My Blog

Posts for: June, 2012

By Springfield Pediatrics
June 24, 2012

 

A family I took care of recently at the hospital, wondered why I suddenly had so many questions to ask about their pet Iguana "Izzy". Far from having an axe to grind with just Iguanas or anger directed at "Izzy", we've know for sometime that all members of the reptile and amphibian family that have become domesticated and favorites for family pets can be fun for the family, but they can just as easily harbor a bacteria that could make young children very sick. Turtles, frogs, snakes, geckos, horned toads, salamanders, and chameleons are other common examples of this family of animals.

The control of salmonella and similar germs transmitted from contaminated water and food remain one of the great triumphs of public health measures. Most people some of whom own these pets actually still think of only water and food-borne sources of transmission as being possible for salmonella as a result. This is incorrect since amphibian and reptilian pets still leave the door open for salmonella to cross from these animals to unsuspecting humans, their contacts and potentially cause very serious problems in children and adults. Reptiles and amphibians very frequently harbor these germs.

The CDC cautions families with children aged less than 5-years to especially avoid these families of animals for pets. Smaller sized pet Turtles were banned for sale in 1975 in the USA because little children were more likely to put the small animals in their mouth and increase likelihood of transmission through the gut. Children in this age group have developing immune systems and this makes them especially vulnerable to serious complications from salmonella infection though the same risk is applicable to all ages. These animals despite being kept clean and appearing healthy can transmit these bacteria during handling, cage cleaning etc.

Find useful tips below from the CDC on precautions if your family has a reptilian or amphibian animal as a pet to reduce salmonella transmission from the animals to their human owners. Remember, “an ounce of prevention is worth a pound of cure”.

How do I reduce the risk of Salmonella infection from reptiles and amphibians?

  • Wash your hands thoroughly with soap and warm water immediately after touching a reptile or amphibian, or anything in the area where they live and roam. Use hand sanitizer if soap and water are not readily available.
  • Adults should always supervise hand washing for young children.
  • Do not let children younger than 5 years of age handle or touch reptiles or amphibians, or anything in the area where they live and roam, including water from containers or aquariums.
  • Keep reptiles and amphibians out of homes with children younger than 5 years old or people with weakened immune systems.
  • Reptiles and amphibians should not be kept in child care centers, nursery schools, or other facilities with children younger than 5 years old.
  • Do not touch your mouth after handling reptiles or amphibians and do not eat or drink around these animals.
  • Do not let reptiles or amphibians roam freely throughout the house or in areas where food or drink is prepared, served, or stored, such as kitchens, pantries, or outdoor patios.
  • Habitats and their contents should be carefully cleaned outside of the home. Use disposable gloves when cleaning and do not dispose of water in sinks used for food preparation or for obtaining drinking water.
  • Do not bathe animals or their habitats in your kitchen sink. If bathtubs are used for these purposes, they should be thoroughly cleaned afterward. Use bleach to disinfect a tub or other place where reptile or amphibian habitats are cleaned.
  • Wash any clothing the reptile or amphibian might have touched.
  • Use soap or a disinfectant to thoroughly clean any surfaces that have been in contact with reptiles or amphibians.

 

- Dr. Diji Vaughan


 

Breast milk really is best! and the way to go through the first year of life. As the number of mothers who want to breast feed their newborns continues to increase in our experience, we’ve decided to address the issue of Vitamin supplementation for exclusively breastfed and formula supplemented newborns in this post. The recommendations addressed here apply to full-term healthy newborns between birth and 12-months of life only. Additional considerations would apply for newborns who do not fit into this category. The element, Iron and Vitamin D will be discussed.

Iron is a key element in body cells and for biochemical processes. It’s many benefits and need to maintain adequacy of intake are protean and will not be discussed in great detail here.

Term, healthy newborns have sufficient iron in the blood cells and in storage forms in the body for at least the first 4 months of life.  Breast milk contains iron that despite it’s low quantity has been shown to be more efficiently available for absorption by the body. This goes a long way in offsetting the impact of its relatively low quantity. Recognition of the effects of insufficient iron for use by the body on blood formation, a condition called anemia which may be evident on a blood test. The body could also be dealing with insufficient iron levels without any abnormalities evident on a blood test. Their is evidence that developing nervous system is also affected by insufficient iron which can manifest as poor cognitive abilities in later life.

Newborns who are exclusively breastfed are at an increased risk of having insufficient iron available for use in the body after 4 months of life. Therefore, at 4 months of life exclusively breastfed infants should be supplemented with oral iron at this age until appropriate iron-containing complementary foods (including iron-fortified cereals) are introduced into their diet. For partially breastfed infants, the same risk above is often applicable once intake of the formula ingested in less than 500ml in a day. Therefore, beginning at 4 months of age, partially breastfed infants (more than half of their daily feedings as human milk) who are not receiving iron containing complementary foods should also receive supplemental iron at a dose determined by your physician.

Vitamin D is essential for good bone health and insufficient levels have been linked to a condition called rickets in infants and children. Bone maturation and formation does not progress as expected in children with Vitamin D deficiency.  Scientific research has in addition found an expanded role for Vitamin D in the body and conditions like type 1 diabetes mellitus as well as inflammatory diseases are being more readily identified in individuals with Vitamin D deficiency. There are limited natural sources of vitamin D in a typical diet. Nature makes up for this lapse with sunlight converting some chemicals in the skin into Vitamin D forms. Clothing and lifestyle choices in the outdoors and ethnic skin pigmentation and geographic location are some of the factors that do not easily allow for clear recommendations on what amount of sunshine is adequate for a given mother who is breastfeeding her newborn exclusively. Mother’s with insufficient Vitamin D levels will not have adequate Vitamin D in breast milk as well and will therefore, put their exclusively breast fed infant at risk for Vitamin D deficiency.

Current recommendations to ensure adequate vitamin D status have been revised to cover all infants, including those who are exclusively breastfed. These infants need to have a supplemental dose of 400 IU of Vitamin D orally daily.

There are many formulations for administering recommended doses of vitamins in eligible infants, discuss vitamin supplementation options with you doctor before administration.