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Daily Dose

Acetaminophen & Vaccines

1:30 to read

A recent article in Lancet was quite thought provoking as it studied the common practice of giving infants a dose of acetaminophen (Tylenol) with their routine immunizations.

Many parents and some pediatricians routinely dose their infants with acetaminophen prior to receiving their vaccines at two, four and six months of age. In the study of 459 infants from 10 different centers in the Czech Republic, patients were randomized to either receive three doses of acetaminophen every six to eight hours at the time of vaccination or no acetaminophen. The researchers then looked at both the reduction of febrile reactions post vaccination and at antibody titers among the two groups. Interestingly, there were both some expected and some not so expected results. Not surprisingly, the group that received acetaminophen had a lower incidence of fever post immunization. Of those that received acetaminophen 94 out of 226 (42 percent) developed a fever, compared to 154 out of 233 (66 percent) in the non-treated group after their primary immunization series. After booster vaccination 64 out of 178 (36 percent) in the treated group and 100 out of 172 (58 percent) developed fever. So the widespread perception by both many parents and doctors that routine acetaminophen use with vaccination does reduce the incidence of fever was supported.

The most interesting result of this study was the vaccine antibody response in the acetaminophen treated group. Surprisingly, antibody responses to several of the routinely administered vaccines (including tetanus, diphtheria, h. flu, and pneumococcal serotypes) were lower in the group who received routine acetaminophen. This was also seen after booster doses of the same vaccines between 15 to 18 months of age. The hypothesis is that acetaminophen may reduce the inflammatory response and that this may also induce less of an immune response. So, it would seem prudent to no longer encourage routine use of acetaminophen with vaccines unless a baby develops significant fever, or is at risk for fever and febrile seizures. As a parent you are always trying to “protect” you child, and this would include any pain or fever that might develop with vaccination. Now we have science to show how this may actually provide less protection, against disease. Thought provoking!

That’s your daily dose, we’ll chat again tomorrow.

Your Teen

Schools Start Too Early, Teens Sleep Deprived

2:00

It’s a battle that is picking up steam, whether to start school a little later so teenagers can get the sleep they need or keeping schedules as they are for the sake of planning before and after school activities.

Research from the American Academy of Pediatrics (AAP) found that teenagers are biologically programmed to go to bed later than most adults and sleep later in the morning.

Last year, the AAP issued a set of guidelines recommending that school schedules are modified across the U.S. to start at 8.30 a.m. This way, children and teens would be able to meet the recommended sleep hours per night during school days.

Fewer than one in five middle and high schools in the United States start at 8:30 am or later, as recommended, according to data from the U.S. Centers for Disease Control and Prevention (CDC).

The same recommendations suggested that indeed, the biological rhythm of teenagers particularly is very different than that of adults. While they need 8 and a half to nine and a half hours of sleep per night, their circadian rhythm doesn’t allow them to go to sleep before midnight or a little after.

School nights are particularly difficult for adolescents because in order to get the rest they need, they have to go to bed earlier than their minds and bodies are set to fall asleep.

The CDC released a new study supporting the recommendations of the AAP. According to the findings, 83 percent of U.S. schools still start before 8:30 a.m. On average, the starting time was calculated at 8:03 a.m., based on data collected from 39,700 combined schools, middle schools, and high schools between 2011-2012.

Depriving teens of that sleep could wreak havoc on their academic performance, the CDC said in its Morbidity and Mortality Weekly Report.

"Getting enough sleep is important for students' health, safety, and academic performance," said Anne Wheaton, lead author and epidemiologist in CDC's Division of Population Health.

"Early school start times, however, are preventing many adolescents from getting the sleep they need."

The issue is driving a heated debate between supporters of later school start times and school administrators.

Safwan Badr, former president of the American Academy of Sleep Medicine stated:

“It makes absolutely no sense. You’re asking kids to learn math at a time their brains are not even awake”.

On the other hand, Daniel Domenech, the executive director of the School Superintendents Association stated with regards to changing school starting time:

“It’s a logistical nightmare. This has been going on forever, and kids have been graduation from school and going to college. It certainly doesn’t seem to have hurt them all these years”.

Some experts note that the long-term consequence of sleep deprivation is hurting our teens and has been for quite some time.

Judith Owens, the director of sleep medicine at Boston’s Children Hospital suggests that chronically sleep deprivation characterizes the majority of today’s teens. This results in increased risk of onset depression, substance abuse, unhealthy BMIs. Long-term effects of sleep deprivation result in type 2 diabetes or heart diseases.

There are things that parents can do to help their teens at least rest better if they can’t fall asleep earlier. The first and foremost agitator for sleep is viewing or being on a computer or smartphone right before bed.

Recent studies have shown that the use of any electronic device in the hour before bedtime was associated with an increased risk of taking longer than 60 minutes to fall asleep. In particular, the use of a computer, smartphone or MP3 player in the hour before bedtime was strongly linked with taking longer to fall asleep.

Make your teen’s bedroom a quiet place that can be a retreat at night from busy schedules and social media.

Your teen can take a hot bath or shower before bed to boost deep sleep. Then keep his or her room cool (about 68 F) to cool down the body. One study showed that sleep happens when the body cools. Wakefulness occurs when the body temperature warms up.

Aromatherapy helps some people fall off to sleep. Certain scents are shown to be relaxing such as orange blossom, marjoram, chamomile, and lavender. You can apply these oils before bed or put them on pillows, sheets or in potpourri. If candles are used, make sure they are put out before getting in bed. 

Having a regular schedule can help the body adjust. Going to bed at the same time each night can assist in adjusting the body’s circadian rhythm.  

More high schools are considering changing their schedules to a later start time, but currently most schools are keeping with the typical earlier schedules. You may not be able to convince the school board to start school at little later, but you can help your teen find what works for them at night to help them get the amount of sleep they need to function at their best.

Sources: Bonnie Gleason, http://www.trinitynewsdaily.com/chronically-sleep-deprived-teens-need-schools-starting-time-changed/3209/

http://www.ctvnews.ca/health/u-s-teens-start-school-too-early-need-more-sleep-study-1.2506322

http://teens.webmd.com/features/8-ezzz-sleep-tips-teens

 

 

 

Your Baby

Should You Let Your Baby Cry Itself to Sleep?

1:30

As any parent of an infant will tell you- sleep is a precious thing. So, what’s the best way to get your baby to sleep through the night? There are many ways to help baby drop off to dreamland, but two of the most common had researchers wondering if there might be long-term harm resulting from these techniques.

Turns out, they was nothing to worry about.

The study tested two methods; graduated extinction and bedtime fading.

Graduated extinction is more commonly known as controlled-crying or letting baby cry his or herself to sleep while learning how to self-soothe without parental involvement

Bedtime fading is keeping baby awake longer to help them drop of more quickly.

Researchers discovered that both techniques work and neither had any long-term negative effects.

The graduated extinction approach also showed babies waking up fewer times during the night.

Parents worry about the controlled-crying method, in particular, according to study leader Michael Gradisar, a clinical psychologist at Flinders University, in Adelaide, Australia.

With that technique, parents resist the urge to immediately respond to their baby’s nighttime cries, so he or she can learn to self-soothe. Some parents worry that will damage their baby emotionally, and possibly cause "attachment" problems or other issues in the long run, Gradisar explained.

But, he said, his team found no evidence that was the case.

For the study, the researchers randomly assigned parents of 43 babies to one of three groups: one that started practicing controlled crying; one that took up bedtime fading; and a third, "control" group that was just given information on healthy sleep.

The babies ranged in age from 6 months to 16 months. All had a "sleep problem," according to their parents.

Parents in the controlled-crying group were given a basic plan: When their baby woke up crying during the night, they had to wait a couple of minutes before responding. They could then go comfort, but not pick up, the baby.

Over time, parents gradually let their baby cry for longer periods before responding.

Bedtime fading is a "gentler" approach, according to Gradisar: The aim is to help babies fall asleep more quickly by putting them down later.

Parents in that study group were told to delay their baby's bedtime for a few nights -- to 7:15 p.m. instead of 7 p.m., for instance. If the baby was still having trouble falling asleep, bedtime could be pushed back another 15 minutes.

After three months, the researchers found, babies in both sleep-training groups were falling asleep faster when their parents put them down -- between 10 and 13 minutes faster, on average. On the other hand, there was little change in the control group.

A year after the study's start, children in the three groups had similar rates of behavioral and emotional issues. They were also similar in their "attachment" to their parents -- which was gauged during standard tests at the research center.

Experts say that infants are usually able to sleep longer through the night, as they get a little older. By the age of 6 months, 80 percent of infants sleep all night. By 9 months, about 90 percent do.

If your baby doesn’t seem to be able to sleep through the night by those ages, contact your pediatrician to see if your little one may have a problem that needs checking out.

Story source: Amy Norton, http://www.webmd.com/parenting/baby/news/20160524/what-really-works-to-help-baby-sleep

 

Your Child

The Benefits of Being Bilingual

2.00 to read

Do children who speak more than one language score higher on cognitive tests? Yes, according to a new Canadian study. Researchers say that bilingual students develop a deeper understanding of the structure of language, an important skill in learning to read and write.

Cognitive tests study the mental processes that allow us to perform daily functions such as paying attention, solving problems, producing and understanding language appropriately and making decisions.

Does being bilingual make a child smarter? Not necessarily, but previous studies have shown that children who learn two languages from birth are able to concentrate on the meaning of words better than monolingual children and have an advantage in developing multi-tasking skills.

In the Canadian study, researchers compared 104 six-year olds to measure their cognitive development. Some children were English speaking only. Others were Chinese-English bilinguals, French-English bilinguals, and Spanish-English bilinguals.

The experiments investigated the effects of language similarity, cultural background and educational experience on verbal and non-verbal abilities.

The children did a battery of tests that measured verbal development and one non-verbal task that measured executive control, in this case, the ability to focus attention where necessary without being distracted and then shift attention when required. The bilingual children demonstrated a superior ability to switch tasks.

"The results endorse the conclusion that bilingualism itself is responsible for the increased levels of executive control previously reported," the study's authors wrote.

To acquire language, bilingualism where the languages are similar in origin may have slight advantages, the researchers found. For example, Spanish-English bilinguals outperformed Chinese-English bilinguals and monolinguals on a test of awareness of the sound structure of spoken English.

Dr. Ellen Bialystok, one of the world's foremost experts on bilingualism among children, led the group of researchers from York University in analyzing the effects of bilingualism. Summarizing the results, Dr. Bialystok commented, "Our research has shown that reading progress amongst all bilingual children is improved" over monolingual children. In a separate statement, she said, "I think there's a lot of worry out there about other languages conflicting with a child's ability to learn to read in English, but that's absolutely not the case. Parents should not hesitate to share their native tongue with their children—it's a gift."

Because bilingualism is often tied to other factors such as culture, socioeconomic status, immigration history and language, the researchers partly took those into account by enrolling participants who all attended public schools and came from similar socio-economic backgrounds.

During the study, the children learned to read in both languages at the same time. Dr. Bialystok and her team thought that the additional time spent learning two languages might give the children an advantage. But, results showed that the advantages garnered by the children were independent of the instruction time in the other language.

Researchers noted in the online issue of the journal Child Development that "People always ask if the languages themselves matter and now we can definitively say no," study co-author, Dr. Bialystok, said in a release.

Learning a second language teaches children more about their first language. They understand the intricacies of grammar and acquire an additional awareness of how language is used to express thoughts.

The Canadian study was published in the February 8th, online issue of the journal Child DevelopmentThe study was funded by the U.S. National Institutes of Health.

Sources: http://www.cbc.ca/news/health/story/2012/02/08/bilingual-children-brain....

http://www.early-advantage.com/articles/learningtoread.aspx

Your Child

Can Dogs Help Kids Be Less Anxious?

1:45

Scientific studies have already linked fewer allergies and asthma in kids that own dogs, now a new study says you can also add less anxiety to the list of benefits from man’s best friend.

Researchers say a new study shows kids who live in a home with a pet dog score far lower on clinical measures of anxiety.

Although the study was small, the results were not surprising. Researchers focused on 643 kids between 6 and 7. But the team at Bassett Medical Center in New York found that just 12 percent of children with pet dogs tested positive for clinical anxiety, compared to 21 percent of children without a dog.

"It may be that less anxious children have pet dogs or pet dogs make children less anxious," Dr. Anne Gadomski and colleagues wrote in the journal Preventing Chronic Disease.

Previous studies have also shown that adults benefit from owning a pet as well as kids. In fact, many health officials suggest that adults should consider getting a dog. Not only can they provide companionship but can encourage more exercise.

Gadomski acknowledged how special pets can be to a child by noting that, "Sometimes their first word is the name of their pet," she told NBC News. "There is a very strong bond between children and their pets."

What makes dogs such special pets for kids?  Godmski’s team said, "From a mental health standpoint, children aged 7 to 8 often ranked pets higher than humans as providers of comfort and self-esteem and as confidants," they wrote.

"Animal-assisted therapy with dogs affects children's mental health and developmental disorders by reducing anxiety and arousal or enhancing attachment," they added.

"Because dogs follow human communicative cues, they may be particularly effective agents for children's emotional development."

The researchers asked parents for specific details about what type of anxiety a child showed.

Pets seemed to help in several areas.

"Significant differences between groups were found for the separation anxiety component ('My child is afraid to be alone in the house') and social anxiety component ('My child is shy') favoring pet ownership," they wrote.

Most of the families in the study - 73 percent - had a pet of some kind. Most - 58 percent - had dogs. Families with pets may be more stable and may be more affluent, but the researchers suggest there's more to it than that.

"A pet dog can stimulate conversation, an ice-breaking effect that can alleviate social anxiety via a social catalyst effect," they wrote.

Other studies have also shown that playing or cuddling with a dog can release the bonding hormone oxytocin, and lower the stress hormone cortisol, they noted.

There’s already an abundance of research on dogs and families, which is one of the reasons Gadomski chose to look at the relationship between dogs and kids for this study.

However, she noted that cat lovers might also benefit from the same type of interaction.

If you’re interested in getting a dog as a pet for your family, there are several websites that offer a quiz to help families decide which breed may best be suited for them. Just search “best dog breeds for families.”

Shelters also have puppies and dogs that make wonderful pets.  Many of the older dogs are already house trained and socialized. Shelter staff can answer your questions about whether a particular dog that is up for adoption would be suitable for a family and small children.

Source: Maggie Fox, http://www.nbcnews.com/health/kids-health/heres-reason-get-puppy-kids-pets-have-less-anxiety-n469591

Image:http://www.popsugar.com/moms/Benefits-Dogs-Kids-36052085#photo-36052085

 

 

 

 

Your Baby

Study: Fracking Linked to Babies Low Birth Weight

High volume fracturing, also known as fracking, has increased in production all through the United States. The process allows access to large amounts of natural gas trapped in shale deposits by utilizing natural gas wells.

These types of wells were once more likely to be found in rural settings but are now increasingly located in and near populated neighborhoods.

A new study from the University of Pennsylvania has found a link between mothers who live close to high volume fracking wells and an increased risk of having a lower birth weight baby.

Researchers analyzed the birth records of more than 15,400 babies born in Pennsylvania's Washington, Westmoreland and Butler counties between 2007 and 2010.

Women who lived close to a high number of natural gas fracking sites were 34 percent more likely to have babies who were "small for gestational age" than mothers who did not live close to a large number of such wells, the study found.

Small for gestational age means a baby is smaller than normal based on the number of weeks the baby has been in the womb, according to the March of Dimes.

The findings held true even after other factors were accounted for such as whether the mother smoked, her race, age, education and prenatal care. Also taken into account was whether she had previous children and the baby’s gender.

Like other cities around the country, the number of fracking sites in Pennsylvania’s Marcellus Shale has increased substantially in the last few years. In 2007 there were 44 wells; by 2010, more than 2,800.

"Our work is a first for our region and supports previous research linking unconventional gas development and adverse health outcomes," study co-author Bruce Pitt, chair of the University of Pittsburgh Graduate School of Public Health's Department of Environmental and Occupational Health, said in a university news release.

"These findings cannot be ignored. There is a clear need for studies in larger populations with better estimates of exposure and more in-depth medical records," he added.

The main concerns around fracking sites are the air and noise pollution and waste fluids.

"Developing fetuses are particularly sensitive to the effects of environmental pollutants. We know that fine particulate air pollution, exposure to heavy metals and benzene, and maternal stress all are associated with lower birth weight," Pitt said.

While the study provides an association between fracking and lower weight babies, it does not prove that living close to a high concentration of natural gas fracking sites causes lower birth weights. Researchers said that they believe the study’s findings warrant further investigations.

The study was published online in the June edition of the journal PLOS One.

Source: Robert Preidt, http://consumer.healthday.com/environmental-health-information-12/environment-health-news-233/fracking-linked-to-low-birth-weight-babies-700018.html

Your Teen

What Is the Most Common and Deadly Cancer Found in Teens?

2:00

Do you know the most common and deadly cancer found in teens and young adults? You may be as surprised as I was when I read that a new study shows it is brain cancer.  It’s also not a particular type of brain cancer, but can vary widely as people age.

"For these individuals -- who are finishing school, pursuing their careers and starting and raising young families -- a brain tumor diagnosis is especially cruel and disruptive," said Elizabeth Wilson, president and CEO of the American Brain Tumor Association (ABTA).

"This report enables us for the first time to zero in on the types of tumors occurring at key [age] intervals over a 25-year time span, to help guide critical research investments and strategies for living with a brain tumor that reflect the patient's unique needs," Wilson said in an association news release.

Researchers look at data from 51 separate cancer registries, representing 99.9 percent of the U.S. population in the 15 to 39 year-old-age group.

While 2 types of tumors were the most frequently found in this age group, brain and central nervous system tumors, the report also noted that other types of cancer became more prevalent as people got older.

"What's interesting is the wide variability in the types of brain tumors diagnosed within this age group, which paints a much different picture than what we see in [older] adults or in pediatric patients," said report senior author Jill Barnholtz-Sloan, an associate professor at Case Western's Comprehensive Cancer Center in Cleveland.

"For example, the most common tumor types observed in adults are meningiomas and glioblastomas, but there is much more diversity in the common tumor types observed in the adolescent and young adult population," Barnholtz-Sloan said in the news release.

"You also clearly see a transition from predominantly nonmalignant and low-grade tumors to predominantly high-grade tumors with increasing age," she added.

Nearly 700,000 people in the United States have brain and central nervous system tumors. And more than 10,600 such tumors are diagnosed in teens and young adults each year, with 434 dying of their disease annually, according to the ABTA.

The most common treatment for brain cancer continues to be surgery, radiation and chemotherapy. However, new research is looking into the development of tailored therapeutics involving a combination of targeted agents that use different molecules to reduce gene activity and suppress uncontrolled growth by killing or reducing the production of tumor cells based on their genetic character. Experimental treatment options may include new drugs, gene-therapy and biologic modulators that enhance the body’s overall immune system to recognize and fight cancer cells.

"There are clearly unique characteristics of the 15-39 age group that we need to more comprehensively understand, and the information in the ABTA report starts that important dialogue," Barnholtz-Sloan said.

The ABTA-funded report was recently published in journal Neuro-Oncology.

Story source: Robert Preidt, http://consumer.healthday.com/cancer-information-5/brain-cancer-news-93/brain-cancers-both-common-and-deadly-among-young-adults-report-shows-708339.html

http://www.ninds.nih.gov/disorders/brainandspinaltumors/brainandspinaltumors.htm

Your Child

Antibiotics Often Prescribed When Not Needed

2.00 to read

By now, most parents understand that antibiotics are not effective for viral infections, only for illnesses caused by bacteria.

However, that hasn’t deterred many physicians from over-prescribing antibiotics for children with ear and throat infections.

More than 11 million antibiotic prescriptions written each year for children and teens may be unnecessary, according to researchers from University of Washington and Seattle Children's Hospital. This excess antibiotic use not only fails to eradicate children's viral illnesses, researchers said, but also supports the dangerous evolution of bacteria toward antibiotic resistance.

"I think it's well-known that we prescribers overprescribe antibiotics, and our intent was to put a number on how often we're doing that," said study author Dr. Matthew Kronman, an assistant professor of infectious diseases at Seattle Children's Hospital.

"But as we found out, there's really been no change in this [situation] over the last decade," added Kronman. "And we don't have easily available tools in the real-world setting to discriminate between infections caused by bacteria or viruses."

 Doctors have limited resources when it comes to differentiating between bacterial or viral infections. Physicians can use the rapid step test to determine if the streptococcus bacteria is the cause of a child’s sore throat, but that is about it for immediate diagnostic tools.

Most colds are virus related and one of the first symptoms will be a sore or scratchy throat. It will typically go away after the first day or so and other cold symptoms will continue. Strep throat is often more severe and persistent.

A virus often causes ear infection as well. Many doctors treat ear infections as though they are bacterial to be on the safe side and avoid serious middle ear infections.

To determine antibiotic prescribing rates, Kronman and his colleagues analyzed a group of English-language studies published between 2000 and 2011 and data on children 18 and younger who were examined in outpatient clinics.

Based on the prevalence of bacteria in ear and throat infections and the introduction of a pneumococcal vaccine that prevents many bacterial infections, the researchers estimated that about 27 percent of U.S. children with infections of the ear, sinus area, throat or upper respiratory tract had illnesses caused by bacteria.

But antibiotics were prescribed for nearly 57 percent of doctors' visits for these infections, the study found.

Kronan hopes that the study’s results will encourage the development of more diagnostic tools and will spur doctors to think more critically about prescribing antibiotics unless clearly needed.

Previous research has shown that parents often pressure their doctor to prescribe an antibiotic to treat their child’s ear or sore throat symptoms. However, when parents are given other suggestions on how to alleviate the symptoms they have been much more receptive than when their doctor just flat out says he won’t prescribe antibiotics.

Many physicians and researchers are concerned that the amount of antibiotics being prescribed these days is setting us all up for future problems when dealing with bacterial infections. Bacteria are adaptable and mutate over time becoming less responsive to antibiotics. When possible, it’s much healthier in the long run to treat your child’s symptoms with simpler therapies. Ask your physican ways you can make your little one more comfortable until the symptoms pass. 

The study was published online in the journal Pediatrics.

Source: Maureen Salamon, http://consumer.healthday.com/infectious-disease-information-21/antibiotics-news-30/antibiotics-prescribed-twice-as-often-as-needed-in-children-study-says-691686.html

Daily Dose

No Screen Time for a Week!

Kids are spending over 7 hours a day in front a screen: TV, watching video, playing games event texting. How much is too much?So, how much screen time does your child have?  You know what I mean, TV time, computer time, playing video games, using a cell phone (including texting). The list goes on and on!

The average American child spends 7 hours a day involved with some type of media, which is more than any other activity besides SLEEP! With that being said, this is National Turn Off Week!  My colleagues at the American Academy of Pediatrics are supporting an effort to encourage parents to implement a “screen free week” in their home. If the average child spends over 1000 hours a year involved in some type of media but only 900 hours a year in school it seems obvious that we are doing something wrong. The solution is to start limiting screen time beginning at the earliest ages. With so many parents believing that Baby Einstein videos will make their infant smarter (there is no proof), and parents who are teaching their children to use a computer or I-phone or I-pad by the age of two, early guidelines regarding time spend “on screen” are exceedingly important. The AAP endorses a “no TV for children under the age of two” rule and limiting TV/media time to 2 hours per day for children and teens.  Unfortunately, many parents may know that their children are home, but are not clear about what they are doing while at home, which often involves screen time in the “privacy” of their own rooms. I ask every patient and or parent about media time and if there is a TV or computer in the child’s room. I am continually amazed at how often the answer is yes, even for the elementary school set. Parents often view putting a TV in their child’s room as a “right of passage” despite the fact that there are really good studies to show that having a TV in a child’s room contributes to poor sleep habits which may impact children in many negative ways. I must say, there isn’t a teenager that I take care of that is “happy” that we are discussing media time, but just like other subjects that need to be addressed during a pediatric visit, this one may be more important than previously thought. For all of this interactive screen time may actually be becoming new “peer group” for a child, rather than having face to face time with their peers. So by turning off the “screens” and spending some time enjoying one another, a new normal could be started.  Families cooking together after the homework is finished, or going outside for a family walk or quick game, or reading together, or even playing board games, the list seems endless.  What a treat to get back 2, 3 or even 4 hours a day with your child.  Think about the  benefits that come from decreasing screen time, which include better academics, better sleep, less depression and anxiety and even an impact on obesity. I know it is challenging for all of us, but this is a “do-able” task for a week. While all of the screen are in the “OFF” mode, talk about new guidelines for when the screens go back on.  In this case the adage “less is more” seems appropriate. That's your daily dsoe for today.  We'll chat again tomorrow. Send your question or comment to  Dr. Sue!

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