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Your Baby

Alert! 180,000 Baby Pacifiers Recalled Due to Choking Hazard

1:30

Munchkin is recalling their Lightweight Pacifiers and Clips. The clip cover can detach from the pacifier’s clip, posing a choking hazard for young children.

his recall involves Munchkin’s Latch lightweight pacifiers and clips sold as a set. The pacifiers were sold in five styles: designer, rattle and heartbeat clips with 0m+ natural shape pacifiers, and designer and rattle clips with 6m+ orthodontic pacifiers. The designer pacifiers and clips 0m+ and 6m+ are in three color patterns: blue and white strips, orange and with white polka dots and pink with white polka dots. The rattle pacifiers and clips 0m+ and 6m+ are green with beads in the pacifier cover to make a rattle sound and have a polka dot strap. The heartbeat pacifiers and clips have a red, heart-shaped pacifier cover and red and white polka dots on the strap.

About 180,000 of the pacifier and clip sets have been sold. They were available from Babies R Us, Target, Wal-Mart and other mass merchandisers, juvenile product, baby boutique and discount stores nationwide and online at amazon.com, munchkin.com and other website from March 2014 through March 2016 for between $11 and $15.

The firm has received 10 reports (5 in the U.S. and 5 in Canada) of the clip cover detaching from the pacifier clip. No injuries have been reported. 

Consumers should immediately take the clip away from young children and contact Munchkin for a free replacement Lightweight Pacifier pack with two pacifiers or a full refund.

There is a toll-free consumer hotline available for more information at 877-242-3134 from 7 a.m. to 5 p.m. PT Monday through Friday or online at www.munchkin.com, click on Help at the bottom of the page and then Recalls for more information.

Story source: http://www.cpsc.gov/en/Recalls/2016/Munchkin-Recalls-Latch-Lightweight-P...

Daily Dose

It's the Sick Season

1:30 to read

Well, the New Year is starting off with a flood….of illness that is.  It is a typical winter in the pediatrician’s office with a bit of every virus you can name. RSV, flu, norovirus, just to start the list.  While so many parents want to name the virus, it is typically not necessary as you treat many viruses in the same manner, symptomatically.  

 

So, if your child is coughing and congested it may be due to any number of upper respiratory viruses, but the most important thing to remember…..how is your child breathing and is your child having any respiratory distress?? I sound like a broken record in my office as I remind our nurses to have parents take off ALL small children’s shirts, gowns, onesies and look at how they are breathing as you never want to miss a child who may be “working to breath”. In many cases, the visual of a child’s chest as they take breaths is more important than any cough they may have.  So remember this: “visual inspection and not just audible”.  Sending me a video of a child coughing is rarely helpful, but a video of their breathing is very important when trying to decide how to guide a parent.

 

Another tip: In most cases if your child is having respiratory distress they are quiet, as they are conserving their energy…which means they are not fighting with their sibling or running around the house, but are often sitting quietly. This also means that when they come to the doctor they are not screaming and yelling in anticipation of the doctor…again, they are usually sitting quietly in their parent’s lap. While a happy quiet child is a pleasure at my office, in a toddler it is not typical.

 

Lots of diarrhea and vomiting in our area as well. In this case, I am always trying to make sure that a child is not getting dehydrated. So, the things to look for include if your child has tears, saliva in their mouth and if they are urinating (having wet diapers).  If your child is vomiting you have to remember to wait about 30 minutes after they have vomited before giving them anything to drink….even if they are “begging for a drink”. Once they have not vomited you need to give them TINY sips of clear liquid and keep offering sips every 10 - 15 minutes. If you do this, in most cases you can keep the child from vomiting repeatedly.  Once they are keeping down sips you can go up in volume.  It is like the turtle and the hare….slow and steady wins!!  

 

With diarrhea alone it is more difficult for your child to become dehydrated, as you can have them keep drinking to keep up with the loss in their stool. Many parent “worry” as their child does not want to eat…and that is ok, the fluids are the most acute issue. You can go without food for quite some time…..don’t you ever skip a meal?

 

Keep washing those hands…and I hope you had your flu shot as I promise…it will come. 

 

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Daily Dose

Best Toys for Kids: No Batteries!

1.30 to read

I have been talking with my patients about gift ideas for the holidays and I had an epiphany!!  I think this season we should all try to buy children’s toys with the slogan “no batteries required”.  This is a great idea for children of all ages, even for my “almost adult” children.  By going back to basics and skipping the electronics I am certain that there will be more family time, maybe face to face, rather than having your child’s face staring at yet another screen.

So with that in mind I have polled patients/parents on toy ideas that will fit the “no batteries required”. Top of the list would be blocks for toddlers through pre-schoolers.  A good set of blocks will last a lifetime and you can add on to the set each year.  Blocks also work well for both boys and girls and siblings can play together and use their imagination to build towers, forts and cities. Children can easily spend hours with a set of different shaped and sized blocks.

Along the same line as blocks, but for older children are the classic Lego sets. I still have tubs of Lego’s in our house that I hope will one day be used by grand children. What a great way to learn to basic engineering as well as fine motor skills while putting a Lego set together. From beginner to adult, there are sets for all ages.  One of my pediatric partners still loves to build and has the Empire State building and Eifel Tower on display in his office.

Games are always a great gift. The classics like Candyland, Chutes and Ladders, Clue and Monopoly. What about checkers, chess and our family favorite (at least mine) Rummikub.  I still love to have “family game night” and the boys will humor me and play a few games before slowly begging off.

What about card games as well, from Go Fish for the preschool child to bridge for the teen (I am still taking lessons!)? The kids all still love to play Spades and Hearts and we also play a lot of Onze during the holidays. Cards work for all generations too and are a great way to keep everyone engaged.

Lastly, what about some crafts. Crayons and markers and coloring books can be just as much fun as fancy Apps for coloring on the I-pad. Learning to color between the lines and hold the crayon are great exercises in fine motor skills as well. Not sure you get the same benefit on the screen version? Teaching a child how to weave, or use scissors to cut strips of paper to make chains to decorate the house for the holidays. There are also some fun sewing crafts too. Good way to teach your child how to hem and sew on a button as well, which are definitely life skills!

So this year, think about trying the “no batteries required” idea. I am sure you too have your old favorites. But, you may have to exchange a few gifts before Christmas???

That’s your daily dose for today. We’ll chat again tomorrow.

 

 

Daily Dose

Power of Medical Attorney While Away

When you're out of town, make sure you prepare a medical power of attorney for your child's caregiver in case of an emergency.It is the time of year for family vacations and I have noticed many parents are also opting for a little vacation time for themselves too! (I tell my patients it’s important).  I have recently seen a number of grandparents and family babysitters bringing their “charges” into the office for a visit while mom and dad are out of town.

Have you prepared a temporary power of attorney so that in case of am emergency your child can receive medical care when you leave town? In reality, you should always leave a notarized letter that states who legally has the right to seek medical care for your children. Why does it seem like a 2 year old always gets a fever within 2 days of their parent’s departure?  While your long standing pediatrician may not require this document to see your child for an office visit while they are under the care of grandparents, there are times when it might really be needed. If your child needed surgery, stitches or even a trip to the ER to rule out a broken arm, the emergency room will require the letter that states that the caregiver in question has the authority to seek medical care for the under age child. In most cases a parent could be reached by cell phone, even in very remote areas of the world, but on the occasion that the parents cannot be reached this document will be needed. So, why not be prepared? We used to leave the letter on the front of the refrigerator with the names of everyone that might have the need to take our child to the hospital or doctor. The same letter was there for years, and included not only the grandparent’s names, but also friends and neighbors who would be available if necessary.  We had it notarized and updated as necessary, and thankfully I don’t think it was ever used. (My children always seemed to get hurt with me around!) Before leaving for an adult trip, you should leave the numbers of the pediatrician, the dentist, and any other doctors that your child routinely sees. It is also helpful to leave a copy of the medical insurance card! Seems you can’t do anything without it! Lastly, include the phone number for your pharmacy. For the very organized, you might also leave directions on how to get to the doctor, pharmacy or hospital etc. I have drawn many a rudimentary map for a lost grandparent who is now going to have to head from my office to the pharmacy to get the pink medicine filled. In most cases, the child is already well before the parents even return! That's your daily dose for today.  We'll chat again tomorrow.

Your Child

Doctors May Unknowingly Discourage HPV Vaccine for Preteens

2:00

The majority of physicians say that the HPV vaccine given to preteens, before they become sexually active, can help prevent infections with viruses that can cause cervical, penile and anal cancers as well as genital warts.

However, about 27 percent of doctors may inadvertently discourage parents from having their preteens vaccinated against human papillomavirus (HPV), according to a new study, because they don’t recommend the vaccine strongly enough.

Pediatricians and family physicians deliver the bulk of HPV vaccines. Some of these physicians do not offer the vaccines as strongly as they do when urging parents to vaccinate against meningococcal disease or to get tetanus, diphtheria, and pertussis booster shots, the study reported.

The study, which is based on a national online survey of 776 doctors, found a quarter did not strongly endorse the need for HPV vaccination with the parents of the 11- and 12-year-olds under their care.

Nearly 60 percent were more likely to recommend the vaccine for adolescents they thought were at higher risk of becoming infected — perhaps because the doctors knew or suspected they were sexually active — than for all 11- and 12-year-olds.

“You kind of get the sense that some [health care] providers see this as a somewhat uncomfortable situation,” said lead author Melissa Gilkey, a behavioral scientist in the department of population medicine at Harvard Medical School.

Many parents don’t like to think about the possibility of their child having sex, particularly when they are only 11 or 12 years old. The vaccine is actually meant to provide protection for when they are older. That’s why it is recommended before a child typically begins engaging in sexual activity. Studies have also shown preteens get the best immune response to the vaccines.

Evidence generated by one of Gilkey’s earlier studies suggests it’s not necessarily parents that are squeamish about the vaccination, but physicians that overestimate a parent’s response when the vaccination is urged. 

 “It’s not necessarily that physicians always are negative about it. But it’s kind of that HPV vaccine may get damned with faint praise, if you will,” Gilkey said. “Compared to the way that they recommend these other vaccines, parents may suspect that there’s something wrong with it.”

The aim of the research is to help figure out why HPV vaccination rates remain disappointingly low. The CDC reported that in 2014, 40 percent of adolescent girls and 22 percent of adolescent boys had received the recommended three doses of HPV vaccine. The agency says girls and boys should have all three doses by their 13th birthday.

According to the study, how the information is presented has an impact on how well it is received. Doctors who started conversations about the HPV vaccination by telling parents the vaccines protect against cancers and genital warts gave stronger recommendations than those who opened saying HPV viruses are sexually transmitted.

The study was published Thursday in Cancer Epidemiology, Biomarkers and Prevention, a journal of the American Association for Cancer Research.

Although Gilkey declared no conflicts of interest, the senior author of the study, Noel Brewer of the University of North Carolina, has received research funding and speaker fees from companies that sell HPV vaccines.

Source: Helen Branswell, https://www.bostonglobe.com/lifestyle/health-wellness/2015/10/21/study-says-doctors-inadvertently-discourage-hpv-vaccines/LuJaMFoEupeOeYrrUOlYRN/story.html

 

 

 

 

 

Your Baby

Teething May Make Your Baby Fussy, But Not Sick

2:00

Parents sometimes have trouble distinguishing between whether their cranky baby is actually ill or is just getting his or her first teeth. Because a baby’s gums may be tender and swollen as their teeth come in, a slight rise in temperature can occur.  Other changes may happen as well such as fussiness and increased drooling. All- in –all, babies can be pretty miserable till those first teeth break through.

That said, teething does not cause a full-fledged fever above 100.4 degrees Fahrenheit or any other signs of illness according to a new review led by Dr. Michele Bolan, of the Federal University of Santa Catarina, Brazil.

Certain symptoms can be confusing for parents says Dr. Minu George, interim chief of general pediatrics at Cohen Children's Medical Center, in New Hyde Park, N.Y.

"I get questions about this on a daily basis," said George, who was not involved in the study.

When a baby’s temperature reaches 100.4 degrees F or higher, it becomes an actual fever, not just a slight increase in temperature.

"Fevers are not a bad thing," she pointed out. "They're part of the body's response to infection." But, George added, parents should be aware that a fever is likely related to an illness.

Of course, new parents are going to be somewhat edgy when it comes to caring for their infant. It’s a new world of responsibility that can seem overwhelming at times. 

Pediatricians and family doctors regularly answer questions about this topic with an explanation of how a typical teething experience presents.

Over the ages, other symptoms have been linked to teething that should never apply. They include sores or blisters around the mouth, appetite loss and diarrhea that does not go away quickly. Any of these symptoms warrant a call to your pediatrician.

Babies differ in age as to when their teeth begin to come in.  Typically, the fist tooth begins to erupt around 6 months of age. It can also be as early as 3 months and as late as 1 year of age. There really isn’t a set age for teething to begin, just an average.

Baby’s teeth usually erupt through the gums in a certain order:

·      The two bottom front teeth (central incisors)

·      The four upper front teeth (central and lateral incisors)

·      The two lower lateral incisors

·      The first molars

·      The four canines (located on either side next to the upper and lower lateral incisors)

·      The remaining molars on either side of the existing line of teeth

By age 3, most children have all 20 of their primary teeth.

As for helping babies get through the misery of teething, George advised against medication, including topical gels and products that are labeled "natural" or "homeopathic."

Instead, she said, babies can find relief by chewing on a cooled teething ring or wet washcloth, or eating cool foods.

The analysis was published in the February online edition of the journal Pediatrics.

Sources: Amy Norton, http://www.webmd.com/parenting/baby/news/20160218/teething-makes-babies-cranky-but-not-sick-review

http://www.webmd.com/parenting/baby/tc/teething-topic-overview

Your Child

New Guidelines for How Much Sleep Kids Really Need

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As adults, we all know that without a good night’s sleep, we’re going to be struggling to get through the day’s activities. When we’re not running on all rested cylinders, small troubles seem like mountains, being able to focus and complete a project is difficult and nodding off while driving is more likely to happen.

Restful sleep is a wonderful thing and unfortunately, many of us just aren’t getting enough.

Most adults know about how much sleep they need the night before to feel their best the next day. Children, on the hand, need a certain amount of sleep depending on their age.

For the first time, a new set of sleep guidelines specially tailored to children, have been released from the American Academy of Sleep Medicine. The new recommendations give a precise number of hours for each age range, spanning from infancy up until 18 years old.

"Sleep is essential for a healthy life, and it is important to promote healthy sleep habits in early childhood," said Dr. Shalini Paruthi, fellow of the American Academy of Sleep Medicine, in a statement. "It is especially important as children reach adolescence to continue to ensure that teens are able to get sufficient sleep."

A team of 13 top sleep experts conducted a 10-month research project to find out how much sleep children actually need. The team reviewed 864 published scientific articles that revealed the link between sleep duration and the health of children across all age categories.

Here’s what they found:

·      Infants between 4-12 months of age should get 12 to 16 hours of sleep for any 24-hour period. This includes naps.

·      Children between 1 and 2 years of age need 11 to 13 hours for every 24-hour period.

·      Children between 3 and 5 years old need a little less at 10 to 13 hours per 24-hour period.

·      Children between 6 and 12 years old need 9 to 12 hours of sleep – not including naps- in a 24-hour period.

·      Teens between 13 and 18 years old need 8 to 10 hours per 24-hour period.

All told, babies, kids, and teens spend roughly 40 percent of their childhood asleep, according to the National Sleep Foundation.

The panel points out that the right amount of shut-eye is critical for a child’s developing brain and body and overall mental and physical health.

Researchers also noted that when children do not get enough sleep, their behavior is affected and their long-term health can be negatively impacted.

"Adequate sleep duration for age on a regular basis leads to improved attention, behavior, learning, memory, emotional regulation, quality of life, and mental and physical health," the American Academy of Pediatrics (AAP) wrote. "Not getting enough sleep each night is associated with an increase in injuries, hypertension, obesity and depression, especially for teens who may experience increased risk of self-harm or suicidal thoughts."

According to Dr. Nathaniel Watson, the president of the American Academy of Sleep Medicine, making sure that their child gets enough sleep is one of the best ways parents can lay a foundation of healthy habits that children can take with them into adulthood. With more than one third of the adult population sleep deprived, sleep becomes paramount for children to avoid the slew of consequences that come with a lifetime of sleep problems.

"The AAP endorses the guidelines and encourages pediatricians to discuss these recommendations and healthy sleep habits with parents and teens during clinical visits," they announced. "For infants and young children, establishing a bedtime routine is important to ensuring children get adequate sleep each night.”

Story source: Samantha Olson, http://www.medicaldaily.com/how-much-sleep-do-kids-need-sleeping-baby-constantly-tired-389448

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Discipline Kids That Are Not Yours?

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