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Keeping Kids SAFE and HEALTHY this Holiday Season

By Dr. Shelly Klein

Holiday decorations, parties, and the overall hustle and bustle around this time of year can pose a threat to children. What are some safety

tips to keep in mind when preparing for the holidays? Children are at risk for electrical injury from lights and decorations and possibly heat related injuries. Families should keep in mind the ages of their children and limit what decorations they may use, or put more dangerous decorations out of reach. Christmas trees pose a fall hazard and, again, hazardous ornaments (i.e. glass) should either be stored for another year or placed high up on the tree. Parents may consider creating a barrier to keep small children away from the tree. While attending festivities, children need to be monitored around hot drinks or other “spiked” refreshments. In addition, parents should place close attention when visiting homes that are not accustomed to children as they may have poisonous materials (cleaning supplies, etc) within children’s reach. This also applies to visitor’s purses or handbags that may contain medications that could harm a child.

Another topic to keep in mind is that children, especially toddlers, have less tantrums and irritability if they maintain a schedule… regular healthy meal times and regular bedtimes. Alterations in either of these often lead to unhappy children and then unhappy adults!

When should we get the flu shot? Influenza season is usually October thru March. Typically, recommendations have been to get the flu shot as soon as it is available in the fall, September to October. With the current pandemic, the seasonality has not been typical and last season, flu cases were minimal compared to previous seasons. It’s not too late to get your flu shot this season.

Now that kids can get the COVID vaccine, when should we plan that

with the flu shot? COVID and the influenza vaccine can be given at the same time or at any interval, meaning you can get the COVID vaccine one day and flu shot the next or vice versa.

Is it ok to visit family that isn’t vaccinated? And vice-versa?

Everything in life has its risks, but, also what is life for but to share with people we love? Parents should make their own decisions on their risk factors and their interaction needs. Every situation needs to be considered on a case by case basis.

Ho can we stay healthy while traveling and seeing family? The general principles apply: Good hand washing, keep your hands away from your face, stay home if sick, and stay away from sick people.

What respiratory symptoms should parents keep an eye on?

What are the biggest risks this winter? Anytime a child is ill, Dr. Shelly Klein is a

board certified pediatrician who started Cornerstone Pediatrics in 2002. She is originally from North Dakota and graduated from the University of North Dakota School of Medicine. She completed her residency at Phoenix Children’s Hospital in 1995. After working in Nebraska for two years, she returned to Prescott, Arizona in 1999. For more information check out their website cspaz.com and Facebook at CornerstonePediatrics.

Dr. Klein has three adult children and in her spare time she enjoys hiking or running or biking in the beautiful Prescott community.

Raising Arizona Kids partners with the Arizona Chapter of the American Academy of Pediatrics to bring evidence-based child-health information to

our communities.

parents need to monitor all of their symptoms. Hydration is important. When respiratory symptoms are present, parents need to ensure their child’s lips are pink and the child is alert (when it’s not normal sleep time). Unusually sleepy children can be low in oxygen. The work of breathing is also important to monitor. With a respiratory illness or fever, a child may breathe faster. If this rate is excessive (actual number is based on age) or the child is working hard to breath by using abdominal muscles, heaving with shoulders, or ribs are visible with each breath in, the child should be evaluated by a medical professional.

Each winter, influenza and RSV are primary respiratory illnesses that affect children. This past year and the current year, we have added Coronavirus as another concern. All are respiratory viruses that are easily transmitted, so, maintain good hand hygiene and stay home when feeling under the weather.

Ankyloglossia (tongue-tie) due to a short lingual frenulum, in a 4 years old child. Photos courtesy of Creative Commons.

POOR SLEEP? ATTENTION ISSUES? HEADACHES? BED WETTING?

A tongue-tie may be having a bigger impact on your child’s health than you realize!

By Dr. Erika Rowe

I TRIPLE DOG DARE you to breathe solely through a coffee stirrer straw for ten minutes. Did you try it? Do you have the worst headache of your life? Would you be willing to breathe like that overnight and then attend a continuing education course and be graded on what you learned? Well here’s a shocker: many children spend every minute of their sleep struggling to breathe due to tethered oral tissues (TOTs) or tongue ties. The average 7-year-old has 7mm of airway space to breathe with. When they lie down and their tongue is not sealed to the roof of their mouth, their airway

collapses down to 6mm! That leaves a 1mm coffee straw to get oxygen through all night. Take a moment and think how hard it was to function and focus after 10 minutes!

You may have an idea that oxygen deprivation is not a good idea for anyone, but when you take a closer look at Sleep Disordered Breathing (SDO) in children there is a terrifying list of consequences to our children not getting enough oxygen while they sleep. The condition ankyloglossia or tongue-tie is a remnant of tissue in the midline attaching the undersurface of the tongue to the floor of the mouth. It restricts the movement of the tongue and prevents it from being able to seal to the roof of the mouth and allows an individual to breathe properly through their nose while sleeping. This tiny bit of leftover tissue affects how we breathe, if we can fully cleanse our teeth, how we speak, how our upper jaw and therefore our lower jaw grows, our endocrine system, being misdiagnosed as having ADD/ADHD, potty control, and training issues, if we get allergies, if we will get lots of ear infections, if our tonsils and adenoids enlarge to just name a few.

For many people, they discover their child has a TOT when they have difficulty breastfeeding and deal with pain, and sadly sometimes the end of a journey they wanted to take. For others, they don’t discover it but overproduce, suffer from many bouts of mastitis, and deal with babies who are labeled “colicky”. Some even are given acid reflux medications that do carry some significant side effects of their own. I have heard from lactation consultants in Phoenix that they are not even allowed to call a new parent’s attention to their baby’s tie in the hospital setting. The lucky ones are identified early and matched with a great team including a release provider, a lactation consultant, and a chiropractor, physical therapist, or bodyworker who is familiar with Oromyofacial therapy. When aftercare is properly managed by the parents and their team these babies are in a great place for optimum jaw growth, a much happier breastfeeding journey, and get to avoid all the consequences of an untreated tongue-tie.

So I am sure by now it has crossed your mind so if my child has a tongue tie and didn’t get it released as a newborn does it matter? Here’s where you have to ask yourself do you like to prevent health problems before they happen or do you like to fix things after they become a problem. Dr. Kurt and I have always run our practice based on the philosophy that our #1 job isn’t doing fillings or crowns, it's preventing the need for them. There are always going to be people who don’t change their oral care habits and plenty of teeth to treat. We want to teach our patients how not to need us for restorative care. So we strongly believe if there is a way to help jaws grow and not need orthodontic care, a way for tongues to move freely and not need extensive speech therapy and most importantly grow a big healthy airway, future issues with SDO won't happen and affect your or your child’s systemic health. Oh yeah did I mention there’s a very high genetic connection with TOTs? So if your little one had a tie, you or your husband or both likely do too.

Your tongue is the muscle in your mouth that determines how ideal your upper jaw grows. If it doesn’t provide the pressure it would when properly sealed a person will end up with a high vaulted or v-shaped palate and a very narrow nasal floor, which also increases upper airway resistance, and a small lower jaw with no room for all the adult teeth to be properly aligned. If the tongue is in its proper sealed position we get a nice wide and flatter upper jaw, nasal floor, and our lower jaw is able to grow and has space for all our teeth. All these things together influence how large your airway will become. How effortlessly and well you can get enough oxygen throughout your lifetime. This is a huge influence on your systemic health from birth to death. It is time to ask ourselves are tethered oral tissues really just a breastfeeding issue?

There is a great resource thehealthystart.com/quiz to see if your child is exhibiting signs of Sleep Disordered Breathing (SDB).

Drs. Kurt and Erika Rowe,

parents to Kole (12) and Lilly (9) received their DMD from the University of Pennsylvania School of Dental Medicine in Philadelphia, PA. Their practice Rowe Family Dentistry is in Paradise Valley, AZ. rowefamilydentist.com