What should I know about bug bites and bee stings before our family goes on vacation?
With summer fun comes exposure to insect bites and bee stings. Most bites don’t result in significant problems, but there are a few things to look out for. First, if your child is stung by a bee, you want to be sure that the stinger is not left behind (wasps and hornets do not leave a stinger, only bees). If the stinger is visible, scrape the area horizontally with a credit card or your fingernail to remove it. A serious allergy (anaphylaxis) to a bee sting would result in symptoms like hives on the skin, difficulty breathing, lip or throat swelling, or fainting. If any of these symptoms arise, seek medical attention immediately.
Most bites and stings are best treated by keeping them clean with soap and water, applying a cool compress or ice pack and over the counter itch cream like calamine lotion. (Hint: Often the calamine is even more effective if it’s cold, so keep it in the refrigerator.) If a bite appears to be increasing in size or redness or if there is any red streaking away from the bite, you should call your pediatrician to have it looked at.
Prevention is always a good strategy (albeit difficult to achieve in the Virginia summer) but consider applying insect repellant before going outside. Be sure to avoid combination sunscreen/insect repellant products, as sunscreen needs to be continuously reapplied throughout the day and the insect repellant is not intended to be reapplied. The American Academy of Pediatrics (AAP) recommends DEET 10-30 percent for children over 2 months of age. Ten percent DEET provides protection for about two hours and 30 percent DEET lasts for about five hours. Choose the lowest concentration that will provide the required length of coverage.
What can I do about my child’s bedwetting?
Preparing for play dates, summer camps, and family travel always reminds families about the inconvenience of bedwetting. Thankfully, the problem is rarely caused by a serious medical condition and almost always gets resolved on its own with time. It can, of course, be a cause of worry and embarrassment for children and frustration (and extra laundry!) for parents.
The major factors at play for children who still wet the bed are family history (usually at least one parent was a bedwetter as a child), small bladder size and increased urine production at night, being a deep sleeper, and constipation. While a few families may find restricting fluids in the evenings and waking their children up regularly during the evening and night is helpful in preventing bedwetting, usually these strategies just frustrate parents and children alike. If your child seems motivated to work on the issue (talks about wanting to be dry, not wanting to wear Pull-Ups, or not wanting to go on sleep-overs because of bedwetting), that is a good time to go for it.
The single best strategy for bedwetting is a bedwetting alarm. For younger kids, I call this “magic underwear,” which helps to sense the smallest amount of moisture in underpants and then sounds an alarm to wake the child from his/her deep sleep so he or she can go to the bathroom. After several weeks, the brain is usually more “tuned in” to the bladder and your goal is accomplished. Don’t forget: No matter what your strategy, it is important to let your child know that there are lots of kids (an estimated 10 to 15 percent of 8-year-olds) who wet the bed. Try praise for success rather than punishment for wetting.
Should I take my teenager off his ADHD meds over the summer?
Many families see the summer as a time to take a vacation from daily medications used for Attention Deficit Hyperactivity Disorder (ADHD). If your school-aged child has ADHD and is on daily medication, though, you may want to reconsider. First, an incredibly important safety issue for teenagers with ADHD is driving. All of us worry about distracted teen drivers and those with ADHD are particularly prone to driving distraction. If your driving teen is on a medication that is successfully treating his or her inattentive, impulsive, hyperactive, or distracted behavior during the school year, it is a good idea to keep her on the medication throughout the summer.
Kids of all ages attend summer camps, participate in swim teams or other sports camps, or stay with a babysitter or summer school. Your child is most likely to succeed and have fun in these ventures if the symptoms that require treatment during the school year are also controlled during the summer. Either way, it is a good idea to discuss this issue with your pediatrician and your teenager so everyone is on the same page.—Paige Perriello
Paige is a general pediatrician practicing at Pediatric Associates of Charlottesville. She is married, with a 2-year-old daughter.