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  • Many parents ask us what is the best way to heat up their baby's food.  Here are some recommendations from the Food and Drug Administration. Breast milk or Formula (for bottl
  • Toddler's diarrhea is a common condition in children between the ages of 6 months and three years old. Its only symptoms are loose, watery stools, and although these children have

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Info on Flu Vaccines

Posted by Shelly
Shelly
Shelly Nalbone is a Pediatric Nurse Practitioner who has worked with children fo
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on Wednesday, September 04 2013
in Staying Healthy

The flu is caused by a virus and usually occurs from October through May.  The rates of infection are highest among children, and flu symptoms can last a week or longer. For most people, the flu can cause fever, cough, sore throat, headache, chills, muscle aches, and fatigue.  Some people can get much sicker, and can develop symptoms such as high fever or pneumonia. On average, about 36,000 people die each year from influenza.  Because influenza viruses are always changing, scientists work every year to match the viruses in the vaccine to those most likely to cause flu that year.

The Centers for Disease Control and Prevention (CDC) recommends a yearly flu (influenza) vaccine for all children 6 months and older, given as soon as the vaccine is available each year.   To allow adequate time for production of protective antibody levels, vaccination should occur before the onset of influenza activity in the community and should be offered throughout the influenza season.

Depending on your child's age, you might be able to choose between a flu shot and the nasal spray vaccine:

  • Flu shot:  Flu shots can be given to children 6 months and older.
  • Nasal spray:  The nasal spray flu vaccine (FluMist) can be given to children 2 years and older.

 Information for this post was obtained from the following sources:  American Academy of Pediatrics, American Academy of Family Practice, and The Centers for Disease Control and Prevention.

To schedule a flu vaccine for your child, call (281)292-0999 for an appointment.

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Reliable Information From the Internet

Posted by Shelly
Shelly
Shelly Nalbone is a Pediatric Nurse Practitioner who has worked with children fo
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on Thursday, August 29 2013
in Pediatric News & New Research

The Internet contains some extremely valuable, high-quality information sources, but it also contains some very unreliable, biased sources of information and can be misleading.  Websites can be created by anyone who pays for it, so not all information out there can be trusted as accurate and factual.  That puts a higher burden on you to evaluate the quality of each website you use.  Everyone has seen the Allstate commercial with the pretty girl who found a French model on the internet, right?  You don’t want to fall into that trap!  Here are some tips to follow when getting info from the World Wide Web.

1. Look for Sites from Established Institutions

The web is full of websites that were started five minutes ago. What you want are sites associated with trusted institutions that have been around for awhile and have a proven track record of reliability and integrity.

2. Look for Sites with Expertise

Look for websites that specialize in the kind of information you're seeking. So if you want information on symptoms of strep throat, check out medical websites rather than mommy blogs.  Ask the question: Who is responsible for the content?  What are their qualifications for providing information on this topic? Are references cited and is there a description of research methods used to obtain the data? Who reviews the information before it is published/posted?  For medical information, a trained medical professional should have reviewed the research. 

3. Steer Clear of Commercial Sites

Sites run by companies, businesses, or advocacy groups.  They are more often than not trying to sell or convince you of something.  Chances are whatever information they're presenting will be tilted in favor of their product or issue.  Ask yourself:  What is the underlying purpose of the site?  Is the site selling something, supporting a cause, or expressing personal opinions?  Has factual information been distorted or broadly interpreted?

4. Beware of Bias

Are the viewpoints expressed balanced or one sided?  Who is paying for the project and what is their purpose? Here is an example:  Reporters write a lot about politics, and there are plenty of political websites out there. But many of them are run by groups that have a bias in favor of one political party or philosophy. A conservative website isn't likely to report objectively on a liberal politician, and vice versa.   The same goes for medical issues.  Steer clear of sites that we based on opinion and instead look for ones that are non-biased and based on scientific research.

 Here are some trusted sites that we recommend for medical information: 

www.kidsgrowth.com

The site was developed and created by medical leaders in the field of pediatrics and adolescent medicine. Members of the Medical Advisory Board oversee all KidsGrowth content, thereby guaranteeing its medical accuracy.

www.kidshealth.org

The Nemours Center for Children's Health Media is a part of The Nemours Foundation, a nonprofit organization devoted to improving the health of children. They work with various medical professionals and commercial companies such as, Cheerios, Merck, Seventeen magazine, the Michael Phelps Foundation, the American Academy of Family Physicians to provide factual information and education for children and families. 

www.aap.org  (American Academy of Pediatrics)

The AAP is an organization of 60,000 pediatricians committed to the optimal physical, mental, and social health and well-being for all infants, children, adolescents, and young adults.

www.cdc.gov  (Centers for Disease Control & Prevention)

The CDC consists of researchers, scientists, doctors, nurses, economists, communicators, educators, technologists, epidemiologists and many other professionals who all contribute their expertise to improving public health.

www.vaccinesafety.edu  (Institute for Vaccine Safety: Johns Hopkins School of Public Health)

 Their mission is to provide an independent assessment of vaccines and vaccine safety to help guide decision makers and educate physicians, the public and the media about key issues surrounding the safety of vaccines. The institute’s goal is to work toward preventing disease using the safest vaccines possible.

References for this article on evaluation of internet sites:  Drexel University, Lee College, University of Milwalkee, & About.com/journalism

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Lunches for School Age Kids

Posted by Shelly
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Shelly Nalbone is a Pediatric Nurse Practitioner who has worked with children fo
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on Monday, August 26 2013
in Recipes

Kids can get tired of eating the same things every day.  How many days in a row can you eat a peanut butter sandwich?  Below is a link to some great ideas for your kid's lunch.  Thanks Pinterest for great ideas!!!

http://pinterest.com/pin/34058540905343774/

 

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Blocked Tear Ducts in Infants

Posted by Shelly
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Shelly Nalbone is a Pediatric Nurse Practitioner who has worked with children fo
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on Monday, August 26 2013
in Infants

A blocked tear duct is a common problem with infants.  A blocked tear duct occurs when the duct that normally allows tears to drain from the eyes is obstructed or fails to open properly.   The blockage does not allow the tears that are made to drain out, and the eye becomes flooded.  For some babies, blocked tear ducts aren't immediately evident at birth and may not be noticed until the baby is a month old.

 What are the symptoms?

  • When an infant has a blocked tear duct, the eye looks wet or tears may spill over onto the cheek, even when he or she is not crying. There can be a mucus-like substance, on the edges of the eyelid.

How is it treated?

  • Since the majority of cases resolve without treatment, most doctors suggest waiting to see if the duct opens on its own. Blocked tear ducts usually resolve without treatment by age 1.
  • If a tear duct (lacrimal duct) remains partially or completely blocked, the tear duct sac fills with fluid, and an infection can develop. The infection may cause inflammation (redness and swelling) and tenderness alongside the nose, and yellow/green mucus or pus in the eye.

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Helping your Infant Develop Fine Motor Skills

Posted by Shelly
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Shelly Nalbone is a Pediatric Nurse Practitioner who has worked with children fo
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on Tuesday, August 20 2013
in Infants

Fine motor skill is the coordination of small muscle movements which occur in body parts such as the fingers, usually in coordination with the eyes.  Developing fine motor skills is an important part of infant development.  Babies begin to use their fine motor skills between 8-12 months.  Here are some ways that you can encourage the development of fine motor skills in your baby. 

  • Let your baby paint with food. Yogurt, soft mashed carrots, or any other type of soft, smooth food is the perfect consistency for doing some finger painting.
  • Have your baby work for his or her meal. Pulling cooled noodles apart is a fun way to practice using his or her fingers.
  • Have fun in the tub. Plastic cups, pitchers, measuring cups and sponges let your baby practice holding, pouring, and squeezing.
  • When supported, a sitting child will follow you with his or her eyes, reach and grasp for objects, drop objects, hold onto small objects, bring hands to mouth, and place both hands on a bottle when being bottle fed.
  • To promote pincer grasp (thumb and index finger) development, encourage pulling tissues from a box, pegs from a board, or a straw from a cup.
  • To promote banging objects together, use blocks, spoons, small plastic cups, plastic rings from ring stacker toy.
  • To promote taking items out of containers, use these items for containers: shoe box without lid, butter tub, pots, pans, and toy buckets. Use these items to fill the container: blocks, pop beads, bean bags., etc.
  • At mealtime, place finger foods into an empty butter cup, and at bath time, use cups filled with water to dump into tub.
  • To promote more wrist movements, encourage waving "hi' and "bye." 
  • To encourage voluntary release, roll a ball back and forth together. Let your baby grasp and release sand, grass, pasta, etc.
  • To promote poke and probe using index finger, explore holes of toy dial phone, holes of a peg board, encourage pushing buttons such as doorbells or keys of a piano.
  • Babies love to clap. Help your baby bring his or her hands together and clap. Then hide baby's hands under a blanket. Your baby will enjoy watching his or her hands go away and come back.
  • Some babies love to rip paper. If that sounds like your baby, get a big basket and some old magazines and let him or her rip, shred, and tear the paper.

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Making Sense of Infant Formulas

Posted by Shelly
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on Thursday, August 15 2013
in Infants

If you have walked down the baby isle at the grocery store, you may have noticed that there are ALOT of infant formula variations.  Deciding which one is right for your baby can be confusing.  Here is some information that may be helpful.

Milk-Based Formula

The most common type of infant formula is milk based formula.  These formulas have a small amount of protein from cow's milk, along with a variety of vitamins and minerals.  Examples of milk based formulas include Enfamil Premium & Similac Advanced. Most babies can tolerate cow's milk-based formula, but some have allergic reactions such as rashes or diarrhea and may need a different type of formula.

Milk Based Formula for Spit Up

Some babies have problems with excessive spit up or reflux.  Formulas such as Enfamil AR or Similac Spit Up may be recommended by your doctor.  These formulas are milk based, but have added rice starch to thicken the formula to decrease spit up. 

Milk Based Lactose Free

For babies that are sensitive to lactose in the milk based formula, Similac Sensitive may be recommended.  Lactose intolerance is the result of a deficiency in the lactase enzyme necessary to help break down and digest lactose, a sugar most commonly found in dairy products. Although not a common condition for infants, lactose intolerance may result in increased fussiness, diarrhea and gas.

Milk Based Formula for Supplementation

Similac for Supplementation designed for breastfeeding moms who choose to supplement. It has more prebiotics than other Similac formulas. Some moms may notice changes in stool patterns when introducing formula and studies have shown that prebiotics produce softer stools more like those of breastfed infants.

Soy Formula

Soy formula does not contain cow's milk protein. Instead, it uses protein from the soybean plant along with iron and other vitamins and minerals to provide nutrition for the baby. Soy formula does not contain lactose.  Some examples of soy formula are Enfamil Prosobee, Similac Isomil, & Gerber Good Start Soy.

Partially Hydrolyzed

These formulas take a cow's milk protein, such as whey, and break it into large pieces. Some babies with  cow's milk-allergy will react to these large pieces of protein, so these formulas are not indicated for use in babies with milk-allergy.  These formulas may be good for infants with atopic dermatitis.  Examples of partially hydrolyzed formulas are Enfamil Gentlease , Gerber Good Start, & Similac Total Comfort.

Hydrolyzed Formula

Sometimes babies have a difficult time tolerating both cow's milk and soy-based formulas. When a baby has reactions like gas, diarrhea, or rashes with both types of formula, a hydrolyzed formula may be recommended. Hydrolyzed formulas can contain either cow's milk or soy components, but are broken down into smaller amino acids instead of large protein chains. This process makes hydrolyzed formulas hypoallergenic and easier for babies to digest.  Enfamil Nutramigen and Similac Alimentum are examples of hydrolyzed formulas.

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Tongue tie-Ankyloglossia

Posted by Shelly
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Shelly Nalbone is a Pediatric Nurse Practitioner who has worked with children fo
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on Thursday, August 08 2013
in Info on illnesses

Tongue-tie (ankyloglossia) is a problem that is present at birth. It happens when the tissue that attaches the tongue to the bottom of the mouth (lingual frenulum) is too short. Typically, the lingual frenulum separates before birth — allowing the tongue free range of motion. With tongue-tie, the lingual frenulum remains attached to the bottom of the tongue.  This can limit the movement of the tongue. 

When Is Tongue-tie a Problem?

Feeding – A new baby with a too tight frenulum can have trouble latching on, sucking, and may have poor weight gain.  Nursing mothers may experience nipple trauma (the pain doesn’t go away no matter what position is used), plugged ducts, and mastitis.  However, some tongue-tied babies are able to nurse effectively, depending on the way the frenulum is attached. If the mother has small or medium nipples, the baby may manage to extract the milk quite well in spite of being tongue-tied. On the other hand, if the nipples are large and/or flat, then tongue-tie may cause problems for a breastfeeding baby.

Speech – While the tongue is able to compensate and many children have no speech issues due to tongue-tie, others may.  Evaluation may be needed if more than half of a three–year–old child’s speech is not understood outside of the family circle. There is no obvious way to tell in infancy which children with ankyloglossia will have speech difficulties later.

Symptoms -

  • Difficulty latching onto the breast, difficulty sucking, and poor weight gain
  • Persistent maternal nipple pain during breastfeeding
  • V-shaped notch at the tip of the tongue
  • Inability to stick out the tongue past the upper gums
  • Inability to touch the roof of the mouth
  • Difficulty moving the tongue from side to side
  • Parents might ask themselves if the child can lick an ice cream cone or lollipop without much difficulty. If the answer is no, they cannot, then it may be time to consult a physician.

Treatment - Tongue tie surgery is called a frenulotomy.  It involves cutting the tissue under the tongue. It is usually done by an Otolaryngologist (Ear Nose & Throat Doctor) in their office. Surgery is usually only for severe cases of ankyloglossia.

 

Info obtained from:

www.mayo clinic.com, National Library of Medicine, American Academy of Otolaryngology, LaLeche International, & www.breastfeedingbasics.com

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Starting Kindergarten

Posted by Shelly
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on Wednesday, August 07 2013
in Parenting Tips

The first day of Kindergarten can be stressfull for kids and parents.  Here is a good article on how to make the transition smooth. 

http://school.familyeducation.com/kindergarten/anxiety/51261.html?page=2&detoured=1

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How to Add a Baby to a Dog Household

Posted by Shelly
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Shelly Nalbone is a Pediatric Nurse Practitioner who has worked with children fo
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on Thursday, August 01 2013
in Parenting Tips

When a new baby comes along, it can change the dynamic of your household.  Other children may experience sibling rivalry or begin to act out.  Our pets can have the same feelings.  Below is a link to a good article on introducing a baby into a home with pets.

http://www.pet360.com/blog/post/dog-appeal/how-to-add-a-baby-to-a-dog-household/iL9jjmVE2UuNppFksge68Q

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Umbilical Cord Care in Newborns

Posted by Shelly
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Shelly Nalbone is a Pediatric Nurse Practitioner who has worked with children fo
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on Wednesday, July 24 2013
in Infants

Your baby’s umbilical cord stump should be kept clean and dry until it falls off.  The cord will usually fall off after the first couple of weeks of life.  Fold the baby's diaper below the stump or buy newborn diapers with a cut-out space for the cord so it's exposed to the air and won't come in contact with urine.  Sometimes you may see some yellowish discharge underneath the dried cord and there may be some oozing of blood for a few days as the cord separates.   If you notice discharge from your baby’s cord, you can apply a small amount of rubbing alcohol with a cotton ball to help dry it out.  Don't be afraid to lift up the dry part of the cord in order to apply rubbing alcohol to the moist part below. Call us immediately if there is red streaking, swelling or inflammation around the cord.

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Complimenting your kids

Posted by Shelly
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on Thursday, July 18 2013
in Parenting Tips

All kids need to hear positive feedback from parents.  Here is a good article on how and what to compliment kids on.

http://www.imom.com/parenting/tweens/relationships/child/10-compliments-your-kids-need-to-hear/

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Potty Training

Posted by Shelly
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on Monday, July 15 2013
in Parenting Tips

Potty training is a big step for kids and parents.   How do you know when is the right time to begin potty training?  Potty-training success is based on physical and emotional readiness, not a specific age. Many kids show interest in potty training by age 2, but others might not be ready until age 2 1/2 or even older — and there's no rush. If you start potty training too early, it might take longer to train your child.

Is your child ready? Ask yourself these questions:

  • Does your child seem interested in the potty chair or toilet, or in wearing underwear?
  • Can your child understand and follow basic directions?
  • Does your child tell you through words, facial expressions or posture when he or she needs to go?
  • Does your child stay dry for periods of two hours or longer during the day?
  • Does your child complain about wet or dirty diapers?
  • Can your child pull down his or her pants and pull them up again?
  • Can your child sit on and rise from a potty chair?

If you answered yes to most of these questions, your child may be ready to give it a try.

  • Place a potty chair in the bathroom. Encourage your child to sit on the potty chair — with or without a diaper. You might dump the contents of a dirty diaper into the potty chair to show its purpose, or let your child see family members using the toilet.
  • Schedule potty breaks often.  If your child is interested, have him or her sit on the potty chair or toilet without a diaper for a few minutes several times a day. For boys, it's often best to master urination sitting down, and then move to standing up after bowel training is complete. Read a potty-training book or give your child a special toy to use while sitting on the potty chair or toilet. Stay with your child when he or she is in the bathroom. Even if your child simply sits there, offer praise for trying — and remind your child that he or she can try again later.
  • When you notice signs that your child might need to use the toilet — such as squirming, squatting or holding the genital area — respond quickly. Help your child become familiar with these signals, stop what he or she is doing and head to the toilet. Praise your child for telling you when he or she has to go.  When it's time to flush, let your child do the honors.
  • Always be positive.  Kids respond to positive reinforcement.  Consider stickers or stars on a chart, trips to the park or extra bedtime stories as rewards for using the potty.  Reinforce your child's effort with verbal praise, such as, "How exciting! You're learning to use the toilet just like big kids do!" Be positive even if a trip to the toilet isn't successful.
  • After several weeks of successful potty breaks, your child might be ready to trade diapers for training pants or regular underwear. Celebrate this transition. Go on a special outing. Let your child select "big kid" underwear. Make sure that you dress your child in clothes that are easy to pull up and down while potty training.
  • Nap and nighttime training might take months — or years — longer. In the meantime, use disposable training pants or plastic mattress covers when your child sleeps.

Info obtained from www.kidshealth.com, www.parents.com, & www.mayoclinic.com

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Hand, Foot, & Mouth

Posted by Shelly
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on Monday, July 01 2013
in Breastfeeding

Hand, foot, & mouth (HFM) disease is a virus that is common among children from 6months to 4 yrs of age. If your child has hand, foot, & mouth disease, you may see red spots and/or blisters on the hands, feet, face, buttocks. Your child may also have small ulcers or sores in his/her mouth and a low grade fever. The fever and discomfort caused by HFM usually lasts 3-4 days and mouth sores typically resolve within 7 days. The sores on the body can last up to 10 days. Feed your child a soft diet and encourage plenty of fluids. Cold drinks & popsicles are good choices for children with mouth pain. HFM is contagious. Children may return to school or daycare once they are fever free for 24hrs.  If you have any questions, feel free to call the office.

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Vaccines for Kids

Posted by Shelly
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on Friday, June 28 2013
in Staying Healthy

Babies are born with protection against certain diseases because antibodies from their mothers were passed to them through the placenta. After birth, breastfed babies get the continued benefits of additional antibodies in breast milk. But in both cases, the protection is only temporary.  Immunization (vaccination) is a way of creating immunity to certain diseases by using small amounts of a killed or weakened microorganism that causes the particular disease.  Microorganisms can be viruses (such as the measles virus) or they can be bacteria (such as pneumococcus). Vaccines stimulate the immune system to react as if there were a real infection — it fends off the "infection" and remembers the organism so that it can fight it quickly should it enter the body later. 

Some parents may hesitate to have their kids vaccinated because they're worried that the children will have serious reactions or may get the illness the vaccine is supposed to prevent. Because the components of vaccines are weakened or killed — and in some cases, only parts of the microorganism are used — they're unlikely to cause any serious illness. Some vaccines may cause mild reactions, such as soreness where the shot was given or fever, but serious reactions are rare.  The risks of vaccinations are small compared with the health risks associated with the diseases they're intended to prevent.

Parents who choose to skip vaccines or delay vaccination often do so because they’re concerned about sticking their baby with needles multiple times or worried that too many shots clustered in one visit can trigger complications. But vaccine advocates note that no evidence has been found to show that delaying vaccination is helpful for babies — and it can be harmful. “There is absolutely no scientific data that shows a delayed schedule is any safer,” says Wendy Sue Swanson, a pediatrician from Seattle Children’s Hospital.   “Small decreases in vaccine coverage are known to lead to dramatic increases in the risk of vaccine preventable disease outbreaks,” says Amanda Dempsey, M.D., Ph.D., M.P.H., assistant professor in the department of pediatrics and communicable diseases and a member of the Child Health Evaluation and Research Unit at C.S. Mott Children’s Hospital.   “Not following the recommended schedule leaves kids at risk for these diseases unnecessarily.”   Following a vaccination schedule that deviates from those recommended by recognized groups such as the Centers for Disease Control and Prevention and the American Academy of Pediatrics leads to under- immunization.  Under-immunization has been shown to significantly increase the risk of contracting and spreading vaccine preventable diseases like measles and whooping cough,” Dempsey adds. 

The biggest medical problem with the delayed schedule is that it leaves babies open to disease for a longer period of time. If a baby is vaccinated by the CDC’s tried, tested and true vaccine schedule, that baby will have immunity to over 14 diseases by the age of two.  We immunize children so young against these diseases because infancy is the time period that kids are MOST vulnerable to life-threatening diseases. The people at greatest risk of dying from vaccine-preventable disease are the very young and the very old. We recommend vaccines to save lives.

If you have questions or concerns about vaccines, talk to us.  We are here to help you sort out information and misinformation.

Info for this article was obtained from the following sites:

www.kidshealth.org

www.cdc.gov

www.aap.org

parents magazine http://healthland.time.com/2012/06/18/why-listen-to-the-doctor-because-parents-alternative-vaccine-schedules-may-cause-harm/#ixzz25nYesQYl

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Protecting your kids in the sun

Posted by Shelly
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on Thursday, June 20 2013
in Staying Healthy

Protecting your kids in the sun:  General Guidelines

  • Use sunscreen every day.  Most sun damage occurs with day to day exposure, not necessarily with the annual trip to the beach.
  • Avoid the strongest rays of the day between 10am-4pm.
  • UV rays can still cause sun damage even on cloudy days.  Even on overcast & cool days, UV rays travel through the clouds and can cause skin damage.
  • Be extra careful near water, sand and snow.  They reflect the UV rays and may result in sunburns more quickly.
  • Cover up with clothing, hats, glasses, & umbrellas.   Select clothes made with a tight weave - they protect better than clothes with a looser weave. If you’re not sure how tight a fabric’s weave is, hold it up to see how much light shines through. The less light, the better.
  • Teens should avoid tanning beds.  There is an increased risk of melanoma in people who have used tanning beds before age 35.

Protecting your kids in the sun:  Guidelines for Infants

  • Sunscreen is not recommended for babies under 6 months of age.
  • Keep babies younger than 6 months out of direct sunlight. Find shade under a tree, umbrella, or the stroller canopy.
  • Limit infant’s time out in the heat.
  • Dress infants in lightweight, long pants, long sleeved shirts, & hats to shade the neck.  If adequate clothing and shade are not available, parents can apply a minimal amount of sunscreen with at least an SPF 15 to small areas such as the face, and back of the hands.
  • For kids age 6 months and older, select an SPF of 30 or higher to prevent both sunburn and tanning. 

Sunscreen: Making Sense of SFP

  • Choose a sunscreen that states on the label that it protects against both UVA and UVB rays (referred to as "broad-spectrum" sunscreen).
  • Use water resistant formulas even if the kids are not going swimming. 
  • Apply sunscreen to all areas of the body, but be careful around the eyes. If your child rubs sunscreen into her eyes, wipe the eyes and hands clean with a damp cloth.
  • Use enough sunscreen to cover all exposed areas, especially the face, nose, ears, feet, and hands and even the backs of the knees. Rub it in well.
  • Apply sunscreen 15 to 30 minutes before going outdoors to give time for the sunscreen to bind and absorb into to the skin.

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Keeping Hydrated in the Summer Heat

Posted by Shelly
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Shelly Nalbone is a Pediatric Nurse Practitioner who has worked with children fo
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on Tuesday, June 18 2013
in Staying Healthy

With the hot days of summer come summer sports: baseball, tennis, football practice, both in the neighborhood and at camp. Many kids will soon begin school sport and club practices in the Texas August heat.  Before you send the kids out to practice -- or just for a long day of play in the sun -- learn to protect your child against the dangers of dehydration and heat illness.

1. What puts my child at risk for dehydration?

The same things that put you at risk for dehydration: prolonged exposure to high temperatures, direct sun, and high humidity, without sufficient rest and fluids. The difference is that a child's body surface area makes up a much greater proportion of his overall weight than an adult's, which means children face a much greater risk of dehydration and heat-related illness.

2. What signs of dehydration should we watch for?

Early signs of dehydration include fatigue, thirst, dry lips and tongue, lack of energy, and feeling overheated. But if kids wait to drink until they feel thirsty, they're already dehydrated. Thirst doesn't really kick in until a child has lost 2% of his or her body weight as sweat.

3. What can I do to prevent dehydration in my child?

Make sure they drink cool water and sports drinks early and often. Send your child out to practice or play fully hydrated. Then, during play, make sure your child takes regular breaks to drink fluid, even if your child isn't thirsty. The American Academy of Pediatrics recommends five ounces of cold tap water or sports drink for a child weighing 88 pounds, and nine ounces for a teen weighing 132 pounds.

Get them acclimatized before summer practice.  If your child is  going to soccer camp, they shouldn't be sitting around doing nothing in May/June  and then going out to play all day in July.   It is a good idea to get kids outside jogging, riding a bike, and slowly building up their fitness and ability to handle the heat. 

Know that dehydration is cumulative. If your child is 1% or 2% dehydrated on Monday and doesn't drink enough fluids that night, then gets 1% or 2% dehydrated again on Tuesday, that means your child is 3% or 4% dehydrated at the end of the day. They may be gradually developing a problem, that may not show up for several days.  A simple rule of thumb: if your child's urine is dark in color, rather than clear or light yellow, he or she may be becoming dehydrated.

For more info, check out this website.  http://children.webmd.com/dehydration-heat-illness

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Childhood Obesity and Exercise (3 of 3)

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Shelly Nalbone is a Pediatric Nurse Practitioner who has worked with children fo
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This is the final article in the Childhood Obesity Series. 

Tips to get kids moving

Many kids don't get enough physical activity. Although physical education (PE) in schools can help kids get up and moving, more and more schools are eliminating PE programs or cutting down the time spent on fitness activities.  Some children get just 30 minutes of vigorous activity each week during PE.  Families also lead busy lives and more and more children are spending their free time in front of the tv or playing video games.  The American Academy of Pediatrics (AAP) recommends that kids over 2 years old not spend more than 1-2 hours a day in front of a screen. The AAP also discourages any screen time for children younger than 2 years old.  It is important for kids to get up and get moving.

Current guidelines recommend that kids over 2 years old get at least 60 minutes of moderate to vigorous physical activity on most, preferably all, days of the week. Babies and toddlers should be active for 15 minutes every hour (a total of 3 hours for every 12 waking hours) each day.

Encourage kids' natural tendency to be active and help them build on developing skills.  Take kids to the park, pool, or splashpad to encourage physical activity.  Playing with push toys, hopscotch, or riding bikes and trikes is great exercise.  Have family swimming races in the pool or get out the hula-hoops.  Encourage kids to be physically active every day, whether through an organized sports team or a game of soccer during recess.  You can also go to the track and walk or join a gym that has kid friendly activities like basketball or a climbing wall.  There are some great video games that promote physical activity on Wii and X-box.  Dancing games, skiing, tennis, boxing, and other fitness games provide for good indoor exercise.

 More info can be found at these sites:  Centers for Disease Control, Mayo Clinic, American Heart Association, and Kids Growth.

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Childhood Obesity and Healthy Eating (article 2 of 3)

Posted by Shelly
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Shelly Nalbone is a Pediatric Nurse Practitioner who has worked with children fo
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on Monday, June 03 2013
in Staying Healthy

As discussed in the previous article, childhood obesity is on the rise in America.  Obesity can cause many longterm health complications.  The first step to combating childhood obesity is eating right.   We all know the importance of eating healthy, but this can be challenging with our on the go lifestyles.  Here are some tips that you can use. 

  • Don't reward kids for good behavior or try to stop bad behavior with sweets or treats. Come up with other solutions to modify their behavior.
  • Don't maintain a clean-plate policy. Be aware of kids' hunger cues. Even babies who turn away from the bottle or breast send signals that they're full. If kids are satisfied, don't force them to continue eating. Reinforce the idea that they should only eat when they're hungry.
  • Don't talk about "bad foods" or completely eliminate all sweets and favorite snacks from kids' diets. Kids may rebel and over eat these forbidden foods outside the home or sneak them in on their own.
  • Make healthy food choices for the entire family.  Here are some suggestions:
  1. Snack on hummus and raw veggies or baked veggie chips instead of chips and dip.
  2. Choose pizza made with whole wheat crust, skim cheese, and turkey sausage rather than pepperoni pizza.
  3. Have fresh fruits and veggies available at each meal and try different ways of preparing foods.  Involve your kids, this makes it more fun for everyone.
  4. Limit processed and boxed foods in your diet.
  5. Make sure that you are monitoring portion sizes to avoid over eating.  If your child is still hungry and wants seconds, have them in this order:  veggies, fruits, protein, then carbs.
  6. Limit sugary drinks such as sodas and juice.
  7. Switch to skim milk
  8. Cook meals at home so that you can monitor calories and portion sizes
  9. Pre-cook healthy meals on Sunday for re-heating during the week.  This will make dinnertime quick and easy, but also keep you from eating fast food after evening activities.

Eating right is an important part of healthy living, but remember to let your kids be kids.  It is ok to have pizza and cake at a birthday party, burgers at the team picnic, and candy at Halloween.    Moderation is key.

Stay tuned for the next article on exercising.

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Childhood Obesity and Changing Lifestyles (1 of 3)

Posted by Shelly
Shelly
Shelly Nalbone is a Pediatric Nurse Practitioner who has worked with children fo
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on Thursday, May 30 2013
in Staying Healthy

This is the first article in a series on Childhood Obesity and Changing Lifestyles

Childhood obesity is on the rise and rates of obesity have tripled in the past 30 years.  Children become overweight and obese for a variety of reasons. The most common causes are genetic factors, lack of physical activity, unhealthy eating patterns, or a combination of these factors. Only in rare cases is being overweight caused by a medical condition such as a hormonal problem.  Although weight problems run in families, not all children with a family history of obesity will be overweight. Children whose parents or brothers or sisters are overweight may be at an increased risk of becoming overweight themselves, but this can be linked to shared family behaviors such as eating and activity habits.

A child's total diet and activity level play an important role in determining a child's weight. Today, many children spend a lot time being inactive. For example, the average child spends approximately four hours each day watching television. As computers and video games become increasingly popular, the number of hours of inactivity may increase.

Obese children are at risk for developing medical problems that include:

  • High blood pressure
  • Type 2 diabetes
  • Elevated blood cholesterol levels
  • Bone and joint problems
  • Liver and gall bladder disease
  • Shortness of breath that makes exercise, sports, or any physical activity more difficult and may aggravate the symptoms or increase the chances of developing asthma
  • Restless or disordered sleep patterns, such as obstructive sleep apnea
  • Depression
  • Tendency to mature earlier (overweight kids may be taller and more sexually mature than their peers, raising expectations that they should act as old as they look, not as old as they are; overweight girls may have irregular menstrual cycles and fertility problems in adulthood)
  • Obese children are more prone to low self-esteem, negative body image and depression.
  • Excess weight at young ages has been linked to higher and earlier death rates in adulthood

 

People in the same family tend to have similar eating patterns, maintain the same levels of physical activity, and adopt the same attitudes toward being overweight. Studies have shown that a child's risk of obesity greatly increases if one or more parent is overweight or obese.  The key to keeping kids of all ages at a healthy weight is taking a whole-family approach.  Make healthy eating and exercise a family affair. Get your kids involved by letting them help you plan and prepare healthy meals, and take them along when you go grocery shopping so they can learn how to make good food choices.  By involving the entire family, everyone is taught healthful habits and the overweight child does not feel singled out. 

Stay tuned for the next article on Developing Health Eating Habits

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Hand, Foot, & Mouth

Posted by Shelly
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on Tuesday, May 28 2013
in Info on illnesses

Hand, foot, & mouth (HFM) disease is a virus that is common among children from 6months to 4 yrs of age. If your child has hand, foot, & mouth disease, you may see red spots and/or blisters on the hands, feet, face, buttocks. Your child may also have small ulcers or sores in his/her mouth and a low grade fever. The fever and discomfort caused by HFM usually lasts 3-4 days and mouth sores typically resolve within 7 days. The sores on the body can last up to 10 days. Feed your child a soft diet and encourage plenty of fluids. Cold drinks & popsicles are good choices for children with mouth pain. HFM is contagious. Children may return to school or daycare once they are fever free for 24hrs.

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