Bambini Newsletter   January 2015
Staffing Update

Late last summer, when we heard that Dr. Anna was returning to pediatric nephrology, we set to work to find help. We hired recruiters, posted ads, wrote to residency programs, and even reached out to pratitioners through social media.

 

After two months without a nibble, we painfully made the decision to close the practice to new families. But then, over the last month, we were contacted by three associate practitioners - specifically, Lauren (a pediatric physician assistant), Jennifer (a family nurse practitioner), and Olga (an emergency medicine physician assistant). We found each of these to be cordial, bright, articulate, and hard-working. We couldn't say no. We have hired all three. Go figure!

 

What does this mean? We're still trying to process this all ourselves, but without a doubt it will spell an end to the waiting list sometime around March 1st. It will also very likely mean expanded evening and weekend hours as well as new services. More details in our next newsletter.

 

We are now seeing patients as early at 8 AM on weekdays. What additional hours would you like to see us add:

  • Early evening?
  • Saturday afternoon?
  • Sunday morning?

Post your thoughts on our Facebook page.

Do Kindles and iPads Cause Sleep Troubles? 

Does your son or daughter read from an iPad, smartphone, or other blue-light emitting device near bedtime? According to a study published last month by researchers from Brigham and Women's Hospital, this might not be a great idea.

 

During the two-week inpatient study, twelve subjects read eBooks on an iPad for four hours before bedtime each night for five consecutive nights. This was repeated with printed books. The iPad readers had reduced secretion of melatonin, a hormone which plays a role in inducing sleepiness. Participants who read from the iPad were less sleepy before bedtime and less alert the following morning after eight hours of shut-eye.

 

If your child must stay up late to study or read:

  • use old-fashioned printed books rather than iPads or Kindles, especially as bedtime approaches.
  • giving 1-3 mg of melatonin might help offset the negative effects of an eReader.
  • encourage her to use blue-light blocking glasses such as Uvex if she must use an eReader.

Flu Shots for Our NYC Patients  

Despite the travel distance, several tots from the boroughs of New York City receive their primary care at Bambini. These children are now facing a mandate by the NYC Board of Health to receive influenza vaccine if they attend licensed daycare or preschool.

 

They now join kids from New Jersey and Connecticut, as well as NY adults that work in hospitals and nursing homes - who also face government mandates for flu vaccine.

 

Here at Bambini, we have seen a big uptick of influenza patients in the last two weeks. So far, none have been hospitalized. Although several hundred of our 5,000 plus patients received vaccine, the CDC has reported that the currently circulating H3N2 strain is not in the current vaccine.

 

Relatively few parents opted to have their children receive the nasal vaccine - even though the CDC came out favoring it over the shot in children for the first time. We aren't going to order many Flumist for next season. This vaccine is expensive and can't be returned. It does not contain thimersol.

 

When we see children with influenza symptoms, we often ask parents if they would use Tamiflu (even though it carries some side effects). If there is interest, their children are given a nasal swab. If they test positive for the "A" strain, we write for the Rx.

 

For kids whose parents prefer to avoid Tamiflu, or if the swab is negative, there are several other treatment options, including:

C-Section Babies Can Still Enjoy Mom's Biome 

Last fall, British film-making couple Toni Harman and Alex Wakeford released Microbirth, a documentary about the latest research on the microscopic events during childbirth.

 

The data coming in are showing that when a baby is properly "seeded" with the mother's bacteria at birth, his immune system is helped along toward its full potential. With a Caesarian delivery, this seeding does not occur.

 

But Dr. Maria Gloria Dominguez-Bello, an associate professor in the Human Microbiome Program at the NYU School of Medicine, is doing something about that. She placed a tampon in the birth canal of several women about an hour before their baby was delivered by C-section.

 

Immediately after delivery, the tampon was placed in the baby's mouth and rubbed on the skin. What did Dr. Maria find? The tampon treatment doubled the number of maternal bacteria found in the baby at a month of age.

 

In a control group of vaginally delivered infants, the number of maternal bacteria in the baby was six times those born by C-section. She speculated that the antibiotics routinely administered with all C-sections could be a factor in keeping these numbers down.

 

This seems like a pretty neat, simple technique that will catch on quickly. Will it reduce the incidence of colic, GERD, and eczema that we see in so many C-section babies? Time may tell.

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