Yersiniosis

Yersiniosis is a relatively uncommon infection contracted through the consumption of undercooked meat products (especially pork), unpasteurized milk, or contaminated water. Usually, someone with an infection caused by Yersinia bacteria recovers within a few days without medical treatment (in some cases, doctors prescribe antibiotics).

About Yersiniosis

Of the three main types of yersiniosis that affect people, Yersinia enterocolitica (bacteria that thrive in cooler temperatures) are responsible for most infections in the United States. The infection seems to be more common in cooler climates. The bacteria can infect the digestive tracts of humans, cats, dogs, pigs, cattle, and goats. People can contract it by eating or handling contaminated foods (such as raw or undercooked meat) or by drinking untreated water or unpasteurized milk that contain the bacteria. An infant can be infected if a parent or caretaker handles contaminated food without cleaning up adequately before handling the baby's toys, bottles, or pacifiers.

Signs and Symptoms

Symptoms of yersiniosis appear 4-7 days after exposure and can last up to 3 weeks. They include fever, stomach pain, nausea, vomiting, and bloody diarrhea. Sometimes, older kids also get pain in the lower right side of the abdomen, which can mimic appendicitis. Some people also have a sore throat along with other symptoms. If your child has these symptoms, call your doctor. For infants, it's particularly important to call the doctor as soon as symptoms appear to prevent the infection from leading to other health problems.

In rare cases, the infection can cause a skin rash called erythema nodosum, or joint pain that appears a month after the initial symptoms. The rash usually occurs on the legs and trunk. The joint pain is usually in the larger joints and is thought to be due to an immune system response. These symptoms typically go away with time but can last several months. The diagnosis of Yersinia can be confirmed with a stool culture. If the Yersinia infection leads to an infection of the blood, known as bacteremia, it can be confirmed with a blood culture.

Treatment

Diarrhea caused by yersiniosis generally goes away on its own, though in some cases antibiotics are prescribed. In infants, however — particularly those who are 3 months old or younger — it can develop into bacteremia. Infants who contract yersiniosis are usually treated in a hospital. Depending on the severity of the diarrhea, your doctor may suggest modifying your child's diet for 1 or 2 days and encouraging your child to drink more fluids (which may include drinks with electrolytes to replace body fluids quickly). If your child has frequent bouts of diarrhea, watch for signs of dehydration, including:

• severe thirst
• dry mouth or tongue
• sunken eyes
• dry skin
• not urinating as often
• in infants, a dry diaper for several hours
• no tears when crying
• looking lethargic

Prevention

To reduce the risk of yersiniosis, take these precautions:

• Don't serve or eat raw or undercooked meat.
• Drink and serve only pasteurized milk and milk products.
• Wash hands with soap and water particularly before eating and preparing food; before touching infants or their toys, bottles, or pacifiers; and after contact with animals or handling raw meat.
• Use separate cutting boards for meat and other foods.
• Clean all cutting boards, countertops, and utensils with soap and hot water after preparing raw meat.
• Always cook meat thoroughly before you eat it, especially pork products.
• Dispose of animal feces and sanitize anything they have touched.
• Avoid drinking directly from natural water sources such as ponds and mountain streams, particularly if the water is near farmland where cattle, pigs, or goats are raised.
• As you care for a family member who has diarrhea, remember to wash your hands thoroughly before touching other people and before handling food.
• If your pet dog or cat has diarrhea, wash your hands frequently as you care for it, and check with your veterinarian about treatment and/or contagiousness.

When to Call the Doctor

Call your doctor if your child:

• has diarrhea streaked with blood
• is vomiting
• has abdominal pain
• has a fever

With some rest, kids with yersiniosis usually make a full recovery quickly.

Source: kidshealth 

 

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Typhoid Fever

Typhoid fever is a serious and sometimes life-threatening infection that mostly affects people in developing countries, where clean water and other sanitation measures are hard to come by. The disease usually causes symptoms that include a high fever, a stomachache, and achiness. It can be cured with antibiotics.

If you live in the U.S. the chances of someone in your family getting typhoid fever are slim. But if you're planning to travel to a foreign country, especially one in the tropics, it's a good idea to know about typhoid fever. Before you travel, get vaccinated against the disease and learn about safety precautions regarding food and water.

About Typhoid Fever

Typhoid fever is caused by bacteria called Salmonella Typhi (S. Typhi), which are related to the bacteria salmonella that cause food poisoning. S. Typhi typically live in humans and are shed through a person's feces (poop) or urine (pee). Once the bacteria get into the body, they quickly multiply and spread into the bloodstream. The body responds with a high fever and other symptoms, usually a week or two after exposure to the bacteria (but sometimes later). Symptoms can be mild to severe and usually disappear 2 to 5 days after antibiotic treatment begins.

Without treatment, typhoid fever may last a month or more and become very serious, even life-threatening. After recovering from typhoid fever, some people still can become carriers of the bacteria. This means that they'll have no symptoms, but do have the bacteria in their bodies and can pass it on to other people.

How People Get It

People usually get typhoid fever by drinking beverages or eating food that has been handled by someone who has typhoid fever or is a carrier of the illness. Those infected also can pass the disease onto others directly (for example, by touching them with unwashed hands). People also get the illness by drinking water that is contaminated by sewage that contains the S. Typhi bacteria. For these reasons, the disease is common in areas with poor sanitation and inadequate water treatment. It is also common in tropical and subtropical areas around the world, including Africa, Asia, and Latin America.

Signs & Symptoms

The symptoms of typhoid fever may range from mild to severe, depending on factors such as the age, health, and vaccination history of the infected person and the geographic location where the infection originated. Typhoid fever can come on suddenly or very gradually over a few weeks. Early signs and symptoms of the illness include:

• fever that can reach as high as 104°F (40°C)
• feeling achy, tired, or weak
• constipation
• diarrhea
• headache
• stomach pain and loss of appetite
• sore throat

When typhoid fever isn't untreated, symptoms become worse week by week. Besides a fever, someone may lose weight; develop a swollen or bloated belly; or develop or a red, spotted rash on the lower chest or upper belly. The rash usually clears up in 2 to 5 days. In most cases, the symptoms of typhoid fever start to go away in the third and fourth weeks, as long as the disease doesn't cause any other health problems. After the illness has appeared to go away, it can come back.

Complications

Serious health problems (complications) as a result of typhoid fever are rare in children. When kids do develop complications, they tend to be gastrointestinal problems, specifically an intestinal perforation (a hole in the intestines). This is life-threatening condition that requires immediate medical attention. Less common complications include problems with the lungs or heart, infections in the bones or joints, urinary tract infections, or mental health problems.

When to Call a Doctor

Call a doctor if you think your child has been exposed to typhoid fever or develops any symptoms of typhoid fever, even mild ones, especially after visiting an area where the infection is common. To make a diagnosis, the doctor will evaluate the symptoms and ask you about your child's medical history and recent travels. The doctor probably will take a sample of stool (poop), urine (pee), or blood to test it for the disease.

Treatment

Typhoid fever is treated with antibiotics that kill S. Typhi bacteria. If the doctor prescribes antibiotics, be sure your child completes the course of treatment. Do not end the treatment early even if your child begins to feel better. Most kids start feeling better within 2 to 3 days of beginning treatment. In addition to giving antibiotics, offer your child plenty of fluids to prevent dehydration. Kids who are severely dehydrated from a loss of fluids due to diarrhea might be given IV (intravenous) fluids in a hospital or other medical care facility. Acetaminophen can help reduce fever and make your child feel more comfortable. Call a doctor immediately if your child's symptoms persist, if symptoms go away and then reappear, or if your child develops any new symptoms.

Source: kidshealth

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Tapeworm

Tapeworms are flat worms that live in a person's digestive tract. Though upsetting to think about, they usually don't cause any serious problems. Tapeworm infections aren't common in the United States and, when they do happen, they're usually easy to treat.

Tapeworm Basics

Tapeworms are parasites. As you probably remember from biology class, parasites are organisms that live in, or on, other organisms (called "hosts"). Parasites take their nutrients from the host, sometimes depriving the host of nutrition.

Tapeworms get into the body when someone eats or drinks something that's infected with a worm or its eggs. Once inside the body, the tapeworm head attaches to the inner wall of the intestines. The tapeworm feeds off the food that the host is digesting. It uses this nutrition to grow. Tapeworms are made up of segments, and they get longer by growing new segments. Each segment can reproduce by making thousands of eggs. Since tapeworms can have more than a thousand segments, that's a lot of opportunity to spread. They can grow to more than 33 feet (10 meters) and live as long as 25 years.

New segments grow at the head of the tapeworm, pushing older segments to the end of the line, where they break off. These segments, along with the eggs they contain, pass out of the digestive tract in the host's feces (poop). If the infected feces aren't disposed of in a sanitary way — like down a flush toilet — they can get into the soil or water. Tapeworm segments can live for months in the environment, waiting for a host to come along. Animals like cows or pigs that eat grass or nose around in the soil can pick up tapeworm segments or eggs. When the tapeworm reaches the animal's intestine, the attach-and-grow cycle begins again.

Causes

Most of the time, people get tapeworm infections from eating food that's contaminated and not prepared properly:

• Tapeworms can spread when someone eats or drinks food or water that's contaminated with infected feces. This is one reason why tapeworm infections are rare in places that have good sanitation, like the United States. Flush toilets, sewer systems, and water treatment plants help keep feces out of the water and food supply.
• People can pass tapeworm eggs on to others when they don't wash their hands after using the bathroom. Tapeworm eggs in feces can easily spread into food or onto surfaces like doorknobs. If you ever need another reason to get your kids to wash their hands, this might do it!
• Kids can get tapeworms from eating meat or fish that hasn't been cooked enough to kill the tapeworm or its eggs.

Symptoms

Most kids who have a tapeworm infection don't feel anything. It can take months or years to notice any symptoms. Some of the things a child might complain of are:

• mild nausea
• diarrhea
• abdominal pain
• loss of appetite and weight loss

Kids with a tapeworm infection may feel a piece of the worm coming out through the anus. If your child has an infection, you may see a tapeworm segment in his or her feces. There are different types of tapeworms. One (fish tapeworm) can cause anemia because it absorbs vitamin B12, which helps make red blood cells. This can lead kids to feel tired, short of breath, or have other symptoms of anemia.

The eggs of another type of tapeworm (pork tapeworm) can hatch into larvae in the intestine. These larvae go through the intestinal wall and enter the bloodstream. From there they can travel to different parts of the body (such as muscles, eyes, or the brain), where they form cysts. This disease is known as cysticercosis. It is rare in the United States, but common in many developing countries. With cysticercosis, kids might develop:

• lumps under the skin
• seizures, if the cysts are in the brain
• vision problems, if the cysts are in the eyes
• an abnormal heartbeat, if cysts are in the heart
• weakness or trouble walking, if cysts are in the spine

Eating contaminated pork can lead to a tapeworm infection in the intestines, but it won't turn into cysticercosis. To develop cysticercosis, someone would have to swallow the eggs of the pork tapeworm, and these eggs aren't found in the meat itself. They are found in feces and around the anus.

Cysticercosis occurs as a result of eating food that has been contaminated with feces. It can be any kind of food — all it takes is for that food to come into contact with feces.

When to Call a Doctor

Call a doctor if you see worms in your child's feces or if he or she has abdominal pain or other symptoms that might suggest a tapeworm infection. You'll also want to call a doctor if your child shows signs of infection after traveling to a part of the world that doesn't have good sanitation. Call a doctor right away if your child has masses or lumps under the skin and develops a fever, headache, or any of the other symptoms of cysticercosis. If your child has seizures or trouble moving, walking, or talking, go to the emergency room right away.

Source: kidshealth

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Diarrhea

Most kids battle diarrhea from time to time, but the good news is that it's often caused by infections that don't last long and usually are more disruptive than dangerous. Still, it's important to know what to do to relieve and even prevent diarrhea.

Causes of Diarrhea

Diarrhea — frequent runny or watery bowel movements (poop) — is usually brought on by gastrointestinal (GI) infections caused by viruses, bacteria, or parasites. The specific germs that cause diarrhea can vary among geographic regions depending on their level of sanitation, economic development, and hygiene. For example, developing countries with poor sanitation or where human waste is used as fertilizer often have outbreaks of diarrhea when intestinal bacteria or parasites contaminate crops or drinking water.

In developed countries, including the United States, diarrhea outbreaks are more often linked to contaminated water supplies, person-to-person contact in places such as child-care centers, or "food poisoning" (when people get sick from improperly processed or preserved foods contaminated with bacteria). In general, infections that cause diarrhea are highly contagious. Most cases can be spread to others for as long as someone has diarrhea, and some infections can be contagious even longer.

Diarrheal infections can be spread through:

• dirty hands
• contaminated food or water
• some pets
• direct contact with fecal matter (i.e., from dirty diapers or the toilet)

Anything that the infectious germs come in contact with can become contaminated. This includes toys, changing tables, surfaces in restrooms, even the hands of someone preparing food. Kids can become infected by touching a contaminated surface, such as a toilet or toy, and then putting their fingers in their mouths.

A common cause of diarrhea is viral gastroenteritis (often called the "stomach flu," it also can cause nausea and vomiting). Many different viruses can cause viral gastroenteritis, which can pass through a household, school, or day-care center quickly because it's highly infectious. Although the symptoms usually last just a few days, affected kids (especially infants) who are unable to get adequate fluid intake can become dehydrated.

Rotavirus infection is a frequent cause of viral gastroenteritis in kids. Rotavirus usually causes explosive, watery diarrhea, although not all will show symptoms. Rotavirus has commonly caused outbreaks of diarrhea during the winter and early spring months, especially in child-care centers and children's hospitals, however, a vaccine now recommended for infants has been found to prevent approximately 75% of cases of rotavirus infection and 98% of the severe cases that require hospitalization. Another group of viruses that can cause diarrhea in children, especially during the summer months, are enteroviruses, particularly coxsackievirus.

Source: kidshealth

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Dengue Fever

Dengue fever is a tropical disease caused by a virus carried by mosquitoes. The virus can cause fever, headaches, rashes, and pain throughout the body. Most cases of dengue fever are mild and go away on their own after about a week.

Dengue fever rarely strikes in the United States (the last cases were reported in Texas in 2005), but if you plan to travel to a foreign country — especially one in the tropics — it's wise to guard against dengue fever. Wearing insect repellant, covering sleep areas with netting, and avoiding the outdoors at dusk and dawn (when mosquitoes are most active) can help lower the chances of infection.

About Dengue Fever

Dengue (DEN-gee) fever is caused by four similar viruses spread by mosquitoes of the genus Aedes, which are common in tropical and subtropical areas worldwide. When an Aedes mosquito bites a person who has been infected with a dengue virus, the mosquito can become a carrier of the virus. If this mosquito bites someone else, that person can be infected with dengue fever. The virus can't spread directly from person to person.

Many kids with dengue fever don't have symptoms; others have mild symptoms that appear anywhere from 4 days to 2 weeks after being bitten by an infected mosquito. Symptoms typically last for 2 to 7 days. Once kids have had the illness, they become immune to that particular type of the virus (although they can still be infected by any of the other three types). In rare cases, dengue fever can lead to more serious forms of the disease. These conditions, called dengue hemorrhagic fever and dengue shock syndrome, can cause shock and death and need immediate medical treatment.

Signs & Symptoms

In the past, dengue fever was known as "breakbone fever," which might give you an idea of the symptoms it can cause — that is, if a person ends up having any symptoms at all. The fever isn't actually breaking any bones, but it can sometimes feel like it is.

Common signs and symptoms of dengue fever include:

• high fever, possibly as high as 105°F (40°C)
• pain behind the eyes and in the joints, muscles, and/or bones
• severe headache
• rash over most of the body
• mild bleeding from the nose or gums
• bruising easily

Symptoms are generally mild in younger children and those who get infected with the disease for the first time. Older kids, adults, and those who have had a previous infection may experience moderate to severe symptoms. People with dengue hemorrhagic fever or dengue shock syndrome will have the regular symptoms of dengue fever for 2 to 7 days. After the fever subsides, other symptoms worsen and can cause more severe bleeding; gastrointestinal problems like nausea, vomiting, or severe abdominal pain; and respiratory problems like difficulty breathing. If left untreated, dehydration, heavy bleeding, and a rapid drop in blood pressure (shock) can occur. These symptoms are life threatening and require immediate medical attention.

Diagnosis

If your child has any symptoms of dengue fever, call a doctor right away. You should also contact a doctor if your child has recently been to a region that has dengue fever and develops a fever or severe headache. To make a diagnosis, the doctor will examine your child and evaluate the symptoms. The doctor will ask about your child's medical history and recent travels, and send a sample of your child's blood to be tested for the disease.

Treatment

No specific treatment is available for dengue fever. Mild cases can be treated by giving lots of fluids to prevent dehydration and getting plenty of rest. Pain relievers with acetaminophen can to treat the headaches and pain associated with dengue fever. Pain relievers with aspirin or ibuprofen should be avoided, as they can make bleeding more likely.

Most cases of dengue fever go away within a week or two and won't cause any lasting problems. If someone has severe symptoms of the disease, or if symptoms get worse in the first day or two after the fever goes away, seek immediate medical care. This could be an indication of dengue hemorrhagic fever or dengue shock syndrome, which needs immediate medical attention.

To treat severe cases of dengue fever at a hospital, doctors will deliver intravenous (IV) fluids and electrolytes (salts) to replace the fluids lost through vomiting or diarrhea. This is usually enough to effectively treat the disease, as long as fluid replacement therapy begins early. In more advanced cases, doctors may have to perform a transfusion to replace lost blood. In all cases of dengue infection, regardless of how serious symptoms are, efforts should be made to keep the infected person from being bitten by mosquitoes. This will help prevent the illness from spreading to others.

Source: kidshealth

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Cholera

Cholera is a serious and sometimes life-threatening infection that mainly affects people in developing countries, where clean water and other sanitation measures are hard to come by. If you live in the United States, the chances of someone in your family getting cholera are slim. But if you're planning to travel to a foreign country, especially one in the tropics, it's a good idea to know about cholera, and how to prevent it. Taking precautions with your food and water is the best way to avoid the illness.

About Cholera

Cholera is an intestinal infection caused the bacterium Vibrio cholerae. This bacterium produces a potent toxin that binds to the walls of the intestines. The body responds by secreting large amounts of water, causing watery diarrhea, vomiting, and subsequent dehydration as fluids and salts exit the body.

As a result, people with cholera can become dehydrated very quickly. Untreated severe dehydration can cause serious health problems like seizures and kidney failure. A person who doesn't get the proper medical treatment might even die. The good news is, cholera is easy to treat if it's caught early. Kids who have mild to moderate cases usually get better within a week. Even people with severe cases of cholera recover fully in a week or so if they get medical care.

Cholera is mostly found in hot, tropical climates — in particular Asia, Africa, Latin America, India, and the Middle East. Although it's rare in the United States (the last outbreak was in 1911), cases can still occur. Travelers from countries where cholera is more common can bring it into the country, and some people in the U.S. have become sick from eating raw or undercooked shellfish from the Gulf of Mexico.

How It Spreads

People get cholera from eating or drinking food or water that's been contaminated with the feces (poop) of someone who has cholera. This is one reason why cholera is rare in countries with good sanitation systems. Things like flush toilets, sewer systems, and water treatment facilities keep poop out of the water and food supply. Cholera epidemics also sometimes happen after a disaster (like an earthquake or flood) if people are living in tent cities or other places without running water or proper sanitation systems. Less commonly, the bacteria that cause cholera are found in brackish rivers and coastal waters. Cholera is not contagious, so you can't catch it from direct contact with another person.

Signs & Symptoms

When someone is infected with the cholera bacterium, symptoms can appear in a few hours or as late as 5 days later. Many kids with cholera have no signs or symptoms, but some cases can be severe and life threatening.

Common symptoms of cholera and the dehydration it causes include:

• watery, pale-colored diarrhea, often in large amounts
• nausea and vomiting
• cramps, particularly in the abdomen and legs
• irritability, lack of energy, or unusual sleepiness
• glassy or sunken eyes
• dry mouth and extreme thirst
• dry, shriveled skin
• low urine output and a lack of tears
• arrhythmia (irregular heartbeat) and low blood pressure

If your child develops symptoms like these, especially after visiting an area where cholera is likely or common, call your doctor or get medical help right away. Severe dehydration can happen very quickly, so it's essential to start replacing lost fluids right away to avoid damage to internal organs.

Diagnosis

To confirm a diagnosis of cholera, doctors may take a stool or vomit sample or a rectal swab to examine for signs of the bacteria. Rapid, dipstick-style tests are now available, which help health care providers in remote areas identify the disease more quickly and control outbreaks more effectively. All confirmed cases of cholera must be reported to local health officials.

Treatment

Since severe dehydration and death can occur within hours, cholera needs to be treated immediately. Most kids recover with no long-term problems as long as they receive prompt treatment. The goal of treatment is to replace all the fluids and salts lost through diarrhea and vomiting. For mild dehydration, a doctor may recommend giving your child an over-the-counter rehydration solution. Kids with more severe cases of cholera may need to stay in the hospital and get intravenous (IV) fluids.

Sometimes doctors prescribe antibiotics to treat cholera. The antibiotics are not as important as rehydration, but can help shorten the length of time someone is sick. They also might make cholera-related diarrhea less severe. Sometimes doctors also prescribe zinc supplements. Anti-diarrheal medicines can actually make the symptoms of cholera worse, so if your child has cholera (or you think your child has it), do not offer them.

Source: kidshealth

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Appendicitis

Appendicitis (inflammation of the appendix) requires immediate medical attention, so it's important to learn its symptoms — and how they differ from a run-of-the-mill stomachache — so you can seek medical care right away. The first symptoms of appendicitis usually are a mild fever and pain around the bellybutton. The pain usually worsens and moves to the lower right side of the belly. Vomiting, diarrhea or constipation, and loss of appetite are other common symptoms. Call your doctor immediately if you suspect that your child has appendicitis. The earlier it's caught, the easier it will be to treat.

About Appendicitis

The appendix is a small finger-like organ that's attached to the large intestine in the lower right side of the abdomen. The inside of the appendix forms a cul-de-sac that usually opens into the large intestine. Blockage can be due to hard rock-like stool (called a fecolith), inflammation of lymph nodes in the intestines, or even parasites. Once the appendix is blocked, it becomes inflamed and bacteria can overgrow in it. If the infected appendix isn't removed, it can burst and spread bacteria. The infection from a ruptured appendix is very serious — it can form an abscess (an infection of pus) or spread throughout the abdomen (this type of infection is called peritonitis). Appendicitis mostly affects kids and teens between 11 and 20 years old, and is rare in infants. It's one of the most common reasons for emergency abdominal surgery in kids. Appendicitis is not contagious.

Symptoms

Call the doctor immediately if your child shows symptoms of appendicitis, including:

• significant abdominal pain, especially around the bellybutton or in the lower right part of the abdomen (perhaps coming and going and then becoming consistent and sharp)
• low-grade fever
• loss of appetite
• nausea and vomiting
• diarrhea (especially small amounts, with mucus)
• swollen or bloated abdomen, especially in infants

There is no way to prevent appendicitis, but with sophisticated diagnostic tests and antibiotics, most cases are identified and treated without complications. If appendicitis goes untreated, the inflamed appendix can burst 24 to 72 hours after the symptoms begin. If the appendix has burst, the pain may spread across the whole abdomen, and the child's fever may be very high, reaching 104°F (40°C). The symptoms of appendicitis can vary according to a child's age. In kids 2 years old or younger, the most common symptoms are vomiting and a bloated or swollen abdomen, accompanied by pain. If you suspect that your child has appendicitis, call your doctor immediately and don't give your child any pain medication or anything to eat or drink unless instructed to by the doctor.

Source: kidshealth

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Birth Defect

Like most expectant parents, you probably alternate between fantasies about a healthy baby and worries that your baby will have a health problem. Or perhaps you've been told through prenatal screening that your baby might be born with a birth defect. Many parents assume that all birth defects are severe or even fatal, but the fact is that many are treatable, often immediately after birth — and sometimes even before the baby is born.

It's especially important to know the risk factors involved and how to prevent birth defects. However, it's also important to realize that most babies born with congenital defects are born to two healthy parents.

About Birth Defects

Birth defects are defined as abnormalities of structure, function, or body metabolism that are present at birth. Major birth defects are abnormalities that lead to developmental or physical disabilities or require medical or surgical treatment. There are more than 4,000 different known birth defects, ranging from minor to serious, and although many can be treated or cured, they're the leading cause of death in the first year of life.

According to the March of Dimes, about 150,000 babies are born with birth defects each year in the United States. The American College of Obstetricians and Gynecologists (ACOG) says that 3 out of every 100 babies born in the United States have some kind of major birth defect. Birth defects can be caused by genetic, environmental, or unknown factors. For most birth defects, the cause is believed to be an interaction of a number of genetic and environmental factors.

Structural or metabolic defects are those in which a specific body part is missing or formed incorrectly; metabolic birth defects are those in which there is an inborn problem in body chemistry. The most common type of major structural defects are heart defects, which affect 1 in 150 babies in the United States. Other common structural defects include spina bifida, cleft palate, clubfoot, and congenital dislocated hip.

Metabolic defects affect 1 in 3,500 babies and usually involve a missing or incorrectly formed enzyme (a protein necessary for processing chemical substances in the body). Most children with a metabolic birth defect do not have any visible abnormalities, but metabolic defects are usually harmful or can be even fatal. Metabolic defects include Tay-Sachs disease, a fatal disease that affects the central nervous system, and phenylketonuria (PKU), which affects the way the body processes protein.

Defects caused by congenital infections result when a mother gets an infection before or during the pregnancy. Infections that can cause birth defects include rubella (German measles), cytomegalovirus (CMV), syphilis, toxoplasmosis, Venezuelan equine encephalitis, parvovirus, and, rarely, chickenpox. None of these affect 100% of babies whose mothers are infected during pregnancy. If the mother is infected during early pregnancy, rubella carries the highest risk for birth defects (approximately 20%). Because of nearly universal immunization in the United States, rubella is very, very rare and the congenital rubella syndrome is almost never seen. CMV is probably the most common congenital infection and may be associated with intellectual disability (mental retardation) and hearing loss.

Other causes of birth defects include alcohol abuse by the mother. Although a few medications, such as medicines used for epilepsy, are associated with increased risks for certain birth defects, most commonly prescribed drugs are not associated with a significant risk of birth defects.

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Pediatric Care

You may remember, not too long ago, stepping into the pediatrician's office for your child's very first visit. And you might have been a little nervous as you got to know the person who'd be caring for your little one. But after years of interaction (complete with late-night phone calls, last-minute appointments, and trustworthy advice), your pediatrician probably feels like part of the family. So when the time comes for your child to transition into adult health care, it can be hard to say goodbye.

Done abruptly, this change can be overwhelming and anxiety-inducing for you and your child. But if you're both prepared and plan accordingly, it can be a smooth step on the path to adulthood.

Finding a New Doctor

Once kids become legal adults at age 18, they should visit an adult primary care physician (PCP), such as an internal medicine doctor (internist), a general practitioner, or a family medicine doctor. Your pediatrician, who is specifically trained to care for kids and teens, might be able to provide care for a little longer if your child is in college (usually until college graduation or age 21). But this varies from doctor to doctor, so be sure to ask.

Ask your pediatrician for a referral if you don't have a family doctor that your child wants to see or if your child has a chronic condition that will require an adult specialist's care. If your child has a rare condition, disability, or pediatric-onset condition (one that only develops in childhood), it may be challenging to find a PCP or adult specialist who is knowledgeable and comfortable caring for these complex needs. In this case, start searching for doctors early on, during the teen years.

Ask if your child can see a new doctor for a trial period; then, follow up with the pediatric specialist to discuss how things went and put both doctors in touch to plan for the transition of care. Allow plenty of time for this process — that way, if there is an issue your child can continue seeing the pediatric specialist until you find an adult provider who is a better fit.

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The Cardio

I've been meaning to write this email for a long time. Today I'm going to give you the story of how I solved the problem of getting an efficient and effective fat loss program finished in 45 minutes. Essentially, how I invented Turbulence Training.

And then I'll end with a sample TT workout for you...

But first, let's take a trip down memory lane to the winter of 98-99. I was but a lowly grad student, studying the effects of androstenedione (the supplement taken by the might Mark McGwire during his record-breaking home run quest in '98).

In my study (which was published in the Canadian Journal of Applied Physiology for any science nerds like myself out there), we had guys use the supplement and go through a couple of weight training sessions. By February of '99 I was stuck in the lab, analyzing the blood samples using some fancy radio-active isotopes.

And when I say stuck in the lab, I mean STUCK. I'd get there at 7am, and record my last data point at 11pm. Sixteen hours of mad science. And if I wasn't there, I was downstairs in the medical library, studying papers on testosterone and training.

Now coming from a very athletic background, this sedentary lifestyle didn't sit well with me. But there I was, studing for a degree in Exercise Physiology and left with no time for exercise. Or so I thought.

Fortunately, I actually had a 50 minute window once per day of "down-time" while the lab's gamma-counter analyzed blood samples.

That left me 50 minutes to get to the gym (5 minutes across campus) and get a workout in the remaining 40 or so minutes. I knew that if I applied my studies to the workout, I could get maximum results in minimum time.

As a former athlete, I knew that I had to find a way to stay fit and to avoid the fat gain that comes with working long hours in a sedentary environment. And I also had to stay true to the high-school bodybuilder I once was, so there was no way I was willing to sacrifice my muscle to one of those long-cardio, low protein fat-loss plans that were popular at the time.

Instead, I had to draw on my academic studies and my experiences working with athletes as the school's Strength & Conditioning Coach.

I knew that sprint intervals were associated with more fat loss than slow cardio, and I knew that you could also increase aerobic fitness by doing sprints (but you can't increase sprint performance by doing aerobic training).

So clearly, intervals were (and ARE!) superior to long slow cardio.

I had seen first hand the incredible results of sprint intervals in the summer and fall, as the athletes made huge fitness improvements and shed winter fat in a short time using my interval programs. I knew that intervals had to be the next step in the evolution of cardio.

The biggest benefit of intervals? A lot of results in a short amount of time. I knew that I only had 40 minutes to train, and therefore I could only spend 15-20 minutes doing intervals.

Now onto the strength training portion of the workouts. I knew that a high-volume bodybuilding program wasn't going to cut it - I just didn't have time. But in the past year I had read so many lifting studies, that I knew exactly what exercises I needed to do to maximize my lifting time in the gym.

Those exercises were standing, multi-muscle, movements such as squats, presses, rows, power cleans, and plenty of other standing single-leg exercises. I knew that those exercises would bring me far more results than those people sitting on machines would ever achieve.

And I also knew that I had to lift heavier than the average Joe or Jane Gym-goer lifts. I just knew that doing lighter weights and high-reps wasn't going to cut it. And a research study from 2001 later showed that I was right - when women did 8 reps per set, they had a significantly greater increase in post-workout metabolism than if they did 15 reps per set.

So I had my plan. Bust my tail over to the gym, through the cold, dreary Canadian winter afternoon, and do a quick but thorough warmup (specific to my lifts - none of that 5 minutes on the treadmill waste of time).

Once I got through the warm-up, I did as many sets as I could in the remainder of the 20 minutes for strength training.

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"White Foods" - Friend or Foe for a Lean-Body?

I'd like to start a little discussion today about carbohydrates... and in particular, "white foods" as well as potatoes. One reason I wanted to mention this is because so many health and fitness professionals trash talk potatoes about being a bad carbohydrate choice because of the high glycemic index. Some even say such ridiculous things as "avoid any and all white carbohydrates".

Ok, now while I certainly agree that white bread and refined white sugar are two of the worst things we can be feeding our bodies, I definately don't agree with avoiding any and all "white carbohydrates". Now I know all of the buzz lately has been about colorful foods and the protective antioxidants that they contain. They tell you to focus on colors and stay away from white.

It's true that colorful foods are great, but it is a big mistake to specifically avoid white foods! There are plenty of white foods that have specific nutrients that are hard to find elsewhere. Let's look at a few examples...

Onions & Garlic

What about onions and garlic? They are both white and they are chock full of protective phytonutrients, vitamins, and trace minerals that aren't easy to find elsewhere in a normal diet... such nutrients as allicin, quercetin (an important flavonoid), chromium, and other unique anti-inflammatory nutrients.

Cauliflower

Another example of something white that is great for you is cauliflower. Cauliflower is loaded with vitamin C, fiber, minerals, and special compounds such as glucosinolates and thiocyanates, which are specifically abundant in cruciferous vegetables such as broccoli, cauliflower, and cabbage. And a little-known fact is that some of the compounds in cruciferous vegetables help to combat other estrogenic compounds in our food supply and environment and can help prevent excess belly fat. So eat up on that cauliflower!

Mushrooms

Not many people realize this, but surprisingly, even white mushrooms have high levels of unique nutrients and antioxidants. White mushrooms are high in a couple types of antioxidants called polyphenols and ergothioneine.

Potatoes

Now that also leads us to another example - white potatoes (which by the way, can also be found in red, yellow, purple varieties, etc). Many health professionals claim that potatoes are a bad carbohydrate because they are thought to have a high glycemic index. First of all, if you've read Truth about Six Pack Abs book, then you understand that glycemic index is not necessarily the most important factor in choosing your carbohydrates.

While a generalization can be made that most low glycemic index carbohydrate choices will help you lose body fat easier than high glycemic index choices, it is not all that it's cracked up to be. There are many other factors that determine how your body will react-to and process the carbohydrates you ingest, such as glycemic load and also how you combine the high GI food with other foods.

For example, using glycemic load as an example... it is known that watermelon has a high glycemic index. However, the glycemic load of a normal serving of watermelon is just way too low for your body to start packing on body fat just because you ate a high glycemic index fruit. You would have to eat such an enormous quantity of watermelon just to get enough grams of carbohydrates to have any negative glycemic effect, that it is just non-sensical.

Not to mention that watermelon is also a great source of vitamins, minerals, and lycopene. There's just no reason to avoid it simply because it has a high GI. My point is... candy bars, cupcakes, and donuts make you fat... NOT watermelons, carrots or potatoes.

Also, as i mentioned, food combinations are important in how your body processes the carbohydrates and the associated blood sugar and insulin response you receive. For example, if you mix a high glycemic index carbohydrate with an extra source of fiber, healthy fats, or even certain proteins, many times the blood sugar and glycemic response will be slowed down considerably by the way you combined the food. Again, I talk in detail about this entire topic in my Truth about Six Pack Abs book

Alright, so back to my point that white potatoes are actually a healthy carbohydrate as long as you eat them in the right form... with the entire skin, and please don't ruin them by deep frying them into french fries either! French fries are one of the most evil things ever invented for your health, but only because we ruin them by soaking them in a scorching bath of trans fats in the deep fryer from the hydrogenated oils that are typically used.

Keep in mind that potatoes contain so many vitamins and minerals that the list is way too long to even try. Also, as long as you eat the skins, you get a decent shot of fiber too.

On the topic of potatoes not being so bad after all, I don't remember where I saw this referenced, but I recently saw a particular study that had participants eat something like 7-9 whole potatoes per day for several weeks.

At the conclusion of the study, the potato eaters had actually consistently lost weight! I'd venture a guess that the reason the people lost weight is that they were probably so full from eating all of those damn potatoes, that they actually consumed less calories than normal! An average sized potato only has about 100-120 calories, and I can surely imagine you'd be full constantly from eating 7-9 potatoes each day.

Now I would never recommend going to those extremes, but my point is that an occasional potato is not going to hurt your efforts to get lean, especially if you combine it with some other fibrous vegetables and maybe a healthy fat and some protein. On that note, I have one of my favorite recipes for you, using potatoes.

Geary's Lean-Body Potato Side Dish

• Desired quantity of baby potatoes (I like to use this mixture I found recently at a health food store... it is a mixture of white, red, yellow, and purple baby potatoes)
• 1 red pepper
• 1 green pepper
• 1 yellow pepper
• 1 or 2 onions
• a couple cloves of garlic, finely chopped
• 1 or 2 Tbsp extra virgin olive oil
• a little salt and pepper to taste (I like using a sea salt instead of normal commercial salt)

Cut the baby potatoes into slightly smaller pieces and place in a steamer until soft all the way through. Slice up the peppers and onions into strips and add with the chopped garlic into a pan with the olive oil. Cook the peppers, onions, and garlic until tender, and then add the steamed baby potatoes. Stir it all together and serve. This is a delicious and healthy side dish that goes great with chicken or red meat.

I hope you've enjoyed this little topic today about potatoes, healthy carbohydrates, glycemic index, and my killer potato recipe idea!

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5 Common Ab Myths

Ab exercises aren't the only thing you have to do in order to get your 6-pack. You also have to work hard on your diet as well, sticking to a fat-burning, muscle-building diet all year round.

Here's a list of 5 common myths about abs.

Myth 1) You don't need to watch what you eat

Diet is first and foremost the key factor when trying to get 6-pack abs. Plan your nutrition in advance, to avoid dietary downfalls.

Myth 2) As long as you do a lot of ab exercises and repetitions, it doesn't matter how well you do them

It is important to do all repetitions with good form. Focus on quality, not quantity. Avoid sit-ups and an excessive number of crunches. Both exercises can damage the lumbar spine in your low back, and crunches are rarely effective anyways.

Myth 3) You can "Spot reduce" the fat on your abs with crunches

No matter how many crunches you do, you won't be able to get rid of your ab fat with crunches alone. You need a good diet and an increase in your calorie burning from strength training and interval training.

Myth 4) Infomercial products will help you get a 6-pack

You've probably seen dozens of ab gadgets on TV, but none are magic bullets. You can't expect anything you order from TV to help you get a 6-pack. You have to do the hard work with nutrition and training to get results.

Myth 5) You must do abs every day

You don't need to do abs every day. Instead, train them twice per week and use non-conventional exercises such as Mountain Climbers and Stability Ball Jackknives to reduce the stress on your low back.

 

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To Getting A Six-Pack

  

Abdominals Are A Muscle, Too!

You want your arms to be bigger, your shoulders to be broader and your chest to be fuller, correct? And what is the solution to making these muscle groups increase in size? High intensity weight training, overload, consistency and a healthy surplus of calories. Starting to sound familiar?

The same goes for your abdominals. Your abdominals are a muscle group that requires the same formula and attention and are not any different. For some reason many consider abdominals to be a 'special' body part that requires a different set of rules and a completely different formula for training. Abdominals were not given a 'secret code' to crack. To get thick, dense abs - those ones that 'pop' out - you must train them with intensity and overload. Here are some practical tips you can apply to your program so that you can be the 'man' or 'gal' at your gym with a ripped and muscular six-pack!

Prioritize By Sequence

If your abs are your worse body part, then why do you keep training them last, at the end of your workout? Which muscles groups will receive the highest priority when you train? The ones done at the start of your workout or the ones done at the end of the workout? Of course, the ones done at the start of the workout while you have the most energy and focus. If abdominals are the muscle group you wish to prioritize, then don't be afraid to disagree with the 'experts' who say "Never train your abdominals first because you'll weaken your core muscles for the rest of your workout...". I completely disagree with this and often reply, "Show me the evidence." The typical response is "Nobody does abdominals first...". That is pure BS. This just supports the notion that many people who work out don't ever question what they hear or do. They want to be spoon fed answers and follow the trends of others without thinking for themselves. I ALWAYS train abdominals first in a workout if they need the highest attention.

Prioritize By Frequency

What's going to receive better results? A muscle group that is trained one time a week or two times a week (assuming you are recovered prior to the second workout commencing)? Of course, the muscle that is trained 2x a week. The more stimulus on a muscle, the more growth. That is why professional athletes are professional athletes. They have conditioned their bodies to such a high amount of stress that they are able to train more frequently. 

How often you train your abdominals is based on the inverse relationship of intensity and volume. The harder you train your abs, the more rest they need. The less intense you train your abs, the more frequently you can train them! If your goal is rehab or injury prevention, then you will be able to train them often with more frequent and lower loads. If your goal is to make your abs more muscular and dense, then a higher load and less frequency would be ideal. If your goal is maintenance, then a medium load and frequency would be ideal.

If building a sexy six-pack is on your 'to do' list for 2008, then start training abdominals 2-4x a week. I will teach you in a moment how to split your abdominals up into two different days based on movement.

Divide Your Abdominals Into Two Separate Workouts

To train your abdominals safely and effectively you must know the basic movement patterns of your abs and train them within all sub-categories:

• Truck Flexion (upper abs)
• Hip Flexion (lower abs)
• Rotation (obliques)
• Lateral Flexion (obliques)

The majority of books and articles you have read revolve the bulk of the ab exercises around trunk flexion that is better known as 'upper ab' exercises. A full sit up is a perfect example of this.

Bill Starr in his 1976 classic 'The Strongest Shall Survive' wrote that the abdominals "...can be strengthened in a wide variety of ways. Sit-ups of all types, leg raises, truck rotation movements all involve the abdominal muscles to a different degree..."

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Low Carb Diets

There is no denying the fact that obesity is a problem in this country. Take a look down any street, in any office, in classrooms at school and you will see just how big of an issue weight is. This is part of the reason as to why there are so many diets on the market. It seems that everyone that has ever lost weight thinks they should write and book and promote a product or certain eating strategy. Many of those diets boost eating high protein and low carbohydrates is the best way to loose weight and get healthy. Here are seven arguments as to why you should drop that high protein, low carb diet.

1. Many high protein, low carb diets increase your fat consumption and decrease the nutritionally packed foods that you body needs.

On a long term basis this form of eating will rob your body of essential minerals and vitamins that your body needs for proper functioning.

2. There is no documentation showing that high protein low carb diets deliver the promise of sustained weight loss. While they provide quick weight loss, they have not been shown to help people long term. It is important that you realize that most of the weight you loose initially is water weight, not fat, and the longer you are on the diet the more muscle you will loose.

3. High protein low carb diets are rich in animal products that have not only protein but a lot of saturated fat. Eating large amounts of these foods over time has been shown to increase your risk of several cancers, diabetes, stroke and coronary heart disease.

4. As Americans we already eat more protein then our bodies need. This is especially dangerous for people that have any kidney or lover problems. Eating even more protein may worsen their ailment.

5. High protein low carb diets cause muscle loss and fatigue. The body needs glycogen to fuel the body. These diets force the body fluids out as it eliminates your consumption of carbohydrates causing a loss in glycogen and muscle deterioration.

6. Progression of diabetes and diabetic renal disease is also caused by the high protein low carb diets. Your liver and kidneys have to work over time to rid the body of the excess nitrogen that is being produced due to the high amounts of proteins.

7. Weaker bones result form high protein low carb diets. Harvard did an 18 year long study of over 110,000 nurses who ate a high protein diet, those that consumed large amounts of animal protein were shown to have weaker bones then nurses that did not eat a high protein diet.

Loosing water weight, destroying your heart, liver and kidneys as well as weakening your bones should be reasons enough for you to not want to continue your high protein low carb diet. There are healthy alternatives that will not only work at the beginning but will help you loose weight and maintain your lower weight for the rest of your life.

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Seven Mistakes to Lose Fat

1. They fail to consider the consequences of their actions.

Alwyn Cosgrove (one of the top trainers in the business) once told me, "I get my clients to think, "Will this help me or not? Is this a positive step or not?" If you can see that every action that you take is either helping you lose fat or stopping you from losing fat, then you will start to make better choices. So remember that everything you put in your mouth is either for or against fat loss. And every exercise choice you make is either for or against fat loss. "Get that", Alwyn says, "and you're a hit."

2. They neglect to control their insulin and blood sugar levels - 2 key factors in determining whether or not the body fat will come off.

If you eat processed foods you are guaranteed to elevate your insulin & blood sugar levels. If you do that, your body sends the message, "Store fat!", and you won't make any progress. So avoid white-flour based bakery products, sugary drinks, and almost any carbohydrate snack that comes in a bag or a box.

3. They train like it's the 80's.

Yes, I know. Eighties music is popular again. But that doesn't mean ineffective training methods from the 80's like light weights, low intensity steady state cardio, and endless low-intensity ab work should also make a comeback. That type of training should stay buried in the back issues of cheesy muscle magazines. Stick to strength training and interval training for efficient and effective body changing routines.

4. They don't take 30 minutes to plan their next day's food intake.

If you fail to do this, you will set your fat loss efforts back by a minimum of 72 hours. Without a good meal plan, you are left to hunt and gather food in the modern world. And that's a recipe for fat loss disaster. You are bound to eat something processed if you aren't prepared. You will lose the fat burning benefits from yesterday's workout and it will take until the end of the following day to get back on track. An entire 72-hour period wasted.

5. They don't eat enough vegetables.

We can thank John Berardi for making it common knowledge that you should eat fibrous vegetables at every meal to assist your fat loss efforts. By doing so, you'll control your blood sugar and insulin - thus supporting the optimal hormonal situation for fat loss.

6. They screw up their hormones with poor lifestyle choices.

If you are out boozing and staying up late on the weekend, you are shutting down your fat loss and messing up the optimal hormonal environment for fat burning. I will talk a lot more about the optimal hormonal levels for fat loss, as I believe this is the underrated key to building your best body ever.

7. They don't plan and monitor their training sessions.

If you are still going to the gym without a plan, then you are going to have a hard time losing fat. And if you aren't recording your workouts and eating habits, then you aren't losing as much fat as you probably can. To fix this mistake, start by getting on track with strength training and interval training. It's guaranteed to get you lean. 

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Gain Muscle and Lose Fat

Are you ready for my famous "gain muscle or lose fat" chart?

I know this is going to make a few people mad, but it's the truth about whether a guy should lose fat or gain muscle. If he doesn't stick to my recommendations, he won't get the ripped abs and muscles he wants.

I often get scrawny guys asking me how to lose fat, when they have no muscle underneath the fat...they think they will look good if they "get ripped", but in reality, will look like they are starving. They should focus on gaining muscle instead.

This is a harsh lesson in reality, but too many guys are trying to lose weight when the focus should be on gaining muscle.

In fact, through my experience in working with athletes and dozens of men in the gym trying to lose fat and gain muscle, I've come up with a height-weight chart that determines whether or not you should lose weight.

Here's the chart identifying the cut-off weight for muscle building, and the rule below.

5'6" - 140 pounds
5'7" - 145 pounds
5'8" - 150 pounds
5'9" - 155 pounds
5'10 - 160 pounds

And so on. For every inch taller, add 5 pounds. For every inch shorter, subtract 5 pounds.

For example, if you are 5'8", 150 pounds, you should NOT be focusing on losing weight. You need to gain muscle if you want to look good on the beach and have muscle. Focusing on weight loss would be the worst thing you could do. If you do, you'll look like crap, and practically anorexic, to be blunt.

Instead, you must focus on gaining muscle. This will improve the appearance of your body, and take you from a stick-figure to a lean, muscular physique with a better chance of seeing your abs.

And don't worry, you're not going to look huge. At 5'8", a guy would have to be at least 180 in order to be considered "jacked" or "huge".

And the best news of all? Because skinny guys are untrained, simply starting a muscle building program will give them maximum fat loss and muscle gain at the same time. They are going to get the best of both worlds.

To use Turbulence Training to gain muscle and lose fat, simply stick to the weight training workouts only. Avoid the hard interval cardio for at least 4 weeks as you gain muscle, and eat extra calories right after your workout (as well as having a bigger breakfast than normal). These two changes will
allow you to gain muscle and lose fat.

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Food Allergies and Food Intolerance

Food allergies or food intolerances affect nearly everyone at some point. People often have an unpleasant reaction to something they ate and wonder if they have a food allergy. One out of three people either say that they have a food allergy or that they modify the family diet because a family member is suspected of having a food allergy. But only about 3% of children have clinically proven allergic reactions to foods. In adults, the prevalence of food allergy drops to about 1% of the total population.

This difference between the clinically proven prevalence of food allergy and the public perception of the problem is in part due to reactions called "food intolerances" rather than food allergies. A food allergy, or hypersensitivity, is an abnormal response to a food that is triggered by the immune system. The immune system is not responsible for the symptoms of a food intolerance, even though these symptoms can resemble those of a food allergy.

It is extremely important for people who have true food allergies to identify them and prevent allergic reactions to food because these reactions can cause devastating illness and, in some cases, be fatal.

How Food Allergies Work

Food allergies involve two features of the human immune response. One is the production of immunoglobulin E (IgE), a type of protein called an antibody that circulates through the blood. The other is the mast cell, a specific cell that occurs in all body tissues but is especially common in areas of the body that are typical sites of allergic reactions, including the nose and throat, lungs, skin, and gastrointestinal tract.

The ability of a given individual to form IgE against something as benign as food is an inherited predisposition. Generally, such people come from families in which allergies are common -- not necessarily food allergies but perhaps hay fever, asthma, or hives. Someone with two allergic parents is more likely to develop food allergies than someone with one allergic parent.

Before an allergic reaction can occur, a person who is predisposed to form IgE to foods first has to be exposed to the food. As this food is digested, it triggers certain cells to produce specific IgE in large amounts. The IgE is then released and attaches to the surface of mast cells. The next time the person eats that food, it interacts with specific IgE on the surface of the mast cells and triggers the cells to release chemicals such as histamine. Depending upon the tissue in which they are released, these chemicals will cause a person to have various food allergy symptoms. If the mast cells release chemicals in the ears, nose, and throat, a person may feel an itching in the mouth and may have trouble breathing or swallowing. If the affected mast cells are in the gastrointestinal tract, the person may have abdominal pain or diarrhea. The chemicals released by skin mast cells, in contrast, can prompt hives.

Food allergens (the food fragments responsible for an allergic reaction) are proteins within the food that usually are not broken down by the heat of cooking or by stomach acids or enzymes that digest food. As a result, they survive to cross the gastrointestinal lining, enter the bloodstream, and go to target organs, causing allergic reactions throughout the body.

The complex process of digestion affects the timing and the location of an allergic reaction. If people are allergic to a particular food, for example, they may first experience itching in the mouth as they start to eat the food. After the food is digested in the stomach, abdominal symptoms such as vomiting, diarrhea, or pain may start. When the food allergens enter and travel through the bloodstream, they can cause a drop in blood pressure. As the allergens reach the skin, they can induce hives or eczema, or when they reach the lungs, they may cause asthma. All of this takes place within a few minutes to an hour.

Which Food Allergies Are Most Common?

In adults, the most common foods allergies include: shellfish such as shrimp, crayfish, lobster, and crab; peanuts (a legume that is one of the chief foods to cause severe anaphylaxis, a sudden drop in blood pressure that can be fatal if not treated quickly); tree nuts such as walnuts; fish; and eggs.

In children, the food allergy pattern is somewhat different. The most common food allergens that cause problems in children are eggs, milk, and peanuts. Adults usually do not lose their allergies, but children can sometimes outgrow them. Children are more likely to outgrow allergies to milk or soy than allergies to peanuts, fish, or shrimp.

The foods that adults or children react to are those foods they eat often. In Japan, for example, rice allergy is more frequent. In Scandinavia, codfish allergy is more common.

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Infectious Diarrhea

Most kids battle diarrhea from time to time, but the good news is that it's often caused by infections that don't last long and usually are more disruptive than dangerous. Still, it's important to know what to do to relieve and even prevent diarrhea.

Causes of Diarrhea

Diarrhea — frequent runny or watery bowel movements (poop) — is usually brought on by gastrointestinal (GI) infections caused by viruses, bacteria, or parasites.

The specific germs that cause diarrhea can vary among geographic regions depending on their level of sanitation, economic development, and hygiene. For example, developing countries with poor sanitation or where human waste is used as fertilizer often have outbreaks of diarrhea when intestinal bacteria or parasites contaminate crops or drinking water.

In developed countries, including the United States, diarrhea outbreaks are more often linked to contaminated water supplies, person-to-person contact in places such as child-care centers, or "food poisoning" (when people get sick from improperly processed or preserved foods contaminated with bacteria).

In general, infections that cause diarrhea are highly contagious. Most cases can be spread to others for as long as someone has diarrhea, and some infections can be contagious even longer.

Diarrheal infections can be spread through:

• dirty hands
• contaminated food or water
• some pets
• direct contact with fecal matter (i.e., from dirty diapers or the toilet)

Anything that the infectious germs come in contact with can become contaminated. This includes toys, changing tables, surfaces in restrooms, even the hands of someone preparing food. Kids can become infected by touching a contaminated surface, such as a toilet or toy, and then putting their fingers in their mouths.

A common cause of diarrhea is viral gastroenteritis (often called the "stomach flu," it also can cause nausea and vomiting). Many different viruses can cause viral gastroenteritis, which can pass through a household, school, or day-care center quickly because it's highly infectious. Although the symptoms usually last just a few days, affected kids (especially infants) who are unable to get adequate fluid intake can become dehydrated.

Rotavirus infection is a frequent cause of viral gastroenteritis in kids. Rotavirus, which usually causes explosive, watery diarrhea, infects almost all children in the United States by the time they're 4 or 5 years old, although not all will show symptoms. Rotavirus commonly causes outbreaks of diarrhea during the winter and early spring months, especially in child-care centers and children's hospitals.

Another group of viruses that can cause diarrhea in children, especially during the summer months, are enteroviruses, particularly coxsackievirus.

Many different types of bacteria and parasites can cause GI and diarrhea. Here are a few that you may have heard about:

• E. coli bacteria: Most E. coli infections are spread through contaminated food or water, such as undercooked hamburgers or unwashed fruit that came into contact with animal manure. E. coli infections, which usually affect kids during their first few years of life, also can be spread via contaminated swimming water and petting zoos.
• Salmonella enteritidis bacteria: In the United States, these bacteria (found in contaminated raw or undercooked chicken and eggs) are a major cause of food poisoning, especially during summer.
• Campylobacter bacteria: Infants and young adults are most commonly affected by these infections, especially during the summer. The bacteria are often found in raw and undercooked chicken.
• Shigella bacteria: Shigella infection (called shigellosis) spreads easily in families, hospitals, and child-care centers. Kids 2 to 4 years old are the most likely to be infected.
• Giardia parasite: Infection with Giardia (called giardiasis) is easily spread through child-care settings and contaminated water supplies, especially water parks and pools (the bacteria are resistant to chlorine treatment), children's "touch tanks" in aquariums and museums, and contaminated streams or lakes.
• Cryptosporidium parasite: Found especially in drinking and recreational water, this parasite often is the culprit behind diarrhea epidemics in child-care centers and other public places. Cryptosporidiosis often causes watery diarrhea that can last for 2 weeks or more.

Diarrheal infections are a normal part of childhood for many kids, but diarrhea can be a symptom of a number of non-infectious diseases and conditions, especially when it lasts several weeks or longer. It can indicate food allergies, lactose intolerance, or diseases of the gastrointestinal tract, such as celiac disease and inflammatory bowel disease.

Signs and Symptoms

Symptoms typically start with crampy abdominal pain followed by diarrhea that usually lasts no more than a few days. Infections with many of the viruses, bacteria, and parasites that cause diarrhea also can bring on other symptoms, such as:

• fever
• loss of appetite
• nausea
• vomiting
• weight loss
• dehydration

In cases of viral gastroenteritis, kids often develop fever and vomiting first, followed by diarrhea.

Preventing Diarrhea

Although it's almost impossible to prevent kids from ever getting infections that cause diarrhea, here are some things to help lessen the likelihood:

• Make sure kids wash their hands well and often, especially after using the toilet and before eating. Hand washing is the most effective way to prevent diarrheal infections that are passed from person to person. Dirty hands carry infectious germs into the body when kids bite their nails, suck their thumbs, eat with their fingers, or put any part of their hands into their mouths.
• Keep bathroom surfaces clean to help prevent the spread of infectious germs.
• Wash fruits and vegetables thoroughly before eating, since food and water also can carry infectious germs.
• Wash kitchen counters and cooking utensils thoroughly after they've been in contact with raw meat, especially poultry.
• Refrigerate meats as soon as possible after bringing them home from the supermarket, and cook them until they're no longer pink. After meals, refrigerate all leftovers as soon as possible.
• Never drink from streams, springs, or lakes unless local health authorities have certified that the water is safe for drinking. In some developing countries, it may be safer to drink only bottled water and other drinks rather than water from a tap. Also, exercise caution when buying prepared foods from street vendors, especially if no local health agency oversees their operations.
• Don't wash pet cages or bowls in the same sink that you use to prepare family meals.
• Keep pets' feeding areas (especially those of reptiles) separate from family eating areas.

When to Call the Doctor

Call your doctor if your child has diarrhea and is younger than 6 months old or has:

• a severe or prolonged episode of diarrhea
• fever of 102°F or higher
• repeated vomiting, or refusal to drink fluids
• severe abdominal pain
• diarrhea that contains blood or mucus

Call the doctor immediately if your child seems to be dehydrated. Signs of dehydration include:

• dry or sticky mouth
• few or no tears when crying
• eyes that look sunken into the head
• soft spot (fontanelle) on top of the head that looks sunken
• lack of urine or wet diapers for 6 to 8 hours in an infant (or only a very small amount of dark yellow urine)
• lack of urine for 12 hours in an older child (or only a very small amount of dark yellow urine)
• dry, cool skin
• lethargy or irritability
• fatigue or dizziness in an older child

Caring for Your Child

Mild diarrhea is usually no cause for concern as long as your child is acting normally and drinking and eating enough. Mild diarrhea usually passes within a few days and kids recover completely with care at home, rest, and plenty of fluids.

A child with mild diarrhea who isn't dehydrated or vomiting can continue eating and drinking the usual foods and fluids, including breast milk or formula for infants and milk for kids over 1 year old. In fact, continuing a regular diet may even reduce the duration of the diarrhea episode, while also offering proper nutrition. Of course, you may want to give a child smaller portions of food until the diarrhea ends.

Antibiotics or antiviral medications are not prescribed for cases of diarrhea caused by bacteria and viruses because most kids recover on their own. But antibiotics are sometimes given to very young children or those with weak immune systems to prevent a bacterial infection (such as salmonellosis) from spreading through the body.

If the illness is caused by a parasite, it can be treated with antiparasitic medicines to cure or shorten the course of the illness. The doctor may order a stool test, in which a stool sample will be examined in the laboratory to see which specific germ is causing the diarrhea (bacteria, virus, or parasite).

Although you may be tempted to give your child an over-the-counter anti-diarrhea medication, don't do so unless your doctor gives the OK.

The primary concern when treating a diarrhea is the replacement of fluids and electrolytes (salts and minerals) lost from the body from diarrhea, vomiting, and fever. Depending on the amount of fluid loss and the severity of vomiting and diarrhea, your doctor will probably instruct you to:

• Continue your child's regular diet and give more liquids to replace those lost while the diarrhea continues if there are no signs of dehydration.
• Offer additional breastmilk or formula to infants.
• Use an oral rehydration solution (ORS) to replace lost fluids in non-dehydrated children.

Many of the "clear liquids" used by parents or recommended by doctors in the past are no longer considered appropriate for kids with diarrhea. Don't offer: plain water, soda, ginger ale, tea, fruit juice, gelatin desserts, chicken broth, or sports drinks. These don't have the right mix of sugar and salts and can even make diarrhea worse. Infants and small children should never be rehydrated with water alone because it doesn't contain adequate amounts of sodium, potassium, and other important minerals and nutrients.

Doctors often recommend that kids who show signs of mild dehydration be given oral rehydration solutions to replace body fluids quickly. These are available in most grocery stores and pharmacies without a prescription. Brand-name solutions often end in "lyte." Your doctor will tell you what kind to give, how much, and for how long. Never try to make your own ORS at home unless your doctor says it's OK and gives you a precise recipe.

In some cases, kids with severe diarrhea may need to receive IV fluids at the hospital for a few hours to help combat dehydration.

The best way to manage your child's diarrhea depends on how severe it is, what germ caused it, and your child's age, weight, and symptoms. So be sure to ask your doctor for recommendations about treatment.

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