Parenting - Prenatal to preschool/Parenting_PrenatalToPreschool.bin/dp/0023/00230.txt

Text File | 1993-06-14 | 39KB | 654 lines

$Unique_ID{PAR00230}
$Pretitle{}
$Title{2 1/2 Years to 5 Years:  Safety and Health}
$Subtitle{}
$Author{
Editors of Consumer Guide
Mendelson, Robert A
Mendelson, Lottie M
Meyerhoff, Michael K
Ames, Louise Bates}
$Subject{2 1/2 Years to 5 Years Safety Health monitoring bathroom street
streets preschooler car seat belt buckling up bicycle tricycle sidewalk
sidewalks unsupervised fire matches lighters barbecue grill fireplace stove
swim swimming sledding jungle gym peers fights peer fight stranger strangers
snatching sexually molested day care separated oral temperature thermometer
cold colds spreading tummy ache aches injury injuries sprain sprains broken
bone bones knocked out teeth pedodontist scabies ringworm skin infection
Pinworms bowel movement paradoxical diarrhea poison ivy oak sumac rhus
dermatitis rash rashes antihistamines topical medication medications systemic
steroids bee sting stings reaction pediatrician insect insects hyperactive
hyperactivity attention deficit disorder ADHD knock knees pigeon toed legs
feet kindergarten shots DTP booster polio vaccine vaccines tuberculosis test
preschoolers vision ACCIDENT ACCIDENTS TEACHING}
$Log{
Poison Oak, Poison Ivy, and Poison Sumac*0023009.tif
Help your child to face situations and experiences for emotional growth*0053901.tif}

The New Parents' Question & Answer Book


2 1/2 Years to 5 Years:  Safety and Health


     Now that my preschooler can understand a lot of my safety instructions,
can I ease up on some of my safety precautions?

     Naturally, the home of a preschooler need not be as thoroughly safety
proofed as the home of an infant or toddler.  However, your preschooler's
capacity to understand, remember, and follow safety instructions will not be
nearly as great at the beginning of this period as it will be toward the end.
Therefore, it is a good idea to ease up gradually, monitoring your preschooler
carefully to see just how far you can really trust him at each point along the
way.  It also is a good idea to keep your home "child-oriented" as much as
possible for as long as possible.  If you really don't need to have corrosive
cleansers, surplus medicines, or hazardous equipment lying around, don't
invite trouble.  Similarly, keeping potentially dangerous substances and items
you do need in locked drawers and cabinets is worth the little bit of
inconvenience.


     Since he's toilet trained, I don't want to continue supervising my
preschooler's trips to the bathroom.  Will he be okay on his own in there at
this point?

     By the time your preschooler is toilet trained, he should be able to
handle unsupervised visits to the bathroom.  However, especially if the
bathroom he uses is shared by adults, make sure that hazardous items and
substances, such as razors and medicines, are still kept in a securely latched
cabinet.  Also, see to it that your preschooler understands that trips to the
bathroom are for toileting and hygiene.  Emphasize that the inside of the
toilet is out-of-bounds and that he is not to play with the bathtub faucets.
For the sake of your own sanity more so than for your preschooler's safety,
you also may want to make sure that he doesn't have access to shampoo bottles,
jars of baby powder, and other such things that might result in quite a mess
if your preschooler decides to use them as toys.


     Since I live in the city, I'd like to teach my preschooler to cross the
street by himself as soon as possible.  When can I begin?

     It is never too soon to start teaching your preschooler how to cross the
street properly.  Increasingly throughout this period, he will be able to
understand, remember, and follow directions such as "wait for the light to
change," "cross only at the corner," "look both ways before you cross," etc.
However, even at the end of this period, allowing your preschooler to cross
the street by himself just is not a good idea.  Again, although you may be
able to count on him to not do anything dangerous deliberately, his strong
sense of adventure, his capacity to be distracted easily, and other such
factors can lead to trouble.  In addition, while a preschooler can be expected
to learn the basic rules of traffic, he can't really be expected to take into
account the many complications created by unsafe drivers who do not follow the
rules.  Therefore, by all means, start giving your preschooler lessons in this
area, but wait another year or two before you start giving him the chance to
put them into practice without supervision.


     My preschooler has outgrown his car seat.  What do I do now?

     While every state has a mandatory child-restraint law, the specifics of
the laws vary from state to state, so it's wise to check the law in your state
to make sure you are complying.  Once your preschooler is over four years of
age and weighs more than 40 pounds, you may no longer need to keep him in a
car seat, but you will have to make sure that he is securely restrained in a
booster seat and/or by a standard lap-and-shoulder belt--regardless of whether
or not the law requires it.  For a while, you probably will have to use a
booster seat along with the lap-and-shoulder belt to ensure a proper fit.
Keep in mind that the top portion of the belt must pass over your
preschooler's shoulder, not his neck.  For your child's safety, buckling up is
mandatory every time you take him in the car, even for short trips.  It is a
good idea to keep the doors locked as well.  Don't let your preschooler play
with sharp objects, such as pens and pencils, while riding in the car, and
keep the rear ledge free of objects that might fly forward in the event of a
sudden stop.  Should any problems arise while you are driving, pull over and
stop the car, and don't start moving again until everything is in order.


     I'm tired of fighting with my preschooler to stay in his safety restraint
when he's in the car.  What can I do?

     Some parenting rules are open for discussion and negotiation, and some
aren't.  There is no negotiation when it comes to wearing a safety restraint
in a motor vehicle.  It's a safety measure that must be rigidly obeyed.
Explain to him that the car will not move if he releases the restraint.  If he
unbuckles the restraint or otherwise begins to misbehave, stop the car, and
get him to rebuckle.  Then, leave him at home the next time, and tell him he
needs to cooperate in order to ride in the car.  When he agrees to comply, try
another trip in the car, and be sure to praise him if he behaves
appropriately.  He'll get the message if you are serious about getting it
across to him.  If the unbuckling has become a game or test of wills, it's a
game you must win now.


     Now that he's capable of keeping himself quietly entertained for a while,
is it okay to just leave my preschooler in the car for a minute or two while I
run into the store?

     This seemingly innocent set of circumstances can lead to disaster.  A
minute or two is an eternity for an active, curious preschooler.  The many
facets of a typical automobile may very well be irresistible even for the most
well-behaved and obedient preschooler.  In that short period of time, your
preschooler could find the cigarette lighter, he could release the safety
brake, he could move the gearshift out of the park position, etc.  He also
could become impatient and attempt to get out of the car to find you, possibly
stepping into traffic as he does so.  Furthermore, since you will have to at
least keep a window partially open for him, your preschooler will be rather
vulnerable for the period that he is in the car and you're not.  In other
words, in this case, what minor inconvenience you save yourself simply is not
worth the risks to your preschooler.


     Is it safe to take my preschooler for a ride on my bicycle with me?

     Bicycle accidents are a common cause of injury in children.  While you
don't have to give up on riding with your preschooler, you do need to take
necessary precautions.  Your preschooler must be securely harnessed in a child
seat specifically designed for this purpose.  Both you and your preschooler
must also wear a helmet.  In addition, begin teaching your child good
bicycle-safety habits as soon as he begins riding with you or riding on his
own--even if he's only riding a tricycle.  As he graduates to a larger
bicycle, you may want to enroll him in a bicycle-safety class.  Remember,
however, that the best teacher is a parent who knows and practices safe riding
techniques.


     I live in a quiet suburb.  Is it okay to let my preschooler ride his
tricycle unsupervised on the sidewalk?

     This probably is not a good idea.  Your preschooler's limited sense of
responsibility may be too easily overcome by his strong sense of adventure at
this point.  Although he might be counted upon not to ride into the street
deliberately, he may very well do so when distracted, or he may wander off
into unfamiliar territory and become disoriented.  There are just too many
accidents every year involving preschoolers riding or running suddenly in
front of unsuspecting motorists on suburban streets to make this sort of
activity worth the risk.  As an alternative, you might consider blocking off
the end of your driveway to create a reasonably large and safe area for your
preschooler to pedal around on his own.  If you do, just be sure you always
look carefully before you back out of the garage.


     My preschooler seems extremely fascinated by fire.  Is this unusual, and
can I do something about it?

     Unfortunately, fascination with fire is quite common among preschoolers.
It usually seems to be a love/hate relationship.  They generally are
irresistibly drawn to anything connected with flames, but as soon as things
get a little out of hand, they become terrified.  Therefore, no matter how
responsible your preschooler is becoming, take extra care to make sure that he
does not have access to matches, lighters, or any other such items.  If a
barbecue grill, fireplace, stove, or any other such piece of equipment is in
use, make sure that he is not left unsupervised in the area.  At this point,
you probably can teach your preschooler how to follow a family fire drill, but
realize that in case of emergency, you can't count on his memory and
rationality overcoming his terror.  Good prevention practices are still your
preschooler's best protection against fire.


     I've taught my preschooler to swim, and he's good at it.  Can I relax a
little when he's in the water now?

     You can relax a little, but that doesn't mean you can let your
preschooler swim unsupervised.  In fact, it is not a good idea for
anyone--including adults--to go swimming alone.  While your preschooler may
understand and remember a prohibition about going into the pool by himself,
his sense of adventure may get the better of him.  Therefore, it is still wise
to prevent him from having easy access to a swimming pool or any other body of
water that he can get to without your help.  Furthermore, to the extent that
your preschooler will be engaging in water activities, he should be introduced
to appropriate safety rules as well--such as checking for proper depth and
absence of obstructions before diving or jumping in.  Keep in mind, however,
that his natural exuberance at this point may lead to trouble no matter what
you teach him, so you can relax a bit--but don't fall asleep!


     There's a hill next to my home that is ideal for snow sledding.  Can I
let my preschooler go down himself, or should I still ride with him?

     It depends upon the precise size and location of the hill, as well as
upon the condition of the snow at the moment.  For example, if the hill is
long and steep so that a sled is able to pick up considerable speed, it's
probably best if you still ride with your preschooler.  Similarly, if the
bottom of the hill abuts a busy street or some other hazard, you probably
cannot count on your preschooler always being in sufficient control to stay
out of danger.  Even if the hill is softly sloping and is in a protected area,
you have to be careful about icy conditions.  A fun ride on fluffy snow can
turn into something else entirely when the sled hits a patch of slick ice.  By
the way, you might consider restricting any solo rides to a saucer-shaped or
toboggan-type sled rather than a standard sled with sharp-bladed runners at
this point.


     I'm scared to death every time my preschooler goes on a jungle gym or
other climbing apparatus.  Can I trust him to stay within his capacities?

     In general, preschoolers are pretty careful during their climbing
activities.  However, it is always possible that your preschoolers natural
enthusiasm or sense of adventure will get him into trouble.  Therefore, it is
a good idea to make sure that whatever piece of equipment your preschooler is
using is sturdy, well-designed, and appropriately placed.  For example, if the
location is a playground that has an asphalt surface rather than one of grass
or sand, the jungle gym should be low and wide so that your preschooler can't
get seriously hurt from a fall.  On the other hand, you also will have to
accept the fact that, to a certain extent, bumps, bruises, and scrapes will be
a part of your preschooler's experience.  It's okay to be concerned and
cautious, but keep in mind that your child will never learn to fly if you
don't give him a chance to really spread his wings now and then.


     When my preschooler plays with his peers, they sometimes get into fairly
serious fights.  Can they really hurt each other?

     Fights between preschoolers typically involve a lot more barking than
biting.  Your preschooler and his friends may do a lot of name-calling, wild
gesticulating, and even some pushing and shoving during a quarrel, but it is
rare that their anger will reach a level that moves them to cause serious
injury.  However, it is possible that someone could get hurt in a fight, so it
is wise to always have an adult reasonably nearby who can step in before a
disagreement escalates to the point where it becomes potentially dangerous.
You might also consider introducing your preschooler to certain rules about
playing with his peers in this regard.  For example, you can teach him that
wrestling is okay for fun, but fighting of any sort is not the way to handle
disputes.  You can also teach him that if he's got a real problem, he can ask
for adult intervention, but under no circumstances should he ever
intentionally seek to injure someone.


     I'm afraid of my child being snatched by a stranger, but I also don't
want him to fear everyone.  How do I handle this?

     It is probably a good idea to go easy on this subject at this point.
Given your preschooler's tendency to create very dramatic and often very
violent fantasies, talking to him about kidnapping and other such dangers is
likely to have a much more unpleasant impact than you may have anticipated or
desired.  Your preschooler's best protection for the time being still will be
your supervision.  You might consider giving him some general warnings as
well, but if you do, try to keep them positive.  For example, instead of
saying "Don't ever go into a car with a stranger," say something like "You can
only go in a car with us or Aunt Sally unless we first give you permission to
do otherwise."  At the end of this period or possibly a little beyond, your
preschooler may be ready to handle a discussion about how most adults are kind
and helpful but how some are not.


     I've heard that many children are sexually molested by people they know.
How can I protect my preschooler from this?

     As he proceeds through this period, your preschooler may become
increasingly able to handle a discussion about "good touches and bad touches."
You can talk to him about hugs and pats that he wants and enjoys, and those
that are uninvited and make him feel uncomfortable.  You can also teach him to
come to you and tell you immediately whenever someone has tried to do the
latter.  Keep in mind that it is imperative for your child to be very clear
about this subject and have total trust in you.  Many parents confuse their
preschoolers and lose their confidence when they force them to accept a kiss
from an unfamiliar aunt or to shake hands with an imposing acquaintance when
they really would much rather be hiding behind Mommy or Daddy's leg.  Unless
you are compassionate under these circumstances, there's a good chance that
whatever important instructions you try to impress upon your preschooler will
lose their effect through inconsistent application.


     I'd like my preschooler to attend day care, but I've read horror stories
about what happens in some places.  How can I protect my child?

     First of all, the number and nature of such day-care incidents tend to be
exaggerated a great deal by the media.  The overwhelming majority of centers
are safe places staffed by competent, caring people.  However, it is a good
idea to protect your child against the remote possibility of an unpleasant
incident.  The only way to do that effectively is to know very well who is
caring for your child and know exactly what your child does during the day.
You can start by checking references carefully, but in the long run, there is
no substitute for getting involved.  Volunteer to help out at the center as
often as you can so you can really get to know your child's teachers.  Drop by
unannounced on occasion.  Linger a little at drop-off and pick-up times.  And
most important of all, always get a detailed account of what happened to your
child during the day, both from his teacher and from him.  In addition to the
multitude of other benefits this practice provides, it will give you a chance
to establish a sense of routines against which to check gaps and
discrepancies.


     How can I teach my preschooler to protect himself in case he
inadvertently becomes separated from me?

     Especially toward the end of this period, you may have success in getting
your preschooler to memorize important information such as his last name, his
telephone number, his address, the first names of his parents, etc.  You'll
probably do better if you try to achieve this in a fun atmosphere by making it
into a game rather than by taking the chance of frightening him about the
subject.  You also can teach him to approach a policeman should he ever become
separated from you.  Many parents make the mistake of introducing their
preschoolers to the police as people "who will put you in jail if you do
something bad."  That makes it very hard for a preschooler to accept the
notion that he should approach one of these people voluntarily.  Since it is
unlikely that your preschooler will be committing any crimes during this
period, make sure his first explanation is that "police are people who can
help you when you're in trouble."


     Will I ever stop worrying about my child's safety?

     Of course not.  As a parent, it always will be your job to be intensely
concerned about your child's well-being.  And if you think you're worried now,
just wait until he gets his driver's license and starts going out on a dates
in a few years.  The important things to remember are, first, that growing and
learning require a certain amount of risk, and your task is not to eliminate
that risk entirely but rather to make it manageable and reasonable, and
second, the most effective way to take care of your child from this point on
is to start making sure he knows how to take care of himself.  You won't
always be able to be with him, but the things you teach him about safety will
be with him always.


     Can I now take my child's temperature orally?

     Most five year olds and many four year olds can hold a thermometer under
their tongue for the two minutes it takes to obtain an accurate reading.  Ask
him to hold the thermometer under his tongue and to close his lips around it
while you hold the thermometer.  It may be more comfortable for him if you use
a rounded-bulb thermometer rather than the type with the longer mercury-filled
tip.


     What is the "normal" oral temperature for a preschooler?

     A normal temperature for a child can be up to 100 degrees Fahrenheit.
(The arrow found on most thermometers at 98.6 degrees Fahrenheit does not
apply to children.)  In children (and often in adults) the normal variation in
temperature during a single day can be two or more degrees.  A child may
awaken with a temperature of 97 degrees Fahrenheit; by the end of the day,
however, it may be 99 degrees Fahrenheit or even a little higher.  The
temperature is usually highest between six and nine in the evening.  In
addition, it is not unusual for a child to run a "subnormal" temperature in
the healing phase of a viral infection such as the flu.  This temperature,
usually between 97 and 98 degrees Fahrenheit, often follows several days of
fevers over 100 degrees Fahrenheit during the acute phase of the illness.  As
long as your preschooler feels fine, no further treatment or precautions are
necessary.


     How can I keep my five year old from giving his three-year-old brother
every cold he gets?

     In most cases, you can't.  A child with a cold is often contagious for
one to two days before he has any symptoms.  Therefore, all family members are
likely to be exposed to that particular virus.  If your three year old has not
developed antibodies to that virus by previous exposure, he's going to get the
cold.  It is helpful, however, to make sure that a child with a cold washes
his hands frequently and carefully; that dishes, glasses, and utensils are not
shared, and that tissues used by the child with the cold are appropriately
discarded.  Aside from these simple measures, there is little one can do to
avoid spreading a cold within a family.


     My preschooler frequently gets tummy aches on mornings when I have to go
to work and he's scheduled to go to preschool.  How do I handle these?

     If a tummy ache comes on frequently on days when you are scheduled to
work, you need to find out why.  You should probably take him to the
pediatrician to rule out any physical reason for them.  Accompanying symptoms
that would be a cause for concern include fever, vomiting, diarrhea, and
urinary discomfort.  A tummy ache can be a symptom of many conditions and
diseases.  Among them are appendicitis, gastroenteritis ("stomach flu"),
urinary tract infections, dairy product intolerance, and ulcers.  It's also
important to find out whether or not your child is able to carry out the
normal daily activities that he really wants to do.  In other words, is he
feeling fine when it's too late for you to go to work or too late for him to
go to preschool?  Fifteen to twenty percent of school-age children will
develop a condition called "recurrent abdominal pain" at some point during
their school years.  It can occur over several months, but the child is
pain-free between the episodes.  Even if the cause is emotional, the pain can
be real.  The underlying cause is often stress and unresolved fear or anxiety.
The child exhibiting this pain needs to be screened to reassure him that he's
really okay, too.  Children often need help to identify and face situations
and experiences in order for them to grow emotionally and intellectually.  The
tummy aches may be a symptom of separation anxiety or a fear of a new
experience like preschool.  We need to help children adjust to preschool and
kindergarten.  They need to be discouraged from avoiding preschool due to
minor complaints or minor illnesses.  A child should be returned to his school
situation as soon as possible.  Allowing avoidance behavior to continue almost
always makes the situation worse.  Enlist the help of your child's teacher and
pediatrician to work things through so your child can comfortably adjust to
his changing environment.


     How can I tell if my child's injury is a sprain or a broken bone?

     Unless you have X-ray vision--or unless the bone is obviously
deformed--you can't.  If the bone appears to be deformed (not in its usual
position or not straight), medical consultation is necessary.  The amount of
pain your child is experiencing is also often a good indication.  If the pain
is severe enough to keep the child from resting or sleeping, it is a good idea
to have the injury examined by a physician.  If the child is fairly
comfortable, applying a cold pack will help control the swelling.  Immobilize
the affected area using a splint or sling or by having the child rest with the
affected part elevated.  Re-evaluate the injured part at frequent intervals as
the swelling goes down to help determine if medical attention is necessary.
In any case, if you are worried, consult a physician.


     What do I do if one of my child's teeth gets broken or knocked out?

     If a tooth is knocked out, find it, place it in some liquid (milk or the
child's own saliva is preferable), and contact the pedodontist (children's
dentist) immediately.  If the tooth or teeth are merely loose, observe them
for a few hours or a day or two.  If they remain loose, consult a pedodontist.
If a large piece of a tooth has been chipped off, if there is a red dot
visible inside a broken tooth, if your child is in extreme pain, or if you
can't stop the bleeding from an injury to the mouth, consult your pedodontist
immediately.  If you cannot reach your pedodontist, contact your pediatrician.


     How do children get scabies?  Are they caused by dirty surroundings?

     Scabies is a skin condition caused by a small insect (mite) that burrows
into the skin to lay eggs.  The rash is characterized by small, itchy, red
bumps and/or raised streaks.  The major symptom is itching.  Children get
scabies from direct contact with another person with the disease.  It spreads
most easily in areas where people are in close contact for extended periods.
It is not caused by dirty surroundings.  There are effective treatments once
the proper diagnosis is made.  These treatments are available by prescription
only, so if you suspect scabies, consult your pediatrician.


     My preschooler's best friend has ringworm.  Should I keep them from
playing together?

     Ringworm is a superficial infection of the skin; it can also affect the
hair and nails.  It was given its descriptive name because many of the skin
lesions look like "rings" (a round red area with clearing in the center).  It
is usually acquired from contact with an animal that has similar lesions or
areas of red skin where the hair has fallen out.  Ringworm is not considered
to be contagious from person to person so it is not necessary to isolate the
child, especially after treatment has been initiated.


     Is there a way to prevent pinworms?

     Pinworms are tiny organisms that look like wiggly white or tan thread;
they're about a quarter of an inch long.  Their life cycle is very simple.
The microscopic eggs get onto the hands or toys of a child, usually through
contact with an infected playmate.  The child puts his hands or the toys in
his mouth, and the pinworm eggs are swallowed and then mature in the child's
intestine.  The adult worms reside in the lower part of the large intestine.
The adult female crawls out and deposits eggs in the skin folds around the
anus, usually at night.  This causes intense itching.  When the child
scratches, the eggs get onto his fingers, and the cycle starts again.  Pinworm
infestation rarely causes symptoms other than rectal itching.  If your child
is complaining about rectal itching and you suspect pinworms, examine the anal
region two to three hours after his bedtime.  If you notice the worms, report
the condition to your pediatrician.  If you are unable to see the worms but
still suspect pinworms as the cause, your pediatrician can do a microscopic
examination of material from around the anus to reveal the worms or the eggs.
There are excellent medications to eliminate the infection, and your
pediatrician can prescribe the appropriate one.  The only way to avoid
reinfection with pinworms is to practice meticulous hand-washing techniques
and to keep an infected child away from other children until treatment is
complete.  While this infestation is a nuisance, it is not dangerous.


     My three year old usually goes two to three days without having a bowel
movement.  Is this normal?

     This pattern can be perfectly normal.  If there are no symptoms of
abdominal pain or straining during bowel movements and if the bowel movements
are not hard and dry, you should not be concerned.  Many perfectly healthy
children go days between bowel movements.  If your child is complaining of
abdominal pain or discomfort, if he is experiencing pain or discomfort with
the passing of the stool, or if the stools are hard and dry, consult your
pediatrician.  Try to do so before your child starts to voluntarily withhold
stools because of the discomfort; this can develop into a physical and
emotional problem for your child and for the family (see the following
question for more on this problem).


     My four year old has been toilet trained for more than a year, but lately
he has been constantly soiling his pants with stool.  Could this be a medical
problem?

     The most common cause of fecal soiling in children who are toilet trained
is "paradoxical" diarrhea.  It results when a child holds stool for days at a
time, and the stool becomes firm, dry, and large.  The origin of this
condition is usually a bowel movement that is accompanied by pain while it is
being passed.  The child, feeling that subsequent stools will also be painful,
holds back the stool and refuses to have a bowel movement.  The stool
accumulates at the end of the large intestine and becomes firm, dry, and even
more difficult to pass.  Liquid stool from above works its way around the
firm, dry stool and leaks out of the anus, resulting in fecal soiling of the
pants and paradoxical diarrhea.  This is a condition which requires medical
attention and supervision over a period of time to correct.  If you suspect
that your child has this condition, consult your pediatrician for advice and
treatment.


     How can I keep my child from getting poison ivy?

     Poison ivy, poison oak, and poison sumac are all in the family called
"rhus dermatitis."  In sensitive individuals, direct contact with the plants
causes a red, itchy, and sometimes weeping skin rash that lasts one to two
weeks.  Oral antihistamines and topical medications can be used to treat the
symptoms.  Sometimes systemic (oral or injectable) steroids are prescribed.
The rash is not contagious from person to person.  It occurs only in children
and adults who have had direct contact with the plant leaves or, occasionally,
with the smoke when the plants are burned.  One other source of contact is the
fur of pets who get the oil from the leaves onto their coats and then come in
contact with the child.  If you suspect that your child has been exposed to
poison oak, ivy, or sumac, remove his clothes and shoes, and wash everything
(including shoes and shoelaces) in warm, soapy water.  Give him a shower
immediately, and shampoo his hair.  To avoid further episodes, be sure that
you and your child know what the plants look like (see the illustrations on
the following page), and avoid contact whenever possible.  Also, have your
child wear clothing and footwear that cover his legs and feet when he is in
areas where such plants may be found.


     My preschooler had a severe reaction to a bee sting.  What can I do to
protect him in the future?

     Whenever the reaction to a sting is systemic--that is, it is more than a
local reaction at the site of the sting--immediate medical evaluation is
indicated.  If your child has already experienced one severe reaction, your
pediatrician (or a pediatric allergist) can test your child for sensitivity to
stinging insects (honeybee, wasp, yellow jacket, hornet, bumblebee, etc.) and
determine if hyposensitization is necessary.  If so, your child will be
started on a series of injections to gradually decrease the reaction if your
child should be stung again.  In the meantime, you should have a "bee sting
kit" with you at all times.  This kit should contain an antihistamine to be
given by mouth and a syringe with adrenaline (epinephrine) to inject in the
event of a reaction to another sting.  Specific instructions for the use of
such a kit will be provided by your pediatrician.  You can also decrease the
probability of future stings by avoiding areas where bees are likely to
congregate, such as clover fields, gardens, orchards in bloom, etc.  Be sure
your child's feet are always covered whenever he is outdoors.  Avoid perfumed
soaps and lotions, since they tend to attract these insects.  Keep in mind,
too, that insect repellents are often not effective against these stinging
insects.


     How and when can I tell if my child is hyperactive?

     Relative to older children, most preschoolers could be called
hyperactive.  Their behavior can be impulsive, their attention spans are
short, and they are generally always on the go.  As mentioned previously, this
normal behavior commonly leads parents to fear that their child is
"hyperactive."  The danger here is that a child will be labeled as
"hyperactive" because his parents have a low level of tolerance or patience,
rather than because the child has an abnormally high energy level.  So you
need to be patient and cautious.  By the time your child reaches school age,
these characteristics should be gradually decreasing in frequency and
severity.  If the impulsiveness and short attention span make it difficult for
the child to perform in school and/or if he can't seem to calm down even if he
wants to, you should consult your pediatrician.  She will help you determine
if what you are observing is normal development or if your child requires
further evaluation for the syndrome known as "attention deficit disorder with
hyperactivity" or ADHD.  Keep in mind that this syndrome is relatively rare.


     My three year old has knock knees and is pigeon toed.  Will he outgrow
this?

     Many children at this age do not have straight legs or feet; for the vast
majority of them, the apparent problems will correct themselves as the child
matures and develops.  During routine well-child examinations, the
pediatrician will examine your child's feet and legs.  If there is a
significant problem, your pediatrician will refer you and your child to a
specialist.


     My five year old will be starting kindergarten soon.  Does he need any
special shots or tests?

     Many school districts make a prekindergarten exam mandatory.  Even if
yours doesn't, it's wise to take him in for a medical checkup before he enters
school.  During the visit, his height, weight, and general health and
development will be checked and a complete physical examination and any
appropriate laboratory tests will be done.  The DTP booster and polio vaccines
will he given, and a test for tuberculosis may also be performed.


     How often should I have my child's vision tested?

     It is important to have your child's vision tested any time you suspect
there is a problem.  One way that you can help detect a possible problem is by
playing "vision games" with your child; compare your vision with that of your
child by identifying distant objects and asking your child to do the same.
You should also pay attention to whether your child's eyes appear aligned and
whether both eyes move together when the child is looking at something.
During routine medical checkups, the pediatrician will examine your child's
eyes as part of the total physical examination.  Testing of visual acuity can
be accurately done by age five in most pediatric offices.  The prekindergarten
checkup is also a good time for formal vision screening.  By the age of five,
a child's vision should be at least 20/30, with no more than a two-line
difference between what each eye can read on a standard eye chart.  If the
pediatrician suspects a problem during routine checks or formal screenings,
consultation with an ophthalmologist or pediatric ophthalmologist will be
advised.  If you suspect there is something wrong with your child's vision in
between checkups, however, you should contact your pediatrician.  After the
prekindergarten screening, your child's vision will be screened by your
pediatrician at each subsequent medical examination; often, it is also checked
at school.


ACCIDENTS AS TEACHING TOOLS

     Accidents will happen--sometimes you simply have no control over various
circumstances surrounding your preschooler's experience.  On the other hand,
you do have some control over how you react when accidents happen.  How you
react will have an effect on future incidents for better or for worse.  Of
course, when your preschooler is injured under any circumstances, your
immediate reaction probably will be quite emotional.  However, once you've
calmed down, it is important for you to remember that any accident can--and
should--be used in a positive, constructive manner to teach your preschooler
how to avoid getting into similar trouble again.  Take the time to talk to him
about what happened, how it happened, what his alternatives were, what to
watch out for next time, etc.  If appropriate, you may consider some form of
punishment as well, such as suspending a relevant privilege if the accident
occurred because of gross negligence or direct disobedience on his part.  But
be very careful not to make the accident worse than it already is by
overreacting and terrifying your preschooler further.  Keep in mind that a cat
who jumps on a hot stove once will never jump on a hot stove again--but it
also won't jump on a cold stove either.  In attempting to keep your
preschooler safe, you don't want to scare him into avoiding the world; rather,
you want to teach him how to deal with the world in a responsible way.