Popular Myths about Parenting and Pediatrics

What You Need To Know

A Child with a Fever
A Child with a Fever. Photo (c) Melis Kameel

There are many popular myths that are spread to new parents by family members, friends and sometimes even their pediatrician. Many of these myths are just 'old wives tales,' and while they are generally not harmful, they can be confusing to a new parent who is trying to learn to do the right thing for their children.

Myth 1: A green or yellow runny nose means that your child has a sinus infection and needs antibiotics.

This is usually not true.

A sinus infection is commonly defined as having a green or yellow runny nose that lasts for more than 10-14 days without improvement. Many other infections caused by viruses can also cause a green runny nose, but unlike a sinus infection, these infections will not respond to an antibiotic.

I think most parents understand the difference between an infection caused by a virus and an infection caused by a bacteria, and that only bacterial infections respond to antibiotics. But many believe the myth that a green runny nose means a sinus infection, which can lead to your child taking antibiotics unnecessarily. So remember that while a green or yellow runny nose does mean that your child has an infection, unless it has been lasting for more than 10-14 days, then it is probably just a cold that will get better on its own. And it is not because your child will likely get better on his own that antibiotics aren't used for viral infections, instead it is because they just don't work on these types of infections.

Myth 2: A fever is bad for you.

Fever by itself is not harmful or dangerous, and is unlikely to cause brain damage or other problems. Even febrile seizures (a seizure triggered by a fever) aren't usually dangerous. Fever is not a disease. Instead, it is a symptom that can accompany many childhood illnesses, especially infections.

In general, you should call your pediatrician if your infant under three months of age has a rectal temperature above 100.4 F, if your infant aged 3-6 months has a temperature above 101 F, or if an infant above 6 months has a temperature above 103 F.

For most older children, it is not so much the number, but rather how your child is acting that is concerning. If your older child is alert, active and playful, is not having difficulty breathing, and is eating and sleeping well, or if the temperature comes down quickly with home treatments (and he is feeling well), then you don't necessarily need to call your doctor immediately.

That is why the old adage of "feed a cold, starve a fever" doesn't work. If your child has a fever and is hungry, let him eat.

However, it is important to keep in mind that a fever is not the only sign of a serious illness. While some children are fine with a temperature of 104, others can be deathly ill with a temperature of 101 or even without a fever or a low temperature.

Whether or not your child has a fever, if he is very irritable, confused, lethargic (doesn't easily wake up), has difficulty breathing, has a rapid and weak pulse, is refusing to eat or drink, is still ill-appearing even after the fever is brought down, has a severe headache or other specific complaint (burning with urination, if he is limping, etc.), or if he has a fever and it is persistent for more than 24 to 48 hours, then you should call your pediatrician or seek medical attention immediately.

Myth 3: A fever is good for you.

While a fever is a sign that your body is fighting an infection, lowering the fever will not make it take longer to get over the infection. You do not necessarily need to treat your child's fever, but in most cases, fever can be treated as a comfort measure. Treating a fever, especially if it is caused by an infection, will not help your child to get better any faster either, but it may help make it feel better. If your child has a fever, especially if it is low grade, but does not feel bad, then you don't really need to give him a fever reducer.

Treatment of a fever can include using an age-appropriate dose of an over-the-counter fever reducer, including products that contain acetaminophen (Tylenol) or ibuprofen (Motrin or Advil). If you child has an infection, using a fever reducer will not help your child to get better any faster, but they will probably make him feel better. You should also give your child a lot of fluids when he has a fever, so that he does not get dehydrated. Keep in mind that treatment of a fever is usually to help your child feel better, so if he has a fever, but doesn't feel bad, especially if the fever is low grade, then you do not need to treat the fever.

Is it safe to alternate acetaminophen and ibuprofen? If you are using the correct dosage of each medicine at the correct times, then it is probably safe, although there is no research to prove that it helps. The problem is that it is easy to get confused and give an extra dose of one or the other medicines. If you are alternating fever reducers, then write down a schedule with the times that you are giving the medicines so that the correct medicine is always given at the correct time.

Myth 4: Teething causes ...

fever, diarrhea, vomiting or diaper rashes. Not true. Teething may cause some fussiness and nightwakenings in some children, but if your child has other symptoms, especially a high fever, then you should look for another cause, such as a viral infection, which are very common during the time that children's teeth are coming in. Your child's first teeth will begin coming in between three and sixteen months (usually around six months).

The two bottom front teeth will be the first to come in and this will be followed by the four upper teeth in four to eight weeks. Your child will continue to get new teeth until he has all twenty of his primary teeth when he is three years old, with most children getting about four new teeth every four months.

In most children teething only causes increased drooling and a desire to chew on hard things, but in some it does cause mild pain and irritability and the gums may become swollen and tender. To help this you can vigorously massage the area for a few minutes or let him chew on a smooth, hard teething ring. Although most children do not need teething gels or treatment with acetaminophen or ibuprofen for pain, you can use them if necessary.

Myth 5: You must boil your water before preparing your infant's bottle of formula.

This one is actually controversial. Boiling the water when preparing infant formula was universally recommended and was then thought to be unnessesary.

In 1993, an outbreak of cyclosporiasis from contaminated water in Milwaukee prompted officials to again recommend that water be boiled when preparing infant formula.

If you live in a city with sanitized water and you are preparing bottles one at a time, then boiling water or sterilizing the bottles and nipples probably isn't necessary.

You can use this water out of the tap and bottles can be washed in hot soapy water or in the dishwasher. If you are not convinced that your water supply is safe or if you are using well water, then you should boil the water for five minutes before preparing formula.

Myth 6: Giving your infant cereal will help him to sleep through the night.

This is one of the most common myths that just isn't true. When your child begins to sleep through the night has more to do with his development and having a good bedtime routine where he learns to fall asleep on his own, and not on how hungry or full he is. And remember that many children do not begin to sleep though the night until they are about 3-4 months old.

Breast milk or infant formula supplies all of your baby's nutritional needs for at least the first 4 to 6 months of life, so don't be in a rush to start solid baby foods. Starting solids too early can cause your baby to develop food allergies. Your baby's intestinal tract is not as fully developed during the first few months and introducing solids at this time can be too much to handle.

Another reason for not giving solid foods earlier than 4 to 6 months is unintentional overfeeding, since younger babies can not offer you signals when they are full, such as turning away or showing disinterest. A third reason for holding off on solids is your baby's inability to swallow solids correctly before 4 to 6 months of age and this can potentially cause choking.

Myth 7: Colic is caused by -

It is not known what causes colic, but it is not usually thought to be from abdominal pain, formula allergies, the iron in infant formula or gas. It is known that normal babies have a fussy period toward the end of the day that begins when they are two to three weeks old and that this may be their way of 'blowing off steam' or dealing with the normal stimulus of their day. It may be that babies with colic are more sensitive to this normal everyday stimulation. It is also known that babies with colic do not have more difficult temperaments and are not more hypersensitive as they grow older.

Colic is a common problem, affecting 10-25% of all newborns. It is defined as recurrent inconsolable crying in a healthy and well-fed infant. It usually begins at about two to three weeks of age, is at its worst at six weeks of age and then gradually improves and finally resolves on its own by three to four months. The most common symptoms of colic are the sudden onset of screaming and crying that can last for more than two to three hours at a time. Babies with colic will often seem as if they are in pain and are difficult to console. While crying they will usually pass a lot of gas, draw up their legs and their abdomen may seem hard or distended. Most babies with colic have one or two episodes of this type of crying each day. In between these episodes they usually act fine.

Unless your baby has reflux or a formula allergy, there are no medicines to make colic go away. Some tips to help deal with colic until it clears up on its own include reassuring yourself and other family members that this is a benign problem that always clears up on its own without any long term effects. Some things that you may try to comfort your baby include swaddling, cuddling, rhythmic rocking, going for a walk or ride, warm baths, singing, rhythmic sounds, massages, or using a pacifier, windup swing or vibrating chair.

None of these measures work for all children, but you can try one or two at a time until you find what works for your baby.

If nothing works, it is okay to just put your baby down and let him cry for short periods. Always remember that it wasn't anything that you did or didn't do that caused your baby to have colic and as a last resort try to take a break by having a family member or friend help care for your baby.

Myth 8: Your child needs a daily multi-vitamin.

It is estimated that a daily multivitamin is given to 25-50% of children in the United States, although this is generally not necessary for most children with an average diet, even if your child is a picky eater. Some children that have a poor or restricted diet, liver disease or other chronic medical problems, especially those that lead to fat malabsorption, such as cystic fibrosis, may need vitamin and mineral supplements to prevent deficiencies.

Preterm infants and children who are exclusively breastfed, with either very dark skin or limited exposure to sunlight, may also need vitamin supplements. Also, children may need fluoride supplements if they do not drink fluoridated water.

Although you may give your child an age appropriate multivitamin if you or your Pediatrician feels that your child needs one, it is probably better to try and reach his daily requirements or recommended daily allowance by providing him with a well balanced diet.

Consuming a diet with the minimum number of servings suggested by the Food Guide Pyramid will provide your child with the recommended daily allowance of most vitamins and minerals.

Myth 9: A mobile infant walker will help your child learn to walk faster.

In general, you should not use a mobile baby walker, as it will not help your child learn to walk faster and they can be dangerous if they make your child too mobile. Stationary walkers are much safer. If you do use a mobile walker, make sure the area is child proofed and away from stairs, and that your child is supervised at all times.

Myth 10: You should/shouldn't let your children sleep in your bed.

There are no definite right or wrong ways to put your child to sleep and if you and your baby are happy with your current routine then you should stick to it. However, it is not good if it is a struggle to put your child to bed, if he gets overly frustrated in the process, strongly resists being put to bed or if he is waking up so much that he or other family members end up not getting adequate sleep.

Myth 11: You shouldn't give milk or other dairy products to your child when he is sick because it will increase mucus production or make it thicker.

In general this isn't true, unless your child has a milk allergy. When your child is sick, you can let him eat his usual diet as tolerated. If your child does not want to eat then you can try the typical BRAT diet (bananas, rice, applesauce and toast) with lots of fluids and then advance his diet as he will tolerate it.

Myth 12: You can tell if a child has strep throat just by looking at him.

This is a common myth that is propagated by doctors, but it isn't true. While most parents are worried about strep throat when their child has a throat infection (tonsillitis), there are also many viruses that cause infections that look very similar to strep. If your child has a sore throat with fever and a red, swollen throat or tonsils with white pus on them, then he should be seen by his physician so that he can be tested for strep throat. If the tests for strep are negative, then your child's throat infection is caused by a virus and antibiotics will not work. Viral infections of the throat usually improve in two to three days without treatment.

Most studies have shown that doctors and other health professionals are only correct about half the time when they think a child has strep after just a physical exam. So if your child was treated every time it looked like he had strep, then he might be overtreated or mistreated with antibiotics half the time.

Myth 13: You should begin potty training when your child is _______ months old.

Although most children show signs of readiness to begin potty training between 18 months and 3 years of age, there is no set time at which you should begin. When to start potty training has more to do with your child's developmental and physical readiness, and the time when this occurs varies in different children. Signs that your child is ready to begin potty training include staying dry for at least 2 hours at a time, having regular bowel movements, being able to follow simple instructions, being uncomfortable with dirty diapers and wanting them to be changed, asking to use the potty chair or toilet, and asking to wear regular underwear.

You should also be able to tell when your child is about to urinate or have a bowel movement by his facial expressions, posture or by what he says. If your child has begun to tell you about having a dirty diaper you should praise him for telling you and encourage him to tell you in advance next time.

Myth 14: Punishment and discipline are the same thing.

Discipline is not the same as punishment. Instead, discipline has to do more with teaching, and involves teaching your child right from wrong, how to respect the rights of others, which behaviors are acceptable and which are not, with a goal of helping to develop a child who feels secure and loved, is self-confident, self-disciplined and knows how to control his impulses, and who does not get overly frustrated with the normal stresses of everyday life.

You should understand that how you behave when disciplining your child will help to determine how your child is going to behave or misbehave in the future.

If you give in after your child repeatedly argues, becomes violent or has a temper tantrum, then he will learn to repeat this behavior because he knows you may eventually give in (even if it is only once in a while that you do give in). If you are firm and consistent then he will learn that it doesn't pay to fight doing what he is eventually going to have to do anyway.

Some children, however, will feel like they won if they put off doing something that they didn't want to do for even a few minutes.

Be consistent in your methods of discipline and how you punish your child. This applies to all caregivers. It is normal for children to test their limits, and if you are inconsistent in what these limits are, then you will be encouraging more misbehavior.

Myth 15: If your child is doing badly in school and he has a short attention span and is easily distractable, then he has Attention Deficit Hyperactivity Disorder.

There are many reasons for teens to underperform at school, including a lack of motivation to do well, problems at home or with peers, poor work habits or study skills, emotional and behavior problems, learning disabilities (such as dyslexia), attention deficit hyperactivity disorder, mental retardation or below average intelligence and other medical problems, including anxiety and depression. It is important to find the reason for your child's poor performance, especially if she is failing, and come up with a treatment plan so that she can perform up to her full potential and to prevent the development of problems with low self-esteem, behavior problems and depression.

It is sometimes difficult to figure out if a child's problems at school are caused by their other medical problems, such as depression, or if these other problems began because of their poor school performance. Children who do poorly at school may be under a lot of stress, and will develop different ways to cope with this stress. Some may externalize their feelings, which can lead to acting out and behavior problems or becoming the class clown. Other children will internalize their feelings, and will develop almost daily complaints of headaches or stomachaches. A thorough evaluation by an experienced professional is usually needed to correctly diagnose children with complex problems. When you realize your child has a problem at school, you should schedule a meeting with her teacher to discuss the problem. Other resources that may be helpful including talking with the school psychologist or counselor or your pediatrician.

Myth 16: Children and adolescents don't get depressed, and if they do, then they don't need treatment.

Depression in children has long been an overlooked health problem.

Depression in children can, if untreated, affect school performance and learning, social interactions and development of normal peer relationships, self-esteem and life skill acquisition, parent-child relations and a child's sense of bonding and trust, can lead to substance abuse, disruptive behaviors, violence and aggression, legal troubles, and even suicide.

According to the American Academy of Pediatrics, suicide is the 3rd leading cause of death among children and adolescents, just behind accidents and violence. Moreover, depressive thinking can become part of a child's developing personality, leaving long-term effects in place for the rest of a child's life.

The most common symptoms of depression reported in children and adolescents were sadness, inability to feel pleasure, irritability, fatigue, insomnia, lack of self-esteem, and social withdrawal. Children are as well somewhat more likely than adolescents to suffer from physical symptoms (e.g., stomach aches and headaches), hallucinations, agitation, and extreme fears. On the other hand, adolescents showed more despairing thoughts, weight changes, and excessive daytime sleepiness.

Myth 17: You should force your picky eater to finish his dinner.

Not true. Forcing your child to eat when he isn't hungry is a good way to encourage feeding problems in the future.

The best way to prevent feeding problems is to teach your children to feed himself as early as possible, provide them with healthy choices and allow experimentation. Mealtimes should be enjoyable and pleasant and not a source of struggle.

Common mistakes are allowing your children to drink too much milk or juice so that they aren't hungry for solids, forcing your children to eat when they aren't hungry, or forcing them to eat foods that they don't want.

While you should provide three well-balanced meals each day, it is important to keep in mind that most children will only eat one or two full meals each day. If you child has had a good breakfast and lunch, then it is okay that he doesn't want to eat much at dinner. Although your child will probably be hesitant to try new foods, you should still offer small amounts of them once or twice a week (one tablespoon of green beans, for example). Most children will try a new food after being offered it 10-15 times.

Myth 18: Physical punishment is an effective discipline technique.

You should avoid physical punishment. Spanking has never been shown to be more effective than other forms of discipline and it will likely make your child more aggressive and angry and teach him that is sometimes acceptable to hit others.

Myth 19: You should just observe your child with speech or motor delays because he will probably eventually grow out of it.

If you think that your child is not meeting his normal speech or language developmental milestones, if he is at high risk of developing a hearing problem, or has school performance problems, then it is very important that his hearing be formally tested by a professional.

Again, it is not enough that they think that your child hears because he responds to a loud clap or bell in the doctor's office or because he comes when you call him from another room.

Parents are usually the first ones to think that there is a problem with their child's speech development and/or hearing, and this parental concern should be enough to initiate further evaluation. In addition to a formal hearing test and developmental assessment by their pediatrician, children with speech and language delays should be referred to an early childhood intervention program (for children under 3) or the local school district (for children over 3), so that an evaluation and treatments can be initiated by a psychologist (if indicated) and/or a speech therapist/pathologist.

Early diagnosis is also important if your child has motor delays, so that treatment can be started, and your doctor will probably refer you to an Early Childhood Intervention program if your child is not meeting age appropriate gross motor milestones, such as sitting up or walking.

Myth 20: You should always or your should never __________ .

There are very few things that you should always or you should never do when taking care of your child. In general, you should trust your instincts, and if what you are doing is working well, then you can usually stick to it. If your methods or techniques aren't working, then try something else or get some help.

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