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  • Is genetic testing right for my child?

    Angelina Jolie shared publicly last month her decision to have a preventive double mastectomy after genetic testing revealed that, due to a mutation in the BRCA1 gene, she carried an 87% risk of developing breast cancer and a 50% risk of developing ovarian cancer. Jolie identifies her mother’s decade-long struggle with ovarian cancer and death from that disease six years ago as one of the primary influences behind her decision.

  • Katie Karp is a cancer survivor.

    Katie Karp remembers the day when she was diagnosed with cancer very well. The diagnosis of osteosarcoma in her left leg was unexpected and quite a blow, but Katie was not going to let cancer win. She's a fighter. Through dozens of chemotherapy treatments and surgery that resulted in 11" of her thigh bone being removed, Katie persevered. Watch her amazing story and how she's used her experience with cancer to help children currently going through their own battle.

  • A Dirty Baby is a Healthy Baby!

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

  • 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 is hand, foot, and mouth disease?

    If you’re the parent of small children, odds are you’ll become familiar with hand, foot, and mouth disease at some point. It’s fairly common, but not nearly as serious as its name might suggest.

    What is Hand, Foot, and Mouth Disease?

    Hand, foot, and mouth disease is a viral illness that can affect anyone, but is most commonly seen in children under 5 years old. Along with the usual symptoms of a virus- fever, irritability and lack of appetite- children often develop small blisters or red spots on the palms of their hands and soles of their feet. Blisters may also be found in the webs between fingers and toes, or on the buttocks, and can resemble chickenpox. Children also will develop small, painful ulcers in their mouth and on their tongue.

  • What is a Certified Nurse-Midwife (CNM)?

    If you’ve ever felt a little confused about what exactly midwives do, or how they’re different than other healthcare professionals, don’t worry! Between physicians, physician assistants, nurse practitioners, and certified nurse-midwives, there’s a lot to keep straight.

  • Is CrossFit safe when you’re pregnant?

    Over the past several years, ultra-intense exercise programs have become increasingly popular. From P90X to INSANITY to High Intensity Interval Training (HIIT), it seems there’s no shortage of fitness gurus promoting the benefits of fast, high-intensity workouts designed to push your body to the limit.  Arguably, one program stands out among the rest as the most popular and most intense of the bunch: CrossFit. Once an underground fitness movement mostly practiced by elite military units and die-hard fitness fanatics, CrossFit is now a mainstream phenomenon that’s attracted hundreds of thousands of followers, from Hollywood A-listers to everyday working professionals. Increasingly, CrossFit has also become a trendy way for expecting women to stay in shape during their pregnancies. Unsurprisingly, it’s led many people to wonder if CrossFit and programs like it are safe for moms-to-be.

  • How my son’s diagnosis is changing me

    Other than the occasional cold and runny nose, both of my children have been perfectly healthy. Until now, that is. Last week, my 7-month-old son had a severe reaction after eating eggs, and he’s been diagnosed with an egg allergy.

  • What it means if your child fails his/her newborn hearing screening part 2

    In our previous post, we discussed the newborn hearing screening. Now let’s discuss what a failed hearing screening means and what will usually follow. In general, there are two types of hearing loss: sensorineural and conductive. Conductive hearing loss occurs when there is a break in the conduction of sound between the outside world and the end of the stapes or 3rd hearing bone. The second type of hearing loss is sensorineural, or nerve-related. This can occur within the cochlea or anywhere along the path of the cochlear/auditory nerve and remainder of the pathways from the cochlea to the brain.

    Conductive hearing loss

    Conductive hearing loss is easy to understand: something is blocking the sound from getting into the inner ear. There are several things that can cause conductive hearing loss which results in a failed newborn hearing screening. The most common of these is fluid in the ear canal or middle ear. The middle ear space is filled with fluid in general up until delivery. As the baby is delivered, the movement through the birth canal helps push the fluid out of the middle ear space. When this does not happen effectively, fluid can remain in the middle ear space and cause a conductive hearing loss and a failed newborn screening. This usually goes away after a short time, but it can persist for 4-6 months and may necessitate a procedure to drain the fluid from the ears.

  • What it means if your child fails his/her newborn hearing screening

    Amid all of the excitement of a newborn child, there are several tests that your baby will undergo shortly after birth while the baby is still in the newborn nursery. One of those tests is a hearing screening, which checks to see if the most basic parts of the hearing mechanism are intact. We will discuss the newborn hearing screening, how it works, what the results mean, and what you should do if your child has an abnormal test result.