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  • Cutting and self-injury: what to do if someone you know is hurting themselves

    “Is it weird that I cut myself on purpose?”

  • 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

  • Reading aloud to your kids affects literacy and school readiness

    Did you know that by the time your child reaches the 3rd grade, experts can reliably predict whether he will graduate high school?

  • 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.

  • How my roles as a woman, wife and mother have made me the doctor I am today

    This post was written by Dr. Brozyna, pediatrician at Arnold Palmer Hospital for Children

  • 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.

  • Car Seat Safety Guidelines: what you need to know.

    There are few things in parenting as complicated as the rules and regulations of car seats. And yet, there are few things as important for the safety and well being of our kids.

  • What are the most important things we can give our children?

    We have but a few, short years to shape and refine them, to help our children become the people they were meant to be. And then, we send them out into the world to find their way. It’s a tough job, isn’t it? To love and care so deeply about someone, about the outcome of this process of growing up, and yet be forced to let go of how it all turns out?

  • Are you concerned about bedwetting?

    It makes me sad as a pediatrician to see families who stress over children who wet the bed. This is usually a normal, natural issue that goes away in time, yet it can really hurt children who are treated like it is their fault.

  • How to have a safe and spooktastic Halloween

    Halloween may not be the most anticipated time of year among adults, but for kids, it’s a different story. The anticipation of dressing up in their favorite costume and collecting candy until their trick-or-treat bucket is too heavy to carry can be overwhelming. For some kids, it seems almost torturous to make them wait until it’s time to go trick-or-treating to show off their costumes to their friends and family. Dressing up in a favorite costume, going door-to-door screaming “trick-or-treat!”, and coming home to a pile of candy is the highlight of the fall season for many kids.