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Your Baby

Preventing Peanut Allergies with Peanuts


As the number of U.S. children with peanut allergies continues to grow, researchers are looking for ways to help these youngsters overcome or manage their allergy better.

The American Academy of Pediatrics (AAP) is now endorsing a recommendation that infants at high risk of peanut allergies be given foods containing peanuts before their first birthday.

How can you tell if your infant might be at risk for developing a peanut allergy?  Children are considered at high risk if they've had a previous allergic reaction to eggs or experienced a severe eczema skin rash. Allergy tests are recommended before exposing at-risk infants to peanut-containing foods.

An earlier published allergy study found that exposure to peanuts in infancy seemed to help build tolerance -- contrary to conventional thinking that peanuts should be avoided until children are older.

Here’s how the study was conducted.  Researchers in Britain followed 640 babies, 4 months to 11 months old, who were considered at high risk of developing peanut allergies. One group avoided peanuts; the others ate a small amount of peanut protein or peanut butter every week. After five years, the group that ate peanut products had 81 percent fewer peanut allergies than the group that didn't.

"There is now scientific evidence," the AAP says, "that health care providers should recommend introducing peanut-containing products into the diets of 'high-risk' infants early on in life (between 4 and 11 months of age) in countries where peanut allergy is prevalent because delaying the introduction of peanut can be associated with an increased risk of peanut allergy."

The advice comes in a consensus statement that the American Academy of Pediatrics helped prepare and endorsed in June along with the American Academy of Allergy, Asthma & Immunology and major allergy groups from Canada, Europe, Japan and elsewhere. The recommendations are meant to serve as interim guidance until more extensive guidelines can be prepared for release next year, the consensus statement said.

While getting the exact percentage of children with peanut allergies is difficult, peanut allergy is one of the most common food allergies. The Centers for Disease Control and Prevention states that four out of ten children suffer from a food allergy. It also notes that hospitalizations resulting from severe attacks have been increasing.

Severe cases can cause an allergic child to experience anaphylactic shock, a potentially life-threatening reaction that disrupts breathing and causes a precipitous drop in blood pressure.

Parents who are interested in the idea of treating peanut allergies with peanuts should not attempt to do this themselves. Children, particularly infants, should only be treated under the care of their pediatrician or pediatric allergist.

The AAP’s recommendation on treating peanut allergies with small doses of peanut protein will be published in the August 31 edition of the journal Pediatrics.


Your Baby

Recall: More Than 217,000 Instep and Schwinn Jogging Strollers


Pacific Cycle is working with the U.S. Consumer Product Safety Commission (CPSC) in a recall involving more than 217,000 Instep and Schwinn swivel wheel jogging strollers.

This recall includes single and double occupant swivel wheel jogging strollers that have a quick release mechanism for removing and re-attaching the front wheel. Instep Safari, Instep Grand Safari, Instep Flight, Schwinn Turismo and Schwinn Discover Single and Double Occupant Swivel jogging strollers with the following model numbers are affected. These models come in a variety of colors. The model number is located on the inside of the metal frame above the rear right wheel.

Instep Safari



Instep Grand Safari


Instep Safari



Instep Grand Safari


Instep Flight 





















































































Instep Flight


— Double

Schwinn Turismo



Schwinn Turismo



Schwinn Discover



Schwinn Discover























The front wheel can become loose and detach, posing crash and fall hazards.

The firm has received 132 reports of the front wheel becoming loose or unstable, resulting in 215 injuries, including head injuries, sprains, lacerations, bumps, bruises, and abrasions.

Consumers should immediately stop using the recalled jogging strollers and contact Pacific Cycle to obtain a repair kit to secure the front wheel. The repair kit includes a replacement mechanism for securing the front wheel that uses a traditional screw on/off method of attachment instead of the quick release lever method of attachment shipped with the product, as well as new warning labels. Consumers should not return the jogging strollers to retailers where purchased. A repair video is available at

These models were sold at small retailers nationwide and online at,,, and other online retailers from January 2010 through June 2016 for between $130 and $350.

To see photos of the strollers, click on the website below. 

Story source:




Your Baby

Babies Shouldn’t Be Given OTC Cold Medicines


When a baby is sick with a cold, the first reaction for many parents is to want to give their infant something to make him or her feel better. It’s a natural response; no parent likes to see their little one feeling bad. But turning to the medicine cabinet or making a trip to the pharmacy isn’t going to help your baby get better any quicker and could be dangerous says the U.S. Food and Drug Administration (FDA).

Over-the-counter (OTC) cold and cough medicine should not be given to children younger than 2 because they could cause serious and potentially deadly side effects, the agency warned.

Children often get more colds than adults, and parents might want to give them pain relievers, decongestants and other medicines, but that would be a mistake. The FDA says the best medicine is simple rest and care.

"A cold is self-limited, and patients will get better on their own in a week or two without any need for medications. For older children, some OTC medicines can help relieve the symptoms -- but won't change the natural course of the cold or make it go away faster," Dr. Amy Taylor, a medical officer in FDA's Division of Pediatric and Maternal Health, said in the news release.

A virus is what typically brings on a cold, but people often ask their physician or pediatrician (for their children) for antibiotics to treat them. Antibiotics are only useful for treating bacterial infections.

Colds are usually accompanied by coughing which can actually be useful to the body.

"Coughs help the body clear the mucus out of the airway and protect the lungs; so you don't want to suppress all coughs," Taylor said.

"Coughs help the body clear the mucus out of the airway and protect the lungs; so you don't want to suppress all coughs," she said.

Fever helps the body fight off an infection and does not always need to be treated. But if your child is uncomfortable because of fever or other symptoms of a cold, there are alternatives to cough and cold medicine to help them feel more comfortable. Taylor says they include the following actions:

·      Using a clean cool-mist vaporizer or humidifier in a small area near the child’s bed may help moisten the air and decrease the drying of the nasal passages and throat.

·      For infants with a stuffy nose, use saline or salt water drops/spray to moisten the nasal passages and loosen the mucus. Then clean the nose with a bulb syringe.

Non-drug treatments to ease coughs in children with colds include giving them plenty of fluids, especially warm drinks to soothe the throat.

While most children with colds do not need to see a doctor, Taylor said parents should call the doctor if they see any of these symptoms:

·      A fever in an infant aged 2 months or younger, or a fever of 102 Fahrenheit or higher at any age.

·       Signs of breathing problems, including nostrils widening with each breath, wheezing, fast breathing or the ribs showing with each breath.

·      Blue lips, ear pain, not eating or drinking, signs of dehydration.

·      Excessive crankiness or sleepiness, a cough that lasts for more than three weeks, or worsening condition.

·      A persistent cough may signal a more serious condition such as bronchitis or asthma.

"You have to know your child," Taylor said. "With small infants, fever is a major concern, and you need medical advice. If you are worried about your child's symptoms, at any age, call your pediatrician for advice."

The FDA voluntarily removed cough and cold products for children under two years old from the market because of on-going safety concerns discussed in 2007.  These safety concerns revealed that there were many reports of harm, and even death, to children who used these products.  These reports of harm occurred when the child received too medication such as in cases as accidental ingestion, unintentional overdose, or after a medication dosing error.  In those reports of harm that lead to a child’s death, most of those children were under two years of age.  

Since infant formulations of cough and cold products were voluntarily removed from the market years ago, parents who currently give these products to their infants (less than 2 years of age) may be using cough and cold products designed for older children and modifying the doses, for instance by giving half the recommended amount to the infant than what is recommended for an older child.  This can be especially dangerous as dosing adjustments cannot safely be made this way and could add to the existing risk of giving these products to young children.

Colds can be tough on children and adults and this is certainly the time of year when we all are more susceptible to getting one. Fluids and plenty of rest, plus sanitizing the area around the sick person and not sharing objects like silverware and drinking cups is the best treatment for colds. And of course the most important cold remedy for baby is mommy and daddy’s love and tender touch. 

Source: Robert Preidt,

Your Baby

Eating Chocolate While Pregnant May Improve Mom and Baby’s Health!


 Put another check in the win column for a reason to eat chocolate - as though anyone really needs one!

 A new study suggests that moms-to-be that eat a small piece of chocolate every day may improve their baby’s cardiovascular health and reduce the risk for preeclampsia.

 Researchers found that their findings held up regardless of whether the chocolate consumed contained high or low amounts of flavonoids, a group of phytochemicals that have antioxidant abilities. Various studies have also suggested that flavonoids may offer heart health benefits.

 As with most studies, the research did not prove that eating chocolate during pregnancy caused better circulatory health in pregnant women and their babies, only that there was an association.

 "Our observations suggest that a regular small consumption of dark chocolate -- whether or not the level of flavanol is high -- from the first trimester of pregnancy, could lead to an improvement of placental function," said study author Dr. Emmanuel Bujold. He is a professor of obstetrics and gynecology at Universite Laval in Quebec City, Canada.

 Bujold's team decided to see whether differences in flavanol content had any effect on the pregnancies of nearly 130 women.

 All of the women in the study were at the 11- to 14-week mark of their pregnancy, and carrying one child.

 All were instructed to consume 30 grams of chocolate (a little more than one ounce) each day over a 12-week period. That's equivalent to about one small square of chocolate per day, Bujold said.

 Half of the women consumed high-flavanol chocolate, while the other half was given low-flavanol chocolate. All were then tracked until their delivery date.

 Regardless of which type of chocolate was consumed, the women faced the same risk for both preeclampsia and routine high blood pressure. Placental weight and birth weight was also the same in both groups, the investigators found.

 Similarly, fetal and placental blood circulation levels, as well as in-utero blood velocity, did not appear to be affected by shifting flavanol levels.

 However, simply consuming a small amount of chocolate -- no matter what the flavanol content -- was associated with notable improvements in all blood circulation and velocity measures compared to the general population, the researchers said.

 Bujold said this suggests that there's something about chocolate, apart from flavanol levels, that may exert a positive influence on the course of pregnancy. Finding out exactly what that is "could lead to improvement of women's and children's health, along with a significant reduction of treatment cost," he said.

 While that’s good news for chocolate lovers, Bujold cautions that pregnant women keep the portion small and calorie intake low.

 So, a bit of chocolate daily while pregnant is not going to hurt you, in fact it just may give you and your baby’s health a little boost.

 The findings were scheduled for presentation at the Society for Maternal-Fetal Medicine's annual meeting, in Atlanta. The data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

 Source:  Alan Mozes,

Your Baby

Never Leave a Child Unattended in a Car Seat, Swing or Bouncer


Placing an infant in a car seat, swing or bouncer as a substitute for a crib can be a fatal decision. These objects work fine when used properly for their intended purpose, but when a child is left unattended – they can quickly turn deadly according to a new study.

Using these devices as directed and not as substitutes for a crib would reduce the risk of death, according to lead author Dr. Erich K. Batra of Penn State College of Medicine in Hershey, Pennsylvania.

“The overarching advice goes back to a more basic message of safe sleep,” Batra told Reuters Health. “In an infant, a safe sleep environment includes the ABCs: they sleep alone, not in bed between parents, on their backs, and in a crib or bassinet without any loose bedding.”

The study reviewed young children’s death in devices like car seats, swings and bouncers and found that most were due to suffocation by improper positioning or strangulation in straps.

The researchers reviewed the reports of 47 deaths of children under two years old that happened in car seats, bouncers, swings, strollers or slings and were recorded by the U.S. Consumer Product Safety Commission between 2004 and 2008.

The study used only reports submitted by consumers or manufacturers, so the number of deaths may actually be higher.

Most of the deaths occurred in car seats (31 of 47). Five happened in slings, four each in swings and bouncers and three in strollers.

About half of deaths in car seats were due to strangulation by the straps, while the other half were caused by suffocation due to positioning, the authors reported in The Journal of Pediatrics.

Strap strangulation usually happens when the restraints are not fastened as directed, Batra said. Whenever a child is in a car seat, the harness should be secured.

“If people leave an older infant or young toddler in a car seat and undo the straps thinking that it makes them more comfortable, that’s a significant hazard,” he said.

“A child properly secured in a car seat is in very little risk of danger,” he said.

However, many times the child falls asleep in the car seat and a parent or caregiver decides to bring the car seat, with baby still attached, into the home.

Dr. Shital N. Parikh, an orthopedic surgeon at Cincinnati Children’s Hospital Medical Center in Ohio, has studied the risk factors for injury in these devices in infants up to age one. He also found car seats to be the most common setting.

“The commonest mechanism of injury was infants falling from car seats when not used in the car, used in the home,” Parikh told Reuters Health. Often parents would bring the car seat in the house while the infant still slept, undo the straps and place it on an elevated surface, he said.

Even four-month-old babies are mobile enough to wiggle out of the top straps and fall, or topple the whole seat from an elevated surface, he said.

“These are very simple things, very basic things,” Parikh said. “The basic idea is that you use (the devices) for their intended purpose only. For infants, you should not use it to make them sleep or carry them around if it’s not intended for that.”

Batra notes that baby in slings need to be “visible and kissable,” as a sling may put baby’s head in a hazardous position.

It only takes four to five minutes for an unattended baby to suffocate in one of these devices.

“That is one of the things we need to draw attention to,” Batra said. Sometimes a few minutes unattended is all it takes.

“If your infant is sleeping and you’re not observing them, then they need to be in a safe sleeping environment,” adhering to the ABCs, he said.

While it may seem safe to leave a baby in a car seat, swing, sling or bouncer for a few minutes unattended, go ahead and place the child in his or her crib. It may wake them up if they are sleeping, but it’s much safer than allowing them to continue to sleep in a device that was never intended for that purpose.

Source: Kathryn Doyle,

Your Baby

CDC Warning: Dangerous Germ Found in Powdered Infant Formula


The Centers for Disease Control and Prevention (CDC) issued a new warning about Cronobacter contamination in powdered infant formulas.

Because powdered infant formula is not sterile, it can sometimes contain Cronobacter — formerly known as Enterobacter sakazakii — a germ found naturally in the environment that can survive in very dry conditions, the CDC reports.

Cronobacter bacteria can cause severe blood infections or meningitis, an inflammation of the membranes that protect the brain and spine. If infected, infants two months of age and younger, are most likely to develop the infection.

Infants born prematurely and those with weakened immune systems are also at increased risk for serious sickness from Cronobacter, the CDC warns.

In infants, the sickness generally starts with fever and usually includes poor feeding, crying or very low energy. Very young infants with these symptoms should be taken to a doctor.

In some outbreak investigations, Cronobacter was found in powdered infant formula that had been contaminated in the factory. In other cases, Cronobacter might have contaminated the powdered infant formula after it was opened at home or elsewhere during preparation, according to the CDC.

Because Cronobacter lives in the general environment, it’s likely there have been other sources of this rare sickness.

Using current methods, manufacturers report that it is not possible to get rid of all germs in powdered infant formula in the factory. Powdered infant formula can also be contaminated after the containers are opened. Very young infants, infants born prematurely, and infants whose bodies have trouble fighting off germs are at highest risk.

The CDC offers these tips on protecting your infant:

·      Breastfeed: Breastfeeding helps prevent many kinds of sicknesses among infants. Almost no cases of Cronobacter sickness have been reported among infants who were being exclusively breastfed.

·      If your baby gets formula, choose infant formula sold in liquid form, especially when your baby is a newborn or very young. Liquid formulations are made to be sterile and therefore should not contain Cronobacter germs.

·      If you use powdered infant formula, follow these steps:

1      Clean up before preparation

Wash your hands with soap and water.

Clean bottles in a dishwasher with hot water and a heated drying cycle, or scrub bottles in hot, soapy water and then sterilize them.

Clean work surfaces, such as countertops and sinks.

2      Prepare safely

Keep powdered formula lids and scoops clean and be careful about what they touch.

Close containers of infant formula or bottled water as soon as possible.

Use hot water (158 degrees F/70 degrees C and above) to make formula.

Carefully shake, rather than stirring, formula in the bottle.

Cool formula to ensure it is not too hot before feeding your baby by running the prepared, capped bottle under cool water or placing it into an ice bath, taking care to keep the cooling water from getting into the bottle or on the nipple.

3      Use up quickly or store safely

Use formula within two hours of preparation. If the baby does not finish the entire bottle of formula, throw away the unused formula.

If you do not plan to use the prepared formula right away, refrigerate it immediately and use it within 24 hours. Refrigeration slows the growth of germs and increases safety.

When in doubt, throw it out. If you can’t remember how long you have kept formula in the refrigerator, it is safer to throw it out than to feed it to your baby.

Story Source:


Your Baby

Chubby Baby = Obese Child?

2.00 to read

“Look at those cute little rolls of fat and chubby cheeks.” “It’s just baby-fat, he’ll grow out of it.” Common comments when people see a chubby baby. But, what was once thought of as a well-fed and healthy infant might prove to be just the opposite.

Researchers say they’ve found a way to determine if a rapid growing baby will become obese later in life. A new study says that if your baby has passed two key milestones, on a doctor’s growth chart by the age of two, then he or she has double the risk of being obese by the age of 5.  Rapid growers were also more likely to be obese at age 10, and infants whose chart numbers climbed that much during their first 6 months faced the greatest risks.

Children who grew more slowly were less likely to be obese by the same age.

That kind of rapid growth should be a red flag to doctors, and a sign to parents that babies might be overfed or spending too much time in strollers and not enough crawling around, said pediatrician Dr. Elsie Taveras, the study's lead author and an obesity researcher at Harvard Medical School.

Contrary to the idea that chubby babies are the picture of health, the study bolsters evidence that "bigger is not better" in infants, she said.

In an online article on Dr. Michelle Lampl, director of Emory University's Center for the Study of Human Health, expressed concerns.

“It’s a bad idea that could backfire in the long run,” said Lampl.

"It reads like a very handy rule and sounds like it would be very useful _ and that's my concern," Lampl said. The guide would be easy to use to justify feeding infants less and to unfairly label them as fat. It could also prompt feeding patterns that could lead to obesity later, she said.

Lampl noted that many infants studied crossed at least two key points on growth charts; yet only 12 percent were obese at age 5 and slightly more at age 10. Nationally, about 10 percent of preschool-aged children are obese, versus about 19 percent of those aged 6 to 11.

Taveras said the rapid growth shown in the study should be used to raise awareness and not to put babies on a diet.

The study involved 45,000 infants and children younger than age 11 who had routine growth measurements during doctor checkups in the Boston area from 1980 through 2008.

Growth charts help pediatricians plot weight, length in babies and height in older kids in relation to other children their same age and sex. Pediatricians sometimes combine an infant's measures to calculate weight-for-length _ the equivalent of body-mass index, or BMI, a height-to-weight ratio used in older children and adults.

The charts are organized into percentiles. For example, infants at the 75th percentile for weight are heavier than 75 percent of their peers.

An infant whose weight-for-length jumped from the 19th percentile at 1 month to the 77th at 6 months crossed three major percentiles _ the 25th, 50th and 75th _ and would be at risk for obesity later in childhood, the authors said.

Larger infants were most at risk for obesity later on, but even smaller babies whose growth crossed at least two percentiles were at greater risk than those who grew more slowly.

About 40 percent of infants crossed at least two percentiles by age 6 months. An analysis of more than one-third of the study children found that 64 percent grew that rapidly by age 2.

Dr. Joanna Lewis, a pediatrician at Advocate Lutheran General Hospital in Park Ridge, Ill., said she supports the idea that infancy is not too young to start thinking about obesity.

Still, she emphasized that rapid growth in infancy doesn't mean babies are doomed to become obese. "It's not a life sentence," and there are steps parents can take to keep their babies at a healthy weight without restrictive diets, she said.

Lewis said many of her patients are large babies whose parents feed them juice or solid food despite guidelines recommending nothing but breast milk or formula in the first six months.

"The study reinforces what we try to tell parents already: Delay starting solids and don't put juice in a bottle," Lewis said.

Your Baby

“Furry Pets” May Help Kids Avoid Some Allergies


You might think that having pets would be a nightmare if you have small children with a family history of allergies. A new study says that furry pets may actually help protect children against some allergies.

The infants’ mothers had a history of allergy, so the babies were at increased risk too, and it was once thought that pets might be a trigger for allergies in such children, the authors point out in the Journal of Allergy and Clinical Immunology.

“Earlier it was thought that exposure to pets early in childhood was a risk factor for developing allergic disease,” said Dr. Merja Nermes of the University of Turku in Finland, who coauthored the research letter. “Later epidemiologic studies have given contradictory results and even suggested that early exposure to pets may be protective against allergies, though the mechanisms of this protective effect have remained elusive.”

Adding pet microbes to the infant intestinal biome may strengthen the immune system, she told Reuters Health by email.

The study team collected fecal samples from diapers when the babies were one month of age and these were tested for the DNA of two types of Bifidobacteria that are found specifically in animal guts: B. thermophilum and B. pseudolongum.

One third of infants from the pet-exposed group had animal-specific bifidobacteria in their fecal samples, compared to 14 percent of the comparison group. It’s not clear where the infants without furry pets at home acquired their gut bacteria, the authors write.

When the babies were six months old they had skin prick tests to assess allergies to cow’s milk, egg white, flours, cod, soybeans, birch, grasses, cat, dog, potato, banana and other allergens.

At six months of age, 19 infants had reactions to at least one of the allergens tested. None of these infants had B. thermophilum bacteria in their fecal samples.

Other studies have pointed out the connection between kids exposed to farm animals and household pets and building a better immune system.

“When infants and furry pets live in a close contact in the same household, transfer of microbiota between pets and infants occurs,” Nermes said. “For example, when a dog licks the infant´s face or hand, the pet-derived microbiota can end up via the mouth into the infant´s intestine.”

Human-specific Bifidobacteria have beneficial health effects, and animal-specific strains may also be beneficial, she said. It is still unclear, however, if exposure to these bacteria protects against allergies later in life, she said.

“Future research is needed to assess if these infants develop less atopic dermatitis, asthma or allergic rhinitis later,” she said.

Nermes also noted that she believes pediatricians should not discourage pregnant women or parents of infants from having pets in order to prevent allergies.

“If a family with a pregnant mother or an infant wants to have a pet, the family can be encouraged to have one, because the development of allergic disease cannot be prevented by avoiding pets,” she said.

Source: Kathryn Doyle,



Your Baby

Homemade or Commercial Baby Food- Which is Best?


A new study from the U.K. looked at homemade baby food versus commercial baby food bought in grocery stores. They both come up winners in some categories and losers in others.

The researchers wanted to assess how well homemade and commercially available readymade meals designed for infants and young children met age specific national dietary recommendations.

Once thought to be the ideal baby food, homemade meals turned out to be higher in calories and fat and more time-consuming to prepare, but less expensive and higher in nutrients and variety. Commercial baby food came in more convenient, lower in calories, total fats and salt but was more expensive and lacked variety. Sugar content was about the same in both foods.

Each option had upsides and downsides. For example, home-cooked food had higher nutritional content, but 50% of homemade meals also exceed calorie recommendations, and 37% exceeded the recommendations for calories from fat, reported a research team led by Sharon Carstairs, a PhD student at the University of Aberdeen in Scotland.

Only 7% of the commercial baby food evaluated exceeded calorie recommendations, and less than 1% exceeded recommendations for calories from fat, Carstairs and colleagues reported in Archives of Disease in Childhood.

Researchers compared the store-bought meals with 408 recipes for home-cooked infant meals obtained from best-selling published cookbooks. The investigators entered the recipe ingredients into dietary analysis software to calculate the nutritional composition of the recipes per 100 grams.

A chief limitation of the study was that it only analyzed the recipes for homemade meals and did not take into account how these meals might be prepared in "real life."

"Parents may use cookbooks prescriptively or only as guidance, and thus the nutritional content of home-cooked recipes can vary greatly, and this can be augmented further by natural variations in the nutritional composition of raw ingredients," Carstairs and colleagues noted.

In addition, "the authors may have overestimated the values for salt within home-cooked recipes as it was often cited as optional; these results should thus be considered with caution."

The study reassures parents that it is okay to give homemade food to babies being weaned from breast milk or formula, Lauri Wright, PhD, of the University of South Florida College of Public Health and a spokesperson for the Academy of Nutrition and Dietetics, told MedPage Today.

"This is an important study, because in the United States parents think they have to do the commercial foods. Parents are afraid their child will miss out on nutrients if they don't give the specialized baby food."

The greater variety offered by homemade food may result in healthier taste preferences later in life, Wright added. "We used to think that taste preference developed at age 4 or 5, but we now know that taste preferences develop with the introduction of these first solid foods."

The bottom line from this study is that both types of baby food are acceptable; each comes with its own pros and cons. Just like with any other meal, how your homemade baby food is prepared is the key to whether it’s going to be healthy or not for baby. Understanding the guidelines for nourishing infant food and knowing the nutritional values of the foods you use, can help you prepare a wholesome meal for baby. Commercial baby foods also offer convenience and lower calories and fats. A mix of both will probably suit most families very well.

Story source: Medpage Today staff,




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