KV Healthcare

Your Home for Health

kids

Bad Breath in Children

· ·

As a parent, you may occasionally wonder how your sweet child can have such bad breath, but bad breath in kids happens!

As opposed to just ‘morning breath’, chronic bad breath (“halitosis”) can have a variety of causes and occasionally can indicate a true medical problem. The most common reasons for halitosis in children include:

  • Poor dental habits: Without routine brushing and flossing, bacteria on the teeth increase, which can cause a filmy layer called plaque. Plaque can lead to cavities and gum inflammation, both of which can cause bad breath.
  • Dry mouth: This can result from not drinking enough water, sucking of thumbs or fingers, chronic nasal congestion, or chronic mouth breathing.  A dry mouth means saliva is not adequate to wash bacteria and food particles away.
  • Infection or disease: Viral or bacterial throat, tonsil, or sinus infections can cause bad breath. The bad breath should improve once the infection resolves. If your child has fruity breath, this is quite unusual and could indicate a serious problem like diabetes, though other signs like excessive thirst and urination would typically be present as well.
  • Allergies: Chronic nasal congestion or postnasal drip due to allergies can create bad breath.
  • Foreign body: If a bead, piece of tissue, or some other small foreign body is stuck up in the nose, a foul odor and nasal discharge from one side of the nose may develop.
  • Large, pitted (having an irregular surface) tonsils: Although shallow pits are normal, they can trap bacteria, nasal secretions, and bits of food, which can become calcified, resulting in a tonsil ‘stone’ or tonsillith. This looks like a small whitish lump and can have a bad odor. It is not, however, pus and does not indicate a throat infection.
  • Certain foods: Eating foods with strong odors like garlic, onions, etc. can cause bad breath, but it is usually temporary.

There are multiple things to try if your child is having bad breath. Brushing teeth well (begin when teeth are touching) at least twice a day, flossing, and brushing the tongue is important. Make sure your child is drinking plenty of water throughout the day. Older kids can chew sugar-free gum with Xylitol which increases saliva, decreases bacteria, and lowers plaque buildup which can keep the mouth healthier overall.

If you observe chronic nasal congestion or mouth breathing, talk with your child’s health care provider.  If tonsil stones are noted, recall that these are harmless and usually go away on their own. Older kids can try gargling with salt water which may loosen the stone. If your child’s breath has a fruity odor especially if there are signs of diabetes, call your child’s provider right away.

Remember that in most cases bad breath is not serious and can be easily remedied. If your child’s breath is not improved by the above measures, a visit with your child’s healthcare provider and/ or dentist may be in order.

more about The contributor

Dr. Elise Herman

Blog Posts
Profile

Dr. Herman is passionate about community health outreach, school programs, and child/family health and wellness. She has more than 31 years of experience as a pediatrician in Ellensburg, Washington, the last 3 with KVH Pediatrics. In 2022 Dr. Herman mostly retired from practice and continues to contribute blog posts and remain a visible advocate for kids in the community.

Indoor Activities with Your Child

· ·

It is great for everyone to get outside daily but sometimes we are stuck inside, often due to stormy weather or extreme cold temperatures. It may be easy to default  to ‘screens’ like video games, iPads, and scrolling on smartphones, but there are lots of things your child can do that involve creativity, brainpower, and just simple play. Use your judgement with the following activities depending on the age of your child.

Art- In addition to drawing and painting, don’t forget Play-doh (home-made Play-doh recipe on-line), cut or torn paper, collages, etc.

Baking (with good supervision of course)

Crafts- Local craft and dollar stores have inexpensive materials appropriate for different ages. “C” can also be for ‘Charades’, the classic guessing game.

Dancing- Put on the classic music you grew up with and rock out with the kids!

Eggs- Use paints or markers to decorate the shells of hard-boiled eggs.

Fort- Let you child get creative making a fort of boxes, blankets, chairs, etc.

Giggling- Tell jokes, riddles, do hand clap routines, etc.

Hair- Have fun with wacky hair styles for the kids (and maybe for you—let them play hairdresser!).

Indoor scavenger hunt- Give kids a list of colors, shapes, and specific items to look for in one room or small area of the house.

Jump rope- This is great indoor exercise if you have enough space.

Kitchen duty can be fun when kids come up with a (simple) menu and you prepare food together.

Listen to music- Consider exploring music of different cultures and parts of the world.

Make music- Use real instruments or pots and pans, shaking a jar of beans, etc. Have a musical parade through the house- noisy but fun!

Necklace– Dye tube-shaped pasta using a small amount of food coloring mixed with white vinegar and let dry. Thread on yarn for a cute necklace (make big enough to go over the head).

Obstacle course-Your child can create a course with cardboard boxes, towels as ‘water’ to be jumped over, a length of string as a ‘tightrope’, throw pillows as rocks to be stepped on with the floor as ‘hot lava’, etc.

Pretending- Kids love to pretend, whether it is acting out a fairy tale or pretending to be a teacher. Endless options!

Quiet activities like puzzles and Legos are a nice way for your child to play independently.

Reading- The reader (either you or your child) can use funny voices and exaggerated emotions which make it very entertaining. Or try Racing in unusual ways: crab-walk, bunny hopping, while holding a big spoon of water, etc.  

Seal, swan, snake- Take turns acting like different animals and see if others can guess which critter is being imitated. Also do some ‘Science experiments’—you can find many ideas on-line.

Tell stories about when your kids were little or make up stories together about adventures their stuffed animals might have. There is a lot of guidance on-line for storytelling.

Uno or other kids’ card games are simple, fun and can encourage good sportsmanship.

Vet office for stuffed animals- Set up a pretend animal clinic- use a flashlight and other household items as ‘instruments’ to examine the ‘patients’.

Writing letters- Teach your kids this ‘lost art’ and let them experience how happy the recipients will be to get an actual letter!

X marks the spot- create a simple map of one room in the house and hide ‘treasure’ (small things like fridge magnets) and put an X on the map for their location. See how your treasure hunters do without too much help.

Yarn- Kids can learn finger knitting, crocheting, or standard knitting with on-line instruction.

Zinnia seeds- Plant zinnia or other (small) flower/ herb seeds in cups with seed or potting mix. A small UV light or a spot on a sunny windowsill will be needed once the seeds sprout.

more about The contributor

Dr. Elise Herman

Blog Posts
Profile

Dr. Herman is passionate about community health outreach, school programs, and child/family health and wellness. She has more than 31 years of experience as a pediatrician in Ellensburg, Washington, the last 3 with KVH Pediatrics. In 2022 Dr. Herman mostly retired from practice and continues to contribute blog posts and remain a visible advocate for kids in the community.

Preventing Respiratory Syncytial Virus Infections

· ·

Contributor Dr. Elise Herman

As the winter weather approaches, so does the ‘sick season’, including illness due to RSV (Respiratory Syncytial Virus). RSV typically starts in fall, peaks in winter, and causes cold symptoms including runny nose, cough, and fever in children and adults. Most kids have had RSV by age 2. Although usually mild, RSV can cause more serious problems like wheezing, pneumonia, and trouble breathing. These problems are more likely in premature babies or in kids with heart disease, lung issues like asthma, and immune system problems. Between 58,000 and 80,000 kids under age 5 are hospitalized due to RSV each year. Adults aged 60 and above are also at higher risk of more severe RSV illness. Reinfections with RSV are common.

Like other colds viruses, RSV spreads by the droplets released by coughing or sneezing. You can also get it by direct contact (for example kissing) or touching a contaminated surface like a counter or cup and then touching your eyes, nose, or mouth.

There is no effective treatment for RSV and since it is a virus, antibiotics do not help. There are, however, two new good ways to prevent RSV—vaccines for adults and antibody treatment for young children. Vaccines stimulate the formation of antibodies to help fight infection (active immunity). Antibody treatments give antibodies directly to the body (passive immunity).

RSV vaccines are available for those 32-36 weeks pregnant during RSV season and if given at least 2 weeks before delivery, will help protect the baby from severe RSV. RSV vaccine is also recommended for those 60 years and older.

Antibody therapy (Nirsevimab) is approved for babies less than 8 months during RSV season (if mom did not get vaccine at least 2 weeks before delivery). Nirsevimab is also appropriate for some infants aged 8-19 months with severe health issues including extreme prematurity, immune system problems, cystic fibrosis, and heart disease. Nirsevimab is an injection and lasts 5 months, so helps protect for the entire RSV season. There is another antibody treatment called Palivizumab that has been used for years, but this is only approved for very high-risk children under age 2 and requires a monthly injection.

Side effects of Nirsevimab are uncommon and include temporary discomfort, redness or mild swelling at the injection site, and a rash. Nirsevimab can be given with routine childhood vaccines and may be given if a child has mild cold symptoms. Children who have had RSV should still receive the antibody therapy due to the risk of getting infected again later in the sick season.

There may be some difficulty having enough Nirsevimab for all kids who are eligible this year; contact your child’s provider about this. Supplies of RSV vaccine for those who are pregnant or 60 and over seem adequate; check with your provider or local pharmacy.

Remember the routine ways we can all help prevent the spread of RSV and other viruses, such as frequent hand-washing, avoiding touching one’s face, staying home if sick, and wearing a mask when appropriate. Also, cover sneezes and coughs, do not share cups or utensils, and keep countertops and other frequently touched surfaces clean. Don’t forget your child’s other important vaccines including Influenza and COVID vaccines as these are also important to help keep your child healthy this winter season.

more about The contributor

Dr. Elise Herman

Blog Posts
Profile

Dr. Herman is passionate about community health outreach, school programs, and child/family health and wellness. She has more than 31 years of experience as a pediatrician in Ellensburg, Washington, the last 3 with KVH Pediatrics. In 2022 Dr. Herman mostly retired from practice and continues to contribute blog posts and remain a visible advocate for kids in the community.

Parent Advice / Back to School

· ·

Contributor Dr. Elise Herman

As summer winds down, parents and children are well aware of the approach of the new school year. Some kids are very excited about learning and seeing their teachers and friends again, while others have more reservations. COVID and recent school shootings complicate this often emotional transition. There are steps parents can take now to make this go more smoothly.

Sleep

If sleep schedules got lax over the summer, start now to get back on track. To make bedtime earlier, adjust the wake-up time, moving this up by 15 minutes a day. Kids ages 3-5 years need 10-13 hours total sleep daily, those ages 6-12 years should get 9-12 hours, and teens need 8-10 hours. Remember, no ’screens’ of any kind for at least one hour before bedtime. Reading to your child before bed (or kids reading on their own) aids in falling asleep and is an excellent habit to develop now.

Nutrition

Ensure your child gets up early enough to have a healthy (not sugary) breakfast, improving attention and mood. If your child is taking lunch to school, review what they would like to bring—plan on including fruits and veggies and avoiding processed foods. Water is much better than juice; if they drink milk, nix the chocolate milk, which has as much sugar as soda. Family dinners are a great way to connect during the school year and have been shown to improve nutrition and emotional health. Although it can be tricky to have family dinners with kids’ sports and activities, try to make this a priority.

School Prep

For younger kids, being able to go to school and play on the playground now is very reassuring. Some schools will allow a visit to the classroom and a brief meeting of the teacher as well. You and your child can look at their school online, where they can see photos of the building and the school staff. Review transportation plans and always spend 10 minutes of “getting ready” time on school mornings so your child can be on time with less stress.

School Supplies

Look at the list for your child’s school and classroom (schools often post this on their website) and buy supplies early. Have your child practice packing their backpack and designate a place at home where it goes at the end of the day. All papers and notebooks should come out of the backpack daily so homework gets done and other things don’t accumulate. Pack the backpack with completed homework and any needed items the night before to help mornings go smoothly.

School Safety

In view of recent events, your child may have questions or concerns about school safety. Reassure them that a school is a safe place and that you are comfortable having them there. Although there may be a spike in COVID this fall, we have good tools (vaccines, treatment, etc.) to help. As tragic as school shootings are, they are rare, and schools continue to work on security to help prevent such violence. We must display confidence in our child’s safety at school, even if we are concerned.

Back to school “nerves”: If your child feels a bit nervous about the return to school, let them know they are not alone. This is common, especially if they are going to a new school (as will be true of many kids in Ellensburg with the new attendance zones). Talk up the positives of learning new things, making new friends, and meeting their teacher. If you recall feeling the same way, share that with them and how your nervousness dissipated over time.

Going back to school in the fall is a big deal for you and your child; let them know you have confidence in their ability to rise to this challenge. Planning a fun post-school activity and a special family dinner after that first day will give them something to look forward to and be a terrific way to celebrate this transition.

Local School Districts

Below is a list of Kittitas County school districts and their Facebook pages. Schools often post supplies lists, drop-off/pick-up info, scheduling, and other important information for parents and students.

more about The contributor

Dr. Elise Herman

Blog Posts
Profile

Dr. Herman is passionate about community health outreach, school programs, and child/family health and wellness. She has more than 31 years of experience as a pediatrician in Ellensburg, Washington, the last 3 with KVH Pediatrics. In 2022 Dr. Herman mostly retired from practice and continues to contribute blog posts and remain a visible advocate for kids in the community.