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  • Spray sunscreen: is it safe for kids?

    Consumer Reports has recently updated their recommendations on sunscreen use in kids, saying that spray sunscreens should not be used in children.

  • Preparing your child for kindergarten?

    Kindergarten is a big step in the life of a little person. Children are expected to get through their day with greater independence and meet academic standards. As an occupational therapist, I’d like to shed a little light on one of the “other skills” needed to be a great student.

  • 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.

  • 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.

  • Can infant sound machines harm your baby’s hearing?

    You may have heard some talk lately about sound machines used for white noise and the possibility that it could damage a baby’s hearing. If your house is like mine, white noise is an absolute must- a small house with multiple children and bedrooms close together means that white noise helps everyone sleep better. But, is that okay?

  • If news headlines have made you feel like a bad parent, you aren’t alone

    You are a bad parent.

  • 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.

  • Inspired to give back after becoming a childhood cancer survivor: Whitney’s story

    After meeting Whitney, you would never realize the hardships she endured by spending most of her childhood in the hospital, battling several childhood illnesses. Instead, you would see a sweet, quietly confident 16-year-old girl who is passionate about art and medicine, as well as fundraising, pursuing excellence in everything that she does. While most girls her age are interested in the latest fashion trends, boys, and the usual high school drama, Whitney is different. Although she thinks about these things, she is on a greater mission. A mission to educate people on childhood cancer and to one day, find a cure for this ugly disease.

    The diagnosis that changed everything

    At eight years old, Whitney was diagnosed with a T-cell post-transplant lymphoproliferative disorder (PTLD), or a T-cell Lymphoma, a rare and aggressive form of blood cancer. In fact, it is so rare, that only one to two percent of the population in the United States is affected by this type of cancer today. Having been previously treated at a local hospital in Gainesville for a liver transplant that she underwent at the age of three, she began treatment for cancer there, so that her previous team of physicians could care her for. However, after three months of treatment, Whitney was not responding well, and her parents asked if she could be transferred to Arnold Palmer Hospital for treatment so that she could be closer to home. Once Whitney transferred, they started to see significant signs of improvement and she was finally responding to treatment. Over the course of her treatment, Whitney was a trooper and did extremely well. However, with the intensity of treatment that childhood cancer requires, there are good days and bad days. And some days, they feel so dark you wonder if there is a light at the end of the tunnel, according to her mom. Despite all of the trials and hardships that came her way, Whitney persevered through it all, and in April 2006 she was told she was “cancer-free!”

  • 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.

  • 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.