Lamisil

A year is a long, long time in the life of a child. In every 365-day period, he'll grow by leaps and bounds, wind up with numerous scrapes and welts, and constantly get into the grimiest things the world has to offer.

Yet a year is also the length of time between most childhood physicals. If you want to make sure your child is negotiating life's bumps and lumps relatively unscathed, you may want to give her your own at-home version of a physical from time to time. All you need is a keen eye and a few extra minutes.

Of course, if you find anything that concerns you during one of these midyear examinations, make a doctor's appointment and have your child checked out.

Here, from head to toe, is what to look for.

THE HEAD

Begin by having your child sit on a stool in front of you so that you can see the top of her head. Take a comb, slowly run it through her hair, and take a peek at her scalp. If you see tan or grayish-white specks no bigger than sesame seeds firmly stuck on hairs near the base, she probably has head lice. Those specks you see are the eggs. The lice themselves are almost invisible.

The tiny insects are commonly found on kids, especially those ages 3 to 10. It has nothing to do with how clean your child is--the bugs delight in freshly washed scalps as much as they do in dirty ones.

Head lice don't cause any real problems (except to make parents squirm) but the tiny insects are easily spread to other kids and family members, says Dr. Mariana Glusman, a pediatrician at Children's Memorial Hospital in Chicago. Girls are the unhappy hosts of head lice more often than boys, probably because gifts share hats and brushes more often.

Carefully check, too, for any rashes or flaky skin on the scalp--which could signify anything from scalp ringworm to dermatitis.

Moving southward, take a look at your child's eyes next time he's watching TV late at night. If he has a lazy eye, it's more likely to be apparent when he's tired. It's something your pediatrician could miss, because your child's eyes may appear normal during a visit. But when he's bushed, one eye may turn in toward his nose.

Also, if she usually turns her head to one side while watching television, this too could indicate that one eye is weaker than the other, Glusman says. Tell your doctor because early treatment of lazy eye can prevent a more serious problem where the brain learns to ignore signals from the weaker eye.

If you're the parent of a 6-month-old to 2-year-old, the next stop is the ears, where you can do a quick and easy test of his hearing. Sit him on your lap, facing you. Place some coins in one hand--don't show him which one--and make a fist. Also make a fist with your other (empty) hand.

Extend your hands out to arm's length, one on each side of your child's head, about a foot away from his ears. Shake your hands so that the coins jingle. "The child should turn in the direction of the hand that the coins are in," says Dr. Ken Haller, assistant professor of pediatrics at Saint Louis University School of Medicine, who created the test.

Then secretly switch the coins to your other hand and repeat the test. This test only works for toddlers up to age 2. "After that, kids get a little more sophisticated," says Haller.

Next, have a look at her teeth. Children don't usually complain about tooth pain unless it's pretty bad. After all, they've spent their whole life with new teeth poking through their gums.

If you see a little black dot on any of the teeth, it might be a cavity, Glusman says. A dentist can tell you for sure. Also take a quick peek at her tongue and the inside lining of her mouth. You're looking for any white patches (perhaps caused by thrush, a yeast infection) or other discolorations.

Take note, too, whether your child's breath smells bad. A scent like mildly rotting meat could be caused by a cavity, a sinus infection, or an abscessed tooth, Glusman says.

It can also be caused by something lodged up his nose. Seriously. Toddlers, in moments of curiosity, have a tendency to push things, like raisins, up their nostril. A quick look up each one will tell you if there's something there that shouldn't be.

If so, tread lightly in trying to remove it. "Sometimes, you can push it in farther if you're not careful," cautions Glusman. A narrow pair of tweezers will help. Or head to the doctor's office.

The last thing to do in your child's mouth is pop a thermometer in it. Many low-grade fevers go undetected by parents because they may not slow your child down. A high fever, on the other hand, will make your child look and feel sick. If you see a fever up to 101 degrees, keep checking it for the next few days. If it doesn't go away in five days, or if it climbs above 101, your child needs to be seen by a doctor.

Common causes of persistent low-grade fever include such mild aggravations as teething and minor respiratory infections, but they also can be caused by more serious conditions, such as staph infections, cat scratch disease, and mononucleosis.

THE TORSO

When you see your family doctor feeling around your child's neck and armpits, he's usually checking on the lymph nodes, says Dr. Daniel Neuspiel, a pediatrician at Beth Israel Medical Center in New York City. You can do the same thing by going over your young one's neck and underarms with your fingertips.

In preadolescent kids, normal lymph nodes are either unnoticeable to your touch or feel like small uncooked peas, says Neuspiel. "If they grow larger than the size of a nickel, this may commonly indicate infection, especially if they are painful to the touch."

Scoliosis, an abnormal curvature of the spine, affects about 3 out of 100 kids. It often begins to be noticeable around age 8. Girls are about five times more likely as boys the same age to have the condition.

You can check for signs of scoliosis at home using the Adam's forward-bend test, says Dr. Michael Neuwirth, director of the Spine Institute of Beth Israel in New York City. Sit behind your child with your eyes level with her middle back. Have her remove her shirt or, if her little brother is around, a snug-fitting T-shirt will do.

Tell her to bend over and reach toward the floor, as if she's touching her toes. A 90-degree angle is ideal.

"Then you look to see if the rib cage is symmetrical," says Neuwirth. If one shoulder blade is higher than the other, it could be scoliosis. Fortunately, only about 10 percent of cases need treatment.

While her shirt is off, check her upper body for any rashes or other skin oddities. If you find red, thickened, rough, dry patches of skin, your child may have eczema, says Glusman. It tends to show up on the parts that bend--behind the knees, and on the elbows, wrists, and ankles.

If you see red bumps that are itchy in those same areas, have your doctor check your child for scabies. Like lice, scabies are a frustratingly common parasite in kids. A prescription cream can knock them dead overnight, although the itching may continue for a while.

THE TOE (AND OTHER NEARBY PARTS)

For both kids and adults, the lowly foot is generally ignored unless it causes real problems. The first things you want to look for on your child's feet are ingrown toenails. "That's something you need to monitor throughout their childhood," says Jane Andersen, a doctor of podiatric medicine in private practice in Chapel Hill and Durham, North Carolina.

Ignoring an ingrown toenail may lead to more serious complications later, such as infections that can spread right down to the bone. Look for redness, swelling, or drainage on the side of the toenail, Andersen says. Fixing an ingrown toenail requires a doctor's skills (and professional-grade anesthetic).

Also take a look between the toes. If you see white crusty stuff, your child may have athlete's foot--a highly contagious fungus that she probably picked up in the shower from another family member. It's easily treated with over-the-counter medications you can find at any pharmacy.

On the bottom of her feet, look for round skin-colored bumps. If you see one, it's likely a plantar wart. Sometimes they're white, and occasionally they have dark spots. Whatever it looks like, get it removed.

"You could end up with five warts instead of one," Andersen says. That can actually make it painful to walk.

If your child complains of foot or leg pain, check the shape of her foot. Kids are born flat-footed, but most have developed arches by age 7 or so, Andersen says. If you don't see an arch by that age and she's having discomfort, see your doctor about arch supports.

So now you're done. Again, if you've found anything that seems out of place, and you're not sure what it is, see your child's doctor.

Oh, and thank your child for being such a good patient. Maybe even with a lollipop.

EDITOR'S PICKS

IN THE COURSE OF DEVELOPING THIS STORY, WE CAME ACROSS SEVERAL ITEMS THAT MIGHT FIT NICELY INTO DR. MOM'S BLACK BAG.

* Healthometer Deluxe Ear Thermometer. It you've ever tried to hold a glass thermometer in a sick and wiggling kid's armpit or mouth, you'll love the fact that this ear thermometer gives you a reading in 0.1 seconds. Costs about $49 at most mass merchandisers and pharmacies. Also available by calling 800/435-1250

* Wartner Wart Removal System. Most at-home compounds for removing wads take weeks of daily application to work. Wartner freezes them off in a single treatment with an ingenious device that contains ether and propane. It costs $19.99 at pharmacies and mass merchandisers. Note: Ifs not for use on kids under 4.

* Lamisil AT. It's pretty much a given that someone in your family will come down with a fungal skin infection at some point. When that happens, we've found Lamisil AT cream to be the best at killing the fungus behind athlete's foot, ringworm, or lock itch. A small tube costs about $10 at any pharmacy or supermarket.

COPYRIGHT 2003 Meredith Corporation