Measles is extremely contagious, infecting nearly 90 percent of unvaccinated people who come into
contact with it. Why is it so contagious? It’s spread through the air (via coughing/sneezing). People standing in the airspace around the infected person can become infected by breathing in these respiratory droplets; they do not need to be sneezed
or coughed on directly. Those infected with measles are at their most contagious the four days prior to the appearance of the rash, meaning they are extremely contagious before they themselves are aware of the virus.
Measles symptoms develop
approximately 8-12 days after exposure but the measles rash will not develop until 3 -5 days after symptoms first appear. The first symptoms are similar to a severe cold:
The measles rash begins on the face but quickly spreads downward, covering the body. Fever may be at its highest—topping 104 degrees Fahrenheit—at
the appearance of the rash.
Before the measles vaccine, more than three to four million people in the U.S. would contract the virus each year. Infected individuals can develop mild-to-severe complications including pneumonia, blindness, deafness,
brain swelling, permanent neurological damage and even death.
Julie Holland, MD, Head of General Pediatrics at NorthShore,
discusses who should receive the MMR (measles, mumps and rubella) vaccine and when:
Everyone should be vaccinated. Vaccines like MMR are a safe and effective way to prevent the spread of the virus. While there have been small outbreaks in the
U.S., measles is very common in other parts of the world and can spread easily to the unvaccinated and under-vaccinated in the U.S.
Make an appointment or call your doctor or your child’s pediatrician
to ensure you and your children are adequately vaccinated.
Every parent has been there at one point or another—at the mercy
of his or her child’s tantrum in the checkout line at the grocery store, in a crowded restaurant or at home. In a matter of minutes, your child goes from quiet and well-behaved to completely inconsolable.
The good news is
that temper tantrums are entirely normal, especially in toddlers. For toddlers, tantrums are often brought on by a young child’s inability to understand and cope with his/her emotions, emotions related to hunger, tiredness or feeling overwhelmed and
While it’s not possible to prevent every single emotional meltdown, there are ways to manage them. Leslie
Deitch Noble, MD, Pediatrician at NorthShore, discusses some of the best techniques for approaching tantrums:
Don’t overschedule. Try not to overexert your child by packing too much into the daily schedule. This
is not to say that every day needs to be the same, but when possible try not to push your child to the limits with errand running. A hungry or tired child is much more likely to act out. If you know you have a long day ahead, let your child know in advance
so he or she will be better prepared for the change of pace.
Be consistent with your approach. Try your best to manage your child’s behavior during every tantrum. Encourage communication during a tantrum. Say, “Use
your words” or ask clear questions to better understand what might be causing your child’s frustration. Lastly, do not give in. Letting your child have his or her way during a tantrum won’t help break the cycle, even if it ends the immediate
tantrum. Ideally, you don’t want to give your child any attention—positive or negative—while he or she is having a tantrum. So, as long as you are not in public and your child is not going to hurt him or herself, the best approach is to completely
ignore your child until the tantrum stops.
Distract. Distract. Distract. If you can, try to divert your child’s attention away from what may have prompted the tantrum in the first place. Be sure that you recognize that
he or she maybe be upset by a situation, but then offer different options or new activities. For example, if your child has a tantrum over wanting a new toy or treat at the store, you can suggest that you find the “new” toy she got most recently
when you go home. A similar approach can be tried with treats. If necessary, try to avoid going down aisles at stores that might prompt meltdowns.
Celebrate (and embrace) the good times. Let your children know when they are
behaving well and encourage this type of behavior. Tell them how happy it makes you when they listen and follow the rules. Along with acknowledging good behavior (and even rewarding it), be sure your children know how much you love and care for them. Much
of what triggers tantrums is children wanting to express their emotions and wanting attention.
Have questions about tantrums? Get answers from other parents and our team of experts in our new online community The Parent 'Hood.
Find out more here: The Parent 'Hood.
There is no magic age for when it’s best to transition your toddler from a crib to the “big-kid”
bed. Much of the timing depends on your child’s readiness as well the need to free up the crib for a new little brother or sister. In most cases, toddlers transition to a bed between the ages of 18 months to 3 years.
Whether you are mid-transition
or only in the planning stages, Susan Roth, MD, Pediatrician at NorthShore, offers helpful tips to make the change a smoother one:
Have questions about transitioning your toddler from a crib to a bed? Join NorthShore's new online community, The Parent 'Hood, to ask and answer questions as well as connect with
our team of medical experts. Check it out here.
Hand, foot and mouth disease (HFMD) is a typically mild but highly contagious
viral infection most common in children under seven years of age. The illness is characterized by mouth or throat pain (due to sores), fever and a rash (typically involving the hands, feet, buttocks, arms and legs). The infection is caused by enteroviruses—most
often coxsackie virus A16—which are transmitted from person-to-person by oral contact with stool, saliva, fluid from skin lesions or respiratory fluids via coughs or sneezes. Herpangina, also caused by enteroviruses, is a cluster of symptoms characterized
by fever and mouth lesions (but no rash). These illnesses are particularly common in child-care settings because of the frequency of contact and germ sharing between children and inadequate handwashing—especially after diaper changes or toilet
use. The viruses can also be transmitted by contact with contaminated surfaces or objects, like toys.
Outbreaks occur most often in summer and fall but can happen anytime, especially if your child is in daycare. Kenneth Fox, MD, Pediatrician at NorthShore, shares symptoms parents should watch for and outlines ways you can make your child more comfortable while the virus runs its course:
Symptoms of Hand, Foot and Mouth Disease:
Symptoms of Herpangina:
Fever and mouth/throat pain usually last three to five days. Other symptoms, like mouth sores and rash (with HFMD)
can last up to seven to ten days. The virus is shed orally for one to three weeks and in stool for two to three months after infection. While there are no cures for HFMD or herpangina, there are things you can do to make your child more comfortable during
those first few days, as well as reduce the risk for dehydration which can occur because of pain and difficulty swallowing.
What can parents do?
Keep little ones hydrated. Try Pedialyte or Gatorade to keep
their electrolytes up. Also popsicles, ice chips and other frozen treats can replenish fluids while also helping with pain.
Reduce pain or fever. Use Acetaminophen or Ibuprofen but check age-appropriate dosages before administering.
Make swallowing easier. Eliminate salty, spicy or acidic foods to avoid further irritating mouth sores. Consider providing a variety of soft foods, like yogurt, pudding and rice. And always rinse mouth after meals.
is not always possible to prevent your child from contracting hand, foot and mouth disease, you can reduce his or her risk, and your own. Here are some ways to keep your kids healthy and prevent the spread of HFMD in your home:
If your child does get hand, foot
and mouth disease, watch for these signs of complications:
Have questions about hand, foot and mouth disease or any other pediatric illness? NorthShore's new online community,
The Parent 'Hood, has answers. Join today to connect with other parents in the community as well as our expert physicans. Click here to start now.
For David Roberts, MD, Pediatric Orthopaedics at NorthShore, helping people was always the goal on the horizon,
which is what ultimately brought him to medicine. Once there, it was the challenge and the enjoyment of treating children that brought him to pediatric orthopaedics.
Here, he explains the ins and outs of his unique specialty
and how his experience as a father has informed the way he treats his patients and their parents:
What first attracted to you medicine? Was there something that inspired you to go
into the field? I chose a career in medicine because I wanted to help people. There wasn’t one specific moment of realization; it was always what I wanted to do with my life. Why did you decide to pursue pediatric orthopaedics as a specialty? I decided to become a pediatric orthopaedist during the middle of my orthopaedic surgery residency.
During my training, I enjoyed all different areas of orthopaedics so it was hard to pick just one area! Pediatric orthopaedics is unique in that you take care of a variety of conditions affecting all areas of the body, from fractures and congenital
anomalies, to scoliosis and spine conditions. It also covers a wide age range, from newborns to young adults. The diverse nature of pediatric orthopaedics is challenging but that’s also what I enjoy most
about it. And, of course, kids are fun.
What do you like most about your job? Seeing my patients get better. Often my patients are in pain or recovering from an injury when we first meet. Seeing them recover and get back to normal, being a part of that, is what I like best about my practice.
What do you find most challenging? Encountering overuse injuries in young athletes is difficult. Young kids are increasingly involved
in sports at "elite" levels, playing harder and longer than ever before. Overuse inevitably can lead to chronic and recurrent injuries of various types. Generally, the cure is simple—rest—but these
are some of the hardest conditions to treat given the pressure from coaches, teammates, parents and even the children themselves. Fortunately with time, rest and realistic expectations, these conditions typically
resolve and permit the child to fully return to activities.
What do you think is an essential skill of a pediatric orthopaedic surgeon? You have to really enjoy working with
children. Treating children is very different from treating adults. Children of different ages require different approaches at interview and examination, which represents the "art" of medicine. To be truly good at it this, you really have to like working with kids, and this is what I like most about my job.
How is treating orthopaedic cases in children different
from adults? Kids are not just little adults. From an orthopaedic perspective, treatment of children's conditions can
be drastically different than in adults, and not just because we have more cast colors to choose from.
Unlike adults, children's bones are still growing, which means they require special respect and consideration during treatment
for orthopaedic conditions. For example, fractures that typically require surgery for an adult may be treated without surgery in a child because of the ability to correct bone alignment over time with growth. Other injuries can potentially affect growth and require close monitoring over time for years after injury. Very young children also may require different treatment for
the same type of injury in an adult because a child may be too young to follow treatment instructions.
Within pediatric orthopaedics, you specialize in scoliosis. What inspired this interest? I specialized in scoliosis because of the positive impact surgery for this condition has on a patient's life. For many patients with severe scoliosis, the condition is more than just a curvature
of the spine. Severe curves negatively affects self-esteem and body image, which are already vulnerable during the teenage years even for those without scoliosis. After
surgery for scoliosis, these patients literally and figuratively stand taller and straighter. It can make a difference to the rest of their lives.
What are some of the biggest influences
on the way you treat your patients? My own experience as a parent has really informed my practice. Having a child gives you practical experience working with children but also the perspective of
a parent. I believe it is my duty to care for your child as I would my own.
Asthma is one of the most common chronic disorders in children, and, for unknown reasons, is on the rise.
Asthma is a reversible lung disease that inflames and narrows airways, causing chest tightness, shortness of breath, wheezing and coughing. While there is no cure for asthma, with modern knowledge and proper treatment, you and your child can take an
active role in managing this disease. If diagnosed, your child can live an active life and sleep through the night without ever experiencing asthma symptoms.
Leslie Noble, MD, Pediatrician at NorthShore, discusses risk factors for and signs of pediatric
What are the risk factors for developing childhood asthma?
What are common triggers that can cause a child with asthma to have “flare-ups”
or asthma “attacks”?
How can you tell if your child has asthma?
Symptoms are not the same for every child and symptoms may even vary from one attack to another in the same child, so diagnosis can be difficult. Here are common symptoms to watch out for and discuss with your child’s pediatrician:
If your child has prolonged experience with any of these symptoms, take them to their doctor immediately
Have questions about pediatric asthma or any other pediatric concern? Join NorthShore's new online community, The Parent 'Hood, to connect with other new and expecting parents, as well as our expert
physicians. Find support, ask questions and share your stories. Click The Parent 'Hood to start now!
Nervousness on the first day of school is perfectly normal both for parents and young students. New routines, new people, new information: it’s a time of transition. But “transition” doesn’t have to be a bad word.
Nancy Zinaman, LCSW, shares some simple back-to-school preparation tips that will make the first day easier on the entire family:
For kindergartners try not to make the first day over emotional. If parents are anxious they need to be aware of their own feelings so as not to make their children more nervous.
Children who have made a smooth transition into preschool may have a harder time transitioning into Kindergarten. You can help make this transition easier by playing on the school playground with your child before classes begin. Visit the school when it
is empty or schedule a tour. If time allows, visit or arrange a one-on-one meeting with the teacher and staff. Familiar faces and places will make the first day so much easier.
For children with special needs it’s important for parents to connect with teachers prior to the first day of class to make sure they are aware of separation anxiety, ADHD or any other family challenges
Find out the best way to communicate with your child’s teacher. Ask your child’s teacher what he or she would prefer: email, phone, etc. This will foster a positive, productive relationship from the start.
Prepare for the new routine early. Don’t wait until the first day to start implementing your new routine. Put the school day structure in place one or two weeks before: establish a back-to-school bedtime; get up early; give kids a fun school-day
task like packing their own lunch or backpack. Don’t over-schedule after school activities the first couple of weeks because your children will be tired after a long day of school.
Talk to your children. Find out how your children really feel about starting a new school year. Is there something in particular that is causing nervousness or dread? Give yourself time to address it or talk to the school about it if it’s
something the school can address. Let your children know their feelings are normal and that they are not alone.
How does your family prepare for the first day of school?
Are stomachaches and messy potty breaks frequent occurrences for little ones in your home? “Stomach problems” happen to
everyone, and children are no exception. Sometimes an upset tummy is just an upset tummy, but children, just like adults, can suffer from food allergies and sensitivities, and just like adults these allergies and sensitivities can and should be addressed.
Vincent Biank, MD, Pediatric Gastroenterology at NorthShore, answers some common questions about GI food allergies and sensitivities
Is there an easy, relatively non-invasive test to see which foods a child is allergic or sensitive to?
There are several simple blood tests for allergies but unfortunately we do not have simple tests for sensitivities that are accurate in children; therefore, we will commonly have to do an elimination diet. We will remove one food item at a time for
two weeks and then replace that food item after those two weeks, carefully documenting any changes in the symptoms. The two most common sensitivities are lactose and gluten. I would not recommend removing gluten from a child’s diet until they have been properly
tested for Celiac disease otherwise you will just need to add it back in for one to two months before it can be accurately checked in the blood.
What foods are typically off-limits for child with soy and dairy allergies? Is it possible to eliminate these foods entirely from a child’s diet?
Soy and diary are in almost everything, so eliminating them is difficult. For this reason, we will have our pediatric dieticians work with families to make sure no soy or dairy in getting into a patient’s diet. Until then, check labels! Anything that
has soy, soy protein, milk, milk protein, casein or whey in its label should be avoided.
Are children with GI food allergies more likely to develop other GI-related issues as young adults and adults?
Unfortunately we don't have enough data to answer this question at this time. Although food allergy with typical symptoms of anaphylaxis, hives, trouble breathing etc. has been diagnosed and treated for many years, the majority of the GI manifestations
of food allergy are recent in their discovery. For example it wasn't until 1995 that Eosinophilic Esophagitis was even considered a diagnosis and now we are diagnosing it one to two times per week. The result is we still don't have a clear idea of the natural
history of GI food allergies over time.
Should children with stomach “issues” be given probiotics, as well as brought in for testing?
The short answer is to go ahead and try probiotics prior to the visit. The long answer is that unfortunately we are only at the beginning of our understanding of what probiotics do, such as which varieties are best, how much to give and how long they
should be taken.
What are some of the warning signs of GI issues in toddlers/children? Should a parent be concerned about frequent loose stools?
The biggest sign of GI issues is poor weight gain. Diarrhea can be a symptom of an underlying GI disorder but not always. We frequently see toddlers with loose stools with no additional systemic signs of disease, like poor weight gain; therefore, we
will typically rule out some common GI-related problems. If tests are negative, we will then discuss how to thicken the stool.
Are the foods known to cause GI allergic reactions in kids the same as those that cause skin or more severe allergic reactions? What are the common foods for GI allergies?
Yes, for some individuals the foods that cause GI allergic symptoms could also cause skin and the typically more severe allergic reaction; however, this is not the case for everyone. Some individuals will only have GI symptoms and others will only
have skin or respiratory symptoms. The most common foods for GI allergies are the “Big Six:” milk, soy, wheat, eggs, nuts and fish.
Does your child have a food allergy or sensitive that results in GI issues?
It’s cold and flu season. There’s no way around it. If it hasn’t happened already, it won’t be long before the common cold and the flu start making the rounds at your child’s school. And kids in school are particularly susceptible because regular hand-washing
probably isn’t at the top of their to-do lists.
Parents, it’s the perfect time to prepare for the sick days ahead. Susan Roth, MD, Pediatrician at NorthShore, shares some effective home
remedies for parents with little ones stuck at home with a bad cold.
What home remedies have worked for you?
Are your kids getting the sleep they need each night? Is your picky eater turning down fruits and vegetables
at every meal? Are bedtimes and mealtimes a daily struggle in your home? This is the “tough stuff.”
Lindsay Uzunlar, MD, Pediatrician at NorthShore, answers these tough questions, sharing bedtime and mealtime solutions and tips
to ensure every member of the family—large and small—is getting the sleep and nutrition they need to thrive.
When should your child start to regularly sleep through the night? When should you be worried that they aren’t sleeping through the night or are waking up too frequently?
Your child is biologically able to sleep through the night around 3-4 months, so with your help they should be able to sleep through the night by six months—meaning sleeping between 6-7 hours without waking up. If your baby is still waking up frequently
at nine months, talk with your pediatrician about some possible sleep-training strategies. Consider talking to your pediatrician about sleep-training techniques earlier than six months, or even during pregnancy.
How do you set bedtimes? How much sleep do children need?
A lot of babies need help learning when and how to sleep so this is where you can make a big difference. Observe when your child seems become naturally sleepy or when he starts to be fussier. When that time comes, put him to bed drowsy but not sleeping.
The key to remember is that you are in charge of bedtime, from infancy until they leave your house. Setting bedtimes is really important and can vary depending on age. Children will naturally start to go to bed later as they need less sleep. A newborn needs
up to 15-17 hours of sleep; a six-month-old needs 13-14 hours; 9-24 months need about 12 hours; school age between 9-10 hours and adolescents 8-9 hours.
How long is it normal for a child to wet the bed? Is a family history of bedwetting a contributing factor? What can you do to stop it?
It is still normal to have nighttime wetting up to the age of six, especially if there is a family history. There are different techniques that you can try. The simplest is just having scheduled wake-up times. With this technique, you set your own
alarm and wake him up to take him to the bathroom. In a perfect world, you could wake him up before you go to bed (assuming you go to bed later than him) and then not worry about it for the rest of the night.
How do you wean an infant of needing a pacifier to remain asleep at night?
As you may have realized, children use pacifiers as a self-soothing object. So the key to helping them transition to good sleeping without is to replace the pacifier with something else. For instance, this is a great time for a teddy bear or blanket. Put them
to sleep with both the pacifier and the new object so that they can learn to associate both with self-soothing. Then you can take away the pacifier and ideally he or she won't notice its absence too much. You can work on having the pacifier gone over the next
2-3 months. I would recommend that you take all pacifiers away at once, that way when he wants it, you can 100% truthfully say that they are "all gone."
What do you do if your child refuses meat? How do you ensure he or she gets enough protein?
Vegetarianism is fine for kids but it is understandable to worry about protein intake. There are other sources of protein besides peanut butter and meat. Some other good sources are: eggs, milk, soy products and whole grain cereals. Try to make sure
your child gets a combination of these at each meal.
How do you handle a picky eater who won’t eat anything other than his or her favorite and probably unhealthy foods?
It takes kids about 10-15 tries of a food before they will like it. So making sure that they take a “no thank you” bite will help give them exposure to the new foods. You can also try introducing new tastes of food mixed with their favorites such as
peas with macaroni and cheese. Your child should be eating the same dinner that everyone else is eating. If they don’t want it, then accept their opinion and let them know that this is the only thing that will be prepared tonight. He or she will be more likely
to eat what has been prepared if they know that they don’t have other options. The key to helping instill change is consistency. So it is important that anyone who consistently cares for your child be on the same page about introducing new foods.
What are some strategies to help children learn to explore more food types if they have texture sensitivities?
For texture sensitivities, it’s a good idea to attempt “try and try again." It can take kids awhile to get used to new things, tastes and textures, so just encourage a single bite each meal and if he or she takes it, consider that a success! If you
find that this is taking longer than you think it should, speak with your pediatrician.
Are dairy and gluten considered safe for children? Are they a necessary part of a child’s diet?
Dairy-free and gluten-free diets are very popular right now; however, they are only necessary for a select number of people and otherwise are part of a healthy diet. Children who experience gastrointestinal symptoms like diarrhea, stomach cramping,
vomiting or bloating after eating one or both of these may have a sensitivity. In that case, it is a good idea to see your pediatrician about safely removing these from the diet. If they don't experience these symptoms, they are fine and your children can
continue eating food with dairy and gluten without issue.
When should babies start drinking animal milk? Do you have recommendations on cow vs. goat?
To help with brain growth, babies should remain on breast milk or formula until 12 months old. After that, trying cow's milk is best as it has a more complete set of nutrients. Goat's milk is an option if you feel your child may not be tolerating the
cow's milk,but in that case, he should be taking a multivitamin with it.