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Welcome Dr. Lily Joseph

We are very excited to announce that Dr. Lily Joseph will be joining Spring Valley Pediatrics this summer.

A native Washingtonian and former patient of Spring Valley Pediatrics, Dr. Joseph is a graduate of the University of Pennsylvania where she earned a B.A. with honors in Psychology and Chemistry. She went on to attend Georgetown University School of Medicine where she was honored for excellence in Pediatrics. She completed her pediatric residency at Children’s National Medical Center.

Dr. Joseph emphasizes health education and prevention in her practice. She is especially interested in childhood development, mental health, and creating long-lasting relationships with patients and families. She is thrilled to return to Spring Valley Pediatrics to provide her patients with the same excellent care she received as a child.

She lives in Washington, D.C. with her husband and their corgi, Abraham. In her free time, she enjoys experimenting with new recipes at home and eating at D.C.’s many delicious restaurants.

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The Common Cold

Dr Shawn Binns, MD, helps us navigate this runny nose time of year.

It’s back to school season once again, and we all know what that means – a return of those all-too-familiar coughs, sniffles, and sneezes. That’s right, cold and flu season is upon us once again.

The common cold is a viral illness that is associated with varying amounts of cough, congestion, sore throat, fevers, headaches, decreased appetite, and fatigue. It is not caused by just one type of virus – rather by many different viruses including rhinoviruses, adenoviruses, enteroviruses, and parainfluenza viruses. RSV is also a common cold virus, though may cause more significant symptoms in infants and young toddlers. Influenza viruses tend to cause a more abrupt onset of symptoms, higher fevers (102-104F), body aches, and more of an upset stomach than the common cold does. I’ll mainly focus on the common cold today, but check back later this season for more information on the flu.

How do you get it?

Cold viruses are usually transmitted via droplets that spread from a cough or sneeze of an infected person or from touching a virus-contaminated surface and then touching our nose or eyes – no wonder they’re so easy to catch!

It is entirely normal for your child to have around 6-8 colds every year, possibly even more if your child has recently started daycare or preschool. While this can mean a seemingly endless stream of sniffles and coughs those first few months, know that children who previously attended daycare or preschool tend to have fewer colds during school-age due to having built up prior immunity from all the bugs they had as toddlers.

How can we treat the common cold?

So I have both bad news and good news for you – the bad news is that there is no treatment that will immediately treat your child’s underlying virus. This means we don’t have silver bullet meds like antibiotics that we use to treat bacterial infections. The good news is that our bodies already have all the tools it needs to fight off these nasty bugs, and there are even some things you can do to help:

Hydration, hydration, hydration
– Keeping your child well-nourished will help their body stay in the fight against these viruses. Your body will need even more nutrition, especially from fluids, to help keep the virus at bay and eventually overcome it. Make sure your child is drinking plenty of fluids and urinating regularly. Continue to offer food regularly, but don’t be shocked if your child’s appetite is less than usual while they are sick – their appetite should come back in full force once they recover.

Tylenol and Ibuprofen
– Fevers are a normal and healthy response by your body – they help to keep the viruses from continuing to replicate and spread throughout your body and give your immune system a chance to catch up and eventually win the battle. Despite these benefits, fevers can make your child feel pretty crummy, and make them breathe harder and faster while decreasing their appetite and energy levels. You can help them feel better by giving Tylenol or Ibuprofen (AKA Motrin, Advil) for comfort. Ibuprofen should not be given to infants under 6 months of age. Please see our table at https://springvalleypediatrics.net/medication/ for weight-based dosing recommendations.

Is there anything I can do about that stubborn cough, stuffy nose, or sore throat?
– In fact, there is! Warm fluids, such as tea or soup, can help soothe sore throats and relieve congestion. You can also use a cool mist humidifier to help your child breathe a little easier at night. For children older than 12 months, you can give 1 teaspoon of honey either straight or mixed into a beverage to help with cough and sore throat (honey should be avoided in children under 12 months old due to the risk of botulism). For infants, you can use nasal saline drops – apply several drops to each nostril and suck out those pesky boogers with a NoseFrida.

– There are also numerous over-the-counter cough and cold medicines – too many to fully discuss here. Many of these medications may not be very helpful or may even have unwanted side effects. Please call your pediatrician if you have questions regarding these medications.

When should we be concerned that this is more than just a cold?

Most common colds resolve after about 5-7 days, though it is common for a cough to linger for a bit longer than that. If the other symptoms are resolving and the cough is steadily improving, this is not necessarily a concern and can be monitored at home. If the cough lasts for more than 2 weeks or does not seem to be improving, please follow up with your child’s pediatrician.

Fevers due to a common cold generally only last up to 3-4 days. You should call your pediatrician if your child has a fever for more than 3 days in a row without any sign of improving, especially if accompanied by a persistent sore throat or cough. If your child is under 3 months old and has a rectal temperature of 100.4F or higher, you should call your pediatrician immediately as this can be a sign of a more serious illness and may require evaluation in the emergency room.

Other reasons to contact your child’s pediatrician include if your child is working hard to breathe, if their symptoms initially improve but worsen again within a few days, if they develop a brand-new fever or ear pain several days into their illness, or if symptoms persist without improvement for more than 1 week.

How can we prevent spreading these germs to others?

The best methods for preventing the spread of these cold viruses are the tried and true – frequent handwashing/use of hand sanitizer and avoiding frequent touching of your face. Sneezing or coughing into a tissue or into the crook of your elbow will help to limit the number of respiratory droplets spread into the air and thus, decrease the risk of transmission.

If your child is experiencing viral symptoms and must go out, please encourage them to wear a mask to help prevent spread. Once your child has been fever-free for 24 hours with improving symptoms, they may return to school unless otherwise specified by your pediatrician.

And as always, get your yearly flu vaccines.

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RSV and the new monoclonal antibody injection

Read more
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Dr. Sexter in The New England Journal of Medicine

Dr. Sexter’s work on the COVID-19 vaccine in children under the age of 5 years old has been published in The New England Journal of Medicine.  Check out this link to read the article.

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Spring Valley Pediatrics in the News

We are always honored to speak out on behalf of our patients and medicine.

Dr. Sexter got to talk to WUSA9 about the COVID-19 vaccine trial for kids.  Click here to hear her interview and read more!

Dr. Long spoke with ABC Australia about the COVID-19 vaccine for children 5-11 years old.  Click here to watch her interview or read the article.

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FAQ: Pfizer Vaccine for Ages 5-11

The CDC approved the Pfizer COVID-19 vaccine for children 5-11 years old on November 2nd.  Spring Valley Pediatrics is currently vaccinating our patients in this age group.  To schedule an appointment for the vaccine, please call our front desk Monday through Friday from 9am-5pm.  We are working hard to quickly accommodate our families so please be patient and understanding as not everyone can be first.  It is important for your child to receive the vaccine and we stress getting the COVID-19 vaccine at any location if you are not able to get it at our office in a timely fashion.

 

The information below has been pulled from reputable sources, such as the Centers for Disease Control and the FDA.  Links to the primary sources are at the end of this FAQ.  If you have additional questions, please contact your pediatrician.  We always welcome conversations regarding best decisions for your children.

 

What is the dose of the vaccine for children 5-11 years old and how many will my child need?

The Pfizer vaccine is a 10ug dose and is a two shot series.  The shots should be separated by 21 days.  If it’s been more than 21 days since your first shot, you can and should get a second dose.

 

Can my child receive the COVID-19 vaccine at the same time as others such as the flu shot?

Yes, the CDC says this vaccine may be administered without regard to timing of other vaccines.  We strongly recommend receiving a flu shot each season.

 

My 11 year old child weighs as much as a 13 year old.  Should she receive the bigger dose for kids 12+ instead?

No, all children ages 5-11 should receive the 10 ug dose.  The vaccine dosage is based on age, not on size or weight.

 

My child has tested positive for COVID-19.  Should he receive the vaccine and when?

Yes, it is important to vaccinate people who have had the illness as well.  Your child should be vaccinated once he has recovered from the acute illness and has met criteria to discontinue isolation.  Data also shows that it is safe to give the vaccine to children who have already been infected with the novel coronavirus.  We also know that natural immunity from infection decreases overtime; vaccination helps to increase protection.

 

What side effects should I be prepared for in my child after vaccination?

The FDA noted that the medical data showed children may actually experience fewer side effects than adolescents or young adults.  If your child does have side effects, they tend to be mild and include pain, swelling, or erythema at the injection site; fever, fatigue, headache, chills, myalgia (body aches), arthralgia (joint pain), or lymphadenopathy (enlarged lymph nodes).  It is safe to give your child acetaminophen or ibuprofen afterwards if she is uncomfortable.

 

There was a lot in the news about myocarditis risk after vaccine.  Is that a concern in this age group as well?

Myocarditis (inflammation of the heart muscle) and/or pericarditis (inflammation of the pericardium around the heart) have occurred rarely in some people after vaccination against COVID-19 (though it is more common to have it after COVID-19 infection).  This was noted primarily in 12-29 year old males.  In fact no cases of myocarditis or pericarditis were reported in the clinical trial for children 5-11 years old.  While it is impossible to say that there is no risk of this complication after vaccination, it is a rare and unlikely event.

 

Isn’t the risk of COVID-19 to kids really low?  Is it really necessary to vaccinate my 5-11 year old child?

Children are certainly at lower risk of developing severe disease from COVID-19 infection, but they are not exempt from it.  Throughout the pandemic, infected children have experienced both short and long-term health complications as well as continued spread to others.  There is also the risk of multisystem inflammatory syndrome (MIS-C), a serious complication of COVID-19 infection that can be fatal.  COVID-19 is now one of the leading causes of death in children.

 

By getting vaccinated, children 5-11 years old are not only protecting themselves but also their communities.  The more people vaccinated, the slower spread of the virus which decreases the opportunities for it to mutate into a more severe variant like we have seen with the Delta strain.  Vaccinating this age group is an important step in controlling the novel coronavirus.

The FDA: Comirnaty and Pfizer-BioNTech COVID-19 Vaccine

CDC: COVID-19 Vaccines for Children and Teens

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UPDATE: COVID-19 Vaccine for Ages 5-11

The Pfizer vaccine has been approved for children 5-11 years old.    Spring Valley Pediatrics is offering the vaccine for our patients 5 and above.  Please call our office Monday through Friday from 9am to 5pm to make an appointment.  Below are resources provided by the surrounding Departments of Health with more information on other locations where your child can receive the vaccine.

 

  • From Montgomery Co:

“Pfizer’s COVID-19 vaccine for 5-to-11-year-olds is expected to be authorized for emergency use in the coming days. MCPS is partnering with the county’s Department of Health and Human Services and Holy Cross Hospital to offer a number of free vaccination clinics for children at schools and county sites once the vaccine is available.”

Here is the link with more details:

  • From Fairfax Co:
“Vaccine will be available through pediatric and family medical practices, as well as local pharmacies and the Tysons Community Vaccination Center. In addition, the Health Department will provide COVID-19 vaccine to children by appointment only. Since it is a different dose, it is not interchangeable with the COVID vaccine used for 12 years and above, so parents will need to wait to seek vaccine for their younger children.”
Here is the link with more details:
  • From DC:
“Today, the Bowser Administration announced plans for vaccinating children against COVID-19. Once the pediatric Pfizer-BioNTech vaccine is approved and distributed, families will be able to be vaccinated at more than 60 pharmacies, hospitals, and health centers in DC that will have the vaccine. Information about where the vaccine is available will be on vaccines.gov.
Once approved, the vaccine will be shipped out. Washington, DC is expected to initially receive 24,600 doses that will be distributed to pharmacies, hospitals, and health centers across DC.
To provide additional opportunities for access, families will also be able to go to District operated pop-up sites set up specifically for 5-11 year olds. Families will be given more details about the second dose after their first dose. The COVID-19 vaccine for 5-11 year olds will not be immediately available at the District’s Take the Shot sites.
Here is the link with more details, including locations and dates when the pop-up sites will open:

 

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Dr. Sexter on WUSA9

Dr. Sexter got to talk to WUSA9 about the COVID-19 vaccine trial for kids.  Click here to hear her interview and read more!

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Summer Camps 2021

Summer is just around the corner and after many months of limited activities during a long winter in a pandemic, many parents and children are looking forward to being outside and enjoying summer camp activities.  There are important physical and mental health benefits to summer camp.  Summer camps offer children opportunities for peer interaction, increased independence, leadership roles, exercise and the challenge of trying new things.  These experiences are even more significant given the social limitations that the COVID-19 pandemic has placed on children.  It will be important for parents to find summer camps that help children reestablish these important social connections while maintaining the important COVID-19 risk mitigation strategies to keep children healthy while at camp.  Below are some guidelines to consider when thinking about day camp and sleepaway camp for your children.

 

Day Camps

  • All camps should follow the CDC’s guidelines to maintain healthy environments for campers.  How will your camp implement these guidelines?
  • Creating a Healthy Camp Environment:  Camps should be clear that any camper or counselor experiencing COVID symptoms must remain at home and obtain a COVID test before returning to camp.  What are your camps protocols on daily screenings and quarantine requirements for exposed campers and/or staff?
  • Face Masks:  All campers and counselors should wear face masks.  Exceptions include children under 2 years of age or anyone that is having difficulty breathing.    
  • Physical Distancing:  Campers should maintain a physical distance of 6 feet.  Physical distancing is particularly important during times of high intensity activity.  How will the camp accommodate increased spacing of campers and counselors?
  • Limit Carpooling: Unvaccinated campers should ride to camp with people in their own household.  
  • Hygiene: Campers and staff should wash hands frequently.  Surfaces and shared objects should be wiped down often.
  • How many of the staff/counselors are vaccinated?  
  • How will camps monitor campers and staff daily for COVID-19 symptoms while at camp?  If a child develops symptoms, how will the camp manage sick children and facilitate their safe departure?  Will the camp notify other families if a child tests positive for COVID and what will the policy be?
  • What will be the maximum number of campers per group?  Will the same staff be assigned to the same group everyday?
  • How and how often will shared areas (bathrooms, lunch tables and craft rooms) be cleaned?

 

Sleepaway Camps

Most sleepaway camps plan to create a “bubble” this summer for children.  In order to do this, children and families will need to limit high risk activities and avoid large gatherings during the week before camp starts.  Most camps will require a COVID test before the camper arrives and many will perform COVID testing on campus once the camper arrives.  Questions to consider when thinking about sleepaway camps are the following:

  • How will camps structure the first week of camp?  Will the camp be able to perform COVID screening tests on all campers once they arrive at camp?  How many times will the campers be tested during the first week?  Will the camp be able to test throughout the duration of the camp session?  
  • Have most of the staff/counselors received the COVID vaccine?
  • Will children wear masks during the first few days of camp?  Will the children be in cohorts for the first week or for the entire camp session?  
  • How will the camp utilize and maximize outdoor spaces?
  • Will any activities take place indoors?
  • Where will children eat?  Inside or outside?
  • How will the camp implement the CDC’s guidance on hand hygiene and increased sanitization of charred surfaces?
  • Does the camp plan to hold parent visiting days?  Unfortunately, most camps will not be able to have camp visiting days as the arrival of many people outside the camp bubble carries the risk of bringing COVID into the camp environment.  If your child’s camp is hosting a visiting day, it is important to ask the camp how they plan to mitigate the risk of COVID exposure.   
  • What is the camp’s plan for a child that has developed COVID like symptoms?  Have they created a place to isolate sick children?  Will the camper be sent home to recuperate and when can they return to camp?  And of course, if a camper does test positive for COVID, how will the camp manage quarantining bunkmates and other staff or campers exposed to the sick camper?  

 

Sports Camps

It is important that children, who have not been competing and practicing athletics at the same level as they did pre-COVID, return to sports slowly.  An emphasis on increasing strength and conditioning is very important to limit injuries in athletes who are undoubtedly not in the same physical shape that they were before the pandemic.  Sports camps and parents should be particularly aware of the importances of returning to sports slowly and carefully to mitigate risk of injury.

 

Sports Post-COVID

The American Academy of Pediatrics recommends that any child that was diagnosed with COVID in the past 6 months,  even asymptomatic infections,  must be seen in person and evaluated by a pediatrician to be cleared to return to sports.

 

There are so many important medical and mental health benefits of summer camp for children and being able to return safely to camp will be an exciting and long awaited experience for many.  It is important to consider each child’s underlying medical history and to weigh the risks and benefits of returning to camp.  If you have specific questions about summer camp for your child, please don’t hesitate to call to discuss with your pediatrician at Spring Valley. 

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Breastfeeding and the COVID-19 Vaccine

With the COVID-19 vaccine becoming more available to the general population, many families have reached out with questions.  Is it safe to receive it while breastfeeding?  If so, does it offer any protection to the baby?

The bottom line is we don’t know yet.  Studies are ongoing but, based on the science behind them, mRNA vaccines (like the Pfizer and Moderna shots) are not believed to be a risk to the breastfeeding infant.  Both the Centers for Disease Control and Prevention (CDC) and The American College of Obstetricians and Gynecologists (ACOG) agree that the COVID-19 vaccine should be offered to lactating women.  There is even the likely possibility that antibodies your body makes against COVID-19 will pass to your infant through your breastmilk and offer protection.

Data is being constantly collected and information is being updated daily.  Follow up with the links above to get the most current recommendations and always discuss your questions or concerns with your physician.

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