain potent ingredients that protect against infections. Plus specific antibodies to the organisms the mother has encountered.

And they nourish the lining of the gut. But beyond that, there are hundreds of ingredients in colostrum and breast milk that the baby can’t digest. They are prebiotics.

Who do they feed? These prebiotics nourish the bacteria in the gut – and signal the immune system in the gut lining. One way to help your gut bacteria is to eat a diet rich in prebiotics, most notably found in fiber-rich foods such as fruits, vegetables, and whole grains. This can be tough when traveling — especially in countries where it’s not recommended to eat raw vegetables. (Note: Salads have been the traveler’s diarrhea culprit for me on multiple occasions.) My wife travels with both a prebiotic fiber supplement and a great traveler’s diarrhea solution made from colostrum and egg yolks.

Taking care of your gut bacteria helps them take care of you.

Note: Dr. Greene is the pediatric advisor for DiaResQ.

References

Circadian Rhythm and the Gut Microbiome. Int Rev Neurobiol. 2016;131:193-205.

Message in a biota: gut microbes signal to the circadian clock. Cell Host Microbe. 2015 May 13;17(5):541-3

A day in the life of the meta-organism: diurnal rhythms of the intestinal microbiome and its host. Gut Microbes. 2015;6(2):137-42.

Rhythm and bugs: circadian clocks, gut microbiota, and enteric infections. Curr Opin Gastroenterol. 2016 Jan;32(1):7-11.

Human colostrum oligosaccharides modulate major immunologic pathways of immature human intestine. Mucosal Immunol. 2014 Nov;7(6):1326-39..

Anti-infective bovine colostrum oligosaccharides: Campylobacter jejuni as a case study. Int J Food Microbiol. 2012 Jul 2;157(2):182-8

The post Your Gut Bacteria Get Jet Lag Too appeared first on DrGreene.com.

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The Center for Disease Control and Prevention (CDC) estimates that between the years of 2011 and 2015 nearly 350,000 children in the US were taken to the emergency department for adverse drug events caused by antibiotics – and that at least one-third of antibiotic prescriptions given to children are unnecessary.

Seven of the top ten drugs causing adverse drug events in children that lead to emergency room visits are antibiotics.

What’s the Cost of Antibiotic Related ER Visits?

ER visits average about $2000 each, so the total cost of ER visits for antibiotic side effects may have been around $700 million. And again, at least one third of antibiotic prescriptions given to children are unnecessary. And more than $200 million of unnecessary ER costs.

On the one hand, a total of 350,000 emergency visits is a relatively small number compared to the 370 million antibiotic prescriptions given to children during that same period. Only about 0.1% of the time that an antibiotic prescription is taken by a child, does that child ends up in the ER. And the added ER cost is only about an extra $2 per antibiotic prescription.

But this represents around 140 million real dollars every year and almost 70,000 emergency visits every year, about 40% of them for children under age two. These are real children, not just numbers. These are real parents who were concerned enough about their kids to brave the cost and time and hassle of an emergency visit.

Antibiotic Related ER Visits are the Tip of the Iceberg

And emergency visits are only the tip of the iceberg. When a child is seen for an adverse drug event, only about 12% of the time are they taken to an emergency department. But 78% of the visits are to different waiting rooms: doctor’s offices, outpatient clinics, or urgent care centers.

Not to mention the tens of millions of times antibiotics caused uncomfortable side effects that didn’t lead to a medical visit. Or the long-term problem of antibiotic resistance, fueled by antibiotic overuse, which has become “one of the most urgent threats to public health.”

Antibiotics are some of our most wonderful medications. I am hugely grateful for them. And want to protect them. And our kids.

Whenever we can get the job done with gentler remedies, we all win.

References (last accessed August 26, 2018):

US Emergency Department Visits for Adverse Drug Events From Antibiotics in Children, 2011–2015. Journal of the Pediatric Infectious Diseases Society, piy066, https://doi.org/10.1093/jpids/piy066  23 August 2018.

Pediatric adverse drug events in the outpatient setting: an 11-year national analysis. Pediatrics. 2009 Oct;124(4):e744-50. doi: 10.1542/peds.2008-3505.

US emergency department visits for outpatient adverse drug events, 2013-2014.” JAMA   316(20): 2115-2125. 2016

Cost of ER visits increased 31% between 2012-16: 5 findings. Becker’s Hospital Review 2018.

The post More than a Quarter Million Antibiotic Related ER Visits appeared first on DrGreene.com.

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Button battery ingestion is a big deal. So much so that The National Battery Ingestion Hotline (NBIH) was created in 1982 to study and advise best practices. They look at all types of batteries but swallowed button batteries account for 94% of batteries ingested.

Until recently the agreed-upon first aid guidelines for a swallowed button battery were to take nothing at all by mouth (no oral intake!) but to get to the ER as soon as possible for timely x-rays to find the position of the battery, before promptly removing the battery with an endoscope.

Who Swallows Button Batteries?

Kids swallow button batteries, particularly kids under 6 years old. The peak age for this is in toddlers 1 to 2 years old, just old enough to toddle into trouble and just young enough not to know better. Typically, they pop it in the mouth as soon as they remove it from the object.

Button batteries are in games and toys and lights and remote controls, garage door openers and key fobs and singing greeting card – powerfully fascinating items to young kids.

(The elderly also swallow button batteries, perhaps mistaking a hearing aid battery for a pill)

What’s the Big Deal?

First the good news: most people who swallow button batteries end up fine. But for a significant minority, the battery nestles into the mucus lining of the esophagus and the electrical discharge begins to cause corrosive injury. Burns are seen within a couple of hours, and serious burns as soon as 8 to 12 hours. If the battery remains in place longer than that, perforation of the esophagus may occur.

Sometimes the battery doesn’t get stuck in the esophagus and makes it all the way in to the acid bath of the stomach. This may not be good news. The stomach acid can open the seal of the battery and release the dangerous chemicals inside.

What about Dead Batteries?

The fresher the battery, the higher the chance of harm – but swallowed dead batteries are still an emergency. They can still generate enough current to burn tissues.

Honey, I Think My Child May Have Swallowed a Button Battery! What Should You Do?

Honey can significantly reduce burn injuries from swallowing button batteries. The latest recommendations are to give 1 to 2 tsp of pure honey, if available, before heading to the ER as long as:

  • Your child is at least a year old.
  • There is no obvious chest pain or fever.
  • The known or suspected swallowing happened within the last two hours.

Do the same if the person who may have swallowed the battery is an adult.

Head to the emergency department for evaluation. If you have the battery identification code from the packaging or similar batteries readily available, bring that with you.

Call the 24-hour National Battery Ingestion Hotline (800-498-8666) or a Poison Control Center (800-222-1222) immediately for help along the way. Here are Poison Centres outside the United States.

Also, call the hotline if there may be a battery stuck in the nose or ear. And don’t use nose drops or ear drops. One of my kids stuck 5 peas up the nose. I’m glad they weren’t button batteries.

Not So Fast!

If the battery may have been swallowed more than two hours ago, or if there is obvious chest pain or fever, do not give honey. Do not give anything by mouth. Call a hotline and head straight to the emergency department for evaluation.

Button Battery Ingestions Are on the Rise

Button batteries are a convenient way to power devices that make our lives better in many ways. But they can also be mistaken for a pill or a tempting treat. Be alert for the possibility someone may have swallowed a battery – they may not tell you. And they may not have any symptoms yet. Don’t hesitate to give a spoonful of honey if they fit the guidelines above. This is a simple way to make a big difference for someone you love.

References:

  1. pH-neutralizing esophageal irrigations as a novel mitigation strategy for button battery injury. Laryngoscope
  2. Serious complications after button battery ingestion in children. Eur J Pediatr 2018; 177:10
  3. Button Battery Powered Fidget Spinners: A Potentially Deadly New Ingestion Hazard for Children. J Pediatr Gastroenterol Nutr 2018; 66:595.
  4. Preventing battery ingestions: an analysis of 8648 cases. Pediatrics 2010; 125:1178.

The post Swallowed Button Batteries and Honey?! appeared first on DrGreene.com.

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