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  • Overcoming postpartum depression: Heather's Story

    January 20, 2012. Within 24 hours of the birth of my beautiful baby girl, my eyes filled with tears and I couldn’t move from my bed. While watching my all-time favorite TV show “Friends” in my recovery room, the all-too familiar feeling of anxiety and uncontrollable sadness flooded my system. 

  • A Dirty Baby is a Healthy Baby!

    Chuckles aside, there is really some very important science here. The “hygiene hypothesis” suggests that:

  • When your sibling is sick: dealing with illness in the family

    Being sick isn’t easy, but neither is being the sibling of someone who’s sick.

  • 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.

  • ADHD medications: Things you should know as a parent

    Attention deficit/hyperactivity disorder (ADHD) is one of the most common conditions among school-aged children, affecting roughly one in 25 kids. Children with this disorder often have trouble controlling their behavior, which can have wide-ranging effects on their home and academic lives.

  • Q & A on Scoliosis with Dr. Herrera and Dr. Knapp, Pediatric Orthopedic Physicians at Arnold Palmer Hospital

    Scoliosis is a relatively common condition among children and adolescents. It’s important to know that no spine is perfectly flat, but those who are unaffected by scoliosis have a spine that is straight when looking up and down the middle of the back. Likewise, those who are affected by scoliosis have a curve that runs side-to-side, sometimes resembling the letters “S” or “C,” instead of the letter “I.”

    What exactly is scoliosis and how common is it?

    Scoliosis is a condition of the spine where your back may become curved with time. Not only is the spine curved, but it also rotates on its axis, which leads to the famous “rib hump,” noticed on the spine screenings done at school, or during yearly physicals administered by primary care physicians.

  • Shopping cart injuries are on the rise

    How often do you go to the grocery store anticipating leaving in an ambulance with your child, due to a shopping cart-related injury? My guess is, never. Most parents want to get in and get out when doing the grocery shopping, especially with kids in tow. The problem is, many parents sacrifice safety while trying to hurriedly check things off their list. And despite a voluntary shopping cart safety standard implemented in 2004, the overall rate of shopping cart-related injuries among kids have not declined.

    The Study

    A recent study published in Clinical Pediatrics brought to light the prevalence of injuries among children related to shopping carts that were treated in US Emergency Departments, and the numbers were unexpected. Rather than seeing a decline in the number of injuries following the 2004 shopping cart safety standard, researchers actually found an increase in the number of concussions and closed head injuries treated. This can only mean one thing – the current safety standard is not adequate, and further action must be taken to help keep kids safe while cruising around the grocery store.

  • 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.

  • Emotional Eating: Parenting and its effect on our children’s eating behaviors

    I was asked to speak on TV recently about an article entitled “Eating Your Feelings? Your Mom Might Be to Blame.” Of course, for TV, the story had to sound catchy, so the TV host really played up the blaming mother and grandmother aspect. That made me sad; parenting is really a hard job and it is rough to be blamed for errors we make while doing our best. The data, though, really does suggest that how we were parented may affect eating behaviors and those of our children. The issue is important, since at least a quarter of preschool children in the United States are overweight. Obesity at the age of five is a very strong predictor of whether or not someone will be obese as an adult. So how we feed our young children and how we teach them to eat really matters for their whole lives. My take is that this information is not an opportunity to point fingers, but an opportunity to learn and to do better as parents.

    What the study has to say

    The article was based on a study done by researchers at the University of Illinois and published in the Journal of Developmental and Behavioral Pediatrics. It showed that primary caregivers (usually moms) who had an insecure attachment to their own mothers are more likely to have young children with unhealthy eating habits who are overweight or obese. “Insecure attachment” is a term from psychology that has to do with how we feel about parents who don’t respond consistently to our needs. Parents who grew up insecure tend to have more trouble dealing with their own children’s needs, especially when it has to do with negative things like distress, anger, or sadness. That in turn is connected with some unhealthy behaviors surrounding food and eating.

    Real life examples

    The study clearly showed that homes where children’s sadness or anger are dismissed are also homes where there are fewer family mealtimes, more television viewing time, and more “comfort feeding.” These behaviors are known to lead to obesity in even the youngest of children. For example, an overwhelmed mother might respond to a temper tantrum by feeding her toddler snacks to make him stop crying instead of using appropriate parenting techniques to deal with the tantrum. Another example might be the parent who puts her four-year-old in front of the TV to eat dinner instead of having a family mealtime, since the TV keeps the child quiet and makes her sit still longer than sitting at the table for dinner. Sadly, this also leads to overeating in the whole family.

    So, what do we do with this?

    Well, if you have a two-year-old who is already overweight, maybe there is room to work with your parenting behaviors around food. Look at how you respond to your child’s negative behaviors. Do you tell your child, “that’s nothing to be angry about?” Or do you find yourself saying, “don’t be sad?” Instead you could say, “I hear that you are angry” or “you seem to be sad.” It’s hard to do. If you need to, ask your pediatrician for suggestions to deal with (and to help your child to deal with) those negative feelings. Could you tolerate a little tantrum or some tears instead of abandoning the family table for a meal in front of the TV (we call it the brain sucker in my house)? Could you give up feeding your child snack foods or treats to console them when they are angry or sad? Could you let go of the expectation that your small child will sit still to eat and will clean her plate? Could you serve a healthy, well-balanced meal and deal with it if your “picky” toddler gives you a hard time about it or refuses to eat?

  • When Mother’s Day brings sadness along with joy

    My mom died seven years ago. We were very close. Not a day goes by that I don’t think about her about a hundred times. To be honest, I miss her more than words can even express. As a result of this, Mother’s Day is always a strange day for me. I am a mom, but I don’t have a Mom anymore. Year after year, my Mother’s Days are filled with sentimental joy when I read my son’s homemade cards and aches of sorrow when all I want to do is be able to call my own Mom and tell her I love her.