Twitter Facebook RSS Feed Print
Your Baby

Moms Getting Poor Advice on Baby’s Health Care

2:00

Moms are getting conflicting advice on infant and child care from family members, online searchers and even their family doctors a recent study found.

Oftentimes, that advice goes against the American Academy of Pediatrics (AAP) recommendations for topics such as breast-feeding, vaccines, pacifier use and infant-sleep, researchers say.

"In order for parents to make informed decisions about their baby's health and safety, it is important that they get information, and that the information is accurate," said the study's lead author, Dr. Staci Eisenberg, a pediatrician at Boston Medical Center.

"We know from prior studies that advice matters," Eisenberg said. Parents are more likely to follow the recommendations of medical professionals when they "receive appropriate advice from multiple sources, such as family and physicians," she added.

The researchers surveyed more than 1,000 U.S. mothers. Their children were between 2 months and 6 months old. Researchers asked the mothers what advice they had been given on a variety of topics, including vaccines, breastfeeding, pacifiers and infant sleep position and location.

Sources for information included medical professionals, family members, online searches and other media such as television shows. Mothers got the majority of their advice from doctors. However, some of that advice contradicted the recommendations from the AAP on these topics.

For example, as much as 15 percent of the advice mothers received from doctors on breast-feeding and on pacifiers didn't match recommendations. Similarly, 26 percent of advice about sleeping positions contradicted recommendations. And nearly 29 percent of mothers got misinformation on where babies should sleep, the study found.

"I don't think too many people will be shocked to learn that medical advice found online or on an episode of Dr. Oz might be very different from the recommendations of pediatric medical experts or even unsupported by legitimate evidence," said Dr. Clay Jones, a pediatrician specializing in newborn medicine at Newton-Wellesley Hospital in Massachusetts. He said inaccurate advice from some family members might not be surprising, too.

Mothers got advice from family members between 30 percent and 60 percent of the time, depending on the topic. More than 20 percent of the advice about breast-feeding from family members didn't match AAP recommendations.

Similarly, family advice related to pacifiers, where babies sleep and babies' sleep position went against the AAP recommendations two-thirds of the time, the study found.

"Families give inconsistent advice largely because they are not trained medical professionals and are basing their recommendations on personal anecdotal experience," Jones said.

Less than half of the mothers said they used media sources for advice except when it came to breastfeeding. Seventy percent reported their main source of advice on breastfeeding came from media sources; many of these sources were not consistent with AAP recommendations.

In addition, more than a quarter of the mothers who got advice about vaccines from the media received information that was not consistent with AAP recommendations.

"Mothers get inconsistent advice from the media, especially the Internet, because it is the Wild West with no regulation on content at all," Jones said.

The possible consequences of bad advice depend on the topic and the advice, Jones said.

"Not vaccinating your child against potentially life-threatening diseases like measles is an obvious example," he said. "Others may result in less risk of severe illness or injury but may still result in increased stress and anxiety, such as inappropriately demonizing the use of pacifiers while breast-feeding."

Mothers who look for information online should stick to sources such as the AAP, the American Academy of Family Physicians or the U.S. Centers for Disease Control and Prevention, Eisenberg suggested.

Even though some advice from doctors did not follow AAP recommendations entirely, Eisenberg and Jones agreed that doctors are the best source for mothers on the health and care of their children.

"While our findings suggest that there is room for improvement, we did find that health care providers were an important source of information, and the information was generally accurate," Eisenberg said. "But I would encourage parents to ask questions if they don't feel like their provider has been entirely clear, or if they have any questions about the recommendations."

The study was published in the July edition of the journal Pediatrics.

Source: Tara Haelle, http://www.webmd.com/parenting/baby/news/20150727/new-moms-often-get-poor-advice-on-baby-care-study

 

Your Child

Gluten-Free Diet Not Recommended for Healthy Children

2:00

A “gluten-free “ label on a food product is one sure way to increase sales as the popularity of such items continues to rise.

For people with Celiac disease or gluten sensitivity, eating gluten can cause diarrhea, abdominal pain, upset stomach and bloating. However, for healthy adults and particularly children, there are many reasons to avoid going gluten-free according to a commentary recently published in the Journal of Pediatrics, by Norelle Reilly.

Dr. Norelle Reilly is Assistant Professor of Pediatrics at Columbia University Medical Center and the director of pediatric celiac disease in the Division of Pediatric Gastroenterology and the Celiac Disease Center at Columbia University.

In a recent Time Magazine article, Reilly lays out four reasons why healthy children should not be on a gluten-free diet.

1. Gluten is not naturally toxic except for people with celiac disease, however, in almost all children, gluten travels through the intestine without causing disease and will never lead to problems. To date, science has not shown that there is a toxin in gluten that makes it bad for our bodies. A balanced diet containing fresh fruits and vegetables, lean proteins, and a variety of carbohydrate sources is the best way for healthy children to stay healthy, Reilly notes.

2. A gluten-free diet may not provide balanced nutrition for children. Some people assume that gluten-free food and healthy food as the same thing. Not necessarily so, says Reilly.

Many gluten-free substitutes for items such as breads and cookies are actually higher in fat and calories than gluten-containing varieties. Gluten-free items such as some cereals and breads may also not be nutrient fortified to the same degree as those with gluten. Folate and B-vitamins are often added to our usual starch staples, silently protecting people whose diets may not be very balanced from deficiency. Without these quiet sources of nutrition, vitamin deficiencies could develop, she writes.

Gluten-free foods are often fiber deficient, which is important for gastrointestinal health, including maintaining regular bowel movements. Quite commonly, children who initiate a gluten-free diet become constipated. Increased consumption of rice, a common gluten substitute, may also expose children to more arsenic in their diets, as arsenic is frequently present in the earth where rice is grown.

Reilly says that growing bodies and brains require balanced nutrition. For those children who need a gluten-free diet, balance can be implemented safely and healthfully with the guidance of an experienced registered dietitian to help avoid all of these and other nutritional pitfalls.

3. Have your child tested for celiac disease before putting them on a gluten-free diet. You can’t know for sure whether your child is gluten sensitive or has celiac disease until a physician has tested them. Symptoms alone are not enough to determine whether your child has celiac disease. Being on a gluten-free diet before having your child tested can make it more difficult to determine whether he or she actually does or does not have the disease.

Reilly suggests that if you are concerned that your child may have a problem with gluten, speak to your child’s doctor before banning it from your child’s diet. A child with celiac disease needs special monitoring over time and their family members may need to be tested. Even if you plan to give the diet a try regardless of the test result, it is extremely important for your child and family’s health to know why the diet is necessary.

4. A gluten-free diet is hard to maintain and expensive. For children who require this limited diet for long-term health, parents, schools, and the medical teamwork to make the child’s experience in school and at home as easy as possible.

Reilly notes that the children she has treated for celiac disease would trade in their gluten-free diet in an instant if they knew gluten would not make them sick.

In addition she adds, gluten-free foods are incredibly expensive and for many families the diet can be challenging to financially sustain in the long run.

Many adults prefer a gluten-free diet, but Reilly cautions that parents should check with their pediatrician or family doctor before putting their healthy children on the same eating plan.

Story source: Norelle Reilly, http://time.com/4329517/4-reasons-why-your-kids-should-not-be-gluten-free/

Daily Dose

National Poison Prevention Week

1:30 to read

It is National Poison Prevention Week and it seem appropriate since I just received a call last week from an anxious mother whose toddler had gotten into some medication at their house. The child was fine but I reminded her that more than 2 million people each year, about half under the age of 6, ingest or come into contact with a poisonous substance.  The majority of these incidents occur when parents or babysitters are present but are not paying attention at the time. As I remind parents, it is IMPOSSIBLE to watch your child, even with just one child, all of the time. So…it is necessary to take steps to try to prevent accidental poisonings.

 

The most dangerous potential poisons are medicines, cleaning products, liquid nicotine, pesticides, gasoline and kerosene. I am always surprised to hear that a child will drink gasoline (YUCK right?) but toddlers do crazy things and put EVERYTHING in their mouths.

 

When “child-proofing” the house against so many dangers, try to keep as many poisonous products outs of a child’s reach and view as possible.  Install safety latches on all cabinets that may contain any hazardous products …including laundry products and cleaning products. I would advise against using any detergent “pods” with children under the age of 6 and use powder or liquid instead.  A safer product is worth a little bit of hassle!

 

Make sure that ALL medications, even vitamins are in containers with child safety caps (adults can’t open them but kids seem to?), but you must also keep them out of reach of children and I would recommend a cabinet that you can lock.  There have been several occasions when a parent has left a pill out on a counter for another child to take and then suddenly the toddler has chewed it up…this has been most common with stimulant medications.  Grandparents who are visiting also forget and leave their medications out and kids seem to find these as well.

 

Another common potential poison comes in the form of a button cell battery. These are common in remote controls, key fobs, greeting cards and even musical children’s books and not only pose a choking hazard but may cause tissue damage. If your child ingests a battery it is imperative that you seek immediate treatment at an emergency room.

 

If you are ever in doubt about the potential for poisoning call Poison Help at 1-800-222-1222. They are experts in walking you through potential side effects, treatments and need for an ER visit!  One of my patients just asked me if there is a limit to how many times you can call Poison Control…she seems to be a frequent flyer.

 

 

 

 

 

 

 

 

Your Child

FDA Warning: High Lead Levels in Herbal Remedy

2:00

The Food and Drug Administration is issuing a warning to parents and caregivers about high lead levels found in the herbal remedy, Balguti Kasaria Ayurvedic Medicine.

The herbal remedy is marketed for use in infants and children for various conditions such as rickets, cough and cold, worms, and teething. According to the product packaging, the product claims to help with digestion and bowel movement and improve the immune system.

The North Carolina Division of Public Health first reported high levels of lead after testing the product.

In addition, the Michigan Department of Health and Human Services notified the FDA that two children were found to have high levels of lead associated with the use of this product. The families of the children affected stated that they had the product mailed to them from India. At this time, the FDA has received one report of developmental delays in a child who was administered this product.   

Ayurvedic medicine is one of the world's oldest holistic healing systems. It was developed more than 3,000 years ago in India.

It’s based on the belief that health and wellness depend on a delicate balance between the mind, body, and spirit. Its main goal is to promote good health, not fight disease. But treatments may be geared toward specific health problems.

In the United States, it’s considered a form of complementary and alternative medicine (CAM).

Parents and caregivers should familiarize themselves with the symptoms of lead poisoning. High lead levels have also been found in toys, costume jewelry and other products that children use.

The symptoms are:

  • Developmental delay
  • Learning difficulties
  • Irritability
  • Loss of appetite
  • Weight loss
  • Sluggishness and fatigue
  • Abdominal pain
  • Vomiting
  • Constipation
  • Hearing loss
  • Seizures
  • Eating things, such as paint chips, that aren't food (pica)

Lead poisoning symptoms in newborns - Babies exposed to lead before birth might:

  • Be born prematurely
  • Have lower birth weight
  • Have slowed growth

The FDA is urging parents and caregivers to stop giving the product to children and to consult a healthcare professional. Balguti Kesaria is sold online and made by different companies, including Kesari Ayurvedic Pharmacy in India. The product has also been mailed or brought into the United States.

Story sources: Da Hee Han, PharmD, http://www.empr.com/safety-alerts-and-recalls/balguti-kesaria-ayurvedic-medicine-high-lead-levels/article/680132/

http://www.webmd.com/balance/guide/ayurvedic-treatments#1

http://www.mayoclinic.org/diseases-conditions/lead-poisoning/symptoms-causes/dxc-20275054

Your Child

Teaching Kids About the Meaning of Memorial Day

2:00

For many kids, Memorial Day is just another three-day weekend celebrated with family bar-b-cues, a visit to the lake or pool, watching the latest action movie or any other of the numerous ways people spend the beginning of warm weather and a holiday. This year it falls on May 29th.

What is often lost in the celebrations is the meaning of Memorial Day and why it is an important reminder of sacrifice and service. Talking to your child about the history of Memorial Day and what it stands for can help them learn about the immeasurable cost of the freedoms they enjoy.

The preamble to Memorial Day was Decoration Day, established in 1868 – three years after the Civil War ended. The Grand Army of the Republic (GAR) — established Decoration Day as a time for the nation to decorate the graves of the war dead with flowers. Maj. Gen. John A. Logan declared that Decoration Day should be observed on May 30. It is believed that date was chosen because flowers would be in bloom all over the country.

The first large observance was held that year at Arlington National Cemetery, across the Potomac River from Washington, D.C.

Local ceremonies were also held across the northern and southern parts of the United States, honoring union and confederate soldiers.  It was not until after World War I, however, that the day was expanded to honor those who have died in all American wars.

In 1971, Memorial Day was declared a national holiday by an act of Congress, though it is still often called Decoration Day. It was then also placed on the last Monday in May.

In December 2000,  “The National Moment of Remembrance Act” was passed to “encourage the people of the United States to give something back to their country, which provides them so much freedom and opportunity” by coordinating commemorations in the United States of Memorial Day and the National Moment of Remembrance.

The National Moment of Remembrance asks all Americans to pause wherever they are at 3 p.m. local time on Memorial Day for a minute of silence to remember and honor those who have died in service to the nation.

Memorial Day doesn’t have to be only a day of remembrance for our veterans, but also a day to think about and celebrate the lives of family and friends that have been lost.

Most children learn why we celebrate Christmas and other religious holidays. They learn early about what the July 4th holiday is all about. Many a child’s first play is the re-enactment of the pilgrims and Native American Indians gathering to share food on Thanksgiving. But Memorial Day is sometimes given a vague description or is scrambled in commercials promoting holiday savings.

Enjoy this 3-day holiday break from the stress of school and work but also take a little time to talk about the meaning of Memorial Day with your child. And perhaps, stop for a moment of silence at 3:00 pm in remembrance of those who have lost their lives because of their service to our country.

Story source: https://www.va.gov/opa/speceven/memday/history.asp

 

 

Your Baby

Safety Recall: Infant Bicycle Helmets

1:30

Pacific Cycle is recalling about 129,000 bicycle helmets with magnetic no-pinch buckle chinstraps, due to choking and magnet ingestion hazards. These helmets are sold exclusively at Target stores.

The magnetic buckle on the helmet’s chinstrap contains small plastic covers and magnets that can come loose, posing a risk of choking and magnet ingestion to young children.

The helmets are made for infants ranging from one to three years old. The helmet and its straps come in various colors and design patterns. The buckles have small plastic covers and enclosed magnets. “SCHWINN” is printed on the front of the helmets. Only helmets with the magnetic no-pinch chinstrap buckles are affected by this recall.

Pacific Cycle has received three reports of the plastic cover coming loose. No injuries have been reported.

Consumers should immediately take the helmets away from children and contact Pacific Cycle for instructions on how to receive a free replacement helmet.

The helmets were sold exclusively at Target stores and online at www.target.com from January 2014 through April 2016 for between $18 and $25.

Consumers can contact Pacific Cycle toll-free at 877-564-2261 from 8 a.m. to 5 p.m. CST Monday through Friday, email customerservice@pacific-cycle.com or online at www.schwinnbikes.com and click on “Support” then “Safety & Recalls” or www.target.com and click on “Product Recall” for more information. 

Source: http://www.cpsc.gov/en/Recalls/2016/Pacific-Cycle-Recalls-Infant-Bicycle-Helmets/

Your Teen

10 Reasons Teens Act The Way They Do

2:30

Anyone in the midst of raising a teen knows that the adolescent years can be some of the most difficult to get through and understand.

As a parent or guardian of a teenager that wants to be more independent, but also needs supervision and guidance, the times can be challenging indeed.

If that’s the position you find yourself in, you may be asking – what’s going on in that youngster’s brain? Actually, there’s a lot happening!

There are several scientific reasons an adolescent brain can be similar to a toddler’s: After infancy, the brain's most dramatic growth spurt occurs in adolescence. Here’s 10 things you may not know about your teen’s brain.

10. Critical period of development. Adolescence is generally considered to be the years between 11 and 19. It’s easy to see the outward changes that occur in boys and girls during this time, but inside, their brains are working on overdrive.

"The brain continues to change throughout life, but there are huge leaps in development during adolescence," said Sara Johnson, an assistant professor at the Johns Hopkins Bloomberg School of Public Health.

Parents should understand that no matter how tall their son has sprouted or how grown-up their daughter dresses, "they are still in a developmental period that will affect the rest of their life," Johnson told LiveScience

9. The growing brain. Scientists used to believe the greatest leap in neuronal connections occurred in infancy, but brain imaging studies show that a second burst of neuronal sprouting happens right before puberty, peaking at about age 11 for girls and 12 for boys.

The adolescent's experiences shape this new grey matter, mostly following a "use it or lose it" strategy, Johnson said. The structural reorganization is thought to continue until the age of 25, and smaller changes continue throughout life.

8. New Thinking Skills. This increase in brain matter allows the teenager to become more interconnected and gain processing power, Johnson notes.

If given time and access to information, adolescents start to have the computational and decision-making skills of an adult. However, their decisions may be more emotional than objective because their brains rely more on the limbic system (the emotional seat of the brain) than the more rational prefrontal cortex.

"This duality of adolescent competence can be very confusing for parents," Johnson said, meaning that sometimes teens do things, like punching a wall or driving too fast, when, if asked, they clearly know better.

Sound familiar?

7.  Teen tantrums. While teens are acquiring amazing new skills during this time, they aren’t that good at using them yet, especially when it comes to social behavior and abstract thought.

That’s when parents can become the proverbial guinea pig. Many kids this age view conflict as a type of self-expression and may have trouble focusing on an abstract idea or understanding another's point of view.

Particularly in today’s heavy media influenced world, teens are dealing with a huge amount of social, emotional and cognitive flux says Sheryl Feinstein, author of Inside the Teenage Brain: Parenting a Work in Progress (Rowman and Littlefield, 2009.)

That’s when they need a more stable adult brain (parents) to help them stay calm and find the better path.

6. Intense emotions. Remember the limbic system mentioned earlier (the more emotional part of the brain)? It’s accelerated development, along with hormonal changes, may give rise to newly intense experiences of rage, fear, aggression (including towards oneself), excitement and sexual attraction.

Over the course of adolescence, the limbic system comes under greater control of the prefrontal cortex, the area just behind the forehead, which is associated with planning, impulse control and higher order thought.

As teens grow older, additional areas in the brain start to help it process emotions and gain equilibrium in decision-making and interpreting others. But until that time, teens can often misread parents and teachers Feinstein said.

5. Peer pressure. As teens become better at abstract thinking, their social anxiety begins to increase.  Ever wonder why your teen seems obsessed with what others are thinking and doing?

Abstract reasoning makes it possible to consider yourself from the eyes of another. Teens may use this new skill to ruminate about what others are thinking of them. In particular, peer approval has been shown to be highly rewarding to the teen brain, Johnson said, which may be why teens are more likely to take risks when other teens are around.

Friends also provide teens with opportunities to learn skills such as negotiating, compromise and group planning. "They are practicing adult social skills in a safe setting and they are really not good at it at first," Feinstein said. So even if all they do is sit around with their friends, teens are hard at work acquiring important life skills.

4. Measuring risk.  "The brakes come online somewhat later than the accelerator of the brain," said Johnson, referring to the development of the prefrontal cortex and the limbic system respectively.

At the same time, "teens need higher doses of risk to feel the same amount of rush adults do," Johnson said. Not a very comforting thought for parents.

This is a time when teens are vulnerable to engaging in risky behaviors, such as trying drugs, sex, getting into fights or jumping into unsafe water.

So what can a parent do during this risky time? "Continue to parent your child." Johnson said. Like all children, "teens have specific developmental vulnerabilities and they need parents to limit their behavior," she said.

It’s when being a parent to your child instead of trying to be their “friend” is more difficult but much more important for their physical and emotional safety.

3. Yes, parents are still important. According to Feinstein, a survey of teenagers revealed that 84 percent think highly of their mothers and 89 percent think highly of their fathers. And more than three-quarters of teenagers enjoy spending time with their parents; 79 percent enjoy hanging out with Mom and 76 percent like chilling with Dad. That’s not 100%, but it’s probably more than you thought.

One of the tasks of adolescence is separating from the family and establishing some autonomy, Feinstein said, but that does not mean a teen no longer needs parents – even if they say otherwise.

"They still need some structure and are looking to their parents to provide that structure," she said. "The parent that decides to treat a 16 or 17 year old as an adult is behaving unfairly and setting them up for failure." 

Listening to your teen and being a good role model, especially when dealing with stress and the other difficulties life can present, can help your teen figure out their own coping strategies.

2. Sleep. Ah, yes, sleep. Although teens need 9 to 10 hours of sleep a night, their bodies are telling them a different story. Part of the problem is a shift in circadian rhythms during adolescence: It makes sense to teen bodies to get up later and stay up later, Johnson said.

But due to early bussing and class schedules, many teens rack up sleep debt and "become increasingly cognitively impaired across the week," Johnson said. Sleep-deprivation only exacerbates moodiness and cloudy decision-making. And sleep is thought to aid the critical reorganization of the teen brain.

"There is a disconnect between teen’s bodies and our schedules," Johnson said.

Shutting down the electronics an hour before bedtime has been shown to help teens as well as adults get to sleep quicker and sleep better. No computer, TV, video games or cell phones.

1.The “I am the Center of the Universe” syndrome. You may have noticed that your teen’s hormones are causing quite a bit of havoc. Experts say that’s to be expected. But you may still wonder- what the heck is going on with my kid?

The hormone changes at puberty have huge affects on the brain, one of which is to spur the production of more receptors for oxytocin, according to a 2008 issue of the journal Developmental Review.

The increased sensitivity caused by oxytocin has a powerful impact on the area of the brain controlling one’s emotions. Teens develop a feeling of self-consciousness and may truly believe that everyone is watching him or her. These feelings peek around age 15.

While this may make a teen seem self-centered (and in their defense, they do have a lot going on), the changes in the teen brain may also spur some of the more idealistic efforts tackled by young people throughout history.

"It is the first time they are seeing themselves in the world," Johnson said, meaning their greater autonomy has opened their eyes to what lies beyond their families and schools. They are asking themselves, she continued, for perhaps the first time: What kind of person do I want to be and what type of place do I want the world to be?

Until their brains develop enough to handle shades of grey, their answers to these questions can be quite one-sided, Feinstein said, but the parents' job is to help them explore the questions, rather than give them answers.

And there you have it. Teen’s brains are exploding with new data, confusing signals and dueling desires. It’s a tough time in one’s development- but rest assured, what you teach them by example and compassion as well as how you gingerly help guide them will last a life-time. Even when you do the best you can, there are no guarantees that they will turn out the way you’re hoping they will – they are after all- individuals with a will and a mind of their own. But now you know a little more about why your teen acts the way they do.

Story Source: Robin Nixon, http://www.livescience.com/13850-10-facts-parent-teen-brain.html

Daily Dose

Lead Testing

1:30 to read

Lead exposure is young children may lead to long term consequences. Therefore, blood lead level testing has been recommended for all children at their 1 and 2 year check ups. Most doctors offices either prick a child’s finger or heel to draw the blood for testing, and many use an in office machine to perform the test.  

 

Some of the blood testing is performed by Magellan Diagnostics and the F.D.A. just announced that the 3 minute test run in many doctor’s offices could “yield inaccurate results when used on blood drawn from a vein”.  The F.D.A. went on to say “that there was no evidence at this point that the finger and heel prick methods have provided inaccurate results, and for some reason only venous blood has been associated with inaccurate readings”. 

 

I have already been getting some calls and emails from concerned parents wondering if their child needs to have repeat testing performed.  Fortunately, in our office we have routinely used capillary blood from a finger stick. We test that specimen for both lead and also a hemoglobin test to look for anemia.  You would probably remember a “venous blood draw” as it requires finding a vein (usually in the crook of the arm) and actually using a needle and syringe to draw the blood sample…a lot more difficult than a finger stick, especially in a squirming toddler.

 

We are all exposed to some lead in our environment, and lead levels under 5 mcg/dl as being “safe”.  If a child’s screening lead level is higher than 5, then most doctors will draw a venous sample to confirm the elevated levels and to then try to determine if the lead exposure is coming from the home, school, or environment. Infants and young children are especially vulnerable to the effects of long term lead exposure and lead poisoning, especially during periods of rapid brain growth and development. High lead levels may lead to long term effects on IQ and performance as well as affecting other body systems.

 

If your child is under the age of 6 years and you are concerned about the accuracy of their lead testing, you should call your doctor’s office and inquire if they had testing done on venous or capillary blood.  If there are concerns it would be appropriate to draw another sample from capillary blood or sent to an outside lab.  It is estimated that most of the testing performed in a doctor’s office was done on Magellan equipment which is used by about 10,000 pediatricians throughout the country.

 

Play
1868 views in 2 years
Health

Parenting News You Can Use

Pages

Please fill in your e-mail address to be included in our newsletter.
You may opt out at any time.

 

DR SUE'S DAILY DOSE

Count your blessings this Thanksgiving!

Please fill in your e-mail address to be included in our newsletter.
You may opt out at any time.

 

Please fill in your e-mail address to be included in our newsletter.
You may opt out at any time.