News

  • Is It a Medical Emergency or Not?

    When your child is sick or hurt, it can be difficult to tell whether an urgent care or emergency department is the best choice. In making that decision, it is important to stay calm and recognize the difference between a medical emergency and a medical situation where a different type of care may be more appropriate. 

    Nonemergency Medical Situations:

    As a first step in nonemergency situations, the American Academy of Pediatrics (AAP) recommends calling your pediatrician's office—your child's "medical home"—to discuss your child's needs. Pediatricians are very accustomed to taking phone calls at all times and can often deal with problems over the phone.

    Learn more here and see a list of examples.

  • Fluoride Varnish: What Parents Need to Know

    Healthy gums and teeth are important to your child's overall health. This is why your child's doctor will talk with you about good dental habits even before your child's first tooth appears.

    Once your child has a tooth, your doctor may recommend that your child receive fluoride varnish treatments in the pediatrician's office to help prevent tooth decay. This can be done 2 to 4 times per year. The number of treatments depends on how likely it is that your child may get a cavity.


    Pediatricians are trained to apply fluoride varnish because many young children do not see or have access to a dentist until they are older. If your child is seeing a dentist at a young age, as recommended by the American Academy of Pediatrics, fluoride varnish may be applied in a dental office instead.

    Read on for more information from the American Academy of Pediatrics about fluoride varnish.

    What is Fluoride Varnish?

    Fluoride varnish is a dental treatment that can help prevent tooth decay, slow it down, or stop it from getting worse. Fluoride varnish is made with fluoride, a mineral that can strengthen tooth enamel (outer coating on teeth).

    Keep in mind that fluoride varnish treatments cannot completely prevent cavities. Fluoride varnish treatments can best help prevent decay when a child is also brushing using the right amount of toothpaste with fluoride, flossing regularly, getting regular dental care, and eating a healthy diet.

    Is Fluoride Varnish Safe?

    Fluoride varnish is safe and used by dentists and doctors all over the world to help prevent tooth decay in children. Only a small amount is used, and hardly any fluoride is swallowed. It is quickly applied and hardens. Then it is brushed off after 4 to 12 hours.

    Some brands of fluoride varnish make teeth look yellow. Other brands make teeth look dull. However, the color of your child's teeth will return to normal after the fluoride varnish is brushed off. Most children like the taste.

    How is Fluoride Varnish Put on the Teeth?

    Fluoride varnish is painted on the top and sides of each tooth with a small brush. It is sticky but hardens once it comes in contact with saliva. Your child may feel the hardened varnish with his tongue but will not be able to lick the varnish off.

    It does not hurt when the varnish is applied. However, young children may still cry before or during the procedure. Fortunately, brushing on the varnish takes only a few minutes. Also, applying the varnish may be easier when a child is crying because his mouth will be slightly open.

    You may be asked to hold your child in your lap while you are placed knee-to-knee with the person applying the varnish.

    How Do I Care for My Child's Teeth After Fluoride Varnish is Applied?

    Here are general guidelines on how to care for your child's teeth after fluoride varnish is applied. Check with your child's doctor for any other special instructions.

    • Your child can eat and drink right after the fluoride varnish is applied. But only give your child soft foods and cold or warm (not hot) foods or liquids.
    • Do not brush or floss teeth for at least 4 to 6 hours. Your child's doctor may tell you to wait until the next morning to brush or floss. Remind your child to spit when rinsing, if he knows how to spit.


    Remember:

    Steps to good dental health include: 

    • Regular care by a dentist trained to treat young children 
    • Getting enough fluoride 
    • Regular brushing and flossing 
    • Eating right 

    The American Academy of Pediatrics recommends that all infants receive oral health risk assessments by 6 months of age. Infants at higher risk of early dental caries should be referred to a dentist as early as 6 months of age and no later than 6 months after the first tooth erupts or 12 months of age (whichever comes first) to establish their dental home.Every child should have a dental home established by 12 months of age.


    Additional Information:

    Water Fluoridation

    Fluorosis Facts: Information for Parents & Caregivers

    FAQs Fluoride and Children

  • Fun in the Sun

    Babies under 6 months

    The two main recommendations from the AAP to prevent sunburn are to avoid sun exposure, and to dress infants in lightweight long pants, long-sleeved shirts, and brimmed hats that shade the neck to prevent sunburn. However, when adequate clothing and shade are not available, parents can apply a minimal amount of sunscreen with at least 15 SPF (sun protection factor) to small areas, such as the infant's face and the back of the hands. If an infant gets sunburn, apply cool compresses to the affected area.

    For All Other Children

    • The first, and best, line of defense against harmful ultraviolet radiation (UVR) exposure is covering up. Wear a hat with a three-inch brim or a bill facing forward, sunglasses (look for sunglasses that provide 97% -100% protection against both UVA and UVB rays), and clothing with a tight weave.
    • Stay in the shade whenever possible, and limit sun exposure during the peak intensity hours - between 10 a.m. and 4 p.m.
    • On both sunny and cloudy days use a sunscreen with an SPF 15 or greater that protects against UVA and UVB rays.
    • Be sure to apply enough sunscreen -- about one ounce per sitting for a young adult.
    • Reapply sunscreen every two hours, or after swimming or sweating.
    • Use extra caution near water and sand (and even snow!) as they reflect UV rays and may result in sunburn more quickly.

  • Media and Children

    The American Academy of Pediatrics has designated April 30 through May 6 as screen free week. We urge families to try turning off the TV and other screens (video games and computers), and spend time doing other activities like reading, hiking, playing games or gardening.

    Media is everywhere. TV, Internet, computer and video games all vie for our children's attention. Information on this page can help parents understand the impact media has in our children's lives, while offering tips on managing time spent with various media.

    The AAP recommends that parents establish "screen-free" zones at home by making sure there are no televisions, computers or video games in children's bedrooms, and by turning off the TV during dinner. Children and teens should engage with entertainment media for no more than one or two hours per day, and that should be high-quality content. It is important for kids to spend time on outdoor play, reading, hobbies, and using their imaginations in free play.

    Television and other entertainment media should be avoided for infants and children under age 2. A child's brain develops rapidly during these first years, and young children learn best by interacting with people, not screens.

    Today's children are spending an average of seven hours a day on entertainment media, including televisions, computers, phones and other electronic devices. To help kids make wise media choices, parents should monitor their media diet. Parents can make use of established ratings systems for shows, movies and games to avoid inappropriate content, such as violence, explicit sexual content or glorified tobacco and alcohol use.

    Studies have shown that excessive media use can lead to attention problems, school difficulties, sleep and eating disorders, and obesity. In addition, the Internet and cell phones can provide platforms for illicit and risky behaviors.

    By limiting screen time and offering educational media and non-electronic formats such as books, newspapers and board games, and watching television with their children, parents can help guide their children's media experience. Putting questionable content into context and teaching kids about advertising contributes to their media literacy.

  • Backpack Safety

    What do I need to know about backpack safety?  

    Backpacks are a popular and practical way for children and teenagers to carry schoolbooks and supplies. When used correctly, backpacks can be a good way to carry the necessities of the school day. They are designed to distribute the weight of the load among some of the body's strongest muscles.  

    However, backpacks that are too heavy or are worn incorrectly can cause problems for children and teenagers. Improperly used backpacks may injure muscles and joints. This can lead to severe back, neck and shoulder pain, as well as posture problems. Share these guidelines to help your family use backpacks safely.  

    Choose the Right Backpack

    Look for the following:  

    • Wide, padded shoulder straps — Narrow straps can dig into shoulders. This can cause pain and restrict circulation.  
    • Two shoulder straps — Backpacks with one shoulder strap that runs across the body cannot distribute weight evenly.  
    • Padded back — A padded back protects against sharp edges on objects inside the pack and increases comfort.  
    • Waist strap — A waist strap can distribute the weight of a heavy load more evenly.  
    • Lightweight backpack — The backpack itself should not add much weight to the load.  
    • Rolling backpack — This type of backpack may be a good choice for students who must tote a heavy load. Remember that rolling backpacks still must be carried up stairs. They may be difficult to roll in snow.  

    To prevent injury when using a backpack, do the following:

    • Always use both shoulder straps. Slinging a backpack over one shoulder can strain muscles. Wearing a backpack on one shoulder may increase curvature of the spine.  
    • Tighten the straps so that the pack is close to the body. The straps should hold the pack two inches above the waist.  
    • Pack light. The backpack should never weigh more than 10 to 20 percent of the student's total body weight.  
    • Organize the backpack to use all of its compartments. Pack heavier items closest to the center of the back.  
    • Stop often at school lockers, if possible. Do not carry all of the books needed for the day.  
    • Bend using both knees, when you bend down. Do not bend over at the waist when wearing or lifting a heavy backpack.
    • Learn back-strengthening exercises to build up the muscles used to carry a backpack.  

    Ask Your Pediatrician for Advice  

    Parents also can help in the following ways:  

    • Encourage your child or teenager to tell you about pain or discomfort that may be caused by a heavy backpack. Do not ignore any back pain in a child or teenager. Ask your pediatrician for advice.  
    • Talk to the school about lightening the load. Be sure the school allows students to stop at their lockers throughout the day. Team up with other parents to encourage changes.  
    • Consider buying a second set of textbooks for your student to keep at home.
  • Water Safety: Tips for Parents of Young Children

    Water is one of the most ominous hazards your child will encounter. Young children can drown in only a few inches of water, even if they've had swimming instruction.

    Swimming Lessons Are Not a Way to Prevent Drowning in Young Children

    In the past, the AAP advised against swimming lessons for children ages 1 to 3 because there was little evidence that lessons prevented drowning or resulted in better swim skills, and there was concern parents would become less vigilant about supervising a child who had learned some swimming skills.

    But new evidence shows that children ages 1 to 4 may be less likely to drown if they have had formal swimming instruction. The studies are small, and they don't define what type of lessons work best, so the AAP is not recommending mandatory swim lessons for all children ages 1 to 4 at this time. Instead, the new guidance recommends that parents should decide whether to enroll an individual child in swim lessons based on the child's frequency of exposure to water, emotional development, physical abilities, and certain health conditions related to pool water infections and pool chemicals.

    The AAP does not recommend formal water safety programs for children younger than 1 year of age. Safety training does not result in a significant increase in poolside safety skills of young children. If you do enroll a child under four years old in a swimming program, be sure the class you choose adheres to guidelines established by the national YMCA. Among other things, these guidelines forbid submersion of young children and encourage parents to participate in all activities. But remember that even a child who knows how to swim needs to be watched constantly.

    Whenever Your Child is Near Water, Follow These Safety Rules:

    • Be aware of small bodies of water your child might encounter, such as bathtubs, fishponds, ditches, fountains, rain barrels, watering cans—even the bucket you use when you wash the car. Empty containers of water when you're done using them. Children are drawn to places and things like these and need constant supervision to be sure they don't fall in.
    • Children who are swimming—even in a shallow toddler's pool—always should be watched by an adult, preferably one who knows CPR. The adult should be within arm's length, providing "touch supervision" whenever infants, toddlers, or young children are in or around water. Empty and put away inflatable pools after each play session.
    • Enforce safety rules: No running near the pool and no pushing others underwater.
    • Don't allow your child to use inflatable toys or mattresses in place of a life jacket. These toys may deflate suddenly, or your child may slip off them into water that is too deep for him.
    • Be sure the deep and shallow ends of any pool your child swims in are clearly marked. Never allow your child to dive into the shallow end.
    • Backyard swimming pools, (including large, inflatable above-ground pools), should be completely surrounded with at least a 4-foot (1.2 meters) high fence that completely separates the pool from the house. The fence should have a self-closing and self-latching gate that opens away from the pool, with the latch at least 54 inches high. Check the gate frequently to be sure it is in good working order. Keep the gate closed and locked at all times. Be sure your child cannot manipulate the lock or climb the fence. No opening under the fence or between uprights should be more than 4 inches (10 cm) wide. Keep toys out of the pool area when not in use so that children are not tempted to try to get through the fence.
    • If your pool has a cover, remove it completely before swimming. Also, never allow your child to walk on the pool cover; water may have accumulated on it, making it as dangerous as the pool itself. Your child also could fall through and become trapped underneath. Do not use a pool cover in place of a four-sided fence, because it is not likely to be used appropriately and consistently.
    • Keep a safety ring with a rope beside the pool at all times. If possible, have a phone in the pool area with emergency numbers clearly marked.
    • Spas and hot tubs are dangerous for young children, who can easily drown or become overheated in them. Don't allow young children to use these facilities.
    • Your child should always wear a life jacket when he swims or rides in a boat. A life jacket fits properly if you can't lift it off over your child's head after he's been fastened into it. For the child under age five, particularly the non-swimmer, it also should have a flotation collar to keep the head upright and the face out of the water.
    • Adults should not drink alcohol when they are swimming. It presents a danger for them as well as for any children they might be supervising.
    • Be sure to eliminate distractions while children are in the water. Talking on the phone, working on the computer, and other tasks need to wait until children are out of the water.

    Additional Information:

    • Summer Safety Tips: Sun and Water Safety
    • Where We Stand: Water Safety
    • Swimming Pool Safety
    • Drowning Prevention
  • Reduce the Risk of SIDS

    I know it's best to put my baby to sleep on his back, but what else can I do to reduce the risk of SIDS?

    Many infants die during sleep from unsafe sleep environments. Some of these deaths are from entrapment, suffocation, and strangulation. Some infants die from sudden infant death syndrome (SIDS). However, there are ways for parents to keep their sleeping baby safe.

    Read on for more information from the American Academy of Pediatrics on how parents can create a safe sleep environment for their babies. This information should also be shared with anyone who cares for babies, including grandparents, family, friends, babysitters, and child care centers.

    What you can do

    • Place your baby to sleep on his back for every sleep. Babies up to 1 year of age should always be placed on their backs to sleep during naps and at night. However, if your baby has rolled from his back to his side or stomach on his own, he can be left in that position if he is already able to roll from tummy to back and back to tummy. If your baby falls asleep in a car safety seat, stroller, swing, infant carrier, or infant sling he should be moved to a firm sleep surface as soon as possible.
    • Place your baby to sleep on a firm sleep surface. The crib, bassinet, portable crib, or play yard should meet current safety standards. Check to make sure the product has not been recalled. Do not use a crib that is broken or missing parts, or has drop-side rails. Cover the mattress that comes with the product with a fitted sheet. Do not put blankets or pillows between the mattress and the fitted sheet. Never put your baby to sleep on a chair, sofa, water bed, cushion, or sheepskin. For more information about crib safety standards, visit the Consumer Product Safety Commission Web site at www.cpsc.gov.
    • Keep soft objects, loose bedding, or any objects that could increase the risk of entrapment, suffocation, or strangulation out of the crib. Pillows, quilts, comforters, sheepskins, bumper pads, and stuffed toys can cause your baby to suffocate. Note: Research has not shown us when it’s 100% safe to have these objects in the crib; however, most experts agree that after 12 months of age these objects pose little risk to healthy babies.
    • Place your baby to sleep in the same room where you sleep but not the same bed. Keep the crib or bassinet within an arm’s reach of your bed. You can easily watch or breastfeed your baby by having your baby nearby. Babies who sleep in the same bed as their parents are at risk of SIDS, suffocation, or strangulation. Parents can roll onto babies during sleep or babies can get tangled in the sheets or blankets.
    • Breastfeed as much and for as long as you can. Studies show that breastfeeding your baby can help reduce the risk of SIDS.
    • Schedule and go to all well-child visits. Your baby will receive important immunizations. Recent evidence suggests that immunizations may have a protective effect against SIDS.
    • Keep your baby away from smokers and places where people smoke. If you smoke, try to quit. However, until you can quit, keep your car and home smoke-free. Don’t smoke inside your home or car and don’t smoke anywhere near your baby, even if you are outside.
    • Do not let your baby get too hot. Keep the room where your baby sleeps at a comfortable temperature. In general, dress your baby in no more than one extra layer than you would wear. Your baby may be too hot if she is sweating or if her chest feels hot. If you are worried that your baby is cold, infant sleep clothing designed to keep babies warm without the risk of covering their heads can be used.
    • Offer a pacifier at nap time and bedtime. This helps to reduce the risk of SIDS. It’s OK if your baby doesn’t want to use a pacifier. You can try offering a pacifier again, but some babies don’t like to use pacifiers. If your baby takes the pacifier and it falls out after he falls asleep, you don’t have to put it back in.
    • Do not use home cardiorespiratory monitors to help reduce the risk of SIDS. Home cardiorespiratory monitors can be helpful for babies with breathing or heart problems but they have not been found to reduce the risk of SIDS.
    • Do not use products that claim to reduce the risk of SIDS. Products such as wedges, positioners, special mattresses, and specialized sleep surfaces have not been shown to reduce the risk of SIDS. In addition, some infants have suffocated while using these products.

    What expectant moms can do

    • Schedule and go to all prenatal doctor visits.
    • Do not smoke, drink alcohol, or use drugs while pregnant and after birth.
    • Stay away from smokers and places where people smoke.

    Remember Tummy Time

    • Give your baby plenty of “tummy time” when she is awake. This will help strengthen neck muscles and avoid flat spots on the head. Always stay with your baby during tummy time and make sure she is awake.
  • New Car Safety Seat Recommendations

    HealthyChildren.org Updates Car Safety Seat Information to Reflect New AAP Guidelines

    As you may be aware, an updated AAP policy addressing the use of car safety seats was released today. The new policy advises parents to keep their toddlers in rear-facing car seats until age 2, or until they reach the maximum height and weight for their seat. It also advises that most children will need to ride in a belt-positioning booster seat until they have reached 4 feet 9 inches tall and are between 8 and 12 years of age.

    Several articles on HealthyChildren.org have been updated to reflect the new policy, including
    Car Safety Seats: A Guide for Families 2011 
    Car Safety Seats Product Listing for 2011
    Car Safety Seat Check Up
    Air Bag Safety

  • Myths and Facts about the Flu

    Flu season is now upon us and fever is one of its most common symptoms. Unless your child is less than 2 months of age, most fevers are simply a sign that your child’s immune system is doing its job. For a temperature greater than 100.4 F in a child less than two months call us immediately. Otherwise the following information is helpful to avoid common misconceptions about fever. Many parents needlessly worry when their child has a fever. This is called fever phobia. Overall, fevers are harmless. Let the following facts help you put fever into perspective:

    MYTH: My child feels warm, so she has a fever.

    FACT: Children can feel warm for a many reasons such as playing hard, crying, getting out of a warm bed or being outside on a hot day. They are “giving off heat”. Their skin temperature should return to normal in 10 to 20 minutes. Once these causes are excluded, about 80% of children who feel warm and act sick actually have a fever. If you want to be sure, take their temperature. The following are the cutoffs for fever using different types of thermometers:

    Rectal, ear or temporal artery thermometers: 100.4° F (38.0° C) or higher

    Oral thermometers: 100° F (37.8° C) or higher

    Under the arm (Axillary or Armpit) temperatures: 99° F (37.2° C) or higher

    MYTH: All fevers are bad for children.

    FACT: Fevers turn on the body's immune system and help the body fight infection. Fevers are one of the body's protective mechanisms. Normal fevers between 100° and 104° F (37.8° - 40° C) are actually good for sick children.

    MYTH: Fevers above 104° F (40° C) are dangerous and can cause brain damage.

    FACT: Fevers with infections don't cause brain damage. Only body temperatures above 108° F (42° C) can cause brain damage. The body temperature climbs this high only with extreme environmental temperatures (for example, if a child is confined to a closed car in hot weather).

    MYTH: Anyone can have a febrile seizure (seizure triggered by fever).

    FACT: Only 4% of children can have a febrile seizure.

    MYTH: Febrile seizures are harmful.

    FACT: Febrile seizures are scary to watch, but they usually stop within 5 minutes. They cause no permanent harm. Children who have had febrile seizures do not have a greater risk for developmental delays, learning disabilities, or seizures without fever.

    MYTH: All fevers need to be treated with fever medicine.

    FACT: Fevers only need to be treated if they cause discomfort. Usually fevers don't cause any discomfort until they go above 102° or 103° F (39° or 39.5° C).

    MYTH: Without treatment, fevers will keep going higher.

    FACT: Wrong. Because the brain has a thermostat, fevers from infection usually don't go above 103° or 104° F (39.5°- 40° C). They rarely go to 105° or 106° F (40.6° or 41.1° C). While the latter are "high" fevers, they are harmless ones.

    MYTH: I should give my child a cold bath or sponge him with alcohol to speed the reduction in fever.

    FACT: These techniques should NOT be used. They do nothing to treat the child’s core temperature, can be dangerous, and are uncomfortable for your child.

    MYTH: With treatment, fevers should come down to normal.

    FACT: With treatment, fevers usually come down 2° or 3° F (1° or 1.5° C).

    MYTH: If the fever doesn't come down (if you can't "break the fever"), the cause is serious.

    FACT: Fevers that don't respond to fever medicine can be caused by viruses or bacteria. It doesn't relate to the seriousness of the infection. The main reason the fever doesn’t respond is usually due to inadequate dosing of fever reducers.

    MYTH: Once the fever comes down with medicines, it should stay down.

    FACT: The fever will normally last for 2 or 3 days with most viral infections. Therefore, when the fever medicine wears off, the fever will return and need to be treated again. The fever will go away and not return once your child’s body overpowers the virus (usually by the fourth day). You should call if your child has had a fever more that 3 or 4 days or if they have a specific symptom which needs to be addressed such as an earache or sore throat.

    MYTH: If the fever is high, the cause is serious.

    FACT: If the fever is high, the cause may or may not be serious. If your child looks very sick, the cause is more likely to be serious. Conversely, if your child acts fine the cause is likely to be less serious.

    MYTH: Oral temperatures between 98.7° and 100° F (37.1° to 37.8° C) are low-grade fevers.

    FACT: These temperatures are normal variations. The body's temperature normally changes throughout the day. It peaks in the late afternoon and evening. An actual low-grade fever is 100° F to 102° F (37.8° - 39° C).

    SUMMARY: Remember that fever is fighting off your child's infection. Fever is one of the good guys.

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