Children and Teen Health

Keeping children safe and healthy is a main concern as we watch them cut new teeth, hit growth spurts and struggle through adolescence into adulthood. The health risks children and teenagers face are as varied as the interests and skills they learn as they grow up. From infections to falling out of trees to experimenting with sex, some health issues facing children and teenagers will always stay the same, while others are new and unnerving.

You need to weigh many factors when deciding how often to bring your children and teens to their health care provider. Questions about a child's developmental stages, a family history of certain health problems, or significant changes in a child's environment or behavior are all reasons to take your child to see his or her provider.

Planning for a Visit to Your Child's Health Care Provider

Whether you're seeing a health care provider for a well-child visit or because your child is sick, it's a good idea to think ahead of time about the questions you want to ask. If you're not sure whether your child needs medical care, you can call his or her provider's office at any time of day or night. A staff member or doctor on call can tell you if your child needs to be seen in the office or at an urgent care clinic or emergency room. The following are sample questions you might want to ask when visiting your child's provider.

Well-Child Exam

• What are the office hours?

• How can I contact my child's health care provider in an emergency or when the office is closed?

• If I have a minor question, when is the best time to call?

• If the provider isn't available, who can answer my questions?

• Is there anything the provider needs to know about my family?

• What immunizations does my child need, and when?

• How often does my child need a well-child exam?

• What else can I do to keep my child safe and healthy at home or with a caregiver?

• Should I be concerned about my child's weight or activity level?

• How can I encourage my child to exercise?

• How can I be sure my child eats a nutritious diet?

• How can I help my child cope with a recent divorce, death, or emotional or behavioral problems?

When Your Child Is Sick

• What isn't working, and why?

• What caused the problem?

• When will my child start feeling better?

• Are there signs or symptoms I should watch for?

• How can I make my child comfortable?

• Will my other children catch this illness?

• Can I do anything to prevent this illness or injury from happening again?

• Is this related to any past medical conditions?

• Does my child need to stay home from school?

• When can my child start doing normal activities again?

• Is it OK for my child to play with other children now?

• What is the plan for my child's treatment?

• Does my child need to be on a special diet?

• What is this medication for? When is the best time to give it?

• How long will it take this medication to work?

• Is it OK for my child to take vitamins or over-the-counter medications with this prescription?

• What are the side effects of this medication? Can I do anything about them? Will they go away?

• How long should my child take this medication?

• Are there organizations or support groups that can give me more information about this condition?

• Does the doctor need to see my child for a follow-up visit?

Childhood Immunizations

Among the greatest achievements in modern medicine, vaccines protect children from serious diseases, including mumps, measles, diphtheria and polio. Some immunizations work by giving a very weak dose of the disease—strong enough to prompt the body's immune system to develop antibodies against the disease but not strong enough to cause it. The following section describes each of the major vaccines.

Diphtheria/Tetanus/Pertussis (DTaP)

The DTaP shot combines three vaccines to protect against these life-threatening diseases. Most children should have five DTaP shots before they enter kindergarten. Babies should have three shots by the time they reach 6 months of age—at 2, 4 and 6 months—plus one at about 15 months. The fifth shot is given between ages 4 and 6.

In 2005, the Food and Drug Administration (FDA) approved a booster vaccine, Tdap, to be administered every 10 years, beginning at age 11. This vaccine provides increased immunity against diphtheria, tetanus and pertussis (whooping cough). The vaccine contains a reduced dosage of diphtheria, and a full dosage of tetanus and acellular pertussis.

Inactivated Poliovirus (IPV)

Since becoming available in the 1950s, this vaccine has nearly wiped out polio. Experts warn, however, that without continued vaccination, the risk of contracting this crippling, potentially fatal disease could return. Children should receive four doses of IPV by age 6. In most cases, this provides protection for life.

Haemophilus Influenzae Type B (Hib)

Hib is a dangerous bacterium that can cause meningitis, pneumonia and other serious infections. The Hib vaccine protects almost all children who receive the full four doses. It is given by injection three times before a child is 7 months old, followed by a booster at 12 to 15 months.

Measles/Mumps/Rubella (MMR)

The MMR vaccine is given by injection once at 12 to 15 months of age and again at 4 to 6 years of age to guard against these common childhood infections. For most people, these two doses provide protection for life.

Hepatitis B (HepB)

Hepatitis is an inflammation of the liver that can damage the liver and result in cancer or cirrhosis. Hepatitis can even cause death. Hepatitis B is considered to be the most serious form of hepatitis. It is transmitted most frequently through sexual contact or from mother to child during or shortly after birth. The HepB vaccine is given three times before 18 months of age. Teenagers may also be vaccinated if they weren't vaccinated earlier.

Hepatitis A (HepA)

This vaccine is given to children in two does, the first at 24 months and the second at least six months later.  Adults at risk for hepatitis A should also be vaccinated. When originally approved, this vaccine was recommended only for at-risk populations.  In 2006, however, the Advisory Committee on Immunization Practices (ACIP) recommended this vaccine be given routinely to all children, not just those in selected populations.  HepA has now become part of the routine childhood immunization series.

Chicken Pox (Varicella)

Chicken pox is seen most often in children under the age of 10. This contagious infection is caused by the varicella-zoster virus. The vaccine is given between 12 and 18 months of age, but also is given to older children who have not had chicken pox and have not been vaccinated; this is given as a single dose. Healthy children older than 13 who have not been immunized previously and have not had chicken pox should be immunized with two doses of vaccine, four to eight weeks apart.

In 2006, the ACIP published updated recommendations for the varicella vaccine.  The committee now recommends a second dose of the varicella vaccine for children 4 to 6 years old.  In addition, they recommend a second dose for adults previously vaccinated as children.

Pneumococcal

The pneumococcal vaccine protects against the seven most common types of pneumococcal bacteria.  Pneumococcus is responsible for serious infections, including pneumonia, septicemia and meningitis. It has also been implicated in minor illnesses such as ear infections. This vaccine is normally given at 2, 4, 6 and 15 months of age.

Meningococcal

The meningococcal conjugate vaccine (MCV4) should be given to all children at the 11- to 12-year-old visit, as well as to unvaccinated adolescents when they enter high school (age 15) and unvaccinated college freshman living in dormitories.  

Influenza

Experts also recommend that healthy children ages 6 to 23 months and close contacts of healthy children ages 5 months and younger receive the influenza vaccine, because children in this age group are at higher risk for influenza-related hospitalizations.

Rotavirus (RV)

In February 2006, the FDA licensed a rotavirus vaccine for infants. That same month, the ACIP began recommending routine immunization of all infants with RV. The provisional ACIP recommendations say that infants should receive three doses of oral vaccine at 2, 4 and 6 months of age. Talk to your health care provider to find out if your child should have the rotavirus vaccine.

Safety in the Home

Accidents are the leading cause of death and disability for children and young adults. Here are several tips for making your home safer for everyone.

Child Safety - Inside and Outside

• Cover all electrical outlets with safety covers.

• Put childproof locks wherever poisonous substances (including alcohol) and sharp utensils or tools are stored.

• Set water to 120 degrees F or lower to prevent scalding.

• Use unbreakable dishes and cups for toddlers.

• Keep all cribs and beds away from windows.

• Keep pins, paper clips and other small, swallowable objects out of the reach of young children.

• Dispose of or properly store plastic bags to prevent suffocation.

• Put fences around pools, spas and ponds.

• Make sure kids wear helmets when biking or skating.

• Mark sliding glass doors so that they are visible.

Fire Safety

• Install smoke detectors in hallways and outside all bedroom doors, and replace batteries at least once a year.

• Keep a fire extinguisher in a central location and make sure that the whole family knows how to use it.

• If a fire starts when you are cooking, put it out by turning off the burner and smothering the flame with baking soda, a pan lid or a fire extinguisher.

• Teach all the members of your family how to "stop-drop-roll" if their clothes catch on fire.

• Have a household fire drill and plan emergency escape routes.

• Make sure that second-floor rooms have escape ladders.

• Have your fireplace inspected annually for creosote buildup. Make sure that the fire screen closes completely. Keep newspaper and upholstery a safe distance from your fireplace.

• Never leave a fire unattended.

• Keep flammable objects away from space heaters, and use space heaters with care.

• If your efforts to put out a fire aren't effective after one minute, it's too big. Leave the house right away and call 911.