Holy Toledo! The tsunami, that began a month ago, of requests for:

-  OT, PT, or speech therapy prescriptions

-  permission slips for inhalers, Epipens, etc.

-  letters addressing delayed vaccination (more on this below)

is finally letting up in the last day or so. That was on top of the overwhelming demand for last minute school physicals and urgent visits for suspected pertussis (no, the outbreak hasn't slowed yet).  Daycare and pre-school entrance forms requests were also particularly brisk this last month. So, please bear with us if we look a little glassy-eyed!

We have been diligently recruiting for a third physician or PNP. Hopefully, we'll have positive news on that shortly. Fortunately, Express Pediatrics has opened a second office in Highland, NY. Like their main office in Hopewell, it's open 5PM - midnight M-F, and noon to midnight weekends.

Please note that our office is open with regular hours on Columbus Day (Monday, October 8th).  Flu shots for school-age children will be available that day on an appointment basis.

About one year ago, Dr. Amanda Dempsey and others from Child Health Evaluation and Research Unit at the University of Michigan in Ann Arbor, reported that more than 10% of children in the US currently are receiving vaccinations on a delayed schedule at the request of their parents. No doubt many have found this to be a contentious matter; there are lots of strong feelings.

Recently, we have received several urgent calls from families who had requested delayed vaccination and suddenly were asking us for a medical exemption letter as their child entered kindergarten, preschool, or a licensed daycare. Some of these families had previously told us that they had religious reasons for not vaccinating.

This presents a problem! The criteria for medical exemption in New York are stringent. The NYSDOH refers to the CDC policy statement on vaccine contra-indications. Basically, a child must have had a seizure, coma, or anaphylactic shock from a previous vaccine to be considered exempt - and the exemption only applies to that particular vaccine. Moreover, our experience in the past has been that a school physician or the Department of Health can overturn the recommendation of a child's pediatrician to exempt her on a medical basis.

Last year, for instance, a little boy that we provided care for was threatened with discharge from preschool. He had severe eczema and allergies. He had received all but one of the required vaccines. The second DPT shot had resulted in a very large local reaction. He also developed croupy with stridor a few hours after the shot. We wrote a medical exemption letter, but it was challenged by the state health department.

For more information on vaccination recommendations, requirements, and exemptions, please click here.

We've all noticed it - eight year-old girls wearing bras, twelve year-old girls that look like grown women. Children today are exposed to estrogens in ways never previously known.

Beside premature puberty, these artificial or so called xeno-estrogens can cause other effects - ovarian cysts, endometriosis, irregular periods, and others.

How are children exposed to these estrogens? The sources are myriad - micro-waved popcorn and non-stick cookware, tea tree or lavender oil (in excess) - to name a few.

What can a concerned parent do, especially if signs of hormone excess are already appearing? Recently, research has shown that a number of natural substances can dampen the effects of these bad estrogens. For details, click here.

In a study published in the journal Pediatrics last month, Dr. Eija Bergroth and colleagues from Kuopio University Hospital reported their findings on the association of family pet ownership with sickness in the first year of life.

The Finnish researchers tracked almost 400 children from before birth through their first year of life.   35% lived in homes with dogs, 24% had cats as pets.

Infants that lived in homes with dogs had:

• 31% fewer colds
• 44% less ear infections
• 29% fewer antibiotics scripts

compared with children living without a pet. Cat ownership had less dramatic effects on sickness rates.

This study lends further support to the so-called "hygiene hypothesis;" that is, early exposure to some dirt, soil, and allergen actually strengthens an infant's immune system. For years, we've, noted that children raised on farms just don't show up in our office with colds, ear infections, asthma, or allergies as often as kids raised in the city.

BTW, last month our practice committed to offer Xolair treatments to our sickest asthma sufferers. There's a bit of paperwork and back-n-forth with managed care (it's very expensive). As far as we are aware, we are the first non-allergy practice in the region to offer this option to families. We'll provide updates periodically.  We hope that during treatment with Xolair, we can work with families on transitioning to natural asthma care options.