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Welcome
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Happy June! With the school year over and summer camp right around the corner, we congratulate everyone on getting through another year! Once again, please remember to book any Pop Warner or sport physical soon so as to avoid the last second crunch. Remember, summer is the season of accidental injury, so take care!
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Summer Is Here - Prevent Swimmer's Ear! ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Swimmer's Ear (otitis externa) is a common malady of summer time in which water gets trapped in the external ear and causes inflammation of the ear canal. While generally not dangerous, Swimmer's Ear can be exquisitely painful and the source of much discomfort for patients.
If your child is swimming a lot, especially if he or she has had multiple episodes of Swimmer's Ear in the past, we would recommend utilizing ear drops to prevent infection. You may purchase an over-the-counter Swimmer's Ear prevention kit, or you may mix 1 part white vinegar with 1 part rubbing alcohol (3-5 drops to each ear twice daily on those days when your child swims). You must keep your child's head tilted to the side for ~3 minutes to allow the drops to function.
DO NOT USE DROPS IF YOUR CHILD HAS TYMPANOSTOMY (EAR) TUBES.
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| New Office Nutritionist: Laura Einbinder
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We are happy to announce the addition of Laura Einbinder (RD, LDN, MBA) to our practice as our first "in-house" Nutritionist.
Laura brings a wealth of experience and knowledge to our practice in the areas of healthy lifestyles, nutrition, healthy cooking and food shopping, and obesity. Laura's primary goals are not only to provide information on nutrition to our patients and their families, but also to educate all of our staff (including physicians, nurse practitioners, nurses, and front desk). She will be intimately involved in the Get on Track Program and the Healthy Lifestyle Program (our two programs addressing eating, activity and weight management in children and adolescents).
Laura initially plans to provide group nutrition classes. Eventually, she will offer individualized and family nutritional counseling. In addition, Laura will be contributing regularly to our newsletter on various issues in nutrition.
We are excited to have Laura on our team. She will begin working with our office this fall.
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| Patient Safety: Similarly Named Patients
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Have we ever confused your child with a similarly named child in our practice? For patient safety, when calling our office, please identify your child by name (including first, last, and middle initial) as well as date of birth.
If we have ever had the wrong chart for your child (or sent a prescription in for the wrong child), please e-mail us with your child's full name and date of birth.
Help us make patient safety a priority!
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| Spending Too Much On Medication?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ The current trend in health care is for insurers (Blue Cross/Blue Shield, Harvard Vanguard, Tufts, etc. . . ) to displace more and more of the costs of healthcare onto you, the patient. This is seen in hgher premiums and higher co-pays. Most insurers offer a discount on co-pays if you mail away a 3-month prescription to their private pharmacy.
Contact your insurer to see if this would be a money-saving opportunity for you.
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| 0-1 Year Olds: Sunscreen and Bug Spray
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ With the warm weather here, we would like to remind you about the importance and safety of using sun screen and bug spray in babies.
Sunscreen can (and should!) be used at any age (even on a newborn), regardless of if the bottle says "6 months and up only." You may find that, in the very young, it is fairly easy to keep them out of the sun completely, either through utilizing long sleeved, lightweight clothing and sunhats, or by keeping them in the shade of their carseat canopy! Read the American Academy of Pediatrics safety recommendations
Bug Spray can be used on all babies two months old and over. We recommend Deep Woods Off (with 25% DEET) as the current epidemiology suggests that the risk of bug bites far outweighs the risk of DEET. Remember, bug spray should be sprayed over clothing and applied to the exposed areas only (excluding the hands and face). It should not be occluded by clothing, and should be washed off at the end of the day. Read more about DEET from the American Academy of Pediatrics
Please contact us with any questions!
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| 1-4 Year Olds: Toilet Training Pearls
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Toilet training your child is a major milestone of the preschool years, and one with many potential pitfalls. Although there is no "right" age to start this process, we generally recommend starting when your child is approximately two and a half years old. While there are some children who may seem ready at a younger age, many of those children experience periods of regression (which is often frustrating to the parents).
In general, toilet training is all about positive reinforcement (and not punishment). Make it fun! Before training, create a sticker chart (your child can help decorate this) and hang it up in the bathroom near the potty. Take your child to the store and buy some stickers for the chart (buy some nicer stickers and some more plain ones).
When starting to toilet train, the initial goal should be having your child sit on the potty. Give out a sticker if your child sits on the potty for 2-3 minutes. No pooping is required to earn a sticker! Offer to read a book while your toddler is sitting there.
After two to three weeks of sitting on the potty 3-4 times daily, offer to give your child a better sticker is he or she poops. If the child sits on the potty but does not poop, give him or her one of the original (less fancy) stickers. Don't be negative!
Two pitfalls to avoid include trying to train the resistant child (a child who is not ready) or the constipated child. If your child is fighting your attempts to have him or her sit on the potty, back off for a few weeks before trying again. You cannot win this battle! In addition, if your child has frequent or chronic issues with constipation, it is important to get them on a medical regiment before starting the training process. Please contact our office if this is the case.
Be consistent and practice sitting on the potty every day as this will help make the process go more smoothly. Good luck!
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| 4-9 Year Olds: Nighttime Bedwetting
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Nighttime bedwetting is a common occurrence in children. It is not unusual for children to require pull-ups for several years after becoming "potty-trained" and achieving daytime dryness. Nighttime bedwetting is more likely to occur in children who are very deep sleepers, especially those with a family history of bedwetting.
Studies suggest that approximately 15% of developmentally normal five-year olds experience nighttime bedwetting. This number decreases to 10% of eight-year olds, and 5% of ten-year olds.
Some simple strategies for helping your child stay dry at night include: limiting fluid intake after dinner, avoiding caffeine and chocolate, peeing immediately before bed, and, if desired, waking your child to pee prior to the parents going to sleep.
Young children may chose to remain in pull-ups at night until their bodies mature enough to stay dry at night. For older children, a variety of options exist to help with this issue.
As always, if you have questions, please to not hesitate to contact us!
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| 9-13 Year Olds: Screening for Asthma in Girls
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Data suggests that many girls with undiagnosed asthma (or exercise-induced asthma) may have trouble keeping up with their peers and may choose not to participate in sports. Overweight girls are at particular risk.
In an attempt to detect girls who may have silent asthma, we have begun to screen all girls for some subtle signs and symptoms of asthma at their 9, 11, and 13 year old physicals. All girls will be asked if they have trouble keeping up with other kids when running or playing sports, if they get winded more easily than other girls, or if they have a night-time cough.
All girls with any positive findings on their screening questionnaire will undergo pulmonary function tests (breathing into a calibrated tube to assess lung function) both before and after exercise. Any girl with findings suggestive of possible asthma will have the opportunity to begin therapy that we hope will allow them to participate to their highest potential.
If your child has any symptoms that you may think represent asthma, please don't hesitate to let us know.
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| 13-20 Year Olds: Teens Worship the Sun!
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ It is well known that some teenagers seek that sun-kissed look at all costs. What is less well known is why? Some researchers believe it is the abundance of media images portraying tanned bodies on the beach. Other data suggests that teens view tanned bodies as being healthier than pale ones.
A recent survey by the American Academy of Dermatology revealed that less than 30% of all teenagers apply sunscreen when outside in the summer. In addition, more than 30% of 17-year-old females have visited a tanning salon within the past year. Yet, the majority of those teens surveyed stated that they knew that excessive sun exposure can lead to potentially fatal skin cancer.
It is important to ensure that adolescents are aware of the risks of sun exposure - both elevating the risk of skin cancer and of premature aging. It takes only one severe sunburn (or chronic/frequent tanning without sunburn) to result in melanoma later in life. While no one is immune to the damaging effects of UV radiation produced by the sun, those at particular risk for melanoma include anyone with a family history of melanoma, fair skin, easy freckling, or multiple moles.
Peak UV exposure times (between 10am and 4pm) should be avoided whenever possible. Wearing sunblock (SPF 15 or greater) is essential and must be reapplied every two hours as well as after swimming or sweating. Wide-brimmed hats and lightweight clothing (covering most of the body) are even more effective.
Discuss the dangers of sun exposure with your teenagers and educate them about means of prevention. If they remain determined to achieve that bronzed look, consider helping them invest in self-tanning lotions - a safe alternative to sun-worshipping. For best results, buy a "non-comedogenic" self-tanner (one that won't cause or increase acne) and try it out first on a small area of skin before applying everywhere. Remember that self-tanners DO NOT contain sunscreen.
Most importantly, remind your children that all shades of skin - from the lightest to the darkest - are what make our world beautiful.
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| Reaching Beyond Ourselves
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Reaching out beyond ourselves is so importnat. It is quite heartening to hear of all the people (college students, religious groups, and others) who have taken time out to rebuild houses on the Gulf Coast. This past May, Habitat for Humanity just built its 1,000th post-Katrina house. Let us all continue to support our fellow Americans. | |
