PSST! The heat is on!

Fall and winter means using furnaces, fire places, and space heaters. This means it is especially important to have carbon monoxide and smoke detectors in working order. Below is a link to additional holiday safety tips:

http://www.aap.org/en-us/about-the-aap/aap-press-room/news-features-and-safety-tips/Pages/Holiday-Safety-Tips.aspx

Protect your family and have a happy, healthy holiday season!

A Truce on Juice

Did you know that 1/3 of American children are considered overweight?
Where is it coming from?
What can you do?

One easy change to make is to reduce the sweetened beverages children drink. Drinking liquids that contain sugar adds nutrition-less, excess calories to your child’s diet. Soda is the obvious “sugary” drink but there are other more “hidden” culprits.

• “100% juice” should be limited to 4-8 oz per day (depending on age) as a substitute for one fruit/vegetable serving per day.
• Sports drinks are largely not necessary for children. Water is the drink of choice for before, during and after routine sports competition. Sports drinks may play a supplemental role for some children during prolonged, vigorous exercise and/or during extremely hot/humid weather conditions.
• Sweetened teas, lemonades, fruit “drinks” and sodas, if used at all, should be considered a substitute for dessert because that is what they are: sugar without any nutritional benefit.

If you think about the above sweetened beverages as desserts (things to be enjoyed on occasion and not daily) and teach your children to regard them this way as well, you will both be healthier!

Flu vaccine has arrived

On 2/24/10, the Center for Disease Control recommended that everyone 6 months and older should get a flu vaccine each year. It is especially recommended that people at higher risk get the flu vaccine, including children under 5, adults over age 50, individuals of any age with chronic medical conditions, pregnant women, and children who live with individuals at risk for flu complications. Main Street Pediatrics currently has plenty of flu vaccine for both patients and their parents for the coming flu season. Please contact our office as soon as possible to schedule your appointment.

New USDA Guidelines

As kids head back to school, they are likely to continue to bring home tidbits of information from the USDA’s “My Food Plate.” This model for healthy eating replaces the old “Food Pyramid.” Visit ChooseMyPlate.gov for details; below is our “Cliffs Notes” version:

First and foremost, mealtime should be a fun and social time to slow down for 20-30 minutes and savor what is before you. If portion control is an issue, use smaller and not trendy “oversized” plates.

Half of your plate should be filled with fruits and vegetables. Keep them varied to avoid boredom. It is the colorful pigments in these foods that contain their vitamins so vary those as well.

One quarter of your plate should be filled with whole grains. Learn what a “whole” vs. a “refined” grain is at the site above.

One quarter of your plate should be filled with a lean protein source. Consider introducing non-meat proteins for the health of your family and the planet.

The dairy group does not have its own place on the “plate” but can be used as a beverage (low fat milk) or considered a meatless protein (yogurt or cheese) or sparingly as a sweet treat (puddings and ice creams). There are many options for those who get upset tummies from dairy products (“lactose intolerance”)…ask your doctor for more information.

Again, this is just a preview. Spend a few minutes checking it out yourself or better yet, with your children. Remember, change is hard and a process. It needs to be slow and manageable to be lasting. Try one easy thing once and see what happens. Involving your children in the process of contemplating and making changes for better health is a worthy lesson to model in and of itself!

Car Safety

There has been a recent change in car safety recommendations we would like to share with you, as well as a reminder about ongoing car safety guidelines:

The American Academy of Pediatrics now recommends that infants and toddlers ride in a rear-facing car seat until they reach two years of age. After two years, we recommend keeping your child in a forward facing convertible car seat (one that is equipped with a 5-point harness) until they have reached the maximum height and weight limits for the seat (usually around 4-5 years old). At that point, your child should ride in a belt-positioning booster seat until at least age 8 (or until the shoulder strap comes comfortably across the top of the shoulder rather than across the neck). After that, your child should ride in the back seat with a lap and shoulder belt through at least age 12.

If your child has reached driving age, remember that the first 6 months of driving is the highest risk period for all teens. It is safest for your early driver to have an adult present in the car at all times, and avoid distractions like having more than one friend in the car, talking on the cell phone, and texting.

Water Safety

1) Children should always wear life jackets while boating or near bodies of water.

2) In addition, NEVER leave your child unattended near the pool or near bodies of water.

3) Use sunscreen (preferably at least SPF 30) whenever you plan to be outside for longer than 10 minutes. Apply at least 30 minutes before anticipated exposure, and repeat application every 2 hours.

No matter how pigmented your skin is, remember that sun exposure is an environmental risk factor for melanoma, as well as non-melanoma skin cancers for all skin types.

Sun Safety

Now that our days are sunny, skin sun protection is a must. The sun is strongest each day from 10am-2pm but can burn you all day long. Children over the age of 6 months should wear sunscreen with an SPF of 15-30 when outdoors. Sunscreen needs to be re-applied approximately every 2 hours. Clothing and glasses with ultraviolet protection are also becoming more popular. These products along with hats are perfect for children under 6 months of age who should be kept out of direct sun. Remember, any degree of sunburn causes skin damage. This damage to skin accumulates over a lifetime leading to higher risks of skin cancer. From more information, see www.melanomaprevention.org.

Insect Bites

Insect bites are annoying, painful and may occasionally lead to serious skin infections. The best way to treat these annoying bite injuries is to avoid them. Avoid standing water especially in the evening hours when these pests become active. If you must be out in high exposure areas, wear long clothing to cover as much of your skin as possible. When more protection is needed, DEET-containing insect repellants can be used with caution. Because this chemical can be absorbed into the skin, it should be used carefully. It can be applied to clothing and to skin not covered by clothing. Unlike sunscreen, DEET containing lotions do NOT get reapplied more than once per day and they need to be washed off completely each evening. For more information, log onto www.cdc.gov and use the alphabet index to search “DEET”.

Sleep Hygiene

Balancing your life begins with good sleep; we cannot emphasize this point enough. A restful night can improve your child's school performance, give him or her more energy, and may even make him or her more pleasant to be around! The biggest barrier to good sleep hygiene is a hectic schedule that seems to change from day to day. While homework, school sports, and extra-curricular activities make it difficult to be consistent with our sleep habits, establishment of a consistent bedtime routine significantly improves both bedtime difficulties and night wakings.

For younger kids, the bedtime routine should last about 20 to 30 minutes and include three to four soothing activities, such as taking a bath, changing into pajamas, and reading stories. After age one, the introduction at bedtime of a security object such as a blanket or stuffed animal is very helpful. The child should be put to bed drowsy but awake, to minimize dependence on parental presence. For older kids, it is important to keep a regular sleep schedule and not "sleep in" too long on weekends.

Screen Time

One thing we’ve certainly observed as pediatricians is our increasing distraction with technological gadgets. Between our television, iPod, computer games and cellular phone, it can often be hard to "turn off" our brains from our ever-present devices. One thing that is certain is that they take us away from healthier activities such as reading and exercising, as well as interfering with our sleep routine - and this is harmful. We recommend limiting screen and phone time to 1-2 hours maximum per night, and only then after completing our more "necessary" tasks, like homework and chores. We strongly recommend no TV or computer in a child's room at least before the teen years. Remember, these items are a privilege, not a right.

Sports improve grades

Studies have shown though that children who participate in extracurricular sports actually perform better in school than kids who do not participate. Perhaps it is the benefit of exercise, the thrill of competition, or the camaraderie of your teammates, or some combination of the three. If you haven't already done so, consider signing your child up to play a sport. At a minimum, all children and teens need 1 hour of vigorous exercise 3-4 days per week. They should get at least as much exercise as TV and phone time!

Sports Safety

One of the most common causes of sports injuries we see in pediatrics is over-exerting oneself at the start of the season. Our excitement and desire to impress our peers and coaches often causes us to jump in too fast. Using muscles which haven't been used very much can result in numerous injuries, ranging from a simple muscle strain to a torn ligament. To avoid these injuries, we recommend starting slow at the beginning of each season and working up to full activity over a period of several weeks. It may also be helpful to start fitness workouts 1-2 weeks before the season begins to help ease the transition into full activity.

As the season progresses, the wear and tear of daily practices and numerous games can cause overuse injuries, particularly in sports which involve lots of running. We recommend performing stretching exercises before and particularly following activity, when muscles are warm. Before activity, perform a gradual active warm-up that involves the major muscles to be used. Hold static stretches for 15 to 30 seconds; longer holds provide no additional benefit. Repeat each muscle group stretch three times to get full benefit, and stretch regularly, with a goal of three to five days per week.

Concussions

Concussions are another increasingly recognized sports hazard. The American Academy of Neurology defines concussion as a trauma-induced change in mental status that may or may not involve loss of consciousness. Symptoms may include a brief period of confusion or loss of memory of the traumatic event. If there is any question that a concussion has occurred, never return to practice or the game until you have been evaluated by a medical professional. Suffering another concussion before you have recovered from the first concussion (called "second impact syndrome), can have profound long-term neurologic consequences.

Disease Prevention Tips

To help prevent the spread of disease, be sure your children get in the habit of washing their hands frequently, preferably using an antibacterial soap or hand sanitizer. And remember, if your child has a cough, be sure that he/she knows how to cough into the bend in their elbow to help prevent the spread of their illness.

Another important step in prevention of serious illness is having your child vaccinated against influenza, starting at the age of 6 months. We start stocking our vaccines in mid September and continue into the early spring! Preventing influenza helps to prevent its common complications, such as pneumonia, ear infections and sinus infections (and the week or more of missed school!) It’s important to get a flu vaccine each year, because the flu strains change from year to year, and receiving an updated vaccine will provide protection for the most likely influenza virus strains that will cause disease, including the H1N1 strain.

Presidential Praise for Main Street Pediatrics!

Well ok, not exactly. But did you know that Main Street Pediatrics has been using Electronic Medical Records since 2002? In the interests of improved record documentation, accuracy, availability, patient safety and care quality, we have been improving, updating and expanding this system ever since. We are delighted that this major quality enhancement is now being recognized and encouraged by the Federal Government, Blue Cross/Blue Shield and other major insurance plans.

Main Street Pediatrics Sets the Bar!

Main Street Pediatrics’ physicians have been singled out for recognition for outstanding patient and family care. The entire organization has received quality enhancement ratings and rewards from Blue Cross/Blue Shield, Aetna, United Health Care, and State of Maryland Medical Assistance. Many of our physicians have been additionally recognized for superior care and service and ongoing medical education, by such organizations as the American Academy of Pediatrics, American Board of Medical Specialists, Who’s Who, Consumers’ Research Council of America, America’s Top Pediatricians, Baltimore Magazine, and others.