Village Pediatrics
Fall Newsletter
September, 2010- Vol 2, Issue 3
In This Issue
Sleep, Glorious Sleep
Vaccines and the Immune System
Influenza Vaccine Now Available
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Quick Links
New driver in the house?    Visit the CDC site "Parents are the Key" for important advice, and an eye-opening quiz on teen driving statistics.
                                   
Looking for some new lunchbox ideas?  Try this site for some good tips on how to mix things up a bit this schoolyear.
School Already?!?!
Summer seems to have gone by in a flash- and the yellow school buses are back on the road.  A special shout-out to our new kindergarden patients: good luck, have fun, and make sure to learn your address and phone number. Try teaching it to your child as a song which makes it easier to remember.

September is also a good time to review a number of basic child safety rules with your children.  Thanks to Weston's Detective Carl Filsinger for sending out this valuable list from the National Center for Missing and Exploited Children.  It is a good idea to remind children of these rules from time to time- just by discussing them you have empowered your children to say no to strangers.
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Gardasil for Boys
Most insurance companies are now covering Gardasil for boys.  This vaccine provides protection against 4 common strains of Human Papilloma Virus, which can cause venereal warts, penile and anal cancer in men (as well as cervical cancer in any female partners the virus is passed on to.)  The vaccine can be given at age 9 or older, and is administered in 3 doses.  It is most protective if given before your child is sexually active.
Sleep, Glorious Sleep
baby sleeping

Sleep!  An essential part of childhood, and critical to parental sanity.  Read on for some of our key points in sleep philosophy, and a guide to a few experts in the field:

 

         Sleep begets sleep (don't wake up your newborn during the day to get her to sleep more at night - it usually backfires)

         Better rested children/infants are less likely to have terrible tantrums and irritable moods.  They also fall asleep more easily.

         The best sleepers are produced by parents who realize that sleep is an essential life skill that needs to be learned.  Don't vacillate on a child's need for sleep by returning to the room multiple times or allowing them to control the time and place for sleep.  It is OK to allow a child to learn to self-soothe (i.e. cry a bit.)  CONFIDENCE is key!

         Adolescents need 8-9 hours of sleep a night - staying up excessively late on weekends and staying up extra late on weekdays doing homework destroy the needed sleep architecture.  Minimize bright lights and activities that "wake up the brain" such as computer use and videos in the hour before sleep initiation to help your teen fall asleep faster.

         In our experience the best sleepers are produced by following Dr. Weissbluth's book, "Happy Baby, Healthy Sleep Habits."

         Incentives given for "staying in your bed all night by yourself" need to be immediate and satisfying to child - i.e. a small prize or mini chocolate bars that they would otherwise never be allowed to wake up and eat.  This may take 1-2 weeks of the immediate reinforcement.  Promises of "do it for 1 week and I'll buy you a bike" don't work nearly as well.

         A young child who is climbing out of his/her crib is may not be ready for a big bed, especially if they are very active.  You have two choices:  Dr. Nikki  strongly recommends crib tents to keep good sleepers sleeping well.  Dr. Jenn suggests trying the crib mattress on the floor for persistent escapees, but be sure to fully childproof their room and put a gate in the doorway to avoid midnight wanderings.  We advocate keeping kids in cribs as long as they are sleeping well- often until the age of 4!

 

Here are some popular sleep strategists:

 

Ferber :  An expert in the field from Boston Children's Hospital.  His cry-it out theory has saved many families priceless sleep hours.

http://www.childrenshospital.org/views/june06/sleep.html

 

Weissbluth - He helps you understand how to initiate sleep BEFORE your child is overtired.  He also is the advocate of the "lock on the door" philosophy for older children that I have seen work many times.  (you almost never actually put the lock on).

Below is a summary of how to implement his theories:

http://www.ehow.com/how_2107237_use-weissbluth-sleep-training-method.html

 

Sears - An advocate of the family bed and attachment parenting, Sears has many helpful suggestions for those not comfortable with the cry it out approach:

http://www.askdrsears.com/html/7/T070100.asp

 

 

NIH:  Here is a link to an in depth look at the pathophysiology of sleep and sleep rhythms (this will help you understand why your teen simply can't wake up in the morning!):

http://science.education.nih.gov/supplements/nih3/sleep/guide/info-sleep.htm

 

Sweet dreams to all tonight...

Vaccines and the Immune System
vaccineParents frequently ask us why we can give multiple vaccines at one visit, and worry that it will "use up" their child's immune system.  The Children's Hospital of Philadelphia (CHOP) website puts this in practical terms: "(one) way to determine the diversity of the immune response would be to estimate the number of vaccines to which a child could respond at one time. Assuming the quantities of antibodies likely generated by an individual in 1 ml of blood (one-fifth of a teaspoon) during seven days after exposure to a vaccine, and the number of different specificities of those antibodies, then each infant would have the capacity to respond to about 10,000 vaccines at any one time. Using this estimate, one would predict that if 11 vaccines were given to infants at one time, then about 0.1 percent of the immune system would be "used up.""  In addition, since the body is constantly regenerating immunity producing cells, the system is never truly "used up" at all. 

At the same time, although we now give children more vaccines, the actual number of immunologic components in vaccines has declined. Whereas previously one vaccine, smallpox, contained about 200 proteins, now the 11 routinely recommended vaccines contain fewer than 130 immunologic components (i.e., proteins or polysaccharides).

With this knowledge in hand, we urge you to vaccinate on time in accordance to the AAP recommended schedule of immunizations.  This past year has seen a resurgence of many vaccine preventable illnesses in our area, including Pertussis, Mumps and Measles.  Visit the CHOP website for more valuable vaccine information.
 
Influenza Vaccine Now Available

We now have in stock both injectable and nasal mist (FluMist) 2010 Influenza Vaccine for.  All vaccine is packaged as single dose, no preservative. We are administering the vaccine at either regularly scheduled physical exam appointments, or during one of several flu clinics we will have throughout the season.

This year's influenza vaccine contains the 2009 H1N1 strain, so there will be only ONE version of the vaccine this year.  The Academy of Pediatrics (AAP) recommends that all children receive the influenza vaccine yearly.  This vaccine is effective for at least one year, so get your children immunized early while we still have ample supply.

Children under the age of 2, or those with moderate to severe asthma or other chronic immunosuppressive medical condition, should receive the injectable flu vaccine.

Healthy children ages 2 and older can receive the nasal spray form of vaccine (FluMist.)

Children less than 9 years of age who did not get 2 doses of H1N1 vaccine last season should receive TWO doses this year, spaced at least 1 month apart.

Children less than 9 years of age who have never received a flu vaccine before, should receive TWO doses this year spaced at least 1 month apart.

Healthy adults may also receive vaccine at our office.  There will be a cash charge of $40 for the vaccine and its administration.  If you are 49 years of age or younger, you can get FluMist.  If you are on immunosuppressive therapy, have asthma or other chronic medical condition, you must get the injectable form of the vaccine.  We are not immunizing pregnant mothers at this time.

If you or your child has an EGG ALLERGY, please contact our office before registering for a flu clinic, as you may need to obtain the vaccine at an allergist's office.

State supplied influenza vaccine for our Community Health patients has been ordered, and will hopefully be available soon.  We will send another email once our supply has arrived.
 
To register for a flu vaccine clinic, click on the links below:

October 11th (Columbus Day)- 11 am to 1 pm
November 2nd (Election Day)- 9 am to 12 pm

If these dates do not work for you, call us to schedule a visit during one of our weekday or saturday morning grouped vaccination sessions.

We would like to pass on this wonderful list we have found- a bit long, but well worth the read:

"20 Things Children Truly Need for School"

1. A No. 2 pencil and a willingness to erase.
2. A respect for themselves and others, especially their teachers.
3. An awareness that the world does not revolve around them, and that they alone are responsible for their actions.
4. Parents (or grandparents) who teach by example a love for reading, learning and life.
5. An assurance that school is a good, safe place, their teachers will like them, and their parents won't leave town without them.
6. An understanding that school is their "job" and no one else can or will do it for them.
7. A system for exchanging communication between school and home; a backpack for notes; an emergency phone number that always answers; a quiet place and time to do homework; a daily chance to read aloud and to be read to.
8. A plan for getting to and from school on time.
9. A pet to care for.
10. A public library card.
11. Someone to welcome them home, laugh at their jokes, answer their questions and listen to what they say and don't say.
12. The power of knowing how it feels to give anonymously and sacrificially to help someone less fortunate.
13. The encouragement to try new things, the freedom to fail and the chance to try again.
14. The gifts of being well- fed, well-rested, well-mannered and well-covered for medical, dental and after-school care.
15. The confidence to deal with bullies (stand up straight, look them in the eye, don't start a fight - but don't back down), how to ask questions (raise your hand and wait to be called on) and to never stop asking questions, especially "Why?"
16. To be the best, or at least pretty good, at something, and to know that it's OK not to be good at everything.
17. To spend more time with humans and less with machines.
18. To have nothing to do once in a while but daydream.
19. To have someone love them unconditionally, regardless of their grades; someone to "beam" at them, to light up when they walk into the room.
20. They need to know that school won't last forever, but learning is a lifelong process.

 We wish you a healthy and happy start to the new school year...

Dr. Jenn and Dr. Nikki
Village Pediatrics LLC

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