Tooth Fairy, Meningococcal Vaccine, Swallowing Gum – PediaCast 113

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  • Tooth Fairy
  • Meningococcal Vaccine
  • Baby Won't Play On His Own
  • Swallowing Gum



Announcer 1: Bandwidth for PediaCast is provided by Nationwide Children's Hospital. For every child, for every reason.


Announcer 2: Welcome to PediaCast, a pediatric podcast for parents. And now, direct from Birdhouse Studios, here is your host, Dr. Mike.

Dr. Mike Patrick: Hello, everyone, and welcome to PediaCast, a pediatric podcast for parents. This is Dr. Mike coming to you from Birdhouse Studio. And as always, I'd like to welcome each and every one of you to our little show. It's Tuesday, March 4th 2008. And this one is Tooth Fairy, Play Yards and Swallowed Gum.


Now first, right out of the shoe, I have to say I'm sorry, there was only one show last week and I had promised you the last time that we met that there would be another show before the week was out and there wasn't one. So I apologize for that.

All I can say is it has been absolutely crazy at the office. Tons of flu. There was more flu that we saw in the office during the month of February alone than we saw during the entire flu season last year. So it's really been busy. Also seeing a lot of strep throat. I've seen a handful of kids who were positive for both the flu and strep at the same time. And I saw one little guy, boy, I really felt bad for him. He was just so miserable. He was positive for influenza A, influenza B and strep throat all at the same time. He's feeling better now though. But boy, it was a rough few days for him.


Alright, I also want to mention, there has been a lot of controversy on our show lately between my little bit on home births and my treatment of the so-called progressive community. And the topic of nurse practitioners and I did perhaps, perhaps, we'll talk more about it. But maybe, I unfairly slammed a study involving preschool kids, their injuries and sleep habits.

So alright, here's the deal, I'm going to put together a special show on listener rants. Now I realize most of you are here for pediatric information. On the other hand, I get lots of comments from people who do enjoy the more controversial sides of the show and kind of egged me on.


And I know that those of you who are in that category would be disappointed if I didn't address these topics. But at the same time, I don't want to take time away from the bread and butter pediatric stuff.

So I figure if we do a rant show down the road, those of you who are interested in the controversial topics and you're just here for the science and the pediatric information, you can skip that show. Because I know you're busy or you might not be interested in that and I certainly don't want to infuse too much controversy into a science show.

Although I do want to address one thing, having said that. Having said that, I'm going to infuse some controversy. I do want to address one thing here real fast. Someone did write in and said that since the show has increased in popularity that I have become less sensitive, more opinionated and arrogant. And I'm going to refuse to accept that characterization. You can lay it on me, but I'll just refuse to accept it. How do you like that?


I want to remind you, it was in the very early days of PediaCast that I stepped on the toes of optometrists by saying that kids with lazy eyes have no business seeing or having their disease managed by the guy who prescribes glasses. That those kids need to see a pediatric ophthalmologist. And did I have an optometrist right then and complain about that? Yes. And did include that in the show? Yes!

It was also in the early days of PediaCast that I made a remark about family-practice doctors and I was called on in it by our now resident rash expert, Dr. Michelle. And did I include her comments? Yes.

I also tore apart the faulty research of some mainstream speech therapists, and this was months ago. They didn't write back in. But if they had, I would have included their comments on the show as well.


So my point is that opinion has always been an element of this program right from the very beginning. And it always will be the case. Now I've also recanted when shown to be wrong by a well-thought out and recent argument and I'll continue to do that.

And I do always try to present both sides of an issue and I'm constantly talking about how we have to weigh risk versus benefit in making decisions that affect our kids. And that too weighing that and looking at both sides of an issue will always be a part of this program. But so in my opinion and you'll just have to take it for what it is, an opinion. And I'll respect your opinion. And really, that's the reason that I prefer to include your rants rather than ignoring them altogether. But again, I think the best way to address the feedback is going to be through a special show that we'll have coming up.

If you're only looking for a frilly, happy, politically correct message, you're going to have to look elsewhere, okay. A purely informative show, in my opinion, producing that and doing it would just be flat-out boring.


And since I'm not making a living off this project, it has to hold my interest. And just pure information, I do that all day at work, folks. All day long. So if you want pure information, go to the library, get a book or better yet, go to medical school.  

On the other hand, I do understand that nothing but opinion and rants gets old. I understand that. So I'll continue to present lots of information infused with some controversy and opinion. But those who have written in, I promise you, we'll get your say and that show will be coming up soon to a feed near you.

Alright, so what are we going to talk about today? The tooth fairy. You can't have a pediatric podcast without mentioning the tooth fairy. So I'm going to talk about that. Also meningococcal vaccine, a baby who won't play on his own in the play yard. And we're going to talk about swallowing gum as well.


Don't forget if there is a topic that you would like us to discuss, all you have to do is go to and click on the Contact link. You can also email or call the voice line at 347-404-KIDS.

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, 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 could find at With that in mind, we will be back with News Parents Can Use right after this short break.



Our News Parents Can Use is brought to you in conjunction with the news partner, Medical News Today, the largest independent health and medical news website. You can visit them online at

The results are in, the tooth fairy poll from Security and Dental Plans reports an increase in the current average gift U.S. children received from the tooth fairy. Children received an average of $2.09 per tooth which is up from last year's gift of $1.71, a 22% increase. Tooth Fairy gift amounts range from a low of $0.05, boy, that's cheap, to a high of $50. Okay, that's crazy for a tooth.


"The tooth fairy poll average usually reflects the health of the economy. However, this direction of change is inconsistent with trends exhibited in other more commonplace indices," said Marty Weiland, operations analyst for the Care Dental, the administrator for Security and Dental Plans. The NASDAQ and Dow Jones industrial average indices have decreased 7.4% and 3.6% over the same time period, respectively.

"It is worth noting that the substantial upswing was largely driven by a substantial increase in the number of $5 gifts," continues Weiland. So either the tooth fairy is an expert investor or we may be seeing something analogous to the lipstick effect where during an economic downturn or recession, the tendency is for consumers to purchase small comforting items rather than large luxury items.


According to Securian's poll, which goes out to a sampling of its commercially insured population, more than half of children's first dental visits do not occur until age 3 or later.


The American Dental Association recommends that the child be seen by a dentist as soon as his or her first tooth erupts, but at least no later than the first birthday, said Dr. Richard Hastreiter, Dental Director for the Care Dental.

Regular visits give the dentist an opportunity to evaluate the child's teeth and discover any problems in their earliest stages. Tooth decay is the most common childhood disease, yet it is completely preventable.

I do want to pause here real quick. We've talked about this before. The American Academy of Pediatrics and the American Dental Association both, their stands is that you should take your child to the dentist as soon as the first tooth erupts and certainly no later than the first birthday. But the reality is, there's just not enough manpower in a lot of communities to make that happen in the dental field.


So as long as you're seeing your pediatrician and you're going to your regular well child checkups, seeing a dentist may not be crucial until a little bit later than that if you have a doctor who feels comfortable examining and taking care of teeth, which most of us are quite qualified to do.

This poll also revealed that more than one-third of the parents indicated that their children consume an average of three or more sugar drinks and/or treats per day. Parents are instrumental in teaching healthy habits to their children at an early age, says Dr. Hastreiter.

Encourage children to make healthy choices, teach them to eat a balanced diet and limit in-between meal snacks of food containing high levels of sugar, especially sticky foods such as raisins, fruits, snacks or candy. This will promote good dental health as well as overall health. Sticky foods tend to adhere to the teeth and gums, making them more likely to contribute to tooth decay, continues Dr. Hastreiter.


Children should brush with a pea-sized amount of fluoride toothpaste after sugary or starchy meals or snacks to help reduce the incidents of tooth decay. Children should also drink fluoridated water after meals to help cleanse the teeth. Boy, Dr. Hastreiter is not making any friends with the raisin growers. Okay, not raisin growers. But you know what I'm saying. The raisin producers because you know, raisins don't really grow. You know what I'm saying.

My point here, okay, raisins and of course, fruits, snacks and candies. Okay, those are out. But raisins, raisins are good food. But brush your kid's teeth after they eat raisins, okay?

The poll also shows most children are working hard to keep their teeth cleaned. According to the poll, 73% of parents report that their children brush their teeth twice a day, good job, moms and dads. And approximately 92% of parents surveyed say their children receive a dental exam every six months.
So again congratulations to moms and dads.  According to this poll, you're doing what you should be doing.

The tooth fairy on the other hand has quite a discrepancy. Tooth fairy, $0.05 for some kids and $50 for others for a single tooth. You may want to standardize that a little bit.


Okay, I'm not sure the tooth fairy listens to PediaCast, but just in case.

As a parent, you often take extra health precautions to protect your children from winter illnesses, such as colds and the flu. But the National Meningitis Association wants to be sure you know about one preventable health measure that is often overlooked. That vaccination against meningococcal disease.

Meningococcal disease, commonly called meningitis or at least it's one form of meningitis, that's my side note, is a potentially deadly bacterial infection that can strike adolescence and young adults. The disease moves quickly and can lead to death or permanent disability such as brain damage, organ failure or limb amputations within hours of first symptoms. So this is a serious disease folks.

While meningococcal disease can occur at any point throughout the year, cases peak in the late winter and early spring months, reinforcing the importance of seeking vaccination this time of year rather than waiting for back-to-school physicals.


To help prevent infection, the Centers for Disease Control and Prevention recommend meningococcal vaccination for all adolescence 11 through 18 years of age and college freshmen living in dormitories. Yet, according to a recent National Consumer Awareness Survey conducted by the National Meningitis Association, nearly half of parents poll were unaware that their adolescent children were recommended for vaccination.

It's unfortunate how many parents don't know about meningococcal disease or that there is a vaccine available to help protect their children, said Tama Lee, Director of the National Meningitis Association.

I lost my son Casey to meningococcal disease when he was in high school. And it wasn't until after he died that I learned his death may have been prevented with a simple vaccination.

Meningococcal disease is spread through air droplets and direct contact with those who are infected, such as through coughing or kissing. The disease strikes nearly 3,000 Americans each year and can be easily misdiagnosed since symptoms often mimic those of the flu.


Early symptoms may include high fever, headache, stiff neck, confusion, nausea, vomiting and exhaustion. And then later stages, a rash may appear. Adolescents and young adults are at increased risk for the disease, accounting for nearly 30% of all US cases.

Certain lifestyle factors such as dormitory-style living, prolonged close contact with large groups of other adolescents, irregular sleep patterns and active or passive smoking are thought to put adolescents at increased risk for the infection.
However, the majority of cases among adolescents and young adults are potentially vaccine-preventable.

While there are steps your children can take to help protect themselves such as getting enough rest to maintaining a healthy lifestyle, vaccination is the best way to prevent meningococcal disease. The meningococcal vaccine protects against four of the five major strains of the disease. Why didn't they pack that last strain in there? I'm sure there was some reason.


When meningitis peak season is upon us, I encourage all parents of adolescents and young adults to learn about the disease and talk to their child's health care provider about meningococcal vaccination, said Tammy Lee. Don't wait, anytime your child visits the doctor is a good opportunity to have this discussion.

For more information about the National Meningitis Association or meningococcal disease, you can visit the group's website and I'll put a link to it in the Show Notes

Alright, that concludes our News Segment for today and we'll be back with your questions right after this.



Alright, we are back. And first up in the Listener Segment today is Lee Ann in Philadelphia, Pennsylvania. And Lee Ann says, "Hi, Dr. Mike. I listen to your show every week and in some ways, feel like you're one of our doctors."

Okay, now look folks, we've talked about this before. I can't be your doctor. Unless of course you see me in my office in Ohio and those of you in the audience then, okay, I'm your doctor. And hello to all of you.

"We have an eight-month-old son named Ashare, who is a generally happy and healthy baby. Over the last few weeks, we've encountered a problem. Ashare won't play on his own. We have a large play yard in a living room with a bunch of age-appropriate toys.

One or two minutes after he goes in, however, he is screaming at the top of his lungs. He gets himself very worked up to the point of hiccupping and almost throwing up. I just want to him to be able to amuse himself while I get some dishes done, blow dry my hair or do some emailing.


I would think that maybe he is starting to get separation anxiety, but he does this even when I am sitting a few feet away from him and talking, smiling and singing to him. When I put him in, I make sure he's not hungry or what and he's not teething at the moment. What is going on? Shall we train him to play like we trained him to sleep according to your instructions on the podcast? Thank you very much. Thanks for all the great work you do. I'm looking forward to your miracle answer. Fondly, Lee Ann. PS, my husband and I both graduated from the Ohio State University, go Bucks."

Alright. Yes, go Bucks. Although the basketball team are not doing so hot. But my son and I have been going to all the home games and rooting them on but it's not looking good. I don't even think we're going to make it NIT tournament this year, let alone the NCAA. Okay, but there's always football.

Let's see. With this, there's no miracle advice, I'm sorry, Lee Ann. I wish there was. I think you're on the right track here and I wouldn't feel guilty about you needing to do something about this because moms need their time to get stuff done.


And efficiency in getting stuff done where you can really focus on what you're doing means you're going to get it all done sooner. And then that's going to give you more quality time with your child.

So a lot of parents think, I mean they feel guilty for letting their kids cry or for putting them in their bed to take a nap and then they cry the whole time and you feel guilty about it and you never get anything done. Whereas if you can sort of train him to soothe themselves and you can get 45 minutes of tons of work done, then you're going to be able to spend more quality time with your child and you're not going to be as frustrated.

So I think this is an important thing to deal with. And unfortunately, there's no quick or miracle fix. But yes, in the end, you do approach this sort of thing the same way that you would approach night time fussiness. But there are some differences.


First, let me say it probably is a little separation anxiety. I mean this is the age when your child knows that you are gone sometimes and is probably afraid that you're going to go and so that's why they want to be with you because they don't want that to happen and they're sad and they miss you and they want you to be around.

Now just because they're sad and they miss you and they want you to be around does not mean that they can't learn to soothe themselves and begin to learn that you will be back. And then it may not be that long of a period of time.

I will say that in some cases, it's going to really depend on the temperament of your child. In some cases, complete separation is going to be needed to successively deal with this because your child is just not going to soothe if they can see and hear you. I mean seeing you is like dangling a steak in front of a dog, at least for some kids. And the situation is not going to get better as long as they see you, they want you, they're going to go crazy until you pick them up. And I know, you will pick them up.


Other children might adjust to this on their own given a few days. I mean some kids if you let them sort of cry it out and you continue to work there in front of them and then they do start to soothe themselves. It may take a half an hour, 45 minutes. And then in the next day, it only takes them 15 to 20 minutes. The next day, it takes them 5 to 10 minutes. Next day, they go right to playing in their play yard, even when you're right there. But there are other kids that just aren't going to do it. They are going to scream the entire time as long as they can see you.

So this is where you're going to have to use your judgment a little bit. But I do think it's fine to let them cry it out at least for a while and try it that way.

My next question is why not just try to get all the work done during nap time? If you have a morning nap time and an afternoon nap time for your baby in his crib where he's used to soothing himself now at night anyway, that way, you're not there.


Now I know you want some more stimulation for him but he's not getting much stimulation if he just sat there screaming and crying the whole time and not learning to soothe themself. So in that case, he may do a better job just being in his crib and learning to soothe themselves during the day, during nap time, as well as at night time.

If you really want him to have stimulation and your presence is an issue, another option would be to put him in a play yard and you go work in a different room. Now you do have to take some safety precautions. You want to make sure that this area is contained, it's completely safe and that you have some way to monitor your child, a video monitor would be a good idea in that case.

But that way, you could still sort of attend to them from a distance. They can't see you and you can get some work done and yet they're getting the stimulation. So there's a third option for you.

Also I should mention this too. If they are crying and you're going through this and you really have to get some stuff done. I mean you really have things to do and you're in the midst of helping them learn to soothe themselves and sort of to cry it out and yet their crying is really distracting you and you can't get your work done.


Don't feel guilty about putting them in their room, closing the door, you getting your work done and you have the video monitor on them so you can make sure that they're safe. Those are so cheap and easy to get nowadays compared to just a few years ago. Or you could even be there with them and listen to some music on your iPod. Some classical music or something with some headphones as long as you can watch them and make sure they're going to be safe.

I mean if you're in a different room, if you could see them with the video feed or if you're in the same room that they are as long as you can keep your eye on them.

Now before I get to the hate mail saying what? Ignoring your children and letting them scream it out, that's just so terrible. I'm not talking about hours and hours and hours here. I mean if your child will not soothe and cries for 45 minutes while you're getting some work done, first, I will say I don't think that's going to happen day in and day out.


I do think if it's 45 minutes one day, it's going to be 30 minutes the next day and 25 minutes the next day, 15 minutes the next day, 10 minutes the next day, that kind of thing. I mean it'd be really an unusual child who cried for 45 minutes straight every day for a month. I mean that just is not going to happen unless after 45 minutes, you pick him up every time and then they're going to keep doing it because they've learned that that's what gets them what they want. We've talked about this before.

But my point is that if you put them through this; make it up with some really serious quality time with your child before or afterward. I mean obviously, you don't want to be spending all day on the computer and doing your chores and your kids screaming for hours on end. I'm not suggesting that you do that.

But at the same time, as adults, you have adult things that you have to get done and you shouldn't feel guilty about it because getting those done is going to help you be a better mom and having your child learning to soothe themselves is going to make you a better mom because you're not going to be as frustrated.


But you do want to make up that with some serious quality time. I mean really spend time with your child down the floor playing or in the play yard together. I also, I didn't put this originally in my notes since I was thinking about this. But this just occurred to me too. You do want to make sure that play yard is not over stimulating. I mean maybe it's scary if there's too much stuff in it so you may want to adjust the contents of the play yard. That might help you out a little bit too and not have quite so much as a part of it. Although again, I don't know exactly what kind of play yard you're talking about, so it's kind of hard for me to picture exactly what situation you're in.
Another idea and this one is in my notes and that is to consider a babysitter. Now I'm not talking — obviously, you're at home with your child and I'm not talking about a sitter's house or day care.


And even if you're a stay-at-home mom and you have work to do, there's nothing wrong with hiring out a high school student for a couple of hours after school, after they're done with school to come over and attend to your child for a couple of hours while you get some stuff done. I mean there's nothing wrong with that at all and you're not ignoring your child, you just have things to do. And so you may be able to help a poor student, like high school student, that sort of thing in your neighborhood. So that's something else to consider as well.

Alright, next up is Delilah from Pacific Missouri. And Delilah says, "Dr. Mike, I have a question about swallowing gum. My three-year-old got to my personal stuff, the whole package of gum in her little mouth. It all disappeared, so I'm guessing she swallowed it." Boy, I'm glad she didn't choke on it. That could have been a problem.


"My mom used to say that swallowing gums sticks to the walls of your stomach or swallowed gum sticks to the walls of your stomach. I know this sounds silly, but I do believe there might be some truth in this. So my question is what happens when kids swallowed gum? Thank you, Dr. Mike, for having such a wonderful podcast. I love it. Delilah"

This is a classic example of an old wives' tale. I mean what really happens to gum when you swallow it? Does it stay in your intestine or your stomach for seven years? The answer is no. It doesn't. It does not stick to your stomach or your intestinal walls either.

Your digestive system, as it turns out, does not break the gum base down. And the gum base is made of gum resin and or various synthetic material. So your digestive system doesn't break it down, but it does pass it along and so swallowed gum gets pooped out. Okay, it gets relatively unchanged and it exits in the poop. Now I know you have swallowed gum before and you've never seen it in your poop. I understand this happens.


But there are lots of things that kids swallowed that do end up in the poop that parents don't see because they're not looking close enough. And again, I'm okay. I can't blame you. And I see this a lot actually.

Coins are probably the most common thing. We hear a lot of times that kids swallow coins. We do worry that the coin could be stuck in their esophagus and that can cause a problem so we'll get an x-ray, see the coin in the stomach or in the upper part of the small intestine and tell the parents, watch their poop.

And invariably, I get a call two weeks later still hasn't seen it. They're worried; you get a repeat x-ray, coin's gone. Where did it go? It did not get digested, folks. It passed. You just didn't search the poop well enough. And that's fine. Again, I can't — I don't blame moms and dads for that. Because you got to go dig in a little bit because the coin gets coated, you know what I'm saying? And so you may not see the gum because it's covered in poop. And that's just the way it is. So it does come out though, you poop it out.


Interestingly enough, our cat, Mowana, wants — this might have been my fault. My wife was cross-stitching and she has a little magnetic holder in the needle. She put the needle on it, magnet hold it And once, she went to do something.

And she might have said, here, keep an eye on this. And I might have been slightly distracted. And the cat might have come along and batted the needle and he swallowed the needle. Okay.

We looked all over for the needle. I felt terrible. I turned my head for — I turned my head for like 30 seconds and the cat took the needle. And he ended up he did swallow it and we took him to the vet, got the x-ray, needle right there in the intestine. Cool x-ray. He passed it. He passed the needle. This would be a good one for Myth Busters. What happens when you swallow gum? Does it stay in the intestine for seven years or do you poop it out? You could do a Myth Busters on that.


Okay, maybe there's a limit to what they'll do. On the other hand they do Listener episode, so if someone wants to put that one into them, I'll put a link to the Myth Busters website in the Show Notes. But please, don't tell them that I sent you.

All joking aside, too much gum at once could be a problem that can cause a bowel obstruction if you have a big chunk of gum. So if you have a kid who did swallow a whole package of gum, boy, I would watch them closely and talk to your doctor. And then of course, it is a choking hazard as well.

And in case you don't believe me about all this, there is more information on swallowed gum at the Mayo Clinic and at and we'll put links to those places in the Show Notes for you. Also how is chewing gum made? I was curious about this so I did a little bit of research and I found a great website that explains the process of baking gum. And it gives you a little history lesson on chewing gum as well and I'll put a link to that in the Show Notes too and you can find that


Alright, we're going to take a quick break and we'll be back to wrap up the show right after this.


Alright, thanks go out to Nationwide Children's Hospital for helping out with the bandwidth for our program today. Also, Medical News Today for helping out with the News segment. Vlad over at for helping us with the artwork at the website and on the feed. And of course, thanks to all of you for taking a little time to listen to the show and to contribute with your comments and your questions. And your rants, those are fine too.


What happens when your kids put two and two together and figure out that steak is actually muscle and not simply the "regularness", as my daughter put it, of a cow? We can find out in the post A Vegetarian In The Making? That's a question mark afterward. At the Pediascribe blog and we'll put a link to that in the Show Notes for you.

Don't forget the PediaCast Shop is open. We have t-shirts and there's no mark-up on those are all. It's just to help spread the word about the show. And I did mention if you are going on vacation anytime soon or this summer and you want to get a shirt and wear your PediaCast shirt next to a famous place, Mount Rushmore, Disney World, the Eiffel Tower, if you go to Paris, you know that kind of things. And send me the picture, we'll put up a special webpage and have a contest to with the winner and all that. So look for that if you buy a shirt. And again, I'm not making any money out of these shirts, folks.

Okay. iTunes reviews are helpful. We have posters on the poster page PDF form that you can print out and hang on bulletin boards. And of course, if you tell a friend or two about the show, I'd really appreciate that as well.

I'm going to try my best to get out another show this week. I'm not going to promise though. But I really am going to try hard. Just we'll see how the rest of this week goes in the office with all the flu and strep. It should be dying down here soon. Of course, then rota virus is going to kick up its ugly head. It's never-ending. What is in the summer but not for a while.

Alright, thanks for joining us and until next time, this is Dr. Mike saying, "Stay safe, stay healthy and stay involved with your kids…. So long, everybody.


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