STRENGTH TRAINING: SAFE FOR KIDS
Question: I’ve always heard that muscle-building exercise will “stunt a child’s growth.” Now I hear it’s recommended for children. Is strength training safe for kids?
Answer: It won’t inhibit growth under any circumstances, but it can cause injury—usually when lifting heavy weights with incorrect form. However, if it’s carefully supervised and correctly done, strength training can actually reduce the risk of sports injuries in youngsters, since greater muscular strength and endurance help protea the joints and tendons. With proper safeguards, strength training can start whenever a child shows interest in the aaivity.
Question: My 9-year-old daughter has had swollen tonsils almost every month for the past two years. Our pediatrician repeatedly prescribes an antibiotic, which does help. I know tonsils no longer are removed routinely; but I wonder whether something more than a prescription is in order. Should 1 be so concerned?
Answer: Tonsillitis is usually caused by a strep infection and (when it’s strep) is treated with antibiotics. Your daughter is a demonstration of how far the pendulum of medical opinion has swung away from the other treatment, tonsillectomy. Years ago there would have been no question. She would have been among the million people each year; most of them children, who had their tonsils removed. Today the number of operations is only about one-fourth as great; hers is a borderline case.
Surgery is certainly not necessary for your child as long as her tonsils are not so swollen that they obstruct breathing or swallowing. Instead, the American Academy of Pediatrics says surgery is “a reasonable option” for a child who has many severe sore throats, especially if they are caused by strep.
How much will it help? For children with frequent sore throats, the operation has been shown to reduce the number of sore throats for a couple of years; after that the improvement appears to be slight. Considering the costs and risks, surgery might be indicated if she’s now missing a significant amount of school.
WHICH MILK FOR KIDS?
Question: What’s the best milk for our 4-year-old? My wife says whole, the doctor says 2 percent, and I say 1 percent or skim milk. I contend that the difference in calories can be made up by offering more nutritious snacks.
Answer: The only firm rules are for infants: The American Academy of Pediatrics recommends no cow’s milk under age 1, and no reduced-fat milk under age 2. After children turn 2 and their need for fat diminishes, many pediatricians recommend switching to 1 percent (low-fat) or 2 percent milk (reduced-fat). That’s a good compromise between a child’s need for a reliable, nutritious source of calories and the desire to instill a low-fat diet as a lifelong habit. However, doctors may modify their advice when a child is obese, is failing to thrive, or has an elevated risk of cardiovascular disease.
WHEN TO CHECK FOR STREP?
Question: I’m sick and tired of hauling all three of my kids across town to the doctor every time they get sore throats, yet fear of untreated strep and its possible complications keeps me running to the doctor every time. Our family spent $250 in doctor visits this week. Are my concerns valid? And if so, can’t my physician treat the family prophylactically without seeing each of us?
Answer: Your concerns about strep are indeed valid. In a small minority of cases, untreated streptococcal infections can cause rheumatic fever or kidney disease. Treatment with antibiotics can prevent those complications. But only a throat culture can tell whether a sore throat is caused by strep and therefore requires antibiotic therapy.
Nevertheless, you may be able to lower your medical bills in some circumstances. If a child has sniffles and a cough as well as a sore throat, then it’s unlikely to be strep; a phone call to the doctor may be all you need. On the other hand, if all three children are sick at the same time with sore throats, fever; and lymph-node enlargement—the typical signs of strep throat— and if one of them has a positive strep culture, then you can assume that the other two are probably also infected. In that case, all three can be treated with antibiotics simultaneously. (There is no reason for a doctor to give antibiotics prophylac-tically to family members who have no symptoms of strep.)
You might also ask your doctor whether he or she can take a throat culture without charging for a full office visit. Some doctors may be willing to do that if a full exam turns out to be unnecessary.
Question: For the past six months, our three-year-old son has averaged five days or more between bowel movements. We’ve tried to give him lots of natural fiber and fluids. On the advice of our pediatrician, we gave our son a stool softener for three weeks, but it hasn’t helped. Should we keep using it?
Answer: Prolonged use of a stool softener in children is not a good idea. Constipation in a 3-year-old is a common problem. In addition to lack of fiber or fluid in the diet, possible causes include resistance to toilet training, painful anal fissures, or even Hirschsprung’s disease (a lack of muscle tone in part of the colon). Ask your pediatrician to refer you to a pediatric gastroenterologist, who may be better able to diagnose and treat the problem.
Question: My 11-year-old daughter occasionally wets her bed. why is this happening, and what can we do about it?
Answer: In most cases, the cause of bed-wetting is unknown. However, psychological stress from such changes as the birth of a sibling or separation from a parent is often responsible. That’s especially likely if the child has begun to wet the bed again a year or more after being successfully toilet trained. Rarely, bed-wetting is caused by an underlying disorder, such as diabetes, infection, or seizures.
Once a physical problem has been ruled out, handle bed-wetting with gentle measures. Avoid mechanical devices that use frightening alarms or electric shocks. Limit fluids after supper. Be sure your daughter urinates just before bedtime. Wake her up to urinate several hours after she’s gone to sleep. Praise and reward her for a dry night; don’t scold or punish for a wet night. If the problem persists, a brief course of the drug imipramine (Tofranil) can help a child gain control by helping to close the urethral sphincter; the muscle that stops the flow of urine. The use of an inhaled diuretic hormone at bed-time has been suggested in resistant cases. Even if all those measures fail, most children outgrow bed-wetting by adolescence.
Health handbook introducing you to read the article: Chest Pain: The Heart Of The Matter
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