Bambini February 2016 Newsletter 
Home Strep Testing
Recently, a parent advised us that she had tested her daughter for strep and wondered what to do with the result.  So did we!

It seems that kits, comparable to the ones we use in the office, can be purchased online for under $50 for a box of 25 tests.  While these might, we repeat might, be an option for parents with a medical background that have several strep prone children at home, we don't recommend families rush to buy a case.

For one, it takes a measure of experience to know what part of the throat to swab and to actually hit it on a moving target.  Moreover, the result is not always black and white -- often there is a pretty faint line that could be missed. 

Then there is that question the parent raised:  what do we we do with a positive result?  The child could be a carrier.  We need more info.  How about a negative?  The child could have ducked and mom swabbed the buccal mucusa or tonsillar pillar.  In addition, these quick tests have a high enough false negative rate that a standard culture is still recommended.

Kids get sore throats for all kinds of reasons this time of year -- colds, dry heat, influenza and many other viruses.  How does a parent know when to suspect strep?  Some might try the MedZam Strep Throat App, which is free.  But we often get what we pay for -- we found this app pretty worthless.  Others might consult our strep advice sheet (download here) which concisely states:

"Classic strep" causes fever, headache, stomachache, swollen glands, musty breath, and red spots on the roof of the mouth. If your child complains of a sore throat but also has a cough, nasal congestion, a hoarse voice, and lacks classic strep features, the culprit is likely a virus. 

We haven't seen a better synopsis.  Incidentally, a study of 111 children published last year indicated that kids who start antibiotics for strep, if afebrile and improving, can return to school the next day. 
Pertussis Paying Another Visit
We sensed this was coming - a really mild flu season combined with crazy weather - 6 below zero one day and almost 60 degrees two days later.... Pertussis, or what the Chinese call "the 100 Day Cough," is back in the area. We started seeing confirmed cases earlier this month.
A thoughtful summary of recent studies by Barbara Loe Fisher of the underwhelming efficacy of the current vaccine in both adolescents and in preschoolers appeared online just yesterday. It confirms our experience. Back in 2012, we saw about 50 kids with suspected pertussis that summer. Thankfully, only one was hospitalized - and just for one night.
So, what are concerned parents to do when they get a memo from the school nurse about a classroom exposure? Our first recommendation, of course, is attention to the basics: healthy diet, adequate rest, and reasonable supplements. This is not a time to be overdoing packaged foods and sodas, staying up until midnight, or forgetting the vitamin D and probiotics.
Beyond that, Bambini has published a more comprehensive program of immune support for kids facing 21st century challenges like whooping cough outbreaks. Parents may also want to be aware that nosodes (available through area homeopaths) are another option worth looking into.
Complex Kids, Orchid Children
Not that parents of children with special needs aren't already pressed for time, but such a parent actually shared a link with us recently to an online journal called "Complex Child Magazine" that we thought we'd pass along to you.

Written by parents for parents, the articles are concise, in plain English, practical, and not interspersed with ads for the latest acid-blocker or cholesterol pill. 

Another link that was shared with us that we wanted to pass along was an essay on sensitive (apparently, also called "orchid") children.  These are otherwise healthy kids that shouldn't be thought of has having a "mild disorder" but certainly require a bit of finesse to raise successfully.  The author, Deborah MacNamara PhD, gives four tips on how to do so.  
Melatonin for Kids with Eczema?
Last month, researchers from the University of Taiwan reported the results of their study on 48 children, age one through eighteen, with eczema that covered at least 5% of their body.  Half the kids received 3 mg of melatonin at bedtime, the others got a placebo.

Most of us know someone that has really bad eczema, and that this condition can make sound sleep a "pipe dream."  Dr. B.L. Chang, the lead author, reported that with the melatonin, not only did the kids get to sleep 20 minutes faster, but their eczema scores dropped from 49 to 40 -- pretty impressive!

What do we think?  We like the study.  Melatonin is safe stuff.  If a child accidentally takes the whole bottle, the folks at Poison Control will yawn when the parents call.  Moreover, it is affordable, over-the-counter, bio-identical, and non-habit-forming.  Kids with eczema have been shown to be deficient.  Moreover, it is an anti-oxidant.  This may be the reason it helped clear the eczema. 

We recommend melatonin quite often for kids with anxiety, ADHD, ASD, and adrenal fatigue. 3 mg is reasonable dose.  Still, we don't recommend it for lactating moms until the babies are a year old. Moreover, we don't recommend that kids take it continuously through childhood -- kids should take one night off per week or a week every two months so that their pineal gland does not get complacent.  
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