Common Winter Illnesses

Below are Dr. Caroline's responses to questions about Rotavirus, a common winter illness.

What is Rotavirus and how common is it?

Rotavirus is one of the most common causes of diarrhea in children ages 3 months to 2 years. It results in approximately 55,000 hospitalizations each year in the United States and the death of over 600,000 children worldwide. Fortunately, advances in our healthcare system keep the death rate very low in the United States.

What are the signs and symptoms of Rotavirus?

The rotavirus disease is characterized by fever and vomiting followed by watery diarrhea and cramping. In most cases, the illness begins 2 days after contracting the virus and lasts from 3 to 8 days. The diarrhea caused by this virus can be so severe that it becomes impossible to orally provide enough fluids to prevent dehydration. If you notice that your child has a decreased number of wet diapers, dry mouth, lethargy, sunken eyes and/or irritability, she may be dehydrated and it is time to call your physician.

How contagious is Rotavirus?

Rotavirus is very contagious. It is passed in the stool and can survive on surfaces, food and in water. If children do not wash their hands after using the bathroom and then touch a toy, the next child to touch the toy and put their fingers in their mouth can become infected. Parents and child care providers should wash their hands after each diaper change to prevent spread. Due to how easily this virus is passed, most children will have been infected by two years of age. If you’ve had the illness, your immunity is not complete and you can get it again, although it will most likely not be as severe.

How can I prevent Rotavirus?

Frequent hand washing is the best way to decrease transmission. Children with the infection should be kept out of daycare or other social settings until the stool can be easily contained within the diaper. Since it is so stable in the environment and can live on surfaces, complete prevention is impossible. The FDA has recently approved a new vaccine for rotavirus called RotaTeq which can be given in three doses at approximately 2, 4 and 6 months; it is currently not approved for older children.

How is Rotavirus treated?

Most children can be treated at home, but approximately 1 in 40 children will need to be hospitalized for intravenous fluids. Since it is a virus, antibiotics will not help.

While your child has diarrhea, the most important thing to keep in mind is fluid intake. Thus, it is fine to continue feeding your children breast milk or formula, as well as a bland diet that avoids fatty foods. Please note that some children may be more sensitive to dairy products, so be sure to discuss any such concerns you have with your pediatrician. If diarhea persists beyond 2 days and your child is not tolerating solids, Pedialyte will help to ensure he receives essential minerals in his diet. As mentioned above, be sure to consult your pediatrician if your child shows any signs of dehydration.

The Scoop on Fluoride

Below are Dr. Caroline's responses to some common dental questions. For more information, you may also wish to review our related parenting articles, listed below.

What is Fluoride?

• Fluoride is a naturally occurring ion which strengthens tooth enamel and prevents tooth decay when applied topically or ingested.
• It has been added to our water supply for the past 50 years and has been found to be safe and effective.
• Research has shown that fluoride reduces cavity formation by as much as 50% when given in proper quantities.

Do I need to give fluoride supplements to my children?

• The answer is usually no.
• The recommended fluoride level in drinking water, supported by the American Medical Association (AMA), Centers for Disease Control and Prevention (CDC), and American Dental Association (ADA), is 0.7 to1.2 mg/L.
• Denver water fluoride levels consistently average 0.84 to 0.91 mg/L.
• The American Association of Pediatrics (AAP) recommends fluoride supplementation only for those children aged 6 month to 16 years whose water supply does not contain adequate levels of fluoride.
• Although breast milk contains very little fluoride it is not recommended to supplement these infants due to the risk of flurosis on the developing teeth.
• Fluorosis, which is due to excess fluoride intake, causes the teeth to become discolored and makes the enamel looked spotted or stained.
• A couple things to keep in mind – ready-to-feed formulas do not contain fluoride and bottled water usually contains no fluoride.
• To sum it up, breast or bottle-fed babies less than 6 months do not need any supplementation. After 6 months, as long as babies are receiving some fluoride-treated water they should be receiving adequate quantities to promote dental health.
• Try to work up to several glasses a day - yet another reason why water is better than juice.

How do I prevent fluorosis in my child?

• Do not supplement babies less than 6 months old.
• Do not allow your children to swallow toothpaste.
• Do not use fluoride toothpaste for children less than 2 years old.
• Only use a pea-sized amount of fluoride toothpaste in younger children.

At what age should my baby first go to the dentist?

• The American Academy of Pediatric Dentistry recommends the first visit within 6 months of the first teeth erupting, or at one year of age.
• Many pediatricians will recommend a first visit during the second year.
• I would recommend calling your local pediatric dentist and asking when they prefer to have the first visit.

Related Parenting Articles

• Care of Your Baby's Gums and Teeth
• All About Teething