It’s cold and flu season and around this time of year I start seeing parents in my office concerned that their child is “always sick,” and that there must be something wrong with their child’s immune system or that they have a “low immune system.” I don’t doubt these parents when they say that their kids are always sick. As I mentioned in a previous post:
“The average child experiences between 6-10 viral upper respiratory infections a year. The average duration of each cold is 7-14 days. That means, on average, infants and toddlers can be sick for 4-6 months each year. Statistically, this means that 50% of children will be sick more than this. Parents, you’re not imagining things when you think your kids are sick all the time. Sometimes they are, and that’s not abnormal.”
So if it’s normal for kids to be almost continually sick this time of year, when should parents worry that their child’s immune system may not be working as well as it should?
There are two main types of immune deficiencies. The first type is secondary or acquired immunodeficiencies. These are the most common. This type of immune deficiency is caused when your child is fighting another illness like cancer, HIV, or is taking certain medications that can suppress the immune system. We’re not going to talk about these today. The second type is primary immunodeficiencies (PID), which are far more rare and genetic (meaning we’re born with them). These are the disorders that parents say they’re most concerned about when they tell me their child is always sick.
PIDs, especially the more severe forms, is quite rare in the general population. There are roughly 180 distinct PIDs, however, as a category, only about 0.0087% of the population has any one of those 180 PIDs. That’s about one out of 1,200 people, but this changes dramatically based upon the type of PID as some are much rarer than others.
Primary immune deficiencies arise when parts of the immune system are not being produced, or are not functioning appropriately. This leaves holes in the normal defense system, making the body more susceptible to infections. Depending upon where and to what degree the defect occurs, the impact can range from mild to very severe.
As I mentioned before, PIDs are genetic, but that doesn’t mean that they’re all inherited or passed from parent-to-child. Some may arise from spontaneous gene mutations with no family history at all. Some appear early in infancy with severe life-threatening infections, whereas others are very subtle and go undetected until adulthood.
So when should you worry that your child’s immune system is deficient? Unfortunately, there’s no easy answer, but there are some indicators in the first years of life that your child needs to be evaluated by a pediatric allergist/immunologist:
- Positive Newborn Screening: As of this writing, 32 states screen for Severe Combined Immune Deficiency, which is an exceptionally rare condition that can cause death by one year of age from severe illness. If your baby’s newborn screening is positive for this, you need to see a pediatric immunologist immediately.
- Family History: If you or if certain blood relatives have been diagnosed with a PID or receive immunoglobulin replacement therapy.
- Failure to Thrive: If your baby fails to gain weight, meet their milestones, suffers from severe skin rashes, recurrent diarrhea, and frequent or invasive infections like sepsis or pneumonia.
- Opportunistic Infections: If your infant or child has suffered from recurrent opportunistic infections, such as fungal infections like thrush, that have affected more than just their tongue or mouth, this is cause for concern.
- Frequent Use of Antibiotics: If your infant or child has required multiple courses of antibiotics each year for confirmed infections such as pneumonia (diagnosed by chest x-ray), ear infections requiring placement of ear tubes, or sinus infections that will not resolve on their own.
- Confirmed Comorbidities: When two conditions tend to occur together we call these conditions “comorbid”. Some conditions, such as DiGeorge syndrome, are known to be comorbid with PIDs.
Most of these warning signs aren’t subtle, and statistically speaking PIDs are incredibly rare. As a board-certified pediatric allergist/immunologist, I have received specialized training to identify children with possible PIDs, but sometimes a child with one of these conditions won’t have any of these warning signs. Sometimes the parents bring them in because their gut tells them that something isn’t quite right, and as the parents tell me more about their child’s issues my radar starts to go off. What are those signs?
- Infections that require treatment with intravenous antibiotics, especially more than once.
- Infections that occur in unusual sites, like internal organs, gums or skin abscesses (non-MRSA, or antibiotic-resistant staph, which is a common infection).
- Infections with unusual organisms, which require appropriate cultures from the site of infection.
- Infections of unusual frequency. While the average child has between 6-10 upper respiratory infections each year, if that number is closer to 20, or if it regularly takes more than three weeks to recover from each infection, I start to get concerned.
When I speak with concerned parents many of them understandably want to tell me everything, concerned that a small detail could be key in properly diagnosing their child. They’re often frustrated when I only ask about certain issues or don’t give some symptoms as much weight as the parents have. As an immunologist, I am extremely picky when taking a history. What I need to see are lab results and confirmed diagnoses.
I know that antibiotics are unfortunately often overprescribed for routine viral infections, so when a parent tells me that their child has been on antibiotics six times this year, I can’t give that information much weight unless it’s backed up with other historical details or test results confirming frequent bacterial infections. Many walk-in clinics or emergency rooms may diagnose a child with pneumonia just by listening to their lungs, but that doesn’t actually confirm pneumonia. What I need to see are the chest x-rays that are consistent with the diagnosis. I need to know that your doctor recorded a fever when they saw your child for an ear infection and that your child was in discomfort, not just that the eardrum was red (especially if they weren’t complaining about it beforehand). If your child has recurrent skin abscesses, I need to see the results from the cultured bacteria to determine if the bacteria are consistent with the type of bacteria we see when the immune system isn’t functioning.
I know this is frustrating for parents, especially if the necessary some of these steps haven’t been taken before they arrive at my office. Testing for PIDs can be invasive, uncomfortable and stressful for children, and the last thing I would want to do is to subject any child to those tests if it wasn’t necessary. So before I can tell if your child requires further testing, I need you to arm me with as much data as possible.
I’m rarely able to give parents a diagnosis or next steps the first time we meet. It takes time to carefully review all of the concerns and then thoughtful consideration about if and what testing should be performed. Sometimes we check labs just to help rule out a scary diagnosis and provide reassurance to parents. Sometimes we decide to perform watchful waiting, knowing that some kids just have bad luck and suffer from a few severe infections in a row. Again, while blood draws and other tests may be no big deal for most adults, for kids they can be terrifying and painful. As a father of two, the last thing I’d want is for my own children to go through that unless it was necessary.
When I tell concerned parents that their child’s medical history and symptoms likely aren’t indicative of a primary immune deficiency, what are some of the other reasons their child is so sick? Before we worry about PIDs we need to first consider the secondary causes of frequent infections. Are they in daycare or have siblings in school? If so, then they are exposed to tons of ‘normal’ infections. Exposure to tobacco smoke in the home or car, underlying chronic health conditions such as allergies, asthma, cystic fibrosis, congenital heart disease, kidney disease, etc. can all lead to increased infections. Additionally, the waiting rooms in hospitals and doctor’s offices are cesspools! People are usually there because they’re sick; every surface they touch is a reservoir of germs. Door handles, chair armrests, magazine covers, the pen you use to check-in are all covered in germs. If your child is at the doctor’s office being treated for one infection then quickly develops another infection, it is likely due to exposure to all the germs in health care facilities. I’ve seen countless kids develop vomiting/diarrhea days after being treated by their doctor for a respiratory illness.
If you have concerns about your child’s health it’s always OK to call your child’s doctor to talk through your concerns and see if a referral to a pediatric allergist/immunologist is appropriate. Hopefully, this post puts your mind at ease or at the very least arms you with more information.
Originally posted at http://thescientificparent.org/frequent-illnesses-immune-system-low-compromised/ by Dr. Dave Stuckus, MD
What Are The Best Colors For Family Pictures Outside?
Picture this: It’s a bright summer day, you’re wearing your best clothes, and your family has gathered together outside for some pictures. Now, what color is best to wear?
This post is meant to give you an idea of the best colors for family pictures outside. It can be tricky trying to figure out what colors will best show the best family pictures outside. Because there are so many different colors, it can be difficult to find out what will best show off your best features.
This is a hard question because every person has his or her best color for photos, which means that everyone should come up with their best colors for pictures outside.
Best colors for outside family pictures.
A color scheme for family photos that works in any season is navy, cream, and tan, which are timeless and work well in any weather. The cream and navy colors go well with the spring pastels and bright greens. They also look good with the green grass and trees in a park.
When it comes to color schemes, most of them have one or two bright colors mixed with one or two “neutral” colors. The outfit’s main color is coral. Navy, gray, white, and other neutral colors help to ground and balance the bright coral in this outfit. They also help to make the coral look less bright.
Wine, cream, and gold
If you want to take a holiday family picture, this color scheme will work well. When we think about holiday family photos, the colors red and green are often the first things that come to mind. For pictures of Christmas, go to the site. However, if you do plan to use them, a wine, cream, and gold color scheme will put you right in the Christmas spirit.
Pink, tan, and cream
The colors that people like the most are pink, cream, and tan. Photos of the family on the beach are good for. Here’s what you should wear on a trip with your family: for It is very simple and monochromatic. The soft, pale pink color of this family set is almost like a neutral. There are a lot of shades of tan and cream.
It’s a good idea to use peach, blue, and denim in your family photos in the springtime. Peach goes well with the pastel-colored flowers that bloom in Northeast Ohio in the spring. As a neutral, jeans keep the outfit from becoming too bright with the new spring colors.
This blue, white, red, and blue color scheme feels right for a Fourth of July family picture. Because red is so attention-grabbing, it can be hard to work within photos because of this. I think it’s great for making eye-catching family portraits. If you want to use red in your color scheme, think about where your meeting will be. It would be best if the backdrop was neutral-colored, like at the beach or in city downtown. This color scheme is why even though there is a lot of greenery, your picture might have a Christmas feel.
Things to consider when picking the best color of clothes for family photos
As soon as you figure out which colors are best for the season, narrow them down to just a few based on where the shoot is taking place.
When it comes to urban themes, bright colors work well, but they don’t look good in a field or with trees and grass around them.
In the same way, don’t use pale pastels when you’re in front of a light background, such as the wall of a building or structure. This goes for dark backgrounds, too.
The colors of your home:
Look at the colors in the place where the photos will be shown. If all you see are muted and soft colors, there’s no need to be bold with your clothes. There is no doubt that the opposite is true, too.
The skin tone:
They look best with warm colors like brown and yellow and warm shades of red and orange and brown and yellow and orange and reddish-purple and reddish-purple and cream.
If you want to look good, don’t wear jewel tones or icy shades. Make sure you don’t wear orange and red near your skin.
Top tips to get the colors right for family pictures!
A color that doesn’t match one of your family members’ skin tones but you still want to stay in your chosen palette? Choose a top and pair it with a bottom from your chosen palette.
Consider looking at store displays for ideas. Typically, the windows show off the season’s most fashionable clothes, as well as the best colors in the clothes.
In order to add a little color to your neutral palette, have one member of the family wear a brighter shade, or even a different shade.
It’s important not to go overboard with your desire to add color.
With different textures and accessories, like belts and scarves, you can make the look even more interesting.
Instead of matching, try to add something to each other. This isn’t just true for colors, but also for different styles of clothes. So, if most of you are wearing jeans, add a dress or two to make things even.
As parents, it is important to choose clothes that are not only in the right colors but also the most comfortable. So you won’t have to deal with kids who are fidgety and angry when they want to undress.
When you are choosing the best colors for family pictures outside, it is best to look at what other people are wearing in the photographs. You do not want your group to look bland or have an entirely different color scheme from everyone else in the photos. This could cause confusion over who belongs with whom.
If you have a hard time picking the best colors for family pictures outside, maybe even the best colors for family photos in general take a look at the best color combinations for group photos.
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5 Best Probiotics For Kids – Buying And Health Guide
Probiotics are live microorganisms (bacteria and yeast) that benefit your digestive system. Researchers aren’t sure how they function, but research suggests that they may aid in a variety of health issues, including stomach problems, skin conditions, allergies, oral health difficulties, immune support, and more. Truvani, Klaire Labs, and Mary Ruth’s Liquid Probiotic are among the best probiotics.
Are probiotics okay to use?
Probiotic supplements are generally considered safe. The FDA has certain rules for some, while a third-party organization performs quality testing on others. The majority of people will not experience any adverse effects from consuming a probiotic, however, if your youngster does, they are usually minor and transient, such as bloating or mild digestive discomfort.
Adding a probiotic to your diet is one of the most natural, efficient, and safest methods to improve your family’s digestive health and immunity. And what’s better, probiotics are manufactured specifically for children! But how do you decide which one is best for your little ones?
The 5 best probiotic supplements for kids
1. Children’s Probiotic and Pre & Probiotic from Llama Naturals
This is the only probiotic on my list that includes prebiotics! It’s also 100 percent organic and contains real fruit. There are no added sugars, sweeteners, waxes, acids, food coloring, or gelatin in it. They’re plant-based with 4 billion colony-forming units and vegan. The size is perfect for kids 5 years and older, and the 2 oz. size is great for those over 5 years of age.
2. Garden of Life Raw Probiotics
It is a supplement made from fermented bacteria .Preschool ABCs Organic, vegan form is a powder that may be used to make smoothies more nutritious. This variation has a subtle banana flavor and is available in powder form, making it easy to incorporate into a breakfast smoothie. It’s also gluten-free, certified organic, and contains no sugar.
It’s gluten-free, lactose-free, and vegan friendly. This product comes in the form of a powder that may be mixed with water, milk, juice, or even food. It’s recommended to keep it refrigerated if possible.
3. Klaire Labs
Lactobacillus reuteri NCHH-3112, also known as Reuterin, is a unique probiotic that’s been shown to help prevent cavities. It’s available as a liquid and powder and can be added directly to milk or baby food. It’s hypoallergenic, low in calories, gluten-free, and non-GMO.
A 2012 study published in the “Journal of Clinical Nursing” found that, when schoolchildren took a L-reuteri preparation for eight weeks, their dental health improved dramatically. A 2014 study published in “The Scientific World Journal” confirmed the findings. Researchers concluded that taking L. reuteri.
This vitamin might be a wonderful addition to your baby’s formula-fed diet. The choice is vegan, including vitamins B and D as well as iron, making it a supercharged multi-vitamin for your child. This option is in powder form and may be mixed into food or drinks. It’s flavored to taste like orange fruit punch for a slightly sweet flavor, but there are no artificial chemicals, colors, or sugars added to it. 5 billion colonies forming units per serving.
4. Mary Ruth’s Liquid Probiotic
It’s a liquid best probiotic that’s also 100 percent Organic, Raw, Non-GMO, Paleo, Wheat Free, and Corn Free, Ketogenic, Gluten-Free,. Bariatric and Celiacfriendly It’s shelf-stable and flavorless, so it’ll last for a long time and can be used in almost any recipe. It’s a great option for those who don’t like taking pills. 5 billion colony-forming units per serving.
This supplement is a great choice if you or your child is lactose intolerant or has an allergy to cow’s milk, as this powder contains no dairy
The capsules are simple to consume. The contents of the capsules may be readily blended into food or beverages for children. With a unique blend of 15 probiotic strains, this little work might pay off big time. This probiotic is GMO-free and does not contain any additional chemicals.
Organic Pre & Probiotic Powder for Kids by Preschool ABCs
This is the only probiotic on my list that also includes prebiotics! It’s also 100 percent organic and made with real fruit. There are no added sugars, sweeteners, waxes, acids, food colorings, or gelatin in it. They’re plant-based and vegan as well as GMO-free.
Rainbow Light Probiolicious Gummies
These delicious cranberry-flavored gummies are free of milk, soy, eggs, fish, wheat, gluten, shellfish, and lactose and contain no artificial flavors or colors. The gel in this supplement is animal-based; therefore it’s not suitable for vegans. 1 gummy contains 500 million CFUs and combines both probiotics and prebiotics.
This supplement was formulated to help those with lactose intolerance, as the digestible carbohydrate in it helps to break down lactose and ease its digestion. Best used daily, this supplement is a great way for adults or kids that have trouble keeping track of pills to get their necessary 5+ strains
Consider giving your child probiotics in addition to his or her regular diet. Similar health advantages for adults — from aiding the development of healthy digestive bacteria to strengthening their immune system — may be gained by giving children probiotics. However, before you start adding this to your child’s diet, talk to their doctor about whether probiotics are right for them. Use the following list of seven probiotics for youngsters as a guide once you’ve gotten the green light to begin supplementation.
Do I need to refrigerate my probiotics?
Probiotics should be stored in an area that is not exposed to direct sunlight. If you have a probiotic pill, it can be stored anywhere because it does not require special storage conditions. Probiotic liquids however will need to be refrigerated if they are kept for any period of time longer than 5 or 6 days.
How can you tell if probiotics should be kept in the refrigerator?
Typically, they should. The labels on the packaging of all probiotics tell us where we can store them and how long we can expect them to be viable outside that range (the usual shelf life). Usually, this is 5 days to 2 weeks – but keep in mind that “best by” or “expiration date” doesn’t really apply to probiotics. They are more akin to food, not medication. If the product gets old but isn’t bad, it’s still good for you. When in doubt though, give it 5 days and see what happens!
Are there any dangers of refrigerating probiotics?
Probiotics are not sterile products. In fact, they’re filled with living microorganisms! More specifically, there’s a whole colony of bacteria. Another step to examine if you should chill your probiotics is by thinking about how you initially purchased them.
Probiotics that need to be kept cold are generally located in the refrigerator section of the shop or pharmacy, while probiotics that can be stored at room temperature are more likely to be found in the non-refrigerated sections.
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