Village Pediatrics 
  Summer Newsletter
June 6, 2010- Vol 2, Issue 2
In This Issue
Sun Protection
Bug Safety
Poison Ivy
Speech & Hearing in Young Children
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Quick Links
Tick season is upon us; take a look at this easy tick-removal tool:
TickTwister


               
                  
Do you have bedtime issues in your house?  Too many "one more drink...one more book... one more hugs"?  Look at this interactive guide to solving children's sleep anxieties:
What to do When You Dread Your Bed



Summer recipe- from a great website "Parents Against Junk Food," an organization dedicated to eliminating junk food from our public school system:
Low Fat Everyday Mac 'n Cheese



We love getting babies off the bottle by 12 months, but the oft-used sippy cup is not the best choice for weaning- the mouth motion needed to suck may cause speech problems, and drinking with the head tilted back can contribute to ear infections. Check out this simple cup that helps teach straw drinking instead:  The Honey Bear


Lions and tigers and bears... oh my!
OK- so there aren't many large jungle animals in Fairfield County, but there are plenty of other threats from our usual summer outdoor pursuits.  Please take a few minutes to read up on our tips for protection from bugs, sun, and poison ivy in our summer newsletter. 

If you haven't visited our website recently, remember there is a lot of information on a host of topics there as well... for example, tick bites and Lyme Disease.  And check out the new tab "Our Favorite Things" for links to recommended childcare and medical items (books to soon follow.)

Prescription Medications now available in office!

med

We are now stocking a small variety of generic medications in the office; these typically cost less than a copay at the pharmacy.  Included are amoxicillin, azithromycin, antibiotic ointments/eye drops, anti-nausea medication and albuterol.  If you would like to avoid a pharmacy trip with a sick child in tow, just ask us if we have what you need.
Gardasil now approved for boys!
We have been using Gardasil in young women now for over 5 years without seeing any significant side effects.  We feel great about protecting a generation of young women from cervical cancer and genital warts.

The FDA has now approved Gardasil for young men as well.  While boys are not at risk for cervical cancer, Gardasil will protect them from the Human Papilloma Virus (HPV) and significantly reduce their risk of aquiring genital warts, or passing HPV on to any sexual partners.  There may also be a reduction in the risk of certain oropharyngeal cancers.

Many insurance companies are now covering this vaccine for males and females, but we do recommend confirming coverage prior to scheduling an appointment.  Gardasil is given on a  0, 2, and 6 month schedule.

Sun Protection
baby sun

For babies under 6 months, the two main recommendations from the AAP to prevent sunburn are to avoid sun exposure, and 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 suncreen with at least 15 SPF (sun protection factor) to small areas, such as the infant's face and the back of the hands.

For Older Children: 

  • Apply sunscreen at least 30 minutes before going outside, and use sunscreen even on cloudy days. The SPF should be at least 15 and protect against UVA and UVB rays.
  • The first, and best, line of defense against the sun is covering up. Wear a hat with a three-inch brim or a bill facing forward, sunglasses (look for sunglasses that block 99-100% of of both UVA and UVB rays), and cotton 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.
  • Use a sunscreen with an SPF of 15 or greater. Be sure to apply enough sunscreen - about one ounce per application.
  • Reapply sunscreen every two hours, or after swimming or sweating.
  • Use extra caution near water, snow, and sand as they reflect UV rays and may result in sunburn more quickly.
How to select a sunscreen:  Sunscreens are available in many forms, including ointments, creams, gels, lotions, sprays, and wax sticks. The type of sunscreen you choose is a matter of personal choice. Creams are best for individuals with dry skin, but gels are preferable in hairy areas, such as the scalp. Sticks are good around the eyes. Creams typically yield a thicker application than lotions and are best for the face.

Ideally, sunscreens should be water-resistant, so they cannot be easily removed by sweating or swimming, and provide broad-spectrum coverage against both UVA and UVB light.  SPFs higher than 15-30 do not mean you can stay out longer in the sun- sunscreen should be reapplied every 2 hours, and after any water exposure or excessive sweating to remain effective.

FDA approved ingredients
to look for on the sunscreen label to ensure broad-spectrum UV coverage include:
  • Avobenzone
  • Cinoxate
  • Ecamsule
  • Menthyl anthranilate
  • Octyl methoxycinnamate
  • Octyl slaicylate
  • Oxybenzone
  • Sulisobenzone
  • Titanium dioxide or zinc oxide- these two ingredients are PHYSICAL rather than chemical blocks, thus are safe to use on small babies and are a good choice if you are looking to avoid chemicals that might be absorbed by the skin.  Look for Blue Lizard Baby brand, or Neutrogena Pure & Free Baby.

Bug Safety
The best protection against insects and ticks is avoidance-
keep children away from thickly wooded areas, stagnant pools of water, uncovered foods, and gardens where mosquitoflowers are in bloom.  Don't use scented soaps, perfumes, or hair sprays on your child.  Avoid dressing your child in brightly colored or flowery print clothing.  And keep children indoors whenever possible at dusk, when many biting insects emerge.

If your child is bitten or stung, remove the stinger as quickly as possible.  The best method is to use a fingernail or credit card to scrape the visible stinger off horizontally (avoid squeezing the stinger, which may inject more venom into the skin.)

Insect repellents containing DEET are most efffective against ticks, which can transmit Lyme Disease, and mosquitoes, which can transmit West Nile Virus and other viruses.  The current CDC and AAP recommendation for children over 2 months of age is to use 30% DEET. 

DEET should not be used on children under 2 months of age, or on the hands of young children who might suck on their fingers.  You can apply the insecticide instead to the wrists/cuffs of long, lightweight shirts and pants to minimize absorption of the chemical.  You should wash off repellents with soap and water once back indoors.

The concentration of DEET in products may range from less than 10% to over 30%.  10% DEET only protects for about 30 minutes- inadequate for most outings.  The concentration of DEET varies significantly from product to product so be sure to read the label of any product you purchase.

Repellents made from essential oils found in plants such as CItronella, Cedar, Eucalyptus, and Soybean are generally much less effective than DEET, and may provide only short-term (less than 2 hours) protection.

Do NOT use combination sunscreen/insect repellents- sunscreens need to be reapplied every 2 hours, and repellents should NOT be reapplied.  DEET may also make the SPF factor lower, decreasing the sunscreen's effectiveness.

Dr. Nikki's Poison Ivy Story
poison ivy
It is 4 am of Memorial Day weekend, and my son comes to my bed, AGAIN.  "Mom, I can't sleep, I'm just too itchy!"  The Benadryl has worn off, and my patience is wearing thin.  I'm not sure why I was in denial that it was poison ivy, but at this point there is no doubt.  Off to the 24 hour CVS, where the myriad of skin treatment products makes my head spin (and I'm a pediatrician!)  Pushed back on the bottom shelf I see one box left of "Zanfel," a product I've recommended in the past.  Time to try it myself...  My hand falters as I see the staggering price tag, but my need for sleep wins out and into the basket it goes.  At home, we immediately get Zach in the bath and use the Zanfel.  While I cannot say that he enjoys the experience, it takes only about 2 minutes before his face lights up and he tells me, "Mom, money well spent!"  He sleeps peacefully the rest of the night, and so do I (at least until my 4 year old gets up at 6:30!)

Here is the link and information about poison ivy, and why this wash works:  Zanfel™ Poison Ivy Wash.

I recommend keeping a tube around for the summer as it works best if used early on small patches to stop the spread.  It is available at most pharmacies.

Speech and Hearing in Infants and Toddlers
child on phoneThe development of communication skills begins in infancy, before the emergence of the first word. Any speech or language problem is likely to have a significant effect on the child's social and academic skills and behavior. The earlier a child's speech and language problems are identified and treated, the less likely it is that problems will persist or get worse. Early speech and language intervention can help children be more successful with reading, writing, schoolwork, and interpersonal relationships.  Click here for more information from a wonderful website that offers many resources for speech, hearing, balance and swallowing issues: http://www.asha.org/public/
We wish you all a safe and fun summer season!

Dr. Jenn and Dr. Nikki

Village Pediatrics LLC

 
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Village Pediatrics | 156 Kings Highway North | Westport | CT | 06880