Music Therapy, Shopping Carts, Marijuana – PediaCast 279

Join Dr Mike in the PediaCast Studio for more News Parents Can Use! This week’s topics include music therapy, bullies & obesity, shopping cart injuries, peanuts & pregnancy, marijuana, and dry skin.

Topics

  • Music Therapy

  • Bullies & Obesity

  • Shopping Cart Injuries

  • Peanuts & Pregnancy

  • Marijuana & Grandchildren

  • Dry Skin

Links

Transcription

Announcer 1: This is PediaCast.

[Music]

Announcer 2: Welcome to PediaCast, a pediatric podcast for parents. And now direct from the campus of Nationwide Children's here is your host Dr. Mike.

Dr. Mike Patrick: Hello everyone and welcome once again to PediaCast, it is a pediatric podcast for moms and dads this is Dr. Mike coming to you from the campus of Nationwide Children's Hospital. We're in Columbus, Ohio it is episode 279 for February 19, 2014. I'm calling this one Music Therapy, Shopping Carts, and Marijuana. Of course we got lots more coming your way. Before we get to the line-up I have to warn you this is going to be a rough show and the reason is couple of weeks ago in one of the episodes we answer the listener question about chronic cough and right on cue I have one. 

0:01:09.9

I had a cold couple of weeks ago you know runny nose, congestion, a little bit of a cough and now I've got that tickle that just won't go away and we talked about that on the program a couple of weeks ago and then I said not only kids, as adults you may experience this, and here we are. I know overall it's not going to be too bad because I did pre-record the news segments and was able to edit it out. But here during the intro with the music playing on the background. Maybe I could edit music in but it's easier just to play it and talk over it to be honest with you. So it's a little bit harder to edit out cough when you got the music playing, but so far so good. 

0:02:04.1

So the winter Olympics are kind of winding down, have you been watching it with your kids and what's been your thoughts on that? It's always an event in our house and we all gather around the TV and watch the Olympics and all the rules on screen time go out the door during the Olympics but pretty soon we have to reinstitute those and get use to talking to one another again. We do talk during the events, but it's a lot of fun and hopefully you've been having fun with it with your family as well. I also want to remind you about our 700 Children's blog it's at 700childrens.org and basically you take all the doctors at Nationwide Children's Hospital, find out who likes to write and you have a bunch of contributors who are all experts in their field. It's a pretty good blog, if you want to check that out.

0:02:57.0

Just a few recent topics The Dangers of Electronic Cigarettes, High Chair Safety, Knee Pain in Teenagers, Massage Therapy for Babies, and Winter Skin Problems. If you like listening about pediatric topics or you love reading a blog, and I'm one of the contributors I got one coming up on raw milk soon so you can look for that, again that's at 700childrens.org. What are we talking about this week? First that music therapy, this is a really cool story. Kids with serious chronic illness, they have a lot of stress in their lives right? Well a new type of music therapy which involves song writing and video production is helping these kids cope and maybe something your family could consider especially if your family, or if your child has lots of stress in his or her life whatever the reason, music therapy maybe something that could help them out so that's coming up. Also bullies and obesity, many kids experience being the last kid pick for team sport.

0:04:00.8

Lots of teasing occurs in gym class, teasing we could classify as bullying, could this contribute to obesity? We talked about bullying a couple of weeks ago and its effect on future mental health, turns out physical health can be affected too in the form of obesity and sedentary lifestyle so we'll talk through that. And then shopping cart injuries, they are on the rise despite safety standards and educational drives parents are still practicing risky behaviors when it comes to shopping carts and kids are suffering. With many types of injuries including concussions on the rise, what can you do to keep your kids safe around shopping carts? And what do you say to parents who are practicing these risky behaviors? Actually what exactly are these so called risky behaviors? We'll consider all these questions coming up. And then peanuts and pregnancy, should pregnant women eat peanuts? Does eating peanuts while you're pregnant increase your child's risk of developing a peanut allergy, or does it decrease the risk, or does it even make a difference at all? I'll have the answer to that.

0:05:07.5

And then marijuana and grandchildren, this is a really interesting story and relevant given the recent legalization of marijuana in a couple of US states. Can smoking weed somehow alter your genes in such a way that future generations are affected even though they aren't directly exposed to the drug? It's an interesting thought, could it be true? We'll take a look. For my final word this week I'm going to talk about dry skin. It's been a long cold winter and many people are dealing with dry skin. Why do we get dried out skin in the winter and what can you do to prevent and treat it? So this is a winter skin problem that is not only addressed over at the 700 Children's blog but also coming your way at the end of this program. I also want to remind you if there's a topic you like us to talk about, or you have question for me or an interview idea, or a new story you want to point me toward.

0:06:02.7

It's easy to get in touch, just head over to pediacast.org and click on the contact link, I do read each and every one of those that come through and we'll try to get your comments on the show. I also want to remind you the information presented in PediaCast is for general educational purposes only, we do not diagnose medical conditions or formulate treatment plans for specific individuals. If you have a concern about your child's health, be sure to call your doctor and arrange a face to face interview and hands on physical examination. Also your use of this audio program is subject to the PediaCast terms of use agreement which you can find at pediacast.org. Let's take a quick break and I will be back right after this.

0:07:01.7

[Music]

Dr. Mike Patrick: A new study has found that adolescents and young adults undergoing cancer treatment gain coping skills and resilience-related outcomes when they participate in a therapeutic music process that includes writing song lyrics and producing videos. This's according to research from Indiana University and recently published in the journal Cancer. Researchers say their findings indicate that music therapy interventions can provide essential psychosocial support to help young patients positively adjust to a diagnosis of cancer. 

0:08:03.0

Dr. Joan Haase and Dr. Sheri Robb say, "Few interventions target the unique psychosocial needs of adolescents and young adults with cancer." So they put together a team and set out to design and test a music therapy intervention aimed at improving resilience in patients undergoing stem cell transplant treatments for cancer. Resilience is the process of positively adjusting to stressors, including those associated with a cancer diagnosis and treatment. The researchers' Therapeutic Music Video intervention was designed to help adolescents and young adults explore and express thoughts and emotions about their disease and treatment that might otherwise go unspoken. Through the creative process of writing song lyrics and producing videos, a board-certified music therapist offers structure and support to help patients reflect on their experiences and identify what is important to them, such as their spirituality, family, and relationships with peers and healthcare providers. 

0:08:59.6

As patients move through phases of the intervention-including sound recordings, collecting video images, and storyboarding, they have opportunities to involve family, friends, and healthcare providers in their project. Activities which maintain important connections during treatment and encouraging communication. Once complete, videos can be shared through video premieres, which allow others an opportunity to gain a better understanding about the patients' perspectives on their cancer, their treatments, and their desires for the future. For the study, 113 patients aged 11 to 24 years who were undergoing stem cell transplant treatments for cancer were randomized to one of two groups. A Therapeutic Music Video intervention group or a control group that received audiobooks. Participants completed six sessions over a three week period. Following the intervention, the Music Video group reported significantly better coping skills and 100 days after stem cell transplant treatments, the Music Video group reported significantly better social integration and family environment. 

0:10:02.0

The investigators found that several protective factors helped adolescents and young adults to be resilient in the face of cancer treatments. These factors included spiritual beliefs and practices, having a strong family environment characterized by adaptability, cohesion, and positive communication, and feeling socially connected and supported by friends and healthcare providers. Dr. Haase says, "These protective factors influence the ways adolescents and young adults cope, gain hope, and find meaning in the midst of their cancer journey. Adolescents and young adults who are resilient have the ability to rise above their illness, gain a sense of mastery and confidence in how they have dealt with their cancer, and demonstrate a desire to reach out and help others." When the investigators interviewed the patients' parents, they found that the videos gave parents insights into their children's cancer experiences, however, parents needed help to initiate and sustain important conversations about messages shared through their children's videos.

0:11:01.8 

To address this need, the study team has received funding from the National Institutes of Health and the Children's Oncology Group to examine the potential benefits of adding a parent communication component to their intervention. The study's findings provide evidence supporting the use of a music-based intervention delivered by a music therapist to help adolescents and young adults positively cope with high-risk, high-intensity cancer treatments. Dr. Robb says, "The availability of music therapy services from a board-certified music therapist in the United States has become more widespread, and through studies like this one, we hope to see increased availability and access to this important allied health service. One of the challenges in healthcare today is making sure that research findings from studies such as ours are used to inform healthcare practices and service delivery. One of our team's next steps is to disseminate findings, train professional music therapists on this intervention, and then conduct an implementation study to examine how the intervention may change as it moves into the standard care setting and whether, in the presence of these changes, patient benefits are maintained."

0:12:08.0

So Dr. Haase and Dr. Robb I'm doing my part to get the word out about your findings and I would think that this sort of therapy could be beneficial to a whole bunch of people not just with cancer but any number of life altering chronic medical conditions. What child with a chronic condition doesn't need improve coping skills and strengthens support systems with improve communication? Lots of kids and adults need these things. Plus with a cool project, maybe your child isn't dealing with a chronic medical condition but they have giant social stresses they're dealing with at home, or at school could a music therapy project help them? Maybe, how can you find out more about music therapy? And perhaps find a music therapist for your child, it's pretty easy just head over to the show notes for episode 279 over at pediacast.org and I'll include a link to the website of The American Music Therapy Association, where you can learn much more about this emerging field. 

0:13:04.8

One more point, those poor kids who are randomized to the control group, I mean I'm all for audio books but after the study I sure hope they had the opportunity to participate in creating a music video. A new study has found that children who are bullied during physical education class or other physical activities were less likely to participate in physical activity one year later. This is according to research from Brigham Young University and published in the journal Pediatric Psychology. Overweight or obese children who experienced teasing during physical activity had a lower perceived health-related quality of life referring to physical, social, academic and emotional functioning one year later. Even children with a healthy weight who were bullied during physical activity tended to exercise less often one year later.

0:13:59.5 

Many previous studies have already correlated bullying with decreased physical activity among kids who are obese or overweight, but it was surprising to find the correlation didn't end there. Dr. Chad Jensen a professor of psychology at BYU and lead author of the study says, "Our finding that normal weight kids who were bullied went on to demonstrate decrease levels of physical activity with something new." Researchers looked at associations between bullying, physical activity and quality of life over time, following up with the same children after a full year. The participants in this study were 4th and 5th grade students from six different elementary schools in the Midwest. They completed three surveys at the beginning of the study and then completed the same three surveys again one year later. The first survey asked questions about problems with health and activities, emotional well-being, getting along with classmates and academic abilities. The second survey assessed teasing experiences during physical activity. The third survey asked specific situational questions to determine whether the student had been bullied during physical activity and the emotional effect it had.

0:15:04.9 

The questions explored experiences such as: being made fun of when playing sports or exercising, not being chosen to be on a sports team or other children looking or acting upset when the child was placed on the team, being called insulting names when playing sports or exercising. Study results showed a decrease in physical activity of healthy-weight students who are bullied, and a decrease in health-related quality of life for students who were overweight or obese who reported teasing in the first survey. Dr. Jensen says, "Overweight kids who were teased reported poorer functional ability in physical, social, and academic domains. If we can help them to have a better perception of their physical and social skills, then physical activity may increase and health-related quality of life is likely to improve…. While most schools participate in comprehensive anti-bullying programs, Dr. Jensen recommends implementing policies that discourage peer victimization based on physical abilities.

0:16:02.1 

He adds, "We hope our study will raise awareness that educators should consider bullying prevention during physical education and free play and recess when kids may be discouraged from being physically active because of teasing experiences…. So there you have it normal weight kids who are bullied during physical activity may stop making an effort to be active which is a risk factor for future obesity. And obese kids who were bullied during physical activity they too may stop making an effort to be active and have trouble with social relationships and academic endeavors. I'll admit I wasn't the first one picked to be on a team in school, or the second, or the third I was pretty far down on the list. It was embarrassing but you know what I didn't really want to play team sports anyway. I would have been fine walking either outside or on a treadmill, or using an elliptical although I don't think elliptical's actually existed when I was in school. 

0:17:00.5

I think skate club should've counted toward P.E or roller skating, I did a lot of that back in the 70's and 80's. My point is physical education class in my opinion should be about encouraging kids to be physically active in any active they find enjoyable so they will hopefully continue on that pursuit down the road. Why are even allowing the opportunity for bullying by forcing kids into activities they aren't built for and don't enjoy? Why have a cookie cutter gym class? Let's get our kids moving with options they can enjoy so they'll keep doing it. I know there's a science to physical education, there's a college degree to get to be a gym teacher but when I look at this state of our schools, and the state of obesity in America, and all this bullying I have to ask myself, is the current plan really working? I don't think it is, my two cents anyway. If you're a mom or dad of a kid who isn't athletically inclined maybe he or she isn't exactly a team player make sure you get your kids moving, find something they enjoy that burns calories and help them discover and develop their God given talents, if it's not sport what is it? 

0:18:14.3

Music, writing, acting, let them flourish in another arena but still get a moving with something that they enjoy to burn calories. Help them figure out at how to let the commons of bullies slide off their back. We need to deal with bullies when we see it but we really have to deal with bullies our entire lives. There are bullies in the adult world, there's a bully or two at just about every job site in America. Yes we need to pay attention to address childhood bullying when we see it. We also have to teach our kids to cope in a world that will never be rid of bullies all together, it doesn't matter what the bully thinks, what matters is your friend and family relationships. So get your kids moving in a way they enjoy, help them discover their talents, shower them with love, and help them develop a thick skin that isn't breached by a bull's words.

0:19:05.0

Although a voluntary shopping cart safety standard was implemented in the United States in 2004, the overall number of injuries to children associated with shopping carts has not decreased. In fact, the number and rate of concussions and head injuries has continued to rise. It's according to a study from researchers here at Nationwide Children's Hospital in the Ohio State University College of Medicine and published in the journal Clinical Pediatrics. Investigators examined data relating to children younger than 15 years of age who were treated in U.S. emergency departments from 1990 through 2011 for an injury associated with a shopping cart. Over half a million injured children were documented during the study period, averaging more than 24,000 kids annually which equals 66 children per day or one child every 22 minutes treated in the US emergency department for a shopping cart injury.

0:20:07.0 

The study found that falls from a shopping cart accounted for the majority of injuries, followed by running into or falling over the cart, cart tip overs and entrapment of extremities in the cart. The most commonly injured body region was the head. While soft tissue injuries was the most common diagnosis for these head injuries, the annual rate of concussions and more significant closed head injuries increased by more than 200% during the study period, with the number of these injuries going from 3,483 injuries in 1990 to 12,333 in 2011. Most of this increase was associated with children ages zero to four years. Dr. Gary Smith director of the Center for Injury Research and Policy at Nationwide Children's Hospital says, "The findings from our study show that the current voluntary standards for shopping cart safety are not adequate. Not only have the overall number of children injured associated with shopping carts not decreased since implementation of the safety standards, but the number of concussions and closed head injuries is actually increasing.

0:21:09.7 

It is time we take action to protect our children by strengthening shopping cart safety standards with requirements that will more effectively prevent tip-overs and falls from shopping carts." Suggested design changes include improving performance standards for restraint systems and placing the child seating area near the floor. This design change would be safer, because it would reduce the risk of cart tip-over by lowering the center of gravity of the cart and decrease the risk of injury from falls because the child is much closer to the ground. In addition to design changes, researchers noted that interventions designed to teach parents how to safely use shopping carts, store-wide broadcasts encouraging shopping cart safety belt use, and having store employees encourage families to properly use shopping cart safety belts would also help reduce the number of shopping cart-related injuries.

0:22:00.1 

Dr. Smith adds, "It is important for parents to understand that shopping carts can be a source of serious injury for their children, however, they can reduce the risk of injury by taking a few simple steps of precaution, such as always using the shopping cart safety belts if their child needs to ride in the cart." Other tips for preventing shopping cart-related injuries include whenever possible, choose alternatives to placing your child in a shopping cart. Always use the shopping cart safety straps. Be sure your child is snugly secured in the straps and that the child's legs are placed through the leg openings. If parts of the cart restraint system are missing or are not working, choose another cart. Use a cart that has a child seat that is low to the ground, if one is available. Make sure your child remains seated. Stay with the cart and your child at all times. Avoid placing infant carriers on top of shopping carts. If your child is not old enough to sit upright by himself in the shopping cart seat, consider other options such as leaving your child at home with another adult while you shop, using in-store child care areas, using a front- or back-pack carrier, and bringing a stroller along for the trip.

0:23:08.6 

So shopping carts can be dangerous and this is something we all know. I mean how many times have you held your breath and grimace your face when you see that toddler standing in the basket leaning over the edge? And how many of us have heard that terrible awful hollow reverberating bonk of a child's head hitting the floor as he or she actually tumbles over? It's a sound you can't get out of your head, you just keep hearing it over and over again days later. I don't understand why parents out there continue allowing their kids in the basket or not securing them with a belt. And when it comes down to it what we need more than stricter safety standards, what we need is smarter parents. Please don't let your child in any portion of the shopping cart other than the designated seats and make sure he or she is at the right size for that seat and buckled in appropriately. Don't Jimmy rigged the infant carrier to the cart. 

0:24:03.7

And those of us who see parents breaking the rules do we say something? It's kind of an awkward situation or then are we being a bully, I guess it depends on your frame of reference. Me I'm likely to say something but I do have the advantage of speaking from a place of authority, hey I work in a pediatric emergency department, you wouldn't believe the number of kids we see with serious head injuries who start out sitting in a shopping cart basket just like your kid's doing right now. Which is why we do need stricter safety standards. Women need not fear that eating peanuts during pregnancy could cause their child to develop a peanut allergy, this according to a new study from Boston Children's Hospital recently published in the journal JAMA Pediatrics. Dr. Michael Young senior author of the study and an Allergy specialist at Boston Children's says, "Our study showed increased peanut consumption by pregnant mothers who aren't nut allergic was associated with lower risk of peanut allergy in their offspring….

0:25:04.4 

"Assuming she isn't allergic to peanuts, there's no reason for a woman to avoid peanuts during pregnancy." Previously, women had been advised to avoid highly allergic foods such as peanuts and tree nuts during pregnancy and while nursing, and their children should avoid peanuts until 3 years of age. The goal of those recommendations, despite a lack of supporting research, was to minimize early allergen exposure and sensitization, thereby reducing the risk of developing childhood peanut allergy. The American Academy of Pediatrics endorsed these recommendations in the year 2000. However, from 1997 to 2007, the number of peanut allergy cases in the U.S. tripled, leading the medical community to re-examine its recommendations. Based on the lack of evidence supporting early dietary avoidance, the AAP rescinded the recommendation in 2008. Dr. Young says, "No one can say for sure if the avoidance recommendation for peanuts was related to the rising number of peanut allergies seen in the late 1990's and early 2000's, but one thing is certain: it did not stop the increase. It was clear a new approach was needed, opening the door for new research." 

0:26:15.4 

To further define the relationship between maternal diet and the development of food allergy in offspring, Dr. Young and his team analysed large amounts of data provided by the Growing Up Today Study. Researchers examined the records of over 8000 children and positively identified 140 cases of peanut or tree nut allergies. They then examined the diets of each child's mother specifically, peanut and nut consumption during the pregnancy period and compared them with the dietary habits of pregnant women whose children did not develop a peanut allergy. What did they find? Well the rate of peanut allergy was significantly lower among children in the study whose mothers ate peanuts during their pregnancy. Although this is a substantial finding, the data demonstrate only an association between maternal diet and the risk of peanut allergy in children. 

0:27:03.9

Dr. Young adds, "The data are not strong enough to prove a cause-and-effect relationship. Therefore, we can't say with certainty that eating more peanuts during pregnancy will prevent peanut allergy in children. But we can say that peanut consumption during pregnancy doesn't cause peanut allergy in children. By linking maternal peanut consumption to reduced allergy risk we are providing new data to support the hypothesis that early allergen exposure increases tolerance and reduces risk of childhood food allergy." So pregnant women rejoice as long as you aren't allergic to peanuts there's no reason to avoid them during your pregnancy which is good news for peanut lovers everywhere. Exposing adolescent rats to THC the primary psycho active ingredient in marijuana can lead to molecular and behavioral alterations in the next generation of offspring even though the offspring were not directly exposed to the drug.

0:28:00.1 

This according to research at the Icahn School of Medicine at Mount Sinai and published in the journal Neuropsychopharmacology. Researchers found that male offspring showed stronger motivation to self-administer heroin during their adulthood and molecular changes in the glutamatergic system, which is the most important excitatory pathway for neurotransmission in the brain. Damage in the glutamate pathway, which regulates synaptic plasticity, has been linked to disturbances in goal-directed behavior and habit formation. Dr. Yasmin Hurd the study's senior author and a professor of psychiatry and neuro-science at the Icahn School of Medicine at Mount Sinai says, "Our study emphasizes that cannabis or marijuana affects not just those exposed, but has adverse effects on future generations. Finding increased vulnerability to drug addiction and compulsive behavior in generations not directly exposed is an important consideration for legislators considering legalizing marijuana….

0:29:01.6 

In the study Dr. Hurd and colleagues divided adolescent male rats into two groups, one group whose parents had been exposed to THC as teenagers and then made it later in life and then other group whose parents had not been exposed to the drug. Researchers then gave all the rats in both groups 1.5 milligrams per kilogram of THC which is similar to about one joint in human use, and what did they find? The rats whose parents had been exposed to THC prior to mating, these rats worked harder to self-administer heroin by pressing a lever multiple times to get heroin infusion. Although marijuana use and safety tends to be discussed in terms of its impact to the individual during the lifetime, few studies have addressed adverse effects in future generations who are not directly exposed to the drug. Dr. Hurd says, "What this opens up are many questions regarding the epigenetic mechanisms that mediate cross-generational brain effects."

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Future studies are now being explored to determine whether THC effects continue to be transmitted to even the subsequent grandchildren and great-grandchildren generations. Another important question relates to potential treatment interventions in order to reverse the cross-generational THC effects. Such insights could also have implications for new treatment opportunities for related psychiatric illnesses. I don't include many animal studies on PediaCast but this one really caught my eye. I mean think about this, is it possible that drug use, now in this case marijuana alter ones genes in such a way that future generations are more likely to become addicted and perhaps have other mental health problems, that what this study is suggesting. Your grandfather smoke weed in the 60's, does that make it more likely that you or your children will have an increased risk of addictive behavior and possible psychiatric disorders even though you and your offspring were never directly exposed to grandpa's weed?

0:31:01.4 

You could say maybe there's some underline genetic thing that made it more likely that grandpa smoke weed in the first place. But what this study showed was that the rats in the two groups, the parent rats did not choose whether they were going to get injected with the THC or not, just some were and we looked at their offspring's, some weren't and we looked at their offspring's. That would suggest that it wasn't really a behavioral thing that maybe the THC really did change something. A lot about this that we don't know but it's definitely intriguing and you know for those of you living in Washington or Colorado or other States on the brink of legalizing pot you got to think about that. Could your smoking a joint affect the mental health of your children, grandchildren, and great grandchildren? If someone had suggested this to me last week I would thought they were crazy. By what mechanism does that happen?

0:32:00.0 

This is a small animal study but a future studies bear this out on a larger scale, perhaps on a human scale. That really changes some presumptions we make about genetic science, can smoking marijuana alter my genes in such way that future generations are affected? Another reason you shouldn't smoke weed even if you live in a state that allows it. Alright that wraps up our news parents can use for this week, we're going to take a quick break and I will be back with a final word right after this. 

[Music]

0:33:00.1

Dr. Mike Patrick: We are back and for my final word we're going to talk a little bit about dry skin, it's winter time and cold air is dry air. So there's not a lot of humidity in a cold air and also if you have forest air heat in your home that tends to be pretty dry as well. We really have a lot of low humidity in the air in the winter time and it's been a particularly cold and dry winter for many of you out there in the United States. What happens when the air is dry is that water is going to move from where there's more water to where there's less water and so the water in your skin evaporates because there's not a lot of moisture in the air and when the water in your skin evaporates you end up with dry skin. It can happen to anyone, it does tend to be worse in kids who have a history of eczema or a topic dermatitis but it can happen this time of year to all of us.

0:34:04.0

And incidentally when you wash your hands a lot like a lot of healthcare providers do, what ends up happening is you wash your hands with soap and water and when the water evaporates at the top of your skin which you just used to wash, some of the water that was in the skin comes with it and so if you wash your hands a lot it really even dries out your hands even more and a lot of folks who wash their hands a lot end up with dry, cracked, and a broken open skin. I used to have that problem a lot and I found that when I switched to the alcohol gels that are out there and especially the ones that also have the moisturizing lotion in them, those basically provide kind of a fatty layer so that all your taking care of killing the bugs with the alcohol component of it on the surface of your skin, the lotion part kind of seals in your moisture so in the alcohol evaporates your skin water doesn't come with it and so you do get a little bit of protection against that drying out effect.

0:35:06.9 

And so using this moisturizing antiseptic hand gels maybe a better alternative to using soap and water if you have to wash your hands a lot in the winter time. What do you do about this when you do have dry skin? We want to increase the moisture in the air, turn your heat down, if you have a humidifier on your furnace that may help or at least put a humidifier in the bedroom at night times so that at least you're sleeping in a more humid environment at night. And then you want to use a moisturizing cream daily. Something with a greasy, fatty content because that's going to seal in the moisture, water doesn't like to evaporate through a fatty or lipid layer. Vaseline is cheap but it's really greasy.

0:36:02.2 

Choose something that you like to feel and the smell of. Some of my favorites if you need something thinner like Lubriderm is a good one, if you want something a little thicker user in cream but there are plenty of others Aqua Four, Neutrogena buy the grocery store brands it's probably very similar in the same thing just with your grocery store label on it. You just want something that's got a little bit of a greasy feel to it that's going to lock in the moisture. Use something that you know works for you in the past and use it a couple of times a day. Again these moisturizing creams have something in common and that's that lipid layer, or fatty layer, greasy layer which seals in moisture and keeps your skin water from evaporating into the air. We used to say limit bathes and showers but as it turns out this can actually hydrate the skin. The key is this, when you get out of the shower or the bath, get out pat dry quickly, and slather on that moisturizer to seal in the moisture.

0:37:00.6 

Extreme cases may need an over the counter or prescriptions steroid cream in addition to the moisturizing cream. Check with your doctor first to make sure you're really dealing with just dry skin because steroids can make some conditions worse. Frequent hand washing with soap and water over and over can really dry things out and leave your hands with cracks and cuts and using those again moisturizing antiseptic hand gel will help prevent this problem. One final word, itching you want to get that under control because if the itch dry skin a lot you can inject bacteria into that dry skin from your finger nails or cause little micro abrasions in just bacteria that's already on the surface of the skin can get in there and cause impetigo or siolitis or even an abscess. So it's important to get itching under control and you can do that with anti-histamine like Benadryl. You can ask your doctor about the dosing and whether that's the right thing in your child's particular situation. Dry skin it's a common in the winter but there are some things you can do to prevent and treat it and that's my final word. 

0:38:07.2

I want to thank all of you for taking time out of your day to make PediaCast a part of it. Don't forget PediaCast and our single topic short format programs PediaBytes are both available on iHeart Radio Talk which you'll find on the web and the iHeart radio app for mobile devices. Reviews and comments on iHeart radio and on iTunes would be most helpful. To find us on iTunes just head over to the iTunes podcast. Get to the iTunes store search for podcast and then look up kids and family and you'll usually find us there. Reviews and comments in iTunes and on iHeart radio would be most helpful.

0:39:01.1 

As our links, mentions, shares, re-tweet, re-pens all those things to get the word out about PediaCast. We're on all the social media sites including Facebook, Twitter, Google Plus and Pinterest. And be sure to tell your family, friends, neighbors and co-workers about the show and tell your child's doctor next time you're in for a well check-up or a sick office visit or a behavioral re-check. Just make sure you tell your doctor that there's a great evidence based podcast out of Nationwide Children's that's aimed at moms and dads and please let their other patients know about the show. We do have posters available under the resources tab at pediacast.org. One more time if you have a question or a comment for the program pediacast.org there's a contact link just write it there and we'll try to get your comments or you questions on the show. That wraps things up I'm going to sign off and until next time this is Dr. Mike saying stay safe, stay healthy, and stay involve with your kids, so long everybody. 

[Music]

Announcer 2: This program is a production of Nationwide Children's, Thank you for listening. We'll see you next time on PediaCast.

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our kids, so long everybody. 

[Music]

Announcer 2: This program is a production of Nationwide Children's, Thank you for listening.  We'll see you next time on PediaCast.

0:40:29.2

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