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Parents Need to Know is a newsletter written by Craig Collison, MD, pediatrician with Mount Nittany Physician Group.
Wheezing in small children

Infants and young children are at risk for respiratory illnesses that involve wheezing as a major symptom. Wheezing is a noise that sounds like a highly-pitched squeak usually when breathing out. It can be associated with a dry, tight, hacking cough and also nasal flaring. The muscles in a child’s neck, ribs and abdomen can also retract as they move the child’s breaths in and out.

The two most common wheezing illnesses in young children are bronchiolitis and reactive airway disease. Infants and children can also have actual asthma and wheezing from non-infectious triggers such as allergies, irritants such as cigarette smoke, and temperature (usually cold). The following is a description of these scenarios and how to respond appropriately if your child wheezes.

Bronchiolitis is an illness that only affects infants, usually under one year of age. It is most commonly triggered by RSV (Respiratory Syncitial Virus). RSV is very prevalent during the winter months in the United States and causes the common cold in adults and older children. Young infants are susceptible to a lung infection when the bronchioles (small airways) in the lungs are inflamed and filled with mucus, causing wheezing, coughing and possibly respiratory distress. This susceptibility comes from immature defenses in the young infant’s lungs compared to older children and adults. On exam, infants with bronchiolitis will have wheezing and trouble breathing that can sometimes lead to albuterol and oxygen treatment. Premature babies are even more susceptible to RSV and its breathing complications. We are fortunate to now have a vaccine (Synagis) to protect premature babies against RSV.

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Bilingual households and speech strategies

With Penn State here in the Centre Region, we have many children in our practice who grow up in bilingual houses. These children are sometimes a little slower in their speech development but end up being fluent in both languages at a very young age.

A recent study from the University of British Columbia (UBC) and Universite Paris Descartes reports that babies as young as seven months old can begin to learn two different languages – even if those languages have different grammatical structures.

The study, which was presented at the 2013 Annual Meeting of the American Association for the Advancement of Science in Boston, finds that infants use pitch and duration cues to decipher between languages that have opposite word orders, like English and Japanese.

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Ask the pediatrician: Omega-3 supplement beneficial to children?

Dr. C.,

Is it beneficial for children to take an Omega-3 supplement if they are not eating fish at least two times a week? I have also read that Omega-3 may be beneficial to children who exhibit signs for ADHD. How true is this?

This is a very good question – and we are starting to see some studies on this and hopefully some concrete answers. There are definite benefits from having Omega-3’s in our diet from birth through old age. Below is a review of Omega-3s from WebMD that I think does a good job explaining what Omega-3s are and their benefits. We don’t talk about this much in my practice, and maybe we should be looking at this closer. Hope this helps.

What are Omega-3s?

Omega-3s are essential fatty acids - we need them for our bodies to work properly. One of their most important benefits is that they seem to have an anti-inflammatory effect.

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Pediatric ACL injuries – how treatment can prevent long-term issues

As the number of children participating in sports continues to grow, we are seeing more significant injuries of the knee, including anterior cruciate ligament (ACL) tears.

According to an article in the February issue of Journal of the American Academy of Orthopaedic Surgeons, ACL injuries were once considered rare in children and adolescents. Now these injuries are on the rise “whether they result from year-round training, less free play or increased single sport concentration,” said lead study author and pediatric orthopedic surgeon Jeremy Frank, MD, with Joe DiMaggio Children’s Hospital’s Department of Pediatric Orthopaedics and {U18} Sports Medicine in Hollywood, FL.

The article states, “Until a child’s bones have fully matured (in girls, typically by age 14; in boys, age 16), an injury to the ACL – the primary, stabilizing ligament of the knee joint – requires special consideration, treatment and care to ensure appropriate healing and to prevent long-term complications.”

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Recent product recalls announced

Here are just a few recent product recalls as announced by the US Consumer Product Safety Commission. For the most up-to-date recall information, please visit and click on the Recalls tab from the home page.

Name of Product: Triaminic® Syrups and Theraflu Warming Relief® Syrups

Hazard: These child-resistant caps can fail to function properly and enable the cap to be removed by a child with the tamper-evident seal in place, posing a risk of unintentional ingestion and poisoning. These products contain acetaminophen and diphenhydramine, which are required by the Poison Prevention Packaging Act to be sealed with child-resistant packaging.

Incidents/Injuries: The firm has received 12 reports of children unscrewing the locked caps, including four reports of children ingesting the product. One child required medical attention.

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