About ITP

Helpful Hints to Manage Your Child's ITP

Here are some suggestions to make your and your child's life better as you live with ITP. 

These should not be used as a substitute for your doctor's recommendations.

What should I look for?

1. Check your child's skin for bruises or petechiae during the bath.
2. Assist your child with toileting or stress to them the importance of reporting blood in the bowel movement or urine immediately.  Blood in the urine may be red or brownish (tea or coke colored).  The same is true for blood in the vomit.  Blood in the bowel movement may look red or black like tar.
3. Watch for bleeding from the mouth or nose, especially during dry air season.  Check the bed linen for signs of bleeding while sleeping.  Encosurage only gentle nose blowing, never closing off one side to blow the other.  Use the softest toothbrush possible.  Avoid dental floss until the platelet count is up.
4. Report any blows to the head, belly, or back to your doctor or hospital promptly.

What else should I do?

1. Avoid giving your child medications until discussed with your doctor or nurse practitioner.  Many over-the-counter pain, cold, and cough medicines can affect your child's platelet function.  Aspirin or any medicine containing salicylates (like Pepto-Bismol or Alka Seltzer) should be avoided.  Ibuprofen and strong antihistamines should also be avoided.  Acetaminophen products (Tylenol, Tempra, etd.) are safe to give to your child for fever or pain while the platelet count is low.
2. Encourage plenty of fruits, fruit juices, water, and fiber foods to avoid constipation.  Hard bowel movements, enemas, or suppositories can cause rectal bleeding.  If needed, a stool softener can be recommended by your doctor or nurse practitioner.
3. Use plenty of toothpaste on a very soft bristled brush, and brush slowly and gently.  You may need to assist or supervise your child.  For infants, use a soft cloth or toothette swab without toothpaste.
4. Use lip balm to keep lips from drying and cracking.  Use saline nose spray (Ocean spray, etc.) if needed to moisten nasal passages during dry weather to help prevent nosebleeds.  Room or house humidifiers can also be helpful. Older children can help maintain healthy sinuses by using a nasal cup, available in the Platelet Store
5. It can be helpful to run a soft wash cloth under water and stick it in a bag in the freezer so you will always have an 'instant cold pack'.  For nose bleeds, run the frozen cloth under cold water until soft and apply it with firm pressure to the nostrils.  
6. Use lotion on dry skin to avoid your child's itching and scratching which could lead to bruises and petechiae.

How can I protect my busy, active child?

1. Do not allow your child to play roughly.  This includes any contact sports such as wrestling, boxing, karate, soccer, and possibly basketball or baseball.  A good rule of thumb when deciding if an activity is okay for your child is to allow anything within reason where the child's feet never leave the ground.  This usually excludes bikes, motorcycles, skates, swings, etc.
2. Avoid toys with sharp edges, drinking straws or popsicle sticks.
3. Pad the sides of cribs. For older children who may fall out of bed, put their mattress on the floor or put a side rail between the mattress and box spring.
4. For small children, pad the corners of furniture and counters that they might run into.  Use a gate at the top or bottom of stairs.  Clear obstacles such as tables or chairs that you frequently have to go around.  Do not allow running through the house with obstacles or on the stairs.
5. Take up loose rugs.  Use rubber no-slip mats in the shower or bath.
6. Older children should avoid shaving with razor blades.  Electric shavers used gently are usually okay.
7. Always put a seat belt around your self and your child.  Use a car seat for smaller children.
8. Avoid travel in non-pressurized aircraft.

Signs of Serious Injury or Bleeding in the Head

• Headache that does not go away or worsens
• Vomiting
  
• Dizziness
• Confusion: child cannot say name or tell where they are
• Unusual sleepiness: difficult to awaken
• Change in or slurring of speech
• Eyes not moving together or looking the same way
• Weakness on one side of the body
• Loss of feeling, numbness or tingling in the hands or feet
• Stiff neck or back: arching of the back
• Seizures: uncontrolled body jerking or twitching
• Child reports inability to see or hear

Call your doctor or hospital immediately for a blow to the head, a fall resulting in hitting of the head, or any event that causes your child to lose consciousness or awareness.