Viewing the Solar Eclipse – Hype or Hazard

A total solar eclipse is a big deal, although it seems like it might be a bigger deal for some people than it is for others.

What kind of eclipse will you be able to see on August 21st? Map courtesy of NASA.
What kind of eclipse will you be able to see on August 21st? Map courtesy of NASA.

It does start to seem like a bigger deal the more you learn about it…

Solar Eclipse HYPE

Still, there is a lot of hype surrounding the upcoming solar eclipse in the United States.

“Observing a total solar eclipse is a life-changing event. It challenges everything you conceive of as normal.”

Sean Lindsay on the Eclipse hype

Do you buy it?

  • will looking at the eclipse make you go blind?
  • will seeing the eclipse change your life?
  • will you regret missing the eclipse for the rest of your life?

While viewing the eclipse won’t make you go blind, at least not instantaneously, what about all of the hype about how important an event the eclipse is to view? That part has to be true, right?

“A partial eclipse is interesting but forgettable, while a total eclipse is a memorable, life-changing event which burns itself into memory – and never fades. And so we, who have seen this sight, ask you to join us on this momentous day, and do everything you possibly can to see it with us. But you must remember that “close” is not close enough; in order to see the eclipse in all its glory, you simply must…”

“Close” is NOT close enough!

It is for some people. And you might not know if you or your kids are that type of person unless you go and see the eclipse! In totality!

Solar Eclipse HAZARD

  • seeing the eclipse without protection will damage your eyes

We all know that you shouldn’t look directly at the sun or your eyes will get damaged.

And in most cases, you can’t.

It hurts to look at the sun. You’re pupils will constrict. You will blink a lot. And you will very quickly turn away.

At least in normal circumstances.

A solar eclipse is not a normal circumstance.

Since most of the sun is covered, you could likely stare at it (but definitely shouldn’t) and get a good long look at the eclipse. Unfortunately, the part that isn’t covered will be painlessly damaging your eyes, leading to burns on your retina and solar retinopathy.

But isn’t all of the sun covered in a total solar eclipse?

“During the very brief time the sun is in total solar eclipse it is safe to look at it, but do so with caution. Even during the total solar eclipse, the total eclipse may last only a short period of time, and if you are looking towards the sun as the moon moves away from blocking the sun, you might get a solar burn on your retina which can cause permanent damage to your eyes.”

Prevent Blindness America

Yes, but only for a very short time and only if you are in the path of totality.

During totality, it is safe to take your eclipse glasses off and look at the eclipse, being aware that totality may last only a minute or two.

This diamond ring means that the eclipse is not at totality yet and you still need eye protection to look at the sun.
This diamond ring means that the eclipse is not at totality yet and you still need eye protection to look at the sun. Photo courtesy of NASA.

Again, you must be very sure that you are inside the path of totality for a chance at looking at the eclipse without protection – a 70-mile wide band from central Oregon through South Carolina.

If you are not in this relatively narrow band, you will still be able to see a partial solar eclipse, but at no time will it be safe to view the eclipse without protection.

Are you going to be able to see a total or partial eclipse on August 21st?
Are you going to be able to see a total or partial eclipse on August 21st?

Remember that even if you live in or have traveled to a spot inside the path of totality, the total eclipse itself will only last a few minutes.

The whole eclipse will last much longer though.

From the start of the eclipse, to maximum eclipse, to the end of the eclipse, you might be looking at a three hour event. That’s a lot of time to be at risk of looking at the sun outside of totality and getting eye damage if you aren’t wearing protection.

Safely Viewing the Solar Eclipse

What kind of protection do you need to safely view a solar eclipse.

Fortunately, you have a lot of options.

This solar eclipse viewing protection can include using:

  • solar filters, including ISO 12312-2 compliant eclipse glasses that have been sold online in packs of 5 or 10 (but including some that have been recalled), handheld solar viewers,  and full aperature solar filters for cameras and telescopes
  • a pin-hole viewer that you can easily make yourself with something as common as a cereal box
  • a 2D or 3D printable pinhole projector
  • a solar viewing projector using binoculars or a telescope (not looking through the telescope itself though, unless it had a proper solar filter!)
  • No. 13 or 14 welder’s glasses

But unless you are building a pin-hole viewer or are going to an official eclipse viewing event, be sure your protection is really going to protect your child’s eyes. Are the eclipse glasses you ordered fake, recalled, scratched, or damaged? Then don’t use them.

And make sure younger children are well supervised during the entire eclipse, so that they don’t look at the eclipse at any time that you are outside the time that you are in totality.

Some people will have a better chance of viewing a total solar eclipse in 2024.
Some people will have a better chance of viewing a total solar eclipse in 2024.

What if they miss it?

They won’t have to wait too long for the next total solar eclipse. Another one is headed our way in 2024.

What to Know About Safely Viewing the Solar Eclipse

I don’t know if it will change your child’s life, but there is no good reason to let them miss this total solar eclipse (or partial eclipse if you aren’t in the path of totality), as long as you take some very simple steps to make sure they view it safely.

More About Safely Viewing the Solar Eclipse

What to Do If a Mosquito Bites Your Child

Mosquito bites aren't good, but you don't have to get panicked about them.
Mosquito bites aren’t good, but you usually don’t have to get panicked about them.

Depending on where you live, a mosquito bite can be just a nuisance or it can lead to a life-threatening disease. From Chikungunya virus to Zika, most parents have learned to fear mosquito-borne diseases and because they hear about them so much, fear or even get panicked over mosquito bites.

While it is good to prepared and learn to avoid mosquito bites, you likely shouldn’t be panicked.

But even if your kids aren’t at risk for a mosquito-borne disease, it’s no fun getting bit by mosquitoes. Mosquito bites are itchy, and even when bites don’t get infected, they can leave behind crusted scabs that kids continue to pick at, over and over again.

Still no reason for panic or fear – just good reasons to learn to avoid mosquito bites.

Mosquitoes and Mosquito-Borne Diseases

Diseases that can be spread from the bite of a mosquito can include:

  • Chikungunya – can develop fever and severe and debilitating joint pain 3-7 days after a mosquito bite from Aedes aegypti and Aedes albopictus mosquitoes in countries in Africa, Asia, Europe, and the Indian and Pacific Oceans, Caribbean countries, and most recently, in Florida, Puerto Rico, and the U.S. Virgin Islands.
  • Dengue – can cause severe flu like symptoms, including fever, severe headache, eye pain, joint and muscle pain, rash, and bleeding, after a mosquito bite in one of at least 100 endemic countries, including many popular tourist destinations in Latin America, Southeast Asia and the Pacific islands. While there are cases in the US, it is important to keep in mind that “nearly all dengue cases reported in the 48 continental states were acquired elsewhere by travelers or immigrants.”
  • Eastern Equine encephalitis – a very rare disease, which is fortunate, as it is one of the most deadly of the mosquito-borne diseases. Transmission is in and around swampy areas, with most cases in Florida, Georgia, Massachusetts, and New Jersey.
  • Filariasis – spread by repeated mosquito bites over months to years, this disease is still found in at least 73 countries in parts Asia, Africa, the Western Pacific, and parts of the Caribbean and South America, these parasitic worms can grow and live in our lymph system
  • Japanese encephalitis – you can get a Japanese encephalitis virus infection after being bit by an infected Culex species mosquito in one of 24 countries in South-East Asia and the Western Pacific, especially if you are not vaccinated.
  • La Crosse encephalitis – rare, but can occur in the upper Midwestern and mid-Atlantic and southeastern states and can cause severe disease, including encephalitis, in children.
  • Malaria – although malaria was eliminated in the US in the early 1950s, we still see about 1,700 cases each year in returning travelers. That’s because malaria is a still a big problem around the world, from certain some states in Mexico to most of sub-Saharan Africa and South Asia.
  • St. Louis encephalitis – can occur in eastern and central states, starts with mild symptoms, but can very rarely (between 1 to 12 cases a year) progress to encephalitis (inflammation of the brain).
  • West Nile – has now been found in every state except Alaska and Hawaii, but up to 80% of people don’t develop any symptoms and only 1% develop severe symptoms, with folks over age 60 years most at risk. Although West Nile season peaks in mid-August, cases are usually reported from late summer through early fall.
  • Western Equine encephalitis – rare, but deadly, like Eastern Equine encephalitis, and is found in states west of the Mississippi River
  • Yellow fever – a vaccine-preventable disease, the Yellow fever virus is still found in tropical and subtropical areas in South America and Africa.
  • Zika – is mostly a risk during pregnancy as it can cause serious birth defects, including microcephaly, so there are warnings to avoid high risk areas, which in addition to multiple countries and territories around the world, includes Brownsville, Texas and previously included Miami-Dade County, Florida

Won’t a long list of diseases get parent’s panicked? Only if they skip the part about where the mosquitoes that cause those diseases are active.

What to Do If a Mosquito Bites Your Child

Original Title: DPD_A.freeborni_861sRGB
 Do you know what to do if a mosquito bites your child? Photo by James Gathany

If a mosquito bites your child, don’t panic. There is no reason to run to your pediatrician or the ER and get tested for West Nile or Zika.

That’s not to say a mosquito bite couldn’t send you to the ER, but it would likely only be if your child was severely allergic, with the bite causing an anaphylatic reaction. Fortunately, most bites just leave little red bumps that go away in a few days if you don’t scratch them too much.

So the key treatment after a mosquito bite is classically about relieving the symptoms of itching. As with other itchy rashes, you can do this by:

  • applying an OTC anti-itch cream (hydrocortisone cream or calamine lotion) to the bite
  • taking an oral antihistamine, especially at night
  • applying a prescription steroid cream to help control itching

Also, keep your child’s finger nails short to minimize damage from scratching and wash the areas with soap and water to decrease the risk of secondary infections.

“Where you live, your travel history, and the travel history of your sex partner(s) can affect your chances of getting Zika.”

CDC on Know Your Zika Risk

In general, you should see your pediatrician if you have the symptoms of a mosquito-borne disease and have been in an area with risk of that disease.

Should you worry about dengue, West Nile, or Zika, etc?

  • Does your child live in an area where you can commonly find the mosquitoes that carry any of these diseases?
  • Did your child recently visit an area where you can commonly find the mosquitoes that carry any of these diseases?
  • Is your child a pregnant teen?
  • Is your teen sexually active?
  • Does your child have a chronic medical condition, such as cancer, diabetes, hypertension, or kidney disease?
  • Is your child a first- or second-generation immigrant from a malaria-endemic country who returned to their home country to visit friends and relatives?
  • Was your child at risk for a mosquito-borne disease and skipped taking preventative medications for malaria or skipped getting a Japanese encephalitis vaccine or a Yellow fever vaccine?

Again, see your pediatrician if your child had a mosquito bite and now has the symptoms of a mosquito-borne disease after being in an area with risk of that disease. This is especially important for anyone who is pregnant or with a chronic medical problem, as they might be at higher risk for severe disease. The elderly are more at risk too.

Preventing Mosquito Bites

Of course, whether you are traveling to the tropics or going for a walk in your neighborhood, your best bet is going to be trying to avoid mosquitoes and mosquito bites in the first place.

  • use insect repellent, which can protect your kids from tick bites too
  • wear long-sleeved shirts and long pants when possible
  • get rid of standing water around your home – places where mosquitoes can breed
  • make sure windows and doors have screens or are kept shut to keep mosquitoes out of your home
  • instead of insect repellent, consider using mosquito netting to cover your infant’s stroller or carrier when outside, and especially when in high risk parts of the world, using insecticide treated bed nets

And review travel advisories before planning a trip to see if you need to take any additional precautions to avoid a mosquito-borne disease.

What to Know About Mosquitoes and Mosquito Bites

Mosquito-borne diseases, like dengue, West Nile, and Zika, can certainly be serious, but you likely don’t need to panic your child has gotten one of them every time he or she gets a mosquito bite.

More About Mosquitoes and Mosquito Bites

The Myth of an Autism Epidemic

We hear stories about the rise in autism and the autism epidemic all of the time.

Autism prevalence rates have been steady at 1 in 68 since 2010.
Autism prevalence rates have been steady at 1 in 68 since 2010.

Every few years, the CDC had been releasing a new report which showed a higher prevalence of autism in the United States, including:

  • 1 in 150 children in 2000
  • 1 in 150 children in 2002
  • 1 in 125 children in 2004
  • 1 in 110 children in 2006
  • 1 in 88 children in 2008
  • 1 in 68 children in 2010
  • 1 in 68 children in 2012

Looking at those numbers, it is easy to see most people think that the rate of autism is rising.

And if the rate of autism is rising, then there must be a cause.

Thinking about it like that, it becomes easy to see why vaccines became the scapegoat for causing autism, especially after Andrew Wakefield told everyone that it “is my feeling, that the, the risk of this particular syndrome developing is related to the combined vaccine, the MMR…”

The Myth of an Autism Epidemic

Many experts don’t think that there is an autism epidemic though.

“…the numbers of people born with autism aren’t necessarily increasing dramatically. It’s just that we’re getting better and better at counting them.”

Emily Willingham

There are several different explanations for the apparent rise in the number of children being diagnosed with autism, including:

  • better recognition among health care providers
  • better recognition among parents
  • diagnostic substitution – children were once diagnosed with other conditions, such as mental retardation and learning disabilities
  • broadening of the criteria used to diagnose autism, including changes in DSM criteria, which went from labeling children with autism as having childhood schizophrenia (1952) and including just three essential features of infantile autism (1980) to adding PDD-NOS (1987) and more subtypes and symptoms to the autism diagnosis category in DSM-IV (1994).
  • social influences, including that more parents may have wanted to seek help when more resources become available and because they may have become more accepting of the possibility that their child had autism, leading them to seek a diagnosis and services. For example, before 1975 and the Education for All Handicapped Children Act, children with disabilities were excluded from school. And then in 1990, the Individuals with Disabilities Education Act (IDEA) included autism as a separate disability, making it a little easier to get services.

All together, these explanations help explain what has been confirmed by numerous studies, that the true prevalence of autism hasn’t changed over time.

What To Know About The Autism Epidemic Myth

There is no autism epidemic.

  • There are adults and older people with autism. Did you know that the the first meeting of the National Society of Autistic Children was held in 1965?
  • The idea that the ‘autism epidemic’ is a myth is not new – experts have been talking about it for over 10 years, which makes you wonder why some people still push the idea. An idea that hurts autistic families.
  • A 2015 study concluded that “Changes in reporting practices can account for most (60%) of the increase in the observed prevalence of ASDs in children born from 1980 through 1991 in Denmark. Hence, the study supports the argument that the apparent increase in ASDs in recent years is in large part attributable to changes in reporting practices.”
  • Autism is thought to be genetically based.

Some folks, especially those in the anti-vaccine movement, don’t want to believe that there is no autism epidemic though.

“If there is no autism epidemic, if there is a “stable incidence” of autism over recent decades, then this alone is powerful evidence against the vaccine hypothesis – and in fact removes the primary piece of evidence for a vaccine-autism connection.”

Steven Novella on The Increase in Autism Diagnoses: Two Hypotheses

After all, if there is no autism epidemic, then they can’t blame vaccines for be causing an autism epidemic…

More About the Autism Epidemic Myth

 

What to Do If a Tick Bites Your Child

Lyme disease.

That’s usually what comes to mind when people find a tick on their child or if they simply think about tick-borne diseases.

It is important to know that there are many other diseases that can be caused by many different types of ticks though, from anaplasmosis to tularemia. And since these ticks and the diseases they transmit are fairly regional, it is easy to be unfamiliar with them if you don’t live in their specific habitats.

That can especially be a problem if, for example, you are from Hawaii, where tick-borne diseases aren’t a big issue, and you travel for a camping trip to Oklahoma and your child is bitten by a tick. Will you or your doctor know what to do if your child develops symptoms of Rocky Mountain spotted fever?

How To Remove a Tick

Fortunately, if you find a tick on your child, you can decrease their chance of getting sick if you remove it quickly. That makes doing daily full body tick checks important.

 

Use tweezers to remove a tick, grabbing it close to the skin, and pulling it upward with steady, even pressure.
Use tweezers to remove a tick, grabbing it close to the skin, and pulling it upward with steady, even pressure. A special tick-removal spoon can make it even easier!

How quickly?

At least 36 hours.

“Parents should check their children for ticks under the arms, in and around the ears, inside the belly button, behind the knees, between the legs, around the waist, and especially in their hair.”

CDC on Preventing Tick Bites

After removing the tick, wash the bite area and your hands with soap and water and observe your child over the next few weeks for symptoms of a tick-borne disease.

Symptoms of a Tick Bite

Although some of the symptoms of tick-borne diseases are specific to the tick that bit your child, some other symptoms are common to all of them, including:

  • fever
  • headache
  • fatigue
  • muscle aches and joint pains
  • skin rashes
  • chills

Like spider bites, tick bites are usually painless. That often leads to a delay in actually figuring out that a tick has bitten your child, which makes it important to do frequent tick checks if they are doing anything that could expose them to ticks.

Many people are also surprised at how many different diseases can be transmitted by ticks, including:

  • Anaplasmosis – transmitted by the black-legged tick (northeast and upper midwestern United States) and the western black-legged tick (Northern California). May not cause a rash.
  • Babesiosis – transmitted by the black-legged tick (northeast and upper midwestern United States). Can cause severe hemolytic anemia.
  • Colorado Tick Fever – a viral infection that is transmitted by the Rocky Mountain wood tick (western United States, especially Colorado, Utah, Montana, and Wyoming). Can cause meningoencephalitis.
  • Ehrilichiosis – transmitted by the lone star tick in southcentral and eastern US.
  • Lyme disease – transmitted by the blacklegged in the northeastern U.S. and upper midwestern U.S. and the western blacklegged tick along the Pacific coast. Erythema migrans rash or Bull’s eye rash.
  • Powassan disease – a viral infection that is transmitted by the black-legged tick (northeastern United States and the Great Lakes region). Can cause biphasic illness, with children appearing to get better and then the symptoms reappearing again.
  • Rocky Mountain spotted fever – transmitted by the American dog tick, Rocky Mountain wood tick, and the brown dog tick in the U.S. Causing a classic petechial rash on the wrists, forearms, and ankles, which can then spread to the trunk.
  • Rickettsia parkeri Rickettsiosis – transmitted by the Gulf Coast tick in the eastern and southern United States.
  • STARI (Southern Tick-Associated Rash Illness) – “transmitted” by the lone star tick (central Texas and Oklahoma eastward to the the whole Atlantic coast). Children have an expanding “bull’s eye” lesion at the tick bite, like Lyme disease, but the cause is unknown.
  • Tickborne relapsing fever (TBRF) – spread by multiple soft ticks in the western United States which live in rodent infested cabins and can cause relapsing fever – 3 day episodes of fever, in between 7 days stretches in which a child might be fever free, over 3 to 4 weeks.
  • Tularemia – transmitted by dog ticks, wood ticks, and lone star ticks or by handling a sick animal, including wild rabbits, muskrats, prairie dogs, and domestic cats. Can cause an ulcer at the site of infection.
  • 364D Rickettsiosis – transmitted by the Pacific Coast tick in Northern California dn along the Pacific Coast.

And although it can be helpful to know about all of the different tick-borne diseases and their symptoms, you should basically just know to seek medical attention if your child gets sick in the few weeks following a tick bite.

What to Know About Ticks and Tick Bites

Of course, it would be even better to reduce your child’s risk of getting a tick-borne disease by avoiding ticks in first place, including limiting his exposure to grassy and wooden areas, wearing protective clothing, using insect repellent, treating your dogs for ticks, taking a shower within two hours of possibly being exposed to ticks, and doing frequent tick checks.

In addition to avoiding ticks, it is important to know that:

  • The Vermont Department of Health advises that the best way to prevent tickborne diseases is to prevent tick bites.
    The Vermont Department of Health advises that the best way to prevent tickborne diseases is to prevent tick bites.

    Tick activity is seasonal, with adult ticks most active in spring and fall, and the smaller nymphal ticks more active in late spring and summer.

  • Tick bites that lead to tick-borne diseases are often not noticed because they are usually painless and are often caused by nymphs, the immature, smaller forms of a tick. So while you might be thinking about a large, adult tick when you are asked about a recent tick bite, a nymph is tiny (about 2mm long) and might even be missed.
  • Testing (on your child), including antibody tests, can be done to confirm a diagnosis of most tick-borne diseases, but keep in mind that testing can be negative early on. You also shouldn’t wait for results before starting treatment in a child with a suspected tick-borne disease. Testing is usually done with either indirect immunofluorescence antibody (IFA) assay or enzyme immunoassay (EIA) tests.
  • It is usually not recommended that you have a tick that has bitten your child be tested for tick-borne diseases. Even if the tick was positive for something, it wouldn’t mean that it transmitted the disease to your child.
  • Experts don’t usually recommend that people be treated for tick-borne diseases after a tick bite unless they show symptoms. The only exception might be if the tick was on for more than 36 hours and you were in an area with a high risk for Lyme disease.
  • Although doxycycline, one of the antibiotics often used to treat tick-borne diseases, is often restricted to children who are at least 8 years old because of the risk of side effects, it should still be used if your younger child has Rocky Mountain spotted fever, ehrlichiosis, or anaplasmosis.

You should also know that most old wives tales about ticks and tick bites really aren’t true. You should not try to burn a tick that is biting your child with a match, paint it with nail polish, or smother it with vaseline, etc. Just remove it with tweezers and throw it away in a sealed bag or by flushing it down the toilet.

What to Do If a Tick Bites Your Child

Don’t panic if a tick bites your child. You have up to 36 hours to remove it, before it is can likely transmit any diseases to your child, like Lyme disease or Rocky mountain spotted fever.

More About Ticks and Tick Bites

What to Do If a Spider Bites Your Child

It can often seem like spiders are everywhere, and when you consider that more than 100,000 species of spiders have been identified, they probably are.

A black widow spider is typically easy to identify because of the classic markings on its body.
A black widow spider is typically easy to identify because of the classic markings on its body. Photo by Vincent Iannelli, MD

Even with only 4,000 species of spiders in North America, that’s a lot of spiders.

And believe it or not, that’s a good thing. All of those spiders eat up to 800 million metric tons of insects each year!

Fortunately, very few of these spiders are dangerous.

In the Unites States, just two species of spiders are poisonous enough to cause harm. They include the black widow spider (Latrodectus mactans) and the brown recluse spider (Loxosceles reclusa).

Even in other parts of the world that have more of a variety of venomous spiders, like Australia, that “reputation is bigger than its bite.”

It is important to remember than even venomous black widow and brown recluse spiders aren’t wandering around your house trying to attack your kids. They usually like to live in places where they won’t be disturbed. So unless your child was crawling through boxes in a closet or attic, or some other place where they might have disturbed a spider, it is unlikely that any bites on their skin were caused by a “bad spider.”

And in most cases, any “bite marks” probably weren’t caused by a spider at all, as many experts think that spider bites are over-diagnosed. Many other conditions, including other insect bites and skin infections can mimic spider bites.

Symptoms of a Spider Bite

Surprisingly, most spider bites aren’t that painful. Although it may feel like a pin prick, many bites often go unnoticed, making it hard to know if you have been bitten.

Common spider bite symptoms can include a single bite mark with:

  • swelling
  • redness
  • itching
  • pain

In fact, most spider bites will resemble a bee sting. Your child may also develop hives and other allergy symptoms if they are allergic to the spider bite.

Symptoms of a black widow spider bite cold include severe muscle pain and cramps, which develop within a few hours of the bite. Other symptoms might include weakness, vomiting, trouble breathing, abdominal pain, and high blood pressure.

Brown recluse spider bites can be painful. In addition to pain, these spider bites might cause burning and itching. Another characteristic finding is that the spider bite may look like a bull’s eye, with a red ring around a white center that turns into an ulcer.

Was Your Child Really Bitten By a Spider?

The most obvious way to diagnose a spider bite is to see the spider biting your child.

Keep in mind that since many of us have spiders in and around our homes, simply seeing a spider and then noticing a bite on your child doesn’t necessarily mean that your child has a spider bite.

As hard as it sometimes is to tell if a child even has a spider bite, it can be even harder to determine what type of spider actually bit him. Again, seeing the spider can help, as “bad spiders” have very characteristic features.

The black widow spider is jet black, with a red hourglass marking on the underside of their abdomen. Brown recluse spiders are smaller, are yellowish-tan to dark brown, and have a violin shaped marking on their back.

Should you try to catch a spider to help your doctor identify it? Probably not, as you are more likely to bring your pediatrician a crushed spider that is impossible to identify than anything useful. And you should likely be concentrating on taking care of your child after he has been bitten, instead of chasing after the spider.

What to Do If a Spider Bites Your Child

For most spider bites, you can follow some simple home treatments, including:

  • washing the spider bite with soap and water
  • apply an ice cube to the bite for about 20 minutes
  • giving your child a pain medicine, such as acetaminophen (Tylenol) or ibuprofen (Motrin or Advil)
  • applying a topical antibiotic ointment to the bite two or three times a day
  • applying a topical steroid cream to help control itching and redness a few times a day
  • continuing home treatments for one or two days, the typical time that it takes a spider bite to go away

Of course, you should seek medical attention if you think your child was bitten by a black widow spider or brown recluse spider, or if any spider bite seems like it is getting infected, with increasing redness and pain after a few days.

Don’t overlook the fact that your local poison control center (1-800-222-1222) can be a good resource if you think your child was bitten by a poisonous spider.

What to Know About Spider Bites and Kids

Other things to know about spider bites include that:

  • Even the poisonous black widow spiders and brown recluse spiders rarely cause life-threatening symptoms or death.
  • In addition to seeking medical attention for a black widow spider or brown recluse spider bite, see your pediatrician if a spider bite isn’t getting better in a few days.
  • Kids may need a tetanus shot after a spider bite.
  • Spiders usually bite just once, so if a child has multiple bites, then it likely isn’t from a spider.
  • Although parents often look for the double fang marks in trying to identify a spider bite, they usually aren’t seen, and even when you see “fang marks,” it doesn’t mean that your child was bitten by a spider.
  • Instead of a black widow or brown recluse, it is more likely that you will come across a more harmless spider in or around your home, like a grass spider, wolf spider, orb weaver, or daddy-long-legs.

Most importantly, teach your kids to avoid spiders by shaking out shoes and clothing that are lying on the floor and not storing boxes or other items on the closet floor or underneath your child’s bed. You can help keep spiders out of your child’s crib or bed by making sure any bedding doesn’t touch the floor.

And remember that spiders eat insects, so might help keep your kids free of other types of bites.

More About Spiders and Spider Bites

Save

Don’t Skip Your RhoGAM Shot

I’m kind of shocked that I am having to write about warning folks to not skip their RhoGAM shot.

“Prophylactic anti-D immune globulin should be offered to unsensitized Rh D-negative women at 28 weeks of gestation. Following birth, if the infant is confirmed to be Rh D positive, all Rh D-negative women who are not known to be sensitized should receive anti-D immune globulin within 72 hours of delivery.”

ACOG on Prevention of Rh D Alloimmunization

Unfortunately, like with the vitamin K shot, in addition to trying to scare new moms away from getting vaccines, they also tell them to skip their RhoGAM shot.

What is RhoGAM?

RhoGAM (RhIg) or anti-D immune globulin is not a vaccine.

A RhoGAM shot can help prevent hemolytic disease of the newborn and fetus.
A RhoGAM shot can help prevent hemolytic disease of the fetus and newborn.

It is a prescription immune globulin shot that is given to some pregnant and post-partum women to prevent Rh (Rhesus) immunization, which can lead to hemolytic disease of the fetus and newborn if you get pregnant again.

RhoGAM was approved by the FDA in 1968.

RhoGAM Questions and Answers

If you have been educated about RhoGAM on the Internet and are thinking about skipping your RhoGAM shot, it might be time for a little more research:

  1. What is hemolytic disease of the fetus and newborn (HDFN)? It is not to be confused with vitamin K deficiency bleeding, which can be prevented with a vitamin K shot. Also known as erythroblastosis fetalis, HDFN occurs when a mother develops antibodies against her baby’s own red blood cells and destroys them, leading to anemia, jaundice, and edema. In severe cases, this can be life-threatening and the baby can develop hydrops fetalis.
  2. Why would a mom develop these antibodies against her own baby’s blood in the first place? Since a baby’s blood type is determined by both their mom and dad’s blood type, it is easy to see how it might be different than moms. This usually isn’t a problem, after all, a mother’s immune system doesn’t usually attack any other cells of the placenta or her baby (immune tolerance of pregnancy) that might be “foreign.” Unfortunately, it is not uncommon for a baby’s blood and “foreign” red blood cells to mix with mom’s blood, which could trigger antibodies to form.
  3. How does a baby’s blood mix with mom’s blood? Doctor’s have long known that while mixing is not common during a women’s pregnancy, it can commonly occur when she gives birth, explaining how Rh disease used to kill 10,000 babies each year in the United States. It doesn’t take trauma, a procedure (amniocentesis or chorionic villus sampling), or a difficult delivery for a baby’s blood cells to leak into a mother’s bloodstream. It can just happen. Mixing can also happen after a miscarriage, an ectopic pregnancy, or an induced abortion. Simply trying to turn a baby from the breech to a head-down position before delivery (external cephalic version procedure) leads to fetal-maternal hemorrhage in 2 to 6% of cases.
  4. Who needs to get a RhoGAM shot? It is hopefully clear already that not everyone is at risk to develop Rh immunization and so not everyone needs RhoGAM. Some folks can safely skip their RhoGAM shot, but only because it would never have been recommended for them in the first place. You only need RhoGAM if your baby’s blood type might be different than yours, specifically the Rh D antigen of the blood  and if you (mom) are Rh D negative (Rh-negative). Why don’t we worry about the ABO part? While an ABO incompatibility can also cause hemolytic disease of the newborn, it is usually much more minor. Why don’t we worry if you are Rh-positive and the baby is Rh-negative? If your baby is Rh-negative, then he or she wouldn’t have any Rh antigens on their red blood cells to make antibodies against.
  5. What is the chance your baby will be Rh-positive? It depends. And is actually more complicated than people think. If dad is Rh-positive, he can be either +/- or +/+, because there are two alleles for the Rh gene and Rh-positive is dominant. So if mom is Rh-negative (she can only be -/-), then their baby could either be +/- or -/-, so has at least a 50% chance of being Rh-positive. On the other hand, if dad is definitely +/+, then there will be a 100% chance that the baby will be Rh-positive. If you are confused now, then you don’t want to think about how two Rh-positive parents can have a Rh-negative baby!
  6. When will I get my RhoGAM shot? The current guidelines are to get a RhoGAM shot at around the 28th week of pregnancy to prevent Rh sensitization for the rest of the pregnancy; within 72 hours after the delivery of an Rh-positive infant; after a miscarriage, abortion, or ectopic pregnancy; or after amniocentesis or chorionic villus sampling.
  7. Can I skip my RhoGAM shot? You can skip your RhoGAM shot if you are already Rh sensitized (because it’s too late and RhoGAM won’t help for any future pregnancies) or if you are Rh-positive.  You will know if you are already Rh sensitized because a blood test is done to check for Rh antibodies. When paternity is certain (you know who the father is), and the father is Rh-negative, you can also skip the shot you would get at 28 weeks.  You can also skip your RhoGAM shot if your baby is Rh-negative.
  8. How do you know if you are already Rh sensitized? Moms who are Rh-negative get an antibody screen to see if they have Rh antibodies when they are 28 to 29 weeks pregnant.
  9. Why do some women seem to safely skip their RhoGAM shot and have a healthy baby? Like with skipping a vitamin K shot or with skipping or delaying vaccines, the risk of a baby developing hemolytic disease of the fetus and newborn isn’t 100%, so these parents who skipped their RhoGAM shot gambled and got lucky their baby wasn’t harmed.
  10. But don’t they do it differently in other countries? Yes. In the UK, they routinely give all Rh-negative mothers either one dose of RhoGAM at 28-30 weeks or two doses, one at 28 weeks and another at 34 weeks. New mums will also get a shot after their baby is born if their baby is Rh-positive.

Don’t skip your RhoGAM shot if it has been recommended. If you do, you will have a 13-16% chance of becoming Rh sensitized, which can affect your next pregnancy.

RhoGAM Myths

But your OB/Gyn doctor gives you RhoGAM, so why is a pediatrician writing about it?

Because getting RhoGAM prevents hemolytic disease of the fetus and newborn. If you ever see, or hopefully just read about a baby with hydrops fetalis, you will understand why pediatricians don’t want you to skip anything just because of something you read on the Internet, especially myths like:

  • RhoGAM is a vaccine – not true. RhoGAM is made of antibodies. And while it is a blood product, it is extensively screened and tested for infections. Of course, you shouldn’t skip any of your pregnancy vaccines either, like your flu or Tdap vaccines.
  • RhoGAM contains mercury – not true. RhoGAM is thimerosal free.
  • You only need RhoGAM if you have been in a car accident – not true, at all. Again, even in a normal pregnancy, with a “gentle birth,” there can be mixing of blood. And it doesn’t take a lot of blood mixing. As little as 0.1ml of blood (keep in mind that a teaspoon is 5ml) can trigger Rh sensitization.
  • hemolytic disease of the fetus and newborn is easily treatable – not true. While it might be true for more minor ABO blood incompatibilities, it is not true for Rh disease. If a baby develops hydrops fetalis, they might need intrauterine fetal blood transfusions and an early delivery. After they are born, babies with hydrops fetalis will likely need blood transfusions (because of severe anemia), exchange transfusions (because of extreme levels of jaundice), medicines to manage heart failure, phototherapy, and will likely be on a ventilator to help them breath. And even in a modern NICU, babies with hydrops fetalis still die.
  • everyone is offered a RhoGAM shot as part of a Big Pharma profit ploy – not true. RhoGAM is only given to moms who are Rh-negative, and since 85% of people are Rh-positive, most are never offered RhoGAM.
  • you can just wait to see if you want to get the shot later – not true. If you are Rh-negative and skip the pregnancy dose, waiting until your baby is born to see if they are Rh-positive, you may have already become sensitized. Mixing of blood occurs during pregnancy in at least 12% of cases and that is not just with car accidents, procedures, or trauma. Before RhoGAM started to be used during pregnancy, instead of just after, almost 2% of moms still became sensitized. Although that might seem like a small number, when you consider that almost 4 million babies are born in the United States each year, it ends up being a lot of babies at risk for HDFN if moms start skipping their RhoGAM shots.
  • you can just skip the shot if you don’t want any more kids – not true. Want if you change your mind and decide you do want more kids or have a “happy accident.”
  • there are natural ways to prevent Rh-sensitization – not true.
  • Rhogam causes serious side effects – not true. Rhogam is safe and doesn’t cause autism or any of the other serious side effects that you might see listed on sites trying to scare you away from getting your shot.
  • “First time mothers do not need it. A dose at 28 weeks is unnecessary unless a test shows sensitization has already occurred.” – ridiculously untrue, but I included it to show what kind of advice you will find on some websites. First time mothers definitely could need it, if they are Rh-negative, so that they don’t become sensitized, and if they are already sensitized, a dose isn’t going to help them!

Again, don’t skip your RhoGAM shot.

What To Know About Getting a RhoGAM Shot

There is no reason to skip your RhoGAM shot if it has been recommended for you during or after your pregnancy.

More About Deciding To Get A RhoGAM Shot

That Black Box Warning on Vitamin K Shots

Vitamin K is not a vaccine, but some parents who plan on skipping or delaying their baby’s vaccines, also choose to skip this shot.

Vitamin K Shots

Given soon after a baby is born, a vitamin K shot is the most effective way to prevent both early onset and late onset vitamin K deficiency bleeding.

“The vitamin K injection is also a supposed safeguard in case your car is involved in a car wreck on the way home from the hospital or birthing center with newborn in tow.”

The Healthy Home Economist on why you should Skip that Newborn Vitamin K Shot

Although vitamin K deficiency bleeding has never been very common, it is often fatal, and it has been known for almost 125 years that it is caused by a temporary lack of vitamin K in newborns and younger infants.

Can’t you just give babies oral vitamin K to prevent this bleeding?

While oral vitamin K can prevent early onset vitamin K deficiency bleeding, which might start from birth to when a baby is about two weeks old, it won’t prevent late onset bleeding, even if you give the recommend three doses on schedule over two months (as they do in some countries). Babies with late onset vitamin K deficiency bleeding might not have symptoms until after they are two weeks old, or as late as 5 or 6 months old, and it can only be prevented with a vitamin K shot.

Can’t you just avoid dropping your baby or getting into a car wreck if you skip the vitamin K shot?

While you will hopefully do that anyway, the truth is that we don’t know why some infants with vitamin K deficiency bleeding develop bleeding in their brains, as it usually isn’t any kind of big trauma.

In 2013, seven babies over a period of eight months had early and late vitamin K deficiency bleeding at the Monroe Carell Jr. Children’s Hospital at Vanderbilt University in Nashville.

Three of them required surgery to remove clots “out of their head” and may “have issues with seizure disorders and will have long-term neurological symptoms related to seizures and developmental delays.”

I don’t think any of them were dropped or were involved in car accidents on the way home from the hospital or birthing center.

All had refused to get their baby a vitamin K shot.

Why Do Parents Refuse Vitamin K???

So why do some parents choose to skip their baby’s vitamin K shot?

There are no toxic ingredients in your baby's vitamin K shot.
There are no toxic ingredients in your baby’s vitamin K shot.

Some parents simply think their baby doesn’t need it, especially if they have an uncomplicated, “gentle birth” at home. Of course that has nothing to do with whether or not your baby develops vitamin K deficiency bleeding days or weeks later. It also doesn’t matter whether or not you plan on getting your baby boy circumcised, although your pediatrician probably won’t do the circumcision if you skip the shot.

Other parents are worried about a possible link to leukemia and childhood cancer, an improbable link that was refuted way back in the 1990s.

And still others are worried about the mercury content of vitamin K shots. Or they are worried about other supposed “toxins” in the shot, that it is a synthetic version of vitamin K, or that the dose is too high.

“There is no evidence to suggest that the small amount of benzyl alcohol contained in Vitamin K1 Injection (Phytonadione Injectable Emulsion, USP), when used as recommended, is associated with toxicity.”

Vitamin K Package Insert

Why are they worried about these things?

Mostly because someone on the Internet told them to be worried about them, even though vitamin K shots are safe, are free of mercury and any other toxins you might really need to be concerned about, and the dose of synthetic vitamin K your baby gets in the shot will not cause an overdose.

Or they might be worried that their baby might get up to 100mcg/L of aluminum with each shot. Of course, since they are only getting 0.5ml with the shot, that only equals about 0.05mcg of aluminum! Although it is an extremely tiny amount, why is it even in there? It is not working as an adjuvant as some would propose (again, vitamin K is not a vaccine), but rather is likely just a byproduct of the manufacturing process. And you can be assured that your baby can quickly, and safely eliminate the small amount from their body.

“…several countries have reported a resurgence of late VKDB coincident with policies promoting the use of orally administered prophylaxis, even with multiple-dose regimens.”

AAP on Controversies Concerning Vitamin K and the Newborn

The shot (which works) is certainly safer than going to a compounding pharmacy for oral vitamin K (which won’t work to prevent all cases of late-onset vitamin K deficiency bleeding).

That’s right – oral vitamin K for babies isn’t even available in the United States.

That Black Box Warning on Vitamin K Shots

And then there is the black box warning in the package insert for vitamin K.

The package insert for vitamin K does include a black box warning, although these severe reactions are extremely rare in newborns who get a vitamin K shot to prevent vitamin K deficiency bleeding.
The package insert for vitamin K does include a black box warning, although these severe reactions are extremely rare in newborns who get a vitamin K shot to prevent vitamin K deficiency bleeding.

Why is it there?

It was found that people could have severe, life-threatening allergic reactions (anaphylaxis) if they got a large dose of vitamin K too rapidly through an IV. This type of dose would usually be given to patients with significant bleeding who were being treated with anticoagulants (anticoagulant reversal).

“Based on a review of the literature, use of parenteral vitamin K1 may result in severe hypotension, bradycardia or tachycardia, dyspnea, bronchospasm, cardiac arrest, and death. These reactions are most consistent with a nonimmune-mediated anaphylactoid mechanism. It appears that intravenous administration is more frequently associated with these reactions and occurs at an incidence of 3 per 10 000 doses of intravenous vitamin K1.”

Jamie N Brown on Characterizing the Severe Reactions of Parenteral Vitamin K1

This is not what happens when babies get their vitamin K shot though, although there is one non-fatal case report of anaphylaxis after a baby in Turkey got a vitamin K shot in 2014.

There are nearly 4 million births in the United States each year.

Almost all of them get a vitamin K shot very soon after they are born.

And yet there are no reports of anaphylaxis in the United States.

There are isolated case reports of anaphylaxis in newborns to other things, including antibiotics, hepatitis B immunoglobulin, total parenteral nutrition (TPN), and atracurium (used in anesthesia) – but not to vitamin K shots.

“Therefore the INTRAVENOUS and INTRAMUSCULAR routes should be restricted to those situations where the subcutaneous route is not feasible and the serious risk involved is considered justified.”

Vitamin K Black Box Warning

That’s why most parents don’t skip getting their baby a vitamin K shot. Or they come to regret the decision if they do.

“What it comes down to is that giving your child a shot of Vitamin K at birth is a small price to pay, especially when the cost of rejecting the shot can be severe brain injury and death. I can’t change what happened to Olive, but I can try to prevent it from happening to another baby.”

Olive’s Story

For most parents, avoiding the serious risk of vitamin K deficiency bleeding justifies their baby getting a vitamin K shot.

And that’s why vitamin K deficiency bleeding is so rare these days – at least among those babies whose parents didn’t choose to skip their vitamin K shot.

What To Know About That Black Box Warning on Vitamin K Shots

For most parents, avoiding the serious risk of vitamin K deficiency bleeding easily justifies their decision to get their baby a vitamin K shot, despite the presence of a black box warning.

More About That Black Box Warning on Vitamin K Shots

Save