Immunization Schedule

Helpful Links
general advice on any topic: www.aap.org 
searchable for any medical term:  www.webmd.org
behavoral topics, advice: www.dbpeds.org
great articles on everything: www.contemporarypediatrics.com

 RESOURCEFUL  READING 'must haves' for your library
Caring For Your Baby From Birth to Age Five (very inexpensive, can be purchased used on Amazon .com)
Baby 411

Commonly Asked Questions (and my answers)
Lyme Disease
"Lyme disease is rampant in this part of Connecticut. I pulled a tick off of Suzy yesterday and now there is a little red spot where the tick was"
www.acponline.org/lyme/patient/diagnosis.htm
Read the above reference, the tick has to be attached for at least 24 hours to transmit Lyme Disease.

"I just pulled a tick off my child, but couldn't get the head out. Do I need to go to the ER to get the rest out?"

No, this is a waste of your time and money. Your child's body will reject the tick parts soon. Vigorously digging will irritate your child's skin, possibly introduce infection, and not decrease the chance of your child getting Lyme Disease. once the main parts are removed, the tick dies and is no longer able to transmit Lyme.
The best tool to remove a tick is a dog tick remover tool, like "Ticked Off." Tweezers, your fingernails and other implements you may use are not as effective.
Never smother a tick with Vaseline - this will increase the chances of the tick extruding bacteria into your child's body.
 What about chronic Lyme? I'm not sure yet but catching Lyme Disease early is always best.

Vomiting
"My child started vomiting 6 hours ago, and won't stop. This bug has been going through the school, and his best friend had it yesterday. What do I do? When do I need to be concerned enough to go to the ER for an IV?  What are the signs of dehydration ?

Ans: In this case, there is exposure to another GI bug (the classmates) so this most likely is an "infectious gastroenteritis."  Most are short lived with the vomiting (< 24 hours) , but the diarrhea may last longer. 
Treatment is very small (5 cc) of an electrolyte balanced solution (like Pedialyte - if older, although not perfect -a Sport Drink - like PowerAde or Gatorade, or the WHO re hydration formula -> the Gold Standard.) every 15 minutes . DO NOT ALLOW YOUR CHILD TO DRINK ANY MORE THAN THIS. This small amount may even have some difficulty staying down -  but a larger amount will definitely cause more vomiting.  Let the child sleep if tired. Do not force her to drink if she is not asking for a drink. "Tincture of time" is often the most powerful medicine.
If your child develops bilious vomiting (green-tinged) or becomes extremely listless, or less responsive, go to ER. Physical signs of dehydration can be an extremely dry tacky mouth, crying without tears, no urinary output for 8 hours, or eyes that appear sunken in. Checkout www.aap.org for more information.

Fever
My 7 year old child has a fever of 103.2. What should I do? Do I need to be concerned?

My ans. Fever is a source of great concern for many parents- and it is a reason for concern in that it tells us something (usually a germ) is "invading " the child's body. However, fever is also your child's body's friend. It raises the body temperature above the level the germ multiplies/invades at most successfully, and therefore inhibits the growth of some germs. MOST FEVERS IN AND OF THEMSELVES ARE NOT A REASON FOR CONCERN. They will not fry your child's brain, or cause seizures (exception is a child with febrile seizures - a whole other topic - but remember these seizures are usually not harmful either - just scary to the parent) Look at your child. What do they look like, are they eating, alert, playing or unresponsive?  If other symptoms besides a fever are involved, then there is more a cause for concern - for example , sometimes a cough and a fever can signal pneumonia. Abdominal pain and fever could be appendicitis.  However, there are many self-limited or 'self-curing'  viral diseases that can present as a high fever for many days (examples: fifth's disease, roseola). The biggest indicator of  "scary" illnesses is the child's overall demeanor - especially after the temperature has been lowered by medicine.
So give your child a dose of an anti-fever drug (get correct dosage of acetaminophen or ibuprofen from your doctor's office at your child's well check). If your child has a miraculous recovery with the medicine, keep a close eye on them, but don't be SUPER worried.




Diarrhea
"My child has diarrhea. Do I need to give him Pedialyte? He is eating fine."

No, no need for Pedialyte. Diarrhea is defined as very frequent watery stools, with no formed elements. If your child can take food by mouth,
keep him/her on a regular diet, but avoid foods that cause stool to be loose (ie pears, pistachios, sugared drinks {which you should not give them anyway}). A supplement that may help the diarrhea resolve more quickly is probiotica, and the most highly recommended is a product called "Culturelle for Kid" - a packet that can be sprinkled on your child's food or put in a cool drink.

Overweight
 "My child keeps putting on weight. He doesn't eat any more than I do. I think he has a slow metabolism. Can you check his thyroid?"
Having an overweight child is a distressing situation for the parent when the child is young, and for the child as they become more socially aware. Obesity in America is growing - please look at www.mmwr.org . Look at the obesity maps. Over the past 30 years, obesity has almost quadrupled. Thyroid disease is not responsible for that. Genetics have not changed, so your child's genetic makeup is not the reason. Excessive caloric intake is. 
What has changed most dramatically is consumption of high fructose corn syrup .  Avoid it, stop drinking soda and EATING sweetened food.  Avoid processed foods.
Stick to whole grain foods, not whole wheat, whole grain!! A good rule of thumb is to avoid the inside aisle of a grocery store, more natural foods tend to be on the outside perimeter.
Eat foods in their natural form as much as possible and quadruple fiber intake. Over time this will be so much more healthy.

Increasing physical activity is important for toning the body and cardiovascular health but it has to be at least 5 days a week, relatively high intensity for about an hour. Try it, it's fun and releases natural endorphins. Appetite will decrease!!!

Development and Behavior

My 3 year old child never listens to me. How can I be a better parent and stop getting angry , yelling and screaming? I know its ineffective, but I don't know what else to do.

A very good resource is a video by Dr. Phelan "1, 2, 3 Magic" You may think you are doing time out correctly, but if you are yelling and screaming, and if your child does not listen, then most likely you are not. Three year old are especially challenging, so it is important to know what you can expect developmentally. Caring For Your Baby Birth to Five   has good sections on development.

Another excellent resources is "The 12 Secrets of Discipline" (available at your library or for purchase via Amazon.com)
Remember to " catch them being good." The reinforcement of positive behavior brings on positive behavior)
If you have other questions, please call the office.
We do not answer calls from patients that are not in our practice and we do not intend for this website to be all - encompassing. The best place to get advice is from your child's pediatrician.

 My 15 year old son is very sullen, and rude to me. I feel like he thinks he is the parent rather me! How do I discipline him, how do I regain his respect?

Remember, teenagers have a brain that is not fully developed, there actually is rapid  "grey matter" growth during this time.
 Teeneages "think" with the emotional part of the brain, the amygdala. That is why they are so impulsive and seem irrational. AS teh frontal lobe develops, the above behavior will decrease.
This does not make it any easier to deal with them as the behavior can be very disruptive to the entire household. It is important to keep in mind they are still children, and as much as they protest, still need to be treated as such. Using deprivation techniques (taking away cell phone, computer, car privileges) can be utilized. This will not make you popular, but you are not there to be you child's friend. Boundaries have to remain well defined, especially for this age group as they are testing all of them.

My 17 year old daughter is going away to college, she is very emotional and sometimes I don't know how to make her feel better. Is this something she just has to go through? 

answer forthcoming