Floyd Pediatrician Dr. Sylvia Washington joins Jen and Dan for this episode and offers great insight about when to take your child to see a doctor. She also talks about when and if you should have your child tested for COVID-19.
Speaker 1 (00:00):
Welcome to the Moms Circle Podcast presented by Floyd Medical Center, a place for new moms, veteran moms and moms to be, to hear expert advice from experienced healthcare professionals. Here are your hosts, Dan Bevels and Jen Carroll.
Dan Bevels (00:17):
Hello again everyone and welcome to the Moms Circle Podcast brought to you by Floyd Medical Center. I'm Dan Bevels and I'm glad to be with you again for this episode. I'm really looking forward to it because honestly, the guest that we have today is one of my favorite people at Floyd. And you're going to get a chance to hear a little bit about her and hear what she's doing in her practice. So that's coming up in just a few minutes, but before we get started, I'm going to bring in our expert, Jen Carroll, who I look forward to talking to every time we do one of these. Jen is a Childbirth educator and Lactation educator at Floyd and does a wonderful job here. So Jen, welcome back in and I'm just grateful to be with you.
Jen Carroll (00:53):
Oh, thanks, Dan. It's great to be here. And I'm also excited about our guests today. She's one of my favorites too. So I'm looking forward to getting to that.
Dan Bevels (01:04):
Absolutely. And we'll do that in just a moment, but first I've got a question for you. How has reading to my child beneficial? So how does that help maybe the child and you as a parent too possibly?
Jen Carroll (01:15):
Okay, reading is a great topic to talk about. Even parents start to read to their babies while they're still in the womb. And there's just so many benefits starting to connect with your child through reading. Obviously one of the first things about reading to a child is the closeness that you snuggle a child, you have them close to you when you're going to read to them. And so for this baby, between zero and up to 12 months, this is a cuddle time. It's a time where children feel safe and they're cuddled next to a care provider or a parent or a family member whoever's reading to them. And it helps them to relax and feel safe. The second thing is that, it's soothing the rhythm that we use with our voice when we read can be very soothing.
Jen Carroll (02:17):
Think about that, it works for adults. It helps us to relax. We are... Breathing starts to slow down. The same thing happens with a child. As we read to them, they start to calm and be soothed by that interaction that close physically close, soothing, interactive experience is calming for a child. The other thing that we know that it does is it exposes children to vocabulary. As you read their vocabulary is going to grow. More words are introduced. And then as they get toward that second half of the first year, and we add little books that have pictures, we are able to identify the picture of something with a word that goes with it. So we're building vocabulary.
Jen Carroll (03:14):
It also promotes a love for reading that doesn't surprise me. When we look at these different things that happen for a child. When we read to them, you can understand why it plants the seeds of a love for reading for a lifetime. I know we started reading with our children from the very beginning and they still love to read and have carried that on with their kids. In fact, we used to have to limit how many books we could read at a time because they would just come in with armloads. So reading is very good for children. And it's also good for children at a young age, even before you think that they're understanding everything they're enjoying the experience. So we encourage you to begin reading straight away with your children.
Dan Bevels (04:08):
And Jen, if I could add, I think just as a parent, we miss sometimes the benefit that we receive from that I can remember reading to my daughters when they were younger. And one, it was a chance to connect with them. But two, it was an opportunity to maybe take your mind off, whatever has been causing you stress for the day. So it's a chance to focus on something else that isn't stressful and maybe give you a chance to disconnect from those parts of your day and reconnect with the things that are really important to you.
Jen Carroll (04:39):
I love that, Dan. Absolutely, I love that. Yeah, it's a way for us to refocus ourselves and actually can permit relaxation in us as we relax with our child.
Dan Bevels (04:49):
Well that's great information. And if you have questions like that, we would love to hear from you momscircle@floyd.org is the email address. And with that, Jen, I'm going to let you jump right in because I'm excited to sit back and listen to our guests today who always brings a wealth of information. So I'll let you introduce the guest and jumped right in.
Jen Carroll (05:09):
Okay. Well, today we are welcoming Dr. Sylvia Washington, one of our pediatricians, and so Dr. Washington, welcome.
Dr. Sylvia Washington (05:20):
Thank you so much for having me. I am so excited about the Moms Circle Podcast. And you guys were just speaking about a topic that is so near and dear to my heart. I'm reading to children, I'm in my office. I give out books, I'm starting from birth. So as soon as they have their first baby, they get their first book and it, every checkup until they're five years old. So they have a whole library by the time they get to kindergarten. So thank you so much for speaking about reading to children because it's so important.
Jen Carroll (05:52):
Oh, thank you, Dr. Washington. And how appropriate that today is that question. So we have asked Dr. Washington to speak with us about colds and coughs and other minor illnesses that parents encounter in that first year of life. And being able to distinguish, or have some guidelines for what to do, because this is a concern on every new parent's mind. And so I'm going to start today, Dr. Washington, I'd like to start with fever because that's usually where parents start is, does the child have a fever? What does it mean? And how do I respond to it?
Dr. Sylvia Washington (06:47):
That is a great question. So there's a difference between a fever in a younger child or an infant versus an older child. The way that we take a temperature in an infant 30 days or less is a rectal temperature. That is the most accurate and rectal thermometer can cost anywhere from about a dollar to maybe $10. It's a very inexpensive piece of equipment that will get you that number that tells that child's temperature. And older children you can use an ear thermometer, a forehead thermometer, an oral thermometer, or even a thermometer under the arm. It could be very overwhelming for older children, but a good digital thermometer is what you need to take your child's temperature. A fever is defined as a temperature greater than 100.4 degrees. People can not remember the 0.4. They always say, it's over 100, just call the pediatrician, we will figure it out.
Dr. Sylvia Washington (07:46):
And also there is an old wives' tales that says, "If it's under the arm, you add a point, or if it's this way, you add your point," I say, just tell me what the temperature was and how you measured it. And I will figure out the rest. You don't have to add any numbers or anything like that, but if your baby is three months or less, and they have a fever, so greater than 100.4, they need to come see the pediatrician. The reason for this is the first three months of life, the babies, their immune system is forming. And so they don't have a lot of that robust immune system that older children have. And so they can have something very subtle, like the pneumonia or urinary tract infection, or an upper respiratory infection. And they won't have any other signs besides the fever. And so we need to check them for all of those important things.
Dr. Sylvia Washington (08:38):
Sometimes they can have an ear infection and won't pull it their ear because they don't have that developmental milestone yet of reaching and grabbing for things. So if your baby is less than the age of three months, and they have a fever, they need to see the doctor. Now, if your baby is over the age of three months, and that could be about four months, all the way up until you consider your child to be a child, and they have a fever, we recommend fever reducers, such as Tylenol, which is meant for any baby that is three months and above at home or ibuprofen for any child that is six months and above at home. And I say, if the Tylenol or Motrin or ibuprofen is bringing the fever down, then you can wait a day or so before you come into the doctor's office, if fever is the only sign, you can treat the fever at home. And then if other signs and symptoms develop, then you'll have more information to present to the doctor.
Jen Carroll (09:44):
That makes a lot of sense, because sometimes you'll start to notice that the baby or child, small child, is starting to run a fever, but you don't see any symptoms. And it's like, okay, we have a fever, but I'm not seeing anything yet. So it's really helpful that if they're over three months, it's okay, it's safe to normally watch that child for 24 to 48 hours and treat the fever, but then wait and see if something else is showing up.
Dr. Sylvia Washington (10:14):
Mm-hmm (affirmative) And I want to come piggyback on that because what happens around that time is signs of teething. And so sometimes I hear next day, a tooth will cut through and you say, Oh, that's why they had the fever. So it could be something as...
Jen Carroll (10:30):
Yeah.
Dr. Sylvia Washington (10:31):
... [inaudible 00:10:31] teething.
Jen Carroll (10:34):
Yeah, Now, what happens if we start to notice a cough again, we start to notice something's going on and this baby's starting to cough. A little cough going on.
Dr. Sylvia Washington (10:47):
A little cough, could be a sign of an upper respiratory infection. Sometimes when you have a little fever and you have some nasal congestion along with it, when that nasal congestion gets to the back of your throat, it causes a tickle. And that causes babies to cough. They're like, "What is that sensation?" And we described this as a dry cough. Nothing really is coming up, but they're a little irritated. So you can see a low grade fever, a cough that is dry, a little bit of nasal congestion, sometimes sneezing, sometimes fuzziness, and sometimes not wanting to nurse or formula feed because they're congested.
Dr. Sylvia Washington (11:26):
And what we usually do in that case is treat the nasal congestion. We recommend Saline drops to the nose, and that's about two to four drops in each nostril and using a bulb syringe to kind of aspirate those nose secretions and running a cool mist humidifier in the infant room so that they can breathe a little bit better. And that usually fixes the problem within about a week. If the cough is wet and the infant has fast breathing flaring of the nostrils or something that we call wheezing, which is a whistling sound when a baby is breathing out. Those are signs and symptoms. That would say, we need to just see the pediatrician about this.
Jen Carroll (12:13):
Okay. And what about little kids can develop like this kind of barking cough, I don't know how to describe it other than, more like a barking cough that happens sometimes with a honking kind of barking cough. What about that? Where does that fall in all of this?
Dr. Sylvia Washington (12:39):
So anytime you think about something that's causing a barking or a honking noise, you're thinking a little bit lower than the nose. So kind of where the voice box come. So where your larynx is, and that's a big word, but when you get a laryngitis or when you get a croup that can give you a barking cough. And you usually will look at the baby's neck and you can see the little neck muscles kind of go in when they're making that coughing sound, it usually peaks in the middle of the night, or sometimes when they've been exposed to cold weather, you'll hear these babies have this barking cough.
Dr. Sylvia Washington (13:18):
And so I usually say, give the pediatrician a call because depending on the age of the child, we may want to see them because infants their breathing tube in their throat, their trachea and their larynx is very, very small. And so it can collapse because it's very flexible. And so we would like to check an oxygen level on that baby, just to make sure that they're okay now in older children. So 12 months, 24 months, three-year-old we can treat that with more of that cool mist. And that kind of helps those early croup symptoms and the little bit older. But if you have a child that's less than 12 months, they need to see the pediatrician.
Jen Carroll (13:59):
Okay. That's really helpful because, you know, trying to distinguish what's going on, especially if it's a middle of the night and the baby's coughing, it's like, what am I supposed to do here? And not wanting to overreact, but wanting to provide good solid care for your baby, of course. So that really helps. And that wheezing part too. And it's the wheezing usually on the intake or the exhale,
Dr. Sylvia Washington (14:27):
The wheezing is usually on the exhale. Usually it's, they can take a nice, good breath in, but when they breathe out, it's almost like they're breathing through a straw and you hear like a whistling sound when they're breathing out. And it's a little bit longer than the breathing in phase. And so that can be distressing for parents. I say, if your baby is wheezing and has never wheezed before, you need to call the doctor.
Jen Carroll (14:54):
Okay. Thanks, Dr. Washington, let's talk about a very common thing that happens with babies and that's ear infections. How can we discern? You mentioned that sometimes babies can get them when they can't actually point us towards their ear. They're not, and sometimes babies just mess with their ears too. And it doesn't always mean it's an ear infection. So can you give us some guidelines on that?
Dr. Sylvia Washington (15:26):
Sure, just as I alluded to you, if your baby is three months or less, and you're concerned, you should bring them to the pediatrician's office. After that time, if your baby has a fever and is tugging on their ear or digging their fingers in their ears, those could be signs of an ear infection. Some people wonder what is an ear infection it's called the middle ear infection. So when babies have nasal congestion, this nasal congestion can track up behind the eardrum. And cause what we call an ear infection.
Dr. Sylvia Washington (16:03):
In younger children, less than the age of two, this is something that requires antibiotics and children that are over the age of two. We can do. What's called a watch and wait and see approach, which means when you come to the doctor and we look at the eardrum, we'll say, "Oh, yes, it looks pretty red. It looks infected, but let's give it a day or so to see if the infection and the fever will go away on its own," because in older kids, sometimes the virus can cause it, whereas in younger children is more likely to be a bacteria that causes an ear infection.
Jen Carroll (16:37):
Mm-hmm (affirmative) That's, fascinating. How long do ear infections last generally?
Dr. Sylvia Washington (16:44):
Usually When treated an ear infection will last about a week, but after antibiotic treatment for the first 48 to 72 hours, so two or three days, the symptoms tend to go away, but the bacteria can take seven to 10 days to clear out of the system.
Jen Carroll (17:03):
So it's really important for those under twos to get the full does of antibiotics, [crosstalk 00:17:09] is what I hear you saying?
Dr. Sylvia Washington (17:11):
Yeah, Some people think that, Oh, I'll just give it until they feel better. And, and three days later they stop, but the bacteria has not gone away. And what that can cause is something called antibiotic resistance. If you stop an antibiotic and the infection lingers and comes back, those bacteria then become resistant to that first choice of antibiotic. And so then we have to use a second round or a stronger course of antibiotic to get the infection to clear.
Jen Carroll (17:41):
Wow, that's really important information for parents too, to grasp, to understand that, you have to keep giving that baby, the rest of that antibiotic until it's done so that we don't wind up back at the pediatrician with a really nasty version of that bacteria.
Dr. Sylvia Washington (18:03):
Yeah.
Jen Carroll (18:04):
So Dr. Washington, we must address COVID and I think it's going to be around for a while and we're going to be learning more about it. It's been very confusing and with a large learning curve for all of us, but we really need you to address the issue of children's exposure to COVID and the COVID illness in children and how it might present. And when do we get children tested and how necessary is that? So could you talk to us a bit about that?
Dr. Sylvia Washington (18:44):
Wonderful question, during this time I'm practicing what I call a Pandemic Pediatrics, a cold and a cough used to be, "Oh, just gave it a week. And I think things will be good." Now with exposure to coronavirus, parents are of course anxious about this topic. When we started testing and seeing cases in the spring, we wanted everyone who is exposed to get a test. Then we realized with wearing a simple mask, keeping distance of about six feet away from other people and keeping your hands clean, help to reduce the transmission of COVID-19. So I always say define what your exposure is, were you around someone without a mask, were you close to them instead of being six feet away, were you able to hand sanitize? If those things are true, you are wearing your mask, you were keeping your distance, you're washing your hands and you don't have any symptoms.
Dr. Sylvia Washington (19:39):
You probably don't need to be tested. If you were exposed in a large group setting, such as a school or a daycare, those facilities have ways of quarantining or cleaning up for about two weeks after a mass exposure. But if your child has symptoms, that's where the pediatrician comes in at Floyd Pediatrics. We have been testing for this nobel coronavirus since we discovered it back in early of 2020. So all pediatrician offices have the availability to do testing in most cases, same day or what we call rapid testing. If your child has any of the symptoms of COVID-19 such as fever, shortness of breath, cough, loss of taste, or smell, muscle aches, nasal congestion, runny nose, vomiting, or diarrhea, please call the pediatrician's office. We would love to see them and talk more about this. Most times, children who develop this illness do just fine. About 1% of Children will need hospitalization and hardly any will require any type of invasive procedure. So a lot of kids that get it tend to recover very quickly.
Jen Carroll (20:59):
Wow. Well, I want you to know as scary as this pandemic has been for everyone, what you have just shared should also bring comfort. One, we are ready there is a low percentage, 1% of children who will really have a serious, not to diminish that of course we're really concerned, but that should bring some comfort to parents that, we're ready for this and we know what to do. And children generally fare well and can fight this well. So, I just so appreciate all you're doing. And it's been a joy to work with you and have you part of our childbirth education series coming on and answering questions for parents. And we need that voice. We need your expertise and your credentialing in our lives as parents trying to navigate through these days. So I really appreciate you bringing that to us today.
Dr. Sylvia Washington (22:06):
Thank you again for having me
Jen Carroll (22:11):
Well, your excellence doesn't surprise me at all. It is always a pleasure to be able to connect with you and to have you present to us, our families. And we really appreciate all you do, Dr. Washington. So thank you for being on today with us. And I know our parents will really appreciate what you have shared. I learned a lot today. Thank you for that.
Dr. Sylvia Washington (22:36):
Well, thank you, Jen. And thank you for having me. The Mom Circle Podcast, as well as floyd.org/baby is a wonderful resource that they can, if they have questions they can reach out to us. And I will be happy to answer any questions that any moms have. I say, I will put on a gown, gloves, a shield, whatever it takes to be able to love these babies through this pandemic.
Jen Carroll (23:01):
Well, thank you. You've been doing a great job of that. We appreciate you, Dan. I know, you know, Dr. Washington, well, and with me, you're excited to have had her on our program today.
Dan Bevels (23:12):
No question about it, Jen. I said earlier, Dr. Washington is one of my favorite people at Floyd always enjoy any opportunity. I have to work with her. And if you are looking for a pediatrician, I know Dr. Washington and her staff would love to take care of your child and you can call their office at 706 295 5103 to make an appointment. And then you can find information about Dr. Washington on our website as well, floyd.org. And you can search for her or go to our physicians directory and get that info. But again, her number is 706 295 5103. Dr. Washington, always a pleasure to talk to you. Thanks for being with us today.
Dr. Sylvia Washington (23:47):
Have a good afternoon.
Dan Bevels (23:48):
You too. Thanks very much.
Dr. Sylvia Washington (23:50):
Thank you.
Dan Bevels (23:50):
And Jen, as you said, just a wealth of information and I think that's something that as parents, if it's... Particularly parents of young children, we always wonder, "Gosh! How serious is this? Do I need to go to the doctor right away?" And particularly in those early days of having a baby. So I just love that we can make that information available for moms, but particularly new moms who are experiencing this for the first time.
Jen Carroll (24:18):
Yeah, I really appreciate it. Real clear guidelines that Dr. Washington just shared. It's really clear and that will help reduce parent's anxiety, but also giving confidence that they are responding appropriately to their child.
Dan Bevels (24:34):
No doubt about it. Well, Jen, thank you as always for bringing your expertise to these conversations as well. And we appreciate that and I know we're just looking forward to the next chance we have to get together and talk about how we can help new moms and dads in this journey.
Jen Carroll (24:49):
Yes. Thanks Dan. Thanks for all you do.
Dan Bevels (24:51):
Absolutely. And if you have questions that you would like to submit about this episode or others that we've had previously, you can do that by emailing momscircle@floyd.org. We would love to hear from you there. You can also join us on Facebook. That's Moms Circle at Floyd. That's a closed Facebook group, and you can be a part of that and get great information from our experts and also build a community with other moms and dads who are walking through this with you. So we recommend that you do that, go to floyd.org/baby for information about our childbirth and lactation classes and everything that we have to offer related to childbirth and pediatrics and so forth at Floyd that's floyd.org/baby.
Dan Bevels (25:28):
And then finally, I can't encourage you enough to download The, My Floyd Baby app. It will be a great resource for you as you're expecting to give birth. And then also once you do, and then throughout the life of your family. So we encourage you to do that as well. Thanks again for joining us today until we have a chance to talk again. I'm Dan Bevels from Floyd Medical Center, ask that you'd be safe, have a wonderful week, and we'll talk to you again very soon Thanks.
Speaker 1 (25:51):
Thanks for joining us on the Moms Circle Podcast. Be sure to join our moms circle Facebook group for more conversation between Floyds experts and moms like you. And if you have any questions about today's podcast or would like to suggest a topic for an upcoming episode, email us at momscircle@floyd.org. Also, if you haven't already be sure to download The, My Floyd Baby app for a personalized health newsfeed for every member of your family, you can find the app at floyd.org/baby or in your app store. Thanks for joining us.