Giving peanut-based foods to babies early prevents allergies

A child holds a bag of peanut snacks in her pediatrician’s office at age nine-months, in Columbus, Ohio.

Most babies should start eating peanut-containing foods well before their first birthday, say guidelines released Thursday that aim to protect high-risk tots and other youngsters, too, from developing the dangerous food allergy.

The new guidelines from the National Institutes of Health mark a shift in dietary advice, based on landmark research that found early exposure dramatically lowers a baby’s chances of becoming allergic.

The recommendations spell out exactly how to introduce infants to peanut-based foods and when — for some, as early as 4 to 6 months of age — depending on whether they’re at high, moderate or low risk of developing one of the most troublesome food allergies.

“We’re on the cusp of hopefully being able to prevent a large number of cases of peanut allergy,” said Dr. Matthew Greenhawt of the American College of Allergy, Asthma and Immunology, a member of the NIH-appointed panel that wrote the guidelines.

Babies at high risk — because they have a severe form of the skin rash eczema or egg allergies — need a check-up before any peanut exposure, and might get their first taste in the doctor’s office.

For other tots, most parents can start adding peanut-containing foods to the diet much like they already introduced oatmeal or mushed peas.

No, babies don’t get whole peanuts or a big glob of peanut butter — those are choking hazards. Instead, the guidelines include options like watered-down peanut butter or easy-to-gum peanut-flavored “puff” snacks.

“It’s an important step forward,” said Dr. Anthony Fauci, director of NIH’s National Institute of Allergy and Infectious Diseases, which appointed experts to turn the research findings into user-friendly guidelines. “When you do desensitize them from an early age, you have a very positive effect.”

Peanut allergy is a growing problem, affecting about 2 percent of U.S. children who must avoid the wide array of peanut-containing foods or risk severe, even life-threatening, reactions.

Winter Safety Tips

Whether winter brings severe storms, light dustings or just cold temperatures, the American Academy of Pediatrics (AAP) has some valuable tips on how to keep your children safe and warm.  Please feel free to excerpt these tips or use them in their entirety for any print or broadcast story, with acknowledgment of source.

What to Wear

  • Dress infants and children warmly for outdoor activities.  Several thin layers will keep them dry and warm. Don’t forget warm boots, gloves or mittens, and a hat. Choose boots that are large enough to comfortably accommodate two pairs of socks.
  • Remove drawstrings from clothing which may get caught on tree branches or play equipment.  Replace with velcro.
  • The rule of thumb for older babies and young children is to dress them in one more layer of clothing than an adult would wear in the same conditions.
  • When riding in the car, babies and children should wear thin, snug layers rather than thick, bulky coats or snowsuits. See Winter Car Seat Safety Tips from the AAP for help keeping your little ones warm and safe in the car.
  • Blankets, quilts, pillows, bumpers, sheepskins and other loose bedding should be kept out of an infant’s sleeping environment because they are associated with suffocation deaths and may contribute to Sudden Infant Death Syndrome (SIDS). It is better to use sleep clothing like one-piece sleepers or wearable blankets.
  • If a blanket must be used to keep a sleeping infant warm, it should be thin and tucked under the crib mattress, reaching only as far as the baby’s chest, so the infant’s face is less likely to become covered by bedding materials.

Hypothermia

  • Hypothermia develops when a child’s temperature falls below normal because of exposure to colder temperatures. It often happens when a youngster is playing outdoors in extremely cold weather without wearing proper clothing or when clothes get wet. It can occur more quickly in children than in adults.
  • As hypothermia sets in, the child may shiver and become lethargic and clumsy.  Speech may become slurred and body temperature will decline in more severe cases.
  • If you suspect your child is hypothermic, call 911 at once. Until help arrives, take the child indoors, remove any wet clothing, and wrap him in blankets or warm clothes.

Frostbite

  • Frostbite happens when the skin and outer tissues become frozen.  This condition tends to happen on extremities like the fingers, toes, ears and nose.  Skin first becomes red and tingly, then gray and painful and finally white, cold and hard without pain.  Blistering occurs after the skin thaws.
  • Prevent frostbite by dressing in layers, covering all body parts when outside in cold weather.  Bring children indoors if clothing gets wet.
  • Playing in temperatures or wind chills below -15 F should be avoided because exposed skin begins to freeze within minutes.
  • If frostbite occurs, bring the child indoors and place the frostbitten parts of her body in warm (not hot) water.  104° Fahrenheit (about the temperature of most hot tubs) is recommended. Warm washcloths may be applied to frostbitten nose, ears and lips.
  • Administer acetaminophen or ibuprofen when you begin rewarming because as the skin thaws pain occurs.
  • Do not rub the frozen areas.
  • After a few minutes, dry and cover the child with clothing or blankets. Give him/her something warm to drink and seek medical attention immediately particularly if blistering occurs.

Winter Health

 

  • If your child suffers from winter nosebleeds, try using a cold air humidifier in the child’s room at night. Saline nose drops or petrolatum may help keep nasal tissues moist. If bleeding is severe or recurrent, consult your pediatrician.
  • Many pediatricians feel that bathing two or three times a week is enough for an infant’s first year. More frequent baths may dry out the skin, especially during the winter.
  • Cold weather does not cause colds or flu.  But the viruses that cause colds and flu tend to be more common in the winter, when children are in school and are in closer contact with each other.  Frequent hand washing and teaching your child to sneeze or cough into the bend of her elbow may help reduce the spread of colds and flu.
  • Children 6 months of age and up should get the influenza vaccine to reduce their risk of catching the flu. It is not too late to get the vaccine! Around 80% of all influenza illness generally occurs in January, February, and March.

Winter Sports and Activities

Set reasonable limits on outdoor play to prevent hypothermia and frostbite and make sure kids have a place to go warm up when they get cold.  When weather is severe, have children come inside periodically to warm up.

Alcohol or drug use should not be permitted in any situation. They can be even more dangerous in winter activities like snowmobiling or skiing.

Ice Skating

  • Allow children to skate only on approved surfaces.  Check for signs posted by local police or recreation departments, or call your local police department to find out which areas have been approved.
  • Advise your child to:
    • Skate in the same direction as the crowd
    • Avoid darting across the ice
    • Never skate alone
    • Not chew gum or eat candy while skating
    • Consider having your child wear a helmet, knee pads and elbow pads, especially while learning to skate

Sledding

  • Keep sledders away from motor vehicles.
  • Children should be supervised while sledding.
  • Children less than 5 years of age should not sled alone.
  • Keep young children separated from older children.
  • Sledding feet first or sitting up, instead of lying down head-first, may prevent head injuries.
  • Consider having your child wear a (hockey not bicycle) helmet while sledding.
  • Sleds should be structurally sound and free of sharp edges and splinters, and the steering mechanism should be well lubricated.
  • Sled slopes should be free of obstructions like trees or fences, be covered in snow, not ice, not be too steep (slope of less than 30º), and end with a flat runoff.
  • Avoid sledding in crowded areas.

Snow Skiing and Snowboarding

  • Children should be taught to ski or snowboard by a qualified instructor in a program designed for children.
  • Never ski or snowboard alone.
  • Young children should always be supervised by an adult.  Older children’s need for adult supervision depends on their maturity and skill.  If older children are not with an adult, they should always at least be accompanied by a friend.
  • All skiers and snowboarders should wear helmets. Ski facilities should require helmet use, but if they do not, parents should enforce the requirement for their children.
  • Equipment should fit the child. Skiers should wear safety bindings that are adjusted at least every year. Snowboarders should wear gloves with built-in wrist guards. Hip pads have been shown to be effective in preventing fractures as well. Eye protection or goggles should also be used.
  • Slopes should fit the ability and experience of the skier or snowboarder. Avoid crowded slopes.
  • Avoid skiing in areas with trees and other obstacles.

Snowmobiling

  • The AAP recommends that children under age 16 not operate snowmobiles and that children under age 6 never ride on snowmobiles.
  • Do not use a snowmobile to pull a sled or skiers.
  • Wear goggles and a safety helmet approved for use on motorized vehicles like motorcycles.
  • Travel at safe speeds.
  • Never snowmobile alone or at night.
  • Stay on marked trails, away from roads, water, railroads and pedestrians.

Sun Protection

The sun’s rays can still cause sunburn in the winter, especially when they reflect off snow.  Make sure to cover your child’s exposed skin with sunscreen and consider using sunglasses or goggles with UV protection.

Fire Protection

Winter is a time when household fires occur. It is a good time to remember to:

  • Buy and install smoke alarms on every floor of your home
  • Test smoke alarms monthly
  • Practice fire drills with your children
  • Install a carbon monoxide detector outside bedrooms
  • Keep space heaters at least 3 feet away from anything that could burn, and turn them off when leaving the room or sleeping

Winter Car Seat Safety Tips from the AAP

Winter is a tricky time for car seats. As a general rule, bulky clothing, including winter coats and snowsuits, should not be worn underneath the harness of a car seat.

In a car crash, fluffy padding immediately flattens out from the force, leaving extra space under the harness. A child can then slip through the straps and be thrown from the seat.

These tips from the American Academy of Pediatrics (AAP) will help parents strike that perfect balance between keeping little ones warm as well as safely buckled in their car seats.

How to Keep Your Child Warm and Safe in the Car Seat:

Note: The tips below are appropriate for all ages. In fact, wearing a puffy coat yourself with the seat belt is not a best practice because it adds space between your body and the seat belt.

  • Store the carrier portion of infant seats inside the house when not in use. Keeping the seat at room temperature will reduce the loss of the child’s body heat in the car.
  • Get an early start. If you’re planning to head out the door with your baby in tow on winter mornings, you need an early start. You have a lot to assemble, and your baby may not be the most cooperative. Plus, driving in wintry conditions will require you to slow down and be extra cautious.
  • Dress your child in thin layers. Start with close-fitting layers on the bottom, like tights, leggings, and long-sleeved bodysuits. Then add pants and a warmer top, like a sweater or thermal-knit shirt. Your child can wear a thin fleece jacket over the top. In very cold weather, long underwear is also a warm and safe layering option. As a general rule of thumb, infants should wear one more layer than adults. If you have a hat and a coat on, your infant will probably need a hat, coat, and blanket.
  • Don’t forget hats, mittens, and socks or booties. These help keep kids warm without interfering with car seat straps. If your child is a thumb sucker, consider half-gloves with open fingers or keep an extra pair or two of mittens handy — once they get wet they’ll make your child colder rather than warmer.Car-seat-pinch-finger
  • Tighten the straps of the car seat harness. Even if your child looks snuggly bundled up in the car seat, multiple layers may make it difficult to tighten the harness enough. If you can pinch the straps of the car seat harness, then it needs to be tightened to fit snugly against your child’s chest. See image right. 
  • Use a coat or blanket over the straps. You can add a blanket over the top of the harness straps or put your child’s winter coat on backwards (over the buckled harness straps) after he or she is buckled up. Some parents prefer products such as poncho-style coats or jackets that zip down the sides so the back can flip forward over the harness. Keep in mind that the top layer should be removable so your baby doesn’t get too hot after the car warms up.
  • Use a car seat cover ONLY if it does not have a layer under the baby. Nothing should ever go underneath your child’s body or between her body and the harness straps. Be sure to leave baby’s face uncovered to avoid trapped air and re-breathing. Many retailers carry car seat bundling products that are not safe to use in a car seat. Just because it’s on the shelf at the store does not mean it is safe!
  • Remember, if the item did not come with the car seat, it has not been crash tested and may interfere with the protection provided in a crash. Never use sleeping bag inserts or other stroller accessories in the car seat.
  • Pack an emergency bag for your car. Keep extra blankets, dry clothing, hats and gloves, and non-perishable snacks in your car in case of an on-road emergency or your child gets wet on a winter outing.

These precautions can make sure your child is as safe as can be when traveling to their next well-child visit or over the river and through the woods to grandmother’s house.

Surviving the Stomach Bug: Truths & Tips for Parents

7 Truths & Tips for Survival of Stomach Bugs When They Hit Your Home

  1. Hand washing and keeping things clean are your best defenses from getting ill with a stomach bug. Not surprisingly, this is particularly true after touching or supporting your child and when preparing food and eating. Some viruses will survive on surfaces for days. And some viruses like Norovirus can even survive hand sanitizer. You have to use soap and water to kill it. But even with ridiculous, meticulous attention to hygiene, every parent knows that when the vomit is flying, it’s hard to lasso every single errant particle. So simply commit to do your best. Change the sheets and clean up areas of vomit immediately after supporting your child. Soapy warm water is your friend. Wash surfaces immediately, use hot water for the wash, and use high heat in the dryer.
  2. 24 hours (or so): In general, most pediatricians will tell you that vomiting doesn’t exceed 24 hours with typical gastroenteritis. Occasionally it can. Many kids don’t follow the rules. Once a virus that causes gastroenteritis takes hold of a child, vomiting starts. Children tend to vomit more than adults. Part may be an easy gag reflex. With most viruses that cause the “stomach flu,” as the infection moves through the stomach and intestines, vomiting stops after about 24 hours. But not always. If you advance liquids too quickly or children eat more solids than they are ready for, even after the first meal 1 to 2 days into eating again, they may have a vomit encore. If you have one of those, start back where you started (sips of clear liquids) and go very slow advancing their diet. If vomiting is accelerating at 24 hours, it is time to check in with your child’s doctor.
  3. Disgusting and terrifying: It’s creepy-eepy to take care of a child with vomiting. Not only is it entirely gnarly and disgusting to remove and clean chunks from vomit-laden carpet, sheets, and clothing, it’s also terrifying to provide support to a vomiting child because you can get equally uneasy about catching the virus. You’re not alone in this. It’s absolutely nauseating to see your own child ill, unwell, and retching. And it’s awful to imagine having to provide care while getting miserably sick. Do your best to keep your hands washedand keep the love going. As all of us know, when you find yourself picking out vomit bits from the carpet at 3:00 am, it really can only get better from there.
  4. Medication: Children rarely need medication when recovering from gastroenteritis. Although some antinausea drugs are available for use in children, most children don’t need prescription medications. Talk with your child’s pediatrician if you feel you child is vomiting longer than 24 hours or becoming dehydrated. Remember that vomiting is a protection reaction of your child’s body to clear infection.
  5. Soap, water, and bleach: William Osler said, “Soap and water and common sense are the best disinfectants.” Cleaning your home to avoid spreading infection is a must. You don’t need expensive products, just vigilance. With some highly infectious viruses that cause vomiting, even 10 viral particles can cause illness. So in addition to soap and water, consider using a dilute bleach solution to clean hard surfaces.
  6. Detective work: Sometimes you’ll simply never know where it all came from. But it won’t stop you from playing the role of infectious detective. The only issue: this is simply wasted time.
  7. Yummy, clingy love: There is an occasional perk to a terrible stomach bug. And we have to find one to maintain a sense of optimism. When our children are ill, they really turn over and show us they want us over anything else on earth.

Then there is resilience. Children do very well recovering from typical viral gastroenteritis, although diarrhea can last for days. Even so, our children’s resilience will long astonish us.

Making the Holidays Safe

Family gatherings, special traditions, delicious treats — the holiday season may be the most wonderful time of the year, especially for kids. Unfortunately, for emergency room doctors it’s also one of the busiest.

Learn how to protect your little ones from some common holiday dangers, so you and your family can enjoy a season that’s happy and healthy.

Poisoning

  • Mistletoe, holly, poinsettias, Jerusalem cherry plants, and other plants are commonly used as decorations during the holidays. Like many plants, these are considered potentially poisonous and should be kept out of the reach of kids. Symptoms of plant poisoning can include rashes, nausea, vomiting, and diarrhea. If you suspect that your child has eaten any part of a plant, immediately call your doctor or the National Poison Center: (800) 222-1222.
  • “Bubble lights” containing methylene chloride can be poisonous if a child drinks the fluid from more than one light (even if labeled nontoxic). Snow sprays may be harmful if the aerosol propellants are used improperly.
  • Alcohol poisoning is a common risk for children during the holiday season. Many parents host holiday parties where alcohol is served. Take care to remove all empty and partially empty cups as soon as possible. Because kids imitate adults, many may drink the beverages they see adults drinking. Children become “drunk” much more quickly than adults, so even small amounts of alcohol can be dangerous.
  • Food poisoning is another potential holiday hazard. Practice food safety by washing hands, utensils, dishes, and anything else that comes in contact with raw meat, including poultry and fish, and raw eggs before and after use. Don’t contaminate a serving dish with raw meat. Store leftovers properly and heat them thoroughly before serving.

Choking and Swallowing

  • Tree ornaments, light bulbs, icicles, tinsel, and small toys are potential choking hazards for small children because they may block the airway. The general rule of thumb is that if it’s small enough to fit in the mouths of babies and toddlers, it’s too small to play with.
  • Common holiday foods such as peanuts or popcorn are potential choking hazards and should not be given to children under age 4.
  • The needles of holiday trees can cause painful cuts in the mouth and throat of a child who swallows them.
  • Angel hair (made from finely spun glass) and ornament hangers may cause cuts, skin irritation, or eye damage if touched or swallowed by children.

Fire

  • Keep your tree secured in a sturdy stand so that it doesn’t tip over (or isn’t knocked over by kids or pets) and keep it away from all heat sources, such as electrical outlets, radiators, and portable space heaters. If you buy an artificial tree, be sure it’s labeled “fire-retardant.” Unplug all lights, both indoor and outdoor, and extinguish all candles every night before you go to bed.
  • Avoid using real candles on a tree because if the needles are dry, they can easily catch fire. Never leave the room with taper candles or menorah candles burning — it only takes a minute for a spark from a candle to burst into flames. Keep lit candles away from windowsills and mantles and use only flame-retardant decorations when decking your halls.
  • Circuits that are overloaded with lights, decorations, and accessories can start a fire. Don’t overload indoor or outdoor electrical outlets.
  • Have your fireplace inspected before you light your first fire of the season. A chimney professional can clean your fireplace and ensure that it is safe to use. You can protect your family by using a sturdy fireplace screen when burning fires. Never burn paper or pine boughs, since those materials can float out of the chimney and ignite a nearby home or your own roof.
  • Practice fire safety, have a family emergency plan in the event of a fire, and check smoke detectors before you put up your holiday decorations. These steps will ensure that your family can celebrate many holiday seasons to come.

Accidents

  • A lot of cooking goes on during the holiday season, so there are many opportunities for burns and scaldings. Keep pot handles turned away from the front of the stove and always keep the oven door closed. To prevent accidents, watch your kids while you bake or cook. Kitchen appliances should be clean to prevent potential fires.
  • Keep breakable ornaments out of young kids’ reach — or keep them off the tree until your children are older. If one does break, clean up the pieces quickly.
  • Car accidents and injuries to children increase during the holiday season. Prevent a holiday ER visit by making sure that kids are buckled up securely during car rides and don’t drive after drinking alcohol. And be extra cautious when traveling at night on holidays such as Christmas Eve and New Year’s Eve, when there is a higher incidence of impaired driving.
  • Sledding accidents can be very serious. Young kids should be supervised and should avoid dangerous sledding areas, such as rocky areas, steep hills, and crowded sledding hills.

 

Happy New Year!

Happy New Year! Wishing all of our patients and their families a Healthy 2017!

Giving Tree

 

We are so proud to continue our tradition of collecting gifts for children in need. Thanks to our nurse Jennifer Miller for spear-heading the effort this year.

Don’t get the Flu this winter

Come in during the week or weekend to get your family vaccinated.

Beat the Flu

Flu SHOTS are IN.

Please call to schedule flu shots for your family.

Flu Vaccination

Why should people get vaccinated against the flu?

Influenza is a serious disease that can lead to hospitalization and sometimes even death. Every flu season is different, and influenza infection can affect people differently. Even healthy people can get very sick from the flu and spread it to others. Over a period of 31 seasons between 1976 and 2007, estimates of flu-associated deaths in the United States range from a low of about 3,000 to a high of about 49,000 people. During recent flu seasons, between 80% and 90% of flu related deaths have occurred in people 65 years and older. “Flu season” in the United States can begin as early as October and last as late as May. During this time, flu viruses are circulating at higher levels in the U.S. population. An annual seasonal flu vaccine is the best way to reduce the chances that you will get seasonal flu and spread it to others. When more people get vaccinated against the flu, less flu can spread through that community.

How do flu vaccines work?

Flu vaccines cause antibodies to develop in the body about two weeks after vaccination. These antibodies provide protection against infection with the viruses that are in the vaccine.

The seasonal flu vaccine protects against the influenza viruses that research indicates will be most common during the upcoming season. Traditional flu vaccines (called “trivalent” vaccines) are made to protect against three flu viruses; an influenza A (H1N1) virus, an influenza A (H3N2) virus, and an influenza B virus. There are also flu vaccines made to protect against four flu viruses (called “quadrivalent” vaccines). These vaccines protect against the same viruses as the trivalent vaccine and an additional B virus.