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  • The best newborn sleep advice I’ve ever received: Part 1

    Before my daughter was born, I read a lot of parenting books. I was probably as prepared as a first-time mom could have been. And yet, when that little bundle finally made her appearance, I didn’t feel prepared at all.

  • Hurricane Kyle: a mother's journey through the storm of childhood cancer

    Friday,  August 13, 2004 is a day I will never forget. It was not only the beginning of three  hurricanes back-to-back that trampled across Florida, but it was the day my 9-year-old son, Kyle, was transported by ambulance to Arnold Palmer Hospital.

  • Helping teens make the leap into adulthood

    Yesterday, I met an 18-year-old young man who was coming in for his yearly physical for the first time. He had previously been followed by a general pediatrician, but he felt it was time to move out of the pediatric care setting into a health home that specializes in caring for adolescents and young adults. “Why?” I asked. To this he responded, "Because I felt it was time. I am not a child anymore."

  • Leading by example

    The other day I had lunch with a friend at one of our favorite mom-and-pop sandwich shops. Well, sort of. We did have lunch, but I only remember this lunch date in flashes of chaos and confusion created by two lively toddlers.

  • Bringing hope and happiness: Tyler's story

    The fight of a lifetime

    On April 14, 2005 Tyler was diagnosed with Stage 4 Neuroblastoma, an aggressive childhood cancer. He was two weeks away from his fifth birthday, and he had no idea that he was about to embark upon the fight of his life.

  • The vaccine schedule is safe and effective

    Pediatricians often hear from parents that they are worried about giving too many vaccines at one time and “overloading the immune system” of their infant. As a result, parents ask to “spread the vaccines out more.” As pediatricians, we know that the vaccine schedule outlined by the Centers for Disease Control and Prevention (CDC) and recommended by nearly all pediatricians is safe and effective. We don’t understand how some rogue physicians and some well-meaning, but ignorant public figures can contradict good science and suggest that the vaccine schedule that we use is unsafe.

    All scientific evidence says that the vaccine schedule

    is indeed safe and very effective.

    Many people draw the conclusion that it must be dangerous to give vaccines all at once. But in fact, that could not be further from the truth. There are very specific reasons that we use each vaccine the way that we do, both when they are started, and how and when they are repeated. What I will give you in this post and in subsequent posts is hopefully a clear, understandable explanation of the design of the CDC’s recommended immunization schedule.

    The Hepatitis B Vaccine

    The hepatitis B vaccine is the one immunization that we routinely give as soon as a baby is born. This is for two reasons. First, it works that early. Newborns’ immune systems are already up and running and are able to respond to the hepatitis B vaccine and make antibodies right away. This is a very fortunate thing, as many of our vaccines don’t work in a newborn body. What we know about hepatitis B is that almost all cases in children are caused by spread from an infected mom during birth. Many moms who are carriers of hepatitis B are missed during pregnancy or in the hospital, either due to lack of prenatal care, lab error, or lack of communication. The amazing thing is that the one dose of hepatitis B vaccine, if given right after birth, is essentially perfect in preventing infection of the newborn. The birth dose of hepatitis B vaccine saves lives every day. The other nice thing about that vaccine is that there are essentially no relevant side effects, not even fever or discomfort.

    The Two-Month Wellness Visit

    We start our next routine vaccines at the two-month wellness visit. When we immunize we want to be sure that enough of mom’s antibodies are out of the newborn’s system and that the newborn’s immune system has matured enough to respond to our vaccines. We know that in the first month or more, some of the vaccines don’t work well yet. However, by six to eight weeks they work very well; this is why the DTaP, Polio, HIB, rotavirus, and pneumococcal vaccine series start when they do.

    This is NOT because the immunizations would

    “overwhelm” the immune system if given earlier.

    They just would not be effective.

    Of note, the most common and relevant side effects of the vaccines given to infants are a little bit of diarrhea or throw-up from the rotavirus vaccine, and maybe a little fever, fussiness, or local reaction in the thigh muscle for the others.

    The MMR Vaccine Controversy

    The MMR (measles, mumps and rubella) vaccine is one that has received a lot of attention since it was wrongly accused of causing autism.

    In fact, vaccines have clearly and repeatedly been shown

    not to cause autism or other developmental disabilities.

    And yet, many parents still believe that we wait to give the MMR until a year of age because it might be harmful if given earlier. They then wonder if waiting even longer might be even better. The problem is that the younger you are when you get the measles, the sicker you get and the more likely you are to die. Our goal with the MMR is to protect small children as young as we possibly can, and to reduce the spread of disease in our communities.

  • What you need to know about bicycle helmets for kids

    One of my favorite things about the neighborhood in which I live is that every weekday I see elementary and middle school kids riding their bicycles to school. The crossing guards take special care to help kids cross the street, and the children look thrilled to be embarking on a grand adventure. It reminds me that mine is a family neighborhood, and I’m so fortunate to live in a place where kids have the opportunity to ride their bikes to school safely.

  • A letter to other families battling childhood cancer

    Written by Colleen and JP Wright, parents of Ethan Wright, Ewing's Sarcoma Fighter and to date, SURVIVOR

  • Itches and sneezes: Understanding allergies in children

    As I prepare to write about allergies, my poor daughter is sitting next to me sniffling away, red-eyed, stuffy-nosed, and miserable. If you don’t live with allergies yourself, it can be hard to understand how bad this common medical problem can make people feel. But allergy sufferers know that as their season draws near, they can count on disrupted sleep, trouble smelling and tasting food, itching out of their skin, and blowing through boxes of tissues.

    Types of allergies

    Allergies can be perennial, meaning all year long, or they can be seasonal. Perennial allergies are to things like: pet dander, dust mites, molds, and, believe it or not, cockroaches. Here in Florida, where humidity reigns, most of these allergens are everywhere. Seasonal allergies are pollen allergies, and involve trees, shrubs, grasses and weeds. In Florida, where things bloom and pollenate year-round, some unfortunate allergy sufferers can react to multiple pollens during multiple seasons, with little relief between seasons.

    Symptoms to look for

    Symptoms of allergies are many, and are sometimes hard to tell from viral or other illnesses. A common cold follows a rather predictable course: sore throat with or without fever at first, followed by runny nose, followed in another few days by cough. Things get worse over the first week, and then improve over the second week. The flu is marked by high fever and body aches. The hallmark of allergy is the lack of fever, itching of eyes, nose, throat, and/or skin, and the ups and downs of symptoms. Some people have classic allergic rhinitis, with itchy, sneezy, runny nose. Some have allergic conjunctivitis, with red, runny, itchy eyes. Some patients have maddening itching in the back of the throat.  Cough is common in allergy sufferers, and can be from post-nasal drip or from bronchospasm (allergy-induced-asthma is wheezing caused by allergic inflammation). Some allergy sufferers also have itchy dry skin, or eczema.  Complications of allergies can include infections of the ears, sinuses, lungs, and skin.

    How are allergies treated?

    Treatment of allergies may involve determining triggers and eliminating or preventing whatever you can. Sometimes, identifying triggers is easy; for example, if every time your child visits grandma and curls up with the cat she starts to tear and sneeze, your child is allergic to cat dander. You don’t need a test to prove that. On the other hand, allergy tests, which can be blood tests and/or skin tests, can be very helpful in patients with severe symptoms. For example, if your child is often congested and has recurrent sinus or ear infections and turns out to be allergic to dust mites, you can remove carpeting and curtains from his bedroom, encase his mattress and pillow in allergy-control casings, limit plush animals in his bed to one or two, and even run a dehumidifier to kill dust mites. Prevention is considered to be preferable to treatment with multiple medications.

  • Savoring the little (and oftentimes unglamorous) moments with my kids

    It’s been a rough couple of weeks at our house. First, it was a round of colds for everyone. The snotty noses and coughs still haven’t ended. Then, it was the stomach virus. I’ll spare you the details, but I’ll just say that it wasn’t pretty. And anyone with kids knows that sleepless nights come with the territory when they’re sick.