Perk up your ears, kids! Did you hear the good news about ear infections?

A new study of 615 kids showed that the rate of ear infections in kids under 3 years has dropped 3-fold over the past 10 years compared to the 1980's. This dramatic decrease in ear infections seems to be due to the pneumococcal conjugate vaccine, which your kids get at 2, 4, 6 and 15 months when they come to Carolina Kids Pediatrics. Pneumococcal bacteria used to be the most common cause of ear infections, but we didn't start immunizing against pneumococcus until the 1990s. Although the vaccine was primarily designed to prevent meningitis and blood stream infections (which it has done beautifully), this seems to be a nice side benefit of the pneumococcal vaccine.

A quick correction - our lactation consultant will teach our next prenatal class on Wednesday, August 30 from 6 pm to 7 pm (I had previously sent out a notification that the class would be from 6:30 pm to 7:30 pm). I apologize for the error. The class is free, and open to all. If you are interested, please call our office to sign up!

Like all pediatricians in Raleigh, North Carolina, and beyond, we at Carolina Kids Pediatrics spend a good bit of our summer completing sports physical forms – and a fair bit of the rest of the year managing some of the injuries that result from sports.

In last week’s blog, we talked a little bit about how to prepare your child for an upcoming sports season. This week, I’d like to address a few common sports injuries, and how to recognize them.

As a pediatrician in Raleigh, NC, these are some of the most common sports injuries I see, and what to do about them:

PATELLOFEMORAL STRESS SYNDROME: A common issue in teenagers – the complaint is usually a vague pain around the knee cap that worsens with going down stairs or squatting. This is caused by uneven movement of the knee cap across the knee joint, leading to inflammation and pain behind the knee cap. It’s often fixable with low-impact exercises that strengthen and stretch the thigh muscle and help it hold the knee cap in the right place as it moves.

ANKLE SPRAIN: This is usually due to stretching or tearing of the ligaments on the outside of the ankle when the foot turns in during a stumble or fall. An ankle brace or wrap, elevation, ice for the first day or two, and crutches for 2-3 weeks may be needed depending on the severity of the injury. What’s even more important is rehabilitation after the sprain. When the brace comes off, it’s important to strengthen the ankle before going back into full sports mode. Simple exercises like tracing the alphabet in the air with your toes are a start, with a gradual increase in training and activity until the ankle is strong enough for running and jumping. Kids get into trouble when they go straight from wearing an ankle brace to participating fully in their sport without proper rehabilitation.

OSGOOD-SCHLATTER DISEASE: Doesn’t that sound awful? It’s not as bad as it sounds, but it does hurt. The bony bump right below the knee cap (called the tibial tuberosity) has a growth plate in growing tweens and young teenagers. With a lot of running and jumping, this one spot right under the knee cap can become painful and swollen. A flexible knee brace can help, as can ibuprofen and ice. However, the ultimate cure happens when this bone stops growing in the mid to late teen years.

SEVER DISEASE: Same problem, different spot. There is a growth plate in the back of the heel which can become painful and inflamed with running and walking in tweens and young teenagers. The treatment is heel cord stretching, sometimes a soft gel heel lift in the shoe, and pain medications like ibuprofen.

SHIN SPLINTS: Pain in the shins with running can be due to swelling in some tight spaces, or compartments, in the front of the lower legs. If this is the case, ice and ibuprofen are the immediate treatment, and the pain should go away quickly with rest. It can be useful to decrease the intensity of training, and build up more gradually toward a goal. However, if pain continues at rest, particularly if it always remains in one spot, this can be a sign of a stress fracture (small break in the bone from over-exertion) - this may need orthopedic treatment and a prolonged period of rest and rehabilitation.

LITTLE LEAGUE ELBOW: If your young pitcher frequently hurts on the inside of his/her elbow, beware. There are growth plates here too, and pain on the inside of the elbow in a growing pitcher can be a sign of bone injury in this location. If it goes untreated, it can require surgery to heal, but injuries caught early can often be treated with rest and physical therapy. Be sure your child’s coach follows strict pitch limits – no more than 350 throws per week – to avoid this problem. A similar problem is also possible higher up – “Little League Shoulder”, which involves the growth plate in the upper arm.

A nice website for reading more is https://www.niams.nih.gov/health_info/sports_injuries/child_sports_injuries.asp#most - or call your pediatrician at Carolina Kids Pediatrics if you’re worried about a sports injury!

Take the time you need to get all of your questions and concerns answered throughout your pregnancy.

Over the last several years, our practice has begun to offer several new types of prenatal parenting classes.  We now offer prenatal parenting classes at Babies R Us monthly and periodic lactation classes by our lactation consultant, in addition to our twice monthly prenatal classes and practice orientations at Carolina Kids Pediatrics. All prenatal education classes offered at Carolina Kids Pediatrics, your Raleigh, NC, pediatricians, are free of charge and are open to all who wish to attend. 

Our schedule for free prenatal classes at Carolina Kids Pediatrics in Raleigh, NC include the following upcoming dates:

Upcoming prenatal classes at Carolina Kids Pediatrics (call our office in Raleigh, NC or sign up on our website):

• Tuesday, June 27 at 5:30 pm
• Wednesday, July 12 at 5:30 pm
• Tuesday, July 25 at 5:30 pm
• Wednesday, August 9 at 5:30 pm
• Tuesday, August 22 at 5:30 pm
• Wednesday, September 6 at 5:30 pm
• Tuesday, September 19 at 5:30 pm
• Wednesday, October 4 at 5:30 pm
• Tuesday, October 17 at 5:45 pm
• Wednesday, November 1 at 5:45 pm
• Tuesday, November 14 at 5:45 pm
• Wednesday, November 29 at 5:45 pm
• Tuesday, December 12 at 5:45 pm

Prenatal classes at Babies R Us in Cary (call Babies R Us to sign up):

• Wednesday, July 19 at 6:30 pm
• Tuesday, August 15 at 6:30 pm
• Wednesday, September 13 at 6:30 pm
• Tuesday, October 10 at 6:30 pm
• Wednesday, November 8 at 6:30 pm
• Tuesday, December 5 at 6:30 pm

Lactation classes (further classes after June will be announced on our website):

• Wednesday, June 28 at 6 pm

Your First Appointment:

We consider our prenatal classes as your opportunity to meet your Raleigh children’s doctor for the first time. Some of the topics we address during these classes include:

How to prepare your home for a newborn

What to expect in the first weeks of life

How to prepare to breastfeed your baby

When to worry (and when not to worry) about illness

Your babies sleep (and what to expect for your own night)

What to expect in your baby's development

How to keep your baby safe, both inside the home and out

What to expect of your pediatrician

We hope and expect that our free prenatal education classes in our Raleigh pediatrician's office at Carolina Kids Pediatrics begin to help you answer these and many other questions.

Behavioral and developmental health is as critical to your child as physical health - and working with a pediatrician in Raleigh, NC that understands this is vital. Carolina Kids Pediatrics is firmly committed to serving your child's behavioral and developmental needs. If you have noticed that your child seems different than their peers, has different interests or is not keeping up with other kids in some way, it may be time to take a step back to dig a little deeper. Often, this starts with a behavioral or developmental consultation at Carolina Kids Pediatrics.

A few common reasons that families seek a behavioral or developmental consultation with us include delayed communication skills in toddlers and preschoolers, excessive or unusual tantrums or behavioral changes, difficulty with age-appropriate play or social interactions, and academic challenges in the early school years. 

If you are thinking that your child is not on the same level as the other kids their age, consulting with the physicians at Carolina Kids Pediatrics in Raleigh could help. If you are worried about whether your young child is developing appropriately, my favorite website to provide you with some additional guidance is www.firstsigns.org. Although designed as a website to increase awareness of early signs of autism, it also provides great general information on normal early childhood development.

The public school system also provides some great resources for early childhood assessment. For kids under age 3, the school system provides free developmental assessment to determine if your child is on track, or if they need access to early intervention services because of specific developmental challenges. Your county's early intervention contact information can be found at http://www.beearly.nc.gov/index.php/contact/cdsa. 

For preschool age children with developmental challenges (age 3 - kindergarten), please contact your county's Child Find office. Information about Wake County's process for evaluating preschool kids for developmental help can be found at: http://www.wcpss.net/Page/4310

Wake County offers an additional program that provides assistance to the parents of toddlers and preschool kids when it comes to common parenting challenges around behavior and development. The Project Enlightenment program offers both parent and preschool consultations, as well as a great series of parenting classes. Check out their website at: www.projectenlightenment.wcpss.net. 

All of these resources are also listed on the "Community Resources" page of www.carolinakidspediatrics.com. 

Regardless of your concerns, the first step is to seek help from a pediatrician in Raleigh, NC that has experience with behavioral and developmental challenges. Making sure that your child has the resources that they need is essential. A qualified pediatrician will be able to assess, diagnose and refer you to the resources that will put you on the right track for the future. If you have concerns about your child's development, call Carolina Kids Pediatrics today at 919-881-9009 to schedule an appointment.