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Nurture Pediatrics Newsletter – Volume 1 | Issue 3

What’s Inside?

halloween-boo-bash-pate-with-2-happy-children

Happy patients at Boo Bash

 nurutre-pediatrics-boo-bash-crewOur team: Janie, Eny, Belinda

Thank you to all of our families who stopped by, decorated cupcakes and received a Trick-or-Treat Safety bag. We provided 30 flu shots to
families and welcomed more than 50 prior or prospective patients. It warmed our hearts to see so many familiar faces!
If you need a flu shot, send us a message on OhMD, patient portal or call us at (713) 894-2751 or (832) 851-8038. Parent flu shots $25.

 

SIDS Prevention

Sudden Infant Death Syndrome prevention was a hot topic at the National American Academy of Pediatrics Convention this month! There are some new recommendations to help prevent sleep related deaths in infants. Take a look at these recommendations from the American Academy of Pediatrics:

1. Back to sleep for every sleep.
2. Use a firm sleep surface.
3. Breastfeeding is recommended.
4. Room-sharing with the infant on a separate sleep surface is recommended until 6 months of age
(due to higher risk of sleep related death in infants less than 6 months of age).
5. Keep soft objects (stuffed animals, bumper pads, blankets, pillows) and loose bedding away from the
infant’s sleep area.
6. Consider offering a pacifier at naptime and bedtime.
7. Avoid smoke exposure during pregnancy and after birth.
8. Avoid alcohol and illicit drug use during pregnancy and after birth.
9. Avoid overheating (room temp 74-76 degrees).
10. Pregnant women should seek and obtain regular prenatal care.
11. Infants should be immunized in accordance with AAP and CDC recommendations.
12. Do not use home cardiorespiratory monitors as a strategy to reduce the risk of SIDS. Avoid the use of
commercial devices that are inconsistent with safe sleep recommendations.
13. Supervised, awake tummy time is recommended to facilitate development and to minimize
development of positional plagiocephaly (misshapen heads).

Full article from the AAP:
http://pediatrics.aappublications.org/content/pediatrics/early/2016/10/20/peds.2016-2938.full.pdf

 

“Snoo” – MIT and Dr. Harvey Karp’s Smart Crib

Along this same topic, Dr. Karp famous for well-loved book The Happiest Baby on the Block and the 5 S’s (swaddle, shush, suck, swing, side or stomach position) of helping your baby calm and sleep, has been working along-side MIT engineers to develop the Smart Crib. It is intended for infants from birth to 6 months of age and touts being able to calm a crying baby within 1 minute.


Is it really worth $1,160?
See for yourself below.


Dr. Pate’s opinion on Snoo and babies sleeping through the night:

All babies take some time to learn to sleep through the night (usually 3 months). Should a device take the place of a parent comforting their child during the night for those first 3 months? Night time awakenings create opportunities for parent/infant bonding, night time feedings to promote growth, and time off the head to prevent plagiocephaly (misshapen head). Freedom to move the hands and body within the crib allows the infant opportunity to learn self-soothing techniques rather than relying on sleep crutches like sleeping in a swing. Anecdotally, I experienced infant colic first hand with one of my own sons. It took him 4 months to learn to fall asleep on his own and sleep through the night. It was exhausting and at times frustrating. Sleep deprivation made me grouchy, often, but with a strong support system, we made it through those first few months and developed a strong attachment. He is a secure and well developed boy who happily goes to bed and sleeps through the night. Believe it or not, I have fond memories of holding him and bouncing on the yoga ball at all hours of the night. The KEY to adjusting to a newborn is a STRONG SUPPORT SYSTEM, not a magic crib or latest and greatest baby device. Don’t let pride, guilt, past problems prevent you from reaching out to your spouse or relative and friends to help support you and care for your infant during these early months of your child’s development. It really does take a village to raise a child!

 

MMR Vaccine vs Measles2016-11-15-12_15_40-settings

MMR (measles, mumps, rubella) Vaccine

  • Issued as a single vaccination in 1971 in response to high rates of disease
  • Booster dose added for older children in 1990 in response to rising cases of measles
  • Available for children 1 year or older and adults
  • To protect babies too young to receive the vaccine (< 12 months) from the illness, our community as a whole needs to be vaccinated at 95% rate.
  • Current MMR vaccination rate has dropped to 92% due to vaccine refusal.
  • Side effects from the vaccine:
    1-3 days after the vaccine: redness, swelling or local skin reaction (common), allergic reaction (rare)
    1-10 days after the vaccine: fever (15%), fatigue (10%), febrile seizure (<< 1%)
    5-14 days after the vaccine: rash (5% of children), joint pain (< 1% of young children)
    2-6 weeks after the vaccine: ITP (low platelets – rare and self-limited)
  • It is very clear that MMR vaccine does NOT cause autism.

 

Measles, the Disease

Timeline:

  • 1960s: almost everyone caught measles as a child and while most improved without long term consequences, of the 3-4 million people infected each year in the US, approximately 500 died and approximately 4,000 developed encephalitis (swelling of the brain).
  • 1980s: MMR vaccine was introduced in the 1970s and the measles rate dropped by 80%
  • 1990s: Outbreak of measles occurred prompting a second booster dose of the MMR vaccine.
  • 2000s: Measles was declared eliminated within the USA, but still endemic in other countries.
  • 2010s: Measles outbreaks have occurred in at least 27 different US states and in 2014 there were 667 reported cases. The cases have occurred in communities of poor vaccination rates and the virus has been introduced by persons traveling outside the USA.

The Illness:

  • Incubation Period of 1-2 weeks without symptoms following exposure/infection
  • 1-3 days of the illness: The 3 C’s: cough, coryza (runny nose) and conjunctivitis (pink
    eye) along with fever and fatigue.
  • 3-7 days: Koplik spots (in the mouth) and Rash develop along with high fever spikes
  • 1-3 weeks: complications may occur including ear infection (10%), pneumonia (5%),
    encephalitis (1 out of 1000 cases, swelling of the brain that leads to seizures, coma,
    deafness and intellectual disability), Death (1 out of 1000 cases).

Long Term consequences

Progressive Subacute Sclerosing Panencephalitis (SSPE) while rare in the USA, shows a rise in other countries where measles cases are more common. A recent publication from a review in Germany reports the incidence to be 1 in 1700 cases for children less than 5 and 1 in 600 cases for infants who contract measles. This disease occurs years after the child has recovered from the measles infection and leads to seizures, dementia, coma and death. There is no cure to SSPE due to measles.
http://www.forbes.com/sites/daviddisalvo/2016/10/30/new-study-further-proves-why-anti-vaccination-thinking-is-deadly/#199a11b35de2

What’s Going Around?

Acute Gastroenteritis

  • Diarrheal illness that is due to several viruses
  • Diarrhea develops in most cases on the second day of the illness
  • In older children and adults, it usually lasts only 1-4 days.
  • In babies and young children, the fever and diarrhea can be severe and the illness can last 2 weeks or more.
  • Treatment includes electrolyte drinks (pedialyte), anti-vomiting medications (ondansetron) and probiotics (Culturelle for Kids).
  • Warning signs to seek treatment include blood in the stools, green colored vomit, high fever (102 or higher), less than 3 urinations per day, and seizures.

AdenoVirus

  • This virus causes pharyngoconjunctival fever in its full manifestation but some children develop only partial symptoms.
  • The illness begins with fever, stomach ache, sore throat, body and joint aches.
  • Pink eye (conjunctivitis), vomiting, diarrhea can develop after 2 days.
  • Nasal congestion and cough follow for 10-14 days.
  • There is not a specific treatment but rest, fluids, ibuprofen are helpful.
  • If there is significant drainage from the pink eyes, antibiotic eye drops may be necessary for control of secondary bacterial conjunctivitis.

RSV (respiratory syncytial virus)

  • Respiratory virus that can severely affect young infants and children.
  • The illness begins with low grade fever and a rather severe runny nose.
  • By Day 5, the congestion moves into the chest causing wheezing and fast breathing, fatigue and sometimes low oxygen levels.
  • By Day 10, there is improvement in the breathing but cough and intermittent wheezing can last for a full month.
  • Treatments are supportive as there is no cure for RSV: increased fluids, rest, nasal saline with suctioning and sometimes breathing treatments.
  • Warning signs to seek care: fever lasting longer than 3 days or reaching above 102, fever that resolved but has recurred a few days later, audible wheezing, breathing so fast that the child cannot drink and urinate at least 3-4 times per day, lethargy (difficult to arouse), lips turning grey or blue.

Toy and Baby Product Recalls

September 30, 2016 CPSC; Graceleigh, Inc. recalls Sammy’s Milk Baby Food
because the food may contain Cronobacter, a bacteria that can cause severe blood
infections and meningitis.

October 3, 2016 CPSC; Hallee Inc. recalls bed canopies because a child may
become entangled in the canopy, posing entanglement and strangulation hazards.
Units: 1,000.

October 6, 2016 CPSC; Summer Infant recalls Lil’ Luxuries infant bath tubs because
the sling that holds the infant can detach from the tub posing injury and drowning
hazards. Units: 86,000.

October 11, 2016 CPSC; Mamas and Papas recalls Armadillo strollers because a
loose latch on the stroller can cause the seatback to tip unexpectedly when the child
is in the parent-facing position, posing a fall hazard. Units: 3,000.

October 13, 2016 CPSC; L’echarpe Port-bonheaur recalls Chimparoo baby carriers
because the strap attached to the side buckle can loosen and the child can fall out of
the carrier. Units: 300 (another 1,000 were sold in Canada).

October 15, 2016 USDA; Tyson’s food recalls Tyson Fully Cooked, Whole Grain
Golden Crispy Popcorn Chicken, Chicken Patty Fritters due to possible presence of
hard plastic material. Units: 1,148 pounds.

October 27, 2016 CPSC; Perego recalls 850 Polaris Sportsman children’s ride-on toy
vehicles because the circuit board can fail causing the motor to overheat, posing fire
and burn hazards. Units: 3,000.

 

Thank you for reading our November Newsletter from Nurture Pediatrics!
J. Pate, MD

Download this article in a PDF!

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