Month: September 2020
Prenatal Exercise
There are endless resources for exercises, outdoor groups, online chat rooms, and prenatal workouts on line. I have found prenatal pilates classes and wonderful instructors who will individualize workouts for your particular needs. Local community centers and colleges offer specialized exercise programs for you. Most moms do better with the encouragement of other pregnant women. Plus it is so much fun to connect with those going through the same process as you. Sharing ideas and suggestions they have come across are a great benefit. As we are moving out of coved restrictions these opportunities are opening up.
Staying active during pregnancy prepares you for both delivery and recovery. Over the next few entries we will look over several different exercise programs suggested for pregnancy. Please let me know which ones you enjoy most! JUDY
Exercising during pregnancy
https://www.pregnancybirthbaby.org.au/exercising-during-pregnancy
Doing regular physical activity has health benefits during pregnancy and also helps to prepare the body for childbirth. However, it is important to modify or choose a suitable exercise program because pregnancy affects the body’s response to exercise.
Be sensible about the level of exercise that you do. Consult a doctor, physiotherapist or healthcare professional to make sure the exercise routine is not harmful for you or your baby. If the pregnancy is complicated (such as expecting more than one baby, high blood pressure, heart disease, pre-eclampsia, or risk of premature births) it is best to talk to a doctor.
Exercise tips
Don’t exhaust yourself – a light to moderate exercise program should be the aim. You may need to slow down as your pregnancy progresses or if your maternity team advises you to. If in doubt, consult your maternity team. As a general rule, a light to moderate level should allow you to hold a conversation as you exercise when pregnant. If you become breathless as you talk, then you’re probably exercising too strenuously.
If you weren’t active before you got pregnant, don’t suddenly take up strenuous exercise. If you start an aerobic exercise program, tell the instructor that you’re pregnant and build up say begin with no more than 15 minutes of continuous exercise, 3 times a week. Increase this gradually up to 5 30-minute sessions a week.
Remember that exercise doesn’t have to be strenuous to be beneficial.
Exercise tips when you’re pregnant:
- Always warm up before exercising, and cool down afterwards.
- Try to keep active on a daily basis; 30 minutes of walking each day can be enough, but if you can’t manage that, any amount is better than nothing. If you haven’t been active or are overweight, start with 3-4 days spread across the week.
- Avoid any strenuous exercise in hot or humid weather.
- Drink plenty of water and other fluids.
- If you go to exercise classes, make sure your teacher is properly qualified, and knows that you’re pregnant and how many weeks pregnant you are.
- You might like to try swimming because the water will support your increased weight. Some local swimming pools provide aquanatal classes with qualified instructors.
- Walking is a great exercise — it is a moderate aerobic activity but will have minimal stress on your joints. Other good choices are swimming, low-impact aerobics and cycling on a stationary bike.
Be sensible about the level of exercise that you do. Consult a doctor, physiotherapist or healthcare professional to make sure the exercise routine is not harmful for you or your baby. If the pregnancy is complicated (such as expecting more than one baby, high blood pressure, heart disease, pre-eclampsia, or risk of premature births) it is best to talk to a doctor.
Additional Data on Fevers
UP TO DATE
https://www.uptodate.com/contents/fever-in-children-beyond-the-basics
Patient education: Fever in children (Beyond the Basics)
Author: Mark A Ward, MD. Section Editor: Morven S Edwards, MD
Deputy Editor: Mary M Torchia, MD
Notes: This is our third installment on fevers. As mentioned several times fevers are a normal part of childhood. As children acclimate to the world around them they come in contact with many bacteria, germs, and viruses. A fever is the body’s way of killing off dangerous adversaries. When your baby is very young (first three months) you want to be especially careful. Contact your pediatrician if your baby develops a fever. As baby matures you will learn how to read his symptoms and understand how ill he is.
As I have previously mentioned, each of us as a unique mean body temperature. 98.6 is the average body temp., but your temperature and the temperature of your baby may differ a bit. When your baby is healthy take her temperature several times over a 24 hour period. Record, for your own knowledge what those numbers are. Keep that record with your notes. Pay attention to external influencers. At night when baby is wearing long sleeved long legged clothing her temp may be a tad higher. After bathing she may be a bit cooler.
If you purchase a new thermometer rerecord this information. It will help you know your baby’s mean temperature. Temperatures usually run in the evening. They usually dissipate in the morning. For babies under three months of age call your pediatrician. I do not recommend using medications to alleviate fevers unless your pediatrician encourages this.
JUDY
Read and learn:
FEVER OVERVIEW. Fever is a normal response to a variety of conditions, the most common of which is infection. Fever occurs when the body’s temperature is elevated as a result of the body’s thermostat being reset to a higher-than-usual temperature.
Nearly every child will develop a fever at some point. The challenge for parents is to know when to be concerned. This topic review will discuss the definition of a fever, how to accurately measure a child’s temperature, how and when to treat fever, and signs and symptoms that require further evaluation.
FEVER DEFINITION Because of the normal variation in body temperature, there is no single value that is defined as fever. In general, a fever means a temperature above 100.4ºF (38ºC). You might get slightly different numbers depending on how you take your child’s temperature – oral (mouth), axillary (armpit), ear, forehead, or rectal.
Axillary, ear, and forehead temperature measurements are easier to obtain than rectal or oral temperatures, but they are less accurate and may need to be confirmed rectally or orally in certain children.
FEVER CAUSESInfection is the most common cause of fever in children. Common viral and bacterial illnesses are the most likely illnesses to cause fever. These include:
●Colds (see “Patient education: The common cold in children (Beyond the Basics)”)
●Gastroenteritis (see “Patient education: Nausea and vomiting in infants and children (Beyond the Basics)”)
●Ear infections (see “Patient education: Ear infections (otitis media) in children (Beyond the Basics)”)
●Croup (see “Patient education: Croup in infants and children (Beyond the Basics)”)
●Bronchiolitis (see “Patient education: Bronchiolitis (and RSV) in infants and children (Beyond the Basics)”)
●Urinary tract infections (see “Patient education: Urinary tract infections in children (Beyond the Basics)”)
There is little or no scientific evidence to support the widespread belief that teething causes fever. Although it is difficult to disprove this notion completely, alternative causes of fever should always be sought and temperatures above 102°F (38.9°C) should never be attributed to teething.
Bundling a child who is less than three months old in too many clothes or blankets can increase the child’s temperature slightly. However, a rectal temperature of 101°F (38.5°C) or greater is not likely to be related to bundling and should be evaluated. (See ‘Evaluation recommended’ below.)
Some childhood immunizations can cause fever. The timing of the fever varies, depending upon which vaccination was given. (See “Patient education: Vaccines for infants and children age 0 to 6 years (Beyond the Basics)”.)
The Top 5 Facts About Fever
September 09, 2016
Posted in Babies & Toddlers, Children’s Health, Preschoolers, Preteens, School-Age Kids, Teens & Young Adults by Vanessa Carlo, MD
As a pediatrician, I know that parents’ panic can set in pretty quickly when it comes to a fever — especially if they have a baby or toddler. Even the calmest of moms and dads can find themselves frantically debating at 1 a.m. whether to give their child medicine and go back to bed, or to call the doctor despite the time.
As strange as it may seem, fevers are a good thing. They’re the body’s way of fighting off infections. Often times, a fever left to do its job will go away on its own within a few days.
However, it’s still completely normal to be worried when your little one’s temperature starts to climb. To help reduce your worry and prepare you for what to do next time the thermometer reading begins to rise, know these top five facts about fevers.
1. A fever in babies under 3 months old should be taken seriously.
When it comes to fevers, 3 months is an important age for infants. Although babies and toddlers may get fevers a few times a year, it is not common for infants under 3 months to have fevers. Fevers in infants this age can be a sign of serious infection and require a full evaluation. If this happens to your infant, remember two things:
Contact your pediatrician or family doctor right away.
If it’s after hours, talk to the nurse on call (if one is available) and/or ask to have your doctor contacted right away. If you can’t get in touch with anyone at your doctor’s office, go to your local emergency department.
Don’t treat the fever.
Don’t give any medication at all before a doctor fully evaluates your baby.
2. A fever once a month in young children (over 3 months old) is normal.
Fevers are a common part of life, and all kids will get one from time-to-time. In fact, one fever a month is a pretty normal frequency to expect in young children, especially if they’re enrolled in child care or have older siblings — which expose kids to germs and infections.
Reason for concern
Although one fever a month can be typical, more than one fever a month may be cause for concern. Contact your pediatrician or family doctor if that’s the case.
And, again, fevers in babies under 3 months old should be taken seriously — and they shouldn’thappen at the same frequency as older children.
3. Medication isn’t always necessary.
Fevers can be scary, and sometimes parents may want to give their children medicine at the first sign of a fever — even when it’s low. But remember that fevers aren’t a bad thing — and they’ll usually go away on their own. So if your child doesn’t seem uncomfortable and is getting plenty of fluids, my advice is to wait to give temperature-lowering medicine (acetaminophen or ibuprofen) and see if the fever naturally resolves.
Alternatives to fever medicine
If your child seems uncomfortable, try some of these tricks to help your kid cool off:
- Apply a cool, wet cloth to your child’s forehead.
- Have your child drink cool fluids.
- Give your child a bath in room-temperature water. Never use a cold bath or rubbing alcohol to try to bring the fever down.
- Avoid bundling your child up in blankets and lots of layers. Kids often report feeling cold when they have a fever, but bundling them up can just trap in that heat — and even make their temperature rise. Instead, dress your child in lightweight clothing and cover with a light sheet or blanket.
If your doctor does instruct you to give your child a pain reliever/fever-reducing medicine…
Give children’s acetaminophen or ibuprofen — making sure to carefully read and follow the package recommendations based on your child’s age and weight. Donot give aspirin (due to its association with Reye syndrome, a rare but potentially fatal disease).
4. How fast the fever rises is often more important than how high the temperature might be.
Many parents are number-focused where fevers are concerned. They worry about how high a temperature is, whether it’s 100 vs. 104 degrees. But the degree of the fever doesn’t tell us much about how sick your child is. A simple cold or infection can result in a high fever, but doesn’t usually indicate a serious problem. Instead of focusing only on how high the fever is, pay close attention to how fast the fever rises.
Why is speed important?
If a temperature rises very rapidly (from a normal temperature to a high one within 30 minutes to an hour) it can cause a febrile seizure. Febrile seizures are convulsions that happen during a fever and usually last for a few minutes.
They aren’t very common, but once children have had a febrile seizure, they’re more likely to have another one in the future. Unfortunately, febrile seizures aren’t preventable — if a fever is going to rise quickly, then there’s no slowing it down.
But, although they are frightening, febrile seizures:
- usually end without treatment
- don’t cause other health problems
- don’t mean a child will have epilepsy or brain damage
5. There is no magic number.
A lot of parents ask me what “the number” is. They’re hoping I can give them an exact number or degree of temperature that indicates when a fever is very serious and they need to call their doctor or go to the emergency room. Although that onenumber doesn’t exist, these numbers might be helpful to remember:
· The normal temperature for a healthy child is between 97 and 99.6.
· Any rectal temperature over 100.4 degrees is considered a fever. When measured orally (in the mouth), 99.6 degrees is considered a fever.
And there are other indications that it may be time to call the doctor about your child’s fever.
Call the doctor if:
- your child has a fever over 104 degrees (a fever of 105 degrees is rare) that persists despite treatment
- you’ve been treating the fever with medication and it’s still not going down
- your child isn’t acting normal, seems uncomfortable, or isn’t drinking
When fever strikes, don’t let panic or worry take control. Fevers may be unpredictable and unpreventable, but knowing the basics about what to do can help keep the panic at bay when a fever does appear.
Fevers
The word ‘Fever’ strikes fear in the hearts of new parents. We have all heard horror stories about babies who contracted fevers and the results were terrifying.
For more experienced parents the fear has subsided. Your thoughts on fevers will greatly impact your parenting. As a mom who has raised five healthy kids, I can tell you fever is a part of life with children. In researching for this blog entry I have read: “Fever is a monthly occurrence for young children.” “Fever is your child’s body telling you something is not right.” “Fever is the body’s way of dealing with infection.”
Your pediatrician’s greatest concern for fever is in your baby’s first three months of life. One of the major reasons for this is the younger a child the greater the percentage of her body is liquid. As children age their bodies gain greater percentages of bone, muscles, flesh. This helps their body regulate it’s temperature.
Fevers run in the evening. You will notice your baby is warm around dinner time. I encourage you to track your child’s body temperature when he is healthy. Write down a 24 hours record of your baby’s body temperature. Everyone runs at an individual rate. Some kids run at the 98.6 temp., but for most that is an average. Some will run at 97, some at 99. Knowing your individual child’s rate will help you discern if his fever is not normal.
If you believe your baby is warm record the temperature. Loosen her clothing to be sure this is not contributing. Usually if baby is running a temperature she will be fussy, not feeling well. There will be more symptoms than just a fever. Give her liquid to protect against dehydration. 30 minutes later retake the temperature. If there is a notable increase, a point say from 100 F to 101 F, call your pediatrician and ask her opinion.
Of greatest concern is a ‘spiking fever’. A ‘low grade fever’ is common; Baby may be uncomfortable and need extra liquid. The rapidly rising fever is of concern. A spiking fever indicates a major infection. If the fever is rising quickly and continues up contact you pediatrician. Remove baby’s clothing leaving a diaper, encourage liquids, wipe her down with a room temperature cloth. Lying her on a blanket rather than holding her will help lower her body temperature. She will not be happy, but reducing her temperature is important.
Fevers usually run at night and subside in the morning. In the morning your baby’s temperature will usually be normal. If the fever is persisting in the morning call your pediatrician again. This indicates an infection and needs immediate attention.
With older children I would provide consistent liquid and watch them closely. Often they run a fever one night and are fine the next day with no recurrence of the fever. This is with a low grade fever. If you measure the fever every 30 minutes and it continues to rise provide liquid, remove extra clothing and blankets, watch closely. If the fever reaches 102 or higher contact you doctor.
As you know your child better you will develop a feel for how to proceed. You can tell by her behavior how ill she is. You know her best, you can tell if she needs help. This is what they talk about when they say “mothers intuition’. You will just know. When my children were young I grew to the point where I could call the fever numbers without a thermometer by holding the child. I used a thermometer to verify. JUDY
MAYO CLINIC
https://www.mayoclinic.org/diseases-conditions/fever/symptoms-causes/syc-20352759
Overview
A fever is a temporary increase in your body temperature, often due to an illness. Having a fever is a sign that something out of the ordinary is going on in your body.
For an adult, a fever may be uncomfortable, but usually isn’t a cause for concern unless it reaches 103 F (39.4 C) or higher. For infants and toddlers, a slightly elevated temperature may indicate a serious infection.
Fevers generally go away within a few days. A number of over-the-counter medications lower a fever, but sometimes it’s better left untreated. Fever seems to play a key role in helping your body fight off a number of infections.
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Symptoms
You have a fever when your temperature rises above its normal range. What’s normal for you may be a little higher or lower than the average normal temperature of 98.6 F (37 C).
Depending on what’s causing your fever, additional fever signs and symptoms may include:
- Sweating
- Chills and shivering
- Headache
- Muscle aches
- Loss of appetite
- Irritability
- Dehydration
- General weakness
Children between the ages of 6 months and 5 years might experience febrile seizures. About a third of the children who have one febrile seizure will have another one, most commonly within the next 12 months.
Taking a temperature
To take a temperature, you can choose from several types of thermometers, including oral, rectal, ear (tympanic) and forehead (temporal artery) thermometers.
Oral and rectal thermometers generally provide the most accurate measurement of core body temperature. Ear or forehead thermometers, although convenient, provide less accurate temperature measurements.
In infants, doctors generally recommend taking a temperature with a rectal thermometer.
When reporting a temperature to your or your child’s doctor, give the reading and explain how the temperature was taken.
When to see a doctor
Fevers by themselves may not be a cause for alarm — or a reason to call a doctor. Yet there are some circumstances when you should seek medical advice for your baby, your child or yourself.
Infants
An unexplained fever is greater cause for concern in infants and in children than in adults. Call your baby’s doctor if your child is:
- Younger than age 3 months and has a rectal temperature of 100.4 F (38 C) or higher.
- Between ages 3 and 6 months and has a rectal temperature up to 102 F (38.9 C) and seems unusually irritable, lethargic or uncomfortable or has a temperature higher than 102 F (38.9 C).
- Between ages 6 and 24 months and has a rectal temperature higher than 102 F (38.9 C) that lasts longer than one day but shows no other symptoms. If your child also has other signs and symptoms, such as a cold, cough or diarrhea, you might call your child’s doctor sooner based on severity.
Children
There’s probably no cause for alarm if your child has a fever but is responsive — making eye contact with you and responding to your facial expressions and to your voice — and is drinking fluids and playing.
Call your child’s doctor if your child:
- Is listless or irritable, vomits repeatedly, has a severe headache or stomachache, or has any other symptoms causing significant discomfort.
- Has a fever after being left in a hot car. Seek medical care immediately.
- Has a fever that lasts longer than three days.
- Appears listless and has poor eye contact with you.
Ask your child’s doctor for guidance in special circumstances, such as a child with immune system problems or with a pre-existing illness.
Adults
Call your doctor if your temperature is 103 F (39.4 C) or higher. Seek immediate medical attention if any of these signs or symptoms accompanies a fever:
- Severe headache
- Unusual skin rash, especially if the rash rapidly worsens
- Unusual sensitivity to bright light
- Stiff neck and pain when you bend your head forward
- Mental confusion
- Persistent vomiting
- Difficulty breathing or chest pain
- Abdominal pain or pain when urinating
- Convulsions or seizures
Exercising During Pregnancy
5 Easy and Safe Pregnancy Exercises
Our favorite workouts for pregnancy will help you stay active and get ready for baby. By K. Aleisha Fetters June 11, 2015
https://www.parents.com/pregnancy/my-body/fitness/4-safe-and-easy-workouts-for-pregnancy/
Walking
Body Benefits: Even if you’ve never exercised a day in your life, a quick stroll around the neighborhood is a great way to start. You’ll get a cardiovascular workout without too much impact on your knees and ankles, and you can do it almost anywhere and at any time throughout the entire nine months.
Safety Bump: “As your belly gets bigger, you can lose your sense of balance and coordination,” says Dr. Crites. Try to walk on smooth surfaces, and watch out for potholes and other obstacles. Remember to wear supportive sneakers. Your feet may swell in your later trimesters, so if your shoes start to feel tight, buy ones that are a half-size bigger.
Yoga
Body Benefits: Prenatal yoga classes keep your joints limber and help you maintain flexibility. “Also, because yoga strengthens your muscle system, stimulates circulation, and helps you relax, you can use the techniques you practice in class to stay calm and have a little more control during labor,” says Sokhna Heathyre Mabin, a yoga teacher at Laughing Lotus, in New York City.
Safety Bump: As your pregnancy progresses, skip positions that really challenge your balance. In your second trimester, steer clear of poses that require you to lie flat on your back – as your uterus gets heavier, it can put too much pressure on major veins and decrease blood flow to your heart. Also, be careful not to overstretch, says Annette Lang, personal trainer and author of Prenatal & Postpartum Training Fan. Pregnant women produce more relaxin, a hormone that increases flexibility and joint mobility, so it’s important to know your limits and hold back slightly when stretching.
Swimming
Body Benefits: “This is the ideal form of exercise during pregnancy,” says Baron Atkins, MD, an Ob-Gyn at Arlington Memorial Hospital in Texas. There’s zero chance of falling on your stomach and injuring your baby. Exercising in water gives you better range of motion without putting pressure on your joints. “I feel weightless in the pool, even though I’m carrying twins,” says Sharon Snyder, of San Francisco, who is four months pregnant. Even in your ninth month, you can swim, walk, do aerobics, or dance in the water.
Safety Bump: Choose a stroke that feels comfortable and doesn’t hurt your neck, shoulders, or back muscles. The breaststroke is a good choice because you don’t have to rotate your torso or belly. Be careful entering the water. Diving or jumping in could cause too much abdominal impact. To avoid overheating, stay away from very warm pools, steam rooms, hot tubs, and saunas.
Weight Training
Body Benefits: Lifting weights is a great way to prepare your body for all the heavy lifting you’ll be doing once your baby is here. Plus, it helps counteract the risk of injury during pregnancy by strengthening the muscles surrounding your joints.
Safety Bump: Reduce the amount of weight you’re used to lifting by half and do more repetitions so you still get a good workout. “Lifting weights that are too heavy can strain your muscles and put a dangerous amount of pressure on your abdomen,” says Dr. Atkins. And when you’re weight training – just like when you’re doing yoga – don’t lie flat on your back. If you find yourself holding your breath, reduce your load ASAP. Breathing incorrectly can increase your blood pressure and decrease the flow of blood to your baby.
All-in-One Workout
Body Benefits: According to new research published in Mayo Clinic Proceedings, light to moderate exercise 50 to 55 minutes three days a week made those pregnant women 40 percent less likely to gain too much weight. What’s more, obese and overweight women who exercised during their pregnancies were 86 percent less likely to have babies with macrosomia (also known as “Big Baby Syndrome”) than those who didn’t.
Here’s the workout:
Stretch it out. Part of the 50-55-minute sweat session included a 10-minute warm-up and 10-minute cooldown, involving stretching. “It’s important to stretch your muscles and connective tissues during pregnancy,” says Marta Montenegro, M.S., C.S.C.S., and exercise physiologist. “The extra weight women carry during pregnancy throws off the whole body’s alignment, so joints and muscles are overly taxed.” To curb joint and muscle pain, you don’t need to stretch for more than a few minutes, you just need to do it regularly, says Montenegro.
Resistance-train twice a week. The women in the study lifted weights twice a week, exercising their arms, shoulders, legs, and ankles for just under half an hour. During your pregnancy, Montenegro suggests using strength machines rather than free weights (there’s less chance of injury) and performing one to three sets of 12 to 15 light reps. Note: After your first trimester, avoid any exercises that involve laying flat on a bench or the floor, which could lead to sudden blood pressure changes.
Do a light aerobic exercise once a week. The study participants did an aerobic dance workout once a week for 30 minutes. Get the benefits by swimming, walking, or spinning for the same amount of time.
When to Stop Your Workout
Any of these symptoms could mean you’ve put too much stress on your body. Stop exercising and call your doctor if you have:
- Vaginal bleeding or leakage of fluids
- Difficult, labored, or uncomfortable breathing
- Heart palpitations or pain in your chest
- Headache, nausea, or vomiting
- Dizziness or fainting
- Sudden change in temperature, clammy hands, or overheating
- Swelling or pain in your ankles and calves
- Decreased fetal movement
- Blurred vision
- Pain in your abdomen
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