8 Children's Health Debates -- Solved
Acetaminophen or Ibuprofen?
Ibuprofen beats acetaminophen for treating both pain and fever, according to recent research. One large study in the Archives of Pediatrics & Adolescent Medicine found that ibuprofen lowered kids' fevers better than acetaminophen at two, four, and six hours after taking the medicine. Another study of kids in the ER concluded that ibuprofen provided significantly better pain relief than acetaminophen (or codeine) for broken bones, bruises, and sprains. Ibuprofen and acetaminophen both act on pain receptors in the brain, but ibuprofen also has an anti-inflammatory effect that helps decrease swelling. "That may also make it a better choice for ear infections, which typically involve inflammation," says Richard Rosenfeld, MD, a pediatric ear, nose, and throat specialist at Long Island College Hospital, in Brooklyn. Ibuprofen also lasts longer than acetaminophen, making it more likely that your child will sleep through the night, especially in the early stages of an ear infection. Interestingly, a new study also found that children who took acetaminophen before age 1 were almost 50 percent more likely to develop asthma by age 7.
Keep in mind: Every child reacts to medicine differently, so if your child responds well to acetaminophen, it's fine to stick with it. Ibuprofen can cause stomach irritation; you also shouldn't give it to babies under 6 months.
Plain or Antibacterial Soap?
There's no evidence that antibacterial soap is any better at reducing common illnesses than plain soap and water, says Harley A. Rotbart, MD, professor of pediatrics and microbiology at the University of Colorado Denver School of Medicine. This isn't a huge surprise, since most colds, flus, and stomach bugs are the result of a virus, not bacteria. In fact, a review of 27 studies published in Clinical Infectious Diseases found that washing hands with either type of soap prevented routine childhood ailments. However, some experts are concerned that widespread use of triclosan, the active ingredient in antibacterial soaps, might lead germs to become resistant to antibiotics. Whichever brand your family prefers, doctors say that it's best to use liquid soap because germs can thrive on the icky residue that tends to collect on bar soap and in soap dishes. And make sure that your child regularly washes her hands with warm water for at least 20 seconds -- the amount of time that it takes for her to sing the alphabet song.
Keep in mind: Hand sanitizers that contain alcohol are a good substitute for soap and water when kids can't get to a sink. "Alcohol kills all the germs that cause the vast majority of childhood infections, and it doesn't increase the risk of antibiotic resistance," says Dr. Rotbart, author of Germ Proof Your Kids. Keep a bottle in your car and your purse.
Nuggets or Burgers?
Burgers have an edge over chicken nuggets when it comes to nutrition. "Ounce for ounce, a burger contains three times as much iron as chicken does, and most kids don't get enough iron," says Parents advisor Connie Diekman, RD, past president of the American Dietetic Association. Iron deficiency can lead to anemia, sluggishness, and learning problems. Plus, nuggets are usually fried, adding extra fat and calories. If your child gobbles up nuggets but won't take a bite of a burger, it's not the end of the world; chicken and beef are equally good sources of protein. "Look for brands of nuggets that are baked rather than fried, or make your own by rolling chunks of chicken in crushed cornflakes and baking them," suggests Diekman. Red meat isn't the only way to get iron; eggs, beans, and fortified breakfast cereals and breads are also good sources.
TV or Video Games?
Your child shouldn't spend too much time with either one, but video games have advantages over TV. "Being actively involved is better than simply watching something because it reinforces learning by letting kids practice skills," says Parents advisor Michael Rich, MD, director of the Center on Media and Child Health at Children's Hospital Boston. Gaming is also less likely to cause weight gain in kids who snack in front of screens -- after all, it's tough for a child to eat when his hands are on the controller. When possible, encourage your child to play calorie-burning games like the Nintendo Wii. Another benefit: no commercials for junk food or toys. Be sure to prescreen games to make sure you approve of the content. (Find reviews at gametrailers.com.)
Keep in mind: The American Academy of Pediatrics recommends that kids ages 2 and older spend no more than two hours per day in front of any screen, including watching TV and movies, playing all types of video games, and surfing the Internet.
Apple or Orange Juice?
Apple juice can cause digestive problems such as diarrhea, gas, and bloating, making OJ the more tummy-friendly choice for younger kids. "There's an imbalance of fructose and glucose in apple juice that can make it hard for some toddlers to digest completely," says Diekman. OJ has an equal amount of these sugars. Orange juice also has eight times more vitamin C than apple juice. "One cup of OJ has 80mg of vitamin C, which is more than twice the recommended daily allowance for young children," says Diekman. Plus, OJ is often fortified with calcium.
Keep in mind: Not all kids have trouble with apple juice, and children usually outgrow the digestive problems associated with it by age 3. If your child loves apple juice and can drink it without a problem, look for brands fortified with vitamin C and calcium.
Rectal or Ear Thermometer?
A rectal thermometer gives you the most precise reading. An ear thermometer is trickier to use because you have to angle the infrared sensor properly in the ear canal, says Mark Widome, MD, professor of pediatrics at Penn State Milton S. Hershey Medical Center, in Hershey. It's fine to switch to an oral thermometer when your child is around 3 years old. The new temporal-artery thermometer -- which you simply scan across your child's forehead -- is another accurate option, but it's pricey.
Keep in mind: Digital thermometers use a battery, so they could die at a crucial time. It's a good idea to keep an extra battery or a backup digital thermometer on hand.
Bandage or Fresh Air?
You should always cover cuts and scrapes with a bandage to keep them clean. "If you expose them to fresh air, you expose them to dirt and germs, which could lead to infection," says Dr. Rotbart. Covering the injury will prevent your child from picking at the scab or touching the wound, which could also introduce germs. Wash it with soap and water, then apply a cute bandage. Change it daily to look for signs of infection, such as redness, swelling, or pus. A cut should heal within a week.
Keep in mind: Bandaging cuts will also help prevent MRSA, the antibiotic-resistant staph infection that's landed hundreds of kids in the hospital recently.
Tap or Bottled Water?
Tap water is the healthier choice for kids most of the time because most bottled water doesn't have fluoride. A recent government report found that tooth decay in baby teeth is on the rise in toddlers and preschoolers, and the boom in bottled water may be partly to blame. Tap water is fluoridated in much of the country, but a survey by Children's Hospital Boston found that 63 percent of families with young children drink only bottled water. "Drinking fluoridated water is especially important for young children because it protects teeth that are still developing and also strengthens the enamel on newly erupted teeth," says pediatric dentist Mary Hayes, DDS, a spokesperson for the American Dental Association. Some bottled waters do have added fluoride, so check labels.
Keep in mind: Home water-purification systems are increasingly popular since many parents worry about tap water's taste or impurities, but systems that use distillation or reverse osmosis (common in those that are built into plumbing systems) typically remove fluoride, says Dr. Hayes. Those that use charcoal or activated carbon (like Brita filters) usually don't. Tell your child's dentist if your home has a built-in filtration system or if your family relies mostly on bottled water; he may recommend giving your child fluoride supplements.
Originally published in the December 2008 issues of Parents magazine.
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