Fairmount Pediatrics

Sunblock vs Vitamin D

jackie@fairmountpediatrics.com (Alexis Lieberman) — Thu, 12 Jun 2025 01:06:56 GMT

Strike a balance!

Sunblock vs. Vitamin D for Kids: How to Protect Their Skin and Ensure Healthy Growth

As parents, it’s essential to find the right balance between protecting your child’s skin from the sun and ensuring they get enough vitamin D. Too much sun exposure can lead to skin damage and even skin cancer, but not enough can result in vitamin D deficiency, which is crucial for bone health and the immune system. In this guide, we’ll break down the importance of sunblock for kids, the need for vitamin D in children, and how you can keep your little ones safe while they enjoy the outdoors.

Why Sunblock Is Crucial for Protecting Your Child’s Skin

Exposing your child’s skin to the sun can cause irreversible damage, especially when they are young. Ultraviolet (UV) radiation from the sun is the leading cause of skin cancer, and childhood sunburns can increase the risk of developing melanoma later in life. According to the American Academy of Dermatology (AAD), protecting your child's skin from UV damage is crucial for long-term skin health.

Using sunblock for children is one of the most effective ways to prevent sunburns, premature aging, and skin cancer. It's important to apply sunblock regularly, even on cloudy days, as UV rays can still penetrate through the clouds and damage the skin. Be sure to choose a broad-spectrum sunscreen that protects against both UVA and UVB rays.

Why Mineral Sunblock is the Best Choice for Kids

When it comes to sunscreen, mineral sunblocks (also known as physical sunscreens) are often a safer choice for children. These sunscreens use zinc oxide and titanium dioxide, which create a physical barrier on the skin to block harmful UV rays. Mineral-based sunscreens are particularly effective for sensitive skin and are less likely to cause irritation or allergic reactions.

Avoid sunscreens containing chemicals like oxybenzone and retinyl palmitate. Oxybenzone has been linked to hormone disruption, and retinyl palmitate may increase the risk of skin cancer when exposed to sunlight. You can refer to the EWG’s Skin Deep database to find safer sunscreen options.

Also, it’s best to avoid spray sunscreens for kids. While they may seem convenient, they pose a risk of inhalation. The fine particles can be harmful to your child’s lungs, so stick with non-spray mineral sunblocks that are easy to apply and safer for their respiratory system.

Vitamin D: Why Your Child Needs Sunlight

Vitamin D plays an important role in your child’s health. It helps the body absorb calcium, which is essential for building strong bones. It also supports the immune system and can even have a positive impact on mood and overall well-being.

The body naturally produces vitamin D when the skin is exposed to UVB rays from the sun. However, in today’s world, many children spend more time indoors, often engaging with screens rather than playing outside. This means they are not getting enough sunlight to maintain healthy vitamin D levels.

The American Academy of Pediatrics (AAP) reports that vitamin D deficiency is becoming more common in children, particularly among those who don’t get enough time outdoors or live in regions with limited sunlight. Without adequate vitamin D, kids are at higher risk for bone problems and weakened immune systems.

Balancing Sun Exposure: How to Get Vitamin D Safely

You don’t need to expose your child to the sun all day, but it’s important to allow for short bursts of No-Sunblock time to let their bodies make vitamin D. During these short periods of sun exposure, your child will get a boost of vitamin D while minimizing the risk of sunburn.

For babies, try No-Sunblock time before 9 am and after 5 pm. These hours provide weaker sun exposure, which reduces the risk of harmful UV rays. For older children, you can extend this window to before 10 am and after 4 pm.

When you’re outside during peak sunlight hours (usually between 10 am and 4 pm), apply a non-spray mineral sunscreen to protect their skin from UV damage. This approach allows your child to get their daily dose of vitamin D without the dangers of sunburn and long-term skin damage.

Best Practices for Sun Safety and Vitamin D

Here’s a summary of key recommendations to balance sun protection with vitamin D production:

Get outside early or late in the day—before 9 am for babies and 10 am for kids, and after 5 pm for babies and 4 pm for kids. These times offer weaker sun exposure, reducing the risk of sunburn.

Use a mineral-based sunblock (zinc oxide or titanium dioxide) when spending extended time outside during peak sunlight hours. Avoid chemical sunscreens containing oxybenzone and retinyl palmitate.

Avoid spray sunscreens—they can be harmful when inhaled. Stick to cream or lotion-based sunscreens.

Check the EWG database to ensure you’re using a safe, effective sunscreen for your child.

Conclusion: Keeping Your Kids Safe While Getting Their Vitamin D

The key to keeping your child’s skin safe while ensuring they get enough vitamin D is to find a balance. Short, safe sun exposure allows them to produce the vitamin they need for healthy bones and immunity, while mineral sunblocks keep them protected from harmful UV rays. By following these sun safety guidelines, you can ensure your child enjoys the outdoors without compromising their health.

With a little planning and a focus on safe sun practices, you can protect your child's skin and keep them healthy. Remember, sun safety for kids is about moderation and making smart choices when it comes to both sunscreen use and outdoor time.

References

American Academy of Dermatology (AAD). (2021). Sun Protection.

Environmental Working Group (EWG). (2023). Skin Deep Cosmetics Database.

American Academy of Pediatrics (AAP). (2023). Vitamin D on the Double.

Thoughts on the Measles case in Montgomery County

jackie@fairmountpediatrics.com (Alexis Lieberman) — Mon, 03 Mar 2025 14:31:20 GMT

When we got the news....

Measles in Montgomery County: What Parents Need to Know About Vaccination and Protecting Your Family

Over the weekend, there was a confirmed case of measles in Montgomery County, Pennsylvania, near Plymouth Meeting. As a pediatric practice in East Norriton, Montgomery County, this news is very concerning, and we want to ensure that our community has all the information they need to protect their families.

The situation is especially alarming because there are already over 100 cases of measles in Texas, with one child tragically passing away. This shows that the threat is real, and it is important for all of us to be prepared. I immediately began looking at the Montgomery County Health Department website for updated information, and today I’m reaching out to them for further guidance. All of the doctors in our office are collaborating to determine the best way to manage this situation, given how close the case is to our East Norriton office.

Why Measles in Montgomery County is a Concern

Measles is a highly contagious virus that can spread quickly. This isn’t just a mild illness; measles can lead to serious complications like pneumonia, brain swelling (encephalitis), and even death.

The fact that a case has been confirmed so close to home is a reminder that measles is still a threat. The outbreak in Texas and other recent cases highlight how important it is to make sure your child is vaccinated. We must all do our part to keep the disease from spreading further.

Early Symptoms of Measles: What to Watch For

If you think your child may have measles, it’s important to recognize the symptoms early. Here are the signs to look for:

Fever: Often the first symptom, which can get worse over time.

Cough: A dry cough that becomes more persistent.

Runny Nose: A clear nasal discharge, much like a cold.

Red, Watery Eyes: Known as conjunctivitis or pink eye.

Koplik Spots: Small white spots that appear inside the mouth, usually before the rash.

Rash: The rash starts on the forehead and behind the ears and spreads down the body a few days after the fever begins.

If you notice these symptoms, it’s best to contact your doctor right away to prevent spreading the illness.

The MMR Vaccine: Safe, Effective, and Long-Used

The good news is that measles can be prevented through the MMR vaccine, which protects against measles, mumps, and rubella. The MMR vaccine has been used for over 50 years and has been shown to be very safe and effective in preventing measles.

Most children receive the MMR vaccine in two doses:

First dose: At age 1.

Second dose: Between ages 4 and 6.

One dose of the MMR vaccine gives about 93% protection against measles, and two doses provide about 97% protection. This high level of immunity is why the MMR vaccine has been so effective in preventing the spread of measles.

Side Effects of the MMR Vaccine: What You Need to Know

Like all vaccines, the MMR vaccine can cause some mild side effects, but these are usually short-lived and not serious. Here’s what to expect:

Fever: A low-grade fever may occur for a few days.

Rash: Some children may develop a mild rash, but this is not the same as the measles rash.

Swollen Lymph Nodes: Swelling of the glands may happen, but it’s typically mild.

Rare Side Effects: Severe allergic reactions are extremely rare, and any serious side effects are quickly treated.

These side effects are far less concerning than the potential risks of measles itself, which can cause permanent damage like pneumonia and brain damage.

The Wakefield Scare: Why You Shouldn’t Worry About the MMR Vaccine and Autism

You may have heard that the MMR vaccine is linked to autism. This myth comes from a study published in 1998 by Andrew Wakefield, which was later found to be fraudulent. The study was retracted, and Wakefield lost his medical license for falsifying data.

Since then, many large studies involving millions of children have shown that there is no connection between the MMR vaccine and autism. Both the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) have made it clear that the MMR vaccine is safe and does not cause autism.

The fear around the vaccine is based on misinformation, and it’s important for parents to understand that the vaccine is safe and necessary to protect your child from measles and other dangerous diseases.

Why Vaccination is So Important

Measles is a highly contagious disease, and if enough people in a community aren’t vaccinated, outbreaks can occur. When more people get vaccinated, herd immunity is created, which helps protect those who cannot get vaccinated, such as infants or children with medical conditions.

That’s why it’s important to make sure your child is vaccinated. The MMR vaccine doesn’t just protect your child—it helps protect everyone in the community.

Our Plan of Action: What to Do If You Suspect Measles

We’ve developed a detailed plan to keep everyone safe, especially given how close the measles case is to our office. Here’s what you need to do if you suspect your child has measles:

If you suspect measles: Please do not come physically into the office. Instead, call us when you arrive, and we’ll come out to see your child in the car. This keeps everyone safe and minimizes exposure to other patients.

For children 6 months to 1 year:

If you want to get an early dose of the MMR vaccine, please book a Medical Assistant appointment online through our website. This will not replace the vaccine given at age 1, but it will help protect your child. Under the age of six months, the vaccine will not be effective.

For children 1 to 4 years old:

If you’d like to get your child’s second dose of the MMR vaccine early, you can book a Medical Assistant appointment online as well. This dose counts as the vaccine given at age 4.

Check Your Child’s Immunization Record:

You can check your child’s immunization record through our patient portal to see if they’re up-to-date on the MMR vaccine. You may see MMR or you may see MMRV. MMRV also protects against chickenpox.

If your child is unvaccinated:

If your child is not vaccinated and you choose not to vaccinate, we recommend keeping your child away from others who are sick.

By following these steps, we can help limit the spread of measles and protect those who are most vulnerable.

Conclusion: Protect Your Family from Measles with the MMR Vaccine

The recent case of measles in Montgomery County shows how important it is to keep your child protected with the MMR vaccine. Vaccination is one of the best ways to prevent measles and protect your family from this dangerous disease.

Don’t let misinformation scare you—vaccines are safe, effective, and necessary to keep our children healthy. If you have any questions about the MMR vaccine, feel free to reach out to our office. We are here to help.

Working with Kids who have ADHD

jackie@fairmountpediatrics.com (Alexis Lieberman) — Wed, 19 Feb 2025 19:55:20 GMT

Supporting Kids with ADHD: A Holistic Approach to Understanding and Treatment

A few days ago, I had the chance to meet with a young patient I’ve known since he was born. Now seven years old, he came in to talk about his recent ADHD diagnosis. It was a big moment for him, but also a reminder of how important it is to really understand and support kids with ADHD.

ADHD Symptoms and School Challenges

Like many kids with ADHD, he was super outgoing and not at all shy about talking to me. He opened up right away about his relationships with his teachers, classmates, and how school was going for him. It was clear he was doing okay—he wasn’t crying at school or yelling at his teachers, which showed he had a pretty good handle on his emotions and impulses. That’s something kids with ADHD often struggle with, so it was nice to see that he had some self-control.

Of course, like many kids with ADHD, he had trouble staying seated for long periods of time. It’s a common issue since kids with ADHD often have lots of energy and a hard time focusing for long stretches. This kid really struggled with staying in one spot for too long, which is a big problem in traditional classrooms where kids are expected to sit still and pay attention for hours.

Creative Solutions for ADHD Kids: Thinking Outside the Classroom

That got me thinking—what if there was a different kind of school for kids with ADHD? I’ve always wondered if programs like apprenticeships, where kids learn to be a woodworker or blacksmith, might work better. These types of hands-on jobs involve a lot of movement and learning by doing, which seems like it might be a better fit for kids who need to move around to stay engaged. Traditional school can feel like a tough fit for kids with ADHD, who often need to move and get their energy out in order to stay focused.

I’ve also seen this firsthand with my own child, who has ADHD. My child had a math teacher who figured out that kids with ADHD need to move in order to stay engaged. Instead of sitting still at desks, the teacher had them stand up and use hand gestures to show math concepts. For example, they’d cross their arms to show multiplication and hold their arms parallel to show the equals sign. It wasn’t just fun—it worked! It helped the kids focus and made math a lot more interactive. That teacher understood that keeping kids with ADHD engaged meant thinking outside the box, and it made a huge difference for my child and the other kids.

The Importance of ADHD Accommodations in School

For the boy I saw recently, things at school were going okay, but we talked about the fact that he’d need support to keep thriving. Luckily, he already has a 504 Plan in place, which provides him with some important accommodations at school. Not all teachers are great at handling kids with ADHD, and some may not understand how important it is for kids to have room to move and get their energy out. But with his 504 Plan, he’s allowed to stand up and move around in class, which will help a lot. This kind of flexibility makes a big difference in helping kids succeed.

ADHD Medication: A Tool for Focus and Success

We also talked about the possibility of trying some medication to help with his ADHD. This is a topic that often brings up questions from parents. Just the other day, a mom asked me if giving her child a pill to help with ADHD might teach the child to look for pills as a way to solve problems in the future. It’s a good question, and I totally understand her concern.

But research actually shows that kids with ADHD who take medication are less likely to develop substance abuse problems later in life. It’s a counterintuitive finding, but it makes sense when you think about it. Medication for ADHD helps improve focus, self-control, and overall functioning, which can actually make it less likely for kids to engage in risky behaviors. When ADHD is left untreated, kids may have a harder time with impulse control and regulating their emotions, which can sometimes lead to problems down the road. So, medication is just one part of a bigger picture—a tool in the toolbox, along with other strategies like therapy, lifestyle changes, and support at school.

The Difference Between Drugs and Medication for ADHD

The day before I met with this boy, I saw another child with ADHD. He was just as chatty and full of ideas, and I could’ve easily spent more time talking to him about his thoughts and creative ideas. He had a really interesting way of explaining the difference between “taking drugs” and “taking medication.” He understood that drugs are bad for you, but he also got that medication, when prescribed properly, can help you manage things like ADHD. It was a great reminder of how these kids, despite their challenges, often have a clear understanding of the world around them and how things work.

The Joy of Working with Kids with ADHD

Taking care of kids with ADHD is something I really enjoy. They’re often so smart, creative, and full of life—it’s impossible not to appreciate the way they see the world. These kids can be wildly inventive, and their way of thinking is often fresh and exciting. As a doctor, it’s incredibly rewarding to be part of their journey and to see how they grow and learn.

For me, the most important part of this work is being a part of their team as they grow and helping them find the tools and strategies they need to become their best selves. It’s not just about treating a diagnosis—it’s about supporting them as they discover who they are and what they’re capable of.

Building Strong Connections with ADHD Kids and Their Families

But it’s also about the connections. Getting to know each child, understanding their unique strengths and struggles, is what makes this work so fulfilling. It’s not just about the medical side of things—it’s about the relationship, the trust, and the shared moments that come with working closely with these kids. Every child brings something special to the table, and it’s a privilege to witness their growth and to be there for them every step of the way. Helping these kids succeed is full of joy, laughter, and meaningful moments, and I wouldn’t trade it for anything.

Conclusion: Supporting Kids with ADHD to Reach Their Full Potential

In the end, my goal is to help kids with ADHD become the best versions of themselves. With the right tools and strategies—whether through hands-on learning, classroom accommodations, therapy, or medication—we can help them manage their challenges and succeed in school and life. It’s a privilege to be part of their journey, and I’m grateful for the opportunity to support these kids as they grow into their full potential.

So many viruses! Winter Update

Thu, 13 Feb 2025 20:31:17 GMT

Flu and RSV Are Here—How to Keep Your Family Healthy This Season

Last month, we were battling the mycoplasma surge, but now we’re shifting gears as flu and RSV cases are on the rise. If you’re noticing more coughs, sniffles, and fevers, you’re not imagining things—this is what flu season looks like in full swing! Let’s break down what’s happening, what you can do to protect your family, and how we’re here to help every step of the way.

What’s Going Around? Flu and RSV Are the Big Players

Flu and RSV (Respiratory Syncytial Virus) are dominating the scene now, in December. Both viruses can affect children and adults, but they often hit kids harder. Flu is especially concerning for those under age 5, and RSV can be dangerous for infants, toddlers, and children with underlying respiratory conditions, like asthma.

Flu Symptoms to Watch Out For

Flu symptoms can look a lot like a cold, but they’re often more severe and come on quickly. Common flu symptoms include:

High fever (often 102°F or higher)
Chills and body aches
Headache
Sore throat
Fatigue and weakness
Cough
Runny or stuffy nose

It’s important to note that the flu can lead to more serious complications, like pneumonia or ear infections, which is why it’s crucial to catch it early.

RSV—What Parents Need to Know

RSV is a respiratory virus that can cause symptoms similar to a cold, but it often leads to more serious breathing problems, especially in babies and toddlers. RSV can cause wheezing, rapid breathing, and severe coughing. If your child starts having trouble breathing or their lips or fingers turn blue, please seek emergency care right away. Asthmatic children are especially vulnerable to RSV and may experience worse symptoms, so if your child has asthma, make sure to follow their treatment plan carefully and reach out to us if you’re concerned.

The Flu Vaccine: It’s Not Too Late to Get It!

Now for some good news—there’s still time to protect your family with the flu vaccine! It’s not too late to get vaccinated, and we can’t stress enough how important this is, especially during a season where flu and RSV are circulating together. Getting the flu shot helps reduce the risk of severe illness, hospitalizations, and complications from the flu.

Even if you’re already seeing symptoms of the flu, there’s a chance the vaccine could still provide some protection or help reduce the severity of the illness. So if you haven’t already, come on in and get your flu shot today!

Tamiflu: The Earlier, The Better

If your child develops flu symptoms and it’s within the first 48-72 hours, there’s a medication called Tamiflu that can help lessen the severity and duration of the illness. It’s most effective when taken early, so if you’re concerned your child might have the flu, be sure to reach out for a rapid flu test. We can quickly confirm whether it’s flu or something else, and if it’s the flu, we can prescribe Tamiflu to help your child recover faster.

However, please note that not all insurance plans cover rapid flu tests. If your insurance doesn’t cover the test, there’s a $25 fee. We know it’s not ideal, but getting an accurate diagnosis early can make all the difference in how your child feels and how quickly they recover.

RSV: What to Do If Your Child Is at Risk

For children who are at high risk of complications from RSV (like those with asthma), it’s even more important to act fast. If your child has asthma, make sure they’re using their inhalers regularly to help control any wheezing or difficulty breathing. If their symptoms worsen or they start having trouble breathing, it’s crucial to get them checked right away. Sometimes, RSV can cause a persistent cough that lasts up to three weeks—so don’t be surprised if the coughing lingers for a while even after other symptoms have cleared up.

We’re here to help manage your child’s RSV symptoms and make sure they’re getting the right treatment. If your child is having trouble breathing, or if they seem unusually tired or irritable, please don’t hesitate to reach out. It’s always better to be cautious when it comes to respiratory issues.

We’re Here for You—Whenever You Need Us

We know flu and RSV seasons can be stressful for parents. Between balancing work, school, and the constant worry about your child’s health, it can feel overwhelming. But remember—we are always here for you. Whether you need advice, a flu test, or treatment options, we are available 24/7 to assist you.

For non-urgent questions or concerns, feel free to message us on the patient portal. Our team will get back to you as soon as possible.

For urgent issues or if you need to speak with a provider right away, you can always call our main office number and follow the prompts to reach a provider. If it’s after hours, we’ll connect you with someone who can help, no matter what time it is.

Final Thoughts: Stay Ahead of the Illness

We understand that the fall and winter months can feel like a whirlwind of germs and illnesses. But with the right precautions, the flu vaccine, and timely care, you can help your family stay healthy and bounce back faster if they do get sick.

So, if you haven’t yet, please schedule your flu vaccine today. If your child is showing signs of the flu or RSV, let us know right away. We can provide rapid tests, guidance, and treatment to get them back on their feet as quickly as possible.

We’re always here for you and your family, whether you need us in the middle of the day or in the middle of the night. Stay safe, stay healthy, and don’t hesitate to reach out if you need anything.

Effective At-Home Anxiety Treatments for Kids: Strategies for Parents

Sat, 01 Feb 2025 20:33:31 GMT

Tips on helping your child with anxiety

Anxiety in children can be challenging for both kids and parents. When your child experiences anxiety, it’s natural to want to comfort them and offer reassurance. However, you might be unintentionally making their worries bigger by giving too much attention to them. The more we focus on a child’s anxiety, the more it can grow. But don’t worry! In this blog post, we’ll explore effective at-home anxiety treatments for kids, including strategies that help them manage their emotions without reinforcing their fears.

By using creative techniques and empowering children to take control of their anxiety, you can help them build resilience and confidence.

Understanding Children’s Anxiety: Why Less Attention Can Help

Anxiety often feels like a monster that gets bigger the more you talk about it. When children feel anxious, their worries can spiral out of control, especially if they get too much attention. Rather than comforting them by focusing on the details of their fears, it’s more effective to acknowledge the anxiety in a fun, lighthearted way.

One useful metaphor is the “worry bug” or “worry bully.” This idea comes from a great book called What to do when you worry too much, a kids guide to anxiety. Explain to your child that everyone has a worry bug that can bother them from time to time. Rather than dwelling on the worry, make a game out of it. Have a little fun by pretending to stomp on the floor to squash the “worry bug” and even run around to chase it away. This shifts the focus from the anxiety to a fun and active solution, helping your child feel more empowered.

How to Help Your Child Manage Their Anxiety: Bedtime Routines that Work

Anxiety tends to peak at night when children are settling down for bed. This is when many kids feel most vulnerable, so having a calming bedtime routine is crucial. The key is to keep the routine consistent and predictable.

After following your usual bedtime steps—storytime, cuddles, and kisses—leave the room promptly. It’s important to reinforce the rule that it’s time to stay in bed. If your child gets up, simply walk them back to bed without engaging in a long conversation. A brief reminder like, “The rule is to stay in bed, Sweetie,” and a quick kiss will suffice. Avoid repeating the entire bedtime routine, as this could reinforce anxious behaviors.

If your child mentions their worries, encourage them to talk to a stuffed animal, like a “Teddy Bear,” about the “worry bug.” Suggest that they brush off the worry bug from Teddy’s shoulder to reassure them that their anxiety is something they can control. Be firm but gentle, and avoid going back into the room if your child calls for you. Instead, call out from another room with a playful line like, “Worry bug, leave my child alone!”

Self-Empowerment and Using Metaphors for Anxiety Management

One creative and effective technique for older children (6 years and up) is using metaphors that help them feel in control of their emotions. A helpful metaphor suggested by the parent of one of my patients for managing anxiety is the “handlebars of a bicycle.” Explain to your child that they’re the one holding the handlebars of their emotional bike. If they let go, their anxiety can take them in any direction. But by holding onto the handlebars, they can steer their way through difficult emotions.

Whenever your child feels overwhelmed, you can remind them by saying, “Handlebars, buddy!” This gentle prompt reinforces the idea that they have control over their anxiety. It empowers them to recognize that they’re not helpless against their fears, and it helps them regain a sense of control.

Supplements for Reducing Anxiety in Older Children

For children aged 6 and older, certain supplements may support their emotional well-being and help calm anxiety. Magnesium, when paired with calcium, can be especially effective. The adult dose is typically 300-400 mg of magnesium per day, but children aged 6 could take a smaller dose (around half).

Another supplement to consider is 5-HTP, which is a precursor to serotonin, a neurotransmitter that helps regulate mood and anxiety. A daily dose of 50 mg may help alleviate anxiety. However, it’s important to consult your child’s healthcare provider before introducing any supplements to their routine to ensure they are safe and appropriate.

Daily Practices to Lower Anxiety and Improve Emotional Resilience

In addition to the strategies mentioned above, there are several daily practices that can help lower a child’s baseline anxiety. Incorporating these practices into your child’s routine can promote emotional well-being and resilience. Here are some simple and effective tips:

Dance and Sing: Engaging in physical activities like dancing and singing can help release built-up tension. Encourage your child to move around and express themselves through music and movement. It’s a great way to lift their mood and reduce stress.
Spend Time in Nature: Nature has a calming and grounding effect. Whether it’s a walk in the park or a hike in the woods, time spent outdoors can help your child feel more centered and relaxed.
Engage in Prayer or Mindfulness: A spiritual practice, such as prayer or mindfulness exercises, can help your child quiet their mind and gain a sense of peace. Guided meditations or deep breathing exercises are also effective ways to promote relaxation.
Volunteer: Helping others fosters feelings of gratitude and purpose. Volunteering can be a wonderful way for your child to develop a positive outlook and connect with others.
Physical Activity: Regular physical activity helps the body release endorphins, which can reduce stress and improve mood. Whether it’s through sports, running, or simply playing outside, encouraging your child to stay active can be beneficial for their mental health.
Supplements like SAM-e and CBD: SAM-e (200 mg per day) and CBD oil (such as Charlotte’s Web or Koi) are natural remedies that may have calming effects. However, always consult with your healthcare provider before using supplements for your child.
Medication and Other Options: In some cases, medications like Prozac may be prescribed to help manage more severe anxiety. It’s always important to discuss treatment options with a healthcare professional. Devices like the Truvaga vagal nerve stimulator can also be used for calming, and it may provide relief during moments of panic.

Conclusion: Empowering Your Child to Manage Anxiety

Helping your child manage anxiety at home involves a combination of compassion, boundaries, and practical strategies. By using metaphors like the “worry bug” and reinforcing calming routines, you can help your child understand that anxiety doesn’t need to control them. Offering gentle guidance, empowering them with the “handlebars” metaphor, and incorporating healthy habits like physical activity, supplements, and mindfulness can further support their emotional resilience.

If your child is struggling with anxiety, remember that consistency is key. With patience and the right tools, your child can build the skills needed to face anxiety and move through it with confidence.

Frequently Asked Questions About Managing Anxiety in Children

Q: What are some natural remedies for anxiety in children?
A: Some natural remedies for anxiety in children include practicing mindfulness, physical activity, spending time in nature, using calming supplements like magnesium, and creating a predictable bedtime routine.

Q: How can I help my child sleep better if they’re anxious?
A: A consistent bedtime routine that includes soothing activities like reading, cuddling, and talking about the “worry bug” can help reduce nighttime anxiety. Make sure to reinforce the rule that they should stay in bed after lights out.

Q: What’s the best way to talk to kids about anxiety?
A: Use metaphors that allow your child to externalize their anxiety, like the “worry bug” or “handlebars of a bike.” Encourage them to take control of their emotions in a playful and empowering way.

Dogs and Kids, by Alexis Lieberman, MD

Tue, 28 Jan 2025 20:39:44 GMT

Here's a story about my own baby and dog... and safety tips!

Safety Tips for Raising a Child with a Dog: What Every Parent Should Know

When raising a child alongside a dog, safety should always be the top priority. As a parent with a deep love for both my baby and my dog, I learned firsthand the importance of proper supervision, training, and understanding animal behavior. One lesson I’ll never forget comes from an experience with my older Great Dane, Onyx, and my infant child. This lesson, which highlighted the unpredictability of even the gentlest dog, shaped the way I approach interactions between pets and children.

The Unlikely Bond: My Baby and Onyx the Great Dane

Onyx was a big, gentle, and calm Great Dane. I believed she was the perfect companion for my six-month-old baby. Watching the two of them together was heartwarming: Onyx laying beside the baby’s play mat, gently nuzzling her little hands, while the baby giggled with joy. It seemed like the perfect bond of innocence and love between a dog and a child.

However, one afternoon, Onyx growled at the baby. It was a deep, warning growl, and I froze. It was a shocking reminder that dogs, no matter how gentle, have instincts and boundaries that can’t always be anticipated.

A Wake-Up Call: The Importance of Supervision and Boundaries

This experience led me to a dog psychiatrist, where I received the blunt yet invaluable advice: “What, are you stupid?” She didn’t mince words, but she helped me realize the mistakes I made in assuming everything would be perfect between my dog and baby. It became clear that raising a child with a dog requires more than just trust—there must be supervision, boundaries, and an understanding of both the dog’s and child’s needs.

Here are some essential dog safety tips for parents or caregivers raising children with pets, especially if your child is a baby or toddler.

1. Always Supervise Dog-Child Interactions

One of the most critical dog safety tips for parents is to always supervise interactions between your child and your dog. Even if your dog is calm and friendly, it’s essential to be present. Babies and toddlers don’t understand a dog’s body language and may unintentionally provoke a reaction by grabbing ears, tails, or paws. Even the most patient dogs can become startled or frustrated, leading to an unpredictable response.

Never leave a baby or toddler alone with a dog, regardless of the dog’s temperament. Supervision is key to preventing accidents and ensuring both the child and dog feel safe.

2. Teach Your Child to Respect Animals

It’s never too early to teach your child how to treat animals with respect. Children need to understand that dogs have personal space and should be treated gently. Demonstrating calm petting techniques and teaching simple rules—like "don’t pull on the dog’s ears"—can lay the foundation for a respectful relationship between your child and the dog.

As your child grows, explaining dog behavior—such as growling or barking—will help them understand how animals communicate and why it’s important to respect those boundaries.

3. Understand Your Dog’s Temperament

Every dog has a unique temperament. Even a dog that’s calm and tolerant around babies may react differently depending on their mood or environment. It’s important to know your dog’s behavior around children. If your dog shows signs of discomfort or stress, it may not be safe to leave them alone with your child.

Take the time to observe your dog’s reactions to various situations, especially if they are aging or experiencing health issues. Dogs can change their behavior as they age, or they may become more sensitive to loud noises or sudden movements.

4. Create Safe Spaces for Both Your Dog and Child

Both your dog and your child need their own space to retreat when needed. Safe spaces can help reduce stress and prevent potential conflicts. Create a designated area for your dog where they can rest or retreat, away from the baby or toddler’s play area.

Additionally, ensure your child has their own safe space, like a crib or playpen, to explore without constant interaction with the dog. This will help ensure safety for both parties.

5. Proper Training for Your Dog

Training is essential when raising a dog in a household with children. Basic commands like “sit,” “stay,” and “leave it” can help prevent accidents. Behavioral training is also key to teaching your dog how to respond to various situations. If your dog has shown any signs of aggression or anxiety, consulting with a professional dog trainer is a good idea to address these issues early on.

6. Monitor Your Dog’s Health

If your dog is elderly or has health issues, be extra cautious around your child. Pain or discomfort can make a dog more irritable or anxious, leading to unpredictable behavior. Regular vet check-ups and paying attention to your dog’s physical health can help prevent health-related behavior changes.

7. Watch for Warning Signs from Your Dog

Dogs communicate through body language, and it’s important to watch for warning signs that your dog might be feeling uncomfortable. Growling, backing away, or showing rigid body posture are clear signals that your dog is stressed or threatened. Learning to recognize these signs can help you intervene before a situation escalates.

8. Keep Your Dog Up to Date on Vaccinations

Since babies and toddlers have developing immune systems, it’s crucial to keep your dog up-to-date on vaccinations and parasite prevention. This reduces the risk of spreading infections or diseases between your dog and your child.

Conclusion: Creating a Safe Environment for Dogs and Children

Raising a child and a dog together is rewarding, but it requires a commitment to safety, respect, and understanding. Through proper training, supervision, and creating safe spaces, the bond between your dog and child can flourish. However, always remember that dogs have instincts and boundaries, and safety should never be taken for granted. It’s important to stay mindful and continue learning how to ensure the well-being of both your child and your dog.

Keywords to include for SEO: dog safety tips for parents, raising a child with a dog, baby and dog interaction, dog-child safety, teaching kids to respect dogs, Great Dane and baby, dog behavior around children, toddler safety with dogs, dog training for families

External Vagal Nerve Stimulators are a Cool Way to Address Anxiety and the Body Fellings it Causes

Sun, 26 Jan 2025 20:53:17 GMT

Here's a summary of the external vagal nerve stimulators on the market.

Vagal nerve stimulation (VNS) is gaining popularity as a therapeutic approach for treating conditions like anxiety, migraines, and emotional GI distress. External vagal nerve stimulators provide a non-invasive way to activate the vagus nerve, helping to promote relaxation, reduce stress, and manage chronic conditions.

What is Vagal Nerve Stimulation?

Vagal nerve stimulation is a technique that stimulates the vagus nerve, which plays a critical role in regulating the parasympathetic nervous system (PNS). The PNS helps counterbalance the “fight or flight” responses of the sympathetic nervous system (SNS), promoting relaxation and reducing stress. By activating the vagus nerve, external devices can help improve heart rate, digestion, and inflammation.

External vagal nerve stimulators harness this calming effect to provide an effective, non-invasive treatment for a variety of conditions, including anxiety, chronic stress, depression, and migraines.

Top External Vagal Nerve Stimulators for Treating Anxiety, Migraines, and Stress

Here are some of the most popular and effective vagal nerve stimulation devices available today:

1. GammaCore by electroCore

GammaCore is a handheld, FDA-approved device used to treat chronic migraines and cluster headaches. It delivers mild electrical stimulation to the cervical vagus nerve to help alleviate pain and promote relaxation. The device is also used off-label for anxiety and depression, providing a natural alternative to pharmaceuticals. GammaCore offers a simple interface for easy daily use.

Learn more about GammaCore : GammaCore nVNS Therapy for Migraine Relief

2. YAPU by Vital Neuro

YAPU is a wearable vagal nerve stimulator designed to reduce anxiety, stress, and mood disorders. Unlike other devices, YAPU is worn like a headband and targets the auricular branch of the vagus nerve. It provides gentle electrical stimulation that helps increase parasympathetic tone and promote calmness throughout the day. Ideal for daily use, it enhances emotional well-being and aids in relaxation.

Explore YAPU : Vital Neuro - YAPU

3. tVNS by tVNS Technologies

The tVNS system by tVNS Technologies targets the auricular vagus nerve with non-invasive electrical pulses. This device helps manage conditions like depression, anxiety, and chronic pain by stimulating the parasympathetic nervous system. The tVNS system is portable and easy to use, providing a convenient treatment option for those seeking natural relief from mental health issues.

Learn more about tVNS : tVNS Technologies

4. TruVaga by TruBrain

TruVaga is a portable vagal nerve stimulator designed to alleviate stress and anxiety. It provides low-frequency electrical pulses to the neck, promoting relaxation and mental well-being. Typically used in 15-20 minute sessions, this device is perfect for those looking for a quick and effective way to manage stress without relying on pharmaceuticals.

Discover TruVaga : TruVaga - Reduce Stress

5. Sensate by Sense Therapeutics

Sensate takes a unique approach to vagal nerve stimulation by combining low-frequency vibrations and sound waves. This device stimulates the vagus nerve through the chest area, helping to reduce stress and anxiety. Sensate is often used in conjunction with meditation or deep breathing exercises, making it a great tool for enhancing emotional well-being and mindfulness.

Get Sensate : Sensate

6. Pulsetto by Pulsed Therapeutics

Pulsetto is an external vagal nerve stimulator designed for stress relief, anxiety management, and improved sleep. Worn around the neck, it uses electrical pulses and biofeedback to engage the parasympathetic nervous system, promoting relaxation. Pulsetto is ideal for daily use, making it a convenient option for people seeking a portable solution for mental well-being.

Learn about Pulsetto : Pulsetto - Relax and Unwind

7. Alpha-Stim by Electromedical Products

Alpha-Stim is a well-established device used to treat anxiety, depression, insomnia, and pain. By applying microcurrent electrical therapy (MET) to specific areas like the ears, it stimulates the vagus nerve to enhance relaxation and improve mood. Alpha-Stim is a portable device that provides drug-free relief for people dealing with emotional distress.

Explore Alpha-Stim : Alpha-Stim - Anxiety Relief

8. IB-Stim by Innovative Health Solutions

IB-Stim is a specialized vagal nerve stimulator designed for individuals with irritable bowel syndrome (IBS). It uses mild electrical pulses to regulate digestive functions and alleviate symptoms like bloating and constipation. While primarily for gastrointestinal issues, it also promotes relaxation and reduces stress by modulating the parasympathetic nervous system.

Learn more about IB-Stim : IB-Stim - IBS Treatment

Conclusion: The Future of Non-Invasive Vagal Nerve Stimulation

External vagal nerve stimulators offer a promising, drug-free solution for managing a variety of chronic conditions such as anxiety, migraines, depression, and stress. By stimulating the vagus nerve, these devices help activate the parasympathetic nervous system, promoting relaxation and improving overall well-being.

Whether you're seeking relief from migraines, emotional distress, or chronic stress, there's likely a vagal nerve stimulator that suits your needs. Always consult with a healthcare provider before using any device to ensure it is the right fit for your condition and that you use it safely.

Keywords:

external vagal nerve stimulators
vagal nerve stimulation for anxiety
vagal nerve stimulators for migraines
non-invasive vagal nerve stimulators
treatment for anxiety with vagal nerve stimulation
best vagal nerve stimulators
stress relief devices
chronic migraine treatment
relieving IBS symptoms with vagal nerve stimulation
GammaCore, YAPU, and tVNS devices
vagus nerve stimulation for depression

I accidentally gave Honey Nut Cheerios to my baby! by Dr Alexis Lieberman

Mon, 06 Jan 2025 20:59:40 GMT

How big a risk is it if you accidentally give processed foods with Honey in the name to your baby under 1?

Clearing Up Misconceptions About Processed Foods With Honey in the Name

Most parents know that honey should be avoided for babies under the age of one, but how many understand why? It’s because honey can potentially contain botulism spores, which pose a risk to infants but not to older children or adults. If you’ve ever wondered about the botulism risk in honey, this article will clarify everything you need to know and provide reassurance about processed foods with “honey” in the name.

What is Botulism and Why is it a Concern for Babies?

Botulism is a rare, but serious illness caused by Clostridium botulinum, a bacteria that produces a potent neurotoxin. This toxin attacks the nervous system, leading to symptoms like muscle weakness, difficulty swallowing, and even paralysis. While botulism spores are commonly found in the environment, they only pose a risk when they are allowed to grow and produce toxins in low-oxygen environments, such as in the digestive system.

Babies, particularly those under one year old, have a less developed immune system and digestive tract, making them more vulnerable to botulism. In contrast, older children and adults have a more mature digestive system that can prevent the spores from growing and causing illness. An infant with botulism might have a weak cry, constipation, drooping eyelids, loss of head control, trouble having the energy to feed, and floppy arms and legs. (If the baby JUST has constipation or poor feeding, that is NOT likely to be botulism!)

Infant botulism is not the same as the botulism that older children and adults get. “In infant botulism, the swallowed botulism spores activate and produce botulinum toxin inside the baby's large intestine. In foodborne botulism the botulism spores activate in the food and produce botulinum toxin.

Older children and adults get foodborne botulism by eating the food in which the botulism bacteria have produced botulinum toxin.” (https://www.cdph.ca.gov/, California Department of Public Health)

My Personal Experience with Botulism

In my 30 years of medical practice, I’ve only encountered two cases of botulism. One involved a infant who contracted botulism from old wallpaper paste during a home renovation, and the other occurred after an infant consumed tea made from a large bunch of dried chamomile flowers purchased at a health food store. Neither of these cases involved honey, which is why I want to emphasize that while botulism in honey is a theoretical risk, it’s very rare in practice. In the United States, about 20% of infant botulism cases are linked to honey consumption. (NIH, Stat Pearls, https://www.ncbi.nlm.nih.gov/books/NBK493178/#:~:text=In%20the%20USA%2C%20there%20are,corn%20syrup%2C%20and%20medicinal%20herbs.)

The Real Risk: Why Babies Should Avoid Honey

The key concern with honey is its potential to contain botulism spores. “Although honey is a known food vehicle for the bacteria that causes infant botulism, we typically don’t consider an individual honey exposure to be overly risky for acquiring the bacteria that causes infant botulism. Honey is the one dietary reservoir of C. botulinum spores thus far definitively linked to infant botulism by both laboratory and epidemiologic evidence. However, that said, not every jar of honey has botulinum spores in it. To date, avoiding feeding honey to infants 12 months of age or less is the only known prevention measure for infant botulism.” (https://www.cdph.ca.gov/, California Department of Public Health)

The Reason for This Article: Reassuring Parents About Processed Foods with Honey

I often hear from parents after they accidentally give their baby processed foods with the word "honey" in the title—like Honey Nut Cheerios or Honey Grahams. While there is no proof that there are no botulism spores in these foods, in my opinion, the risk is negligible. The amount of honey in these processed foods is extremely small.

We do need to keep in mind that “commercial heat pasteurization (including vacuum packed pasteurized products and hot smoked products) may not be sufficient to kill all spores” (WHO, https://www.who.int/news-room/fact-sheets/detail/botulism) so while you should not CHOOSE to give foods with ANY honey to an infant under 1 years old, at the same time, there is so little honey in most foods named “honey” that if you do accidentally give these, you should not worry.

To help reassure parents, I’ve put together a table of common processed foods that contain honey. This table provides an approximation of the amount of honey in each item, showing that these foods do not carry the botulism risk that plain honey does.

Common Processed Foods with "Honey" in the Name: Are They Safe for Babies?

Conclusion: No Need to Worry About an Accidental Ingestion of Processed Foods With Honey In the Name

In summary, while honey itself can pose a botulism risk for babies, the presence of honey in processed foods does not carry the same risk. The small amounts of honey used in these products, coupled with pasteurization and other food safety measures, make them less risky for babies. So, if you've accidentally given your baby processed foods like Honey Nut Cheerios, there's no need to worry.

If you're ever in doubt about what foods are safe for your baby, don’t hesitate to reach out to your pediatrician.

The Flu and the Flu Vaccine, my thoughts, by Dr Lieberman

Mon, 30 Dec 2024 20:36:26 GMT

Taking time to think about the flu vaccine.

As a pediatrician, I work every day to ensure the health and safety of children. This is not just a professional responsibility—it’s a personal commitment to the well-being of every child I see. Recently, I came across a tragic statistic that has weighed heavily on my mind: 200 children died from the flu last year, and about 80% of them were either not vaccinated or not fully vaccinated against the flu. These numbers are not just statistics; they represent lives lost, families devastated, and communities left to mourn.

Flu Vaccination: Protecting Your Child from Preventable Illness

I understand that parental choice plays a significant role in vaccination decisions. The decision to vaccinate is deeply personal, and I respect the concerns many parents have. Some worry about the safety of the flu vaccine, while others believe their child’s health will protect them from contracting the flu. As a pediatrician, my goal is not to pressure, but to provide evidence-based information that might help you make an informed decision for your child's health.

The Importance of the Flu Vaccine

The flu vaccine has been in use since 1945 and has proven to be one of the most effective ways to prevent illness, hospitalization, and death caused by influenza. Despite its efficacy, many children still die from the flu every year, and many of these tragic deaths could be prevented through vaccination. While the flu vaccine isn’t perfect, it remains our best protection against this potentially deadly disease.

Safety of the Flu Vaccine

Concerns about vaccine safety are common, but it’s important to note that severe reactions to the flu vaccine are extremely rare. According to the Centers for Disease Control and Prevention (CDC), less than 3% of people experience serious side effects from the flu vaccine, and those that do are usually mild (like soreness or a low-grade fever). The risks of flu-related complications—such as pneumonia, dehydration, and even death—far outweigh the risks of mild side effects.

In fact, last year the CDC estimated that the flu vaccine prevented approximately 3,700 deaths and 65,000 hospitalizations. This underscores the importance of flu vaccination, especially for children.

Understanding Vaccine Hesitancy and Decision-Making

As humans, we often fear doing something that could cause harm (an act of commission) more than failing to do something that could prevent harm (an act of omission). This is why some parents hesitate to vaccinate their children—the fear of an unknown side effect feels more frightening than the risk of getting sick. However, it’s important to understand that choosing not to vaccinate is, in itself, a decision. When you decide against vaccination, you are taking the risk that your child could contract the flu and face serious complications.

Flu Complications: Why Vaccination Is Crucial

The flu may seem like “just a bad cold” to some, but for others, it can lead to severe complications like pneumonia, heart inflammation, brain inflammation, and muscle inflammation, which can result in long-term hospital stays or even death. Children under six months, the elderly, and those with weakened immune systems are particularly vulnerable to the flu’s complications.

The Flu Vaccine: Protecting Not Just Your Child, But Others

While the flu vaccine doesn’t guarantee complete protection, it significantly lowers the chance of severe illness. And when you vaccinate your child, you are not only protecting them but also helping to protect others. For instance, infants under 6 months old, who cannot get vaccinated themselves, rely on the immunity of those around them.

Supporting Parental Choice While Highlighting the Benefits

As a pediatrician, I respect and care deeply for all my patients, regardless of their vaccination status. However, for parents still on the fence about the flu vaccine, I encourage you to consider the facts. Flu vaccination has a long history of safety and effectiveness, and the benefits far outweigh the risks for the vast majority of children.

For families who remain concerned, I am always available to answer questions and provide guidance. But it’s important to remember that the flu vaccine is not just about avoiding a few days of missed school or work—it’s about preventing potentially deadly outcomes. Every year, the flu claims lives, and many of these deaths could have been prevented with timely vaccination.

The Flu Vaccine Saves Lives

Ultimately, the choice to vaccinate is about making the best decision for your child's health and safety. While I fully support parental autonomy, I urge parents to consider the evidence and the life-saving potential of the flu vaccine. Vaccination is a protective measure—it’s a way to prevent tragedy, reduce the risk of severe illness, and keep your child safe throughout the flu season.

Why Flu Vaccination Is Essential: Protect Your Child Today

I care deeply about every child in my practice, and it’s my job to provide the best medical advice to help ensure they grow up healthy and strong. The flu vaccine is a simple, effective, and life-saving tool that can help prevent your child from suffering, being hospitalized, or losing their life to a preventable illness.

If you’re still uncertain, I encourage you to reach out with any questions. Together, we can make the best choice to protect your child.

Dr. Lieberman

Keywords: flu vaccine for children, importance of flu vaccine, pediatric flu vaccination, flu vaccine safety, vaccine hesitancy and flu, flu vaccine benefits for children, preventing flu complications, flu vaccination in pediatrics, protecting your child from the flu, CDC flu vaccine statistics

Why it's easy to get appointments in our office! Article from Philadelphia Magazine

Sun, 23 Jun 2024 02:16:12 GMT

This article from Philadelphia Magazine explains the ins and outs of getting appointments.

https://www.phillymag.com/be-well-philly/2024/04/22/doctors-appointment-scheduling/

We are proud to be quoted in this article, as the exception to the rule that it's impossible to get a doctor's appointment. At our office, you can ALWAYS get in within 2 weeks, and sick kids get in the same day. We don't go home until all the sick kids are seen.

Patched, an article about eye patches by Anndee Hochman

Wed, 22 May 2024 17:24:43 GMT

Article by Anndee Hochman on her child wearing an eye patch

Vomiting instructions

Wed, 14 Feb 2024 19:33:13 GMT

If your child is vomiting, you need to know what to do! Here are instructions, step by step, for you!

Vomiting

By Dr. Kerby Zeisloft, Advocare Fairmount Pediatrics

Vomiting is usually caused by a stomach virus. Antibiotics do not help. Some children will also have diarrhea.
The pattern you can expect is that the child feels poorly and wants to lie down. Next, they look pale. Finally, there is vomiting. There may be multiple vomits over the course of several hours. The diarrhea usually comes the second day, though it can be the first day. Vomiting will usually be for less than a full day, and then the child feels weak and does not have much appetite. They usually are a bit better on day 2 and then on day 3, they feel better enough that they eat normally. There is often more vomiting on day 3-4, as the child eats more normally before the stomach is quite ready.
The key to improvement is to go slowly! Preventing dehydration is the key.

FOR BABIES UNDER ONE YEAR OLD:

Wait 30 minutes after the child vomits before giving anything to drink.
I know you are worried about dehydration and you want to give something right away. But if you give fluids right away, your baby will vomit them. This will increase the risk of dehydration. Please wait after a vomit to allow the stomach to settle.

Now, give 5 cc of Pedialyte every 5 minutes about 3 times. Next, give 10 cc every 10 minutes, about 3 times. Next, give 15 cc every 15 minutes, about 3 times.
WHY PEDIALYTE? The pedialyte, or any oral rehydration fluid (even a home-made one, please see below for the recipe), has electrolytes in it. Giving just water will lead the child to vomit again, and will also cause the body's electrolytes to be watered down, leading to low levels of salt in the body. It's best to use an oral rehydration fluid.
Gerber Rehydralyte oral rehydration fluid is actually delicious, but is hard to find in the stores.

NEXT STEPS:
Next, every 5-15 minutes, give a small sip of half to one ounce of Pedialyte, Breast milk or Soy formula. If you are breastfeeding, you can try paced breastfeeding, allowing the infant to stay on the breast for 1-2 minutes at a time. If you have a forceful letdown, and rapid milk flow, you are better off pumping and feeding with a bottle at this point.

If there is no vomiting for 2 hours, go back to formula, if you are formula-feeding, or continue to breastfeed often, if you are breastfeeding

FOR CHILDREN OVER ONE YEAR OLD:

Wait 30 minutes after the child vomits before giving anything to drink.
BIGGEST MISTAKE? GIVING WATER RIGHT AWAY AFTER VOMITING.

Next, you can settle the stomach with a heavy sweet syrup. Years ago, people used Coke syrup for this. Today, you can use the syrup that peaches are canned in (buy the heavy syrup, not the light version), or a medication called Emetrol, which is just a heavy sweet syrup and not really a medication

Give the sweet syrup, 1 tsp (1/2 tsp for babies) every 10-15 minutes, three times. After that, the stomach should be somewhat better

Then, every 5-10 minutes, give a small sip of half to one ounce of Pedialyte, or

0.5 strength Gatorade (with water) and 3 saltines/glass

0.25 strength Kool Ade (with water) and 6 saltines/glass

Pedialyte popsicles

Regular popsicles (not the all-fruit kind, you want the cheap, sugary kind, since sugar can be digested with a stomach virus and fruit cannot)

CAN MY CHILD EAT FOOD THE FIRST DAY?
If there is no vomiting for 6-8 hours, you may give more fluids and gradually return to a normal diet. Take this very slowly. If you go too fast, the child will seem better on the 2nd day and then will relapse and vomit again on the 3rd day.

WHAT CAN THE CHILD EAT AS THE CHILD RECOVERS?
So, on day 2, try ginger ale, gatorade, salty broth, and jello. Later that day, try saltines, toast, salted noodles, and cheerios. Later still, try applesauce and bananas. The next day, boiled chicken, toast with jam, ice pops, dry cereal. Go slowly!

IF THE CHILDS BELLY DOES NOT HURT TO PRESS ON, AND THERE IS NO PAIN WITH JUMPING, WE CAN SEND IN ANTI-NAUSEA MEDS. Please schedule a telehealth visit for this. We usually use Ondansetron for this purpose. This drug is safe in young children as long as we can be confident that the belly is not tender or painful. Babies are sometimes given Ondansetron in the ER, but are not prescribed this drug without a physical exam first.

FOR ALL KIDS, ALL AGES:

REASONS TO CALL THE DOCTOR:
Call the doctor if: your child vomits more than 4-5 times, if you see blood or bile (bright green fluid) in the vomit, or if you see signs of dehydration.
What are the signs of dehydrations? Not enough wet diapers, less urination than usual, no tears when crying, a dry-looking mouth and tongue, a sunken soft spot.

WHEN IS IT AN EMERGENCY?
Call if the belly is hard and painful to touch, or if a baby has fluorescent green in their vomit, or go to the ER.
A great guide to recognize an emergency vomiting situation is to have the child jump up and down. If they are able to do this, you can probably stay home. If there is pain or the child is unable to jump up and down, you should head to the Emergency Department.
If there is no urine output for 6 hours, this is dehydration and it is time to go to the ER.

FREQUENTLY ASKED QUESTIONS:
WHAT IF MY CHILD GOES 20 MINUTES WITHOUT VOMITING AND THEN VOMITS AGAIN? This is a common question. Unfortunately, you are best off waiting another 30 minutes before feeding. If your child is very thirsty, you could try to shorten the time to 15 minutes and use less Pedialyte, 2.5 ml, when you start.

I DON'T HAVE ANY PEDIALYTE AT HOME, AND I CAN'T GO OUT!
Here is a recipe for homemade oral rehydration fluid. You don't have to go out to get it!
Homemade Pedialyte:
Please mix 2 cups water, 1/2 tsp salt, and either 1/2 cup instant baby rice cereal or 1 1/2 tablespoons sugar.
Mix this well, and then feed one tsp at a time every minute or two

MY BABY OR CHILD IS REFUSING FLUIDS. WHAT DO I DO?!
Try offering the fluids with a teaspoon.
Try turning on the television, even for an infant, to mesmerize them.
Try a dark room and cuddling the infant or child.
Try a syringe.
Try sugary fluids.
Try little bits of Pedialyte popsicles, or frozen pedialyte, and place the ice chips in the child's mouth.
Try singing while you offer the fluids.
If nothing nothing nothing works and there is no urine for 6 hours, please go to the ER for IV fluids.

Why our No-Show / Short-Notice Cancellation Fee is $100.

Wed, 14 Feb 2024 19:26:50 GMT

How We Run On Time

By Alexis Lieberman, MD

When I meet other doctors, the subject of how we run our our offices often comes up. When I mention that we run on time, most doctors are shocked. How do you do it?! they ask. This post is to tell you how we do it.

When I used to work at a large hospital clinic, we often ran 3 hours behind. You read that correctly - three hours! The doctors would sit around waiting in the back, wishing we could see the patients, and the patients would wait in the front, getting angrier and more frustrated, not to mention hungry! I loved my patients, but I hated the way we ran. There wasn't a particular person at fault -- it was baked into the system.

When I opened Fairmount Peds in 2009, my first order of business was picking apart the system that caused that clinic to run so behind, and to rebuild a system that would run on time.

Number one is to let patients have the right amount of time. If you know one patient will need 30 minutes and then next 10 minutes, one way to run the office is to give each 20 minutes and figure it will come out in the end. Well, it does come out in the end, but someone sat around for 10 minutes waiting to make that happen. We let patients choose the amount of time they need. It is not perfect, but most patients have a better sense of how long they need than we do.

The next step is to only put one patient in each time slot. Many doctors' offices have two patients in each time slot. That's because they have a 50% no-show rate. For real -- half their patients do not show up or cancel at the last minute. Well, we charge $100 for canceling with less than 24 hours, or not showing up, and if patients no-show repeatedly, we ask them to leave the practice. Mean? I guess so. But we only put one patient in each time slot, and it works, since NO ONE no-shows!

Finally, our staff knock on the door when our time is up. We got that idea from the therapists who are known for saying, "Well, our time is up..." Sometimes it's not possible to end at the time we are supposed to. If a patient is very sick or something scary is happening, we have to be flexible, and we are. One thing that helps these days is telehealth. If we didn't get to fully discuss the food allergy or the potty training or whatever else we wanted to discuss, there's the option to have a separate visit via telehealth, so we don't have to cram everything into one visit. That way, we docs and the patients can take the time we need, and not worry that the next kid is getting stir-crazy in the next exam room.

I have heard some doctors say that patients don't mind waiting, since they get the time they need when it is finally their turn. I am sure that is true of some. But I know MY day is better when I don't keep people waiting, and I think their day is better, too.

Three Things To Know About a "Vaccine-Only" visit.

Wed, 14 Feb 2024 19:23:12 GMT

Three Things To Know About A Vaccine-Only Visit

When you book your appointments, you will see that you can choose a Medical Assistant Visit, for either office. Here are some questions you may have:

When you book for the Medical Assistant, you will NOT have an appointment with the doctor or physician assistant, but you still might see them for a minute or two. If you scheduled for a vaccine-only appointment, the doctor or physician assistant will stick their head in to see if you have any questions about the vaccine. They can answer questions about side effects, for example, and they will make sure the right vaccine is ordered.
You do NOT need a vaccine-only appointment if you do have a well visit or sick visit appointment. In that case, you booked to see the doctor or physician assistant, and that provider will see you, and cover whatever topics you wanted covered, and some of their own, as well. Then, after discussing the vaccines with you, they will order the right ones and the medical assistant will come in at the end, to give the vaccines. No separate appointment is needed for the medical assistant -- it's included!
What vaccines are available? We have Sanofi vaccines for the infant series, both in combinations and as single vaccines (for example, you might want Vaxelis which gives DTaP, Polio, Hib and Hep B all in one needle, or you might prefer to get these as separate vaccines). We have all the routine vaccines required for school entry. And we have the COVID vaccines available for 6 month olds and older.

To schedule your Medical Assistant appointment, click on the “SCHEDULE APPT” tab at the top of the page. This will take you to our scheduling tool. To schedule, please select the Medical Assistant in whichever office you usually use. (If you have an HMO, you can ONLY use your usual office. If you have a PPO, you can use both offices.)

For more information and answers to frequently asked questions about appointments, please visit our " Appointments " page or our Vaccine page under Resources .