Practice Updates 

As in previous years, our office will be open today (MLK day) and again on President's Day.  There's no extra charge to be seen on these holidays (we've heard some practices do that...).

Where's all the snow been this winter??  In the event that the white stuff actually starts returning, we'll do our best to notify you if our opening is delayed (both our phone system and computers are accessible remotely) or we close early.  

Have you seen our new "Video Mission Statement" by The Scene Lab?  It really captures the spirit of Bambini!   We've loaded it onto the home page of our website as well.  Expect more video content from us soon. 

Tylenol & Asthma:  A Distrubing Association     

Back in the mid 1980s, the connection between aspirin and Reye's Syndrome became painfully apparent. As a result, doctors began recommending acetaminophen for fever control in children. Over the next two decades, the incidence of asthma quietly doubled.

The association of acetaminophen and asthma was first noted in 1998. Since then, more than 20 studies have supported it. Children whose mothers took Tylenol during pregnancy were found to have an increased  chance of asthma. Why haven't we all heard about this?

Last month, Dr. John T. McBride, a pediatric pulmonary specialist at Akron Children's Hospital, broke the media silence.

The concluding statements of his paper bear repeating:  At present, however, I need further studies not to prove that acetaminophen is dangerous but, rather, to prove that it is safe. Until such evidence is forthcoming, I will recommend avoidance of acetaminophen by all children with asthma or those at risk for asthma...  

So, if Tylenol is out and Motrin on an empty stomach can cause gastritis or worse, what's a concerned parent with a feverish child to do?!  Aconite, belladonna, and other homeopathic remedies (available at our apothecary and some health  food stores) might be an option to consider. 

No, we're not talking about Ling-Ling & Hsing-Hsing!  Rather, Pediatric Autoimmune Neuro-psychiatric Disorders Associated with Streptococcus is a  somewhat controversial condition that seems to be on the rise.  Symptoms include abrupt onset of obsessive-compulsive behavior, tics, anxiety, and such -- typically in a school-age child.  Frequently, there is evidence of recent strep infection.

Last month, the Wall Street Journal ran a feature article on PANDAS.  The report noted that the American Academy  of Pediatrics recommends against a trial of antibiotics when children have abrupt onset of tics or OCD in the absence of an acute strep infection.  Many doctors will treat even young children with anti-depressants or anti-psychotic medications in this situation.

In the last two years, we have seen five children with suspected PANDAS.  Interestingly, four out of the five had previously been diagnosed with Asperger's, SPD (sensory processing delay), or ADHD (attention-deficit hyperactivity disorder).  Not surprisingly, much of the information on the web on alternative approaches to PANDAS come from physicians who treat children on the spectrum.  

Getting a Child to "Eat" Her Veggies    

Last month, the mother of an 18 month-old little girl wrote us about her frustration in trying to get her little one to eat more vegetables. This mom is not alone. We see many a "face-off" at this age, with some children sadly heading down the "white diet road."

At our suggestion, mom tried blending up some green smoothies, but little Olivia handed them right back. In desperation, mom brought her to All Shook Up, a malt shop turned juice bar near Vassar College.

The outcome: Olivia and I went today- she thoroughly enjoyed a full 12 oz serving of a kale apple and lime juice off their menu. She has never been so happy for something green, and neither have I for that matter. I'm so excited!

BTW, for $1.99, there's a great new green smoothies iphone app -- with recipes aimed at beginners, others just for kids, and even a menu for pets!