ParentTime - ParentTime Live! Event Transcript

ParentTime Live! Transcript

Bathtime Earaches
Frequent Infant Ear Infections
Nose-Picking
Ear Infections and Slow Development
Ring Around the Trachea
Hereditary Allergies
Ear Tubes
Ear Tags
Identifying Colds and Allergies
Blocked Tear Ducts
Grinding Teeth
Head Lice
Childhood Hearing Loss
Antibiotics and Secondary Infections
Hoof and Mouth Disease
Exposure to Chicken Pox
Runny Noses
Helping a Congested Baby Sleep
Using Q-tips

Dr. Nancy Snyderman on ParentTime Live!

In this January 24 moderated chat event, Dr. Nancy Snyderman answered questions about children’s ear, nose, and throat ailments.
ParentTime

Be sure to check the schedule of upcoming ParentTime Live! events.

Moderator: Welcome to ParentTime Live! Today we are discussing Your Child’s Ears, Nose and Throat with Dr. Nancy Snyderman, medical correspondent for ABC News, practicing physician, and mother of three.
Bathtime Earaches

Question: My three-year-old daughter hates having her hair washed — which is not unusual — but she complains each time that the water that gets into her ears hurts. Other than this complaint, there doesn’t seem to be anything wrong with her ears; she isn’t holding or pulling them and there doesn’t seem to be any infection. Is this something to bring her to the doctor for? Could there be something wrong with her ears that is asymptomatic until they get wet?
Dr. Nancy Snyderman: Anytime a child complains of ear pain, you have to take it seriously. It’s possible that your child has an infection in the ear canal or a hole in the ear drum. Both of these problems are easy to diagnose. Make sure your pediatrician or ear, nose, and throat doctor take a look. If everthing is okay, the pain may be nothing more than pressure and fullness from having water in the ear canal.

Frequent Infant Ear Infections

Question: Is it common for babies to have frequent ear infections? Our baby is five months old and has had two ear infections in one month.
Dr. Nancy Snyderman: Yup. That’s because the eustachian tube — which connects the middle ear to the back of the nose — is on a horizontal plane in children (in adults, it’s on a 30-degree angle). So anytime a child gets an infection like a common cold, it can immediately go to the ear. You have two options right now: Treat each ear infection with antibiotics and hope that during the spring the infections will stop. If they don’t, consult an ear, nose, and throat doctor to see if tubes should be put in your baby’s ears.

Nose-Picking

Question: What advice would you give a parent whose four-year-old eats his snot? We’ve told him it has germs and that it’s disgusting, but he just won’t stop. Any suggestions?
Dr. Nancy Snyderman: I would approach this not as though his snot is dirty or infected, but that there are some things we don’t do in public. We don’t pick our noses, we don’t pass gas and we don’t pick fistfights. This conversation should center around good manners, and I would keep it at that.

Ear Infections and Slow Development

Question: My son suffered from ear infections for the first year and a half of life. Now he’s three and a half and is just beginning to string together two- and three-word sentences. The speech therapist suggested that he may be a full year behind in his language development. Does this sound right to you? What can we do to help him catch up?
Dr. Nancy Snyderman: Have him see an ear, nose, and throat physician immediately. It’s possible that there is still fluid in the middle ear, or that scarring from an infection has kept his hearing from being normal. For a child to develop normal speech and language on time, a child must be able to hear. So have your child’s ears looked at, and then checked with an audiogram. This should be done before you enter speech therapy.

Ring Around the Trachea

Question: My 14-month-old son may have a vascular ring around his trachea. Have you ever heard of this before, and what is the prognosis?
Dr. Nancy Snyderman: This is a relatively well-known birth defect. It occurs when a blood vessel passes around the esophagus and can interfere with swallowing. Sometimes there is nothing to do, other times it requires surgery. You should have a long talk with your pediatrician and get a second opinion from a pediatric surgeon.
Question: Should the vascular ring be treated by his ENT? Do you know of any leading authorities on this type of problem that we can contact?
Dr. Nancy Snyderman: No. A vascular ring is treated by a pediatric general surgeon. Depending on where you are in the United States, I would check with the nearest Children’s Hospital.

Hereditary Allergies

Question: Our six-month-old is constantly stuffed up. She sleeps with a cool air mister. My husband suffers from allergies and asthma. Is it hereditary? What can we do to help her?
Dr. Nancy Snyderman: It’s very possible that your daughter’s allergies are related to your husband’s. Parents with allergies are more likely to have children with allergies. You should see a pediatrician at your earliest convenience.

Ear Tubes

Question: My five-year-old daughter has had recurrent ear infections and fluid in her ears. She had tubes put in at 13 months, but they fell out last year. She rarely gets ear infections anymore, but she continues to get fluid in her ears. An ENT recommended re-inserting the tubes and having her adenoids removed. I am planning to get a second opinion in January. I really don’t like the thought of more surgery. I also don’t want her to begin school next year and have difficulty learning. Do you have any suggestions?
Dr. Nancy Snyderman: I think that the advice from your ear, nose, and throat physician is good. None of us want our children to have surgery if they don’t need it. But we shouldn’t be so afraid of surgery that we put our child’s welfare at risk. Even though you say that there is no ear infection, there should never be fluid in the ear. Tubes will drain the fluid and put air into the middle ear. It’s true that your daughter is about the age where she should no longer be getting ear infections, but in the meantime she is still having trouble, so I think that the advice you received is sound.
Question: Our eight-month-old baby girl has chronic ear infections and wakes up almost like clockwork every hour. She is on Amoxicillin and will have tubes put in her ears at the end of this month. Will that help her sleep through the night?
Dr. Nancy Snyderman: It may. Stick with the present plan and be sure you get those tubes in.

Ear Tags

Question: I have a ten-month-old daughter who was born with large ear tags on either side of her face. A plastic surgeon removed them two months ago, but after the surgery the doctor said my daughter’s face was assymmetrical. I never noticed this until he pointed it out. Have you ever seen this before, and do you recommend surgery to fix the problem?
Dr. Nancy Snyderman: I have seen many cases like this. Ear tags usually indicate that a portion of the face or hearing system have developed abnormally. The problem may require nothing more at this time. However, this is the time to find out if there might be other problems aroung the corner. You should see a pediatric ear, nose, and throat specialist, which will most likely require you to visit your local Children’s Hospital.

Identifying Colds and Allergies

Question: How can I tell the difference between a cold and an allergy in my child?
Dr. Nancy Snyderman: It can be difficult. The hallmark is that a cold will last seven to ten days, and may be accompanied by a fever. An allergy will last longer and may be accompanied by a watery, runny nose; itchy eyes; and dark circles around the eyes. When in doubt check, with your pediatrician.

Blocked Tear Ducts

Question: My 11-month-old daughter has had blocked tear ducts since birth. Her eyes get yellow-green stinky goop in them. The eye surgeon I’ve seen wants to run a tube through the tear duct. I’m concerned about side effects from this procedure. What would happen if I didn’t have the procedure done?
Dr. Nancy Snyderman: She won’t get better without the procedure. Your eye doctor is giving you good advice. Please go ahead and do this. It sounds like you are in good hands.

Grinding Teeth

Question: My 16-month-old son has been grinding his teeth ever since the first top and bottom ones broke through. I’m not sure it’s related, but he has a double ear infection also. This week he has increased his teeth grinding until it is driving us all crazy. The pediatric dentist says he shouldn’t have a checkup until he’s at least two years old. Why do toddlers grind their teeth, and is there anything that I can do to stop it?
Dr. Nancy Snyderman: Toddlers grind their teeth because of stress or tension, and in that way they are a lot like you and me. There’s really nothing to do at this point. Be reasurred that this will probably go away. It could be related to the ear infections, but overall it should not cause you much concern. However, the grinding could cause a bigger deal when the permanent teeth are in because they could be ground down and damaged.

Head Lice

Question: This isn’t about ears, but my child has head lice. I’ve used nix, tea oil, and prescription medicine, but I continue to find nits. Does this mean the shampoos aren’t killing all the lice and nit eggs? Please help!!!
Dr. Nancy Snyderman: Congratulations! Join the millions of us who have been battling the same problem. Lice have become an epidemic in this country, and there is a growing resistance to many over-the-counter lice shampoos. My advice is this: get one of the anti lice agents from your drug store and use it according to directions. Then, prepare to spend hours meticulously pulling the nits from the hair shaft. When you think that you can’t take it anymore, take a break and then do it again. It may take two or three days of constantly going over your child’s head. Don’t hesitate to alternate the lice shampoos you are using if you think that one is not doing its job. This is a particular problem right now, and I hope that you are comforted by the fact that you are not alone. Don’t forget that an important part of treatment is washing all bedding, and bagging all stuffed animals for at least six weeks.

Childhood Hearing Loss

Question: My five-year-old child lost a significant part of her hearing in one ear from the mumps. How will this affect her speech development?
Dr. Nancy Snyderman: If it’s just in one ear it should not affect anything. If its in both ears, it all depends on how severe the hearing loss is. Make sure she gets hearing tests every year. And if you are worried about the status of her speech, see a speech therapist right away.

Antibiotics and Secondary Infections

Question: Do you think antibiotics make diseases recur? Is there a better course of treatment for secondary infections?
Dr. Nancy Snyderman: Antibiotics should be used when needed — but only when needed. They should not be used for viral infections or because you don’t feel quite right. When an antibiotic is prescribed, be sure to take the entire prescription. If they are used intelligently, the risks of secondary infections and resistence should be minimal.

Hoof and Mouth Disease

Question: Why do children get hoof and mouth disease? Is there anything I can do to prevent this in my child?
Dr. Nancy Snyderman: No. This is a contagious illness that children sometimes get in childhood, but it rarely causes problems.

Exposure to Chicken Pox

Question: Do you recommend purposely exposing your child to chicken pox?
Dr. Nancy Snyderman: Yes. It’s now or later. When one of my children came home with chicken pox, I exposed her to the rest of my family. But, it didn’t work and everyone got it on their own time schedules. The other option right now is the chicken pox vaccine. It appears to be safe and should decrease the chance of a bad infection.

Runny Noses

Question: My eight-month-old’s nose streams constantly and he doesn’t like us to wipe it. What can I do?
Dr. Nancy Snyderman: Wipe it. Join the club. Wipe it or teach him to do it. Those are the options.

Helping a Congested Baby Sleep

Question: When my baby is congested, should he be sleeping in a prone position, or can we put a pillow under his head to help drainage?
Dr. Nancy Snyderman: I don’t like having pillows in babies’ beds. No baby is going to choke from having a stuffy nose or secretions. Get a rubber bulb syringe from your drug store and suction your baby’s nose before going to bed. Then, the same rules apply: your baby should go to bed on his back.

Using Q-Tips

Question: Is it okay to use Q-Tips to clean my children’s ears? I keep hearing that they’re dangerous.
Dr. Nancy Snyderman: They are, and yes you can — if you are oh-so-careful. I do it this way: I put baby oil on the end of the Q-Tip, and my child lies on her back on my bed (my kids know that this is not a time for playing around). I gently clean the wax from the outer ear and ear canal. I think that it is dangerous for a non-physician to put a Q-Tip in the ear. There you have it. If your child complains of any discomfort or doesn’t like this, don’t force the issue.

ParentTime Live! Transcript Bathtime Earaches Frequent Infant Ear Infections Nose-Picking Ear Infections and Slow Development Ring Around the Trachea Hereditary Allergies Ear Tubes Ear Tags Identifying Colds and Allergies Blocked Tear Ducts Grinding Teeth Head Lice Childhood Hearing Loss Antibiotics and Secondary Infections Hoof and Mouth Disease Exposure to Chicken Pox Runny Noses Helping a Congested Baby Sleep Using Q-tips		Dr. Nancy Snyderman on ParentTime Live! In this January 24 moderated chat event, Dr. Nancy Snyderman answered questions about children’s ear, nose, and throat ailments. ParentTime Be sure to check the schedule of upcoming ParentTime Live! events. Moderator: Welcome to ParentTime Live! Today we are discussing Your Child’s Ears, Nose and Throat with Dr. Nancy Snyderman, medical correspondent for ABC News, practicing physician, and mother of three. Bathtime Earaches Question: My three-year-old daughter hates having her hair washed — which is not unusual — but she complains each time that the water that gets into her ears hurts. Other than this complaint, there doesn’t seem to be anything wrong with her ears; she isn’t holding or pulling them and there doesn’t seem to be any infection. Is this something to bring her to the doctor for? Could there be something wrong with her ears that is asymptomatic until they get wet? Dr. Nancy Snyderman: Anytime a child complains of ear pain, you have to take it seriously. It’s possible that your child has an infection in the ear canal or a hole in the ear drum. Both of these problems are easy to diagnose. Make sure your pediatrician or ear, nose, and throat doctor take a look. If everthing is okay, the pain may be nothing more than pressure and fullness from having water in the ear canal. Frequent Infant Ear Infections Question: Is it common for babies to have frequent ear infections? Our baby is five months old and has had two ear infections in one month. Dr. Nancy Snyderman: Yup. That’s because the eustachian tube — which connects the middle ear to the back of the nose — is on a horizontal plane in children (in adults, it’s on a 30-degree angle). So anytime a child gets an infection like a common cold, it can immediately go to the ear. You have two options right now: Treat each ear infection with antibiotics and hope that during the spring the infections will stop. If they don’t, consult an ear, nose, and throat doctor to see if tubes should be put in your baby’s ears.
		Nose-Picking Question: What advice would you give a parent whose four-year-old eats his snot? We’ve told him it has germs and that it’s disgusting, but he just won’t stop. Any suggestions? Dr. Nancy Snyderman: I would approach this not as though his snot is dirty or infected, but that there are some things we don’t do in public. We don’t pick our noses, we don’t pass gas and we don’t pick fistfights. This conversation should center around good manners, and I would keep it at that.
		Ear Infections and Slow Development Question: My son suffered from ear infections for the first year and a half of life. Now he’s three and a half and is just beginning to string together two- and three-word sentences. The speech therapist suggested that he may be a full year behind in his language development. Does this sound right to you? What can we do to help him catch up? Dr. Nancy Snyderman: Have him see an ear, nose, and throat physician immediately. It’s possible that there is still fluid in the middle ear, or that scarring from an infection has kept his hearing from being normal. For a child to develop normal speech and language on time, a child must be able to hear. So have your child’s ears looked at, and then checked with an audiogram. This should be done before you enter speech therapy.
		Ring Around the Trachea Question: My 14-month-old son may have a vascular ring around his trachea. Have you ever heard of this before, and what is the prognosis? Dr. Nancy Snyderman: This is a relatively well-known birth defect. It occurs when a blood vessel passes around the esophagus and can interfere with swallowing. Sometimes there is nothing to do, other times it requires surgery. You should have a long talk with your pediatrician and get a second opinion from a pediatric surgeon. Question: Should the vascular ring be treated by his ENT? Do you know of any leading authorities on this type of problem that we can contact? Dr. Nancy Snyderman: No. A vascular ring is treated by a pediatric general surgeon. Depending on where you are in the United States, I would check with the nearest Children’s Hospital.
		Hereditary Allergies Question: Our six-month-old is constantly stuffed up. She sleeps with a cool air mister. My husband suffers from allergies and asthma. Is it hereditary? What can we do to help her? Dr. Nancy Snyderman: It’s very possible that your daughter’s allergies are related to your husband’s. Parents with allergies are more likely to have children with allergies. You should see a pediatrician at your earliest convenience.
		Ear Tubes Question: My five-year-old daughter has had recurrent ear infections and fluid in her ears. She had tubes put in at 13 months, but they fell out last year. She rarely gets ear infections anymore, but she continues to get fluid in her ears. An ENT recommended re-inserting the tubes and having her adenoids removed. I am planning to get a second opinion in January. I really don’t like the thought of more surgery. I also don’t want her to begin school next year and have difficulty learning. Do you have any suggestions? Dr. Nancy Snyderman: I think that the advice from your ear, nose, and throat physician is good. None of us want our children to have surgery if they don’t need it. But we shouldn’t be so afraid of surgery that we put our child’s welfare at risk. Even though you say that there is no ear infection, there should never be fluid in the ear. Tubes will drain the fluid and put air into the middle ear. It’s true that your daughter is about the age where she should no longer be getting ear infections, but in the meantime she is still having trouble, so I think that the advice you received is sound. Question: Our eight-month-old baby girl has chronic ear infections and wakes up almost like clockwork every hour. She is on Amoxicillin and will have tubes put in her ears at the end of this month. Will that help her sleep through the night? Dr. Nancy Snyderman: It may. Stick with the present plan and be sure you get those tubes in.
		Ear Tags Question: I have a ten-month-old daughter who was born with large ear tags on either side of her face. A plastic surgeon removed them two months ago, but after the surgery the doctor said my daughter’s face was assymmetrical. I never noticed this until he pointed it out. Have you ever seen this before, and do you recommend surgery to fix the problem? Dr. Nancy Snyderman: I have seen many cases like this. Ear tags usually indicate that a portion of the face or hearing system have developed abnormally. The problem may require nothing more at this time. However, this is the time to find out if there might be other problems aroung the corner. You should see a pediatric ear, nose, and throat specialist, which will most likely require you to visit your local Children’s Hospital.
		Identifying Colds and Allergies Question: How can I tell the difference between a cold and an allergy in my child? Dr. Nancy Snyderman: It can be difficult. The hallmark is that a cold will last seven to ten days, and may be accompanied by a fever. An allergy will last longer and may be accompanied by a watery, runny nose; itchy eyes; and dark circles around the eyes. When in doubt check, with your pediatrician.
		Blocked Tear Ducts Question: My 11-month-old daughter has had blocked tear ducts since birth. Her eyes get yellow-green stinky goop in them. The eye surgeon I’ve seen wants to run a tube through the tear duct. I’m concerned about side effects from this procedure. What would happen if I didn’t have the procedure done? Dr. Nancy Snyderman: She won’t get better without the procedure. Your eye doctor is giving you good advice. Please go ahead and do this. It sounds like you are in good hands.
		Grinding Teeth Question: My 16-month-old son has been grinding his teeth ever since the first top and bottom ones broke through. I’m not sure it’s related, but he has a double ear infection also. This week he has increased his teeth grinding until it is driving us all crazy. The pediatric dentist says he shouldn’t have a checkup until he’s at least two years old. Why do toddlers grind their teeth, and is there anything that I can do to stop it? Dr. Nancy Snyderman: Toddlers grind their teeth because of stress or tension, and in that way they are a lot like you and me. There’s really nothing to do at this point. Be reasurred that this will probably go away. It could be related to the ear infections, but overall it should not cause you much concern. However, the grinding could cause a bigger deal when the permanent teeth are in because they could be ground down and damaged.
		Head Lice Question: This isn’t about ears, but my child has head lice. I’ve used nix, tea oil, and prescription medicine, but I continue to find nits. Does this mean the shampoos aren’t killing all the lice and nit eggs? Please help!!! Dr. Nancy Snyderman: Congratulations! Join the millions of us who have been battling the same problem. Lice have become an epidemic in this country, and there is a growing resistance to many over-the-counter lice shampoos. My advice is this: get one of the anti lice agents from your drug store and use it according to directions. Then, prepare to spend hours meticulously pulling the nits from the hair shaft. When you think that you can’t take it anymore, take a break and then do it again. It may take two or three days of constantly going over your child’s head. Don’t hesitate to alternate the lice shampoos you are using if you think that one is not doing its job. This is a particular problem right now, and I hope that you are comforted by the fact that you are not alone. Don’t forget that an important part of treatment is washing all bedding, and bagging all stuffed animals for at least six weeks.
		Childhood Hearing Loss Question: My five-year-old child lost a significant part of her hearing in one ear from the mumps. How will this affect her speech development? Dr. Nancy Snyderman: If it’s just in one ear it should not affect anything. If its in both ears, it all depends on how severe the hearing loss is. Make sure she gets hearing tests every year. And if you are worried about the status of her speech, see a speech therapist right away.
		Antibiotics and Secondary Infections Question: Do you think antibiotics make diseases recur? Is there a better course of treatment for secondary infections? Dr. Nancy Snyderman: Antibiotics should be used when needed — but only when needed. They should not be used for viral infections or because you don’t feel quite right. When an antibiotic is prescribed, be sure to take the entire prescription. If they are used intelligently, the risks of secondary infections and resistence should be minimal.
		Hoof and Mouth Disease Question: Why do children get hoof and mouth disease? Is there anything I can do to prevent this in my child? Dr. Nancy Snyderman: No. This is a contagious illness that children sometimes get in childhood, but it rarely causes problems.
		Exposure to Chicken Pox Question: Do you recommend purposely exposing your child to chicken pox? Dr. Nancy Snyderman: Yes. It’s now or later. When one of my children came home with chicken pox, I exposed her to the rest of my family. But, it didn’t work and everyone got it on their own time schedules. The other option right now is the chicken pox vaccine. It appears to be safe and should decrease the chance of a bad infection.
		Runny Noses Question: My eight-month-old’s nose streams constantly and he doesn’t like us to wipe it. What can I do? Dr. Nancy Snyderman: Wipe it. Join the club. Wipe it or teach him to do it. Those are the options.
		Helping a Congested Baby Sleep Question: When my baby is congested, should he be sleeping in a prone position, or can we put a pillow under his head to help drainage? Dr. Nancy Snyderman: I don’t like having pillows in babies’ beds. No baby is going to choke from having a stuffy nose or secretions. Get a rubber bulb syringe from your drug store and suction your baby’s nose before going to bed. Then, the same rules apply: your baby should go to bed on his back.
		Using Q-Tips Question: Is it okay to use Q-Tips to clean my children’s ears? I keep hearing that they’re dangerous. Dr. Nancy Snyderman: They are, and yes you can — if you are oh-so-careful. I do it this way: I put baby oil on the end of the Q-Tip, and my child lies on her back on my bed (my kids know that this is not a time for playing around). I gently clean the wax from the outer ear and ear canal. I think that it is dangerous for a non-physician to put a Q-Tip in the ear. There you have it. If your child complains of any discomfort or doesn’t like this, don’t force the issue.