By: Dr. Brian Gannon
Q: When can I switch my child to a booster seat?
A: While Kentucky state law may not support car seat safety as a primary traffic offense, we try to follow federal guidelines when it comes to keeping our children safe while traveling. Many neighboring states (specifically Tennessee) have very strict laws which allow troopers to pull over parents for child safety violations even in the absence of speeding. Children should ideally be rear-facing in a “big“ car seat with five-point restraints until age 2 years, because of their weak neck muscles. This is independent of weight or height.
Children may move to a booster seat out of a “big” car seat when they are BOTH 4 years old AND 40 pounds. They should then remain in a booster seat in the back seat until they are either 12 years old or 57 inches tall, whichever comes first. Then and only then should your child sit in the front seat (shotgun) without a booster. And children should NEVER be in the flatbed of a pickup truck on a public road. It is too easy for them to be ejected and seriously injured. Many states will fine these drivers large amounts; the exception is internal driving on farm roads.
I hope this clarifies some common questions parents have about car seat safety.
Q: What are the warning signs of autism, and how will I recognize them in my child?
A: Autism is a very complex diagnosis, and so there is no simple way for a parent to be sure her child has this as an explanation for his delayed development or odd behavior. The main hallmark of autistic children, however, is lack of emotional connection with their world, including the people close to them. Most children by the age of 6-9 months will make eye contact for several seconds at a time, especially at times of strong emotion, like excitement or fear (such as when in a new situation). Autistic children tend not to react in this way to new situations, because they do not seem to have the instinct of “checking in” with the parent when confronted with an unfamiliar setting.
By about 15-18 months, most typically-developing children are using either gestures or words to communicate their needs, and they want to share their curiosity with those close to them, especially their parents. For example, when a train goes by, the child will point at the train and try to get the parent to look as well. A child with autistic tendencies, by contrast, may either ignore the train, or be so interested in the train that he pays no attention at all to the other people in the room.
If your child shows signs of being disconnected to parents, siblings, or the world in general, especially if there is also a delay in speech development, then please talk to your child’s pediatrician about your concerns.
Q: I have been told that Staph is going around at my child’s daycare. How can I protect my child?
A: “Staph” is short for a bacteria called Staphylococcus aureus, also known as MRSA, if it is resistant to many common antibiotics. This particular type of infection used to be only an issue in hospitalized patients, but over the past ten years, it has become a big problem in the general community. There are many theories, mostly centered on the overuse of antibiotics for simple respiratory illnesses like colds, which do not respond to antibiotics since they are caused by viruses instead of bacteria. But MRSA can be very common in athletic team locker rooms and day care centers, among other locales.
MRSA can at times be invasive, requiring surgery to drain the infection, or even causing internal infections like pneumonias. But most people who get MRSA or MSSA (sensitive Staph) will simply have an infected bug bite or boil. The primary treatment for this is to see your doctor and have any local skin infection drained, so the doctor may collect the pus and send it off for testing to see what is causing the infection, and which medication is most likely to work in treating it. Oral and IV antibiotics do not necessarily make much difference in treating these skin infections, but if drainage alone does not work, they may be needed.
Once MRSA enters a home or group setting, it can be almost impossible to eliminate completely. We may try nasal antibiotic creams and sterilizing with bleach, everything from bathtubs to laundry. But this is such a universal problem, families often become recolonized within a few weeks.
The take-home message: MRSA is more common than people think, and usually goes away with supportive care only, so try not to overreact.