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Summer Safety

Lexington Clinic Pediatrics Summer SafetyWarmer weather is here and children want to spend more time outdoors. However warm weather also brings with it certain dangers. Keep these tips in mind this summer to help your child stay safe.

Sun Exposure
As children spend more time in the sun, sunscreen becomes very important.  For infants less than 6 months of age, it is best to limit direct exposure to the sun through umbrellas, hats, using light clothing that covers the skin and remaining indoors while the sun is at its peak. 

For children six months and older, sunscreen with an SPF 15 that protects against UVA and UVB rays is recommended. Remember to have your child reapply frequently, particularly when swimming, since water and sweat exposure will cause the sunscreen to wear off over time.

Insects
In the warmer months, mosquitos and other insects begin to emerge. Children two months and older should use an insect repellant when outdoors during the summer.  There are many DEET products, as well as DEET-free products to choose from. When using insect repellant, check the bottle to see how often the product needs to be reapplied, as this can vary.

Pool Safety   
While fun, a pool can also be dangerous. If you have a pool at your home, it should be surrounded by at least a four foot tall fence. Keep this fence closed and locked when not in use to protect not only your children, but also other children in the neighborhood who may think it would be fun to take an unsupervised splash. When swimming, you should never leave your child unattended in the pool, even if they can swim. If your child can’t swim, swimming lessons are recommended.

Safety on Wheels
Children riding bicycles, scooters, skates and other wheeled toys should wear proper safety gear. For all, a helmet is a necessity. For toys other than a bicycle, a helmet in addition to knee and elbow pads is a good idea. These will help protect from skinned knees and arms and head injuries that could occur with falls.

Summer is a great time to get out and have fun with your child, and even though it does have its dangers, risks can be reduced with these tips. If you have any questions about your child’s health or think they need to see a physician concerning a summer injury, call a Lexington Clinic pediatrician today. For help finding a pediatrician call 859.258.4DOC or visit LexingtonClinic.com/peds.


Ticks   June 4, 2014

Rachel McGuffey, M.D., Lexington Clinic Pediatrics

Lexington Clinic PediatricsDuring the summer, pediatricians see many children who have tick bites. While they may seem harmless at first, if not caught in time and treated properly, tick bites may turn into a larger issue for your child.

Ticks are tiny arachnid parasites that live in grass and bushes. They attach to a host by biting them, and remain there until removed, feeding on the host’s blood. The tick’s secretions can cause local irritation at the bite site, but also can transmit disease, such as Rocky Mountain Spotted Fever and Lyme Disease. The longer a tick is attached, the more likely it is to cause disease. That is why it is important to properly remove a tick as soon as possible.

When removing ticks, be sure to remove as much of the tick as you can. If you find a tick crawling on you or your child and it is not attached, use tape or cellophane to remove the tick and dispose of it. This will help prevent disease transmission. If the tick is attached, the best procedure is to use tweezers to grasp the tick as close to the skin as possible, and then remove it. Avoid using matches to burn the tick off, as this could burn your child.

After the tick has been removed, cleanse the area with soap and water to wash away any of the secretions or remaining tick parts. Applying antibacterial cream for a few days after removal will help prevent infection.

If your child starts running a fever, develops a rash, becomes irritable or has joint swelling after a tick bite, they could have contracted a disease from the tick bite. The signs for Rocky Mountain Spotted Fever include fever, rash, nausea and headache. With Lyme Disease, a round rash surrounding the tick bite followed by swollen joints and flu-like symptoms are common. Both diseases require prompt antibacterial treatment to keep the condition from worsening, and your child’s pediatrician should be consulted as soon as the first symptoms are noticed.

A tick bite alone can cause redness and swelling around the bite, especially if it occurred on a sensitive body area. If your child’s tick bite feels abnormally warm and is painful, or if the redness is spreading, see a pediatrician to check for possible infection.

The key to tick bites is prevention. If you know your child will be in a wooded area, make sure they wear protective clothing and/or bug spray to help prevent any bites, and afterwards, check their hair and body for any ticks. If you own pets, make sure to use preventive spray/medications to help keep ticks off of your pet. Although disease cannot spread from your pet’s tick bite, the tick can come off your pet and reattach to you or your child.

If you have any questions about your child’s health or think they need to see a physician concerning a tick bite, call a Lexington Clinic pediatrician today. For help finding a pediatrician call 859.258.4DOC (4362) or visit LexingtonClinic.com/peds.


Pediatricians Provide Better Assessment of Children’s Overall Health   March 6, 2014

Retail-based health clinics are springing up in grocery and department stores around the country. In fact, as of 2012, more than 6,000 of these “minute clinics” existed in the United States. While the convenience of these walk-in, freestanding clinics is appealing, the lack of a relationship with an established physician can be detrimental, especially for children.

The American Academy of Pediatrics (AAP) released a statement this week advising parents against using retail-based clinics for their child’s care, citing a number of potential issues including decreased quality of care, lack of follow-up care and unfamiliarity with the child’s medical history.

Utilizing a “minute clinic” as the primary source of a child’s care interferes with the relationship building made possible by seeing one primary pediatrician. Contrary to popular belief, even “minor conditions” should be seen by a child’s pediatrician, as it provides an opportunity to diagnose underlying conditions and piece together the big picture of a child’s health. In addition, a child’s primary care pediatrician will be specifically trained in child health issues, which may not always be the case at other clinics.

If parents choose to use a retail-based clinic for any portion of their child’s care, they should be prepared with some basic questions. It is important to know if the clinic has a formal relationship with their child’s pediatrician and if they will communicate diagnoses and findings with the pediatrician’s office. Parents should also clarify the clinic’s protocol for follow-up visits if the child’s issue does not resolve.

Choosing a pediatrician who meets your child’s needs is one of the most important decisions you can make as a parent. For help finding the right pediatrician for your family, call (859) 258-4DOC (4362) or visit LexingtonClinic.com/peds.


Study Shows Recent Decline in Childhood Obesity    March 3, 2014

Childhood ObesityA recent study shows that obesity rates are on the decline in children ages two to five years old. The findings, published in the Journal of the American Medical Association (JAMA), were announced on the heels of many healthy kid movements nationwide, including First Lady Michelle Obama’s “Let’s Move!” initiative.

Obesity rates among children are of particular concern, because research has shown that lifetime obesity risks are established in children by age five. That’s why it is more important than ever to make sure your child is eating a balanced diet and getting plenty of exercise. Children who follow these guidelines perform better academically, feel better about themselves and handle stress and emotions better. Physically, they are also at a lower risk for cavities, eating disorders, unhealthy weight control behaviors and malnutrition, and have lower risks for chronic illnesses later on in life. Children are still developing both their minds and bodies, and through healthy eating and regular exercise, you can help make sure your child is getting the nutrients and activity their body needs.

Before changing your child’s diet or exercise habits, make sure to contact your child’s pediatrician to find out what is right for them. For help finding a physician, call 859.258.4DOC (4362).



Temper Tantrums

What to do about temper tantrums? Lexington Clinic Pediatrics Kandi Waddles, MD, Lexington Clinic Pediatrics
When my youngest daughter was 2, I remember standing in the grocery check out line and my daughter throwing a tantrum—screaming, crying, and trying to escape the grocery cart. I looked behind me and there was a well behaved toddler and her mother (both of whom I knew from work)—I was so embarrassed! I am a pediatrician; I should know how to control my child. HA! HA!

Temper tantrums occur in all children usually between the ages of 1 and 3. Children at this age become frustrated when things do not go their way and do not yet have the verbal skills necessary to express themselves. So they do what comes naturally-scream and cry! After age 3, children can usually express themselves with more words and the tantrums will taper off.

Sometimes as parents we can tell if a tantrum is coming. Our child may seem moody, whiny, or difficult; or the tantrum may come on suddenly for no obvious reason. To help reduce the chances of your child having a tantrum, try the following: encourage your child to use words to express her emotions

  • keep a routine, expectable schedule
  • avoid long outings with your child
  • keep healthy snacks available
  • make sure your child is well rested
Another suggestion is to “pick your battles,” avoid getting in the habit of always saying no to your child’s requests. If a request does not compromise your child’s safety and if the request is not too unreasonable, go ahead and say “yes” sometimes.

Sometimes despite all our good intentions aimed at preventing temper tantrums they will occur. A few suggestions for when the dreaded tantrum does occur:

  • Parents – stay calm! If we shout and get angry it will only make things worse
  • Ignore minor displays of anger such as crying or screaming
  • If your child is kicking or hitting or having prolonged screaming, try a “cool-down” period, remove your child from the situation and give her time alone to calm down and regain control
Remember temper tantrums are a normal part of your child’s development and as your child gets older she will outgrow temper tantrums. In the meantime, a calm and loving approach will help both you and your child get through this part of childhood.

What’s a Fever for My Child?

Lexington Clinic Pediatrics, What is a fever for my child? Fever in ChildrenAndrea Meadows, M.D., Lexington Clinic Pediatrics
Fever is one of the most common reasons for a visit to the doctor’s office. Here are a few things every parent should know about fever.

What is a fever? It is an elevation of body temperature greater than 100.5. Normal body temperature is around 98.6, however it can vary throughout the day and from person to person. In general, our body temperature is lower in the morning and higher in the afternoon and evening. Even though temperatures of 98.7 – 100.4 are “elevated” they are still not considered a true fever.

How do I take my child’s temperature? A digital thermometer can be used orally, rectally or under the arm; this is the type of thermometer I recommend every parent should have. Which method you use depends on the child’s age. For newborns up to the age of three months, the best way to take their temperature is rectally. From age 3 months up to 4 years, you may take the temperature under the arm. For children older than 4 years an oral temperature may be taken.

What about the tympanic (ear) thermometers? I got one as a shower present; can I use it on my newborn? Even though these types of thermometers are very convenient, if not used properly they can give false readings. The American Academy of Pediatrics does not recommend this type of thermometer for young infants and children.

My child has a fever, now what? First, don’t panic. Fever is a natural way for the body to protect itself. Instead of focusing on how high the fever is, pay attention to how your child is acting. If your child is under 2 months of age, notify your pediatrician immediately. For older children, if he/she looks well, you may treat the fever with either Tylenol or Motrin (age appropriate dose) and see what happens. If your child is not acting right, you may want to have them see their doctor.

Will a high fever (>104) hurt my child? There are a lot of misconceptions about high fevers and brain damage. In general, high fevers are not harmful to the body. Before standard immunizations, high fevers were commonly caused by meningitis, which is an infection in the brain. These children frequently had hearing loss or brain damage because of the meningitis, not the fever. Today, most high fevers are caused by viruses and so even though the temperature may be high, it shouldn’t hurt your child.

If your child is sick and you feel uncomfortable at all about how they are doing, it is always a good idea to contact your pediatrician’s office. Our nurses are excellent about talking with parents about what’s going on and deciding whether or not they should come in to be seen. When in doubt, it’s always better to be safe than sorry.

Balancing a Baby and a Career

Lexington Clinic Pediatrics; working mom; balancing work and motherhoodRachel McGuffey, M.D., Lexington Clinic Pediatrics
A baby! This is who you have been waiting for. Without a doubt, parenthood is one of life’s greatest joys…and challenges. Decisions about career and work responsibilities are difficult for new parents. Should we explore part–time work and working from home? Will we be able to manage careers and also be nurturing parents?

I knew from day one that I would be returning to work after maternity leave. This allowed me to make some important preparations for my return to work. First, I had to find quality child care. Finding someone you trust in the care of your infant is very important in successfully returning to work. Next, being a breastfeeding mother, I introduced the bottle a few times prior to returning to work. I also tried formula a few times just in case I was unable to store enough milk once I returned to work. Lastly, a few weeks after delivery, I started going out to the grocery and running a few errands, just to get the baby used to being away from me.

When I returned to work, I started back half–days for a couple of days. This allowed for a better transition for me and the baby. It allowed time for him to adjust to the bottle and his caregiver, and for me to adjust to being away from him.

Having been a pediatrician for 7 years, I have worked with many families and children. Now I have walked in the shoes of those parents who bring their children to see me. I never realized how difficult even a simple thing like coming to the doctor with a baby can be! Organization is key. Small things like preparing bottles the night before help make the mornings go more smoothly. I have to allow a little extra time in the morning since I never know when he will decide he is hungry again right as I am about to walk out the door. While at work, I have to find time to pump breast milk for the next day. Also, a call at noon to check on my baby reduces my anxiety.

The last, and most important aspect of returning to work, is having a strong support system. My husband and I have created a partnership in the care of the baby. With both of our long work hours and my physician’s call, we have to plan our chores and work on them together to keep the household running. Shared responsibility for the baby helps both of us get some much needed rest when we are home. Our network of family and friends give advice, help in child care, and provide emotional support.

Having a career and being a mother are both rewarding. My greatest joy of each day, however, is knowing that there will be a smiling baby reaching for me when I get home—a baby to whom at that moment; I am the only one in the room.



Potty Training 101

tips for potty training; potty training 101; Lexington Clinic PediatricsKandi Waddles, M.D., Lexington Clinic Pediatrics
Teaching children to use the potty can evoke anxiety and stress among many first time parents. I have been a pediatrician with Lexington Clinic for almost 9 years and have had many discussions about potty training with parents and have received first hand experience with my two daughters, ages 4 and 6.

As a parent I was concerned about training too early and causing my child to develop resistant behaviors versus waiting too long and missing a window of opportunity when my child would be most receptive to toilet training.

Without a doubt potty training is a challenging experience, but by following the tips below potty training can be made easier and ensure that the experience is rewarding for you and your child!

When to start:
  • Usually around 18–24 months a child will show readiness. He/she can understand what “pee” and “poop” mean and recognize when he/she is wet or dirty.
  • Make sure your child can pull up his/her pants independently. Be careful with clothing containing buttons, elastic pants are the best to pull up and down.
What to do:
  • Buy a potty chair that sits on the floor. Create a fun experience and let your child know it is his/her “special chair”. This chair can even be placed in the playroom rather then the bathroom temporarily.
  • Praise your child for success! Initially for just sitting on the potty.
  • Let your child look at books while on the potty and read toilet learning books to your child.
What NOT to do:
  • Never force or pressure your child to sit on the potty.
  • Never punish a child for accidents.
For overall potty training success, be supportive and patient. Accidents will happen, expect it. Try to keep the experience fun and upbeat and as always in parenting—keep a sense of humor!

Toddler Meal Time: Fussy or Fun?

Toddler Meal Time: Fussy or Fun?Rachel McGuffey, M.D., Lexington Clinic Pediatrics
Toddlers love to explore and express their independence. These same charming traits, however, can be a recipe for disaster at mealtimes.

Around age one, children’s appetites may drop off suddenly and you may notice a decreased rate of growth. Many parents are concerned about these changes in eating patterns because they were used to their child eating everything that they were offered. Parents are often also concerned about the decreased rate of growth, which is actually typical for toddlers. (Of course, if your child is losing weight, you should contact your pediatrician.)

During toddlerhood, not only does the growth rate drop, but your child will also strive to become more independent. Instead of readily accepting everything placed in front of them, they will learn the word “no,” especially during meal times! Foods your toddler loved will now be foods they turn down. Your toddler may take two bites one day and eat you out of house and home the next day!

Here are some suggestions for making sure your toddler gets adequate nutrition and that mealtimes are fun:
  1. During mealtimes, make sure you offer at least one favorite food you know your child will eat, along with other new foods to try. Children often need to try a new flavor several times before they acquire a taste for it. Exploring and experiencing the colors, smells, textures, and tastes of new foods is fun for toddlers.
  2. Offer a variety of foods from all food groups throughout the week. Your child does not need to eat food from every group at every meal, as long foods from each group are offered throughout the week. Your child does not need vitamin supplementation unless he is on a special diet.
  3. Avoid getting your child other food if what is on the plate is refused. This can become a game of the wills. Your child will not starve as long as nutritious foods are available at each meal.
  4. Do not make mealtime a fussy struggle. Have your toddler sit with the family and decide what and how much to eat. Mealtimes that are relaxed and unhurried, with family members sharing conversation and laughter are fun. If your toddler does not finish her food, save the plate in case she is hungry later. Do not offer snacks in lieu of dinner, rather, warm up her dinner plate and let her eat from that.
  5. Do not give your child a lot of juice or sweets. Juice should be limited to 4 ounces daily. Sweets should be given infrequently. The extra sugar will decrease your child’s appetite for nutritious foods. Happy mealtime!

Common Newborn Complaints

Rachel McGuffey, M.D., Lexington Clinic Pediatrics
Having a newborn baby is exciting and challenging. It’s easy for new parents to feel concerned about their baby. We get many phone calls about newborns daily, to help get new parents through we have included information below about some of the common questions we receive in the first couple months of life:

Cold symptoms
Your infant’s first cold can be a frightening thing. The best treatment is to use saline drops and your nasal bulb syringe to clear the drainage to help with feeding and breathing. Other remedies include a vaporizer or humidifier and elevating the infant’s head to help clear the drainage from the throat. If the infant is struggling to breathe or eat, has a fever greater than 100.5 rectally, or is wheezing, you should contact your physician’s office. Remember, sneezing in infants is common and does not necessarily indicate a cold.

Constipation
Babies may have a bowel movement with every feed or as infrequently as every 4–5 days. As long as the stool is not hard, they do not need treatment. If the infant is uncomfortable, you may try rectal stimulation with a rectal thermometer. You should contact your doctor if the baby does not have a bowel movement within 5 days or if the stool is hard.

Eye drainage
Infants commonly have eye drainage secondary to a blocked tear duct. If you note your infant to have drainage from the eye without redness, you may try warm compresses and massaging the tear duct located in the corner of the eye next to the nose. Your infant should be seen if the eye or skin around the eye has redness.

Rashes
Newborn acne appears as pimples on the face and chest/back of the infant. This develops secondary to passage of maternal hormones to the infant. You should wash the area with warm water and avoid lotions to that area.
Cradle cap appears as thickened, scaly skin on the scalp. The best treatment is to use a fine tooth comb to loosen the scales prior to washing the infant’s hair. You should not apply lotion or oil, as this will cause further scaling.
Erythema toxicum is a normal newborn rash that presents as red blotches that come and go on the body. These areas may have a white center. This rash needs no treatment and will fade away within a few weeks.
Diaper rashes are common in infants. The most common type is a flat, red rash caused by irritation by the diaper environment. A protectant such as A & D or Desitin should help this rash disappear. Frequent stools may also cause a red, flat rash. If your infant has frequent stools and a sunburn–looking rash, using an antacid such as Maalox or Mylanta, followed by a protectant should resolve this rash. The last common rash is a yeast diaper rash. This rash will be thickened and surrounded by small red areas. An antifungal agent such as Lotrimin may be tried or you may contact your doctor for a prescription. Any diaper rash that is worsening with treatment or does not show improvement within 5–7 days, should be seen by your physician.

Spitting up
All newborns will spit up at some time or another. This can be caused by swallowing air during feeding and a loose muscle entering the stomach. Some things to try at home for frequent spitting is to elevate the infant’s head and to keep the infant upright for at least 20 to 30 minutes after feeding. If your infant continues to spit frequently, is very fussy with spitting or has projectile vomiting, you should contact your physician for further treatment.

Thrush
Thrush is caused by a yeast infection in the mouth. It appears as white patches on the tongue and cheeks that cannot be wiped away. Your physician can prescribe a medication for treatment. You should boil your pacifiers and bottle nipples between feedings in order to not reinfect the infant.

**You should contact your doctor immediately for the following**
  • Fever greater than 100.5 rectally
  • Lethargy
  • Inconsolable crying
  • Increased work of breathing
  • Inability to feed

  • The Overweight Child

    The first two years of visits to the Pediatrician; Lexington Clinic PediatricsKandi Waddles, M.D., Lexington Clinic Pediatrics
    It is easy in our fast paced world to get caught up in work and activities that nutrition can take the back seat and all too often our meals are obtained thru a fast food window.

    I certainly can relate, many days my husband and I come home from work after picking up our kids and afterwards stop to eat on the way home. There is little nutrition and a lot of fat in the grilled cheese, fried chicken nuggets and french fries my daughters love to eat.No wonder 1 out of every 3 children in the United States is considered obese or overweight.The incidence of obesity in American children has tripled since the eighties.This is really sad, as an obese child is at greater risk of developing diabetes, high blood pressure, and premature death from early heart disease or stroke.

    Many children are obese because of changes in the typical American family’s lifestyle: Unhealthy eating habits and a decrease in exercise. Our children today are more sedentary with so much time in front of a computer or television screen.To prevent obesity in children we should take the following steps:
    • Monitor food portion size and try to get 5 fruits/veggies in a day, meal planning in advance will help achieve this goal
    • Make sure your child eats breakfast daily and limit the sugary sodas and juices
    • Get your child to exercise- a goal should be 1 hour a day. Playing in the backyard, riding a bike, playing soccer—just get moving!
    • Limit TV, video games, and computer time to less than 2 hours a day, and please do not have a computer or TV in your child’s bedroom.
    • Lastly, as parents we should be role models for our children.If we are overweight, our children are more likely to be overweight.Although sometimes it is difficult to do, we should exercise regularly and demonstrate good nutrition for the benefit of ourselves and our children.

    A Word About Vaccines

    Andrea Meadows, M.D., Lexington Clinic Pediatrics
    As a pediatrician, I know the value of vaccines. There are a very important part of routine well child care and preventative medicine. Unfortunately, thanks to a lot of bad press, more and more parents are starting to question the need for vaccination. I am afraid that misinformation will cause some parents to make a bad decision regarding immunizations.

    If you are one of many parents with questions about vaccines, you have no doubt consulted the internet. There are some really great resources on the web, and then there are some that are not so great. I have found two websites that I particularly like and will often recommend to parents with questions about immunizations. The links are at the end of this post—feel free to check them out. Of course, no resource can be a substitute for your pediatrician, who you should also consult before making any decisions.

    Many people claim that organizations who endorse vaccines use scare tactics to convince people to comply. The bottom line is that the diseases we are immunizing against are devastating illnesses and have the potential to kill. Even though I am a young pediatrician, I have seen healthy kids become deathly ill and even die from diseases that we can prevent with vaccines. It is not a scare tactic—it is a reality.

    We have been hugely successful in this country with vaccines and we have greatly reduced the incidence of these illnesses. While this is a great achievement, it has had the negative effect of convincing many parents that their children don’t need to get vaccines because their children will never be exposed to the disease. Don’t be fooled; these diseases are still out there—and they are closer than you think.

    It is important to continue to have high immunization rates so that we can keep these diseases at bay and continue to ensure our children a healthy future.

    www.cdc.gov/vaccines/spec-grps/parents.htm

    www.vaccine.chop.edu/


    Helpful Links for a Healthy Family: