News of a whooping cough death in the Seattle area rang out yesterday. By afternoon, many of my patients in clinic had heard the news. Although the epidemic levels of whooping cough have gradually faded since a peak of cases here in May, the risk is still very real.
A newborn baby died from whooping cough on December 13th here in Washington State.
Newborn babies are at particularly elevated risk for serious complications from pertussis (whooping cough) infections. Unlike older children and adults who often have cough & coughing fits with vomiting, babies can have severe respiratory distress, pauses in breathing, or even stop breathing. Rarely it can be deadly.
Infants are most likely to catch whooping cough from a parent. We have to cocoon newborns everywhere: surround them with people who are vaccinated and less likely to spread whooping cough infection.
This tragic death serves up a reminder for we pediatricians, family docs, and clinicians everywhere to maintain our efforts and amp up our passion to keep babies surrounded by immunized family and friends. We can’t let up.
Are You Up To Date On Your Whooping Cough Shots?
More than anything, we need to ensure family members (mothers, fathers, grandparents, and siblings) all are up-to-date on their whooping cough shot. The shot is imperfect (meaning not everyone who gets the shot is always immune — most estimates find that 80% of us who get the shot are protected) and we know some of our immunity to whooping cough can fade year after year. So the more people immunized the less likely we are to have whooping cough in our community. Read full post »
Often new parents are nervous about mixing and matching infant formula they offer their babies. They worry if they switch from one formula brand to another, they may cause their baby fussiness, stool changes, upset or worse–that they could put their baby at risk.
It’s safe to mix and match infant formulas if you are following standard mixing instructions. Really.
Although spitting up or gassiness is usually not due to the protein in formula (cow’s milk versus soy versus hypoallergenic), sometimes changing formula helps new babies and their parents who worry. Switching them up can even help clarify worries in some scenarios when a parent worries about excessive gassiness, intolerance, or significant urping or spitting up.
Experimentation with formula brands in an otherwise healthy newborn is okay. But it’s not necessary at all, either.
It’s fine to make a bottle that is ½ formula from the blue can and ½ formula from the yellow one. Fine to serve Simulac one week, Enfamil the next, Earth’s Best or Goodstart followed by Soy formula the following day. Fine to buy one brand that’s on sale only to buy the other brand next week. Read full post »
Recent reports have heightened concerns about arsenic levels in rice products here in the US. This has left many parents wondering if we should be serving rice to babies and children. The video summarizes my current recommendations.
Remember, arsenic is a naturally occurring element on earth. However, natural doesn’t necessarily mean “good for you.” There are two types of arsenic–organic and inorganic. In general, it’s the inorganic arsenic that we worry about. The big picture goal for all of us is to eat a diverse diet full of a variety of foods thus protecting us by decreasing exposures to any one thing.
Arsenic is large quantities has been found to pose health risks. So taking steps to minimize consumption of foods high in arsenic may be beneficial. Before you bail on rice althogether, know that not every group is ready to tell you to rid your pantry of rice. Here’s what the American Academy of Pediatrics says currently (fall 2012).
5 Tips To Reduce Arsenic Consumption For Your Family:
We need a flu shot annually because influenza virus changes structure and shape as it moves around the globe each year. The strains that cause human disease are different from one year to the next, so we update and add to our protection annually by getting a shot or nasal flu spray. Children, especially those under age 5, are at higher risk for severe disease from influenza. In children and adults, influenza can cause a mild illness, but unfortunately, sometimes it can cause severe or even life-threatening complications. Children may have a more difficult time fighting off influenza partly because they don’t have years of exposure to other strains of flu and no real immunity built up. Therefore all children are considered a priority group for flu shots. Pregnant women, families with infants at home, and those with underlying medical problems like asthma, diabetes, or neurologic problems really need to get them, too.
It takes a well-orchestrated, worldwide effort to help predict which strains come to our country and which 3 strains are included in the annual flu shot or flu nasal spray here in The United States. The video explains more.
We had one of each in our house: one baby that we let cry for periods of time to self-soothe and one where I simply couldn’t bear to hear the crying in quite the same way. You’d think it would have been just the same for both of our boys, but it wasn’t. Clearly I wasn’t the same parent each time around.
There are many things that go into the equation of how we get our babies to sleep thought the night. And those of us who struggled after our babies after 6 months of age are in good company. Research shows that about 45% of mothers say they struggle with their 6-12 month-old’s sleep.
Solving the sleep solution requires a diverse mix of instinct, patience with personal and baby temperament, timing, mood, advice we get, and good luck.
The reality is that there isn’t one perfect way to help support an infant who’s learning to sleep through the night. But there are few pearls I believe in: Read full post »
Last week, the American Academy of Pediatrics (AAP) issued an update to their circumcision policy statement that attracted significant attention. In it, the task force clarified the previous neutral policy for boys’ circumcision. The AAP stated that research has advanced since it’s most recent report in 2005 to conclude the health benefits of circumcision outweigh the procedure risks. Like any medical test or procedure, circumcision carries both benefit and risk. With global data expanding about benefits of circumcision and protection against sexually transmitted diseases, the AAP changed its stance. Risks from circumcision are reported to be very unlikely and happen less than 1% of the time. Most common side effects can be a small chance of bleeding or a need for antibiotic ointment. The most frequently reported adverse event from parents is a concern not enough foreskin was removed. Fortunately, circumcision revisions are very rare.
The statement doesn’t go so far as to recommend that boys undergo circumcision, rather the task force stated that the procedure should be done under sterile technique by a trained, experienced clinician. Importantly, they stated for the first time that it should be covered by Medicaid and insurance. This with the hope that every family ought to have the right to make a choice for or against circumcision, not just those with private insurance.
Clearly, the decision to circumcise a newborn baby boy isn’t made simply in the content of medical data. Families weigh religious traditions, cultural practices, family history, and medical information when choosing to circumcise or not. The AAP statement maintains and honors this belief. Ultimately, the decision is a private one for families to make. A pediatrician, family doctor, or ARNP should help you go over medical benefits/risks as needed. As a parent, you go over the rest. Read full post »
Although this video feels a little bit like a video game (and takes you back to the 1970’s), it’s 1 minute of your life you don’t want to miss. Recommendations for CPR have changed this past decade. If you don’t have time to re-certify, take 1 minute and watch this video. Don’t ever be afraid to help immediately in a emergency situation where a teen or adult has potentially suffered a cardiac arrest. Channel your inner-John Travolta. Your actions can only help. Check out the American Heart Association CPR page for more. You can take a CPR class IRL (in real life) or online.
Bystander CPR dramatically improves survival from cardiac arrest, yet far less than half of arrest victims receive this potentially lifesaving therapy.
Parents who have learned how to do CPR are often more confident about their ability to manage an emergency of any kind. As a mom, I always feel more confident after reviewing these recommendations.
CPR For Infants & Children Is Similar But Different
Click on these links for drawings and nice summaries of CPR recommendations. Hands-only CPR is not recommended for children. However, the rate of compressions for infants and children also matches the Stayin’ Alive beat…
Food allergies have more than doubled in the developed, Western World over the last 50 years and the reasons remain unclear. Yet recent data finds 8% of children in the US with a food allergy with 1/3 of those children at risk for severe or life threatening reactions. A Pediatrics study published today has some sobering news about our ability to protect children from allergic ingestions. When it comes to allergies and deadly reactions 2 things are necessary:
Avoidance of known triggers/allergens.
Treatment of anaphylaxis (severe reactions) promptly with epinephrine.
Trouble is, children get exposed to known allergens by mistake and people are often nervous or unsure about how and when to use an Epipen (epinephrine in a pre-measured syringe). All parents/caregivers/teachers/coaches need to practice use of an Epipen & refresh why/when to administer it to an allergic child.
Researches followed over 500 infants and young children allergic to milk and eggs (and many to peanuts) between 3 and 15 months of age. During the 3 years of the study, the majority of children (72%) had an exposure to an allergen that caused a significant reaction. Of the allergic reactions, 42% were reactions to milk, 21% to egg, and just under 8% to peanut. Reactions were most severe when a child was exposed to peanut, followed by milk, and then egg.
Over 1/2 of the ingestions occurred after a non-parent adult offered an allergic food. Read full post »
New research helps clarify ways we can reduce risks for Sudden Infant Death Syndrome (SIDS) or Sudden Unexplained Death in infancy. A recent Pediatrics study found that the convergence of risks (see diagram below & listen to video) for infants is meaningful–reducing number of risks may reduce SIDS deaths. Avoiding multiple and simultaneous SIDS risks may help– especially for babies who are vulnerable due to family history, genetics, prematurity or prenatal exposures. Further, research published the same month in The American Journal of Public Health (April 2012) confirms that sleep environment hazards (co-sleeping, soft sleeping surfaces, shared sleep surfaces with people or animals) contribute to SIDS. 70% of infants who died from SIDS were sleeping in a surface not intended for infant sleep (adult bed, couch, chair) and 64% of infants who died were sharing a sleep surface, with half sharing with an adult. We can decrease SIDS risk by controlling our baby’s environment, knowing their vulnerabilities, and sharing what we know. Put babies on their backs without soft bedding (bumpers/pillows/blankets) in their own crib until 1 year of age.
Separation anxiety varies WIDELY between children. Some babies become hysterical when Mom is out of sight for a very short time, while other children seem to demonstrate ongoing anxiety at separations during infancy, toddlerhood, and preschool. I’ve got one of each in my home. The trick for surviving separation anxiety demands preparation, brisk transitions, and the evolution of time. I would suggest we parents suffer as much as our children do when we leave. Even though we are often reminded that our children stop crying within minutes of our leave-taking, how many of you have felt like you’re “doing it all wrong” when your child clings to your legs, sobs for you to stay, and mourns the parting? As a working mom, separation anxiety creates questions for me. Although it is an entirely normal behavior and a beautiful sign of a meaningful attachment, separation anxiety can be exquisitely unsettling for us all. Here are facts about separation anxiety and 6 tips to improve the transitions I’ve learned the hard way (I’ve made about every mistake). Read full post »
Seattle Children’s provides healthcare for the special needs of children regardless of race, color, creed, national origin, religion, sex (gender), sexual orientation or disability. Financial assistance for medically necessary services is based on family income and hospital resources and is provided to children under age 21 whose primary residence is in Washington, Alaska, Montana or Idaho.