By Audrey DeSilva, MD
For most people the holiday season is a time of celebration and reunion with family and friends. We look forward to being together, especially when there is a new addition to the family. However, for young children, the holidays can be a high-risk time of year.
The holidays are potentially risky for several reasons. Schedules are hectic; homes are full of activity, and even the most conscientious parents get distracted. Mom and dad may not be keeping as close an eye on their young child as visitors come and go. Or, as often happens when lots of relatives are around, they may assume that someone else is watching the toddler.
Children are out of preschool and day care settings during the holidays, and there is less structure to their day. Sometimes they don’t get their maintenance medications because their routines are disrupted. They are exposed to a range of people at a time of year when winter flu and RSV (respiratory syncytial virus) are widespread. There is also a risk of triggering asthma attacks because of exposure to visiting relatives who smoke.
Families tend to sit and chat around the dining room or kitchen table with visiting relatives, while the children play together off in the living room. Out of sight of watchful eyes, it’s not unusual for a toddler to engage in activities like emptying the contents of grandma’s purse and ingesting her blood pressure medication, or eating cigarette butts from the coffee table ashtray. Wrapping paper, tinsel, and ribbons are all hazardous to toddlers who tend to put everything in their mouths. Small toy pieces that have been discarded by older siblings can be quickly ingested or lodged in a tiny nostril. And let’s not forget traditional holiday plants: poinsettias and holly berries are poisonous.
Common sense guidelines
There are a number of easy steps to take that will reduce risks for babies and toddlers.
1) Keep all purses and any medications out of reach of children. Put purses up high or in a closed closet. Enjoy your holly and poinsettias at work, not at home.
2) Clearly designate a child watcher at all times.
3) Make it clear that relatives who smoke may do so outside only.
4) Have everyone wash their hands before touching children under the age of four months, and no visitors should hold a baby under the age of one month. Many viruses are at their most contagious stage just prior to any obvious symptoms.
5) Anyone with a cold should not play with or hold an infant, even if they have washed their hands.
6) For the emotional health of your child, maintain as much of a schedule as possible, especially for toddlers and pre-schoolers. Children this age need routine in their lives. They can become easily overwhelmed and stressed when there are too many changes in their lives, which leads to that embarrassing meltdown parents find so upsetting. Keep meals and bedtime as regular as possible.
7) Take your children out to play. It’s good for toddlers to be outside where they can safely blow off steam and expend energy when they are keyed up.
Following these simple common-sense guidelines can take some of the stress out of the holidays when you have very young children. If you have qualms about telling relatives they may not hold the new baby, simply say this restriction is on your doctor’s orders. Many new parents feel uncomfortable merely requesting that relatives and friends wash their hands before touching the baby; the implication is that they aren’t clean. Just remind them that most viruses are spread by respiratory secretions (saliva and mucous) on the hands, as a result of coughing, sneezing, or blowing one’s nose, or even from shaking the hand of someone with a cold who has not washed their own hands. It’s better to be cautious than to risk the health of your baby.
Dr. DeSilva is board certified in pediatric medicine. She is a member of the medical staff at Cayuga Medical Center and is in practice with Northeast Pediatrics and Adolescent Medicine, where she can be reached at (607) 257-2188.